Patricia S. Lemer, M.Ed., LPC
Neil Nathan, MD, is one of the world’s most acclaimed go-to doctors for diagnosing and treating complex illness. Over the past five decades he has written, lectured, mentored and shared his knowledge on how to decipher the interwoven pieces of what he has labelled, the “Sensitive Patient.” He has heard it all, seen it all, and, yes, healed it all: fatigue, brain fog, depression, allergies, cardiovascular issues, pain, digestive problems, and autoimmunity. He is a generalist who knows all the possible pieces to the puzzle: toxins, viruses, bacteria, mold, chemicals, Lyme, EMFs, and more.
I had the pleasure of hearing him speak at the annual conference of the American Academy of Environmental Medicine (AAEM) conference in November 2023. I was hooked. As a licensed professional counselor guiding families of individuals with developmental, learning, and behavioral disabilities for over 50 years, I am exactly Nathan’s age. I have written three books on healing autism and related disorders and have always focused on determining root causes.
In his latest book, Nathan has gathered the wisdom from esteemed colleagues and organized it into one of the most important books of the century. The Sensitive Patient’s Healing Guide is the manual you have been waiting for. It covers the genetics, biochemistry, neurology, physics, and biology of how we get sick, and what we must do to get well. Like no one before him, Nathan integrates these fields into a comprehensive model that digs deep to determine intricately entwined root causes and develop a prioritized treatment plan that goes well beyond masking symptoms.
Dr. Nathan guides you on how to gather relevant details in a combination of oral, physical, probing evaluations and laboratory testing. Some pieces of the puzzle may be old friends, like tweaking lifestyle issues, diet, nutrition, detoxification, and stress. Others are more subtle, like the ubiquitous effects of mold, thiamine deficiency, oxalates and dirty electricity. Yet others, such as limbic-system dysregulation, vagal nerve dysfunction, and mast cell activation syndrome (MCAS), may be altogether unfamiliar.
The book is divided into five parts. In Part I, the contributors introduce the neurology, biochemistry, and physiology of sensitivity. This part includes the possibly not-so-familiar underpinnings of the sensitive patients’ distress: the limbic and vagal systems, as well as mast-cell activation. Part II focuses on the most common triggers for the development of sensitivity, mold, Lyme, EMFs, and other environmental toxins. Part III includes oxalates, sulfur metabolism, salicylates, dental components, structural abnormalities, SSRI withdrawal, thiamine deficiency, hormonal dysfunction, carbon monoxide, and COVID, as contributors and triggers for sensitivity. Part IV is on treatments, and Part V, written by Nathan himself, is the invaluable roadmap to putting it all together.
The Sensitive Patient
Who are Nathan’s “sensitive patients?” We all know them. They react to everything! Light, sound, touch, smells, foods, chemicals, vibrations, fumes, medications, stressors, all put them over the edge. They are often told that “it’s all in your head.” They have stumped dozens of doctors, been written off by their families, and spent days curled up in the safety of their homes, fearful of the dangerous world out there.
Finally in the 1960’s, the “something” that was affecting these miserable souls had a name: “multiple chemical sensitivity” or MCS. Yet few “believed” it even existed. And, today, in the 21st century, it is STILL controversial. But to Nathan, it is simple: some people are exposed to some stimuli, and their bodies, brains, and cells over-react. Whether it’s from their genetics, their unique biochemistry, or their psychological status, they are suffering, and as their doctor, the good doctor is committed to helping them get well, and get their lives back. How? Read on!
The Physiology of Sensitivity
Why do some people go through life without reactivity, while others over-react? To Nathan, it comes down to SAFETY. If your body doesn’t feel SAFE, it will do everything within its power to protect you. The limbic system and the vagus nerve work together to monitor stimuli for safety. If either registers light, sound, food, chemicals or electrical stimuli as unsafe, they get your attention with fatigue, brain fog, a headache, pain, or other physiological symptoms. As these neurological signs persist untreated, a cellular process known as Mast Cell Activation Syndrome (MCAS) develops. The commonality among these three systems is INFLAMMATION.
Throughout the book, Nathan keeps returning to how understanding of the limbic system, polyvagal theory, and mast cell activation are key to healing the sensitive patient. The good news is that by treating the various inflammatory sites, almost all patients become gradually less reactive and sensitive.
Nathan emphasizes that those patients who do not get well, despite reducing exposures, and strengthening other aspects of physiology, have missed the essential tweaking of these systems. He insists that until the brains of these suffering patients recognize that the stimuli they are experiencing are far safer than they thought, removing triggers alone will be insufficient.
