Dr. Dempsey on Infections: Mast Cell Matters with Dr. Tania Dempsey

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Jill Brook: Hello Mast Cell Patients and lovely people who care about Mast Cell Patients. I'm Jill Brook and this is Mast Cell Matters where we go deep on all things related to Mast Cell Activation Syndrome or MCAS with the help of our brilliant guest host, Dr. Tania Dempsey. Today she is so kind to return for a third time to answer listener questions, because the more questions she answers, the more people write in with even more great questions.

So thank you listeners for asking, and I just have to say, Dr. Dempsey does not get these questions in advance. She's so awesome. She just comes in cold. She says, ask whatever you want. Dr. Dempsey, you're so busy, and we are so grateful. Thank you for making the time to answer these.

Dr. Tania Dempsey: It's my pleasure.

Jill Brook: So I know everybody loves it when we just dive in and get going fast, so if it's okay,

the first couple sets of questions had to do about testing for underlying infections. And so, [00:01:00] there's a lot of questions that were basically all in the category of when do you know is the right time to start testing for underlying infections. Like, is there a certain kind of patient you look for, or is it a certain point in that patient's journey where you're like, it's time to start testing for infections now, or how do you decide when to start?

Dr. Tania Dempsey: Okay. This is, this is such a good question because I was just thinking about this podcast that I just did where I, I kind of covered a little bit, but now I'm going to, I'm going to dive a little deeper. You know, it's tough, from my perspective patients coming to me already maybe have some suspicions, and, and so really, if they're coming to me, 100 percent of my patients are going to get tested.

The minute they walk in the door, to be honest, you know, with, with, with a few exceptions, okay? Because I have a high index of suspicion for a variety of reasons. If we're just talking about [00:02:00] maybe, maybe sort of people in the communities out there who, you know, may not know about whether they could have infection or not, let's talk a little bit about the, the, some of the symptoms that I would think about and some of the exposures, right?

So, so I'm testing for a a lot of vector-borne infections, vectors are things that are transmitting infection. Vectors are like insects you know, ticks, spiders, lice, fleas. So I'm looking for exposure to those types of vectors. There are other types of infections you can get else, you know, other, otherwise, like you can get mono and you can get mycoplasma pneumonia and things like that.

I'm testing for those too. But if we're talking about like in the realm of vector-borne infections, like Lyme disease, Bartonella, Babesiosis, Borrelia and, and Rickettsia and [00:03:00] Tularemia. So we're thinking about things that are being transmitted by, by a vector. I'm asking those questions.

So people listening, right? Think about exposures to those things. You know, have you ever had a pet who's had fleas? Have you been exposed to fleas from a pet?

Jill Brook: Fleas can do it?

Dr. Tania Dempsey: Fleas carry Bartonella. Yeah.

Jill Brook: I've been rethinking my whole life, but go ahead.

Dr. Tania Dempsey: Oh no. Yeah, you know, they carry, oh fleas actually carry a lot of bad things but Bartonella is one of, one of the infections that we think about. And in fact, there's a, there's a form of Bartonella called Bartonella Hengeli, also known as Cat Scratch Fever. And, and so it's transmitted by, it can be transmitted by a cat that scratches or bites, but the reason you're getting from a cat is because the cats carry fleas, or infected by the flea and the flea [00:04:00] feces

usually winds up underneath the cat claws, the, the nails. And the feces is where the Bartonella is living. And Bartonella is a bacteria, I know it's kind of crazy, right?

Jill Brook: Yeah, it's just I knew there were gross things around ticks, but I'm having to expand, yeah.

Dr. Tania Dempsey: So this is, this is the thing. This is, that's why I'm so happy to talk about this question because I really think we need to get this information out there. Everyone thinks Lyme and all these infections are coming from ticks and if they've never been bitten by a tick or they don't think they live in an area where there are ticks, they just think there's no way, you know, they can't have those infections.

Lyme is a, is a bacteria that's transmitted by a tick, but there are lots of other infections that are transmitted by other types of insects and other types of ticks. And a lot of people don't remember [00:05:00] being bitten by ticks, they don't remember being bitten by a flea, or a spider, or a, or whatever, but you have to think about those, those things are carrying lots of different types of infections that can be transmitted very, very easily.

