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From the Townsend Letter
June 2017

Low-Dose Immunotherapy (LDI)
by Ty Vincent, MD
Based on an interview with NJ Faass, MSW, MPH

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Multiple Issues in Autism
Autism is another good example of a multifactorial immune-mediated condition. For many of these young patients, the condition is primarily caused by some type of immunological inflammatory process. The target organ for their inflammation is primarily the brain, and that can manifest in a wide range of symptoms including learning disabilities, communication problems, stimming behaviors, and other neurological manifestations. Working with colleagues who have larger autism patient populations, we have found that many LDI antigens may work for them. Antigens that are commonly relevant in the autism population include the following:

  • Borrelia, bartonella, babesia, mycoplasma;
  • Herpes simplex, streptococcus, clostridia;
  • Yeast and foods;
  • MMR and DTaP vaccines;
  • Chemical and environmental allergens.

With many chronic conditions, one difficulty lies in the fact that symptoms caused by different antigens can look very similar. This is very common in autism. To determine which antigens to use, the provider must ask a great many questions. Some of these patients have digestive problems. Some have symptoms such as rashes, fevers, or swollen lymph nodes, as well as psychological symptoms like OCD tendencies. To determine which antigens are going to fit, it is essential to develop a comprehensive list of specific symptoms. A great deal of clinical experience goes into making good decisions early on, and not every clinician has the patience and diligence to master this technique. An experienced practitioner can figure out difficult cases eventually if they are thorough and get communication from the family or the patient. Through experience, one gets better and better over time, able to get to the right answer quicker. I equate using LDI to playing a piano. When you first sit in front of a piano, you are more likely to make "noise" than music. With practice and experience, you will be able to make music for your patients using LDI.

Modified Allergy Protocol
Allergies have skyrocketed in the last few years, reflected in the number of children in the public school system who need to have an Epi-Pen and emergency measures in place. More and more people now have life-threatening allergies not only to peanuts and shellfish, but also to common foods such as corn, strawberries, or coconut. The low-dose antigen (LDA) mixes have been extremely successful in eliminating those allergy problems for people. I have modified the LDA protocol to a certain degree and gotten even better results in people with the most severe cases, finding that some people need to take the antigens in even more diluted form in order to achieve a good response. Those highly sensitive patients cannot tolerate the standard LDA concentrations without a severe flare of symptoms. I have also used certain foods in isolation such as corn, wheat, egg, or milk with people who have severe reactions to that particular substance. Again, one of the keys to success is achieving the right dilution.

Conclusion
Ultimately, one of my goals is that this therapy (and the underlying concepts) become standard of care for people with autoimmune disorders. This approach is safe, efficacious, inexpensive, and user-friendly. LDI can now be administered in the home using sublingual low-dose antigen formulations, and treatment is often successful for disabling conditions for which there are currently no other effective form of therapy. Although I can only treat a thousand people in my own practice, if I can train a thousand other physicians to do this, then we can treat a million people. There is strength in numbers, and great power in knowledge.

Infection, Commensals, and Tolerance
The concept of infection requires a particular interaction between an organism and the host. By definition, when a true infection is present, the organism has been found in a location within the body where it does not belong. The mere presence of the organism within that tissue site causes a predictable and reproducible immune-inflammatory reaction that is necessary to protect the host and eradicate the invasive organism. Common examples of routine infections include bladder infections with E. coli or pneumonia with Streptococcus pneumoniae. Both the E. coli and S. pneumoniae organisms are common in human beings; they live within the bowels and nasal/sinus passages respectively. They only become "infections" if they enter a body compartment where they do not belong (the bladder or the lungs in these scenarios). The other essential feature of a true infection is that it can be cured by a relatively short course of antimicrobial therapy.
     
