Author: Michaela Falkner, NMD

My new favorite herb: Salvia Miltiorrhiza (aka Dan Shen or Red Sage)


In my practice treating chronic complex illness, Dan Shen is a recent addition to my repertoire that I’ve begun using with success.  This herb is in the sage species that originally comes from China. It was traditionally used to promote blood circulation, calm the mind, regulate menstruation, and to relieve pain. However, modern research papers show body wide effects, including some of the most notable below:

1) Anti-inflammatory and pain support
including menstrual cramps, joint pain, and even endometriosis pain, chest pain (angina), allergies, asthma, even some anti-cancer properties

2) Antimicrobial against many organisms
including some tick-borne bacteria like anaplasma and ehrlichia

3) Liver protective
including decreasing markers of liver inflammation

4) Kidney protective
including protecting from diabetic kidney disease and shock from kidney stone treatment (lithotripsy)

5) Heart protective
including decreasing cholesterol and plaque formation. Also helps heal vascular wounds and fibrosis as well as slightly thins the blood. Human studies include COPD, preventing stroke recurrence, blood clot disorders, high blood pressure

6) Depression and anxiety support
supports GABA, which promotes calm, happy mood and sleep. There are human studies even for Alzheimer’s

7) Spleen protective
Decreases inflammation of the spleen

8) Gut and microbiome supportive
supports the microbiome by reducing bad bacteria and encouraging growth of the good bacteria. It also tightens both the GI mucosa and blood brain barrier

Most studies have shown that Saliva miltiorrhiza can either help the condition itself or prevent recurrence. While it is most known for its cardioprotective effects, I’ve been seeing good results so far for liver support and Lyme support in my patients. 

As with any medicine (natural or otherwise), there are circumstances where this herb may not be appropriate.  If you’re interested in finding a solution to Lyme disease or any other chronic unexplained symptoms, call for a free consultation or schedule an appointment with me to get started. 

Ways Ozone Can Benefit the Body


Ozone is created by exposing 100% pure oxygen to a spark of electricity in a special generator which adds an extra electron onto the oxygen molecule. 

Ozone therapies have been used since its discovery in 1840 and ozone is used all over the world safely.  Boise Natural Health Clinic is proud to contribute this important therapy to the Treasure Valley. Here are some of the amazing things that ozone does for us:  

1) Ozone kills infectious microbes like viruses, bacteria, fungi.

We use ozone in a variety of ways to kill infectious microbes. It can directly kill almost all ‘bugs’. Ozone gas has direct killing effect by using ozone infused olive oil or a process called insufflation. Insufflation is allowing ozone gas to come into direct contact with various tissues, including nasal passages, ear canals, vaginas, and rectums.

2) Ozone increases the delivery and use of oxygen in the cells.

Energy production runs most efficiently with oxygen. If we inject ozone into damaged joint spaces or tissues, we can focus that oxygenation into the injured area and promote healing.  By increasing oxygen in the cells, we can increase our energy production, healing capabilities, and support our immune system.

3) Ozone helps stimulate and improve our antioxidant and detoxification pathways.

Ozone therapies increase our antioxidant production by up to 300% in some studies. Antioxidants help with slowing down the aging process, decreasing some cancer risks, decreasing inflammation, and promoting movement of waste products. Rectally, ozone has been shown to improve our bodies’ own production of the most potent antioxidant, glutathione. Glutathione is often referred to as the master antioxidant and helps the liver to detoxify, is anti-aging, and is used in the immune system to combat infections.

4) Ozone can modulate the immune system.

Immune system modulation means increasing immunity in the presence of an infectious agent or decreasing immunity when the immune system is out of control, like in an autoimmune disease. Ozone mediates some of our cell signaling messengers, called cytokines, to help turn the immune system up or down depending on our needs. Ask your BNHC naturopathic physician if they think ozone therapy may be right for you!

