Dr. Tina Peers from UK Discusses the Management of Long Haul Syndrome

all this is doctor mobine syed from dr bean.com welcome to one more show today we have a rock star from uk dr tina pierce she has a peers protocol for long covered i am honored to have her with us she was participant for the context purposes she was a participant and presenter in dr tess lorri's conference bird conference she has now her own conference coming up next month as well i am honored to be part of that conference as well dr tina peers have now been managing covet long-haul patients for some time so here is a quick introduction to dr pierce so she is a woman's health specialist she has been helping covert long haul since november of 2020 prior to that she has been managing mass cell activation syndrome patients for six years so here the important thing is the mass selectivation syndrome patients because one aspect of the long-haul patients is mast cell activation so that is a very important area that she is working in dr pierce welcome from me and from all the cool beans thank you so much for inviting me i'm very honoured indeed to be able to speak to you because you are an absolute rock star yourself and uh so it's a great pleasure to be able to share our ideas and discuss what we're doing in the you know in america in the uk it's uh that's a fantastic opportunity so um so my background is i trained as a gp originally and um and i did general practice for seven years part-time while i had my three children and then i realized that my great passion was women's health so i became a consultant in contraception actually and i put together um uh the services contraception services for the whole of surrey um for 24 years i led that and really enjoyed that that was fantastic and and at the same time was developing menopausal services and became a menopause specialist um so i now have uh the menopause consultancy where i work with five four other doctors um and we see menopause women and and help them to stay healthy and fit and well which is fantastic and i also um have an interest in mast cell activation as you quite rightly say dr mabin so that interest comes from my daughter actually because i have my youngest daughter is now 28 and she um has been ill all of her life and um and you know we couldn't work out what was going on with her we couldn't find anybody who could help us with her and she just became sort of stepwise more and more ill as she got older and as she had infections like swine flu she became more ill she then became hypothyroid became more ill and then had chickenpox as an as 19 year old and so on and then she became super ill in 2016 and i was so concerned i had to really sort of go trawl through the internet try and work out what was going on with her and that's when i made the diagnosis of master activation syndrome in jessie and and then i had to try and find somebody to help me and that was really really tricky i couldn't find anybody in london and i stumbled across a fantastic professor vic cooler who is a urogynecologist and that's mary's paddington and he confirmed to me that i'd made the right diagnosis and then he has really been my mentor and helped me uh with my with jesse and with my patients to work out what's going on now then once you know about something you can't sort of unknow it can you you can't help yourself but then start seeing it and hearing stories of people and thinking i know what you've got you've got muscle activation so i started diagnosing about six people seven people a week coincidentally they were coming to me for the menopause or for contraception and i would take their history and think oh they've got it too and then i would say to them i think i know what you may have causing your ibs and your chronic headaches and your urticaria and so on and the most common response i had was that they would burst into tears because they were so relieved that somebody was interested in all these funny symptoms that they had and was putting an answer a name to the problem and trying to help them with it so that's where my interest in master activation started and then um i didn't ever advertise that fact but people just come to you don't they and i just got busy and busy with that and then in um in last summer i started hearing more and more about long coved long haulers and the symptoms that they were struggling with and i it just rang but rang bells with me and all of the symptoms seemed to resonate with you know muscle activation so i've i thought this is what's going on their immune system has is responding in this way it's either exacerbating pre uh the precondition of muscle activation syndrome or somehow causing it in them and so i wanted to find out um curiosity being that you know fantastic and and i i went on bbc television a local television station for bbc and i asked the long covered patients if they would download a free app called the people with app and that's written as one word and they could put in their profiles you know their symptoms and record them and 2 000 people did and i could look at their profiles and lo and behold they absolutely matched the profiles of the patients with muscle activation so then i thought um i need to speak to these people and the best way to speak to them is to actually open a clinic and start seeing them i also felt i felt i could help them and it was um immoral not to try and do that you know so so i opened a clinic and um actually it was fully booked very very quickly um and i started because i wanted to ask the patients as well as helping them i wanted to say to them you know what was your previous history like before you caught the coronavirus and did you have a history of allergies ibs etc etc and by far the majority of them have had that history so they've got a sort of previous predisposition if you like genetically to having mast cell problems and then the coronavirus just like any virus made it much worse um and then we started i started treating them and so many of them have got so much better um some of them are completely better some of them are 90 percent better they're able to get back to work they have just a few residual symptoms maybe but they're manageable or they're all you know completely better so it's very very exciting and very um good work to be doing and so but i've been inundated and um it's it's actually difficult to there's such a huge demand there are other doctors like me in the country doing it those who already treat mcas have recognized the similarities and what's going on some nutritional therapists and also functional medicine practitioners they are treating patients with long covert as well but unfortunately the um the nhs has been very slow to catch up with what we're doing and they have opened long covered clinic 70 lancover clinics have opened across the country which is pretty amazing really but unfortunately they're telling people to pace themselves you know they refer them to a cardiologist to be checked out for their pots type symptoms and then they're referred to a gastroenterologist who checks out their ibs type symptoms and then they might see a neurologist for their tingling and their headaches but they're not being offered any treatment as such so um yeah that's been disappointing really so on the back of that i decided i needed to organize a conference which you have honored me in coming to speak at which is fantastic so i think we should have a conference so that we can put out there what some of the leading people are doing in this field to try and spread the word to patients and doctors alike um to just get the message out there awesome such an amazing story starting from your own family all the way a continuity of service throughout and uh for the cool beans a couple of things here number one from an administrative point of view if i'm looking here uh please don't think that i'm losing contact with you or with dr tina pierce i am looking at the presentation that she would be uh talking through and if i'm looking here again not making a content these are the contact these are the comments over here so i'm looking at the comments to see what questions i can present so the request that i can make for the cool beans here if you can put qqq or some question marks with your questions so i can filter them from the question stream over here and present them we are live at five channels at this time so there are many questions that come from all those chapters so having said that going back to dr uh teen appears dr pierce this is such an important area that so there are folks who are asymptomatically healed i am seeing that even they are becoming long haulers too so long hauler does not actually have a target to say that a person must go must undergo following symptom sets during the disease to become a long hauler and you can anyone can actually end up in a long-hauling state and that is the sad part of this the second part as you're just talking about nih as well doctors actually do not know how to manage the long call many times in the beginning of the pandemic when people started having long haul doctors would simply say this is