And so, so exposure to animals in general, because the animals are bitten by those things too, and they can carry it, like a, like a cat or dog, or, so if you've been exposed to a wild animal, or a domesticated animal, if you've been scratched by a cat, if you've, if you've had animals that have had fleas if you've had lice, lice carries Bartonella Quintana, different type of Bartonella species. Biting flies,

spiders, I mentioned, and yeah, so like lots of things. So, so, you want to take that type of history or you want to think about, you know, do you have exposure to those things? And if you do, yes, run out there and get somebody to test you for these various infections. Not just Lyme, but Bartonella and Babesia.

[00:06:00] Oh, Mosquitoes. Let's talk about mosquitoes for a second. I forgot about those. Mosquitoes. Right? Because I think probably close to 99. 9999 percent of people listening have been bitten by a mosquito.

Jill Brook: Sure.

Dr. Tania Dempsey: Has anybody not been bitten by a mosquito? Right? I mean, it's pretty common, right? Mosquitoes can carry Babesia.

They can carry Bartonella, and they can carry Malaria, and they can carry West Nile Virus, and they can carry, so they, so mosquitoes are also a very and other, there's like Deng Fever, there's a bunch of things that you can get from from mosquitoes. So, if you've ever been bitten by any of those things, you need to be tested.

Okay, now, there are symptoms that also might make me more suspicious. The problem is that a lot of these symptoms overlap MCAS symptoms, and in fact, at one conference that I, that I gave where I talked about Bartonella, I kind of lined up the Bartonella symptoms with the [00:07:00] mast cell symptoms, and they're, like, identical.

Bartonella can invade every organ in the body. Mast cells are in every organ of the body. Bartonella can invade the vasculature and it tends to live, live in the sort of the blood vessels. Guess where the mast cells are? Mast cells are in the blood vessels. Bartonella lives in can, can invade red blood cells and so they can also invade it can invade the bone marrow and, and the red blood cells in the, in the periphery.

Well, where are mast cells? Bone marrow and then they come into the bloodstream and then they go into the, into the tissue. So the, the problem is that the symptoms can really overlap tremendously. And, and I think it's really the, these infections are driving the symptomatology

through the mast cells and activating the mast cells causing Mast Cell Activation Syndrome. [00:08:00] But, but, if I just try to generalize a little bit with Lyme I think about joint pain tends to be migratory, which differs a little bit from like the EDS type joint pain that we think about. Migratory joint pain, it's sometimes, it's the shoulders, the knee, it's the hip, it's the, and it's sort of one day it's one thing, one day it's another thing.

That tends to be kind of a common thing we see with Lyme. I've seen it also with Bartonella and other infections, but that could be a more Lyme like thing. Joints can swell. I've had patients with the knees, you know, knees that swell up from Lyme disease. You can have cognitive issues. You can have fatigue.

So Lyme can really also invade just about every tissue and every organ in the body and cause GI symptoms. Bartonella can cause similar things, but also can cause a little more, I think about it more with like the vasculature because [00:09:00] it's infecting red blood cells, it can affect oxygen level and iron levels.

Babesia also, which is a parasite can invade, actually usually invades the red blood cells together with Bartonella. So they can affect, both can affect oxygenation can cause air hunger. Babesia causes that, like a lot of air hunger, feeling like you can't get enough air in. Often you can find anemia.

It's a very common finding on, on, on blood work. A lot of cognitive issues with all these things that can cause anxiety and depression and OCD and and ADHD, brain fog, edema, like, like swelling, sometimes like swelling of the legs, weight gain. Very common with Babesia and Bartonella, like abnormal weight, weight gain.

Bartonella can cause weird stretch marks. I'm calling them stretch marks, but they're really not stretch marks. But they can, it doesn't mean, there are lots of people who don't have it, but if you [00:10:00] have it, it's very concerning and needs to be tested. They, they look, they can look like stretch marks, but they tend to be almost like the opposite of stretch marks.

Instead of being indented, they often are like raised. They can be red. They often go almost like horizontal along, they can be horizontal along the flank, around the abdomen where stretch marks might go like a different direction sometimes they're on the breast in women, sometimes they're under the arms they can be across the back.

I've seen them horizontal across the back. And and so Bartonella actually can invade the skin and we've we've biopsied those and they have found Bartonella in those lesions.

Jill Brook: Wow.

Dr. Tania Dempsey: So anyway, so that's, so if you have these types of symptoms, and you have those possible exposures you've spent time outdoors, you know, let's talk about time outdoors, time, you know, [00:11:00] farming, farm animals, hiking, etc.

