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Jill Brook: Hello, mast cell patients and lovely people who care about mast cell patients. I'm Jill Brook, and this is Mast Cell Matters, where we go deep on all things related to Mast Cell Activation Syndrome or MCAS with the help of our wonderful guest host, Dr. Tania Dempsey, a Johns Hopkins Medical School graduate, world renowned mast cell expert, physician researcher, medical advisory board member to many of the organizations working to improve life for complex patients. Dr. Dempsey, thank you for coming and which of your fascinating colleagues did you bring with you today?

Dr. Tania Dempsey: Oh, I'm so honored to have my fellow board member of ILADS here today, Dr. Eboni Cornish. Dr. Eboni Cornish is Associate Medical Director at Amen Clinics. She is the treasurer of the board for the International Lyme and Associated Disease Society, ILADS, where we work together. With research training at National Institute of Health, as [00:01:00] Howard Hughes Medical Fellow, she's nationally recognized for her evidence-based work in neuroinflammation, autism, chronic toxicity, and complex chronic illnesses including autoimmune disease, Lyme, PANS and PANDAS, mold illness, CIRS and long COVID amongst others. At Amen Clinic, she integrates SPECT brain imaging with advanced biomarker testing to uncover root cause brain imbalances, and has created the Amen Clinics two weak neurointensive program for complex neuro immune disorders.

A sought after speaker and educator, Dr. Cornish is dedicated to advancing brain and body longevity while translating complex science into practical patient-centered strategies. Welcome Dr. Cornish. So excited to have you here.

Dr. Eboni Cornish: Thank you. I couldn't be more excited. Yeah. I love working with you, so this is a pleasure.

Dr. Tania Dempsey: Yeah, no pleasure's mine. I have so many things that I wanna [00:02:00] talk to you about. There's so many things that you can actually speak on, and I've, I've heard you speak at so many conferences and you, you really have such a great sort of perspective that you provide, to really make it simple for people to understand what, what's really going on in the brain and in the world of, of neuroinflammation. So, so let's, let's sort of dig into neuroinflammation. I think that's, that's like your, your baby, right? That's what you're really love, love talking about, I think. But you can talk about whatever you'd like, I'm open to it.

Dr. Eboni Cornish: I know that is my quadruplet. You know, I have triplets. So neuroinflammation is something that I absolutely am in love with. The way I look at the brain, you don't know until you look. And how many patients do we see Tania who come to us and they've had normal MRI, normal CT, normal this, and they're still presenting with those key symptoms of brain fog, chronic fatigue, you know, mast cell activation, and any other [00:03:00] neurological changes, and we're like, okay, what is it? Is this an inflammatory process? Is person's brain on fire? What do I need to do next? And so neuroinflammation just basically means, it can mean numerous things, it can mean there's an autoimmune process going on in the brain that might be causing neuropsychiatric symptoms, like things like PANS, PANDAS, which is pediatric autoimmune neuropsychiatric syndrome associated with chronic infections.

It can be an autoimmune encephalitis, which is just an autoimmune infection of the brain and inflammation. It can be something as simple as mold and environmental toxicity or just something that stimulates these things called cytokines that just get outta control and make that brain overactive. And the beautiful thing is, you know, we say the term a lot, but is it really happening? So that's what makes me so passionate about brain health and brain [00:04:00] inflammation, because if we know it's there, we can put the tools in place to fix it.

Dr. Tania Dempsey: So how do we figure out if it's there? So what's the first step?

Dr. Eboni Cornish: So one of my favorite steps, it's not always the first step, but is to look at a brain scan image called a SPECT scan, which is a 3D image of the brain. So anyone who's ever heard me speak, I love talking about this, because it doesn't tell us exactly what the diagnosis is, but it tells me what questions to ask.

So a lot of times I'll have patients who might present and, you know, they've been diagnosed with tons of lab tests for, you know, chronic complex illnesses, been on, how many of our patients went on 50 60 supplements or been to five or six doctors, and they still have that neurological imbalance that's present.

And the question, just like you said is, what is it? And [00:05:00] we need to at times look. And looking at functional anatomy, having this 3D image, knowing what part of the brain is working well or not working well enough, or not getting enough blood flow can really be dynamic and how you help a person restore their health. Because sometimes it may no longer be inflamed.

