Mimi MacLean:

Welcome to The Lyme 360 Podcast for all things related to Lyme disease and other chronic illnesses. I'm Mimi MacLean, mom of five, founder of Lyme 360, and a fellow Lyme warrior. Tune in each week to hear from doctors, health practitioners, and experts to learn about their treatments, struggles, and triumphs to help you on your healing journey. I'm here to heal with you.

Welcome back to Lyme 360, this is your host, Mimi MacLean, and today I have on Efrat LaMandre, also known as Dr. E, and she owns and operates her medical practice, EG Healthcare, which provides pediatric, adult, and geriatric care to over 20,000 patients. In addition to her primary care practice, she's taken conventional medicine to her next level with her signature process called The Knew Method. The Knew Method helps patients take control of their health destiny using a functional medicine approach that empowers them to realize that their symptoms are not in their head at all. And as a result she helps people optimize their health, prevent illness, reduce medication, and feel great. Dr. E is also a public speaker and offers to consult services to other nurse practitioners who are opening up their practices.

Thank you for joining us today, please subscribe below so you can be notified of the next podcast. Also, visit us at lyme360.com to sign up for our newsletter, and then we also have a shop page there, which is all my favorite products that I have used in my health journey. I do get a small percentage of some of those links, which goes towards this podcast and the expenses of this podcast. So thank you so much for your support, and we'll talk soon.

Dr. E, thank you so much for coming on today, I really appreciate it, and I'm excited to learn about your book and how you decided to get into treating patients functionally and integrative medicine, compared to the traditional conventional medicine, so thank you so much for coming on.

Efrat LaMandre:

It's my pleasure, really an honor to be here.

Mimi MacLean:

Yeah, so okay, let's just start out by just doing a quick how you transition from conventional to functional and how you found functional and integrative.

Efrat LaMandre:

So I would say I transitioned the way almost everyone transitioned, which means it has to hit home. Anyone who starts off in conventional medicine is going to stay in conventional medicine until the day they die unless they or their loved ones are taken ill and conventional medicine doesn't have the answer for them. So right off the bat I want to say I'm not against conventional medicine, I use it a lot for various things, but there are times when it's just not enough.

And so in my particular case it was my wife, she had an autoimmune issue, two autoimmune issues. Quickly I'll just say one was PMLE, polymorphic light eruption. I always like to mention because sometimes I'll have a listener that is dealing with that. And then the second was severe psoriasis that really affected her ability to just get through the day. And I'm in medicine, she's in medicine, all our friends are in medicine, and the only answer is steroids, which didn't sit right with us. And this was pre what the internet is now, now you can get information, but back then, I'm old, older, I'm 50, there was internet but it wasn't quite like this. And so someone said, "You should go see this functional medicine guy," and we're like, "What the heck is functional medicine?" And we're like, whatever, let's just go. It's not going to work, but we have nothing to lose.

Mimi MacLean:

Who, do you mind me asking, back then? Because it was Dr. Mark Hyman was one of the only original ones, who else was one of the original?

Efrat LaMandre:

No, his name is Dr. G, it's a long Greek name, I don't know it.

Mimi MacLean:

Because there was definitely, I've been following it for like 25, I don't even know how long ago this was.

Efrat LaMandre:

Well, anyone who was ill has been following this for a while, and anyone who's coming on right now and this is their first or second podcast, probably just figured out that they're ill. That's just how you get here, you or someone that you love, unfortunately. I'm waiting for it to become a revolution.

Yeah, so we went to this functional medicine guy, and he had the audacity to suggest one, that we weren't eating healthy. Hello, of course we're eating healthy. We looked healthy, we looked "the part." For those of you listening, there's air quotes in my hand, we were thin and athletic and looked the healthy part, so how dare you suggest we didn't eat healthy. And second, the most ridiculous thing to suggest, that our disease process has anything to do with our nutrition was completely insane. But we did, we're like whatever, let's just go on this ridiculous diet, it's not going to work, let's take these supplements, and it freaking worked.

Her skin cleared up, she was able to go in the sun, PMLE is a severe allergy to the sun, and we were like, what the heck is going on here? We did not learn this in school at all. And so then I started going down the rabbit hole, course by course, class by class, patient by patient, until eventually I got my PhD and I invented The Knew Method, and now it's really been a journey to help as many people as possible just realize that they're not crazy and that there's another way to do things. That's why we call it The Knew Method, because the patients always know.

