Welcome to the Tampa Blog of Dr. Matt Lewis

I’m glad you’re here. I have more than six years of postdoctoral education in functional medicine and over a decade of experience in clinical nutrition. Through my Tampa-based practice, I help patients by identifying the underlying causes of low thyroid, fatigue, weight gain, and other chronic health issues and provide holistic treatment through nutrition, lifestyle, and other natural approaches.

By: Dr. Matt Lewis D.C., DACBN, CFMP®

It’s been a few months since I have updated my blog. So, where was I?

It’s been a challenge to write while balancing my Tampa Functional Medicine practice, family life, and studying. I figured all that out, sort of! I am happy to be back to writing!

The purpose of my blog is to educate health care consumers on a range of health care topics, and most importantly help you to find the root cause of your health concerns. Since starting my blog, I am happy to say there are many patients who have reached out for more information in a one on one setting.

Besides that, what has really left me busy in the last few months….I have been in the “hole” reading through a borage of papers and books concerning CIRS-Chronic Inflammatory Response Syndrome. Over the last four years I have been engaged in testing patients for CIRS- mostly due to mold (more accurately, exposures to biotoxins in water damaged buildings) and Lyme biotoxin. I decided to take the plunge to learn the Shoemaker Protocol for CIRS- biotoxin illness through Dr. Ritchie Shoemaker and I am currently in the certification process.

In January 2019, I attended the Meeting of the Minds Conference in Ft. Lauderdale, FL. It was a three-day conference, bringing together mold remediators, inspectors, and physicians who treat CIRS patients. If you are not familiar with what CIRS is-let me explain.


What is Chronic Inflammatory Response Syndrome – CIRS?
Chronic Inflammatory Response Syndrome occurs when a genetically susceptible individual is exposed to a biotoxin and as a result becomes chronically ill over a period that usually spans years. The most notable exposures are to a host of biotoxins and inflammagens found in a water damaged building or home. This is more common than you might think. According to the World Health Organization, 50% all buildings/ homes are water damaged in the United States. Another common cause is the toxins associated with Lyme disease. There are other causes of CIRS, but for now these are the two most commonly recognized, i.e. living or working in a water damaged building or post Lyme disease.

Below is the extraordinary list of inflammagens found in a water damaged building: It’s not just mold!

Symptoms of CIRS
The Most Common Symptoms Include:
• Brain fog, loss of concentration, loss of verbal recall
• Chronic fatigue- usually misdiagnosed as chronic fatigue syndrome
• Muscle aches and pains- usually misdiagnosed as fibromyalgia
• Abdominal pain or GI dysfunction – often misdiagnosed as leaky gut, SIBO, IBS
• Respiratory symptoms, chronic sinuses, coughing
• Anxiety or depression

There are more symptoms. In fact, there are 37 symptoms grouped into 8 clusters for purposes of analysis. If a person has 8 or more clusters there is a greater than 80% chance that they in fact have CIRS. These symptoms must be reviewed with a health provider with a proficiency in CIRS. Other reasons for the symptoms must be ruled out and some symptoms on the check list require a deeper dive, or interrogation by the practitioner to discover more about the symptom.

For example: I have had patients when asked “do you get leg cramps?”, they say “no, not really”. However, when I ask again in a more specific manner “do you have cramps in your legs at night that are painful or wake you up”, “or do you feel your fingers lock at times?”, the response may change. “Oh, yes, I do, but it’s just one or two times per week”. This is relevant, there is a reason for the cramping, and it should be accounted for in order to properly diagnose. It’s also nice to see that symptoms of cramping often resolve in a few short weeks following treatment.

Genetics Play a Role in CIRS
When encountering a biotoxin the normal immune system response it to tag it, bind it, and eliminate it from your body. For those with certain types of HLA-DR genetic codes they are less capable of eliminating toxins and more likely to acquire a chronic inflammatory response that will cause a host of unrelenting symptoms. Reduced biotoxin elimination allows toxins to remain in the body.
The HLA-DR genetic variances are geared towards increasing inflammation throughout the body, hence the diagnosis- Chronic Inflammatory Response Syndrome. This is accounts for 24% of the population that is genetically susceptible. Of course, not all those 24% will be exposed or will suffer once exposed. The genetic predisposition explains while some in a home that has hidden or exposed mold will become ill, while others will feel just fine.

