Chapter 1: What are the three pillars of health according to Dr. Gabrielle Lyon?
You had two original pillars of health, which were eat and exercise, but then you had to add a third one.
I did. The third one was environment and is environment. Do you have time for a quick story?
Yeah. Yeah.
I graduated medical school, obviously, and then did my fellowship. And when you finish your fellowship and go into private practice, you kind of think you know everything. And I was convinced the key to health was diet and exercise. It was all lifestyle. And I was wrong. I had this patient, very successful patient, CEO of a major company.
She was a female as she was doing everything she was supposed to diet and exercise wise, and she was feeling terrible and also gaining weight. I said, no, no, no, it's definitely diet and exercise. And in fact,
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Chapter 2: How does environmental exposure impact health?
A handful of years later, I had to call and apologize because it wasn't just diet and exercise. She had significant exposures that really affected her health and wellness. And I think these exposures affect a lot of people. And, you know, at the time when I was beginning my practice, it wasn't common and we weren't even thinking about it.
So is it getting more common? The talk of complex illness caused by mold, gut health, BPAs, heavy metals, Lyme, parasites, like this, whatever this world is, seems to be kind of gaining speed. Is this because more people are getting it or because we are detecting it more effectively? What do you think is going on there?
It's both. We have more exposures than arguably we've ever had now with microplastics. And we are getting better at acknowledging and detecting it, but we're still not there. So for example, mold. Mold exposure, this is, we hear a lot about it now in terms of buildings with mold or locations and this musty smell. And oftentimes we think that it really doesn't affect people.
However, there are certain people that will move into these buildings
Chapter 3: What are the common environmental toxins affecting our health?
walk in there, break out in a rash, have brain fog, fatigue, feel terrible. And it's this exposure to mold mycotoxins. But the reality is, for a testing perspective, we don't have validated tests for mold. However, I think it's really important that we test for it. But it's not like you walk in and you do a blood glucose test and there's this diagnosis of diabetes. cut and dry.
We don't have that.
Well, no, we don't. Well, you do get stuff like the total tox test. Now, obviously, sort of peering under the skirt of what my last two years has been like, this is a topic of particular interest to me because this is what I've been battling through. But since releasing the health vlog thing that I did a couple of weeks ago, a couple of months ago now, I guess,
the number of people that reach out and say, I lived in a house that had mold, or I had parasites, or I had, I'm dealing with Lyme, or I'm dealing with leaky gut, or I had, you know, fucking H-pylori, whatever. This, yeah, like multi-system challenge really is kind of like a silent epidemic. And it doesn't matter which angle you come into it at. But yeah, as you say,
you can say you are a mold person, like you have been in a house with mold, but you can do stuff like a total tox test, right? Which comes back and you can see, wow, those numbers are right off the chart. But yeah, the main sort of takeaway, I think that I've learned from the last couple of years is how many people are
And living a life that they thought was just getting older or a natural byproduct of, I'm just tired. You know, people are tired. Like, people get tired all the time. Like, yeah, my mood, maybe it used to be a little bit high when I was young, but who doesn't get a bit more moody as they age? Whatever. You know, just chalking up to entropy, something which can be explained by environment.
You know, there's a component to what you're saying that I think is really valuable. And there's a level of diagnostic uncertainty. And people go to their doctor and get all of these blood panels done and everything looks, quote, perfect. And the reality is, These are just a series of biomarkers that we're aware of and that are important.
And when I say biomarkers, I mean testosterone and thyroid, things that are common and we need them to be functioning well.
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Chapter 4: How can mold exposure affect physical and mental well-being?
But there is now a whole host of other influences that really end up affecting the way people show up in their lives. the way that they think, the way that they function, their mood, their energy, and oftentimes it's unexplained. Or what about this?
Arthritis or myalgias or joint pain, this inability to recover the way that they used to, we are seeing a lot more influence from the environment, whether it's mold, whether it's Lyme, parasites. I mean, the reason that I got interested in this was because I started my practice, I finished fellowship, started my practice in New York City. Started with celebrities and professional athletes.