The Limbic System
The book opens with a lesson from the experts. Annie Hopper and Ashok Gupta are pioneers in treating the limbic system. Both developed their methods to heal their own MCS. Their stories are compelling, and their knowledge sound.
Hopper’s Dynamic Neural Retraining System (DRNS) is a drug-free, self-directed rehab program based on the proven neuroplasticity of the body and brain. Research on applying her method successfully to over 400 patients with Long COVID is well-documented. For more information, go to www.RetrainingTheBrain.com.
The Gupta Program is part physiological, and part psychological. Gupta noticed that many “sensitive” patients experience their world as generally “unsafe.” Furthermore, they carry a previous trauma around this belief, often predating exposure to the trigger. For him, restoring a sense of safety in the body, and in the world in general, are key to recovery. This requires a combined approach with an experienced coach or therapist that delves into the patient’s belief system as a contributing element in the creation of the illness in the first place. More information is available at www.GuptaProgram.com
The damaged limbic system is intimately connected to the vagus nerve, the tenth cranial nerve, whose mysteries were uncovered only 30 years ago by psychologist Stephen Porges, PhD. Dozens of books have now been written about how this two-branched longest cranial nerve in the body regulates an array of vital functions, including the body’s response to trauma and safely. According to Porges, “the sensitive patient is locked into a chronic state of defense, with a predictable autonomic profile that fosters constant detection of danger on every level…compromising health, growth, restoration, and even sociability.”
Nathan’s experience is that the vast majority of sensitive patients have both limbic and vagal dysfunction, which are enmeshed at a deep level. He thus mentions many vagal system treatment programs in this book, including Porges’ music-based intervention, the Safe and Sound Protocol. Mast Cell Activation
And then there is mast cell activation, an extremely complicated inflammatory condition that requires an extensive science background to comprehend. Although quite common, according to Nathan, few traditional doctors even recognize, yet understand, its enormous ramifications.
Mast cells are a type of white blood cells that are made in the bone marrow, and migrate to almost every tissue of the body. They sense everything you breathe, put in your mouth, or swallow, and function as the frontline defense of the body’s immune system. If they are stimulated by a trigger of any kind, they create inflammation, and evoke a healing response. The problem is that in today’s world, mast cells experience a constant onslaught of triggers, which puts many folks’ immune systems over their threshold of tolerance, causing their mast cells to lose their fine tuning, and become both overly sensitive and responsive.
Like MCS, MCAS is a relatively “new” diagnosis, reflecting the body’s inability to cope with the constant barrage of an increasing number of stressors in today’s world, and doctors are still continuously debating diagnostic criteria. Unlike the more established chronic conditions, like Parkinson’s, diabetes, and lupus, MCAS is still in its infancy, and promising treatments are emerging almost daily. Nathan’s hope is that understanding, awareness, and treatment options will continue to grow quickly.
For now, in addition to applying the first rule of environmental medicine, avoidance, Nathan details his recommendations for stabilizing the nervous system. He focuses on the limbic and vagal systems, as well as investigates the role of trauma, PTSD, and toxic relationships. This takes time and an army of specialists in related fields,. He highly recommends functional naturopath, Beth O’Hara, who has contributed two chapters to the book, and her community at www.MastCell360.com, as well as physical therapist, Cathleen King’s Primal Trust program.
Spiky-Leaky Syndrome
Part I ends with a discussion of another medical condition call Spiky-Leaky Syndrome, or SLS. Dr. Nathan’s experts on this theory are pediatricians turned researchers, Andrew Maxwell and Deborah Wardly. This condition is the umbrella over the genetically susceptible patient with chronic inflammation and mast-cell activation caused by mold exposure, Lyme, and MCAS. Remarkably, this common combination can lead to the development of loose ligaments, and a probable diagnosis of Ehlers-Danlos syndrome. This joint hypermobility, in turn, leads to structural instability, creating a further cascade of autonomic nervous system dysfunction (think limbic and vagal), and sleep-disordered breathing. Virtually every organ, and every system becomes affected. And the treatment…you guessed correctly…avoidance of environmental triggers, treatment of MCAS, and the addition of some myofunctional therapy.
Triggers in the Sensitive Patient
Part II focuses on the most common and probably most familiar triggers. Chapters on diagnosing and treating illnesses from mold, Lyme, electromagnetic fields, and other chemical exposures, such as pesticides, glyphosate, formaldehyde, and toxic metals, are worth the price of the book for anyone just starting down this “alternative” road. Nowhere else are these “bad guys” enumerated and described so clearly as in this remarkable book.
As if the above poisons are insufficient for making someone extremely sick, Part III adds more fuel to the fire of inflammation in the bodies of our unfortunate patients. The chapters in this section cover a wide range of additional triggers from oxalates, sulfates, and salicylates in our food, to the role of jaw and cranial structure and dysfunction.