Mimi MacLean:

Yeah, and just so people know, it's not N-E-W, it's K-N-E-W, like you knew.

Efrat LaMandre:

Yes, like you knew there's a better way, yes.

Mimi MacLean:

And I love the title of your book, Your Body Doesn't Feel Right But You Don't Know Why, It's NOT In Your Head.

Efrat LaMandre:

Especially for women, especially of a certain age, there's this conversation of is it stress? Maybe, if you lost some weight, maybe exercise more. Are things okay at home? Maybe you need an anti-anxiety medication. And maybe all those are true, maybe you do have stress.

Mimi MacLean:

Or seasonal, I always got, it was between January and March, oh there's not enough sun out.

Efrat LaMandre:

And all those things are true, stress is important and relationships are important, but can we first address the thing that's happening? Can you not make me feel like I'm crazy? And so a lot of times when I do my first consultations with people, and at this point it's all over the country, there is this moment of pure emotion of just having an opportunity to be heard.

Mimi MacLean:

Mm-hmm, and validated, right?

Efrat LaMandre:

Yes, and sometimes the consult itself already did 50% of the work because they're like, "Oh my god, you actually think all these things are connected? Oh my god, this is real? It's not just because I'm 50, or whatever, 60?" And I'm like, "No, no, no, this is all connected, this is all real." So that's what the book title came from, it's not in your head, because most people will come to me and say, "I can't tell you what it feels like," then not be told it's in their head.

Mimi MacLean:

Mm-hmm, because I feel like I'm like, "I promise I'm not making it up, I don't want to be here." I have a good life, I want to be doing so many other things, this is the last place, I do not want to be sick in bed.

Efrat LaMandre:

Yeah, I'm not a lazy person. Everyone will come and say, "This is not me, I'm not a hypochondriac, this is not me, there was a time where I felt better. I want to exercise, I just can't exercise. I want to do the thing, and I just can't," and that's real. One of the first questions I ask my patients, "When was the last time you felt normal?" And there's a time, there's always a time. Sometimes it's not since they were 13, but there was a time where you feel normal, and we need to get you there again.

Mimi MacLean:

No, it's true. Okay, so tell me about your method, there's steps to it, so can you talk about the steps when you work with somebody?

Efrat LaMandre:

Yes, absolutely. So the steps, we've actually changed them up a little bit, it used to be the case, and I'll explain why I changed them up, because I want to be able to reach more people. It used to be the case that we always did blood work first and saliva testing, and then we have this really cool questionnaire that we do, but what happened for a lot of people that weren't able to get the blood work done, because if they're not in the state I can't order it, if they're in state I can order it, and so a lot of their doctors wouldn't give them the blood work. And so it became a stepping stone and they couldn't see me because I was like, one of my requirements is to do the blood work first.

Mimi MacLean:

Did that changed though because of COVID or no?

Efrat LaMandre:

No, you cannot order labs outside your state, it's considered practicing medicine. So I can coach you wherever you live, and we could talk wherever you live, and I can walk you through whatever you're going through, but I can't order labs or send medication to your state. And so it became this ridiculous hurdle of arguing, I would get on the phone with docs and be like, "Hey, could you just order this? It's fine," and they were like, "No," because there were things in there that they weren't uncomfortable with, inflammatory markers and genetic markers. And I was like, you know what? I'm making it too difficult for my patients to access what they need. So we now do a saliva test and this questionnaire, and I want to take a moment to explain what this questionnaire is about, because this is the crux of all of it.

So the questionnaire we use, we did not invent this software, it's called LivingMatrix, and what it does is it has our patients tell their story, and it quantifies their symptoms. So zero means I feel great, and the further you are from zero the worse you feel. And this is important because for many of my patients, the labs don't have the answers. If the labs had the answers, they would've already been diagnosed. If you already have diabetes, you already know, if you have Lyme, conventional, you know might already know. But a lot of these patients have already been through a million tests, and so what's really important is their symptoms. So I need to know your symptoms because that's how I'm going to track if we're getting better, if your symptoms are getting better we're winning, I don't really need the labs to tell me if we're winning. Conversely, if your labs look wonderful and you're feeling like a hot mess, then who cares about the labs?