The Far-Reaching Effects of Hormones on Your Body

Many people are aware that sex hormones like estrogen, progesterone, testosterone, and DHEA influence more than just reproduction and menstrual cycles. While common knowledge acknowledges their impact on bone density, brain health, and cardiovascular risk, emerging medical perspectives recognize that these hormones have even broader effects.

Our Changing Brain Architecture Throughout the Menstrual Cycle

Recent studies have revealed intriguing insights into how the architecture of our brains changes during different phases of the menstrual cycle. These hormonal brain differences could potentially explain the increased incidence of early-onset dementia in women who experience early menopause. These new studies suggest that our thought processes may also vary depending on the cycle phase, potentially influencing behavior. Hormonal fluctuations and physical changes in the brain may contribute to reported instances of “brain fog” at specific points in the menstrual cycle. Although some studies indicate no difference in task performance, patients often report changes in effort. Animal models also suggest increased brain connections before ovulation, aligning with women’s experiences of feeling their best during this period. This research opens new avenues for exploring the validation of reported brain changes throughout the menstrual cycle.

The Impact of Menstrual Cycles on Immunity

Surprisingly, a Long COVID study delved into the sex differences and hormonal influences on the immune system. Hormonal fluctuations during menstruation, early follicular phase, and PMS (end luteal phase) favor the TH1 immune pathway, which is effective against viruses but can escalate inflammation, autoimmunity, and cancer risk. This phase also leaves individuals susceptible to bacterial and parasitic infections. Conversely, during the late follicular phase, ovulation, and luteal phase (higher estrogen and progesterone levels), women favor the TH2 immune pathway. While this pathway protects against parasites and bacteria and is anti-inflammatory, it may enable stealth viruses to replicate. These immune system changes potentially explain the higher incidence of autoimmune diseases in women, with patients often reporting flares of symptoms around ovulation.

In summary, we are entering an exciting era of research that focuses on the monthly changes experienced by females, recognizing that these changes extend beyond reproduction to impact the entire body. The evolving understanding of these hormonal dynamics is poised to reshape the field of medicine.

References:

  1. https://www.washingtonpost.com/wellness/2023/11/30/women-brain-menstrual-cycle-changes/
  2. https://www.nature.com/articles/s44220-023-00125-w
  3. https://www.biorxiv.org/content/10.1101/2023.10.09.561616v1?et_rid=294001483&et_cid=4942736
  4. https://www.nature.com/articles/s41386-019-0435-3
  5. https://link.springer.com/article/10.1186/s12967-023-04515-7

Boise Natural Health Clinic now Carries Beyond Balance Product Line!

Boise Natural Health Clinic is now partnered with Beyond Balance Inc to provide gentle herbal formulations for our chronic complex patients. 

Chronic complex illness is complicated

As many of my patients know, chronic complex illness can not only be difficult to recognize and diagnose, but also difficult to treat. There are so many different factors that play into a body’s ability to tolerate various herbal, nutritional, and even pharmaceutical products. Oftentimes, patients’ bodies are very sensitive and what is well tolerated in one person (or even at one time in a single person’s life!) can’t be tolerated in another person (or time!). This is where Beyond Balance comes in.

We need products to use in sensitive patients

Beyond Balance https://beyondbalanceinc.com/ was created and formulated by an herbalist, Susan McCamish, and is used comprehensively throughout the US, Europe, Canada, and Australia. Her formulations are targeted at supporting the body’s abilities to detox and heal at a cellular level using herbs. These supplements are formulated to be used at very low doses and tend to be very well tolerated in even the most sensitive patients. I typically use Beyond Balance in my Lyme, mold, and co-infection treatment plans.