So if you have any risk factors and and some of these symptoms, you need to be tested. But as, as I mentioned actually in this previous podcast that I did that, that, you know, will, I'll, I'll release, you know, when we're, when it's ready. Well, the person who interviewed me will release when it's ready.

I talked about a study that I did, a retrospective analysis that I did of my of my, my charts and my patients in my practice. And what I did was, I, I looked at 70 patients, so I did this analysis actually last year. So it was like the 70 patients that had come in, you know, like in a certain amount of time.

And, and all those patients underwent testing for MCAS and testing for vector borne infections. And out of the 70 patients, 88 percent met consensus two criteria for Mast Cell Activation Syndrome. But here's the, here's the, the, the clincher, 100 [00:12:00] percent all 70 patients tested positive for one or more vector borne infections.

100%! Now, I used a variety of different testing, but the majority of the tests that I did in those patients was a molecular test, meaning that we were looking at the presence of the infection in the blood. It was either a FISH positive, like a FISH test, which is Fluorescent In Situ Hybridization, or it was a PCR,

Polymerase Chain Reaction. So he was looking for active infection, not just antibodies. So some people get tested for vector borne infections and, excuse me, for Lyme, they might do a Western blot. And, and, and then based on that Western blot, a doctor might say, Oh, you have Lyme or you don't have Lyme. And that's a test based on antibodies. Antibodies are not the best [00:13:00] test because it could be something that you had in the past, it could be, it may not show up if your immune system isn't working well. So the point is that the testing that I use primarily is molecular. So the, so the person who asked this question is such a great question because what I would argue based on this data, which I hope to publish, is that it's important for everyone theoretically to get tested, at least to know

whether it's possible, whether that's one of the drivers of their MCAS. So

that was a long, that was a long, sorry, that was a very long...

Jill Brook: Fantastic, and I think you might have also inadvertently answered another question we got, which was, can people who are on IVIG get tested for these things? And I think their thinking was that if you're getting infusions of IgG every month, then an IgG test is not going to be very accurate, but you don't rely on those [00:14:00] tests completely.

Do you want to talk about that?

Dr. Tania Dempsey: Right, exactly. So, especially for the person getting IVIG, a molecular test, which does not rely on looking at the immune system, would be fine because it would, they're just looking for the bug. Yeah, so antibody tests, so the Western blot is one test that we use for, for Lyme. There are antibody tests for Bartonella.

You can do an antibody test for Babesia. You can do these tests through commercial lab but there's a lot of, a lot of issues with that because there's so many strains of these infections and the commercial labs are really not testing all strains. And so, they're notorious for missing these infections.

So, you might hear this and say, Oh, I'm going to go to Quest and I'm going to have my, you know, PCP, you know, order some testing. And the majority of patients test negative. There's problems with the testing, but the other problem is that a lot of patients, because of these infections, [00:15:00] and because of other things that affect their immune system, mold exposure can suppress the immune system,

having Lyme and Bartonella can suppress the immune system. If the immune system is suppressed, you may not make antibodies appropriately to infection. So this infection is ravaging your body, but you may not even show that you have antibodies to it because you're you know, your immune system hasn't kicked in to make antibodies.

And sometimes what happens is when we start treating the patient and the immune system starts to see, Oh, wait a second, I see Bartonella's here. Sometimes we'll do an antibody test and, you know, lo and behold, there it is. The antibodies are there. So, so, but generally, you know, antibodies are tough to interpret because of a suppressed immune system, the test not testing all the, all the species,

and also, sometimes the [00:16:00] opposite happens. With MCAS, we can see aberrant, abnormal antibody production. In fact, Dr. Afrin and I and Dr. I think Dr. Weinstock was on that paper, Lenny Weinstock, we published was he on that paper? No, it was Dr. Gerd Mulderings was on that paper, where we looked at cases, we looked at over a hundred cases of patients to look at the prevalence of antibodies to various things.

ANA, anti nuclear antibody, rheumatoid factors, thyroid antibodies, and what we found is really that, that patients with Mast Cell Activation Syndrome have a higher rate of having abnormal antibodies that may not be actually, truly doing anything. They may be, mimicking. They may be just, just totally [00:17:00] sort of inappropriate and not pathologic.