So we removed that piece as a criteria to work with me, so we send you a saliva kit, which tells us how your adrenals are doing, it's a cortisol test, and then we send you the software, and the software is really important. Then we have a one-on-one meeting with me and we uncover it, we go over it. And the crux of it is hearing the story, because you have to take a moment to connect the pieces, because if you go to your primary care for five minutes, they're not bad people, they're wonderful people, they do good things, they have five minutes and they have to hear, what is your problem today? They do not have time to go back to what's your symptom? What are we doing? And today, not 20 years ago, there's no room for 20 years now, but 20 years ago it matters, because we're on a continuum, it matters.

So we spend time, it's a 45 minute to an hour conversation, and we uncover it, we find out what are the things that are connecting. And then, there are some patients where that's enough, they're just like, "Okay, I just don't wanted to be validated, it's nice to know you Dr. E and goodbye," and that's great, it's a great moment for them too, great moment for me. And then some people are like, "Okay, what do I do to fix it?" And that's where we created a customized plan, and weekly meetings, monthly meetings, et cetera, et cetera, but it's really that first consult where we hear the story, quantify the symptoms, where we can finally figure out what's going on, and then working together to fix that.

Mimi MacLean:

You have like 20,000 patients, or something crazy, crazy good. So what do you find as being the typical? Is there a typical? Is there, okay, in this bucket half the people tend to, I don't know, have Lyme, or they tend to have their gut all messed up and they're eating gluten. Is there something that you see, okay, this is the first thing I look for.

Efrat LaMandre:

First thing I look for is a different question than what's the underlying thing. So the underlying thing for everyone is inflammation, for everyone, and that that baseline inflammation is also going to determine how unwell you'll be when you have something. So if you have Lyme, that's a thing, but how much it's going to affect you also depends on who you are as a host going into Lyme. So the person who maybe doesn't have any chronic issues and hypothetically it has no inflammation going into it might never even know they have Lyme. I have 90 year olds and they're Lyme through the roof and they're fine.

And then I have 30 year olds that Lyme has devastated them, and that's true for any disease, COVID has devastated them, or flu has devastated them, giving birth of a child has devastated them, something devastated them because it threw them over the edge. They already came into this event with so much inflammation in their system, and this last thing, so they'll say, "Ever since, ever since I got Lyme, ever since I got COVID, ever since I had my child, ever since the divorce, ever since whatever, I have not been the same," and it's really about, well who were you when that thing happened? And if you were already an inflammatory mess, yeah that's going to throw you over the edge.

Mimi MacLean:

Yeah, it wasn't that one thing, you had other stuff going on. I look back on my life, and I was as healthy as anything and I got into a really bad accident when I was 14. And I almost died, but it was four years of surgeries, antibiotics, blah, blah blah, and ever since then I've not been the same person, every year it's something. It's [inaudible 00:13:18], this, that, pre-cancer this, I mean it was just nonstop.

Efrat LaMandre:

I get excited and I cut people off, and I'm known to do that, so I'm sorry, it's the New York. But I got really excited, I get in trouble, I sit on the board, I get in trouble all the time, they're like, "I have the floor," I'm like, "I forgot there's a floor, I'm sorry." I just got really excited about your particular example because you're a classic, this happened when you were 14, you're 50 now, get over it. You had Lyme, I don't know when, when did you get diagnosed with Lyme?

Mimi MacLean:

Like seven years, after my daughter was born, my fifth daughter.

Efrat LaMandre:

Okay, seven years ago? So seven years ago, who the heck is going to, in any conventional medicine, going to say that how you are in Lyme seven years ago is related to that accident at 14? And of course it is, and of course it is. But no one's going to, in fact they're going to be like, "No, no, no, 14, that's unrelated.

Mimi MacLean:

Because my gut and everything has been a mess.

Efrat LaMandre:

Exactly, and so it's connecting those dots. So at 14, at the height of when your body's still trying to make connections, and neurons are connecting, and synapses are connecting, and your immune system is still developing, it's 14. I mean this could happen to, but it's certainly at 14 where everything is being molded. You get this huge trauma, physical trauma, which is an inflammatory cascade in and of itself, like if the accident by itself wasn't enough, let's just say you got up and walked out of the accident. But then every surgery is a trauma, every antibiotic is a complete trauma to your microbiome.