Successful case study of patient with severe allergic reactions

Over the years, I have used multiple of their formulations, but my most significant response was in a VERY sensitive patient who would have a sensation of a severe allergic reaction to multiple everyday odors/environments. We had tried multiple detox supportive supplements, which all caused the same reaction in her. We even tried using food as medicine and found she reacted to adding a tablespoon of cilantro to her diet! We decided to try Tox-Ease GL, which is a very gentle detox formulation by Beyond Balance. We started at 1 drop once a week and, as she could tolerate it, she increased her dose. I’m happy to report that now she can live her life relatively unbothered by her symptoms (they are almost completely gone!) and even engage in activities that would previously trigger her! She’s not even on the supplement anymore. These products are easy to take and effective!

If you are struggling with chronic complex illness, call for a free phone consultation with Dr. Falkner to see if she might be able to help. 

Methylene Blue – The Oldest New Med: for Energy, Chronic Infections, and More!

Methylene blue is one of the oldest synthesized medications to exist. It was originally made in 1876 for malaria. It was approved by the FDA for a condition called methemoglobinemia, which is a relatively rare condition. In simplest terms, methylene blue helps increase the oxygen carrying capacity of the red blood cells.

So, what can methylene blue be used for?

– We have found that not only is methylene blue great for saving lives and fighting malaria (its official uses), but it’s an amazing mitochondrial support that also has anti-inflammatory and antioxidant uses. Methylene blue has been in the news recently for these “anti-aging” actions. By boosting the mitochondria (remember in 8th grade biology- “mitochondria is the powerhouse of the cell” – it generates the energy currency our bodies run on), we increase energy production in the body.

– We also use methylene blue for neurological protection and health, including for concussions, dementia, depression, chronic fatigue, and long COVID neurological symptoms. Methylene blue is especially good for chronic fatigue due to its anti-inflammatory effects, its mitochondrial support (it enables us to skip steps in energy production!), and its ability to also boost mood.

– Lastly, we can combine methylene blue with other meds and supplements to better treat difficult infections like mold, babesia, bartonella, viruses (including potential for long COVID and EBV), and even pain.

We can give Methylene Blue both orally and IV. Unusually, methylene blue is well absorbed and crosses the blood brain barrier easily orally. However, side effects can include nausea (much better with lots of water), headaches, fast heart rate, and blue/green urine and/or saliva.

Methylene blue has a long history of use for various conditions safely. We can use this as another tool to enhance brain function, energy, mood, and fatigue!

Long COVID


Covid is Here to Stay

It’s pretty clear that COVID is here to stay. It continues to not only infect new cases but continues to wreak havoc in the already infected longer than the traditional medical model previously considered possible. Long COVID is a poorly understood constellation of symptoms (both mental and physical) that persist for more than 2 months after infection of COVID that significantly impacts a person’s life and isn’t explained by an alternative diagnosis (Mikkelsen & Abramoff, 2023).

Long Covid Symptoms

The most common symptoms in long COVID are fatigue, difficulty breathing, joint pain, chest pain, and cough (Sudre & Et.al, 2020), but we are often seeing brain fog, anxiety, dizziness, and difficulty in regulating heart rate and blood pressure. Symptoms can also change day to day. We don’t know what causes long COVID and its unclear who is at most risk of developing long COVID due to conflicting reports. What we do know is 87% of patients hospitalized with COVID will still experience symptoms after 2 months (Carfi, Bernabei, & Landi, 2020), so this is not an uncommon issue. Meanwhile, most patients do start to see improvement in their symptoms in 4-9 months (Mikkelsen & Abramoff, 2023) even without intervention.

Why Do Some People Get It?

So, what is causing long COVID? We aren’t sure. There are a few ideas, but it boils down to the following themes: reactivation/reemergence of COVID or other viral illnesses like Epstein Barr virus (Gold, Okyay, Licht, & Hurley, 2021).  Other contributing factors are immune system dysregulation, energy metabolism defects, and imbalances of pro and anti-inflammatory processes.  