So they may not be actually attacking your thyroid. They may not be attacking Bartonella, but they may be showing up. I have patients, interestingly, who you do like these Western blots on them. And some patients, they have no bands, which means that they have no antibodies, but they can still have Lyme disease.

And then I have other patients, it lights up like a Christmas tree. Every band is positive, and yet, when we test them for a molecular test, and we look to see if they have Lyme infection, they actually don't. They might have another infection, but they don't have Lyme, so they can have abnormal antibodies the opposite way.

So that's why I have a real hard time relying on those antibody tests. But unfortunately, they're more readily available, and the molecular testing is definitely more expensive. And that's a, that's a huge downside. I hope that will change in the [00:18:00] future, but that is, that is a problem.

Jill Brook: So, that's interesting because we had one physician write in and thank you for all of your information and say that you had made her encouraged to look into underlying causes of MCAS, including these infections, but then she had gotten to the testing option stage and she thought it was a disaster and that scared her off of the whole thing.

And so what I'm hearing you say is that the antibody tests can be wrong for all kinds of interesting reasons in both directions, false positives and false negatives, but that these molecular tests that actually look in the blood for pieces of the virus or pieces of the bacteria? Is that what I'm hearing?

Dr. Tania Dempsey: Yeah.

Jill Brook: That those are better?

Dr. Tania Dempsey: Not even pieces, like, can actually find the the bug itself. So, so sometimes it is pieces. So sometimes like a PCR can find like, like a piece of the genetics of Lyme, let's say, or Bartonella. With a [00:19:00] FISH test, it's, it's, it's really, yes, isolating the actual bacteria itself. And one of the labs that we use uses a technique with a confocal microscopy, essentially it's like a microscope, so they can, they can visualize it and they use a fluorescent stain.

So basically what they do, I'm going to try to simplify this, they, they take a an RNA of, they have it in the lab, it's a probe. And it matches, let's say, the DNA of the Bartonella, let's say, Hensley, that's the strain. They have this RNA probe and they attach it to a fluorescent like a fluorescent stain, let's say.

If, and they expose it to your blood. If there's Bartonella there, it will bind to the DNA of the Bartonella, and it will light up fluorescent. Then they can [00:20:00] look under the microscope, and they can see where it's, you know, lighting up.

Jill Brook: Cool.

Dr. Tania Dempsey: And, and, and, and you get the pictures to prove it. So, those types of tests, again, they're looking for the molecular

pieces or the entire bug those are going to be more reliable in general when you do it that way.

Jill Brook: So Murphy's Law says that those tests were, will not be covered by insurance and will be more expensive. Is that the case?

Dr. Tania Dempsey: Yeah, unfortunate. That's, yeah, that's the unfortunate thing. And I, and I hate that it's, it's like that, but if you need answers and you do, listen, you can start with the antibody testing. You might, you know, you might luck out, you know, and get some, some information, but I just am worried about the negative tests.

I'm more worried about negative tests and, and not undiagnosing people not diagnosing people properly, [00:21:00] and then people going, you know, around and getting sicker and sicker and not addressing, you know, the, the problem. So if you do the testing, and let's say you go that route because insurance covers it and you don't get any answers and you continue to try other things and you still don't have answers, right?

Then I think you have to, you know, figure out a way to do those other tests.

Jill Brook: So a follow up question that we had gotten was, so let's say that for example, you do find one of these underlying infections. First of all, do you tend to just find one or when it rains does it pour? Like do people tend to find more than one? And then, like just for example, you had mentioned Bartonella Hensley.

If somebody has that, how big a deal is the treatment for that? Is that something you can take care of in a month or is that like a whole another year of like focusing on that? How involved are the treatments for things like infections, if you can generalize?

Dr. Tania Dempsey: Yeah. It's unfortunately [00:22:00] pretty involved. I think part of the problem is, especially with MCAS you know, the immune system is, it's inappropriate and and that is going to interfere with the ability to fight the infection. And so it does take time to figure out the right path. There are lots of different ways to treat and, and everyone is different, you know, sort of my personalized medicine approach, you know, sometimes you can do some herbs, you know, maybe that helps enough and you don't need to do anything more sometimes.

Maybe you could do antibiotics or, or we have a technology we're using, technique we're using called SOT therapy, which we can talk a little more about, but we have these different ways of, of treating and everyone is different and everyone responds differently and some people do respond a little, you know, faster and, and some people a little bit slower.

