[Rhonda]: But back on the ketones since we're back on the ketone, I do want to get to the
Lyme disease because it's a topic that I avoid.
I've never talked about it.
[Tim]: It's one I avoid too.
[Rhonda]: I always have this knee jerk reaction because the signal to noise ratio is so small.
I feel like there's just a lot of confusion.
[Tim]: So much nonsense.
[Rhonda]: But I'd be really interested because you're a very analytical person.
[Tim]: I try to be.
[Rhonda]: So obviously it's a real disease.
People suffer from it.
You can observe spirochetes under a microscope.
So it's definitely real.
It's just a lot of craziness that seems to be associated with it.
But maybe you can talk a little bit about . . . because you mentioned going on the ketogenic
diet to treat your Lyme disease.
Can you talk a little bit about what you found in terms of your experience with Lyme disease
and how you got to treating it with ketogenesis?
[Tim]: Yeah.
I can talk about it.
So where to begin with this . . . First of all, I'd just like to agree with you and sort
of emphasize for everybody that the amount of nonsense and charlatanism out there surrounding
Lyme is just beyond belief.
There are so many fraudulent companies and practitioners who are just printing money
by either misdiagnosing people with Lyme or treating Lyme in the quackiest of quackery.
[Rhonda]: Why Lyme?
[Tim]: So here's my thinking.
So I contracted Lyme on Easter in Long Island.
If you look at the CDC map, the Center for Disease Control heat map for Lyme disease,
that is ground zero.
That's where the bomb went off.
Lyme is named after Lyme, Connecticut.
So it really has historically focused on that Northeastern area--Pennsylvania, Upstate New
York, Hudson Valley.
I think Lyme has become this popular topic of conversation for a few reasons.
Number one, it's poorly understood on a lot of levels.
So there are ample opportunities for non-scientists and quacks to sort of invent stories around
it.
[Rhonda]: That makes sense.
[Tim]: Number one.
Number two, it's scary.
It involves a bug biting you and you catch this disease, so the media loves it.
The media loves it.
The media writes about it.
Then the media sometimes correctly, often incorrectly lists the symptoms of Lyme disease--joint
pain, depression, fatigue--it's like, "Well, that's one out of every two people in the
United States at some point every year."
And then people go, "Oh, my god.
I've had my . . . " I got an email from a friend of mine who says, "My shoulder has
been bothering me for a couple weeks and two of my friends said it might be Lyme."
I'm like, Oh, god.
I would bet $1,000 it's not Lyme disease.
Given where you live, given the likelihood of having contracted it, it's just so unlikely
for most people.
Now, all of that having been said, Lyme is a real thing.
Like you said, you can observe the spirochetes under a microscope.
I think another reason it's popular to talk about is people love saying the word "spirochete."
I'm not kidding.
They love saying spirochetes.
They imagine this screwdriver, this horribly evil like Maleficent like spiral bug that
like digs into your body and like the antibiotics come in and they're like, "Oh no, we're going
to hide from the antibiotics."
It's not that sentient.
[Rhonda]: My husband's grandmother says spirochetes like at least every conversation that I have
with her.
[Tim]: People love saying spirochetes.
So you get it.
[Rhonda]: Yes.
[Tim]: So for all these reasons it's popular to talk about.
I think primarily because the symptoms overlap with a million other conditions.
What I came to realize for myself is like yes, it's a real thing.
It's almost certain after Western blot tests and ELISA tests and looking at all the diagnostics,
which are really primitive, it's very likely that I already had Lyme disease at some point
because I've been bitten by ticks hundreds of times.
Almost everyone in my immediate family has had Lyme disease.
On Long Island, it's just kind of like, "Suck it up.
Take some antibiotics.
You're fine.
Move on with life."
It's not viewed as like a huge crisis by everyone who gets it on Eastern Long Island because
it's so common.
So I shrugged it off.
I took three or four deer ticks that were embedded off of me in the span of two or three
weeks.
It historically hadn't been a big deal.
So I was like, "That sucks."