Treatment Options

Fortunately, as naturopathic physicians, we are very used to treating many of these proposed causes of chronic viral infections naturally. Data shows glutathione/NAC, antioxidants, quercetin, curcumin, magnesium all have potential to balance inflammation and treat spike protein related pathologies (Halma & Plothe, 2023). We can also use Ozone IVs and rectal insufflations to modulate inflammation and help the immune system to kill COVID viral particles (Cenci, Macchia, & ET.al, 2022). We can also use antiviral herbs like cat’s claw, lemon balm, and licorice that have evidence of very robust antiviral properties. We can use nutrients like acetyl l carnitine, alpha lipoic acid, vitamin C to help restore the energy metabolism defects.

Ultimately, treatment isn’t (and shouldn’t) be once size fits all.  Often we are supporting multiple body systems for overall improved health – helping the body to heal itself.   We customize our approach of testing and treatments to help address your long COVID symptoms and support your healing.

References

Carfi, A., Bernabei, R., & Landi, F. (2020, July 9). Persistent Symptoms in Patients After Acute COVID-19. Retrieved from JAMA Network: https://jamanetwork.com/journals/jama/fullarticle/2768351

Cenci, A., Macchia, I., & ET.al. (2022, April 21). Mechanisms of Action of Ozone Therapy in Emerging Viral Diseases: Immunomodulatory Effects and Therapeutic Advantages With Reference to SARS-CoV-2. Retrieved from National Library of Medicine: https://pubmed.ncbi.nlm.nih.gov/35531273/

Gold, J. E., Okyay, R. A., Licht, W. E., & Hurley, D. J. (2021, June 17). Investigation of Long COVID Prevalence and Its Relationship to Epstein-Barr Virus Reactivation. Retrieved from National Library of Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233978/

Halma, M. T., & Plothe, C. (2023, May 17). Strategies for the Management of Spike Protein-Related Pathology. Retrieved from National Library of Medicine: https://pubmed.ncbi.nlm.nih.gov/37317282/ Mikkelsen, M. E., & Abramoff, B. (2023, June 19). COVID-19: Evaluation and management of adults with persistent symptoms following acute illness (“Long COVID”). Retrieved from UpToDate: https://www.uptodate.com/contents/covid-19-evaluation-and-management-of-adults-with-persistent-symptoms-following-acute-illness-long-covid/print

Sudre, C. H., & Et.al. (2020, June 16). Symptom clusters in Covid19: A potential clinical prediction tool from the COVID Symptom study app. Retrieved from MedRxiv: https://www.medrxiv.org/content/10.1101/2020.06.12.20129056v1.full

Mitochondrial Damage and Chronic Illness

In late May, I attended the 13th Advanced Applications for Medical Practice (AAMP)’s conference on Mitochondrial Medicine: Healing in Chronic and Post Infectious Illness. It is a 3-day conference that is packed with amazing information that I’ve been attending for the last three years.

The Cell’s Mitochondria – damage creates long-term symptoms

As some of us remember from school biology, mitochondria are the powerhouse of the cell.  Inside them, complex processes occur to create ATP, which is the currency of energy for the body. These processes (anyone remember the Kreb’s cycle or Electron Transport Chain?) are very delicate and highly dependent on multiple nutrients to work correctly.

There is new information that chronic inflammation as well as chronic and acute infections (including Epstein Barr virus, COVID 19, etc), and even medications and toxins can damage our mitochondria and may contribute to post-infectious illness (such as Long Covid), chronic fatigue from other diseases like cancer, Lyme, and autoimmune disease, and other dysfunctions in the body.

So, when you treat the illness or source of inflammation, but still don’t feel better, you may need to address damaged mitochondria.  By giving more nutrients and also by removing obstacles to healing. 

Nutrients power energy production

The main nutrients needed to power mitochondrial production of energy include carnitine, alpha lipoic acid, multiple B vitamins, CoQ10, PQQ, selenium, zinc, and multiple other antioxidants. We also use phosphatidylcholine to help replace the delicate membrane of the mitochondria as well to allow better diffusion of nutrients in and energy out from both the cells and mitochondria. Here at Boise Natural Health Clinic, for broad spectrum mitochondrial support, we like MitoNRG, MitoCore, and BioPC Pro.