So yes, are you a walking, talking, performing human at age 20, 25? Sure, but you're not optimized health-wise, and there's no conversation at that time like, are you taking your vitamins? Are you optimizing microbiome? You're just living your life eating a standard American diet, I'm making assumptions, I don't know you. And then a little hit there, a little hit there, and then you're like, every sore throat really gets me in bed three days, why, why? Because of what happened when you were 14. So then Lyme comes around, you got no shot, that was it.

Mimi MacLean:

So when you work with people, you go back and you try to get back to where that turning point was, or what really is the cause of what's happening.

Efrat LaMandre:

I try to show them that it's all connected, because a lot of us are taught, like I have a patient right now I'm dealing with, she has cancer, so in her mind everything's about just cancer. I mean, of course, it should be, she has to focus on that. But when you look back at her, everything, how she's going to come out of this is really going to depend on how much we deal with all the other stuff prior to it.

So sometimes they don't find the aha moment, and it all depends how much the patient shares on the software, because sometimes people are a little lazy and they're like, "It's a lot to answer, I don't want to answer it," I'm like, "Please answer it." Once you connect the dots you start to understand that we have to pull the camera out, we cannot look at just the Lyme, or just the cancer, or just the thing that's happening right now and say, how did we get here? Because that's the only way we could start to fix it.

Mimi MacLean:

Mm-hmm. And then as far as what you do to help people, is it primarily diet, supplements, herbs, IVs? What tend to be your toolkit?

Efrat LaMandre:

Okay, so I start everyone on nutrition, and if you read my book, by the way, it's free on Kindle or something, this is not a push for the book, it's 20 bucks, it's not going to make or break anything. But I just want to put it out there that if you read this book, I'm saying the same thing that I'm saying now. I start with nutrition, because 90% of you listening will already feel better, and if you already feel better than who the hell cares about the rest of it, don't even go down the rabbit hole of testing and functional medicine providers. Myself included, if you feel better, you're done. I say in the book, "Take this book and give it to the next person."

So always start with nutrition, because nutrition, there's two components, one is that if you are eating things that are not great you're causing inflammation, which whatever you have going on is going to be worse, if you have a hormonal issue it'll be worse, if you have brain fog it'll be worse, if you have joint pain it'll be worse, whatever it is. And then the other thing is, is that you're not putting in the good stuff, so you can't help the enzymes and the pathways that need to be helped. So we have to remove the toxins, put in the good stuff. So part of putting in the good stuff also is getting some good supplements. Again, 90% of people feel amazing just with that tweaking.

After that it gets a little bit more personalized, what are we dealing with? Like in your case, if you say, "Hey E, I've been on this amazing nutritional program for the past three months, I'm clean, pooping every day, I'm sleeping, everything's great, I'm still feeling X, Y and Z," well with you, you're going to need really specific supplements for Lyme. With someone else we might need to explore some mold testing, with someone else it might be bioidentical hormones that we need to talk about. But there's no point in going down the vortex of testing if you're not willing to do that first cleanup of nutrition.

Mimi MacLean:

You have to make sure you're pooping, sleeping, drinking enough water, clean diet, right? Because if you don't have those basics, but okay, so your perception of a clean diet, is it the same for everyone, or are you a blood type diet?

Efrat LaMandre:

Generally speaking it's the same for everyone to start with. I don't do blood type diet, generally speaking I do, would say, whole foods, first of all. If you're reading a label, just no, just no. Temporarily, at least in the beginning, I'm not saying for the rest of your life. Real food, actual food that you have to cook. I'm sorry, I hate cooking too. There's ways to do it, it doesn't have to be a whole fancy thing. Plant based, that does not mean vegan. Vegans, when people come and say, "I'm a vegan," and when they have diabetic, pasta, they're eating potatoes, I have so many diabetic vegans. So when the term plant based came out, whenever, a decade ago, I was like, what the heck is this rebranding of vegan? And then I realized, no, it's not the same.

Mimi MacLean:

It's not, it's all about as much vegetables as you could possibly get in a day.

Efrat LaMandre:

Yes, eat the rainbow, and I means skittles, just eat the rainbow, so plant based. Whether or not you choose to get your proteins from animals or not, that's an ethical decision, you need proteins in there, do what you got to do for yourself, but at the heart of it, has to be plants. And then the protein part really is, if you're down for animal protein, obviously it should be good quality, grass fed, and good fish. If you're not down for animal protein, that's okay, we got to make sure we get you good quality plant-based protein. So plant based is primarily where it's at.

