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In this episode of Thyroid Pharmacist Healing Conversations, I spoke with Dr. Richard Horowitz, an integrative physician who has spent more than 40 years working with complex chronic illness, including Lyme and tick-borne diseases. What began as a practice focused on Lyme disease eventually led him to recognize patterns that seemed to extend far beyond Lyme, including patterns he believes may be relevant to conditions ranging from Hashimoto’s and chronic fatigue to digestive disorders, migraines, mood disorders, and neurodegenerative disease.
Dr. Horowitz has developed what he calls the MSIDS model, or Multiple Systemic Infectious Disease Syndrome, which looks at 16 different factors that can contribute to chronic illness. Rather than focusing solely on the diagnosis or symptoms, this approach asks what might be driving inflammation in the first place. He describes six major “rivers of inflammation:” infections, environmental toxins, microbiome issues and intestinal permeability, vitamin and mineral deficiencies, and sleep disorders, which can contribute to downstream problems involving hormones, mitochondria, the liver, the nervous system, and more.
What you’ll learn in this episode:
- The “six rivers of inflammation” that may be fueling chronic illness: Since multiple health factors can lead to symptoms, knowing where to start with your healing can feel overwhelming. Dr. Horowitz shares how addressing foundational factors, including infections, environmental toxins, gut dysfunction, nutrient deficiencies, and sleep problems, can help you start putting the puzzle pieces together.
- Why thyroid symptoms may start elsewhere in the body: The thyroid is part of a connected hormone system, with the brain helping direct how it works. Dr. Horowitz explains how inflammation from Lyme may disrupt those signals, potentially affecting thyroid function, adrenal hormones, and sex hormones such as testosterone.
- Why a single Lyme test may not tell the whole story: Getting tested can seem like it should lead to a simple “yes” or “no,” but Dr. Horowitz describes why the picture isn’t always so clear. He discusses how different testing methods, symptoms, and other clues help him put the pieces together when evaluating a possible infection.
- How gut health, histamine, and nutrients may be connected: Gut problems, reactions to foods, and low nutrient levels can seem like separate concerns. Dr. Horowitz explores how intestinal permeability, changes in gut bacteria, and histamine intolerance may overlap, and why he sometimes takes a closer look at nutrient status when someone still isn’t feeling better.
- How conventional medicine and root-cause care can work together: Treatment doesn’t have to come down to choosing between “natural” and “pharmaceutical.” Dr. Horowitz shares how medications can play an important role while he continues investigating what may be driving the illness, making room for both symptom relief and care that addresses underlying contributors.
Ending Chronic Illness
Ending Chronic Illness: A Revolutionary New Program to Reverse Inflammation and Heal Persistent Disease is Dr. Horowitz’s latest book, which presents his 16-factor framework for understanding chronic illness and discusses nutrition, lifestyle, testing, pharmaceuticals, nutraceuticals, and root-cause approaches. It’s available here.
Connect with Dr. Horowitz
- Dr. Horowitz’s website
- Read Dr. Horowitz’s Substack, Medical Detective, where he writes about chronic illness, inflammation, Lyme, and the MSIDS model.
- Follow Dr. Horowitz on Instagram
- Follow Dr. Horowitz on Facebook
Free Resource
- Dr. Horowitz’s MSIDS 38 Symptom Checklist: Complete this free questionnaire to assess for symptoms of Lyme or other tick-borne disorders.
Testing and Diagnostic Tools
- Lyme ELISA: ELISA is a blood test used to look for antibodies associated with Lyme disease and is one of the conventional tests Dr. Horowitz discusses.
- C6 ELISA: Another Lyme antibody test that Dr. Horowitz discusses as a way of detecting antibodies associated with several Borrelia strains.
- Western blot: A Lyme testing method that looks for specific antibody bands associated with Borrelia exposure.
- Immunoblot: Immunoblot testing is a way to evaluate specific Borrelia protein bands, including those considered particularly relevant to Lyme.
- PCR testing: This looks for genetic material from an organism and was mentioned as one of the tools that may be used as part of a broader evaluation for tick-borne infections.
- FISH testing: FISH, or fluorescent in situ hybridization, is an RNA-based testing method Dr. Horowitz discusses in relation to certain co-infections, including Bartonella and Babesia.
- GI testing: Comprehensive digestive stool analysis (CDSA) and GI-MAP testing were discussed as tools for evaluating the gut microbiome and potential digestive or infectious contributors to chronic illness. (Available via Fullscript; if you don’t have a Fullscript account, you can sign up with my credentials here.)
- Red blood cell mineral testing: Discussed as a way of evaluating intracellular mineral status, particularly for nutrients such as magnesium.
- Methylmalonic acid: Methylmalonic acid (MMA) was mentioned as an additional marker that can provide information about vitamin B12 status beyond a standard B12 test.
- Immune testing: Immunoglobulins, immunoglobulin subclasses, CD4/CD8 counts, and natural killer cell testing were among the immune-system assessments Dr. Horowitz mentions as potentially relevant in complex chronic illness.
- Inflammatory markers: High-sensitivity CRP, cytokines, chemokines, and IL-6 are considered when evaluating inflammation for children and adults.
