Transcription of Dr. Kristen McElveen for the show Lyme Disease #135
Dr. Lisa: There are many things that, as a conventional physician, I still struggle with, so I’m happy to have the chance to speak with people who are trained in a slightly different way, including naturopathic doctors. Many of my good friends in the medical community are naturopathic doctors. Today, we have with us Kristen McElveen, who is a naturopathic doctor; who has been in private practice in Springvale since 2009; who focuses chronic illness, which often includes Lyme disease and other tick-born illnesses. Kristen, thanks so much for coming in today.
Kristen: Thank you so much for having me.
Dr. Lisa: I really love what naturopathic medicine, sort of the premise behind it and the science behind it. I think people might be surprised with just how focused on the molecular aspects of medicine, naturopathic medicine can be.
Kristen: Absolutely. Yeah, I think that that’s a big part of why I moved to Maine, actually, was to sort of … There’s a lot of mis-education about us being just sort of the people who tell you to go out in the woods and eat nuts and berries. We do go to actual naturopathic medical schools, which a lot of people don’t understand the first 2 years being very similar to the school that you went to. We just come at it from a different perspective, and we treat the whole.
Instead of learning all of the in-depth surgeries and things like that, we learn more of the natural therapies that have been done for hundreds or thousands of years. They still have obviously quite a bit of … quite an effect on people’s health nowadays. So, yeah, it’s been great. I did struggle, though, choosing between allopathic and naturopathic medicine.
Dr. Lisa: Well, tell me about that.
Kristen: So, well, if I had to do it again and knew I was going to come to Maine, I think that I would’ve gone to allopathic medical school first, and then gotten my ND degree. In Oregon, it’s very different. We’re primary care physicians. We work in hospitals. We work in big clinics. We’re covered by all of the insurance companies, even Medicaid.
Out here, it’s very, very different. We don’t have insurance coverage yet, but that’s coming hopefully. We’re all pretty much hanging our own shingle. I miss that team … that team effort, and I miss working with people, which is why I love meeting people like you, where I can network and get that sense of community back because I do miss that. Out here, it’s just not as common to see a naturopath. Whereas in Portland, Oregon, there’s a naturopath on every corner, which may be a little too many naturopaths.
Dr. Lisa: Well, so, it’s an interesting opportunity for you. You’re kind of doing …
Kristen: Absolutely. That’s why I came out here.
[crosstalk 00:33:23]
Dr. Lisa: [Inaudible 00:33:23].
Kristen: Yeah. I wanted to be part of the movement, which is why I came to Maine. I love it, and I love being part of that movement. But, sometimes, you know when that person is sitting in front of you, and they’re so sick, and you just want to give them that one medication that I used to be able to prescribe, and now I can’t prescribe it? It’s frustrating. It’s frustrating.
Dr. Lisa: That must be quite a significant part of your population if you like to focus on chronic disease and diseases like Lyme.
Kristen: Yeah.
Dr. Lisa: You went in the direction of things that were complex.
Kristen: Yeah, I know.
Dr. Lisa: You’re kind of inviting troubles into your practice.
Kristen: Why? Why did I do that?
Dr. Lisa: But, why did you do that? Because you could’ve done something easier.
Kristen: I could’ve. I love a puzzle. I love a puzzle. I love being part of that team with the patient, where you’re figuring things out. That’s ultimately what drew me to naturopathic medicine because it’s so focused on them. It’s not focused on the symptoms. I always joke because people always … The most common question I get is, “What can I take for this?” They see something on Dr. Oz or hear something from a friend. “What can I take naturally for this?”
Naturopathic medicine is a totally different paradigm because there is no, “What do I take for this?” It’s, “Why do you have that? Let’s fix that because if we fix that, you won’t have the symptom.” So, and what I give one person for eczema or acne or hormone issues are going to be … is going to be a totally protocol than what I give another person because it’s about the person. It’s not about the symptoms. That’s when it becomes even more complex with Lyme because it’s such a complex illness, and there is no one protocol. That’s why I think people struggle with it.
