This episode of the podcast features Dr. Nafysa Parpia, a naturopathic integrative doctor working on treating complex chronic illness. She focuses biochemical imbalances, epigenetic expression, toxin exposure, microbial exposure and emotional imbalance to create treatment plans. Dr. Parpia discusses the role chronic illness plays on mental and emotional wellbeing, how to diagnose infection, detoxification protocols, and preventative health tips.
Note: Dr. Nafysa Parpia offers a coupon code for a discount on her services in the podcast. That coupon expires on 1/31/18.
3:00 Chronic infection in the immune system
5:26 Relationship between an infection and a biotoxin
6:28 Types of infections
10:17 Environmental toxicity & increased autoimmune conditions
13:35 Heavy metals & detoxification protocols
17:55 Symptoms of parasites
25:18 Role of chronic infection on mental & emotional wellbeing
29:55 Dysbiosis & gut health
33:30 Dental infections
40:01 Sinus infections
44:05 Tips for mouth hygiene, oil pulling, tongue scraping
47:12 Tips for gut microbiome health
52:46 Tips to reduce infectious burden & increase immune function
55:57 Recommended diet & nutrition books
56:25 How to find a doctor to work with
59:22 Diagnostics, metabolomics, and prevention
Mentions in the Episode
Recommended Books on diet & nutrition
Daniel Schmachtenberger: Welcome, everybody. This is the Neurohacker Collective Podcast. My name is Daniel Schmachtenberger, I'm with the research and the development team here at Neurohacker, and we are delighted to have Dr. Nafysa Parpia with us today [00:00:30] talking about the role of the microbiome, dysbiosis, and chronic infection on mental, emotional, psychological, cognitive, health, and wellbeing. Huge important topic that we haven't got to give into on the podcast yet.
Dr. Parpia is a naturopathic integrative doctor. She did her schooling at Bastyr University, and then actually went and did a year of training at the Sophia Clinic with Dr. [00:01:00] Klinghardt and some of the world renowned doctors there working on complex chronic illness cases, infection, toxicology, many of those underlying drivers of complex illness, and has worked in a number of cutting-edge facilities since then. She's currently at Gordon Medical, which is largely focused on chronic complex illness in the Bay Area. They're doing some really pioneering work on clinical metabolomics. Her practice is kind [00:01:30] of half and half between people who are seeking optimization and life-extension on the wellness side and people who are working with chronic illness. Then obviously infection and microbiome is just one part of it, but it's a part that she's done a lot of work with. We wanted to dive into that. Nafysa, welcome. Thank you for being here today.
Nafysa Parpia: Thank you for having me, Daniel. Such an honor.
Daniel Schmachtenberger: Yeah. We're happy to have you. Nafysa and I have had the opportunity to actually work [00:02:00] on a few people's cases together, so actually kind of compare notes on addressing things like infection. Knew this would be fun. For a lot of people, the idea of chronic subclinical infection doesn't even make sense. There is a classic idea of acute infection. You have C. Difficile, and you have to get on antibiotics or you're going to die, or you have acute flu or MRSA, whatever it is. [00:02:30] Asymptomatic or where the systems are delayed in time or non-obvious infection is something that the integrative functional naturopathic medicine community has focused on for a long time, many traditional systems of medicine have. It's not one of the common parts of western medical focus, except in cases where now there's more awareness for things like the role of H pylorian stomach cancer or viruses and certain kinds of cancer. That's increasing [00:03:00] in awareness. Can we just start by talking about chronic infection that is not acute? What's that about?
Nafysa Parpia: Yeah. Very often there can be infections in certain areas of the body, dental, in the sinuses, but people have no idea about it. Essentially these illnesses are contained in the immune system. They're completely without symptoms. It can be [00:03:30] viruses, bacteria, even Lyme and [inaudible 00:03:33] infections. People can be walking around with such infections and have no idea about it until there's a stressor. That stress depletes the immune system. All of a sudden now they're walking around with symptoms. I see a lot of patients like that. Stressors can be physical, often motor vehicle accidents. They can be emotional or mental stresses, anything that brings the immune system down and that [00:04:00] allows for the microbes to fester. Suddenly, the person's showing symptoms.
Daniel Schmachtenberger: One of the key ideas here is that if someone starts showing symptoms, it might not be that the infection happened right before then. It might have been that there was infectious exposure that stayed below a particular level long term. This is often times the case with someone who has a long term chronic herpes infection, a physical or emotional stressor can actually bring about an outbreak that can happen with [00:04:30] lots of other kinds of infection.
Nafysa Parpia: Absolutely. Yeah.
Daniel Schmachtenberger: The symptoms might not be obviously connected to the type of infection.
Nafysa Parpia: No. It might not be. These infections can spread to different systems of the body. Someone could have a [inaudible 00:04:45] infection in their jaw, but they'll feel headaches, or sometimes those infections, the bugs, or the biotoxins, or inflammation can drop down towards the [00:05:00] gut or the respiratory system. Then they're having symptoms in those different areas. It takes a lot of hunting around to find out where the infections are and what they are.
Daniel Schmachtenberger: For those who are already deeply familiar with these topics, be patient as we kind of lay down the foundations. We'll get into deeper things, but we want to kind of start at the beginning so those who aren't familiar get a lay of the land. You mentioned biotoxins. What's the difference between an infection and a biotoxin, the [00:05:30] relationship?
Nafysa Parpia: Microbes, parasites, smaller microbes, they send out toxins as a way to protect themselves from our body's immune system. They're smart. Those toxins can actually win over our immune system, especially if we're compromised in other ways. If we have multiple infections if we have environmental toxicity, those [00:06:00] biotoxins, which microbes and parasites send out, they can bring our immune system down even further.
Daniel Schmachtenberger: Yeah. Mold is a pretty classic example, right?
Nafysa Parpia: Sure is. Yeah.
Daniel Schmachtenberger: When people are dealing with mold in their environment, they might not actually have any living mold in their body. They're just dealing with the microtoxic byproducts that the mold produces.
Nafysa Parpia: Definitely. We can measure those, the microtoxins.
Daniel Schmachtenberger: You started to categorize [00:06:30] types of infections. You said parasites, microinfections. Do you want to give a kind of lay of the land of the categories of infection when we look at subclinical cases?
Nafysa Parpia: Yes. There can be viruses, [inaudible 00:06:43] virus, cytomegalovirus, coxsackievirus. These are viruses that can be kind of insidious. They can exist, the person doesn't know. Then there's bacteria. There can [00:07:00] be gut bacteria. There can be bacteria in their respiratory system, and then parasites. Parasites are a big one. They're difficult to test for, so those have to be more a clinical diagnosis based on what the patient is telling me, based on their symptoms, international travel. The other bugs, they're easier to test for.