Supplements and Nutraceuticals Discussed
- Glutathione: An antioxidant that Dr. Horowitz discusses in relation to oxidative stress and inflammatory pathways; he also describes using it in his own approach to chronic illness. Consider Pure Encapsulations Glutathione.
- N-acetyl cysteine (NAC): NAC is a glutathione precursor that Dr. Horowitz discusses as part of his approach to supporting glutathione levels and inflammatory pathways. Consider Rootcology NAC.
- Alpha-lipoic acid: A nutraceutical Dr. Horowitz has used alongside NAC and glutathione.
- Nrf2 activators: Nrf2 activators are compounds that may support an important cellular antioxidant and anti-inflammatory pathway.
- Broccoli seed extract/sulforaphane glucosinolate: Broccoli seed extract and sulforaphane glucosinolate are examples of Nrf2-supporting compounds. Consider Designs for Health BroccoProtect.
- Resveratrol: A nutraceutical Dr. Horowitz uses in his approach to supporting anti-inflammatory pathways. Consider Pure Encapsulations Resveratrol (available via Fullscript; if you don’t have a Fullscript account, you can sign up with my credentials here).
- Green tea extract: Green tea extract is part of Dr. Horowitz’s Nrf2-supporting approach.
- CoQ10: Coenzyme Q10 (CoQ10) is part of Dr. Horowitz’s mitochondrial support protocol and may be helpful for migraines.
- Acetyl-L-carnitine: Acetyl-L-carnitine is part of Dr. Horowitz’s mitochondrial support protocol. Consider Rootcology’s Carnitine Blend.
- MitoNR: MitoNR is part of Dr. Horowitz’s mitochondrial support protocol.
- Bovine immunoglobulins: Noted by Dr. Horowitz in the context of supporting intestinal health and addressing intestinal permeability. Consider SBI Protect Powder (available via Fullscript; if you don’t have a Fullscript account, you can sign up with my credentials here).
- Probiotics and prebiotics: Probiotics and prebiotics are tools for supporting a healthier gut microbiome and encouraging beneficial bacteria.
- Multimineral supplements: Multimineral supplements are one way Dr. Horowitz addresses identified vitamin and mineral deficiencies.
Diet and Lifestyle Approaches
- Mediterranean-style diet: Dr. Horowitz shares that this is the foundation for his own health needs.
- Low-carbohydrate diet: A low-carbohydrate diet can support blood sugar balance and metabolic health.
- Low-histamine diet: A low-histamine approach can support issues like histamine sensitivity, gut health, and symptoms such as migraines and allergy symptoms.
- Low-Candida diet: A low-Candida diet is part of Dr. Horowitz’s personal dietary strategy.
- Exercise: Exercise and high-intensity interval training are foundational components of health and longevity.
- Sleep: Adequate sleep is a foundational pillar of health and an important factor to investigate when someone is dealing with chronic inflammation.
- Meditation: Dr. Horowitz uses meditation for stress reduction and as part of his personal daily practice.
Articles
- Low Dose Naltrexone and Hashimoto’s
- NAC for Immune Health, Detoxification and Gut Health
- How Does Carnitine Support Hashimoto’s?
- Lyme and Hashimoto’s
- Candida and Hashimoto’s Connection
- Histamine and Hashimoto’s
- Podcast episode: Chronic Lyme, Hashimoto’s, and the Hidden Root Causes Keeping You Sick With Melissa Schreibfeder
- Podcast episode: Why Chronic Illness Recovery Requires the Right Sequence With Dr. Jarrod Cooper
Get the Full Episode Transcript
Let’s Connect!
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Got questions? Drop them in the comments! 🙂
About Our Host
Dr. Izabella Wentz
Dr. Izabella Wentz is a compassionate, innovative, solution-focused integrative pharmacist dedicated to finding the root causes of chronic health conditions. Her passion stems from her own diagnosis of Hashimoto’s thyroiditis in 2009, following a decade of debilitating symptoms.
Dr. Izabella Wentz has written several best-selling books, including the New York Times bestseller Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause, the protocol-based #1 New York Times bestseller Hashimoto’s Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back, the Wall Street Journal bestseller Hashimoto’s Food Pharmacology: Nutrition Protocols and Healing Recipes to Take Charge of Your Thyroid Health, and Adrenal Transformation Protocol. Her latest book, IBS: Finding and Treating the Root Cause of Irritable Bowel Syndrome, is now out in the world, and available here!
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About Our Guest
Dr. Richard Horowitz is a board-certified internist and prior member of the HHS Tick-Borne Disease Working Group and New York State Department of Health Tickborne Working Group. As medical director of the Hudson Valley Healing Arts Center, he has treated over 13,000 chronic Lyme patients during his 41-year clinical career. His decades of experience have led to his new book, Ending Chronic Illness. After a deep dive into the medical literature and treating thousands of patients with resistant symptoms, Dr. Horowitz discovered that the 16-point model he pioneered for the diagnosis and treatment of chronic Lyme disease applies to most chronic illnesses causing suffering and disability.
Dear Dr. Wentz,
Thank you so much for this excellent interview. The content hits a lot of points we need to follow on our own health. We need to follow Dr Horowitz advice and so are physicians as well.
Thanks,
Sara
Sara, thank you so much! I’m so happy to hear you enjoyed my interview with Dr. Horowitz!