Dr. Lisa: Well, this is what I have noticed is we started with Lyme being the bullseye rash disease.
Kristen: Right.
Dr. Lisa: This is, “If you have a rash and there was a tick, you have Lyme. You get antibiotics.”
Kristen: Yeah.
Dr. Lisa: But, now we know that it impacts the heart. It impacts the brain. It impacts the entire nervous system.
Kristen: Every system.
Dr. Lisa: Every system, right.
Kristen: Every system; “the great mimicker,” they call it, just like celiac disease.
Dr. Lisa: So, that must make it challenging for you to try to figure out why somebody has it in their nervous system and not their heart.
Kristen: Right.
Dr. Lisa: How do you parse through that?
Kristen: Whenever I get overwhelmed, I think of one of my mentors, Dr. Dick Tom. He’s one of the forefathers, I call him, of naturopathic medicine. He’s one of the big professors at NCNM, where I graduated from in Oregon. He … I just take a deep breath and I think of him saying, “Your patient is an onion, and you’ve got to take it layer by layer.” Especially when it comes to Lyme, that’s exactly what you have to do. As much as you want to give somebody pain relief … Of course, [inaudible 00:36:24] of care, there’s definitely a time and place for that, and I’m all for it in that case.
But, that’s the big struggle with chronic illness, especially with Lyme. When people are having neurological symptoms, it’s scary. When people are having heart issues, it’s scary. That’s one of the hard parts because that education piece, in the allopathic community, is what I want to help build because I feel like there’s so much stigma around Lyme, especially when it comes to specialists. I can’t do it all. I can’t check out somebody’s heart. That’s not my specialty.
I can hear if they have a murmur. I can hear if … I basically have a family physician’s focus, where I know a little bit about a lot of things, but I don’t have a … I’m not a specialist, so I need to be able to send my patients to a cardiologist, to a neurologist, to a rheumatologist just to make sure because I’m also not one of those people that sees Lyme everywhere. Although, ask me that again in another couple years.
But, it’s just going down the checklist. Obviously, if people aren’t feeling well and you think you have a diagnosis, but it doesn’t quite fit and you treat them for it, but they’re not getting better, we need to look further. I think that’s where a lot of people get stuck with Lyme because their doctor either doesn’t agree that there’s chronic Lyme or it’s just not something they thought to look for because of the stigma around it.
So, [inaudible 00:38:04] to years later when they’re in my office, and you really have to take … I mean, that’s why my first appointment is 2 hours long. You have to get a good history. You have to get a good physical exam. Labs are just part of the picture. I’m not one of those people that sees a negative lab and thinks, “Oh, you’re do- … It’s not Lyme,” because as we know, the tests are not reliable.
Dr. Lisa: Well, and that is … That proves to be a problem for people …
Kristen: Absolutely.
Dr. Lisa: … who are trying to practice traditional medicine.
Kristen: Absolutely.
Dr. Lisa: If I … I’m trained in acupuncture and Chinese medicine, and that gives me … If I am using that mindset, I have more time, and I’m able to look more towards the problem …
[crosstalk 00:38:46]
Kristen: [Inaudible 00:38:46], mm-hmm (affirmative).
Dr. Lisa: … and the whole. But, there are times when I’m called to see a patient in 15 minutes.
Kristen: Right.
Dr. Lisa: I need to offer them something, and often that’s a lab test. With Lyme, it is really complicated because the …
Kristen: It is.
Dr. Lisa: … lab tests that we have, they may come out negative, but it doesn’t mean the person doesn’t have Lyme.
Kristen: Exactly. I mean, you think of … Think of just basic immunology. If somebody’s really sick, especially if they’ve been sick for so long, their immune system is not going to be up-to-snuff enough to produce antibodies. You’re not going to … It’s not going to be producing as many antibodies as it was months ago or even years ago. Those antibodies die down anyway. So, I just feel like … I feel like the focus has gotten so lab based, and we need to remind ourselves that, again, that’s just part of the picture. We are good diagnosticians if we just have the time to put all the pieces together.