It may be something completely different that you're missing, like the time they hit their head and they didn't tell you about it, or the sleep apnea they didn't make you aware of, and you can see those patterns on the image. So it really helps me determine if this is a neuroinflammatory process or not, because it will get labs. Sure. How many labs do we draw? We get tons of labs and they can come back positive, but the question is. How much of it is it impacting the brain? And so that's why I like to look at it.

Dr. Tania Dempsey: Yeah, I mean, I'm so fascinated by the SPECT scan and what you can do with that information. Right? [00:06:00] So then once you establish that there's an inflammatory process, let's say, let's say the SPECT scan confirms it for you, then what's next?

Dr. Eboni Cornish: Then you have to know what questions to ask. So we're clinicians, right? So the reason I first started working with Amen Clinics about 15 years ago, it's because they were psychiatrists, they are psychiatrists. We now have functional medicine doctors. But they would find these SPECT scans that didn't quite fit the model of general psychiatry.

They weren't depressed on the scan, or they might've had another layer on top of that inflammation. And then you say, hey, what's really going on here? It's not all in their head. So then as the clinician, you have to say, okay, I have your history. Review all the data that's in front of us, and let's dig one step at a time at what are the common causes.

So I like to look at it as your immune system [00:07:00] being dysregulated, your gut, because we know the gut and the brain are connected, and you can have gut inflammation and neuroinflammation. We can think about the environment because that's a lot of, I know what you talk about on this show, is how the mast cells are influenced by things like mold and environmental toxicity and all the things in this toxic society that can inflame the brain. And then of course one of our favorites are those complex chronic bugs. Those infections that you look down, may that be bacteria, parasites, you know, you name it, that might cause this neurological imbalance. So based on the clinical presentation of that patient, 'cause we don't test for everything, but you wanna make sure you have the staples. You got the hormones, you got the gut, and you have the inflammatory markers, and then you can do the good detective work to find out what's the cause.

Dr. Tania Dempsey: Yes. Yeah. [00:08:00] And so which, what would you say your, your approach is then to treating the neuroinflammation? I know it sounds like a really broad question, but like for a lot of people who are listening, right, they're looking for that one, you know, sort of, magic bullet, you know, magic pill for neuroinflammation.

You know, some people look at it from the perspective of, oh, you know, IVIg is gonna help neuroinflammation if it's causing a PANS or PANDAS. Or steroids or, you know, people have this sort of algorithm that we'll say, right, but, but the reality is, at least this is what I think, and I, and I'm, I'm guessing you probably think the same there, there's no one size fits all and there's no one thing that treats neuroinflammation completely or, or specifically.

Right. So you use, you, you look at that, that wide net, and then you try to figure out where you're going in and how, right, so if you find some hormonal imbalance, that's your way into the [00:09:00] neuroinflammation. Is that, is that right? Is that kind of what you're saying?

Dr. Eboni Cornish: I take it completely back a step. You know, we are in a toxic world, so I make sure I'm optimizing this absolute basics. So anyone listening today, if you have too many pro-inflammatory foods that you're eating, that you're ingesting, guess what. That's going to lead to not only a systemic inflammatory process, but neuroinflammation. If we don't optimize that gut health, right, and we have severe dysbiosis, which means too many bad bacteria, not enough good ones, 'cause we know it's over 300 trillion in that microbiome of ours. So if we don't balance that, have a good gut lining, fix that leaky gut, then that can also lead to inflammatory gut, which can lead to neuroinflammation. So that's kind of the first thing I tell patients. Like, look, we're gonna look at every step [00:10:00] in your body. We're gonna look at all the different systems, but we have to establish a good foundation. I also tell patients, if you're not sleeping, right, if I haven't explored that, if you're sitting around with sleep apnea and actively having a lack of oxygen to your to your brain at rest, then that can also lead to a neuroinflammatory process. And then you tie it all together, that can also impair how the brain, the hypothalamus, is producing those hormones. So then you have to make sure those are balanced as well. But when people start talking about treatment, they're going too advanced. You get there, but you have to stabilize the overall terrain to systemically lower inflammation using the easy steps.

Making sure you're pooping, making sure you're sleeping, making sure you're not introducing those inflammatory foods, and making sure you're [00:11:00] modulating the immune system. And then the other methods would work. How many of our patients, you know, they come to us and we are doing all the digging and we're doing all the prescribing of the supplements and treatments, and then we don't lay that good foundation.