Pick it off, make sure the head is not in there, move on.
I did not develop what's thought of as the trademark bullseye rash.
So I ignored progressively worsening symptoms for eight weeks where my joints started getting
very sore, swollen.
I had trouble getting out of bed in the morning.
I started getting slow cognitively and had trouble recalling friends' names and just
really common words and eventually got to a point where my assistant was like, "I've
seen you sick.
I've seen you tired.
I've seen you burning the candle at both ends.
This is none of those things.
You need to see a doctor."
[Rhonda]: It sounds like dementia, like not remembering friends' names.
[Tim]: Yeah.
Things are really funny.
If you look at the advanced symptoms of severe Lyme, it takes on dementia-like qualities,
even cerebral palsy in some cases, really scary stuff.
So long story short, then I get diagnosed with Lyme.
When I walk into the clinic on Long Island, to give you an idea of how common it is, so
this walk-in emergency clinic open on the weekend, they had a poster up that was like,
"Hey, allow us to send your blood sample to such and such lab, Upstate New York, to do
research on Lyme," and there's a picture of a tick, "And we'll give you a free $50 Amazon
gift card."
It's that common.
But then the question was, "Okay, I have Lyme."
I'm taking doxycycline.
I do that for eight weeks or 12 weeks, whatever it was.
I still feel really shitty.
Now what?
[Rhonda]: That's a long antibiotic course.
[Tim]: Yeah.
Some people take antibiotic for years, which I think is not the thing to do.
This is where I am and I'll try to sum it up because this can be a very long conversation.
I think that there are very, very credible scientists and infectious disease specialists
who do not believe that chronic Lyme exists.
Their position would be there's no evidence that the whatever it is, the borrelia spirochete
cannot be eradicated with broad spectrum antibiotics like a doxycycline or something else.
There's no evidence to suggest that they burrow away and hide and come back, hide in biofilm
or whatever.
[Rhonda]: Yeah, right.
[Tim]: Right.
Then you have people, and there aren't that many, but a handful of people who are like,
"Well, it is possible that this Lyme could behave something like herpes simplex," where
it's like a recurring infection essentially and maybe it takes root in the nervous system
somehow and only comes back out in times of stress.
There are people, credible doctors who have been like, "It's not completely beyond the
realm of possibility that is has some recurring nature."
Okay.
Still, kind of descriptive, not prescriptive, what do we do?
Right?
Then the theory that I kind of came up with, and I'm sure other people have come up with
it, but I haven't read it, I was like, "Well, let's look at the symptoms of Lyme.
You have like depression, fatigue.
What are other potential causes after a long course of antibiotics?
Well, maybe you just completely scorched earth your microbiome among other things.
So one of my theories is that what people perceive as chronic Lyme is in fact a collection
of similar symptoms caused by the long course of antibiotics.
So you should focus on prebiotics, probiotics.
I have had a tremendous amount of difficulty, at least as measured in common stool testing
and so on, in repopulating my gut diversity.
It's been extremely hard.
I have consumed just about every type of pre and probiotic imaginable.
I've also tweaked my diet to be more favorable for certain types of gut repopulation.
It's been really tough.
I did like a three-month intense protocol of all sorts of stuff.
So I'd love your thoughts.
I did a follow-up stool sample analysis and it was still like, "No, you're fucked."
I was like, "Wow . . . " depressing.
[Rhonda]: So you're talking about measuring your fecal bacteria population using uBiome?
[Tim]: Yeah.
UBiome or there are others, like Rocky Mountain blah, blah, blah doctors data, whatever it
was.
[Rhonda]: Okay.
There are other ones.
[Tim]: Yeah.
UBiome has a slightly different approach, but along those lines.
[Rhonda]: I agree with you for one.
First of all, I heard a podcast that you did with Jessica Richman from uBiome and I think
you had talked about this and that's how I became first aware the link between . . . when
you mentioned having this hypothesis that you thought possibly some of these symptoms
of Lyme disease were a symptom of complete gut disbiosis where you're taking several
rounds of antibiotics and you are obliterating your gut bacteria, a lot of the good ones
are going away.