Daniel Schmachtenberger: Parasites mean two things. It means microscopic parasites, which means actual bugs, right?
Nafysa Parpia: Mm-hmm (affirmative).
Daniel Schmachtenberger: Multicellular [00:07:30] things, worms and flukes, and then microscopic protozoa. Protozoa are usually easy to test for.
Nafysa Parpia: I find them [inaudible 00:07:37] test often, but I think of them as sucker fish. If you have those small protozoa, or blastocystis, enterobacter, I find those often on tests. I think of them as sucker fish on sharks. Sharks are the bigger, the bigger parasites, the ones you mentioned, the [inaudible 00:07:56]. Those can exist. I have patients sending [00:08:00] me pictures of what they find.
Daniel Schmachtenberger: This is a fun topic, because outside of pinworms in kids, in the developed world, most people don't think about worms in humans. They think about them in dogs and cats and livestock. They will deworm their dogs every year, deworm their cats. If fleas are around, they know they have to deworm more. They even know that we're not just talking about GI worms. We have heart worm as a common thing in dogs. We're like, "Oh, worms can get into dog hearts, but they don't get into human hearts [00:08:30] or in other organs?" I think most people think about worms in terms of tropical infections in poor areas, like Guinea worm. This is not a really good way of thinking about it. Where you started, Dr. Klinghardt actually, I think, does a lot of emphasis in macroscopic parasite infections. Talk to us more about this.
Nafysa Parpia: These are very common in people, more common than people think. [00:09:00] I'm talking about complex chronic illness right now. Although, I believe it can also be [inaudible 00:09:07] well, but their immune systems are able to tolerate it. Dr. Klinghardt uses the term "uneasy alliance". He says we've got an uneasy alliance with these parasites, meaning that [inaudible 00:09:18] our bodes are more likely to have such parasites. Heavy metals and other toxins make our body more of a breeding ground for such parasites. The alliance, the uneasy [00:09:30] alliance is that these parasites, they hold onto our toxic burden for us, but we have a better way to deal with our toxic burden than to have parasites that are sucking the nutrients out of us, or giving us GI distress, making us weak.
Daniel Schmachtenberger: To just kind of go into this a little bit, we obviously have a symbiotic relationship with the bacteria in our microbiome and with the healthy yeast in the microbiome. What we're saying here is that you can have a symbiotic [00:10:00] relationship in a compromised condition, but it's a compromised symbiosis.
Nafysa Parpia: Absolutely.
Daniel Schmachtenberger: This is a species that wouldn't normally exist or that would exists in much smaller amounts, in the case with parasites wouldn't normally exist at all, that actually serve a symbiant role.
Nafysa Parpia: Yes.
Daniel Schmachtenberger: But at a cost.
Nafysa Parpia: Exactly.
Daniel Schmachtenberger: Can you say a little bit about the accumulation of toxins, because I don't think that is also a commonly known topic?
Nafysa Parpia: No, it's not. One thing we've noticed in medicine over the past few years is that illnesses [00:10:30] are different. Suddenly, we're seeing people with more autoimmune conditions, multiple chemical sensitivity, higher susceptibility to infections. These bugs have always been here. Lyme has been here. Mold has been here. Viruses were here 15 years ago. Why are we more susceptible to them in a way that we weren't before? Why are suddenly people more susceptible to chemicals? These auto-immune conditions, why are we suddenly creating antibodies, suddenly and certainly creating [00:11:00] antibodies to our own self? I think it has a lot to do with the onslaught of toxicity in our world, in the air we breathe, in the food we eat. Dr. Klinghardt really talks about this as well. I do a ton of detoxification work, but I measure it through labs. I'll measure heavy metals. I'll measure pesticides and solvents and chemicals. We'll definitely see these elevated without a doubt in my patients with neurological [00:11:30] illnesses and chronic infectious diseases as well.
Daniel Schmachtenberger: Okay. I want to actually get clearer on the topic of a subclinical condition, whether we're talking about subclinical infection or subclinical toxicology, because again when we think about heavy metal infections from a traditional allopathic point of view, we're thinking about acute industrial exposure. There's a level of mercury exposure where we say, "Oh, there was acute mercury [00:12:00] toxicity, and we're going to do some active kind of detox chelation," we think about that as a toxicology caused illness. Acute, very high level.
Then we think about what ideal levels are, and the key is that there's a pretty big range in between ideal and actual toxic exposure, which we'd call a sub-clinical level of toxicity that's not going to instantly poison you. It might be asymptomatic, but it's going to weaken the system. Do you want to talk a little bit more about from that perspective, [00:12:30] how often you see toxicity, deficiency, and infectious things that people wouldn't normally think of if they were just thinking about normal toxic levels?
Nafysa Parpia: Yeah, so my patients who were sick, they've seen about 20 different doctors before they come to me or before they come got Gordon Medical. They've been told, "You're fine. Your labs look normal. Go home," or, "This is all in your head. Here's an [00:13:00] anti-depressant to help you with this." My patients who are well who are looking for a little bit more optimization, they're told, "It's just age. You're just now in your 40s. These things happen to you. Go home. Your blood work looks normal." When you dig deeper, then you're able to find that toxic load pretty high, in my sick population for sure, borderline high [00:13:30] in people who are well to a level where I want to decrease it for prevention.
Daniel Schmachtenberger: If we take heavy metals, for instance, as one example of a toxic load that according to this model increases the susceptibility for the infections, parasitic and other kinds of infections, because it decreases immune function, heavy metals are maybe as controversial a topic as you can get outside of maybe vaccines [00:14:00] and medicine. Chelation is a very controversial topic, how to even assess it, the problem with hair labs and urine labs, why provoked metal assessment is tricky. I'd be very happy, if listeners are interested, to actually get into the body of clinical data here and research on it. Just from your actual patient experience and clinical experience, not from [00:14:30] the literature, when you do a provoked metal challenge and you see elevated lead or cadmium or mercury, whatever, and then you do some detox protocol using chelation or binders, whatever you do, what do you see happen for people?
Nafysa Parpia: I see quite a few things happen. For sick people, I've seen nerve issues go away, nerve issues meaning things like restless leg syndrome, convulsion. [00:15:00] I've seen those disappear in sick people. I've seen cognition become more clear for people. They're less confused. I've seen memory become better and the immune system improved. They're actually less susceptible to their infections once I start to clear the metals out.