That is where we start. We build the person up, we start at the basics. It's simple. And then you go, and I like to say, you get more into that evidence-based, those details and you make a kind of a strategy that's individually placed, 'cause that was exactly, it's no one stop fits all. It's individualized, and then you tailor that approach based on that patient.

Dr. Tania Dempsey: Well said. I couldn't agree more. So yeah. So could we talk a little bit about the gut then and the gut's role in neuroinflammation, but in general, the gut's role in just about everything, right? Because you mentioned the gut, you mentioned pooping. So how, what's your approach? How do you, how, how do you [00:12:00] approach the gut with your, with your patients?

Dr. Eboni Cornish: So a lot of the patients, since I work at Amen Clinic, I'll see a lot of patients that I collaborate with who might have neuropsychiatric manifestations of disease because we know mental health is brain health. So they may present autism, ADHD, trauma, depression, and I always have to connect the dots, you know, look, 80% of our immune cells are in our gut. Those neurotransmitters for serotonin are in your gut. So when we say you gotta love your gut, it's loving your brain, it's true. You know, I like to break things down very simply because this is something I'm passionate about. So when we look at the microbiome, both in the gut and in the mouth, the oral microbiome as well, we know that you have to balance those pathogens. You wanna make sure that the bad organisms stay at bay because they send the bad [00:13:00] signals, right? They stimulate the cytokines, they stimulate the inflammation, and you wanna make sure you're feeding the good bacteria, one of which that we are hearing a lot more in the literature as it relates to brain health is bifidobacteria. So I'm making sure that I'm looking at bifidobacterium levels in a lot of our patients and making sure that's optimized, but that's just because I know if a person has elevated levels of inflammation in their gut, or they may have a damaged gut lining, right, then that's gonna predispose you to more inflammation. That's gonna get that cascade going. In functional medicine, we use the words like endotoxins. Well, one thing that I find as it relates to the gut is that if your gut lining is damaged, you have imbalance of something called zonulin. You have too much bad [00:14:00] bacteria, organisms, parasites, yeast, then that can predispose you to what we call leaky gut. And I always say leaky gut is leaky brain, because the gut and the brain are connected by the longest nerve in our body, the vagus nerve. So if we have gut imbalances how many patients we know have POTS or have, you know, vagal nerve dysfunction, and a lot of times if we try to heal that gut lining, optimize that good bacteria, that will help stabilize the nervous system. So there are tons of protocols we use. You know, we're both functional medicine trained, so we know the four Rs where you're removing, replacing, repairing, rebalance. So removing the bad foods, repairing the gut lining, replacing the good microbiome that might have been damaged from those years of medications or antibiotics or even other [00:15:00] herbal antimicrobials and trying to rebalance that patient.

But you gotta go in order, right? And the way I explain to my patients is a couple ways. These are my tips, guys. Listen, the more toxic foods you are eating, the more supplements and meds you are gonna require to get better. So even when I'm listening to my teens, I was like, wait, wait, if you give me five toxic foods off your list, I'm going to take meds.

Dr. Tania Dempsey: Oh, I, I, I, I love that. I love that. Oh my gosh. I mean, it's endless, right? No one wants to take pills, right? So we hear this all the time. You're taking too many things, right? But why do you think you're taking so many things right? There you go.

Dr. Eboni Cornish: And then, and you know, the other thing is I tell patients all the time, look, if I need to fix your gut lining, if you are getting leaky gut, then all of those medications and supplements and you [00:16:00] know those responses you're having, those adverse reactions, those inflammatory, that inflammatory burden, hey, those supplements might just be leaking out.

You know, you may not be maximally absorbing all the medications and things you're already spending money and taking, right? And so you're wondering why things aren't working well. So it's that simple. The gut is beautiful and it's simple, right? You don't think, it doesn't require being on a rock, you know, I call it a rocks and paper diet, right. Have to remove every food known to man.

But if you structure it according to the patient and you get them to get buy-in to removing some of those toxic foods, it works. It works. It just, it's common sense. If you want things to work, you wanna absorb them.

Dr. Tania Dempsey: Yep. Yep. And we've, and we've really done a disservice at least in this country and now really all over the world in promoting these fast foods, [00:17:00] processed foods, the the ultra, you know, the hyper palatable foods, all that. And in a way that, you know, it's convenience. There must be nothing wrong with them because look how many millions of people eat them, right. And yet, yet millions and millions of people are sick, right? We've sort of been, you know, kind of been brainwashed to, to really think that, these are foods that are acceptable, you know, and, you know, teens you know, get into it really, really, you know, quickly, then it's college and they, you know, need quick, quick sustenance.