Mimi MacLean:

Does that mean gluten doesn't fit in there?

Efrat LaMandre:

No. So initially, thanks for that, initially, in the first month, I put everyone on a grain free, so that knocks gluten right out, legume free, dairy free, of course.

Mimi MacLean:

Nut free?

Efrat LaMandre:

So nut free, it depends. So so just not to confuse your audience, so dairy free, grain free, legume free, and then no starchy vegetables at first, no sweet potato and stuff, and minimal fruit, like berries. We start there, and I'm going to answer your question on nuts in a moment, and that includes nuts. For most people this is a great start, it's hard enough, and then we slowly open it up based on what that person's body is telling us. For example, they want to reintroduce the legumes, we try chickpeas, their stomach hurts, there's no chickpeas. So we let the body tell us what it is.

The nut question brings us to, I'm sure some of your listeners are familiar with AIP, autoimmune protocol, those are patients who in addition to what I said also remove eggs and nuts. It's a very hard diet, I have about four patients who need to be on that. Those are patients that we got 80%, classically, especially with skin issues, like the psoriasis cleared up 80%, but there's just certain areas that are just not getting there, we put them on autoimmune, and that seems to do the trick temporarily as we build up their system. So AIP, I've been on AIP when I did this with my wife a million years ago, AIP is a hard, hard protocol, I don't start my patients there.

Mimi MacLean:

Yeah, let's just don't eat any meat.

Efrat LaMandre:

Just don't eat meat. If I could do that for a month for my patient they'd feel amazing, just don't eat [inaudible 00:22:09].

Mimi MacLean:

Right, like when you reach the point when you feel so sick you just don't eat and it's like, I actually feel better when I don't eat.

Efrat LaMandre:

Yeah, 100%, I hear that all the time.

Mimi MacLean:

Oh my gosh. Okay, so we talked about this briefly before we started recording and I wanted to touch back, your experience so far with COVID, and I say this is because I was humming along, I was feeling great, I felt like I was out of the woods, and I've gotten COVID twice this year, and it has... It wasn't even that, I mean look, I was in bed for a couple days, but it wasn't like I felt like I was dying or anything, but afterwards I just haven't caught my breath, I'm exhausted, I feel like it re-triggered everything. And so I'd loved for you to just talk about, have you experienced that with your patients? What has been your experience with the long haul?

Efrat LaMandre:

Yeah, so this is really, really big, I just really started understanding it the past few months because so many of my patients were complaining about it. So initially I thought, and I'm sharing this in case your audience hears this, initially I thought like what I said earlier, it depends on how you are coming in, if you're already unwell, this will probably take you down even further, and let's work on strengthening you as a host. Which is not wrong, which is great information and we need that, but with COVID it's a little bit more, and that has to do with how COVID enters the cell. So not to worry too much, there's four ways it enters the cell, but the most prevalent way is that it attaches to an enzyme called ACE2. So for those of you Googling it has to say 2, ACE2, not the same as ACE because then they go into a different rabbit hole, so ACE2.

So it attaches to this enzyme called ACE2 that's on your cell. The thing about ACE2 is that it's in charge of processes in your heart, your blood vessel, your brain, your lung, your kidneys, it's in charge of calling down information, it's in charge of making sure you don't form clots, it's in charge of so many things. On a regular day ACE2 is in charge of making sure everything's working right. Now it is busy with COVID. Instead of it being open to doing these things, it cannot do what it needs to do. And so these long haul symptoms that you have, again, I said brain, brain fog, I said respiratory symptoms, your lungs, clots, they're in charge of that, inflammatory, when ACE2 is busy it skips a certain part of the information pathway, so it goes to what's called a cytokine storm, worse information, so if you have autoimmune, your autoimmunity is getting worse.

So all these things that you're feeling, something called dysautonomia, if you have patients that are listening, they have something called POTS, your blood pressure goes up and down all the time, you get to dizzy. All of that is ACE2. So ACE2 is busy now dealing with COVID, so now you have all these symptoms not in your head, you're not crazy. Now there's no medicine to help ACE2 enhancements, so this is why this is not a conversation, I'm not a conspiracy theorist, I'm just telling you what it is, but there are supplements that you can take that will help you enhance ACE2 activity, and that is where it's at.

Mimi MacLean:

That's not the Z-Stack? You know the Z-Stack? Isn't he in Staten Island? Z-Stack, Dr. Z?