Daniel Schmachtenberger: With regard to immune system, you mean not just that they're getting sick [00:15:30] less often, but you can actually see biomarkers change, immune biomarkers?
Nafysa Parpia: Absolutely.
Daniel Schmachtenberger: Yeah. Now this idea of an uneasy alliance with parasites would say you don't want to get rid of the worms if you have them right away without addressing metals, if the worms are actually accumulating metals and protecting the body from it. It would also say that just getting rid of the metals on its own might not work as [00:16:00] well as if you kind of work with the two together. Is that your approach?
Nafysa Parpia: Absolutely. I layer the approach. Before I start to kill of parasites, I do a lot of detoxification work. It might be with metals or other chemicals that I've seen through laboratory tests. Microtoxins as well. I'll detoxify first to make the body, if you will, less of a breeding ground for the parasites and microbes. I detoxify, and then I come in and I start [00:16:30] to bring the microbial count or the parasite count down using either herbs or pharmaceuticals. Then I rotate, because I know that when I'm killing microbes and parasites, they dump the metals, and they also dump biotoxins. I need to sweep that up from the body, if you will, and discharge it. [inaudible 00:16:50]
Daniel Schmachtenberger: Okay. Coming back to worms, worms, flukes, microscopic bugs, [00:17:00] even though they might not be as acutely lethal to someone as a particular bacteria or virus might be, it just freaks people out to think about bugs inside of them basically eating their tissue. It's an interesting topic. The reason they're hard to diagnose is if you do a stool test, you're obviously only going to see things that show up in the GI tract, not things that would be in other areas. They're not necessarily shedding in the stool, [00:17:30] unlike microbiome, which is going to be everywhere. We might be looking at a small number of these in a particular location. You need many, many stool labs to have a high sense of accuracy and not have false negatives.
Obviously, if we're talking about things in other parts of the body, you're not going to see it in the stool, you have to depend on antibodies, which are fairly unreliable. Diagnosis is tricky. You're largely working on clinical presentation.
Nafysa Parpia: I am. Yep.
Daniel Schmachtenberger: What do you look for where you think maybe it's time to treat parasites?
Nafysa Parpia: [00:18:00] Here are some basic symptoms. A person is hungry all the time, they're ravenous. They're not able to nourish themselves, they eat and the eat. I look at their micronutrient labs. They're low in amino acids, low in minerals, vitamins, anti-oxidants, but they're eating. They're eating a beautiful diet. They'll have other symptoms like gas and bloating, usually constipation, cold [00:18:30] also show as diarrhea, itching of the anus as well is very common.
Daniel Schmachtenberger: These would all indicate GI parasites that would be actually taking nutrients, damaging the mucosal lining, making it hard to absorb nutrients, making GI issues. If you're looking at something like lung worm or liver flukes or things that are outside of the GI system, what would you look at?
Nafysa Parpia: That would by symptomatic [00:19:00] based on information really. Are they sensitive to everything? Now I'm guessing. I can't diagnose those. That's going to be a wild guess. Treating for those directly, that's hard to do. If I treat the system, their whole body systemically, I believe that when I can increase their immunity, make their body stronger, [00:19:30] those other very much harder to diagnose parasite infections can come down.
Daniel Schmachtenberger: The Klinghardt style parasite protocol has a lot of systemic anti-parasitics.
Nafysa Parpia: It does. It does.
Daniel Schmachtenberger: When you run that protocol on people, again, what do you find happens as people go through the anti-parasitic work?
Nafysa Parpia: Initially they can get wiped out [inaudible 00:20:00] [00:20:00] them. We might have to slow them down on it. I might have to increase the [inaudible 00:20:06] methods as well. It's a dance, and it's different for everything [inaudible 00:20:12] wonderful in the middle of it. Others, they feel nothing. They're like, "I can't even tell I'm taking medicine, but I feel increased energy." Some people are just really, really tired. I think that has to do with the body's ability to detoxify. It's going to be a different response [00:20:30] for each person. Then I have to modulate based on how that person reacts.
Daniel Schmachtenberger: Beyond what's happening as they're in the protocol and their body's obviously processing the meds and processing [dioph 00:20:43], if it's happening, what do you actually find as a result of the protocol overall?
Nafysa Parpia: Overall, at the end of the day, they've got much more increased health. Their Lyme systems tend to go away. [00:21:00] I'm not directly treating the Lyme. What I'm doing is I'm treating the parasites. I'm treating the toxicity that makes the body less susceptible to the Lyme and to other infections. There's a general overall sense of wellness after that protocol is done for sure.
Daniel Schmachtenberger: Given that we're not dealing with high reliability diagnostic methods here, but we're dealing with when clinical presentation indicates, and [00:21:30] what percentage of people actually respond, in cases where people have some chronic illness, they're dealing with auto-immunity or neurodegen or chronic fatigue, how often do you see parasites indicated? I'm talking about people at your practice, which means they live in the Bay Area. They don't live in sub-Saharan Africa.
Nafysa Parpia: No. It's very common. Very, very common. Remember how I said when I do a stool test, we can see the smaller pathogens. They're easy to see, the amoebas, the enterobacter, [00:22:00] blastocystis, I see those every day on regular people living in the Bay Area, optimizers on the healthy people, I see it on the sick people as well. Then from there, that's an indicator to me that there are more parasites. I see it every day in my practice on those stool tests [inaudible 00:22:22].
Daniel Schmachtenberger: The interesting thing here is that people who are asymptomatic and healthy, [00:22:30] as you mentioned earlier, might be some stressful incidence away from having an infection that is actually being kept at a relatively low level, be able to go into some kind of cascade.
Nafysa Parpia: Definitely. I'd love to speak to that a bit. Most of my patients who are chronically ill, they have businesses they run. Some of them are Olympians. Some of them are celebrities. They're people who are highly functional in the world, and they had [00:23:00] been for a long, long time. The key was all of a sudden something happened, and that is a case for sub-clinical infections suddenly becoming big in somebody, in somebody who's driven and having a very engaged life. Suddenly, they're not. Suddenly, they're having to have conversations about [inaudible 00:23:29] their house [00:23:30] for mold, conversations that might make them look a little bit weird in the world all of a sudden.