If you don't take a very strong probiotic immediately after antibiotics, it repopulates
with all the bad stuff and it's really hard to get because they occupy space.
They're sitting in what's called the mucin in the gut.
They have to stick in the mucin to stay, otherwise anything you take will kind of just flow through.
It's kind of like the flow through.
So it's really hard to repopulate.
I've been doing a lot of self-experimentation.
I've been using uBiome to track my gut bacteria genotypes.
But have you tried VSL3?
[Tim]: I have it in the refrigerator right now.
[Rhonda]: Do you?
[Tim]: Yeah.
[Rhonda]: Okay.
So the sachets are what I recommend because . . .
[Tim]: Yeah.
I have the capsules.
[Rhonda]: The sachets have 450 billion, which is more than what the capsules have.
450 billion is ten times more than what most probiotics have.
The thing about VSL3, very interesting, so it's the probiotic that I take.
I'm taking it because I've had some gut issues that started in graduate school because I
got MRSA.
[Tim]: Yeah.
That's not fun.
[Rhonda]: Antibiotics were the prescription and I had several courses of strong ones.
Finally, it kept coming back and I was like fed up.
[Tim]: How do you get MRSA?
[Rhonda]: I don't really know.
I worked in a hospital.
[Tim]: Is that methicillin-resistant Staph?
[Rhonda]: Yes.
Aureus.
Staphylococcus aureus.
[Tim]: Staphylococcus aureus, yeah.
[Rhonda]: So I worked at a children's hospital.
[Tim]: That's a good place to get it.
[Rhonda]: They're everywhere in hospitals.
Who knows where I got it?
The point is I got it and it sucked.
Finally after like, I don't know, three or four rounds of antibiotics, I would take it
and it would go away and then a month later it would come back again and again.
I was like, "I can't do this."
So I read the literature, with the help of my husband Dan, that garlic and grapefruit
seed extract, a concoction of things, I applied both topically and made a cream and I orally
took and within 24 hours I got this thing to come to a head, pus out, it never came
back.
[Tim]: Interesting.
[Rhonda]: But as a consequence of antibiotic use, I had serious gut issues, led to IBD.
I've finally been able to recover.
[Tim]: IBD, irritable bowel disorder.
[Rhonda]: Inflammatory bowel, yeah.
[Tim]: Inflammatory bowel disorder.
[Rhonda]: But it's been a really, really long journey in tweaking my diet.
Doctors, of course, I went to see doctors and they were just like, "Here, take an SSRI,
it helps with the pain."
I'm like, "I'm not going to take an SSRI.
[Tim]: Yeah.
No thanks.
[Rhonda]: I walked out of that doctor, like, "You're insane."
This was like a pelvic pain specialist doctor.
So I've just had terrible experiences with doctors.
Finally, I'm like, "Why aren't you asking me about my diet, fiber, things like that?"
So I tweaked my diet and did lots of things.
But VSL3 . . . [Tim]: With the uBiome testing, have you seen
. . . I haven't done a follow-up test in a few months, but I have been taking VSL3, so
now I'm optimistic hopefully.
[Rhonda]: So I did a 30-day VSL3 course with the sachets, which are 450 billion and did
a stool test.
I'm still waiting for those results.
My husband and I both, Dan, he's done a recent course of antibiotics.
So I had him do his baseline and then right after, literally the day he stopped taking
antibiotics, did a sample for uBiome.
I got that data back, so I've been looking at that.
So I'm going to talk about all that.
It's really complicated and things in the literature are confusing and some people think
some things and they're actually not true.
So I've been looking at other people's uBiomes.
I'm going to be doing a series of talks on this.
[Tim]: Cool.
[Rhonda]: I'm pretty excited.
[Tim]: I'll check them out.
May I add just a little bit of color on the ketosis?
[Rhonda]: Yes.
[Tim]: The color there is I began looking at fasting as a tool for many, many different
reasons.