psychological i had guests here on my program who simply said this was psychological and people should stress less and they would become okay and we should give anti you know psychiatric drugs so thank you very much for highlighting it thank you very much for working with it thank you very much for the conference for it i think this is a tragedy at this time an important thing is these folks can actually be these patients can be cured or brought back almost towards normal yeah absolutely absolutely so one of the problems is that mast cell activation isn't well known about and had that been on the the radar of gps and doctors in in a clinical medicine setting in hospitals and so on they would have it would have occurred to them they would have recognized it but because it's not known about um and it they haven't been taught about it they don't discuss it they don't read papers on it they it they just sort of pass them by you know and so it seemed absolutely tragic that patients for example with acute covet aren't treated immediately you know from from the beginning of this um pandemic i have been saying treat people straight away as soon as they catch the virus treat them treat them as if they have mast cell activation get you know things they can do which they can buy over the counter uh in many countries so the antihistamines and the the supplements and you know either mectin in some countries and they can take those and protect themselves from getting worse um but it's it's very strange that the medical profession generally has been sort of sitting on its hands and it hasn't been helping these people until they're really in a bad state and having to be admitted to hospital which which is then obviously much more difficult to sort out the hyperinflammation that's gone on but um yeah so mast cell activation was um put together as a syndrome in the 1980s and it was only given a name in the 1990s and it was in 2007 that the first three case studies were published you know actually actually had a publication so it hasn't been taught and it's not you know as i say it hasn't there are no randomized controlled trials never mind good ones um so everything that we're doing is consensus and sort of expert opinion of those working in the field so it's a very new uh science and and therefore um people don't know that when patients come to them with ibs that they've probably got muscle activation when they come with fibromyalgia they've probably got muscle activation when they have chronic headaches they've probably got muscle activation i know and um and so these patients are not they can spend decades with with a poor quality of life and no help and no diagnosis you know no um not being looked after properly which is i'm hoping i'm hoping that the silver lining of all of this pandemic and long haulers and everything is that we um that this is now putting it on the map you know the landscape is going to change we are having the conversation we are putting it out there about these conditions these states that people find themselves in that are affecting a very high percentage of the population so we reckon as many as as much as 17 percent of the population probably have some mass cell dysfunction and um and therefore this is really important you know this is this is um this is groundbreaking i think to to get this information out there um and so it's very exciting and my dream would be that these long covered clinics which are currently just telling people to breathe and relax um will become centers of excellence for patients with fibromyalgia chronic fatigue you know early stage loss pots etc uh ibs because marst cell's at the center of all of that wow thank you so much for doing this i i can actually see probably a couple of people within within my own family immediate family may need actually help with the mast cell activation syndrome so having this uh said this let's see if we can go over your uh presentation yeah because i'm already seeing the questions rolling in so i think let's have your are you ready with the let's let's roll with the presentation then so let's take this one off and this one off so here is the presentation so cool beans once again please hold on to your questions for the sec for a few minutes we're going to go over the presentation and then we'll have an open discussion please dr pierce okay so do you want me to bring my slides up on my screen so uh let me actually bring them up at them you have them yeah they have them so let's do it one second please here we are thank you so these are the slides um i helped organize the international ivor mectin for kovic conference which was in april um and uh dr mabine was our chairperson uh and did a presentation at that which was fantastic um and so these slides are from that present the presentation i did at that conference um so i haven't changed the the title slide yet but i will do anyway so um so this is me um and the next slide please okay so the hypothesis is that the uh cause of long covid is that the acute covid exacerbates mast cell activation syndrome in patients who already have the condition which up until that point is probably unrecognized and untreated now to going with that hypothesis is that actually if they had been treated and had been on the medication to control their muscle activation syndrome they would have probably had less in the way of first of all acute covered symptoms and then also less in the way of long-haul copic symptoms so that's the first bit of our hypothesis the second bit is that acute covid19 actually causes some muscle activation in the minority of patients with long covers so we think the majority have got a pre-existing problem and the minority maybe have no pre-existing problem but it exacerbates it so the etiology of mast cell activation syndrome is is environmental it's genetic it's viral and it's epigenetic so if it's viral this is where somebody who has normal mast cells it can be stimulated and the mast cells can be really upset by the virus which then results in mast cell activation syndrome but the people who have already existing muscle activation syndrome have got some genetic mutations and there are over 50 kit mutations in patients with muscle activation and probably patients don't just have one mutation they probably have a combination of a whole load which make their mast cells super excited and um a little bit too uh reactive the other the third part of the theory is that viral persistence in some cases was is continuing to elicit the immune response that is causing the mast cells but we now think there isn't viral persistence but it's viral debris and dr mabine you can talk a bit more about that because we've had discussions about that haven't we um so yeah so you know allergies are very very common one in five people worldwide has allergies and allergies are based in some kind of mast cell activation i know one in ten people have urticaria one in five have allergies it's becoming more and more common that people are allergic 10 of preschool children are have food in food allergies which is like unbelievable you know when i was a little girl we used to go to parties and you could have you could have peanuts on the table but now you there are so many things that you can't have out because one child could have anaphylactic shock so allergies are becoming much more um more prevalent the other thing to say at this point about muscle activation is that it's much more common in women than men so 80 percent are generally female which i noticed somebody commented on one of the comments saying is it more common in women yes it is so next slide please so as i said earlier on it's frequently seen and seldom recognized and therein lies the pity it's it's very common up to 17 of the population are estimated to have these dysfunctional cells and all you have to do is think about your friends and family you know do you know anyone with ibs probably yes do you know anyone who's had some funny funny sort of headaches chronic headaches and has to avoid various triggers can't have wine do you know people who flush bright red when they have wine um and they say well i can't have takeaways i can't eat this i can't eat that i've got various food intolerances um and etc or people who have funny rashes who really react to insect bites um and and sometimes wake up with a swollen face and swollen lips have hives um people who have fibromyalgia or psoriasis rosacea eczema these are all patients who've probably got some mast cell dysfunction and it causes chronic inflammation in various different systems and so it can be um multi-systemic you know um and and it can change in one person it can be in one system and then it can be in another system another time so it can be confusing and usually all the tests are normal so it's actually very difficult to come up with a sort of biological biomarker kind of diagnosis at the moment now i think that's going to change and i think that's going to change because of dr bruce patterson and his laboratory which is really exciting so i feel like we're on the sort of precipice of something very very exciting happening here in