Efrat LaMandre:

I don't know him, did he say this?

Mimi MacLean:

Oh, he has a whole supplement regime, it's like zinc, glutathione. I don't know if it's that or not.

Efrat LaMandre:

Yes, and I'll give you some other things, but I'd like to explain the why behind it, because yes zinc, yes glutathione, they're great, but this is the why. ACE2 enhancement is what you need, and the other why is that this suppression of ACE2 causes mitochondrial damage. And by the way, there's no medication for mitochondrial damage. I'm not talking about genetic mitochondrial issues, I'm talking about inflammatory mitochondrial damage. It's the thing that makes us age, it's the thing that makes us sick, and once it's damaged we can't recover, so now we need supplements specific for mitochondrial repair.

So with those two things in mind is how you start thinking of the supplements that you need. Now some of these supplements already, but it's nice to know the why, so Omega-3 helps ACE2, curcumin, resveratrol, helps ACE2, vitamin D, alpha-lipoic acid. Of course fixing your genomes, if you have a genome fatigue, we need to fix your genomes because one of the things ACE2 needs is cortisol, and if you have a genome fatigue you're not producing enough cortisol. And then for mitochondrial we're talking about glutathione, we're talking about NAD. So these are some of the supplements, and then of course your B vitamins, at the very least a multivitamin.

So the point is these supplements specifically targeting mitochondrial repair, specifically targeting ACE2, will help you, along with, of course, what we talk about, which is eating and sleeping and pooping. We can't go out every night and drink alcohol and expect to recover from long COVID. So eating, sleeping, and then taking these targeted supplements is really the key to getting out of it. So with you, and many of your listeners, you have this double whammy, you go into COVID already with trying to recover from your past trauma, trying to recover from your Lyme, and so COVID's going to hit you a little harder to begin with. By the way, you made an excellent point, that even though you weren't very sick, you had mild symptoms, but that connection to ACE2 still happened, and so now recovery is harder as well. So you got it from both ways, coming into it not strong, and then the COVID itself, and that is how long haul is made.

Mimi MacLean:

Yeah, it's a real thing. But the good thing, I almost want to say, about COVID long haul and this whole experience is I feel like that's more accepted and talked about, in the news and media, people are accepting that. It's, oh 20% of people who get COVID get long haul, where no one wanted to talk about, oh 20% of the people who get Lyme get long haul Lyme. It's the same thing, and no one ever wanted to accept it, but it exists, so if it exists for COVID, why can't it exist for Lyme?

Efrat LaMandre:

Do you really want to know the answer?

Mimi MacLean:

I know the answer, but I'm just saying, metaphorically, we know why.

Efrat LaMandre:

We know why, because there's long COVID clinics, you can get reimbursed for it, every hospital has them. Now this is not a question of evil.

Mimi MacLean:

So they're not doing the vitamin that you're talking about, they're doing actual prescription pharmaceuticals?

Efrat LaMandre:

Correct. But you asked why it's recognized, it's recognized because, first of all, numbers. If everybody in America had Lyme, we'd probably have this conversation. So the numbers game, not everybody in America has Lyme, but almost everybody in America was affected one way or another by COVID, so it's a numbers game. So now at 20% of this many people, we have to contend with it, and because we have so many people affected by it, we now can create a system-wide clinics, reimbursement, insurance.

Mimi MacLean:

They have pharmaceuticals.

Efrat LaMandre:

Yes, yes, yes, yes. I just want to say, I'm not saying these people are evil because they use conventional medicine, but the reality of it is that it's going to only be managed if you can reimburse for it, that's just the reality of it.

Mimi MacLean:

And they're only going to reimburse if there's a pharmaceutical, they're not going to reimburse you for glutathione drips.

Efrat LaMandre:

Correct. So there's conversations of whether the medication for COVID can help the long COVID, there's of course the conversation of making sure they deal with all the comorbidities, are your diabetes medication on point, is your high blood pressure medications on point? So we have that part of it. And then there's some trials about whether or not taking famotidine, which helps your belly.q Pepcid, it's the fancy word for Pepcid, so if you take that. So there's a lot of stuff in the pharm world that's being used to help these patients, and God bless, I want them helped, no matter how you get there, get there, but that is why it's being spoken about. It does not, in any way should we draw a conclusion that therefore Lyme is not real, we just don't have enough numbers, and so we didn't create a reimbursable diagnosis for it, that's it. And many of my colleagues hearing this are going to kill me, but that's just the reality.