And whether that be related to, say, longevity or the reason I was excited about it is I
was looking at it as a reboot of the immune system, even shorter fasts, three days.
I began playing around with fasting.
Then, of course, you fast long enough and you go into pretty deep ketosis.
[Rhonda]: Correct.
[Tim]: So it was almost an accidental discovery for me whereby I had not been in nutritional
ketosis for 10 years, 15 years.
I did a lot of experimentation with the cyclical ketogenic diet when I was in college and competing
as an athlete.
Then I just stopped because it was kind of a pain in the ass and it was really boring.
But then I did this fasting to help reboot my immune system.
I'll keep it simple.
So rebooting my immune system kicked over into deep ketosis and it just felt amazing.
My cognitive function just went through the roof compared to what I had felt up that point
after Lyme disease.
I was like, "Well, this is very interesting, isn't it?"
I said, "Well, I don't have to fast to be in nutritional ketosis.
So let me now play around with ketosis and see what I can discover just by tracking and
logging a lot of data."
So I have my pet hypothesis about the gut biome and the antibiotics leading to symptoms
that appear to be Lyme when in fact they're caused by something else.
Another hypothesis, and the reason I'd like to dig into this, but I haven't come up with
a great plausible explanation for this, is that Lyme or the antibiotics or both somehow
interfere with carbohydrate metabolism.
That's just a starting point.
But because I've been public about the Lyme stuff because I was incapacitated, I had to
tell people.
I was like, "Sorry, I'm not going to reply to your email.
I'm archiving 2,000 emails.
Sorry."
"Why?"
"Lyme."
And then people started coming out of the woodwork to be like, "Hey, my wife has Lyme.
She's been debilitated.
What should we do?
What have you learned?"
And the only advice that I gave a few people was like, "Look, there's a lot of BS out there."
So number one is put your thinking cap on and be a good scientist to the extent possible.
Number two is try a carb-restricted diet.
Ideally, go into ketosis.
All of the people who have gone into ketosis have had the same experience I have.
Now, it's a handful of people.
So the sample size is really small.
These are people that like, "Cannot function, had to quit my job," serious cases, go into
ketosis, "Wow, I feel like my old self."
[Rhonda]: Have you measured any changes in gut bacteria after going into ketosis or after
doing the ketogenic diet?
[Tim]: I haven't.
That is also a very interesting topic of discussion.
So what effect does ketosis have on the gut biome or the repopulation, the rate or the
diversity of repopulation?
The short answer is I don't know.
Part of it is, and this is where maybe I'm not being a thorough scientist.
But I felt it worked so well to me that I'm so excited to get back to building things
and creating things and being my old self that I haven't taken the time to dissect it
to the extent I probably should.
[Rhonda]: Your carbohydrate . . . I have this interesting hypothesis that sort of is related.
People that have a severe imbalance of gut bacteria, let's say they have a lot less of
the commensal bacteria which is making short chain fatty acids and metabolites like lactate
that are feeding other good bacteria, they're feeding your gut cells.
So you have less of those and you have more of the bacteria that are methane or hydrogen
sulfate producing, so you get bloated, more of the more pathogenic type of bacteria.
So you have this overgrowth of bad bacteria.
The thing is let's say you eat something that's typically supposed to be good.
You eat something that has a lot of fiber or like vegetables.
So you're getting this fiber that's supposed to be not digested, but the bacteria can digest
it and make it into this good stuff.
Well, bad bacteria can digest that as well.
So you're feeding this bacteria substrates to keep going and to make more of the bad
bacteria.
[Tim]: Right.
[Rhonda]: Now, the interesting thing that I don't know is there are certain species
of bacteria.
There's phyla, class, species, it's incredibly complicated, but certain species only metabolize
fat and I don't know which ones those are and if they're good or bad.
It sounds like you've had a positive experience.
But that would be really interesting to measure in general.
But I'm glad you're feeling better.
[Tim]: Yeah.
[Rhonda]: The ketogenic diet is something that I'm interested in diving into and understanding
more about.