this field um but up until now i haven't really been able to do any blood tests and things on my patients uh that are particularly helpful because of the laboratories that we have in the uk so we can we can do that diamond oxidase blood test which um has to go to belgium to um to to come back to have retested but you know all the other tests the labs don't know how to handle the samples they have to be chilled from you know from the moment you take the blood it has to be chilled it has to be chilled in a centrifuged in a chilled centrifuge and none of the labs i know have that so um so it's very difficult to get a anything other than a clinical diagnosis but to be honest with you the clinical picture is so become so familiar once you start working in this field that you can feel pretty certain that um you you know that they have got this condition um and the symptoms themselves are actually caused by cytokines and amines that are released by the muscles so the mast cells as you've said so many times on your lovely talks uh release over a thousand different chemicals and mediators there's a cytokines and chemokines and the chemo says cytokines are mediators that um are messengers between the cells and the the chemokines attract inflammatory cells to the area um and then you've got the you've got prostaglandin d2 you've got histamine heparin i mean there's just such a huge list of chemicals so it's not surprising that if these are a bit dysfunctional these cells they're going to be releasing sometimes a cytokine storm and sometimes possibly just uh selective chemicals um in a dribble drama kind of way which are irritating the body and causing inflammation so next slide please okay so i was thinking about this from the beginning of the pandemic and then um so some colleagues in america in your country afrin weinstock and mulderings they did a fantastic publication on september the 10th and this was in the international journal of infectious diseases it's really worth a read because they cover so much about master activation in that publication my apologies for interruption yeah you'll be happy that i have discussed afrin's paper with the cool beans in depth oh they're aware they're very familiar with this then which is fantastic so i i'm sorry i'm preaching to the converted which is fantastic so yeah so that the hyper inflammation seen in the copic 19 is absolutely consistent with mkus this was their theory um prevalence is similar to that of mcas in severe covid so it's about 17 percent of patients who catch the covid19 who have it severely and that would fit with the 17 of the population having dysfunctional mast cells um and then drugs that inhibit mast cells and their mediators do show promise and actually do seem to do quite well with kevin 19. now this is completely anecdotal but um i don't see acute patients with acute conditions however i have come across about 10 patients friends and family and a couple of patients of mine who who have had very severe covid and they've been so ill one couple of my patients came on to zoom calls for their appointments for the menopause consultancy and they couldn't talk to me because they were coughing and coughing and coughing and coughing they were in such a state and with a high temperature and sweating and they just looked terrible and um and they um i sit and write we're not going to talk about hrt and the menopause what we're going to talk about is how to get you better now and i asked them to go on antihistamines to take some various supplements so that's the vitamin c d zinc selenium magnesium quercetin and then to and also i would then i prescribed type 2 antihistamine because that's prescription only in this country and all of them within 24 hours was starting to get much better so so much so that they some of them had been in bed for 10 days with these awful cough getting worse and worse and worse and then within 24 hours they were up getting dressed getting showered you know and and feeling no cough at all so absolutely dramatic results it's only 10 and it's anecdotal but um very interesting that and some of them actually had a lot of comorbidities so one friend of the family he has cirrhosis of the liver and heart disease and diabetes and he was really very sick but within 24 hours he started to feel better so that's just an aside um anyway so yes so their theory fits absolutely with what i'm saying um and none of their patients who have muscle activation who caught coronavirus had it severely and none of them died thankfully so because their mass activation was sort of under control they actually did fared rather better with the acute infection and so they were hypothesizing that um that dysfunctional mast cells actually underlie the severe acute and chronic 19 illness so next slide please then there's this paper by berger mashi in cambridge university and um they published in january 2021 and this is that they felt theirs research showed that the likelihood that severe and long coved is established early in the stages of the disease um we should be taking into account that we were missing a trick and we should be treating it early which was what would fit with the mast cell activation um hypothesis as well so they said that people who were asymptomatic or had mild disease it was characterized by a robust immune response and then their immune system set back to normal very quickly after the infection whereas those who admitted with had seemed to have an impaired immune response and severe inflammation as a result of that and those that got better it continued to overreact and the cytokine storm persisted and uh and so um and their cells didn't seem to go back to normal if you could go to the next slide dr mabine that'd be lovely so um so there wasn't there wasn't the quick resolution that was seen with the patients who had it mildly and moderately and just seemed to get over it very quickly but there was a persistence of abnormal immune cells t-cells and and b cells and some of them actually even after limited recovery didn't get back to normal which suggests they were abnormal in the first place so i thought that was a really interesting paper for people to look at okay next slide please so what did i do well i opened as i said earlier i opened my clinic and um and i opened it on the first of november and i put it into my diary until the end of march and within 36 hours it was completely booked up um now i'm i really had a very busy schedule so i could only do one morning a week um and uh so it was you know gone starting at eight in the morning and going through until sort of one o'clock and back-to-back patients and so i've now seen about 75 long-covered patients but when i did this slide it was 60. um eight when men and 52 were women so um it's um yeah predominantly women and um and 58 had a previous medical history suggestive of mcas and so some of them um and some of them had considered that you know these people consider themselves often to be very healthy and they manage to exercise and everything but they've always got you know ibs and they have to be careful what they eat or they they have to have various food intolerances or whatever so it can be quite a mild background uh sort of um uh pathology but there is it is there um but there were two who had no previous history whatsoever no matter no matter how much i looked i couldn't find anything um that suggested that they had any allergies or anything and i suspect then the virus has caused caused the mast cell dysfunction for them um which presented as the mcas but you know and they interestingly got better much more quickly than the others so a few adjustments and they were really on their way um and all of the patients i'm in a very happy position i suppose that by the time the patients come and see me they have been fully investigated by a whole load of specialists so um because um everything is siloed the way we do medicine at the moment it's not a holistic approach which is would be much better in my view but currently everything is siloed so they between a cardiologist for their tachycardia and their palpitations and their low blood pressure and everything was normal and then they'd seen a gastroenterologist and maybe had some biopsies taken and colonoscopies and etc and it was all normal and they've seen neurologists and so on and so forth so actually it's much i'm in a much safer position when they come to see me then because i know i'm not missing any anything else and one always has to remember that people with muscle activation can also have other pathologies you know they can also get cancer uh et cetera et cetera so one has to keep your radar um open and alert for that um at all times so um there were only three three had a diagnosis of myocarditis but everyone else's tests were completely normal apart from the odd eosinophilia or raised c-reactive protein or something like that but nothing dramatic so next slide please so um these were the typical symptoms and i am sure any of your viewers who have got long covid will completely relate to to this list and they would have ibs type symptoms so abdominal pain diarrhea nausea