To get to the first part of your question, the vast majority of patients definitely test for multiple infections. Unfortunately, it seems that there's some, there's some preliminary [00:23:00] research that is showing that Bebesia and Bartonella are cohabitating and they have a synergistic relationship because they both invade your red, the red blood cells, the erythrocytes.

And so, we're rarely, very rarely seeing one without the other, almost always together. And and those more common even than Lyme, again, depending on the area of the country and etc. Although we are seeing a lot more of the various Lyme species beyond Lyme. There's Borrelia is the genus, it's the big category, but then Borrelia burgdorferi is the Lyme that everyone thinks of that was from, you know, kind of discovered in Old Lyme, you know, Connecticut, but there's a lot of other Borrelia species and we're seeing more of them all over the country.

There's Borrelia mayonii that [00:24:00] was discovered, I think, in Minnesota named after the Mayo Clinic. There's, and it causes a similar Lyme, like, you know, condition. There's Borrelia afzelii, Borrelia garinii. Those are European strains of Borrelia. There's Borrelia turicatae, Borrelia miyamotoi, hermsii.

Those are what are called Tick Borrelia. So, the point is that it seems that a lot of people do have multiple infections. And I think that, and I think a lot of people in this world are infected with these various infections. I think that some people's immune systems are able to handle it. And so, they may never really get sick or they may have very mild symptoms.

And I think that, that the people who tend to be sick and tend to have a let's say a worsening MCAS situation are the ones that are really [00:25:00] having trouble getting their immune system to deal with them appropriately. That's really where the problem is.

Jill Brook: Oh, okay. So we had one person who was wondering what kind of expectations they should have when they go into the world of treating infections, like, you know, what are the chances that they're going to improve, and how much, like usually with these patients, can you get, you know, 50 percent improvement in a year?

Or, you know, like, people are just kind of like wondering what expectations to have.

Dr. Tania Dempsey: So, I'm an optimist by nature. And so...

Jill Brook: And you probably get the toughest patients.

Dr. Tania Dempsey: And I do, and I, I, I do, I do. And I, and I, I'd like to, and I just really want everyone to have hope, and I want everyone to just feel good, right? That's like, that's what I want, that's my mission in life, just want everyone to just get better. But this is, but I also, the expectation is really, [00:26:00] you know, people do typically have a long road, you know, there was a long road getting to this place, you know?

Let's just say you're newly sick, you know, you're generally had, you generally have been healthy all your life, and, you know, maybe it's been six months since, let's say, your symptoms started, and maybe you were scratched by a cat, infected, you know, with a, with fleas, you know, bitten by a tick, whatever it is, and it's a relatively new thing, right?

I think it is probably easier I won't say easy, but I think that, you know, maybe the course will be a little different if we can catch it sooner. People who have had 20 years of infection and that have not addressed it completely or at all and have worsening MCAS, you know, worsening [00:27:00] food intolerances, more reactivity, et cetera.

It is going to be more difficult because they may be reactive to the various treatments. It may be hard. There, there is, there is a a, a complication that develops from, from treating these infections called Herxheimer reaction or Herxing or Die Off Reaction. That can, sometimes it's a mast cell reaction, sometimes it's, so the mast cells are getting activated by the toxins being released by these infections as they're dying.

Sometimes it's not just mast cells, it's other things that are involved, and so we're managing that and trying to calm the immune system, the inflammatory reactions down, while we're also trying to kill these things. So, I just, I struggle with giving a timeline. I wish I could. You know, I wish I could just say, okay, give this six months, and it's going to be better.

These get complicated because a lot of patients who have infection [00:28:00] also have other, other potential confounding factors. What I'm seeing a tremendous amount of is mold, mold exposure. So what's happening is, in fact, I had one patient who probably had these infections all her life, but at some, like around the age of 40, had a major mold exposure, got sick, and then as we were sort of trying to deal with the mold and treating the mold, we realized that the infections were coming out.

And, and, you know, the question she had was, well, did I just get these infections from mold or after the mold? Like what happened? And I think it was the immune, the immune system probably kind of kept it at bay until it couldn't because the mold just destroyed the body and the mycotoxins invaded everything and just suppressed everything.

And then, boom, the Bartonella was out. So the point is that if you're trying to treat infection, but you have other things going on, you have to make [00:29:00] sure, you know, it's sort of like that analogy of like, I think it's like if you have like 16 nails in your foot, okay, so, so Dr. Horowitz, Dr. Richard Horowitz, who's a good friend and mentor came up with this sort of way of, of thinking about all the different pieces of what you need to think about in these patients, and he calls it the 16 point MSIDS map.