Really, there is no lab that is 100%, other than a culture, for anything pretty much. It’s part of the picture. It’s a snapshot of the blood taken out of the arm or wherever at that moment. It depends on what they ate the night before. Do they have a cold? I mean, all doctors think of those things when they’re running any kind of bloodwork. Certain things are going to affect that.
But, with our screening test, which is typically the ELISA for Lyme … With our screening test being, at most, 68% sensitive. I don’t think any screening test should be that … have that low of an accuracy rate. So, that’s really where it becomes, “Why don’t we look at another test? Why don’t we look at a culmination of tests?”
Dr. Lisa: So, what would that be in your practice?
Kristen: Well, I really try to focus on getting the most information I can. With me, it’s hard because I’m not covered by insurance, and patients are paying out-of-pocket. I do use a western blot when I can, with PCR is great. The more information, the better. I rarely use the ELISA because I just frankly think it’s useless. Unless you’re really just wanting to screen somebody and that’s our only option, absolutely I will use it.
But, again, we have to remember western blot is showing exposure. It’s not showing active infection. So, if they have a positive western blot, that doesn’t mean that they have Lyme. It doesn’t mean that they have an active infection. I think that’s where some people also get caught up in it because maybe it’s not Lyme. Maybe it really is fibromyalgia. Yes, you have had an exposure to Lyme, but that’s where it really becomes the puzzle.
Dr. Lisa: The goal of the Dr. Lisa Radio Hour is to help make connections between the health of the individual and the health of the community. The goal of Ted Carter Inspired Landscapes is to deepen our appreciation for the natural world. Here to speak with us today is Ted Carter.
Ted: One of my friends, [Ken Jaynes 00:42:02], is … He was a surgeon for his entire career and adult life until he retired. He really, at heart, is a naturalist and does beautiful photography of nature and all of these beautiful nature settings. They went to Africa and shot some amazing shots in Africa. They … He goes out into the wild and takes pictures of the birds. I think what happens is that I’m noticing people are really, as they are retiring or getting to retiring age, and I’m working with many, many people in that bracket, that they really are starting to find themselves in an area that is completely removed and different from their life experience up until this point.
So, the landscape, I think, talks and speaks to them in a special way and helps to nurture that and steward that activity. What I really endeavor to do is to try to create that bridge between what their old life was and what their new life could become or is becoming. We’re always in the state of “becoming.” But, I think that the built landscape gives you a place to really meditate and seriously think about what you’re going to do for the rest of your life.
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Dr. Lisa: So, what are some of the different ways that patients have come to you and have had Lyme? What are some of the experiences you’ve had?
Kristen: Well, in the beginning, when I first moved out here, I was very resistant to treating Lyme. I was like, “Oh, I’m not going to treat that.” But, you can’t control what walks in your door. The first few cases I treated luckily were pretty straightforward. They were chronic cases. I hate to use that terminology, but they were cases where they were infected likely years ago. It wasn’t a recent tick bite or anything like that, but just kind of, again, things that … fatigue, and weird night sweats, and things that we weren’t really finding a cause for.
Going down the line of differentials, I thought, “Well, let’s … We live in Maine. These patients are outside enjoying this beautiful place that we live. Let’s test it.” Actually, my first 2 patients were a couple, and that’s what got me thinking about the potential for sexual transmission, which is now what’s coming out in the research too. One of them had an actual history of a tick bite, and the other one didn’t. That doesn’t mean it was sexually transmitted, but that’s definitely something we’re looking at.
Dr. Lisa: So, that’s interesting. I hadn’t … Maybe I live under a rock, I guess. I hadn’t realized …
Kristen: No, you don’t. It really is very, very new. But, it’s a spirochete, just like syphilis. So, why wouldn’t it be? Why wouldn’t it be? It certainly isn’t common. Otherwise, I think we would see it a lot more often. But, it’s just … It’s interesting to me, as a scientist and as a puzzle person, that I have seen couples where only one had a history of a tick bite. Now, keep in mind, up to 50% of people don’t even recall a tick bite who have Lyme. So, that doesn’t necessarily mean it was sexually transmitted, but it’s something to keep in mind.