vomiting bloating food intolerances sometimes terrible constipation actually as well which needs to be really try sorted out because that's um that's terrible for the reabsorption of the toxins which then have to go around their system again um they had various dermatological problems so itching is a very big feature sudden redness flushing on the neck and the face um rashes would appear and then disappear dermatography dermatographism which is when you can write on your skin and you can see you know you could write your name across your forehead and it stays there for 20 minutes um worsening of eczema worsening of rosacea worsening of psoriasis or starting of rosacea um then they could have various cardiovascular things like palpitations vertigo arrhythmias hypotension be diagnosed with pots cowonis disease which is the um is angina angina without any plaques and this is something that actually my daughter had when she was seven years old so when she was seven she started complaining of severe chest pain which would last a few seconds and she would it was really quite alarming and her description of it was just like angina we had her completely checked out but now we know that when her histamine goes very high she sometimes gets this chest pain and she recognizes it um as a type of vagina then running nose sneezing attacks asthma and shortness of breath then headaches migraines sweating freezing menstrual pain some of these symptoms can be triggered by the most extraordinary triggers like walking from a warm room to a cold room they can suddenly get you know come over all dizzy or start sweating or whatever fibromyalgia tingling sensations a lot of patients with long covet have talked about tingling sensations um and um and a sort of tremoring in their body um especially when they go to bed they feel like their whole body is tremoring inside and they can't see anything they're not they haven't got a visible tremor but they feel it inside it's like their nerves are all jangling uh brain fog is a very common um problem so i find you know i have to make my letters to their gp which they get a copy of very clear because i know they won't remember half of what i said to them in the consultation because of the brain fog you know and then i get loads of emails can you just clarify this clarify because they just can't remember um and then anxiety now the anxiety is an interesting one because when when the histamine is very high in the body which it will be if the mast cells are activated um the body responds by trying to bring the histamine down and one of the things it does is releases adrenaline to do that and that causes terrible anxiety and panic attacks and this is people who are normally calm and say you know i don't worry i'm not that kind of person i'm really not anxious and then suddenly they feel really really anxious like you know there's a lion that's going to pounce and get them insomnia is a big one because again histamine is very important in the circadian rhythm fatigue and post-exertional malaise which is really disappointing because as people start to feel better and then they want to get back to their runs or their cycling they um they then come back and they crash out for two days because they've increased the histamine release by exercising so next slide please so what do we do right this is what you all want to know what do we do so we have we have um i do put my patients on a low histamine diet because i have found it helps 99.999 of the people and uh therefore it is the sort of first thing that we have to do it's not so bad i've been on a low histamine diet for the last three months and it's been a very interesting experience because it's made me creative with my cooking and think about all the different tasty things i can do which are low histamine so it's a it's a very healthy diet it's a very nourishing diet and it's a very tasty diet if you're imaginative with it and it's a lot of vegetables a lot of fruit uh you know meat protein so it's fine there's just certain things you can't have which maybe you love but you can't have um and then we give type 1 antihistamines because the the treatment in muscle activation is to avoid the triggers avoid the triggers so that includes diet triggers then to reduce the release of the mediators and that would be steroids non-steroidal anti-inflammatories um and vitamin c now obviously we don't like to use steroids very much because of all the horrible side effects and that not a long-term solution some patients find non-steroidal anti-inflammatories helpful but some don't in some it actually makes them worse so we have to be careful with that one and then you want to so you release you reduce the release the production of the um of the mediators and the release of them and then you want to reduce the effects of them so that's why we go for the type 1 antihistamines and we take we ask them to very patiently go through the different types of type 1 antihistamines to find which one is best for them and it will be different for different people so that would be loratadine 10 milligrams three times a day or satirizing 10 milligrams three times a day or flexophenidine 180 milligrams three times a day and so one has to patiently try each one of those for maybe a couple of weeks and then um and then decide if you at the end of two weeks you think has this helped me do i feel any better and you're having to ask yourself that question then the answer is no then try another one because when it does help you'll know it does you know you do start to feel better anything this is the one this is the one for me and then we also then add some type 2 antihistamine and we try and add one thing at a time and change one thing at a time so we know whether what what is the good boy the good guy and the bad guy you know otherwise it's impossible to tell so that would be formotating which is the most powerful type to antihistamine that we have 20 milligrams twice a day nice or nice acidity and then we go through the marcel stabilizers which are also antihistamines but they seem to stabilize the marcel rather better than some of the others so reparating 10 milligrams at night if somebody finds that helpful i then ask them to try it twice a day and because some people that can be a game changer if after doing it twice a day for a few days there's no difference then we go back to once a day ketotin is a very useful one because it makes them very sleepy so if they're not sleeping well it can really help with the sleep um and but they might have to titrate up very slowly to the one milligram dose because it can make them feel like they've got a hangover the next day uh so you know you have to let your body get used to it and do it very slowly and gradually surgeon chroma glycol particularly if they have gut issues and tenderness and then quercetin which is one people can buy over the counter 500 milligrams three times a day can be very helpful actually um apart from that we then go to probiotics so vitamin c probiotics are really important i actually very interestingly what i've been doing with my patients dr mabin is i've been getting their genetic testing done for their histamine pathways their methylation pathways nutrition report and their estrogen pathways and so we can sort of try and drill down and see how else we can support their system because it appears that and this is going to be presented at the conference actually by my colleague emma besik from life code gx it appears that um the patients with master activation and long the long callers they seem to have more than the uh than the general population problems with certain genetic variants and these particular genetic variants are ones that mop up toxins and help the body to to stay in balance so it's almost like the perfect storm you know they're producing more toxins and then there they don't metabolize those very well or cope with them very well um and therefore they get the inflammation the toxins persist and and cause uh alterations in their um you know dysregulation of their homeostasis and so on so it's um it's very interesting so we do that so that we can drill down and see if they need extra manganese or zinc or whatever it might be and we also do their um gut testing and that's been very interesting and my colleague debbie cotton is going to present the findings in our patient uh patients on at the conference as well which should be great and and that will be um yeah because a lot of them have got dysbiosis uh and many of them have also got parasites in the gut which is going to be revving up their immune system all the time so clearing all these things out has been very helpful so yeah so we give them probiotics vitamin c slow release a thousand milligrams a day vitamin d3 niacin i like the no flush one i know there's a big debate about that i'm sure you've been involved in that debate um and then selenium and zinc and magnesium and then either lectin which is um which i'm now starting to prescribe now so we so dr mcbean you and i have been involved in trying to put together a protocol haven't we um for long haulers using what what they should