MSIDS stands for, I think it's like a multi system disease index, and he has like a questionnaire that goes with it, but he uses the analogy of like 16 nails in the foot. This is a 16 point map. If you pull out, you know, one nail, there's still 15 nails in there, so you have to deal with the the hormonal imbalances that, that happens, and the adrenal dysfunction, and the mitochondrial problems, and you know, the, the, the, the GI issues, right?

So there are all these things that are, that are, that are happening at the same time as the infection, right? So I'm not, I don't want to say this, and for people [00:30:00] to get overwhelmed, or feel discouraged. It's what I do every day. It just is a process, you know, and somebody, and there are other practitioners like me out there who are doing this work.

It is just, you know, systematic and, and methodical. You have to sort of work through all the nails and you have to sort of figure out for this patient what the right path for, for treating is. Like one of, one of my favorite treatments right now is a I mentioned this thing called SOT or SOT therapy.

It stands for Supportive Oligonucleotide Technique. And basically, an oligonucleotide is like a small little protein like, like an RNA molecule. And they can create, there's a lab that can create basically an RNA molecule, a short strand, that matches the DNA of [00:31:00] whatever strain Bartonella, Babesia, Lyme, Epstein Barr, and lots of other infections.

And when you, and when they, they can, from your blood identify, you know, you, you sort of, you, let's say you know you have Bartonella Hensley, you send the blood to them, they can create this protein and then we infuse it, and, and it's in the body for four to six months, this little protein, for four to six months, binding to the DNA and, and essentially shutting down

the replication...

Jill Brook: Oh, that's brilliant.

Dr. Tania Dempsey: Isn't it? Now, this is a technique that was developed. for cancer, actually. And there's, there is a lot of research in various institutions all over the United States looking at this for cancer. This lab, which is not in the United States, was a cancer lab that then you know, understood that this, this really could work for infections as well and what I love about [00:32:00] this technology is that especially for my MCAS patients who are exquisitely sensitive to medications and antibiotics and herbs, this allows, now they can still react, sure they can still react to this protein, but it has really allowed

me to use less really, really strong you know, chemicals and has allowed, you know, patients who are really sensitive to get the treatment that they might not be able to have gotten. So I'm, I'm really excited about this. We've been doing this now, I actually started doing this in 20 18 and, and certainly in the last few years have done much more of it.

And I'm, I'm actually giving a talk on it at a, at a big conference in the, in the fall. But I I'm excited about it. I, I don't, I, I, I think that for some patients it can be very helpful. We have to be careful to say cure. These infections can linger, [00:33:00] can hide in the body, so anything we're doing is lowering the load and allowing the immune system to kind of kick up and handle whatever might be left behind.

The analogy I like to use is strep throat. You have somebody who gets strep throat, you take antibiotics. You take antibiotics for, I don't know, they come up with this magic number of 10 days. 10 days of amoxicillin. I don't know what's magic about 10 days, but basically when you have strep, let's say you have a billion strep organisms in your throat and you take antibiotics for 10 days and the billion goes down to maybe a hundred.

But they're still strep there. You never actually get it down to zero. It's very hard to bring the strep down to zero, but maybe it's like a hundred. This is an example. I don't know the exact numbers for sure, but what we know is that if the immune system can kick in and [00:34:00] handle the hundred, then you're fine.

But if it can't, then the hundred multiply and become a thousand and ten thousand and then a billion and then you have strep throat again. And so there are people who need multiple rounds of antibiotics for strep because their immune system can't kick in.

Jill Brook: Okay.

Dr. Tania Dempsey: The same concept. We're never killing, we're never trying to kill every Bartonella bacteria in the body or every Babesia.

I mean, we'd love that. That would be amazing. It just doesn't seem to happen. It's because these bacteria and parasites can hide, but as long as the immune system can handle it, then you'll be fine. You might be totally asymptomatic, which is what would be our goal. So that's, so that's a little...

Jill Brook: That is, that is great. And with this with this new, was it SOT that you called it? That [00:35:00] also gets at a question that somebody wrote in, which was that they, I forget which infection they had been diagnosed with, but they were concerned about taking massive amounts of of anti

antibiotics,

because they said it's always drilled into my head that gut health is so sacred for the foundation of my health, and so what's gonna happen if I do that?