So again, it's, you know, not great food. And then they, they grow into adults. And, you know, working hard and then again, relying on, on a lot of processed food. And we really kind of underestimate what it's, what it's really doing, right. Not just the how, how bad the food is in terms of like where the meat came from or where the, you know, how much pesticide is on it, but like beyond [00:18:00] that, right?

How it's packaged, how it's, what, what, what's in contact with it? The, the food borne pathogens, like, like food poisoning from some of these foods, right. Now we, we hear about food, food, poison and foodborne illness now almost daily. There's, you know, all these reports of, oh, the, the, the, the lettuce was contaminated with, you know, e coli and like, oh, you think you're being healthy by eating lettuce, and now you have, you know, e coli, an e coli infection.

So it's just a, it's a great message just to say, look, you, you have to start thinking about what, what you're putting in your body across the board. Like, what are you, what are you breathing? What are you putting in? And that's, that is the foundational stuff. But it's hard, right? We recognize that. It is hard to make change.

Dr. Eboni Cornish: Yes, and you gotta take baby steps. You know, the way you look at it, we all love our brain. We don't want our brain to be [00:19:00] impaired. We all wanna have optimal brain healing and function. We all do. So are the foods and the things you're choosing gonna love your brain, or hurt your brain?

That's the way you think of it. If you think it's going to harm your brain, then don't do it. Try your best. So I've determined a way I use this certain app that, you know, it's, it's fun, and I'll write things in, like, for example, today, a patient I had, patient who eats McDonald's every day is non-compliant, doesn't wanna eat, you know, whole foods. How can they find sugar alternatives and food alternatives that can make them happy, and what are some healthy restaurants in their area? Boom. Try baby steps. And if you write those down and you try your best, guess what? As your brain [00:20:00] starts to feel happier, you are gonna feel happier, and you're gonna wanna have some buy-in to go further. But you also have to remember to forgive yourself.

You know, I know when I first started in functional medicine, it was always gluten-free, sugar free, dairy free, paleo. You know, it was like, okay, what diet works for each person and then, at the end of the day, I have this person stressed out, limbic system in overload because they don't know what to eat.

And so I've learned you gotta meet a patient where they are. And if you express the fact that we all need to love our brain, we do, and we, that means we need to love our gut. So take those steps. And so I had a patient today, he was on the spectrum and he said, look, I'm not changing anything. So I gave him a chance, and this is what I want people to understand. It takes baby steps. I told my patient, look, give me the top five things that you're eating that are toxic and take three out. He [00:21:00] took out soda and some other fast foods and I was fine. I said, okay, that's a start. And then you build and have trust in that patient and they feel like it's realistic. Then they'll keep going with it.

But if you give too many restrictions upfront at once, it sometimes can be overwhelming. And then you'll have what I call diets. We're not looking for diets. You know, us, we're looking for lifestyle changes, and that's why I admire the work you do and the carnivore and people who can be disciplined enough to optimize with whole meats and foods that get their, their brain whole again.

Dr. Tania Dempsey: But it's not for everyone. That's, that's the bottom line, right? That's what, that's what, that's what we're talking about. Like, the diet I do, it may not be the right diet for you. It might not be the right diet for the next person. It's really about trying to figure out what's sustainable.

Dr. Eboni Cornish: Yes.

Dr. Tania Dempsey: In as healthy a way as possible, right, in the life that you're living right now, you know?

Dr. Eboni Cornish: And it's so [00:22:00] wonderful and fascinating. We did a SPECT scan on a patient before and after red dye. And we saw visually the impact that red dye has on the limbic system, the basal ganglion, the thalamus, that part of the brain that makes you anxious, that keeps you in fight or flight, that keeps you, you know, unable to focus, that keeps you in overdrive.

Man, it was lit up so much after red dye, if you look at the pre and post. So then you understand, okay, these are why people aren't focused. This is why they can't sleep. This is why they have brain fog. That's why I love brain inflammation. You can see it. It's visual. You know, we're not making these things up.