And as much as I loved them as humans, it wasn't my calling. Then walks in the first operator. And when I say operator, I mean SEAL. This was a guy who'd been all over the world, came to the office, and his blood work looked weird. And he had been to all these other places. So he had just transitioned out, been to the Mayo Clinic, had been to the Cleveland Clinic. And oddly, he felt terrible.
Even though his testosterone was optimized, his sleep was great, he was exercising, and he had some weird inflammation of markers on. that showed liver elevation and just some really nonspecific type stuff. And it turned out that he had a weird parasite called schistomoniasis that he had gotten from swimming in some obscure river and ended up really affecting him.
Here was this big dude who was becoming anemic and also had issues with his liver. Had we not caught that, I hate to think about the downstream effects having gone undiagnosed.
What happens if you leave a parasite undiagnosed and untreated for too long?
Well, for things like schistomoniasis or entamoeba histolytica, which are really common, it can end up damaging your liver. And that is a major, major problem.
How many people do you think have got parasites that don't know it?
A lot. And a lot more that are going undiagnosed because parasites are not just in isolation. So for example, you don't just go eat sushi and then get giardia. You might go eat sushi, which I hope no one does, and then you go to the bathroom and you're living with someone and that person goes to the bathroom and then they get it. Or you get your idea.
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Chapter 5: What role do parasites play in complex health issues?
Maybe you're having a little diarrhea or just something that seems very nonspecific. And it turns out that you have a helmet or a hookworm infection. It's much more common that you think. And because food is all globally sourced now, it's not as if we're going to this fancy restaurant and because we're at this restaurant, it's safe. It's just not that way.
Okay, that was the first slow down a second, the sushi. The second slow down a second thing. The impact of parasites being left for too long is very, very intense. And if you go and have that and then go to the bathroom, the people that you live with can catch your parasite from you going to the toilet and then them going after you.
Yeah. So I found this out the hard way. Not for me personally, but I found this out from a patient of mine. And what happened was this woman would seem to continue to get these cyclical parasites. She was symptomatic and these symptoms were not crazy. They were abdominal bloating, a little bit of diarrhea. It didn't matter what she ate. We would treat her.
She would have an infection, a worm infection. You know, you pick it. And then a few months would go by and she would catch it again. Meanwhile, her husband was totally asymptomatic. But we ended up having to test him too because what we see often is one partner has symptoms and the other partner doesn't. And that partner who is untreated continues to give it back to the other partner.
But how do you know it's from the toilet?
Well, it's one of the most common places. It could be toilet. It could be sheet.
Wow. Okay. So these parasites will find their way into the human body however they can.
They can. And when someone is feeling, again, these nonspecific symptoms, one of the first places that we always look is to a parasite. And I will tell you this, and this is quite disappointing, is the way that we test for parasites is standardized. And it's called a PCR test. Someone goes and you do a stool sample, maybe you do a three-day stool sample, something of that sort.
It is supposed to catch nearly all of it. It's very sensitive, 95 to 100% sensitivity. That is not what we have found. And, you know, I've had one patient where we would continue to do these PCR testing, but they were very symptomatic and we couldn't figure out why he wasn't coming back positive.
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Chapter 6: What diagnostic challenges exist in identifying environmental illnesses?
I know it's gross and disappointing, but the reality is while we think that these parasites are easy to test for, and in theory they should be, I and many other providers are not seeing that in real life practice.
What's a better approach to testing if somebody wanted to do that?
microscopy. And again, this is not the standard of care. So an infectious disease doctor listening to this would be like, no, it's PCR testing. You're going to get it and you're going to find it. And the reality is we don't see that. We see that if someone is still symptomatic and also doing multiple stool tests where it's negative, you have to take a step back and think, okay, I hear that
Your test is negative, but the reality is when it is done in this old school fashion, which is under the microscope, things show up. And when they show up, you actually can treat it appropriately.
What are some of the other places that parasites are coming from outside of sushi and the toilet bowl or sheets of your infected partner?