Daniel Schmachtenberger: Yeah. This is interesting, because somebody can get in a car accident, and have a sore neck, and do some massage or chiropractics, rest, and then be fine. Or they can get in a car accident, and then start having weird, unexplained symptoms, and then have chronic fatigue syndrome in a few months that is debilitating. Or someone [00:24:00] can have a divorce and be emotionally bummed versus emotionally bummed and then they get a chronic illness. This is why preventative medicine in healthy people is so important is being able to increase resilience to things that are going to happen. People are going to have life events, but they don't have to result in the same level of negative response.
Nafysa Parpia: Exactly.
Daniel Schmachtenberger: Do you have a lot of patients who come just [00:24:30] for preventative medicine and kind of longevity wellness effects?
Nafysa Parpia: That's been happening a lot over the past year, year and a half, most definitely, especially here in the Bay Area. People are really interested in optimization over here. I'm having a lot of people come to me just for that. Then they're surprised at the things I might find. I'm surprised too at the things I find, some clinical infections, toxicity. [00:25:00] The optimizer, they want to test everything. They're interested. They want to know, "What do my hormones look like? Do I have toxicity? How about my neurotransmitters in my adrenal function?" They want to do all the [inaudible 00:25:15] medicine tests, because they want the data on themselves.
Daniel Schmachtenberger: We mentioned that we wanted to talk about the role of chronic infections and dysbiosis in not just overall health and chronic [00:25:30] illness, but specifically mental, emotional wellbeing. We can start with any category, and then we can dive in deeper. Whether we're looking at bacteria or mycoplasma or parasitic, what do you notice in terms of the role that infections play when people are dealing with anxiety, sleep issues, depression, etc.
Nafysa Parpia: Yeah. The key is that it's a sudden change in emotion. [00:26:00] It's normal for healthy people to have some level of anxiety or depression or different variabilities of OCD. That's very normal in a healthy population, but when suddenly you go from having sweaty palms before an important meeting to panic attacks, suicidal ideations, severe mental confusion, right there that's the key for me. I know that there's a ... I [00:26:30] don't want to say I know. I am almost certain there's a subclinical infection that's turned that.
Daniel Schmachtenberger: Can you describe the mechanism? How do we go from some kind of infection to suicidal ideation? You don't have to focus on suicidal ideation, but when we think of anxiety, depression, ideation, we think about neurologic effects, and neurotransmitter effects, and neurohormonal effects. Can you tie the mechanisms together?
Nafysa Parpia: Yeah, absolutely. The gut has been called the second brain [00:27:00] for a really good reason. We have more neurons in our gut than we do in our spinal cord. 90% of the communication, I'd say 90% of feedback of communication is from our gut up to the brain, not necessarily as much the reverse. The gut really informs the brain as to what's going on. It's a second brain in that way, but it's not like we can make decisions with our gut. Well, [00:27:30] that's a whole other topic on intuition, but literally we can't debate politics or play music with our gut the way that we can with our brain. Our gut, having so many neurons in it, is like a second brain. There can be neuro-inflammation, and that inflammation can travel upwards to the brain. That's what can [00:28:00] cause changes in mood. It can cause depression. There's also an increase in cytokines as well, chemical mediators which increase inflammation. The more inflammation there is in our gut, that will travel upwards. It sits at a highway, a neurological highway between the gut and the brain.
Daniel Schmachtenberger: Even though this has been a popular idea in functional [00:28:30] medicine world for some time, it's just kind of really entered the mainstream I'd say in the last couple years thinking of depression as being largely influenced by neuro-inflammation, and the idea of depression almost being thought of as rheumatism of the brain has really kind of caught on. I don't think of it that way, because I don't think of depression as one thing. I think of it as lots of different things with different ideologies. That's certainly one of them. Head trauma can do it on its own, and just purely psycho-emotional things [00:29:00] that are not physiologic can. Whether we're dealing with mold exposure or some kind of sub-clinical infection in the body, the idea that it creates inflammation, inflammation that can cross blood-brain barrier and cause neuro-inflammation. Then the neuro-inflammation affects brain dynamics, whether we're talking about depression or anxiety or neurologic issues or brain fog, those can all be mediated by neuro-inflammation.
Nafysa Parpia: Yeah. Autism, for instance, I think there are many, [00:29:30] many causes for autism. One thing the research has shown is that children who are autistic have very different [miludes 00:29:40] than healthy children. I think that's one way to look at one of the factors of autism. Although, of course it's so many.
Daniel Schmachtenberger: When I think about the gut brain [00:30:00] access, I think about at least three different dynamics. One is the enteric nervous system, the neurologic, the neurons throughout the GI system that then sends signal to the brain. I think about all the chemistry moving from the gut into the blood, which is going to be both nutrients and possibly toxins, inflammation, etc, that can then affect the environment that the nervous system lives in. [00:30:30] Then I also think about the microbiome, and the microbiome both in terms of the way that it modulates genetic expression and the fact that just from a really simple point of view, a huge percentage of our primary neurotransmitters are produced by the microbiome gut. If we've got 50 to 80% of our dopamine, serotonin, gaba produced by microbiome, and we have some kind of dysbiosis or infections driving dysbiosis, that's a pretty massive loss of transmitter function immediately.
Nafysa Parpia: It sure is.
Daniel Schmachtenberger: [00:31:00] Do you assess for that? Do you do things like look at neuro-hormones, neurotransmitters and look at, say, gut microbiome and infection, kind of put those pieces together to then assess priority of treatments?
Nafysa Parpia: Yeah, I do. I'll look at neurotransmitter function. Usually people's neurotransmitters are quite low. That's common, especially in complex chronic illness. It's even common in optimizers who just work so hard that they tank themselves a little bit. I'll look at that, [00:31:30] and I'll look at their GI system. Most of the time when I'm looking at both, I'm going to find dysbiosis in the gut. That link I see very often. These people will have a lot of yeast, different funguses. Again, smaller bacteria, those will be seen. Usually I'll want to treat the gut first, because that's what's insulting the production [00:32:00] of neurotransmitters. I'm treating the insult first, then I work on balancing the neurotransmitters. I'll layer them in. I'll start working on the gut maybe for a month, and then layer in neurotransmitter treatment on top of it. [inaudible 00:32:14] currently, but give the gut a headstart.
Daniel Schmachtenberger: This is a pretty common best practices in naturopathic medicine, start in the gut. We've obviously got the mucosal system, which is everywhere that the environment connects to our body that isn't skin: [00:32:30] eyes, sinuses, mouth, urogenital, bronchials, gut. You can have infection there. You can have infection in the blood. You can have infections in the cells. Why do you start with the gut?