When I consult with patients, it’s quite common that most people in the home have at least some of the symptoms associated with CIRS. Those who are least affected don’t usually attribute the problems to mold or the indoor environment, but once we discover the AC unit that needs cleaning or the musty odor that was coming from the closet, maybe a leak in the plumbing and clean up the problems, their symptoms often go away! Those with CIRS will remain sick even after the exposure is improved. They might find some symptoms resolving but not completely. They can go from twenty symptoms to ten, but the inflammation remains. The CIRS patient requires proper diagnosis and treatment and so rarely do they get it! When was the last time a doctor asked you “Are you exposed to any musty smells or visible mold at home or work?”

If you can’t get rid of the toxin, the immune system stays indefinitely charged. A CIRS patient can leave the water damaged structure or be treated for Lyme disease but remain with symptoms and chronic illness.

CIRS Targets the Brain
The chronic inflammation that ensues creates a type of cytokine storm. Cytokines are immune messenger chemicals that tell the body to create more inflammation. In CIRS patients, cytokines act on the brain, particularly grey matter nuclei in and around the hypothalamus. These cytokines irritate the receptors in these very important control centers of the brain, leading to abnormal secretions of neuropeptides and hormones. In lay terms, this means the control centers of the immune system, temperature regulation, hormonal control and cognitive function start to shut down.

CIRS is Not an Allergy
CIRS patients can typically present with over 20 active symptoms that are seemingly disconnected to the many patients and the physicians they have visited.
Let me be clear here, CIRS is not an allergy! It is not an allergic response to mold. It is an inflammatory response to mold that is caused by an upregulation of the innate immune system and increased cytokines. You can also have symptoms that appear to be an allergy, but that is a distinct entity from CIRS. Why is this so important to understand? Because, allergists will say you have a mold allergy. Does that explain your brain fog or gut problems? No.

How about when the doctor says I checked and you have no allergy to mold, yet you are suffering. Well, I can tell you one thing if you don’t have an allergy that is identified you are now one step closer to a CIRS diagnosis. Patients with CIRS often present with what appears to be mast cell disease (allergic type responses), but this is due to activation of complement cascade with C4a leading the charge. This is tested as part of the Shoemaker protocol and diagnostic workup. Go back and look at the symptom checklist, is it all allergy? No way!

Diagnosis and Treatment

A trained practitioner can spot CIRS. CIRS can be identified in children and adults. Children will present with 6 clusters of symptoms, while adults will usually have 8. Children will often express behavioral issues or anxiety, stomach pain, and congestion. This could be severe or mild in terms of neuro-cognitive symptoms or development. Children or adolescents with POTS postural orthostatic hypertension are often found to have CIRS. Adults will have brain fog, loss of concentration and many other aggravating symptoms including restless sleep. You can refer to the list provided early in this post.

• Typical blood tests are usually normal. Using conventional labs like LabCorp and Quest, CIRS can be diagnosed. We look for altered hormonal balance by checking markers like MSH, VIP, ADH, and ACTH. You don’t need to be familiar with these now, but you will if you have CIRS. Immune markers are checked including TGFB1, MMP-9, and C4a, same rule applies. In future blogs I will go through these in more details. For now, we need to understand that these need to be checked if you meet the symptom criteria and have a history of previous or ongoing exposure. I should also mention that there is a lot of misdiagnosis going on here. CIRS can cause autoimmune responses and appear similar to Lupus, Gluten sensitivity, and be the underlying cause for thyroid illness.

• Brain MRI is usually normal. When we add Neuroquant to the MRI, we find the problem in the grey matter nuclei of the brain, there is atrophy or loss of size in specific brain structures. Neuroquant is a technology that can more finely measure structures on an MRI, checking for changes in volume against controls. Neruoquant testing can help differentiate Mold or Lyme, each showing a different fingerprint on the brain. Most patients I check have CIRS due to water damaged building. Some have had Lyme and then can’t improve because they are in a water damaged environment. Either way, it’s CIRS that often needs to be treated, once the cycle of antibiotics has failed for Lyme patients.