take and that includes ivamectin so i've started as of the last two weeks i've managed to source some ivor mexican in the uk because that's been our big problem is getting hold of some and yeah we've managed to get hold of some and um and so i've actually told them to have maybe not enough but 0.2 milligrams per kilogram for five days and then weekly for four weeks so i've got about 10 patients now who are ordering it from this from this source um and uh and there and then we're going to see how they go with that which a quick uh anecdote over here yeah one of my patients from last year march april time frame she's a medical student now she's in final year almost a doctor she developed covet i managed her she developed some cardiac issues with hydroxy blood pressure variations and tachycardias so i stopped in the middle but fortunately we had helped her enough that she bounced back and she was fine about a few weeks ago she reached out once again her aunt had gotten coveted so while talking about her to how to manage her she mentioned that my her own issue now was that she was not able to focus correctly on her studies and not able to sit up for a longer period of time so she was myalgic she was fatigued she was nervous confused not able to focus correctly and just weak in general so she said i something has happened to me and she had no clue that this is long covered there is another tragedy that is happening in some of the countries where the idea of the long covered has not even reached there so she didn't know that this is long covered with post-covert syndrome i diagnosed it immediately and i said why don't you start taking some ivermectin so she took ivermectin for three days and then i asked her to call me again and my thought was i would have to give her a steroid pulse therapy as well so when she called without asking my my bad without asking that hey how are you doing i said so we may have to start with steroids too and she responded and said i am fine ivor mctin has fixed it so why do i need to have steroids and i was so surprised that she was suffering that for a year and just three days of fibrometin changed the game for her amazing it's amazing so yeah i mean i'm really excited to be prescribing it now because i think it's got a key role um and it's part of the cocktail that we should be you know doing for these people um and what's been very interesting is a lot of my long covered patients have now been better than they have ever been for decades because they've had undiagnosed and untreated muscle activation and now it's being treated so i had one lady who was having suffering from diarrhea eight times a day can you imagine diarrhea eight times a day for the last 10 years and as soon as she started the fermata gene her diary stopped within 24 hours so now she has a normal stool once a day and not believe it i mean imagine the impact on your quality of life you know if you have to have diarrhea in ten nine ten eight times a day you can't go on a long trip journey because you'd be worrying about toilets and stopping all the time you can't go and just shop and you'd always be thinking where's the where's the toilet west toilet it'd be so embarrassing even if we went around to friends for dinner you'd be going popping off to the loo and thinking can they hear me it'd be just awful i mean the whole thing and she was so grateful and she couldn't believe it and other patients who've had again long cove patients who've had funny um symptoms grumbling along in the background for decades have found you know they no longer have headaches they no longer um have their fibromyalgia type symptoms they no longer have got their itchy skin and scalp at night that drives them crazy in the insomnia that stops them sleeping so you know that's been a sort of bonus really i suppose a silver lining for them but anyway the other thing i do recommend is um the neuroplastic retraining of the amygdala and the insular parts of the brain and i refer them to the gupta program and ashok gupta is actually going to also present at the conference and this has been i think this is a very important role to play in um in helping these patients get out of that vicious cycle of of feeling unwell and their immune system anticipating really that it needs to keep being on red alert so instead of instead of ignoring triggers and just getting on letting the body get on with its business these mast cells have become so super sensitive they are jumping at every every chemical trigger every food trigger etc and they just need to be calmed down and you can use your conscious mind to calm down your subconscious mind so that that's been really helpful and we've had some dramatic results with that actually as well so next slide please so when patients haven't responded so well to all of those and some people don't and the other thing that can happen which can be very trying and difficult is um some of the patients become so sensitive to chemicals that they can't take the drugs because of an excipient that's in the drug or there's a chem you know dye that's in the tablet or something and so we have to try different makes that's worth doing and we also have some specialist pharmacies that will mix together you know and dispense some very pure forms but the problem with that though dr mubeen it's so expensive for patients i mean these pharmacies are um ex you know really really expensive so you have to have a sort of trust fund to be able to fund you going through um you know or medications from them and i do have one or two patients who literally have to have their medications made up especially for them um but we are getting there because they're getting some goodness now some of the you know the chemicals are are getting in and they're tolerating them and they're helping them our cells to calm down then we've got montello cast um 10 milligrams a day beware because about 30 percent of people can get depressed on that so just be aware of that ldn low dose naltrexone i've had some amazing results with this especially with the tingling and pain i had one chat one lovely fellow who's a lawyer actually and he had terrible pain in his feet so bad that he could hardly walk but his feet are totally normal but this pain this neurological pain was just awful and within about 24 hours of starting the low dose naltrexone he um his pain has gone just so dramatic amazing amazing um and then dies a pound 0.5 to 1 milligram twice a day people don't become addicted to it if because it sits on the mast cells and it's taken up there it can't give them a d it hasn't got addictive properties for these patients just like um you know if you give if you're given morphine for pain you don't become a morphine addict in the same way and then ssris um yes and i talked about how important the gut health is uh and getting rid of the parasites and the dysbiosis and treating any other infections so i've seen patients i've got patients who've got things like fungal infections in their feet you know chronic infections that are going on are going to be constantly stimulating their mast cells so we need to calm and treat everything we can get rid of infection interstitial cystitis is another one um it's you know 80 of people with mast cell activation are how female 30 have interstitial cystitis uh and um and thirty percent so no eighty percent have higher mobility wow so yeah so you know and yeah so it's it's a it's a very new burgeoning area of research but there's so much if somebody's interested in doing some research there's so much that can be done what i'm really excited about is the that we need you know we need improved diagnostic techniques we need to be able to um to to run the uh to have to run the biomarkers you know find out what's going in each patient because they'll be different these patients have got different genetic mutations therefore they'll be releasing the cytokines in different patterns different quantities and if we knew that and we could see what those are and profile them to the genetics of the patient and their prep their symptom profile then we could see which is the best treatment for them straight away rather than the trial and error which we're sort of doing at the moment well i know i'm doing at the moment um that if we had if we could drill down and have those diagnostics and the biomarkers and the then we could we could sort out the targeted therapies couldn't we for them which would be amazing and i feel actually with dr bruce patterson's work we're getting so close to that for the first time okay we're going to get close to that you know dr yo and dr bruce patterson the in-cell diagnosis and again just for the disclosures we do not have any commercial interests with them at least i do not have any commercial interests with them hope the same thing for you as well doctor yeah and his work is excellent yeah i think it is ground breaking and as you have said it a couple of times as well though the labs that he is working on they are going to become the important guideline for emphasis yeah management i think so yeah and this doctor appears when you were talking about it i was