Nafysa Parpia: Because that is the center of the protection of the immune system, A, and of neurotransmitters. That's where it all begins. However, often times if people have microtoxins, fungus in their sinuses, I may start with their sinuses [00:33:00] first, because it's such a boney concentrated area. I just want to give them some relief. I also know that infections from here, they travel downwards quickly. I want to clear this up first, and then I'll go to the gut, depending on the severity of the sinus infection. I see a lot of people with quite severity in their sinuses.
Daniel Schmachtenberger: Proximal to the brain is relevant?
Nafysa Parpia: It is.
Daniel Schmachtenberger: Same with dental infection.
Nafysa Parpia: [00:33:30] That's right. People turn a corner when we fix dental infections for sure.
Daniel Schmachtenberger: Say that again?
Nafysa Parpia: People turn a corner in complex chronic illness when they fix certain dental infections.
Daniel Schmachtenberger: Let's talk about that. I think as far as biologic dentistry goes, most people are aware that mercury fillings aren't a great thing, and that maybe the proper removal of mercury is a good idea. I think that's the most common idea, the idea [00:34:00] of subclinical infection, other than systemic gingivitis as a less well known idea. Do you want to talk about that?
Nafysa Parpia: Definitely. I also want to talk about the mercury first, just because you brought it up. You'd be surprised how many people come to me saying that they had their metal amalgams removed by a non-biological dentist, they swallowed the mercury, it is vaporized up, and they are sick. I will measure their blood mercury. It's high. I'll do a urine provoke test. [00:34:30] That's high. Once we start to get the mercury out, there's a big difference in their cognition. Some of them have come with neurological symptoms as well. Those as well shift.
Daniel Schmachtenberger: The best practice there is if you're going to remove mercury, go to someone who actually knows what they're doing.
Nafysa Parpia: Exactly, biological or a systemic dentist.
Daniel Schmachtenberger: I pretty much always recommend people who are trained in Huggins Protocol. Is that also what you do?
Nafysa Parpia: Mm-hmm (affirmative).
Daniel Schmachtenberger: Yeah. All right. Speaking of [00:35:00] Huggins Protocol, let's continue on the topic of sub-acute dental infections.
Nafysa Parpia: When root canals have been improperly extracted ... I'm sorry, I'm going to backtrack. When wisdom teeth have been improperly extracted, and underneath root canals, there can be sub-clinical infections. The patient has no idea. They're asymptomatic. They can't feel it, but they have a lot of brain [00:35:30] fog. They have headaches. They might even have trigeminal neuralgia. They have no idea there's an infection in their jaw. I ask them, "Have you had your wisdom teeth extracted? Do you have root canals?" When people have infections up in here, those are my two questions, right away I send them to a biologic/systemic dentist, because those dentists have what's called a CT scan, an I-CAT. It's a [00:36:00] CT scan which allows us to see small slices of the bone and find localized infections which aren't seen on regular Panorex digital X-Ray, and that seeing with the naked eye, they're missed in traditional dentistry, just downright missed. Once those infections are cleaned up, that's when I see a lot of head symptoms resolve.
Daniel Schmachtenberger: Do you run the Huggins PCR assessments [00:36:30] for infection also to look at the species and load?
Nafysa Parpia: Our biological dentist does.
Daniel Schmachtenberger: Yeah.
Nafysa Parpia: Yeah. You'd be surprised by what comes back.
Daniel Schmachtenberger: Yeah. Interesting infections. Explain for people what is an improper extraction, and why would that lead to infection? Why would root canal lead to infection?
Nafysa Parpia: They're small areas. An improper extraction could be leaving an area [00:37:00] not sutured well, not closed well. It stays open. I've had people had material, like gauze left in there. They've had to have the gauze removed. Then that doesn't heal properly. There's many different ways when the surgery isn't quite perfect. That's a finicky area. Like I said before, a lot of bone [00:37:30] in there, small, compact areas. That's when infections can happen.
Daniel Schmachtenberger: I think when compared to extraction, wisdom teeth or other extractions, one of the common things is even if the surgery is done well, there is a ligament that connects the teeth to the bone. If the ligament's not fully removed, then it's dead tissue. Then how does the body get rid of dead tissue? Typically that's a microbe's job. Then you have a pocket with some dead tissue in it [00:38:00] where you end up having breeding ground for microbe. Also, if there was infection in the tooth to begin with, it might have gone into the bone if it wasn't cleaned all the way. The Huggins Protocol is process where they make sure to get rid of the ligament, go into the bone, stimulate bone bleeding so it actually heals more deeply, and you get removal of the infection and no dead tissue left.
Nafysa Parpia: Right.
Daniel Schmachtenberger: Which is the same thing with root canal, in terms of dead tissue, right? You end up getting a tooth left that has no immune system [00:38:30] in it but is permeable so that all those miles of dentin tubule can be a place that infection can hide out.
Nafysa Parpia: Yeah. Then those infections travel. They can travel upwards towards the brain. They can travel down. Infections travel, biotoxins travel, inflammation travels all from those sites. The same goes with sinus issues.
Daniel Schmachtenberger: Let's talk about the sinus thing. With the dental infections, someone can have a [00:39:00] dental infection where they go to their normal dentist, and their dentist says everything is fine. They don't have dental issues. They don't have gingivitis, because if we're looking at something that's maybe at the very root of a root canaled tooth, you're not going to see that unless you do one of those diagnostics that we discussed. It might be affecting ongoing immune and inflammatory dynamics for the blood. The thing that might get better, the thing that might have gotten worse is over the course of 10 or 20 years, so very slow [00:39:30] just effect on decreased homeodynamics of the whole system. What might get better is some systemic thing that's not localized at all, right? The key thing there is that we're not looking at mouth issues as a symptom to assess. We're looking at any kind of systemic issues.
Nafysa Parpia: Right.
Daniel Schmachtenberger: Sinus is similar, right?
Nafysa Parpia: Sure is.
Daniel Schmachtenberger: You're not talking about people who have chronic sinus infections only?
Nafysa Parpia: No. [00:40:00] Definitely not.
Daniel Schmachtenberger: Then what would indicate for you, and then how would you go about testing infections in the sinuses?
Nafysa Parpia: Yeah. It's often people who've had mold exposure. They know they've been in a water damaged place. A lot of people come to me for mold exposure, because all of a sudden they are sick when they were fine. I know I want to test their sinuses right away, because they've been breathing that. [00:40:30] A test for MARCoNS which is a kind of staph infection that's anti-biotic resistant, well, it's resistant to many different anti-biotics, that's common in people with biotoxin illness, mold illness, and with Lyme's ill test for MARCoNS, test for other funguses and bacteria. Very typically I find those things and-
Daniel Schmachtenberger: This is a swab
Nafysa Parpia: A swap, a nasal swab.