And so what I'm hearing you say is, yeah, you are probably taking that into account and looking for alternatives to antibiotics.

Dr. Tania Dempsey: Correct. And because I do understand the issues with antibiotics, but having said that, there are always going to be patients that are going to need antibiotics, sometimes even with the SOT. But I could do maybe a shorter course, maybe I don't have to do it for as long. But, but, but for patients who are really it's really contraindicated for them to take antibiotics for whatever, for lots of reasons.

This is at least one tool that we [00:36:00] can, we can use. So, you know, I think these are exciting times. There are newer technologies on the horizon as well and, and hopefully we will be able to, you know, get, get people better with, you know, less aggressive and less harmful methods.

Jill Brook: Fantastic. Well, this is amazing information. We've covered so much. This has been also just really encouraging about some of the new stuff, but I have to finish with a question that a lot of people ask, actually, which is they're curious how you personally decide for your family how you handle exposure to things like the ticks, and the fleas, and the mosquitoes.

Like, do you let your family go camping in the woods? Or how, how much do you keep yourself in a bubble, versus you know, I don't know. Do you have any thoughts on this?

Dr. Tania Dempsey: I do, I do. This is, [00:37:00] oh, I love this. I really love this question. Cause it is something that I think, I do think a lot about. So, I can't control everyone, you know, my kids are getting, are getting bigger. I can't, I mean, when they were little I could make sure I spray them before they go anywhere. I have sent my kids to sleep away camp in New Hampshire.

I have my older son did camping through the Adirondacks. Gosh so we, we try, I think there's a balance between living your life and and taking some risk and, and, and being prepared. Okay, that's what I, and I struggle with that. I'm going to be, you know, completely transparent and honest, like this is a hard balance because I am worried.

So, I we went hiking recently in in Majorca, in, in Island, that's off the coast of Spain. And I, and it was funny, we had this [00:38:00] conversation, I like to share this stuff, I had this conversation with my kids debating about this hiking trip, okay. It was actually just a, just a four hour hike and my kids, one of my kids said, oh but it's Spain, they don't, they don't have ticks. And I was like, well, I have the picaridin spray, and I, and I, you know, we have some clothes that have been pre treated with permethrin. I think, you know, but we're gonna make sure, we're gonna spray, we're gonna check for ticks and all that. And, and then I did a little, like, Google search, you know, like, okay, let's see, what kind of things do I have to worry about?

And yeah, they have ticks, they have other bugs they have lots of stuff, lots of stuff. It is everywhere, okay? You know, we sprayed, we checked for ticks, we did what we could, and I can't say I wasn't worried, you know, at some point, like, I am a worrier in that, in that regard, like, I don't, I want to make sure to keep my family safe, but I also have to balance it with you know, these sort of opportunities, like once in a lifetime type of opportunities, [00:39:00] and and the kids were so excited.

So, so then I also think is a risk there better than, let's say, hiking in the Hudson Valley in New York. I don't know, you know. So I just try to do as much prevention as possible. So I keep, I have a bottle of picaridin 20 percent insect repellent. I have it in my car. I have it in my purse. I have it, right, because like one day I wanted to, my daughter and I were driving somewhere and we're like, Oh, you know, we should take a little walk.

And, and I was like, Oh, do I have the bug spray? And she's like, Oh, remember you put it in the car. Oh good. Okay. Cause we're not walking unless we have the bug spray. So I, I try to be prepared. We try to remember, we try to check for ticks. And but it's, yeah, it's not easy. I can't keep, I can't keep my kids in a, in a bubble, and I'll, and I'll tell you one of the things that happened last year, which I shared on social media, was that actually my son, my older son, did have a bull's eye rash in, this was actually last August, [00:40:00] and I think he got it from my backyard, and here's the thing, I had a little false sense of security in my backyard, because we have a really great company that has been treating our lawn. We have bait boxes that are, are for like the mice to go in and to carry, you know, the, they, they don't get sick, but they carry this sort of insect repellent sort of thing back to wherever they live because they carry ticks.

Jill Brook: I didn't realize mice could carry tics too.

Dr. Tania Dempsey: Oh, mice are actually the worst. Yeah. Yeah. Worse than deer.

Jill Brook: Oh, jeez. Okay.