• Nasal swabs will show hidden biofilms that are not infections but antibiotic resistant bacteria that are releasing their own form of biotoxin, furthering the out of control immune response in CIRS. This is termed MARCoNS. Multiple Antibiotic Resistant Coagulase Negative Staph.

• Genie testing, a genetic test that looks at gene activation and what proteins are being made by the messenger RNA in real time can be used to asses the inflammatory response. This is not a 23&me test that tells you about genetic SNPs that will never change. This type of testing can tell the provider and patient what genes are currently activating. What is being expressed at this very moment in time. CIRS patients have a specific pattern where the genes for mitochondrial function and inflammation are being over expressed. This is cause for concern with regards to autoimmunity and chronic fatigue. Follow up studies can show the genes functioning more normally, showing a resolution of the Chronic Inflammatory Response.

• Diagnosis my also include Stress Echo, Vo2 max and additional lab testing. This is can help rule out other conditions as well as confirm CIRS, and monitor progression of CIRS treatment.

• All throughout treatment we redo tests to see the positive changes and move to the next phase of treatment. Treatment starts with binders and finishes with peptides if necessary. Vasoactive intestinal peptide can literally reset the immune system and result in improved expression of genetics, as well as improvements in brain MRI as seen on Neuroquant.

• It is not advised to start any treatment with binders, (prescription or natural) until a full assessment and diagnosis has been made.

Now that you have read through this article in its entirety, if you believe that you may be suffering with CIRS, don’t wait to be seen. The longer it takes to address CIRS, the more challenging it can become to treat. I know, because I too was exposed several times to a water damaged home and workplace, and I have the genetics for CIRS. Like many of the CIRS providers I was led to focus on this in practice out of my own experience. It took me over seven years to find an answer, and I already knew a lot of doctors! Now that I am equipped to handle CIRS cases, I am overjoyed seeing how well patients can heal even after feeling sick for so long without answers! I am here to be your guide.

References
Shoemaker R, House D. A time-series of sick building syndrome; chronic, biotoxin-associated illness from exposure to water-damaged buildings. Neurotoxicology and Teratology 2005; 27(1) 29-46.

Shoemaker R, Rash JM, Simon EW. Sick Building Syndrome in water-damaged buildings: Generalization of the chronic biotoxin-associated illness paradigm to indoor toxigenic fungi; 5/2005; Pg 66-77 in Johanning E. Editor, Bioaerosols, Fungi. Bacteria, Mycotoxins and Human Health.

Shoemaker R, House D. Neurotoxicolhttps://www.survivingmold.com/Publications/VIP_AN_GALLEY_PROOF_3_20_2017.PDFogy and Teratology 2006; 28: 573-588.http://www.fungalresearchgroup.com/files/61153352.pdf

https://www.survivingmold.com/Publications/VIP_AN_GALLEY_PROOF_3_20_2017.PDF

Disclaimer: The information in this blog post is provided for general informational purposes only and may not reflect current medical thinking or practices. No information contained in this post should be construed as medical advice from Dr. Matt Lewis, D.C., DACBN, CFMP®, nor is this post intended to be a substitute for medical counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this post without seeking the appropriate medical advice on the particular facts and circumstances at issue from a licensed medical professional in the recipient’s state, country or other appropriate licensing jurisdiction.
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About the Author: Dr. Matt Lewis, D.C., DACBN, CFMP®, specializes in diagnosing and treating the underlying causes of the symptoms related to chronic and unexplained illness through nutrition, lifestyle, chiropractic, and other natural approaches to whole-health healing in Tampa, Florida. He earned his B.S. in Biology from Shenandoah University, his Doctorate in Chiropractic from Life University, his Diplomate status in Clinical Nutrition from the American Clinical Board of Nutrition, his CFMP® from Functional Medicine University, and his certification as a Digestive Health Specialist (DHS) through the Food Enzyme Institute. Dr. Lewis’ passion for health and wellness stems from his own personal experience. With a family history of autoimmune conditions and diabetes, and his own lab tests showing his genetic susceptibility to Hashimoto’s thyroiditis (autoimmune thyroid), he has learned how to restore his own health and vigor to prevent the onset of these and other illnesses and live an incredibly active life. Through this process, he acquired a deeper understanding of health and wellness, which he now offers his patients in Tampa.