thinking about my patients my friends there are people you're correct there are people who have gone through this disease or this syndrome for decades without being diagnosed and without being treated well and they have just taken it as their life is destroyed that way and i was seeing with kovic this was happening as well that there are people who are actually giving up saying this is not going to go away now this is with us this is how i'm going to be now and i see this so much in the youngsters who are so depressed that hey i used to be healthy i used to exercise i used to do this i used to do that and now i cannot do anything so thank you so much for your work and i wanna add one more comment my apologies here for the cool beans if you may have noticed that the doctors who have appeared on this show they have a unique difference from other doctors and that is their thinkers all of them if you talk about dr paul merrick dr corey dr stephen phillips dr jalali dr antonatos dr pierce over here anyone who has been here you would identify it very quickly that they have been thinking so please realize that at this time and this is my statement my opinion i don't think that this dr pierce or i don't want to put this on her i feel at this time there are two type of victims of covet one that are actually the victim of the source of two itself and then the other one that are the victims of the doctor's ignorance or refusal to learn and understand and do research so thank you so much dr pierce for being the one who is thinking and researching and figuring it out back to you my apologies for the interruption no no that was great that was great i um very i'm very grateful to you for saying that that's very kind of you but i think that um yeah i mean the the patients who've come to me with long covid um they have been languishing on their sofas not being able to be parents to their children not being able to work um and it is pretty miserable for them especially when they then go to their doctors their gps who then say well there's nothing we can do for you go home and it's like surely there must be something you know it's so frustrating for them so i think that we have we have given them a sort of lifeline really and and not just me i mean all the doctors who are doing this and the functional medicine doctors and the naturopaths and the homeopaths and everyone who's trying to to to help these people um it's it's a big joint effort really uh which is fantastic when when we come to exercise i recommend that patients do things like yoga and pilates and weights so they don't actually get their heart beating too fast um and i'm sorry if if somebody loves running and the the the high that that gives them or you know the endorphins etc that it releases um but at the moment it's probably not sensible to do that and so they they do lots of weight training and things like that and so they can keep physically fit and they can keep their muscles and their strength but just not um not go on the treadmill basically and they find they can do that which is good yeah but yes but it's it's it's very exciting and it's very humbling actually when um when you ring people and they say i'm so much better it's so lovely absolutely absolutely so uh tell me this thank you so much for this uh are you ready for some questions as well do you do you wanna yeah you should do my best do my best so uh what you would see is that the cool beans here uh i think that cool beans and cool beans tell me if i'm wrong i think this is the most informed in terms of medical mechanics and the concepts this is the most informed group that we have here we have a smaller group compared to many other folks who talk about covet but very deeply aware of the mechanisms of the body so we can actually talk much more openly and much more clearly in terms of medical depth and still go with that so cool beans i know that you had been putting some questions out there before but this is the time that we're gonna go over some of the questions so dr pierce once again thank you for your time and i'm gonna start asking some questions that people are asking so uh denise tg so is there a question okay let's go over the natural muscle stabilizer quesadilla and so that seems like a comment thank you denise we have uh rape singh i'm having tingling sensation around my right eye for the last 15 days after covet recovery am i suffering from post covered long haul blood report had lipoprotein a very high around 1 0 4. highly likely highly likely yes um people can have um blurring of vision uh they can have deafness they can have tinnitus there's a lot of people suffering with tinnitus so it can affect the nerves the nervous system definitely and you must remember that histamine is a neurotransmitter um and also um some of the cytokines and and mediators that are released we don't even know what they do we haven't even yet figured out what they do you know it's highly likely and these are patterns and and symptoms that we have seen before got it and talking about histamine and serotonin uh i think you would enjoy speaking with dr philip jalali as well have you had a chance to speak with him no i haven't no tell me tell me more so he's a he's here in california he's a gastroenterologist but once again he's that curious person who started thinking and researching and please uh in in dr corey's word of go back to doctoring doctoring doesn't mean that if you have become specialist in one area now you cannot think about another area it is doctoring his doctrine doing research figuring it out what would help the patient so dr fred jalali started doctoring and he started trying to figure out what is going on so he appeared here on our show as well he's a big big proponent of hey there are things with histamine with serotonin that we need to take care of and he has a paper as well i'll send it to you 150 slides that he presented here talking about various symptoms and how there are the bases within the within the histamine and serotonin abnormalities so i think you would enjoy speaking with him too oh do you send me the slides that'd be fantastic absolutely yes absolutely i would connect you with him as well so 304 15 says is there also a role of food enzymes yes so there is actually so um so diamine oxidase uh is made by the body to reduce the histamine absorption from the gut and you can buy dao supplements um it's called deus in i think the one we we have available here and um and it's helpful to patients who are going to eat out you know you especially now we're opening up in this country so people are starting to eat in other people's homes and they're going out to restaurants again and where you can't control necessarily exactly how much histamine is going to be on your plate so it's useful to have a couple of days in tablets 20 minutes before you eat also toxic prevent i don't know if you've come across toxoprevent it's a zeolite and that can also absorb some of the histamine out of the food for you so you don't absorb it and those kind of little tricks are helpful um then the other thing that can happen in his in the histamine and tolerance and muscle activation is that patients can get pancreatic insufficiency and when we do the gut testing we can see whether they're actually not producing enough in the way of of enzymes pancreatic enzymes and if they're not some giving some supplements of those can be really helpful so often these patients have you know yellow funny stools that float and difficult to flush away and things like that and then you give them um sort of d-pan uh thorn d-pan or some or some other digestive enzyme and they transformed their stools are transformed and and obviously then they're absorbing much more of their their food and so on so it's really helpful yeah so they do have a role to play got it next question jimmy lo says dr pierce have you discovered any neuropathy specifically related to post-menopausal women with brca reactive history having tingling or neuropathy pain in breast no this is the first time i've had that question actually i haven't come across any patients who've had that particular symptom i do see a lot of braca patients and women post-breast cancer who have decided they'd like to have hrt we you know often they've tried all the alternatives to help with their symptoms a menopausal symptoms and they haven't done very well with them and therefore they you know we end up going on hrt um and that can completely transform their life but i haven't had that particular symptom no i have i haven't come across that sorry no no worries thank you very much colin hamill he is actually from uh uk as well uh hamill if i'm correct you're from uk correct uh hemi we have been actually talking before as well so he said dr bean how do you always manage to get the best guests well oh very flattered i mean the doctors that get the go the extra mile showing how they care doctor tony pierre teen appears thanks for all you do and your energy oh thank you thank you i think uh what happens is when the times are hard or dark lights shine out well these doctors are like lights i have seen i have talked with so