Animals, dogs, giardia. Unfortunately, there's many people that love their animals, right? Of course. But when that dog is licking you in the face or sleeping with you in the bed, it is oftentimes a vector for some kind of parasite.
Okay, so treat the dog first, the husband second, and yourself third. Is that the...
That's about right. Yeah.
Okay. The priority. All right. Dig into the mold stuff for me. Obviously, I don't know whether it's going to be as common outside of the US. I get the sense that the US is particularly bad because you guys build your houses out of timber. Yeah. you decide to build them out of organic material and it gets wet and hot and wet and hot while it's being built.
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Chapter 7: How do emotional stress and environment interact in health?
And there's a number of reasons to why that is. I will say that according to the American College of Medical Toxicologists, which these are in the group of individual doctors that look at the environment and these exposures, there is, according to them, there's not really a diagnostic criteria for mold.
What's a diagnostic criteria mean?
Meaning, if I were to state this simply, we have a diagnostic criteria for something like diabetes. Diabetes is elevated blood sugar, you know, either from one blood sample or two hours later, you still see this elevated level of blood sugar. This is a diagnostic criteria saying you have X, therefore you have Y. Yep. When it comes to mold, there is a lot of controversy around this space.
So the traditional environmental doctors that this is their area of specialty do not recommend these deep mold detox protocols. They don't recommend urinary mold testing. And I will say, I understand that body of work, and there's a whole host of other physicians that are seeing something different. And so there is a little bit of a disconnect.
I will tell you for myself, I got extremely sick with mold 10 years ago, and I had no idea. It wasn't in my mind. I just moved to New York, moved into this apartment. I don't know, a month after I got there, I could not get out of bed. My vision changed. I couldn't get out of bed. I was exhausted. I had terrible brain fog. I could barely function. all my labs look perfect.
I found this environmental doctor. She's out of practice now. And we did a whole host of obscure at the time blood work that looked at lipophilic solvents like toluene and VOCs and mold and, you know, mold byproducts. And I had extraordinarily high levels. And then I had my home tested and there was a ton of black mold.
All this to say that mold is not necessarily recognized as something physicians diagnose and treat yet. this is where the art of medicine comes into play.
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Chapter 8: What future trends in environmental medicine should we be aware of?
And I'm hoping that the medical field in some aspects will catch up because we are seeing this. Meaning if someone goes into a house and they smell that musty smell, this is something typically created from a mold or an offshoot of mold and it's there. And whether someone believes that they are sensitive or not, and perhaps there's a genetic component to it,
I personally am in medical practice and I am seeing more and more patients extremely sensitive to their environments. And again, mold is one of them.
What is happening in the body? So you live in a house with mold. What does that do? What's the vector? Are you breathing it in? Is it in water? Like what's going on?
Um, well, if you look in the literature, the literature will say that foods are the primary source of mold and mycotoxins. However, in the environment for those individuals that are sensitive, one of the first things that we see is we see a ton of brain fog, ton of headaches.
Um, oftentimes we see rashes or they break out, they walk into a room and they get this massive response, you know, and of course there is that allergy, allergic rhinitis, coughing, congestion, um, You know, we see these environmental exposures that they can affect brain function, cognition.
Again, I have to say that it's very tricky because we're not there from a medical standpoint in the literature, but us individuals that are seeing patients, we do see this. I don't know if you've ever experienced that when maybe you're in a new hotel room, but these things are real problems.
Well, I mean, the house I was living in, as you know, really sideswiped me. And I was getting shouted at. by the guys that do the filming for the podcast saying, why do you keep going in the sauna before you come on set? You're always coming on set super red. But I wasn't in the sauna.
It's that I'd been in my house and I was leaving the house and all of my neck and my face was really flush, which must be some sort of reaction, I guess. And yeah, we tried to remediate the house, the landlords of the house I was living in tried to remediate it. I lived in hotels for three and a half months. Go back into...
the house and within 30 minutes of being in there and they've spent three months cleaning and removing this stuff and micro air filtration things and like dehumidifies all of this shit for ages. I'm within 30 minutes of being back in the house. Like boom, I'm just, I'm like a stoplight. It's crazy.
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