Certain organisms are truly foreign and seem to have a more intense inherent virulence or immune reactivity when encountered by the human immune system. They do not reside normally anywhere in the body and are always attacked when they are encountered there. Examples include the Ebola virus, salmonella, and typhoid organisms. However, even those rules are not absolute because many organisms thought to be obligate pathogens have a certain asymptomatic carriage rate. Humans have been forced to co-evolve with microbes since there were first humans; and our tolerance for these organisms improves over time with persistent colonization or exposure. In part, that is related to the fact that highly "susceptible" or highly "reactive" (the difference is very blurry) individuals will all die off fairly quickly after the introduction of a new pathogen, leaving only more "tolerant" individuals behind. Examples of such microbial culling include the cholera pandemics of the past, measles, tuberculosis, influenza, and others. Different strains of influenza have certainly demonstrated highly variable rates of immune reactivity. This was evidenced by the pandemic of 1918 that killed millions of people and, also, by the way in which a typical strain of the virus killed a significant percentage of the Alaskan native people upon introduction to that immunologically naive population. It is not clear why certain pathogens are more immunogenic than others, just as it is not clear why certain foods such as peanuts and shellfish are more inherently allergenic than others. Why are those foods frequently lethal allergens, rather than rice or olives, for example, which are more common in the human diet?
     
ABx SupportThe difference between "infection" and an immune-based chronic disorder targeting a specific microorganism is a critical paradigm shift. Consider the example of
Streptococcus pyogenes, the bacterium that causes strep throat. S. pyogenes is commonly a true pathogen and an "infectious" bacterial species, meaning that it tends to cause a predictable inflammatory response in the vast majority of humans upon inoculation. Probably 90% of people will develop a fever, terrible sore throat, swollen tonsils, fatigue, and other symptoms within a few days of colonization. However, up to 10% of people will have none of those symptoms and will simply "carry" the organism with no reactivity. That is an example of variable individual "tolerance" for this particular microbe, and it means those tolerant carriers will spread the infection to others unknowingly. Another manifestation of differential tolerance for this organism is evidenced by the fact that strep is known to trigger at least four very different types of "autoimmune" reactions, including rheumatic fever, post-streptococcal glomerulonephritis (technically an immune-complex disease, but bear with me), guttate psoriasis, and PANDAS. These conditions affect very different systems in the body through a distant or systemic immune response that is somewhat unique to the individual, based on genetic susceptibility and the degree to which the immune system is dysfunctional.
     
Generally speaking, the human immune system has become increasingly dysfunctional due to accumulated environmental toxins within our species over time, and the resulting epigenetic changes that have ensued. Allergies and autoimmune diseases have skyrocketed in recent decades, and I believe this is a response to the environmental pollution we have inflicted upon ourselves and future generations. The result in terms of immune function is that the immune system has developed increasing difficulty in distinguishing "friend" from "enemy" and has begun to attack harmless substances such as foods, plant pollens, and commensal microbes with increasing regularity. The vast majority of autoimmune diseases can be shown to be initiated by an immune attack on some type of internal microorganism, part of our normal flora, which then cross-reacts with the host tissue in some manner due to a lack of appropriate discrimination. Another relevant term is "molecular mimicry" (things look more similar the worse your vision becomes). The fundamental problem is a loss of immune tolerance, which underlies all allergic and autoimmune response, and most chronic inflammatory conditions.
     
When someone with the high-risk HLA genotype for a disease becomes colonized with the relevant triggering microbe, and then some form of stressor agitates the immune system, an autoimmune disease can ensue. Most patients with rheumatoid arthritis, for example, are actually reacting to bacteria within the genus
Proteus, cross-reacting with their joint tissues due to their HLA type. Every autoimmune disease seems to have those same components: molecular mimicry between a host tissue and microorganism, with the inflammatory response set off by some sort of immune-stimulating event. That event can be something like a true infection, a vaccine, physical trauma, intense psychological stress, or a drastic hormonal change (childbirth, for example, is an extremely common "catalytic event").
     