Mimi MacLean:

No, it's true. And maybe we'll get there, but I guess my point of bringing it up is by this happening, hopefully it helps move along the conversation with Lyme.

Efrat LaMandre:

No, no I doubt it.

Mimi MacLean:

Oh, I know.

Efrat LaMandre:

I'm sorry, I'm sorry, I want to be optimistic like you, but I doubt it. I just doubt it, because I live in both worlds, I go to medical conferences all the time, my first practice is in conventional medicine eg, healthcare, I'm a family nurse practitioner before I'm a PhD in integrated medicine, so I live in that world, I go to those conferences, these are my colleagues, I get it. And then I also live in this world, the functional medicine world, and no, it's not happening.

Mimi MacLean:

I know, maybe, I don't know. We'll see, we'll see. Okay, so let's just circle this back to Lyme to close it out. So if patients come, what tests are you using, if you are giving them a Lyme, if you think someone has Lyme?

Efrat LaMandre:

Probably going to be IGeneX in California, I mean that's just where it's at.

Mimi MacLean:

Yeah, that's like the best, right?

Efrat LaMandre:

They are, they're the best. Again, I just want to say that just because you have Lyme doesn't mean that's where your symptoms are from. So back to your point, you have to first clean everything up, fix nutrition, fix your sleep, fix your relationships, fix your adrenals, make sure everything's on point, and then if you're still there, spending money on the testing. You tell me, I'm sure your experience is, and then Lyme is going to be about taking certain herbs and supplements, there's no medication for it once you're chronic.

Mimi MacLean:

Yeah, it's not worth doing the antibiotics.

Efrat LaMandre:

Right, unless it's new, it's new, if it's a brand new Lyme, then yes, definitely take your antibiotics, but if it's an old Lyme. So now how are these supplements and these herbs are going to work if you are still out here eating McDonald's and not sleeping? They're not going to work on you.

Mimi MacLean:

No, it's true. And then I would also throw in their mold and parasites, make sure you don't have mold or parasites. Those two, you're not getting better without... If you have Lyme, you are not getting better if you still haven't dealt with your mold or your parasites.

Efrat LaMandre:

100% true. Yes, all of that.

Mimi MacLean:

And then you waste your money on some expensive Lyme doctor if they're not dealing with your mold or parasites. If you still have mold in your house, don't go, this is my opinion, if you still have mold in your house and you haven't dealt with it, don't bother wasting your money with some expensive Lyme treatments, because you're not going to get better. You got to deal with the mold at the house, get out of your house, go deal with the mold, you're just reinfecting yourself every day going back there

Efrat LaMandre:

If you're mold sensitive, because remember, you could have a whole family in a mold house, and four people are fine and one person's sick, because it's about your ability to detoxify, because mold is everywhere. So you might be exposed to mold, you might even have mold in your urine, but that might not be the cause of the symptoms either, because if you're someone who detoxifies mold, that might be your issue. So I agree and don't agree, I agree all of it should be addressed, but there are some symptoms that are really mold specific, people who will say you have these brains zaps, electrical zaps, are really, really sensitive to smell, there's certain things that are so mold specific then you're like, okay, we should probably address this before we address the Lyme. So you could be positive for so many things, but if you don't really have symptoms that go with that, that might be second or third on your list.

Mimi MacLean:

Right, so you go right off of the symptoms.

Efrat LaMandre:

Yeah, I really try to go off, I mean the tests, of course, but then also the symptoms to decide what to attack first.

Mimi MacLean:

Mm-hmm. Okay, so anything else we haven't covered that you would to cover before we go?

Efrat LaMandre:

Just if you're at the end of this podcast and you made it all the way here, first of all, you're awesome that you didn't speed through it. You could listen to us on two times speed, but at least you got here. And then if you're this far along in the podcast you're obviously hurting in some way, or someone that you love is hurting, so I just want to say kudos to you for being in the search, and you're not crazy, you just have to find more people like us, and together as a community we will help each other.

Mimi MacLean:

Yeah, and stick with it. I mean, I just feel like mentally, you get to a point you're like, how much more can I take? The pain and the suffering, or seeing somebody you love have pain and suffering.