Almost every specialty of medicine is both responsible for contributing to the woes of the sensitive patient and is a possible member of the rehabilitation team. Nathan details how tooth misalignment can profoundly exacerbate sensitivity, and how specialty dentistry can help. Holistic psychiatrist James Greenblatt introduces the concept that SSRI withdrawal can also be a contributing factor. Bob Miller, a genetic-specific nutrition expert, and naturopathic physician Greg Nigh discuss the role of several important polymorphisms that also can contribute to sensitivity. Repairing these deficiencies, especially those related to sulfur processing and histamine stimulation, can make a world of difference to the sensitive patient.
Nathan himself writes the chapters on hormone imbalances, carbon monoxide, secondary porphyrias and emotional/energetic/and spiritual considerations in the sensitive patient. Obviously, mold, Lyme, and other coinfections directly affect the pituitary, thyroid, and adrenal glands, and thus hormone disruption is inevitable. Nathan believes that unexpressed emotions are stored, not in the brain, but in the musculoskeletal system. That is why massage, chiropractic, osteopathic, and acupuncture can be so effective in eliciting profound emotional reactions. Almost no one else has written so clearly and succinctly about these subjects.
When his patients have been very compliant with avoidance, lifestyle tweaks, and more, and seem to be “stuck,” Nathan leaves the physical realm, and explores issues in the psychological, emotional, and spiritual arenas. Commonalities in stuck patients are childhood and other traumas, for which talk therapy has taken them only so far. Dr. Nathan has detailed many cases and therapies for these patients in his previous incredible book, that I could not put down,
Energetic Diagnosis. If you are unfamiliar with this work, I cannot recommend it more highly!
Energetic therapies have been used for millennia. Allopathic practitioners rarely have any interest or place any credence in them. Yet, those who have used acupuncture, reiki, tapping, or prayer recognize the power of the combination of belief and energy. Nathan supports your efforts in this non-physical approach.
Part III ends with a look at the role of COVID and COVID vaccines in profoundly changing the world, our bodies, and how medicine is practiced, in ways we could never have imagined. Persistent fearmongering, along with the intense inflammatory response it has instilled in sensitive patients, is unfathomable. Greg Nigh, a naturopathic physician and acupuncturist, writes eloquently about the possible risks and potentially negative health consequences of mRNA therapies. He references the Front Line COVID Critical Care Alliance (FLCCC) as a place to start and adds a couple of additional therapies to mitigate the impact of the injections and spike proteins on the nervous system.
Treatments
Part IV consists of only two chapters, on novel treatments for sensitive patients written by veteran integrative physician, Ty Vincent, on sub-lingual Low Dose Immunotherapy, and by Andreas Grossgold, MD, PhD, on ketamine. Dr. Nathan has found both of these to be “game changers” for many of his patients. Both should be considered as therapies for patients with aberrant immune-system responses.
Putting it All Together
Now the best part! Part V is the practical integration of the previous 400 pages by the master himself. The last chapter offers a condensed version of how to conduct a complete evaluation, how to read the test results from routine blood, urine, stool and other boutique testing that is now available from a variety of labs. As each patient’s unique fingerprint of genetic, biochemical and stress history emerges a unique treatment plan that focuses first on limbic dysregulation, vagal dysfunction and mast cell activation can be developed.
Nathan reviews a few pharmaceuticals and supplements that he has found helpful to accompany the above goal, in the thousands of patients he has treated. Again, some are probably familiar, such as quercetin, while others are new. He cautions that stabilizing the nervous system could take weeks or even months, and must precede a comprehensive treatment plan that identifies and targets one or more “root cause” or triggers such as mold or Lyme. Both are necessary for the patient to get well.
Detoxification through all the body’s available channels is central to all treatment. Staying hydrated, eating organic, sweating, brushing, and oil pulling are essential. So is lessening, and if possible, eliminating EMF exposure. The dental/facial structural imbalance could be an important, often overlooked component of healing. Finally treating the residuals of the COVID vaccine and virus, round out treatment.
The Sensitive Patient’s Healing Guide is a book that will not gather dust on your desk. Even if you do not choose to read it from cover to cover, you will find yourself referring to it time and again, as each new patient tells their story. Thank you, Neil Nathan, for sharing your wealth of knowledge and that of your many disciples and friends. I know that I express the gratitude of health care professionals around the world for this important guide.
Published June 29, 2024
About the Reviewer
Patricia S. Lemer, M.Ed., LPC, is the author of Outsmarting Autism: Build Healthy Foundations for Communication, Socialization, and Behavior at All Ages.