And so knowing that there are different areas of the brain that can be impacted by what it is we're choosing [00:23:00] to eat, and you can visually see that, really helps people, you know, make that well make those changes they need in the order that's appropriate for them. So I think you're absolutely right and you know, we talk about this, I love talking to you about this because it's never a one stop fit all.

But I guess, what, when I'm looking at patients, I look at patients, I collaborate with other doctors who are functional GI 'cause we're trying to better understand the gut brain axis. That's like my goal, you know, when my kids grow up and I can publish, that's what I wanna do. What does that gut brain axis actually look like?

You know, what's going on? Where is it affecting? What's happening? So just like with the red dye analogy and the, it's the the data we have, I mean, it was directly making that area of the brain active called the limbic system after administration of red dye. And that's just a sample, small sample [00:24:00] size.

Dr. Tania Dempsey: That's incredible. How long was it between the ingestion and the scan?

Dr. Eboni Cornish: So they were regularly having red dye for seven days. Mm-hmm. Yep. Yep. And so we looked at it. Yeah. So it's not work unfortunately, that we're publishing, but it's work that worth mentioning because I'm sure once you know, we get that energy and people can publish, that that's my dream, is to know what areas of the brain are impacted by gut instability so that we can make more tailored treatments accordingly. So, so yeah. So there's definitely some visual changes that occur.

Dr. Tania Dempsey: That's incredible and, and what I'm thinking about, this is like all of a sudden my brain starts to, starts going, woo, okay because we know, right, that mast cells or dysfunctional mast cells impact the limbic system. We know that we can use limbic retraining to help Mast Cell Activation Syndrome. [00:25:00] We know that there are excipients in, in certain medications and foods, including dyes like red dye number 40, that that can trigger mast cells to become dysfunctional. So now it starts to like, make me think, well, is it the red dye affecting the mast cell, affecting the limbic system? Is that a direct link to what we're seeing when someone has an excipient that they are reacting to. That's like mind blowing to me.

Dr. Eboni Cornish: Yeah. And, and when I look at the brain image, 'cause like I said, the SPECT scan is a 3D image of the brain, we look at both the surface of the brain, so we're looking at areas where you're getting, we're not getting enough blood flow. So that's called hypoperfusion or deficits, not enough activity. So we can tell if there's a traumatic brain injury, prefrontal, temporal, dementia, if this person has an [00:26:00] inflammatory process, you know, so sleep apnea higher on our differential diagnosis, focus problems. And then when we look deeper at the brain, right, then we're looking more at the areas that are too active and the areas of the brain that should be the most active is in the back of the brain.

We used to think of it as the little brain in school, right? The cerebellum.

But it, we've learned how it controls so many other areas and how it also sends signals to that deep limbic system, to that amygdala, you know, basal ganglia, thalamus, that whole area. And when I look at scans, I see hyperactivity, it's like a, it's like a light bulb, it's like white. It's like you can't miss this. When you're looking at the limbic system, when you're looking at the basal ganglia, when you're looking at the thalamus, even in the front of the brain called that turn your signal, it's like ring. I know that patient probably has some sensitivities. You know, it's not [00:27:00] just medical anxiety.

That's why we say mental health is brain health. So typically my patients who do suffer from mast cell activation syndrome, typically I can visually see limbic system that's overactive on a SPECT scan, and that does, like you said earlier, help direct my course. So those patients, I may say, hey, you're coming to my office. You're on mast cell stabilization, you're still not tolerating things. Let's go and do some neuromodulation. You are gonna need to do DNRS, you're gonna need to do biofeedback. You're gonna need to do neurofeedback so that we can calm that limbic system and you can start having more mast cell stabilization, ability to tolerate things better, and you can go through my treatment program. So you hit the nail right on the head. That's something we should [00:28:00] start looking at.

Dr. Tania Dempsey: Wait, why are we not studying this and why did I not know this?

Dr. Eboni Cornish: I taught you one day. Just kidding. It's something. It's something that I'm very passionate about.

Dr. Tania Dempsey: No, no. We need to run, we need to run a study.

Dr. Eboni Cornish: Oh, we do, but I gotta wait. These triplets are nine. You know, I gotta wait till they give me a little more time. But I, I do, I have collected so much data over the years.