By: Dr. Matt Lewis D.C., DACBN, CFMP®

Persistent fatigue is a tough mystery to solve. Causes include anemia, anxiety, depression, infection, cancer, chronic fatigue syndrome (CFS), poor diet, too little or too much exercise, poor sleep, liver or kidney disease, and the list goes on. One of the most overlooked conditions that can cause fatigue is autoimmune gastritis— a chronic inflammatory disease in which the immune system mistakenly destroys parietal cells— cells that produce the stomach acid and intrinsic factor (IF), which the body needs to be able to absorb vitamin B12.

As a result, people with autoimmune gastritis often suffer from pernicious anemia — a condition in which the body is unable to absorb the vitamin B12 needed to manufacture healthy red blood cells. Without sufficient numbers of healthy red blood cells to carry oxygen throughout the body, it is no surprise that people with pernicious anemia suffer persistent fatigue.

When we think about autoimmunity, a few specific conditions come to mind including rheumatoid arthritis (RA), multiple sclerosis (MS), juvenile diabetes, hyperthyroid, and Lupus. Of course, there are others.

What we don’t often consider are the less discussed or less aggressive autoimmune conditions that can have a large impact of how we feel day to day, lead to more progressive illness, and are often associated with the development of additional autoimmune conditions.

Unfortunately, conventional medical doctors often overlook autoimmune gastritis in patients who report chronic fatigue. They may test for anemia and treat it with iron supplements or test for B12 deficiency, see that your B12 level is fine, and never consider whether your body is actually able to absorb and use that B12. Even worse, some people who report fatigue are simply diagnosed as having Continue reading…

By: Dr. Matt Lewis D.C., DACBN, CFMP®

The Plant Paradox Book CoverQuick-fix diets often single out one component of food and blame it for all of our health woes. Shortly thereafter, products begin popping up on shelves that are fat-free, gluten-free, wheat-free, sugar-free, and so on. That brings me to a recent diet that is beginning to gain traction — the lectin-free diet promoted by Dr. Steven Gundry in his book The Plant Paradox: The Hidden Dangers in “Healthy” Foods That Cause Disease and Weight Gain.

In his book, Gundry asserts certain plant proteins called lectins are primarily responsible for a wide range of chronic illnesses, including obesity, autoimmune disorders, and cardiovascular disease. Critics argue that Gundry fails to back up his claim with scientific research, using only his own and his patients’ results on the diet as clinical evidence of its effectiveness.

Others question whether his dietary recommendations are sound. For example, the lectin-free diet calls for replacing whole grains with white bread and white rice, even though these refined grains have been linked to spikes in blood sugar levels.

Where do I stand on The Plant Paradox? Somewhere in between Gundry and his critics. Placing a limit on the amount of lectins consumed in some populations — people with arthritis and autoimmunity, for example — certainly makes sense. However, I believe the book Continue reading…

By: Dr. Matt Lewis D.C., DACBN, CFMP®

As a Tampa doctor trained in functional medicine and integrative healthcare, I take a patient-focused, integrative approach to doctoring. That is, instead of merely diagnosing and treating illness, I focus on restoring health by addressing the root causes of illness, which are unique to each patient. These causes of illness include everything from genetic susceptibilities to environmental toxins and pathogens to diet and exercise and even psychological and emotional states.

This approach to doctoring is standard practice in functional medicine. However, each functional medicine doctor has his or her own approach to doctoring and to managing his or her practice. In this post, I describe my personal approach to doctoring and practice management, so you can:

  • Compare my approach to that of other doctors.
  • More effectively team up with me to restore your health, if you choose to become one of my patients.

Earning Patients

I do very little marketing to build my practice. Instead, I earn my patients through referrals from several sources:

  • Other patients — typically a friend, relative, or colleague I helped with a similar health issue or concern.
  • Conventional doctors who are “stuck” with a patient’s health issues and realize a different approach is needed (especially those who have had experience with my methods and witnessed the profound improvement in these most difficult cases).
  • Other natural healthcare providers who do not practice functional medicine but understand its value and prefer an approach that helps their clients avoid the automatic application of pharmaceuticals or invasive medical tests and treatments.
  • Personal trainers or nutritional or health coaches whose client are frustrated because they have plateaued.