Daniel Schmachtenberger: Yeah. If someone can come see a functional medicine doctor, get a swab, [00:41:00] check it out, treat it, awesome. If they can't, I'm switching to treatment, I'm bouncing around a little bit, but what is something someone can do for sinus hygiene on their own that can help to decrease infections load in the sinuses?
Nafysa Parpia: Yeah. You can do neti pot rinses of just some filtered water, put a little bit of salt in there. Neti pot both sides. That really [00:41:30] helps clear things out. They can use, I'm a fan of argent and silver. That can also help clear out infections there, as they can nebulize it. There's nasal sprays for it as well.
Daniel Schmachtenberger: Or put it in the neti pot.
Nafysa Parpia: Exactly.
Daniel Schmachtenberger: How about the xylitol nasal sprays?
Nafysa Parpia: Yep, that too.
Daniel Schmachtenberger: I think that unless somebody has an Ayurvedic background, most people don't think of nasal cleaning as part [00:42:00] of their daily or regular hygiene like they think of teeth cleaning, but you would suggest that people do.
Nafysa Parpia: I do. I suggest they do it on a regular basis at least three times a week. It's a place where we can harbor bugs, for sure. We have more of a susceptibility to bugs now than we ever did before, due to environmental toxins. Yeah.
Daniel Schmachtenberger: And travel where the bugs from any part of the world are now everywhere, and [00:42:30] antibiotic resistance and pesticide use, etc.
Nafysa Parpia: Yeah, and also I think there's an obsession with over-sanitizing and people using too much Purell, too much hand sanitizer, not letting children play in the dirt, or not allowing our immune systems to be exposed to the beneficial bacteria which allow our immune system to become stronger and recognize.
Daniel Schmachtenberger: Actually on that topic, when you think about using germicidal [00:43:00] soaps, the triclosan, which is the most common antibiotic put in the soaps, how often do you see that show up when you're doing environmental toxicity?
Nafysa Parpia: I see it, and then I tell them that the triclosan has a link to cancer. Yeah, that's one that I see often.
Daniel Schmachtenberger: [inaudible 00:43:19] too, antibiotic resistant of any infections that happen to be there.
Nafysa Parpia: Yeah.
Daniel Schmachtenberger: Yeah, I've seen a lot of triclosan show up on toxicology profiles also, [00:43:30] and typically find that addressing infections in those people takes more work.
Nafysa Parpia: It does. I also see a lot of parabens show up. Those are in our beauty products and our soaps and shampoos and makeup. There's a whole new trend towards holistic beauty as well.
Daniel Schmachtenberger: Similarly, if someone was going to want to have a hand soap that had some antibacterial properties, essential oils would do it?
Nafysa Parpia: [00:44:00] Yeah, lavender, tea tree, thyme, oregano [inaudible 00:44:05]. Yeah.
Daniel Schmachtenberger: Okay. We talked about hygiene for the nose. How about when we were talking about subclinical infections in the mouth, hygiene for the mouth? Besides going to see a biologic dentist and get those primary things done, are there any things beyond just basic teeth brushing you recommend?
Nafysa Parpia: Yeah. For sure, flossing, that's basic, but it's so important, because that's right in the tissues. Oil pulling [00:44:30] can really help, tongue scraping. Now we're talking about more Ayurvedic methods, but they sure work.
Daniel Schmachtenberger: Describe those two, because oil pulling and tongue scraping are both Ayurvedic, but they might not be familiar to everybody.
Nafysa Parpia: Yeah. Tongue scraping is a little tool, which actually you take that tool and you brush it against your tongue, and it removes bio film and coatings, removes little bugs. [00:45:00] Then gargling with salt after that. Then oil pulling is taking coconut oil, which has anti-microbial effects, and holding it in the mouth and swishing it around. That also pulls microbes.
Daniel Schmachtenberger: The way that I generally recommend having people do the oil pulling is whether it's coconut oil or sesame oil or they get a specialized oil pulling [00:45:30] pre-made product that has essential oils in it is that they're actually vigorously swishing until the oil and saliva have mixed and it actually looks like saliva, it looks white rather than yellow when they spit. It's usually 10 or 15 minutes. They hypothesis there is that you have some anti-microbial properties in the oil, that it helps the integrity of the tissues, the gums, it's [inaudible 00:45:57], but also that [00:46:00] as an oil, as a fat, that it creates an osmotic pressure for fat soluble toxins to come into the oil and then get spit out. It is a way to detox some fat soluble toxins, which supposedly has been microscopy verified. I can't verify that myself. Yeah. What about water picking?
Nafysa Parpia: That can definitely help clean between the gums for sure. There can be food stuck in there [00:46:30] on which, of course, will attract microbes but just washing that out.
Daniel Schmachtenberger: I add silver to the water pick, and use that, and it decreases the chance of deep pockets.
Nafysa Parpia: Definitely, the silver will kill of microbes as well.
Daniel Schmachtenberger: All right. Good. We're discussing now some kind of home methods people can do outside of the medical therapies. What about with the gut? We were talking about if someone actually [00:47:00] has macroscopic parasites in the gut, they're going to have to go get appropriate diagnosis, treat that. It'll probably involve meds. If they've got dysbiosis, protozoa, those are going to be very customized protocols. If someone doesn't have the resources to go with a functional medicine doctor right away, what are some basic things that are generally well-indicated for gut microbiome health?
Nafysa Parpia: Yeah. Eating probiotics, these are foods that are high in the beneficial bacteria, [00:47:30] things like [inaudible 00:47:31], sauerkraut, miso, kimchi, kombucha. Eating prebiotics, these are the foods that feed the healthy bacteria, these are mostly vegetables and fruits, but common ones are apples, pears, celery, artichoke, lentils. Healthy bugs love those. Healthy fats as well, those are going to help to decrease inflammation in the gut: [00:48:00] avocado, coconut, olive oil, chia seeds, hemp seeds. The things that we want to avoid, we want to avoid the overuse of antibiotics. I think for sure there's a place for antibiotics. Will prescribe them to people knowing they're necessary, but they're often over-prescribed. They're prescribed when they're not needed. To avoid the overuse of antibiotics, definitely do avoid processed sugar, processed foods, those feed the bad bacteria, [00:48:30] artificial sweeteners, artificial foods and preservatives, they feed the pathogen bugs.