Dr. Tania Dempsey: This is incredible. Because what, what I would do if we had, if we had, you know, unlimited resources, let's just say, right, you have all the time in the world, and I have all the time in the world and we have all the money in the world, right? Maybe we have, we have funding for this. What I would love to do is take patients, with symptoms obviously, put them through the mast cell testing that we do. Okay, so 24 hour urine analysis, we're looking for metabolites like N-methyl histamine, we're looking for prostaglandin D2. You know, all those things. We're looking for in the blood, histamine, [00:29:00] heparin, chromogranin A, tryptase. We're looking maybe even at biopsy samples and they've had some CD117 staining, right?

So I'm doing my consensus two criteria for Mast Cell Activation Syndrome, and then put them through a SPECT scan, right? And see what the correlation is between the data that we get with testing and the, and the SPECT scan.

Dr. Eboni Cornish: I'm sold. It does because right now, yes, because I see it so often we're gonna find the data, 'cause I do draw the labs. But even before drawing those labs, I already know from their questionnaire, from their history, from the way their brain is presenting, that that is something that I should put on my differential diagnosis.

And that's why the SPECT scan is so important because it won't say, hey, this person has mast cell activation, but it will give me the questions to ask, things to think about. You know, is this a [00:30:00] toxicity? Is this really a histamine imbalance? What else could be going on? So it allows me to start to know where to do my detective work for that patient, but more importantly, incorporating and just about, I would say 60% of my mast cell patients I have to incorporate neuromodulation of some sort as a part of their treatment to calm the limbic system. I mean it's, it's fascinating and we probably could do that study with, let's get some money guys and get this study going.

Dr. Tania Dempsey: So what do you use for neuromodulation? What does that, what does that really mean? What are, what kind of techniques are you using for, for patients? I hear this a lot, I've had patients who have done it, but I'd like to hear a little bit more about what, what you're doing.

Dr. Eboni Cornish: And the wonderful thing to note you know, the ILADS, International Lyme and Associated Diseases Society, always put in plugs, we're gonna have a whole section on neuromodulation in our upcoming meeting in October in San Antonio, [00:31:00] because it's so important and there are so many different modalities of neuromodulation.

So basically what happens is you have different, to make it very simple for our listeners, you have different brainwave patterns, right, and you wanna make sure that they are firing simultaneously and synchronous. So that is what you use to modulate that, those brainwave patterns. So that can be something my, one of my favorite methods is biofeedback and neurofeedback. That's where you are working with a therapist who's using computers and exercises. You place different leads on the scalp and they'll tell you, hey, we've gotta get that, you know, alpha wave, delta wave, all those different waves to work together. We gotta get them in synchrony because right now it's a lot of [00:32:00] noise going on in the brain. But once you can get them working harmoniously, those different brainwaves, that too can help calm the limbic system. I also utilize neural retraining, which is just different programs that patients go through at home, that they go through different lessons, it takes discipline, and it allows for them to reset that limbic system using different modalities and training to reset the brain. And that's a fascinating way to treat. Because I'll never forget, I learned about that me when I first started treating chronic complex illnesses and I was focusing primarily on vector-borne diseases.

Had a patient, she came to my office, she took a drop of anything and she fell out. You know, and I was like, what kind of field did I get in? This was like 15 years ago. I was like, what is happening? And it was because of limbic system, her limbic [00:33:00] system was too active and she didn't start to do the Annie Hopper, DNRS, you know, and other, they have other programs, Re-Origin, Primal Trust, whatever, HeartMath, whatever is, you know, suitable to that patient.

And then there are things like, that are simple, they're taking an even step back. Like watches. I use Apollo Neuro in a lot of my patients. It's another kind of modulating device where you set it on different settings throughout the day and it helps to calm down that limbic system as well.

And then of course you have supplements, right, like GABA and L-theanine, Phosphatidylserine that can come in and kind of quiet the brain. But for those who really have challenges, because I know you and I have a lot of patients with histamine imbalance, they just have difficulty getting started. They just can't tolerate anything. Fragrances, food, supplements. It's miserable. [00:34:00] But if you start calming down those pathways with non-oral methods, it's beautiful. It can be so rewarding. So, you know, I even have to use it for patients who might have trauma. There's something called EMDR, which really helps people with PTSD 'cause who doesn't have PTSD going through complex chronic illness. How many doctors have you been through, your family shaming you, you know, you're stressed and it's a lot of trauma involved. But I feel like those have really changed how I treat my patients with complex chronic illness. But a lot of times looking helps me know and determine how I need to go about presenting that to patients.