There was a study … Gosh. But, I think it might’ve been Science Daily. They … It was in the last month or two that they released the study that it was found in fluids, and the spirochetes were found in fluids. Do we know how contagious it is? Again, I think that if it were more common, we would definitely see that.
Dr. Lisa: So, you’ve seen patients that have come in as a couple before, and both of them have had Lyme. What are some of the symptoms that people have when they walk through your doors?
Kristen: Usually, fatigue is the big one, and a lot of memory issues, a lack of focus. Sometimes, it almost borders on ADD, ADHD. They can have joint pain. That’s also very common, especially migrating joint pain where it’s not the same joint every day. General soreness, which again is why fibromyalgia is one of the common misdiagnoses, and fevers or night sweats. Those are probably the big ones that set off my red flags, and those are the ones that I definitely hear, in the history, of these people that have been trying to figure out what’s wrong with them for years.
Then, they see me, and they come and see me, and we go down the line. We check adrenals first; make sure their hormones are up-to-snuff; making sure they’re getting enough magnesium, which is lacking in our soil these days and is very important for muscle health and heart health. I test for it. I’ll do a western blot, with a PCR hopefully.
There’s also a new test that tests T cell response. It’s from Pharmasan Labs, which is the lab in Wisconsin. It’s really new. It’s not CDC approved. It’s not one of the, “If it’s positive, it’s reported.” But, I’ve been using it. It shows active T cell response, and therefore active infection. So, I have been using that when I can; again, when the patient’s able to afford it because it has … I’ve used it probably 5 or 6 times now, and it has reflected what I’ve seen clinically, and it’s great to have something to guide you when you’re going through treatment because it does take time. I don’t always use antibiotics. Luckily, those first few cases I got did amazing with herbal therapy and homeopathy. They, to this day, have not had symptoms return.
Dr. Lisa: So, did you also treat these patients with antibiotics? Or, did you …
Kristen: Not the first few. When I first moved out here, I did what I do best. That, for me, is a specific form of homeopathy called biotherapeutic drainage. It focuses on a cellular level, and you’re supporting each organ system separately. That’s just what I love, what I do. That’s what I used, and it was successful. Then, I started working with more doctors who treat Lyme, going to the ILADS conferences, and getting scared. “Oh, gosh. I really should be using antibiotics.” Even my own colleagues were saying, “You need to be using antibiotics.” I was like, “But, they got better.”
But, then I got really scared, and I started using more antibiotics. Then, the people on antibiotics started just plateauing, and I was still doing the other naturopathic stuff because you can’t … You can’t just treat with antibiotics. You’ve got to support the detox pathways. You’ve got to support methylation. You’ve got to … There are so many other parts to it than just the infection. I’ve never met anyone who successfully has treated Lyme just with antibiotics. So, I got kind of caught up in that.
Now, the last year or so, I’ve really seen people just plateau on that and get toxic buildup, and it just becomes what I call this “polypharmacy” of them needing more and more drugs, pain medication for the pain, and nerve med- … like gabapentin for the nerve pain. It’s just like all of a sudden, my patient’s on 12 different, really intense medications, and we’re not making any progress. So, I’m kind of revamping my original protocol. I definitely think there’s a time and place for antibiotics if it’s in the nervous system. If the patient is really amino-compromised or they’ve got other morbidities going on like diabetes, heart disease, things like that, we definitely want to be aggressive. But, you can also be aggressive with herbal therapy if you do it correctly.
Dr. Lisa: So, if somebody is interested in, say, they have a Western doctor and they also come to see you, and say the Western doctor is using antibiotics, what types of homeopathic remedies and herbs are effective with Lyme disease?
Kristen: Again, it depends on the person. It depends on what they need specifically, and that’s one reason why I love homeopathy so much because it doesn’t interact with medications. I just … I go by what the patient tells me, what their body tells me, what their story tells me. A lot of it’s about the gut. We’re learning more and more about the microbiome, and of course if you have somebody on long-term antibiotics, that gut flora is going to be really … You need a lot of support. As naturopaths, we’re kind of known as the gastroenterologists of the field sort of … literally the field.