Dr. Tania Dempsey: Rodents, rodents in general. So, so anyway, I had this like false sense of security that I was like, oh, okay. But I live in a very endemic region of the, of the country. So I remember that my son like went out on the lawn.

And for like 10 minutes at max was, was like, you know, throwing a football with some of his friends. He was, he was in college. He was like, Oh, I was just, [00:41:00] I mean, literally, I think it was less than 10 minutes. Right. And I remember looking at where they were in the lawn and I was like, Oh, and they don't have spray on.

And I, you know, but I didn't want to make a big deal. And you know, literally like 10 days later, he has a bullseye rash. And and I was like, Oh my God, look at all the stuff that I do to protect everybody, but there's the one time that they didn't run outside with the bug spray. So it does happen. I mean, you know, I think he's lucky that his mother is a specialist, so I did treat him pretty aggressively pretty quickly.

But but we can't live in a bubble, and we are exposed to lots of things out there. So, I guess, I hope that answers the question. I think it's just about balance, I think it's about not just exposures like that, but also about, you know, lifestyle, eating as healthy as possible. That's not going to prevent, let's say, me being exposed to Lyme, but it's going to help my immune system.

Like, what can I do, right? On a, on a daily basis, you know, [00:42:00] make sure that my home is safe, make sure I have my air purifiers, make sure we just found a little, little mold on, in our bathroom, like, like the tiniest amount. I freaked out. We're going to get it, you know, remediated. So it's, it's being a little more vigilant because of the world that we live in.

Jill Brook: I hear more and more really knowledgeable physicians kind of talk about the toxic soup that we live in, inevitably. It sounds like maybe it's just like what you're saying, just keep yourself as healthy as possible because, I mean, you can stay indoors all day, but the indoor people say that there's, you know, unhealthy things from indoor pollution too, so it's like you can't really win, so you...

Dr. Tania Dempsey: listen, I think that during the COVID pandemic, when people were inside, I think some of, some of my patients got sicker. And that's when they realized they had mold because they were like leaving, you know, going to work before that. They didn't even realize now they're home. So yeah, so the indoor air may [00:43:00] be problematic.

There's, there's, there's so many things that, you know, you could be exposed to now. And, and I think about the plastics and the plastic bottles that people drinking and all the, right? It's, it is a toxic soup. So, we, I like to, to think about things from a, from a hopeful perspective and from a, you know, I think we need to be, um, what's the word?

Just proactive. So, you know, you do what, you do what you can. You, you protect yourself with the things that you know. There's lots of things that we don't know, but the things that you know, you know, like I make sure my cookware, you know, doesn't have, there's no Teflon. Everything is cast iron. I like, I, I think about, you know, glasses, there's no plastic.

There are things that I can control and I've done things, you know, it's sort of one at a time, not all in one day. But over time, as I've learned, [00:44:00] I've, you know, made those changes. I make sure that, you know, we, we limit the sugar in the house. I'm a carnivore, so I don't need, I don't need sugar, but I but whatever you can do, you know, I think even the little things, even if the things that I've mentioned are too much for you, you know, pick one thing and even that can make a difference.

Jill Brook: I love that.

Dr. Tania Dempsey: I hope that's a good message for people.

Jill Brook: Yeah, yeah. Thank you so much, Dr. Dempsey. I mean, I feel like, wow, so much gold has flown out of your mouth today and there's so many wonderful things. The bad news is we didn't even get to half the questions people had. So maybe we can get you back for a part four sometime, but this was amazing information.

And you know, what's funny is we have a lot of very similar questions on the mold side of things. And so maybe next time we can go back and, you know, kind of same thing, when is it time to test for mold, are there good tests and bad tests? You know, I think there, some people wrote in, they're [00:45:00] confused about different tests and maybe kind of do a ditto on that.

But we are so excited to have this information and we're excited about these new technologies and thank you for keeping up on all the latest, greatest info so that you have so many hopeful, hopeful strategies to use on people.

Dr. Tania Dempsey: Of course, I'm happy to be here, happy to get the information out excited to do, we'll do the mold Q& A next time, and we'll, we'll just keep, keep getting the, you know, getting the word out.

Jill Brook: Oh, we're so lucky to have you on Team MCAS. Thanks a million. And hey listeners, that's all for now, but we'll be back again next week with a normal episode of the POTScast. We'll be back soon with another episode of Mast Cell Matters with Dr. Tania Dempsey as our special host. So thank you for listening,

may your health be good to you and please join us again soon.