Are your Mitochondria Working?

We can indirectly test the function of mitochondria with a urine test called an Organic Acid Test (OAT). The OAT test is a nice 10,000 foot view of overall health. The test can give general information about the health of the mitochondria and Kreb’s cycle, gastrointestinal infections and health, indirect neurotransmitter measurements, vitamin levels, and detox abilities. I often use this test when I’m not sure where to start with a case or am suspicious of mitochondrial dysfunction, GI dysfunction, and nutrient deficiency. Contact us if you’d like to get an Organic Acid Test by Mosaic Diagnostics and get a glimpse of your mitochondrial health!

Spring Allergies – tools for symptoms and prevention

With the blooming of another spring (even though it’s late this year), many of us can expect itchy eyes, postnasal drip, sneezing, and itchy noses. Allergies affect up to 26% of adults, according to the Allergy and Asthma Foundation of America. The symptoms don’t just cause discomfort, but can also come with fatigue, brain fog, headaches, and even tooth pain which can make day to day life uncomfortable.

Let’s look at options to blunt the effects of allergies on our lives:

Lifestyle

  • Use HEPA filters in your appliances like your vacuum, air conditioning, and air purifier.
  • Wear a mask when outside. Masks can help decrease the ability of pollen to contact your nose and lungs which can decrease allergy symptoms. Bonus points for washing your face, hair, or body after being outside as well.
  • Use natural cleaners to avoid irritating your sinuses, lungs, and eyes further.
  • Reduce eating your foods sensitivities and pro-inflammatory foods.

Over the Counter Options

  • Natural Options
    • Look for ingredients like stinging nettle, NAC, vitamin C, quercitin to help with allergies.
    • You can shop in Fullscript for natural options such as:
      • AllQlear – this egg-based supplement (not ok for egg allergies and vegans) is a delicious chewable that can help decrease inflammation in the respiratory tract.
      • D-Hist – we call this one “natural Benadryl.”
      • Aller-C – A blend of vitamin C, quercetin, and bromelain all help to stabilize mast cells (allergy cells) and decrease histamine.
      • Xlear nasal spray – this has xylitol and grapefruit seed extract to prohibit adherence of pollen and allergens to the nasal mucosa.
    • Nasal Rinses – rinsing sinuses with saline solution will help to decrease symptoms of allergies. Look for NeilMed Sinus Rinse Kit available at most drug stores.
  • Over The Counter Medications
    • Certain anti histamines are safer in the long term than others. Some medications, like Benadryl, have been found to have a high anticholinergic burden score, which can contribute to risk of dementia later in life (https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2736353). See how your OTC antihistamine stacks up here: https://www.acbcalc.com/

Desensitization Prescription Options:

  • Sublingual Immunotherapy (SLIT)
    • For severe allergies, BNHC can prescribe a medication called sublingual immunotherapy (SLIT). This therapy is similar to allergy shots in that we help your immune system to become tolerant to ever increasing amounts of the allergen. We can tailor this prescription to your individual allergens, which we test through a blood test (no itchy skin scratch test here!). For more information look at https://www.allergychoices.com/ and you can schedule with Dr. Michaela Falkner if you’re interested!

Babesia – Another Common Tick Born Illness

Babesia is a little different from Lyme (borrelia) and Bartonella in that it is not a bacteria, but a parasite that is more similar to malaria than bacteria. Babesia has been found in all 50 states and likes to target the red blood cells. Babesia infection is often in addition to lyme infection as well and we often need to treat both.

Symptoms

  • Symptoms vary from person to person but we tend to see more pulmonary involvement in Babesia.
  • Most common symptoms are:
    • Shortness of breath with negative pulmonary tests, frequent sighing or air hunger, anxiety, night sweats and chills, flushing/hot flushes, the sensation of bugs crawling on your skin, pressure headaches on the top of your head.