But, I’m always focusing on the gut, and I’m focusing on what I can do to … anything I can do to help the antibiotics, help the medications be more effective. So, helping their detox pathways and helping their bodies generally get healthier and reduce as much inflammation that we can in other ways, like diet, is huge. That can help alleviate a lot of the side effects from medications. It can help … and it can help the drugs work better because you’re reducing that inflammation, and the body’s able to get that medication to where it needs to go.
So, I work with a lot of doctors who they kind of handle the antibiotics and the other meds, and then they send them to me for the naturopathic piece. I’m a big diet person. I’m all about … That’s something that we all … It’s hard, but that’s something that we can control is what we’re eating, and that can have a huge effect, as you know, on our inflammatory cascade.
Dr. Lisa: How can people find out about your practice and about the work that you’re doing with Lyme and other chronic illnesses?
Kristen: Well, I have a website, and it’s … My practice is called Bare Medicine, which is Bare, as in naked, B-A-R-E. So, baremedicine.com is my website. I am also very into social media, so I’m on Facebook and Twitter. I’ve also started my new goal, which dreams are fun. But, my new goal is to somehow open a Lyme specific clinic, an integrative clinic where there are MDs, and there are naturopaths, and there are … People can come and get IV therapy, which I can’t do in Maine; come and get sauna therapy, hydrotherapy. Hopefully, we can maybe get a couple specialists to at least come in a couple times a week.
That’s really my long-term goal, and so I’ve kind of started a Facebook page and a Twitter account for Lyme Institute of New England, which is what I’d like to call it. I don’t know that there’s a place like that. I haven’t found one, and certainly my patients haven’t found one. So, that’s really sort of my focus right now is trying to … Because I’m a doctor, and I started a … I hung my little shingle, and I started a little practice on my own.
But, starting a clinic is a whole different piece, so I’m really trying to get out there, and educate, and hopefully network and find people who are likeminded to provide a place where people can come to one place because these people are exhausted. The illness becomes their life. It’s like cancer. They have to come see me one day. Then, they go see their primary care the next day. Then, they go see their acupuncturist for the pain management. Then, they have to go to the gym and get sauna. It’s just, ugh, wouldn’t it be nice for them to come to one place and not have this condition take over their life. So, that’s my goal.
Dr. Lisa: Well, I suspect you’re going to be successful because there is definitely a need, and it sounds like you’re very thoughtful about all of this.
Kristen: I’m hopeful. I’m hopeful.
Dr. Lisa: Well, I encourage people to go to your website to learn more about you and the work that you’re doing. I appreciate the time that you spent with us today and also the work that you’re doing with Lyme in the state of Maine because it is a puzzle.
Kristen: It is.
Dr. Lisa: It’s something that we doctors, naturopathic, allopathic, osteopathic …
Kristen: Everybody.
Dr. Lisa: Everybody, all of us.
Kristen: It’s just …
Dr. Lisa: We all need to have open minds and try to understand that.
Kristen: And, work together, absolutely.
Dr. Lisa: Yeah. We’ve been speaking with Dr. Kristen McElveen, a naturopathic doctor who is in private practice in Springvale, and who will be giving a talk for medical care providers on Lyme disease with Apothecary by Design in May. Thanks for coming in today.
Kristen: Thank you so much for having me.
Dr. Lisa: You have been listening to the Dr. Lisa Radio Hour and Podcast, show number 135, “Lyme Disease.” Our guests have included Anita Roelz, Pam Creamer, and Kristen McElveen. For more information on our guests and extended interviews, visit D-O-C-T-O-R Lisa.org. The Dr. Lisa Radio Hour and Podcast is downloadable for free on iTunes. For a preview of each week’s show, sign up for our e-newsletter and Like our Dr. Lisa Facebook page. Follow me on Twitter and as bountiful1 on Instagram.
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