Daniel Schmachtenberger: What do you think about for the GI system in particular, what do you think about fasting, colonics, salt water flushes, other things for taking a load off the GI system?
Nafysa Parpia: Yeah, I think it's important to have an oral and a rectal route when we're trying to clean the system. Colonics, definitely, [00:49:00] especially when we're trying to get rid of parasites, enemas for sure. What else did you ask about?
Daniel Schmachtenberger: Fasting.
Nafysa Parpia: Fasting, yeah. Fasting, it depends on what people can tolerate. If people can tolerate even a bone broth fast just for three days, that can really help to fix leaky gut syndrome. It can help to restore the permeability of the gut membrane. A water fast can help to reset the metabolism. [00:49:30] Some people can tolerate it. It depends on tolerance. Yeah. Those who can tolerate it, it can help reset the system.
Daniel Schmachtenberger: Talk to me about infections in other parts of the body. We've mostly talked about within the GI system so far, including the mouth, then the nasal and sinuses, which are still part of the mucosal system. Talk to me about infections in the prostate, and urogenital kinds [00:50:00] of infections.
Nafysa Parpia: Yeah. They're common. I see them commonly, actually, in people who have autoimmune conditions and complex chronic illness. The basic UTI shows up in the general population as well, but I do see these infections recurrent for people who are sick. We work with those herbally when I want to start with the gut, because [00:50:30] the inflammation I believe starts in the gut, and it can work its way down into the lower areas.
Daniel Schmachtenberger: What have you noticed about the relationship? I know you worked at an integrative oncology center. What have you noticed about the relationship of, say, people who have prostate cancer, elevated PSA leading into prostate cancer, and increased infectious load prostate infection? Have you noticed those? Obviously, we know cervical cancer and HPV, right?
Nafysa Parpia: Yeah.
Daniel Schmachtenberger: [00:51:00] There's a lot of clinical research on the HPV, EVB, mycoplasmas, and prostate cancer. You speak to that?
Nafysa Parpia: Yeah. We've definitely tested for those for the toxic load in people of ... I shouldn't say toxic load. The microbial load, again, through a stool test, definitely I've seen correlations there. I think that it's the toxins and again, [00:51:30] sorry, the biotoxins that those microbes spit out that cause inflammation in the body and travel downwards, and in such close proximity to the gut.
Daniel Schmachtenberger: When you're thinking about cognitive health, mental, emotional health, obviously infection is one component. Obviously nutrition is a component, and hormones are a component. There's a number of physiologic [00:52:00] components. Biotoxins are a component. Then obviously you have to address psychology and their actual life, relationships.
Nafysa Parpia: Yes, in a big way.
Daniel Schmachtenberger: How often when you're dealing with mental, emotional dynamics for people that have a physiologic origin, do you see infection or at least dysbiosis involved?
Nafysa Parpia: All the time. All the time. The thing is, the people who come to me, more than half of them are complex chronically ill patients. Right [00:52:30] away, I search for infections, and I find them. Research has shown that people with complex chronic illness are more prone to depression and anxiety. I see those hand in hand every day, many times every day.
Daniel Schmachtenberger: Are there any other recommendations you want to share? You mentioned avoid antibiotics that are unnecessary and avoid processed sugar and some dietary guidelines. Besides just saying gut, if we wanted to say how to decrease [00:53:00] infectious burden and increase immune function systemically, what are other home recommendations that are generally a good idea for people?
Nafysa Parpia: Yeah. Definitely my patients travel a lot. Just to be careful when traveling, even when camping not to drink any water or when you're in developing countries to make sure your fruits and vegetables are cooked, and at home [00:53:30] to make sure your fruits and vegetables are washed thoroughly. In cilantro and the small leafy vegetables, there are really tiny bugs that can get stuck in there. We can eat them, and they can cause trouble for us as well.
Daniel Schmachtenberger: You obviously don't just mean bugs. You mean eggs, which are invisible.
Nafysa Parpia: I do. I do.
Daniel Schmachtenberger: What does wash thoroughly mean?
Nafysa Parpia: Just a couple drops of hydrogen peroxide or vinegar [00:54:00] in the sink that you filled with water. Leave your vegetables or fruit in there, but particularly the ones with the small leafies. Put them in there for 10 minutes, and then wash that off thoroughly with water. That helps. That's a pretty extreme measure, but these are for people who have a propensity to illness, for sure.
Daniel Schmachtenberger: That might mean many things, but one part of propensity to actually get infection from what someone eats in their fruits and vegetables would have to do with their [00:54:30] stomach acid levels, right?
Nafysa Parpia: Mm-hmm (affirmative).
Daniel Schmachtenberger: Any thoughts or guidelines on increasing hydrochloric acid production as a first part of stomach immunity, of GI immunity?
Nafysa Parpia: Yeah. You can actually take a little bit of hydrochloric acid. If you tend to have reflux, it's usually because you don't have enough acid, which [00:55:00] seems counterintuitive. Not enough acid in the stomach causes the sphincter to actually open and release acid upwards. If that's happening, then for sure that's often a diagnostic of not having enough acid. I'll just give people a little bit of hydrochloric acid supplement to take. Having a more alkaline diet can help as well.
Daniel Schmachtenberger: Can you say what the rough [00:55:30] overview of that is?
Nafysa Parpia: Yeah. Definitely high in veggies, high in fruit, not fruit that have a high glycemic load, not super sugary fruits. Of course, you can enjoy those as well, but to have those limited, a lot of veggies, low in grains, mostly paleo style, sustainable meats.
Daniel Schmachtenberger: Do you have any [00:56:00] books on diet and nutrition that you think are good starter books for people you'd like to recommend?
Nafysa Parpia: Yeah. Kim Snyder, I like her book. Dr. Perlmutter's books are interesting. Same with Dr. Gundry's books. Those are interesting as well.
Daniel Schmachtenberger: Plant products.
Nafysa Parpia: Yes.
Daniel Schmachtenberger: Yeah. Okay. Then obviously if people are wanting to really address [00:56:30] the topic of their microbiome and infection, this is something that's very well served working with a functional medicine, integrative medicine doctor that can do the appropriate assessment and treatment protocols. What do you recommend someone look for if they're wanting to find a doc to work with?
Nafysa Parpia: Yeah, there's a couple things. Of course, naturopathic doctors are very highly trained in functional medicine. That's where functional medicine began [00:57:00] really, and MDs who've had functional medicine training, also quite wonderful as well. Definitely to have somebody who has a medical license, whether it's an ND or an MD and someone who's got some functional medicine training.