Efrat LaMandre:

My patients, what we started doing this year is we created my patients only, every Tuesday, whoever wants to just joins the Zoom, and we just share, it's ask E questions, but in that people are sharing what's happening to them, which is helping each other know that, "Oh my god, that's your thing? That's great, because I have this thing." So finding communities is really important, but not communities that are going to make you jump off the deep end, communities with the intent to get better is really important.

Mimi MacLean:

Right. And just know you're going to get better. I do think you have to mentally believe that.

Efrat LaMandre:

You need some faith, you do need some faith.

Mimi MacLean:

You just got to find it. But you know what's amazing, and I don't know if you find this with your patients, is one day I feel so good. And the next day I'm like, I want to throw in the towel, I am done, I'm in pain, my life sucks.

Efrat LaMandre:

Yeah, and I'm actually glad you brought that up because there's so many reasons that can happen, because we forget that things are delayed. So if today, Wednesday, I don't feel good, you can be like, how can't I feel good? I ran today, last night I ate a salad. But what did you do two days ago? What happened, two days ago did you go out to eat and you had pizza and a martini, or did you get into a fight with someone, what happened two days ago? We forget ourselves that it's linear.

So always look back, not just that day, but like, I've been eating so well today, why do I feel this way? Lie yesterday was a classic day for me, I was exhausted by 3:00 seeing patients, like why am I so tired? And I'm like, oh yeah, this whole weekend I was at a conference lecturing, so today, Monday, I'm tired. I wasn't tired then because I was running on adrenaline, but Monday, my first day back, I'm exhausted. So you have to look back two or three days. And then, in our age group, we also have to discuss hormones. If your hormones aren't optimized, you're going to have some weird days, even though everything is fine. So many variables you have to look into, but again, if you have that faith that there is an answer, you're not crazy, and you will get there.

Mimi MacLean:

Yeah. Okay, can we end on one other thing? I thought of one question, I thought really important, because I've been reading a lot about it with the 5G rollout, what is your take, or do you have any opinion about EMF, and do you deal with that at all with your patients?

Efrat LaMandre:

I don't deal with it with my patients specifically, it's so big I honestly don't even know how to tackle it. As I sit here with these earphones and I debate them myself, I only wear these earphones on podcasts, I won't wear them in real life.

Mimi MacLean:

For anybody can't see her and just listening, it's just-

Efrat LaMandre:

The wireless ones, and I only wear them on podcasts, I stopped wearing them in real life. It's huge, I don't even know how to begin to tackle it, because for me to tackle it I have to find a solution, and I don't know how to get out of it.

Mimi MacLean:

I know, that's the problem, and that's why I wanted to bring it up, because I feel like it's becoming more and more prevalent with the 5G rollout, and so I want to find out what people are doing, like if you have something in your house, wearing a necklace, or I don't know, whatever, which one works? Because there's a lot of stuff out there.

Efrat LaMandre:

So much stuff. And I'm trying to stay sane, and my wife already thinks I'm crazy. There's only so many rabbit holes you can go down. I don't have, at this particular rabbit hole, I have not begun to go down, but I empower those of you who do, it's not insane. That's all I could say.

Mimi MacLean:

Yeah, anybody who's listening and gone down that rabbit hole, I'd love to have you on, because I'd love to chat about it, because I feel like it's a big rabbit hole and I don't know even, and I do think it causes a lot of issues, health issues on people.

Efrat LaMandre:

There's no doubt, there's no doubt.

Mimi MacLean:

Okay, Doctor E, this has been amazing. So anybody who wants to learn more, she has a great email, and great website with great videos, and it's TheKnewMethod, K-N-E-W, method.com.

Efrat LaMandre:

Yes, and especially on TikTok, I put out educational videos two, three times a week, and so it's great little quick snippets to just get informed.

Mimi MacLean:

Oh, good for you, that's great. Okay, awesome, thank you so much, I really appreciate it.

Efrat LaMandre:

It's a pleasure, thank you for having me.

Mimi MacLean:

Each week I will bring you different voices from the wellness community so that they can share how they help their clients heal. You will come away with tips and strategies to help you get your life back. Thank you so much for coming on, and I am so happy you are here. Subscribe now and tune in next week. If you want to learn how I detox and you want to check out my detox for Lyme checklist, go to Lyme360.com/detoxchecklist. You can also join our community at Lyme 360 Warriors on Facebook, and let's heal together. Thank you.