In my experience, chronic "Lyme disease" fits this model extremely well. Borrelia organisms and other bacteria thought to be "co-infections" appear to actually be commensal flora, not true pathogens. I say this because sensitive detection techniques such as blood cultures or PCR testing will demonstrate the presence of these organisms within the vast majority of completely healthy adults. That means they are not true pathogens, and the disease associated with them is
not an "infection" in the true sense of the word. Consequently, we have to presume the virulence of the organisms themselves is not the issue, and the disease process rests entirely upon the host immune response. I believe this is why LDI has been so effective in treating chronic conditions due to borrelia, bartonella, babesia, candida, mycoplasma, and numerous other microbes. This is also the reason that taking antibiotics for years still fails to solve the problem for the great majority of those who are afflicted. The "infection model" of Lyme disease does not correlate with the growing evidence, and the "immune response" model at this point seems more relevant.
     
The keys to success with LDI for autoimmune and chronic inflammatory conditions are to properly identify the triggering organisms or agents and to find the ideal neutralizing dose for that antigen. If you can determine those two things, you can make 90% or more of these people well to a significant degree. At this point, I have hundreds of Lyme disease patients all around the world; many have responded dramatically to this therapy and no longer need any kind of antimicrobial treatment whatsoever. For me, that has been very eye-opening.

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SUPPORTThe Townsend Letter is dedicated to examining and reporting on functional and integrative medicine. Our editorial content depends on support from readers like you, and we would appreciate your help to keep this content forthcoming. Please take this opportunity to contribute $50, or choose one of the other amounts listed on the next page, and ensure that our independent voices keep up the good fight against the skeptics, who would like to silence us and eliminate your medical freedoms.

Ty R. Vincent, MD
Dr. Ty Vincent grew up in Alaska, graduated from the University of Alaska, magna cum laude, and earned his medical degree at the University of Washington. A family practice physician in Alaska for more than a decade, Ty has been a board member of the American Academy of Environmental Medicine and the American College for the Advancement of Medicine. With diplomate status from the American Board of Family Medicine, he has also completed additional training and fellowships in environmental medicine, medical acupuncture, and Chinese herbal medicine. Recognized as an expert and innovator in the field of low-dose antigen therapy, he has received awards from the American Academy of Family Practice, the Society of Teachers of Family Medicine, and the American Academy of Environmental Medicine. Dr. Vincent now provides training for professionals and co-management of patient care through his company, Global Immunotherapy, LLC, based in Kona, Hawaii.

Resources
LDI Training and Clinical Services
Global Immunotherapy offers distance provider training and patient care. Patients receive consultations with Dr. Vincent by phone or Skype in the comfort of their own home. Provider membership enables practitioners to receive the LDI Training Manual and to order LDI antigens, as well as customized autologous samples. Membership facilitates direct contact with Dr. Vincent, answers questions about LDI, supports case review, and gives practitioners the opportunity to converse with other professionals who are using LDI treatment. Global Immunotherapy also provides LDI antigens for healthcare professionals, to be diluted and used for the treatment of their own patient populations. We have had very good success treating all manner of allergies, autoimmune diseases, and chronic inflammatory disorders. Dr. Vincent also provides consultations and patient co-management in conjunction with local primary care physicians on medical needs beyond the parameters of LDI.
Global Immunotherapy LLC, Kona, Hawaii
907-671-8255
Email: customerservice@globalimmunotherapy.com

Web-based Information
We now have a series of short video clips on YouTube and linked to our Facebook page and website. Most of the videos are brief, conceptual discussions of 5 minutes or less on different aspects of LDI therapy. We are finding that this is a very effective tool for helping patients work with their provider on LDI treatment, and at this point the videos have received more than 10,000 views.
Website: globalimmunotherapy.com
Book: Thinking Outside the Pill Box (available through Amazon, Barnes and Noble, Google Books, etc.)

LDA Providers
Dr. W. A. Shrader maintains a website listing physicians he has trained who administer LDA, alphabetical by state in the US, Canada, the UK, and elsewhere, available at www.drshrader.com/lda_physicians.htm.

Editorial: Nancy Faass, MSW, MPH
Ms. Faass is a writer and editor in San Francisco who has participated on more than 50 books to date. Director of the Health Writers' Group for the past 20 years, she works collaboratively with clients to develop books, articles, Web content, white papers, manuals, and blogs, and can be reached by emailing info@HealthWritersGroup.com or calling 415-922-623

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