Dr. Tania Dempsey: That, that was a great overview. And, and and, and I appreciate the plug too for ILADS, because it's gonna be a tremendous program, it's a, it's a, it's a full day program for medical practitioners.

Dr. Eboni Cornish: It's gonna be fascinating, but I think it's important even to our [00:35:00] listeners, even if these terms don't sound familiar to you, just understand, 'cause we're using a lot of acronyms, but just understand that the goal is to really find ways to calm the brain, to get your brainwaves working synchronously, you know, harmoniously. To also make sure the brain feels safe to heal, right? Because that's a big problem, feeling safe. The brain is, when it's on fire doesn't feel safe. So that to me is a key part of healing.

Dr. Tania Dempsey: Yeah. No, absolutely. I I love that term. Safe and safety is, is is part of the problem, right? When the body is on this high alert, when the mast cells are on high alert and constantly activated, right, the body doesn't feel safe. The brain doesn't feel safe. And so then you wind up in, in this really vicious cycle and loop that [00:36:00] you know, that you try to get them out of. I'm curious about, you know, we, we, we get asked all the time about you know, things to use in, in children versus adults. That children are not just little adults, right? They, they are different. So can you use any of these techniques in children and, and at what age can you do, you know, these difference or neuromodulation techniques?

Dr. Eboni Cornish: So I have found kids as young as 10 and up can benefit from that feedback, that neurofeedback, biofeedback. There's also a method that we use, that I use a lot, called interactive metronome. That's another kind of electronic method where you work with a therapist and it requires that you do certain exercises.

So I use it a lot in my patients who are young who have, who might be on the spectrum, who might have, you know, attention deficits, who might suffer from panic, and even if the root cause might be a [00:37:00] complex chronic illness, like we said earlier, you have to work on brain stabilization. So I've also found that with children using those modalities make a huge difference. I treat a lot of kids who are on the spectrum. You know, I treat kids who have what you call pediatric autoimmune neuropsychiatric disorders, which is when the brain immune system is fighting your own neurons and creating these antibodies. It's like a mess. It's chaos going on. And instead of targeting the pathogens and the bad infections, it's targeting you and making this whole inflammatory storm that then causes you to have psychiatric symptoms. So I see those patients, they do benefit from things like interactive metronome and neuromodulation 'cause a lot of times they may have so many problems from a neuropsychiatric, you know, standpoint that they don't wanna take anything. [00:38:00] They don't wanna take anything orally. You know, they don't wanna change their foods, their diets. So yes, those modalities can be safe for children. The biggest thing I use for not necessarily neural modulation, but for neuroinflammation in kids, especially those who have PANS and PANDAS that I mentioned earlier, I do use a lot of IVIg, which is going to help target the inflammatory response, kind of do immune modulation in those patients. And I have significant improvements with things like OCD, ADHD, anger, depression, anxiety. So you know, it's very important that not only you stabilize the neurological system, but that you stabilize the immune system of the brain.

That's what we're talking about. Immune dysregulation, which leads to neuroinflammation. So it all goes together. But [00:39:00] definitely with my challenging patients, 'cause I have a lot of them who are sensitive and are difficult, and you know, picky eaters, you have to get creative in your approach. And sometimes non-oral modalities, modulation is the way to go with some of these patients, to at least start. And then once you get those brainwaves working well, once they're at that EMDR, once that interactive metronome, all of those things have started working, then they're more willing to change their diet and more willing to take their supplements.

And once, like we said, that safety, feeling safe to heal takes place, but it does take time. And listeners listen, it's not a one-stop shop for any child. It does take finding and creating that individual protocol. It does.

Dr. Tania Dempsey: Yeah. Yep, a hundred percent. How [00:40:00] often are vector borne infections a piece of the puzzle that you also have to deal with?

Dr. Eboni Cornish: Just about all the time. But you know what, you know the question when it comes to neuroinflammation, the reason, you know, I use the brain scan imaging and have my intensive program is because neurological vector-borne diseases, once it's there, you have to treat it intensively, right? But at the same time, we can look at the scan and if I find, so some of the patterns that we see with inflammation may be decreased blood flow, that's something called hypoperfusion. Or you may have this toxic scalloping appearance on the top of the brain, which is the parietal lobe. So you know, like, look, that's a toxic brain.