Testing

  • Like all tick-borne infections, testing is difficult. You can get antibody testing at a general lab or Igenix. These tests are often not very sensitive and can come back falsely negative.
  • FISH testing: FISH testing is looking for unique RNA codes in Babesia. It has been the gold standard for testing Babesia and is available through Igenix.

Treatment

  • Treatment has more in common with treating malaria than Bartonella or Borrelia.
  • Prevention is the best cure! Here are some handy tips from Igenix on how to prevent Lyme disease. https://cdn.igenex.com/wp-content/uploads/2022-Lyme-Disease-Awareness-Month-Tips.pdf
  • Herbal Treatment: The favorite herbs to treat babesia are Artemisia (wormwood), just like malaria. Other herbs that are effective are Japanese Knotweed, Cryptoleptis, Chinese Skullcap. Japanese Knotweed, Cryptoleptis, and Chinese Skullcap are luckily also effective at Lyme and Bartonella as well!
  • Antibiotics: Antibiotics of choice are Bactrim, Atovaquone, and Azithromycin.
  • Ozone therapy: ozone kills bacteria, viruses, and fungi.
  • Treat other supportive body systems: address the thyroid, adrenal glands, vitamin levels, and multiple other organ systems to ensure your body can fight the Babesia and other co-infections.

As with the other co-infections and Lyme, I find it is easiest to assess which infection is causing the most issues symptomatically and start treatment focused on that microorganism, eventually expanding treatment to cover all co-infections as tolerated.  

Dr. Falkner has attended ILADS (International Lyme and Associated Diseases Society) conferences as well as has years of experience treating Lyme both naturally and with antibiotics.

For more information – here are more Dr. Falkner articles: 

Conference Pearl – Supplementing Testosterone in Men reduces Cardiovascular Risk and Helps control Blood Sugar


I recently attended the Advanced Applications in Medical Practice (AAMP)’s fall conference focusing on endocrinology. This was a 3-day, multi-doctor panel that taught all things endocrinology – the study of hormones.  I especially was intrigued by the research showing low testosterone in men affects cardiovascular risk and blood sugar regulation. 

Type 1 Diabetes

While I personally don’t have any type 1 diabetics currently in my practice, I gleaned quite a bit from the diabetes talk by Dr. Jodi Stanislaw, NMD. If you recall, type 1 diabetes is where the body starts to attack the pancreas via autoimmune antibodies, and you cannot make insulin to be able to utilize the blood sugar. This can be life threatening and the patient is insulin dependent.  There were many nuanced and often overlooked helpful points about blood sugar that can be applied to pre and type 2 diabetes.

Prediabetes and Type 2 Diabetes

I do see quite a few patients with prediabetes and type 2 diabetes, where the body’s glucose/sugar use is dysfunctional and often controlled by diet or if needed, supplements and oral medications. Their body can still produce insulin, but sometimes the communication between insulin production and use breaks down.

Hormones and Blood Sugar Regulation – an Important Connection

While blood sugar and hormones (estrogen, progesterone, testosterone) are often not linked together, the Endocrine Society is now recognizing this relationship as more important in the management of diabetes than previously understood.

There have been numerous studies regarding the beneficial relationship testosterone has on blood sugar regulation and atherosclerosis (the buildup of plaques in the artery walls which can cause high blood pressure, heart attacks, and cardiovascular disease).

The Endocrine Society is now recommending measuring testosterone in all newly diagnosed diabetic men as testosterone has not been found to necessarily effect the blood sugars directly, but moreover the inflammation that accompanies high blood sugar.

Bottom line: adding testosterone replacement therapy to a diabetic’s regimen improves cardiovascular inflammation, decreases cardiovascular risk, and decreases obesity. I think this research is amazing and will begin measuring testosterone in my male prediabetic and diabetic patients to further decrease cardiovascular risk!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3167667/