many doctors my friends my class fellows my colleagues peers and i have requested them to look into some of these studies new papers and new ideas and they just simply say that here go to my clinic i practice what i know and i have been practicing for 20 years 30 years 40 years this is what i know this is what i'm gonna practice and then there are doctors like dr teen appears here dr corey dr stephen phillips dr jalali dr sayeth heather and the list goes on these are like lights at this time they are the ones who will be then deciding in the future how these diseases will be managed they are the ones who would be written in the books and with their protocols and with their help this is just natural and i am proud and i am humbled that we have such guests with us i'm very very happy with that um because at the end of the day this talk that we are doing dr pierce over here at the end of the day this helps people right this one hour of the discussion is going to translate into millions of hours of watch time which would then allow people doctors to learn how to manage this and patients to become aware and then seek help accordingly i hope so i hope so i mean that's one of the reasons why we put together the conference which is on the 19th and 20th of june it's open to patients as well as to medic medics and uh health you know clinicians healthcare professionals whatever your your training um if you're interested in it and we've got some fantastic speakers haven't we like yourself your good self and uh and also dr lawrence afrin who's going to be talking about martial activation and it is it's a great opportunity to hear people like this speak and we've got uh bruce patterson talking about his research and what his his findings have been and then um professor cavallo from argentina talking about treating long-covered patients with with ivan mektin and then my colleague who's going to be presenting the genetic findings and the other colleague with the microbiome so we're really really lucky we've got a great line up um i hope people can join us because the whole idea is spread the word let's get it out there you know to help as many people as possible absolutely thank you very much i'm going to continue with some more questions as well i know that we are one hour into it i appreciate your time we all cool beans appreciate your time so here is the next question so rupesh has already asked it bambi secret is actually from uk thank you to all the doctors you've had on your channel for quick thinking and giving their time thank you very much bambi and bambi was putting a comment that she herself is right now going through some of the tests which may be related to this sunshine bean bean could undiagnosed mcas be the cause of severe vaccine side effects would zinc quercetin vitamin d and c help to lessen severe side effects well that is hypothetically possible um that it could could make uh people react to the vaccine so what i've been telling all my patients to do and all my friends and family who aren't m castle long haulers is to take antihistamines the day before their vaccine um to and to take these supplements and then to the day of the vaccine as well to take them uh so in fact my son i've got a son who's going to he's 33 and he's he's going to have his first vaccine on um on saturday tomorrow tomorrow and uh and he sent me a text last night mum what should i do and i said right this is what you have to do get some quercetin get some you know i i've already given him uh he's got flexopenidine and he's got um and he's got some femotidine so he's gonna take those and he's going to take the question and you know let's see i've had two vaccines and and i took those for the day before and a couple of days after i didn't even have a sore arm for both jabs so you know it's worth a try you got it thank you uh doug gross he's a regular cool bean are you tina are you okay if i told cool means your bean salutation yes you can so um cool beans dr tina pierce has chosen binu as the cool bean title thank you very much for that so doug grows so many symptoms labs possible treatments is there a systemic systematic approach so yes i mean i i always give people the the type one the type two antihistamines and marcel stabilizer and then the vitamins and minerals as a basic and then we go from there and for some people that's enough and the low histamine diet um what we're hoping with the with dr bruce patterson's approach is that we will be able to run some blood tests and say to people or you fall into this category or you fall into this category or we might even get to the stage once the research is done where we we know certain symptom profiles are caused by certain biomarkers and results and that they will therefore respond to certain treatments and therefore we could go from the symptoms to the treatments you know uh and if people can't afford to have all the bloods done and things then we could go we could just miss out that step if we know the profiles so that's that's work in the future but at the moment the systematic approach is low histamine diet type one type two antihistamines mast cell stabilizing avoid the triggers um take your stack of of uh your your your vitamin stack i think they're calling it the facebook groups and twitter and everything according to the stack because i've been putting it out there when i give to people to try and just you know let's help as many people as possible i'm very um sort of i'm a technophobe really but i've been forcing myself to tweet occasionally and instagram and things like that and it's fascinating how it gets you know it does get the word out got it thank you very much and doug just to add on to that as well i am also working with dr pierce here doctor yo doctor folks on the f and cccc as well to put together an algorithm for management of long haul i believe that algorithm would further be augmented with the labs and other things and it would keep maturing and evolving so the i would say approach is evolving and it would continue to evolve scarlett manahan says is there an antihistamine that can be used to treat the cytokines so um it's worth trying them all because they will they will block i'm not sure that they'll block the cytokines per se but they will block the histamine uh on the receptors won't they i don't i mean there are other drugs that will block cytokines won't there the um the uh which one's there the tyrosine kinase inhibitors and things they will inhibit the psychic minds got it yeah um this is more of a comment than the question omar klamax says i post the treatment posted here in this channel on facebook and they block me so that's it next mentioned ivan so my twitter so right now you are on a feed on twitter as well so we are on twitch twitter a couple of facebook channels and youtube and twitter would soon after this is over they would come back and they would just remove it so there are there are other challenges then just to look at the disease and manage it colin pamela says dr tina pierce would you consider moving your practice to khan low where's that yes yes so lewis grant says a colleague who received two times madonna wax experiences dysregulated menses and persistent areas of acne or dermatitis is this related to long-haul mcas and what would be good first approach to this i don't know if that's related to something just reaction to the vaccine per se or whether there is some mcas going on there i'm not sure um you know it's early days and we haven't got any research at all or data on patients having the vaccine and having reactions and which groups they sort of fall into um i think i mean that's very unfortunate isn't it there have been quite a few reports of the vaccine causing changes in menstrual cycle but it's very difficult to quantify that because women do have funny menstrual cycles sometimes anyway don't they you know you'd have to have quite a large number of patients to prove and try and see what was going on there so i don't know the answer to that question i'm afraid people are asking got it thank you bilal new jersey says doctor i'm one of those who are suffering from j and j vaccine reactions for 47 days now leg pain brain fog tingling sensation this treatment could be vaccinated over reacted people lifesaver as well so i think if you've had those kind of reactions those look like mcas symptoms don't they i think it would be worth your while trying our approach um and looking at our uh our long-haul protocols that we've worked together on and with some others and um and and have a have a go at it because that does look like mast cell activation symptoms you know brain fog etc that you described thank you and just to so my my wife is usually she does not like her information to be more openly discussed but with her lots of permission i have been talking about her j j vaccine and what happens afterwards she still has joint pains and she still has git sometimes upset and tiredness to me it seems like she also has a so she used to have these symptoms before so maybe she had them cast and it looks like the mcas has flared up since the jnj as well so i'm gonna actually have