Or you may even have that limbic system activity. But what happens when you have all the tests, [00:41:00] you've been treated, and the brain looks great, and there's something else outside of vector-borne disease going on. And I share a lot, you know, a lot of our colleagues will send me patients, like Dr. Cornish, Eboni, I've been treating them for five, six years, they've been through this, this every herbal, IV, blah, blah, blah, and doing all the things, right. Boom. It's PTSD that you're missed. Or look at their limbic system, it's still on fire. Or look at their frontal lobes, you know, and their temporals, they may have had a car accident or traumatic brain injury, so you need to also work on brain rehabilitation while you're simultaneously treating these vector-borne diseases.

But without looking you just keep going, chasing and chasing, chasing, and you don't know with other layers, because you really don't have tests, right, for just traumatic brain injury. You really don't have a test [00:42:00] just for PTSD. You don't have tests for those things. And so, you know, I've had patients, I was embarrassed, because I had my, I'll never forget when I first learned how to read SPECT scans, so embarrassed. Had a patient, she had babesiosis, tick-borne parasite, Bartonella, I put her through IV antibiotics. I mean, I gave her the kitchen sink, fixed her gut, fixed her hormones, and she still wasn't getting better. Did her brain scan. She had a pattern consistent with sleep apnea. And all this time, I didn't even think of her. I mean, she was 120 pounds. I knew she had interrupted sleep, but I didn't really think like I should have done a sleep study, right. I got on her CPAP and her immune system started working again and her brain function started improving. So it's just like simple things like that because we, we know so much in functional medicine, we're learning every day and we all get [00:43:00] so excited and passionate about what we do, but then you see the awful cases. Like you have a patient who might have prefrontal temporal dementia. I had a case like that and it was heartbreaking because he'd been to four different Lyme specialists and you're like, they're brilliant. Like, what is missing? What other tests can you do? And then I looked and I said, you know what, this is irreversible. You know, this might have been triggered by these vector-borne diseases, but there's some things that we just can't, can't fix, you know. Or the kid with ADHD, which might be triggered by complex illnesses and vector-borne diseases, but they might need herbals or something to help support that dopamine need that they have. So it's just fascinating how kind of we go through so much, and we know that in a lot of our cases, when we treat those infections, [00:44:00] those brains improve. But in some resistant cases, that's where brain imaging helps, right, because it then tells you, oh, dang, I missed that.

You know, that could I, I could have done that first. So, you know, that's kind of, you know, where I am in my practice style, and I'm still learning every day.

Dr. Tania Dempsey: As you should. You should never stop learning. There's a problem if I don't learn every day. This has been so incredible Eboni. Any, any last words of, of advice or any last thoughts? Anything you'd like to leave us with?

Dr. Eboni Cornish: Yeah, I just really wanna thank you for this opportunity. I mean, I'm very passionate about what we do and our mission, and I know the people listening are trying to find answers, and you're such a leader in the field and they have been struggling. You know, we don't see those patients that got sick in 24 hours. You know, just got that tick bite [00:45:00] or that one symptom.

They're looking for answers and I tell all my patients, don't give up. These illnesses take a physical, a mental, and a spiritual toll, and you gotta know and keep the faith that there are people out here that are trying to help you. There are organizations like ILADS, there are podcasts and leaders like Dr. Dempsey, people who are on the frontline every day. So keep fighting and know we're talking about neuroinflammation and it is not all in your head. I can be found all over the place. You know, you can follow me on Instagram @dr.ebonic ornish. My website is www.drebonicornish.com.

Very easy. Or you can find me at Amen Clinics. As you said, Associate Medical director. I do telehealth and we have our, for those patients who are [00:46:00] really struggling and need intensive care for complex chronic illness, we do have our two week intensive program where we focus on brain rehabilitation in a two week manner that kind of jumpstarts that healing process.

So yeah, I'm, I'm around, I'm here to help.

Dr. Tania Dempsey: No. You've got some great content and, and a lot that everyone can learn from, so I can't thank you enough for being here. I love, I love your energy. I love when you teach us. I learned, I learned a lot today, as always. I always learned from you, so thank you.

Dr. Eboni Cornish: Oh, thank you so much.

Jill Brook: Dr. Cornish and Dr. Dempsey, thank you so much for this incredible conversation. Thank you for your ongoing work and for being here today. And to everybody else, we'll be back again next week, and until then, thank you for joining us, may your mast cells be good to you and please join us again soon.