For the training around parasites, that's a whole different ball game. That's not taught in regular naturopathic school, regular medical school, or in functional medicine in general. [00:57:30] Infectious disease, you've got to find someone who's particularly trained in that, so someone who's trained with Dr. Klinghardt for example, or who's trained with Dr. Gordon here at Gordon Medical, or Dr. Anderson here. There's certain clinics who specialize in these things. That's rare to find in our education system.
Daniel Schmachtenberger: Did you say when we were talking earlier that for people who listen to this podcast who happen to be in or could come to the Bay Area and want to come to Gordon Medical [00:58:00] and work with you, work with the docs there that you had something to offer?
Nafysa Parpia: Yeah, absolutely. First, patients, any patients who are here listening to this podcast, if they're new to me, I can offer $150 off an initial visit with me. For existing patients $150 off of any new procedure with me.
Daniel Schmachtenberger: Awesome. Is there any code that someone would need to use?
Nafysa Parpia: Yeah, let's use the code Neurohacker.
Daniel Schmachtenberger: Okay. That's fun. [00:58:30] All right. I think this is a good introduction to the topic of sub-acute, sub-clinical chronic infections, and that this has a role in possibly has a role in cancer, auto-immunity, neurodegen, chronic illness, fatigue, energy but also in mental, emotional health. If people want to come work with you, awesome. If they want to [00:59:00] find someone, you give them some resources to find. Anyone working with chronic illness knows that there's a lot of personal responsibility they have to take to figure this out, because typically they're working with a number of different doctors and therapists to kind of figure out what they actually need.
Nafysa Parpia: Yes.
Daniel Schmachtenberger: Is there anything else that you'd like to share with people today, just kind of closing thoughts on these topics?
Nafysa Parpia: Yeah. These complex chronic illnesses can happen to anybody. That's what I see. [00:59:30] It's what surprises me every time, actually. I've seen hundreds and hundreds, hundreds of these cases. Every time it's a bit of a surprise how healthy the person was before, how functional they were, how driven and engaged they were in their lives. Then suddenly something happens, and life is just not the same anymore. Prevention is really, really important, so getting diagnostics to understand what is underneath all of this.
I want to talk [01:00:00] a little bit about metabolomics, actually. We didn't talk about diagnostics, but metabolomics, it's actually research that Gordon Medical is doing with Dr. Bob Naviaux at UC San Diego. It is a test. We're looking at biochemical markers in realtime. It can predict your health, and it can prevent illness in a way that nothing else can. It's looking at organic acids, [01:00:30] amino acids, vitamins, minerals, different lipids in a way that no other test can right now. Research is still being done, but it's predictive.
We learned from the Human Genome Project that genes are only predictive of 10% of our illnesses, whereas metabolomics is predictive because it's looking at these chemicals in realtime. It's actually [01:01:00] looking at the cross between your genes and toxicity, or your genes and whatever is approaching you to create either wellness or illness. That is, I think, it's going to change the face of medicine. I'm excited to be involved in that.
Daniel Schmachtenberger: Yeah. The work you're doing at Gordon Medical is one of the few facilities that I know of that's actually doing cutting-edge research grade metabolomics [01:01:30] along with actual clinical diagnostics to start looking for correlation to be able to then train the software system on the interpretation of the metabolome.
Nafysa Parpia: Yeah. Yeah. We just published some research on chronic fatigue syndrome, being able to distinguish that from healthy people as well as depression. I'm working on it for autoimmunity and toxicity. It's very, very exciting.
Daniel Schmachtenberger: Metabolomics [01:02:00] might not be a familiar term for everybody here. Do you want to just say a little bit about what the metabolome is and why that would be an interesting diagnostic method?
Nafysa Parpia: Yeah, yeah. Metabolomics is the measure of molecules in the body that weigh less than 1,000 kilodaltons. Enzymes weigh 10s of 1,000s of kilodaltons. In metabolomics, we're measuring amino acids, organic acids, like I said before, minerals, [01:02:30] vitamins, all these fats as well, so all these biochemicals that make up the cells, they make up the organelles. Organelles are the little organs that make up the cell as well. Now we're looking at what our cellular response is. That's looking at the true biochemistry and biochemical makeup of the body. What's interesting with metabolomics is it's in realtime. [inaudible 01:02:56] expression of your environment, meaning your genes. It gives [01:03:00] us true validation on moving forward. When we can start to predict the results, that's when we can have the validation that we're looking for. That's why it's exciting me a lot.
Daniel Schmachtenberger: Yeah. So that people understand the word, I'll just say a little bit more. With metabolomics, we're looking at the metabolic byproducts of cells. Cells are taking in energy sources from carbohydrates, from fat, from wherever they're taking the energy, and then they're processing [01:03:30] that energy and doing all the interesting things cells do. Then they're producing metabolic waste products, byproducts. That's 2,600 or so metabolites that we know of, a few hundred primary ones. Basically everything that's happening in the cell ends up showing up in the metabolic byproducts that are coming out of the cell that we can look at in the blood, looking at what's happening inside the cell is kind of tricky. What's being released from the cell gives us some pretty good forensics of [01:04:00] what's happening in the cell. Whether the cell is affected by infection or toxicity or deficiency, and what's actually happening at the level of genetic transcription, not just the genome, but the epigenome, should all show up in the metabolomics. Being able to interpret all that is the work over the next few years. It is a very exciting field.
Nafysa Parpia: Yeah, very exciting.
Daniel Schmachtenberger: Yeah. I'm happy you all are prototyping that. Anyone who comes to Gordon Medical for their own [01:04:30] work has the chance to actually be part of that research?
Nafysa Parpia: Definitely.
Daniel Schmachtenberger: Cool.
Nafysa Parpia: Thank you.
Daniel Schmachtenberger: Nafysa, thank you so much for being here with us. This was interesting. If people want to actually find you and be able to come, what's the website.
Nafysa Parpia: It's GordonMedical.com.
Daniel Schmachtenberger: Okay.
Nafysa Parpia: All the contact information is there. Yeah. We have people come from all over the world, all over the country. They come and stay for a month or longer, get their treatment, go back home, [01:05:00] come back again. Then we also have bay area people who come, of course, as well.
Daniel Schmachtenberger: Yeah.
Nafysa Parpia: Yeah.
Daniel Schmachtenberger: All right. We will put that link in the show notes for those who are interested. It was a delight to have you.
Nafysa Parpia: Thank you.
Daniel Schmachtenberger: Thank you.