her watch this video as well good john ryan says benadryl effective very very effective yes some people that's the one for them yeah try it excellent thank you uh naveen naveen says does broome hexing act as an rdrp inhibitor any comments in the same i don't know is the answer to that do you know anything about that yes so we talked about bromhex and naveen in the past as well brom hexane is a protease inhibitor right from that point of view it should actually inhibit rdrp but bromhexane does not enter the cell to go do that instead it works with the tmprss2 that is present to the surface of the cell and that is how bromhexane in theory in mechanism is able to help reduce the sarcophagus function now there have been studies that i also discussed afterwards that showed that bromhexane may have less effect and then chemostat mesylate or some other drugs which are similar class may have more effect um you see i think i think you've got the brain as the size of a planet actually i do i do it just amazing you're amazing thank you thank you i think what happened was and i have discussed it many times what happened was i saw a paper so dr pierce there was a paper fake paper somebody wrote in which they said stanford doctors say do the following and the covet would not impact you and the things were totally messed up totally wrong and somebody forwarded the forwarded that to me and said can you comment on this for me that should i do this or not and that was just bs paper and i thought people would do this and they'll become severe and they'll die so that was the time when i actually took up the the case of talking about covet related things and it just kept going from there so it was not even a plan to say i am going to come out and i'm going to do this all it was just an intent to say man this is going to cause some and a tragedy is that my own friend's brother yeah was following that papers protocol became severe ended up in icu and died and he died because it was too late he had been doing what that paper had said so my so this is this was the basic driving factor um some more question rajendra raj says dr pierce is there any relation between plasma therapy and vaccine with virus new variants i don't know actually um i think the plasma therapy is only working in people who are immunosuppressed isn't that right yes that was the latest study that i saw do you have anything else to add to that dr mabine so um rajpuro hit plasma therapy and vaccines with the virus with the new variants i know that japan has said that we're not going to take plasma from those who are being vaccinated i have to actually look up what is concerning them and we will talk more about it after i have done some studies pami cubine says how in the world do mks and fibromyalgia and chronic fatigue patients differentiate between their normal bad flare-ups and with the when they catch coverage it's a blue yeah so so when they catch coverage they're normally um signs of a viral infection so they get symptoms which are more than their normal fibromyalgia et cetera and um and then they um so they have the fever and the cough and the all the sort of typical things that might occur um and then it's just afterwards they may not it just grumbles on and on and on so the fever may go or they may feel better for a few days and then it comes back and then they then sometimes their mcas original symptoms flare and are made worse as the as the sort of cytokine storm grumbles on or becomes a a rain shower as dr bruce patterson describes it um you know so it's not as bad as it was but it sort of just keeps grumbling on and on and on so usually they can tell i mean i have you know mcas patients who said to me i you know i was like this and then i definitely had coronavirus because then i was bed bound and i had fever and so on so you usually usually know and of course in the early days when people were catching this they weren't we weren't testing them so we don't know if they were positive or not but but the symptoms and the story fits yeah got it thank you a couple of more questions scarlett monahan says is there an antihistamine you would recommend what is type 1 and type 2 antihistamines so yeah i think i think my list has got has got them there for you really um the ones that we recommend i think in it's a shame we can't use uh renitadine anymore we used to we used to that you know millions of people across the world were using renisting quite safely it was absolutely fine so uh yes so you might want to just take a screenshot or or have a look at this uh for your type one and type two antihistamines and i mean i've only put three on there of the type one antioxidants there are more but those the ones that are readily available for us here in the uk so they're my sort of go-to ones uh but then you know you can add benadryl and et cetera piraton and so on and some people find as i say one better than the other thank you very much so one more question i know it is one hour 18 minutes now one more question natural sounds says following treatment will we be able to exercise again also would you recommend trying a three-day course of fibromyalgia um i i anticipate that after everything has gone down you will be able to uh exercise again now the mast cells that have been around during this troublesome time will be hypersensitized and over reactive and then we we will calm them down but mast cells can last several months and even some last a few years unfortunately so until you get rid of all of those and the new ones that you're making are coming into a calmer environment you could still anticipate a few problems um but i i have got patients who are able now to go on bike rides and to pick up the exercises that they were doing before without suffering too much from that but they they do understand that they can't do that and have spaghetti bolognese for supper you know because that's just too high histamine on top of exercise so they're becoming aware that they have to just titrate themselves carefully really and they and some of them don't have to stick to the low histamine diet forever either you know they they will as things calm down they'll be able to have some introduce some histamine more high histamine foods um but they'll have to be careful to keep everything under the threshold because you know if if your threshold is here you want to keep it below otherwise above and you you're toxic and then you get your symptoms again um and there are certain things it's very interesting our um our modern diets are just so histaminic they really are they're you know we've got people are all having fresh coffee which is a diamond oxidase blocker and very high in histamine they're having green tea they're having loads of cups of tea is that you and they're having out more more alcohol um than we used to i think and that again is a diamond oxidase blocker and chocolate unfortunately one of my great loves but uh there you are and so people you know are modern diets and then they're having spinach avocados tomatoes and we're eating everything all year round we're not eating it seasonally anymore um so people are having you know avocados on their toast for breakfast and they're sticking in their salad for lunch and then they might even have uh you know summons their supper and it's just like too much histamine too many tv dinners leftovers it's processed foods you know we've got to get back to basics and being healthy with our diet seasonal locally produced food i'm sure that's where we need to head really absolutely great and uh i'm sure we have a cool bean dr nick ariza he's a he's a physician as well and he talks a lot about the diet and balanced diet and diet-based therapies so thank you very much i'm sure he's very happy hearing this so dr uh piers thank you so much for your time and for your insights i believe that these these are the tiny lights one hour of our discussion can actually change a whole generation's new issues that we are seeing so thank you very much for doing this thank you very much for bringing this to us it's my complete pleasure thank you so much for inviting me and um for doing what you do which is just amazing getting getting the words out there thank you fantastic and thank you very much from all the cool beans here there is so much you can actually read those comments as well there are so many people who are thanking you who are sending hearts to you who are just just very happy with this oh that's nice thank you what a lovely audience you have yes so thank you very much and cool beans we're gonna take off now and thank you very much i will see you this evening

Channel: Drbeen Medical Lectures

Views: 87,380

Keywords: drbeen, medicine, nursing, med school, microbiology, sars-cov-2, covid-19, coronavirus, usmle, mbbs, nclex, cytokines, Health (Industry), Medicine (Field of Study), Pathology (Medical Specialty), what is, nursing (field of study), Nursing school (organization), Dr. Tina Peers, Dr. Peers, Dr. Tina, long covid, long covid syndrome, post covid syndrome, covid long haulers, long haulers

Id: NOkUDh3vHVU

Length: 80min 25sec (4825 seconds)

Published: Fri May 21 2021