I am not the only provider in functional medicine who can attest to how well patients perform when they have a different option and more time and attention during office visits. Unfortunately, in the current healthcare system, too much is Continue reading…

By: Dr. Matt Lewis D.C., DACBN, CFMP®

Year after year, parents, mostly moms, bring their children into my office seeking treatment for chronic ear, sinus, or respiratory infections. Their stories are remarkably similar — they have been bringing their child to their pediatrician or family doctor who has prescribed round after round of antibiotics, rarely, if ever, mentioning a cause for the recurrent infection or suggesting an alternative treatment plan.

In conventional medicine, the traditional thinking is deeply entrenched — the go-to treatment for any suspected infection is an antibiotic.

However, this approach is deeply flawed for several reasons, including the following:

  • Antibiotics are effective only for treating bacterial infections. Ear, sinus, and respiratory infections are often viral or fungal infections that antibiotics cannot clear up. Rarely do doctors test to determine the nature of the infection before prescribing an antibiotic.
  • Antibiotics kill both harmful and beneficial bacteria. Beneficial bacteria are essential for healthy digestive and immune systems. The antibiotics your child is prescribed may do more harm than good in the long run.
  • Infections often occur in places that antibiotics cannot effectively reach or penetrate, such as the Continue reading…

By: Dr. Matt Lewis D.C., DACBN, CFMP®

While there’s probably only a handful of Philadelphia Eagles fans living here in Tampa, Fla., the team’s 2018 Super Bowl-winning quarterback Nick Foles has certainly been highlighted in the news lately.

That’s because Foles and his wife, Tori, have brought public attention to a private issue within their family. Tori Foles was recently diagnosed with postural orthostatic tachycardia syndrome — better known as POTS — which is an often undetected and underdiagnosed chronic syndrome that causes an increased heartbeat, fatigue, dizziness, and fainting.

POTS patients like Tori Foles frequently find themselves at battle with gravity, which is why this disorder is often referred to as “the fainting disease.” The human heart normally beats 70 to 80 times per minute when we are at rest. That rate climbs another 10 to 15 beats per minute when standing up, then settles back down. But for people with postural orthostatic tachycardia syndrome, the heart rate often increases 30 to 50 beats per minute — or more — leading to the lightheadedness, dizziness and fainting that Tori Foles experienced.

(Image © Maria Hagsten Michelsen)

While the plight of those suffering POTS became more visible last month when Tori Foles took her case to news outlets and a CNN audience, many of us in healthcare — especially those of us who practice functional and integrative healthcare — are committed to raising awareness about the disorder, and the misconceptions and frequent poor diagnoses surrounding POTS.

Women and the Misdiagnosis of POTS

Between one and three million Americans suffer from postural orthostatic tachycardia syndrome, and 80 percent of them are young women — particularly those in their early teens — with the condition getting worse through the growing years. Because these women are younger and otherwise appear healthy when the disorder strikes, doctors often dismiss the physical prognosis, choosing instead to explore the Continue reading…

By: Dr. Matt Lewis D.C., DACBN, CFMP®

One of the more recent studies to highlight the negative health impact of sugar and artificial sweeteners is “The Influence of Sugar and Artificial Sweeteners on Vascular Health during the Onset and Progression of Diabetes,” by Brian Hoffman, Ph.D., an assistant professor in the Department of Biomedical Engineering at the Marquette University and Medical College of Wisconsin in Milwaukee.

In his study, Hoffman points out that high amounts of dietary sugar have been known for some time to contribute to a wide range of systemic health problems, including obesity, diabetes, and cardiovascular disease. He also points out that “it was not until recently that the negative impact of consuming non-caloric artificial sweeteners in the place of sugar had been increasingly recognized as a potential contributor to the dramatic increase in diabetes and obesity, along with the associated complications.”

The fact that artificial sweeteners had been on the market for so many years before being proven to cause serious health problems is, unfortunately, no surprise. Companies are allowed to profit (and withhold information from the public) until their products are proven dangerous. The burden of proof for the safety of their products is rarely placed on the Frankenfood manufactures. Instead, consumers, doctors, and researches carry the burden of proof that a product is unsafe, and then it takes years to decades before the Food and Drug Administration issues a warning or orders the products off the shelves, assuming it ever does.

When I was a kid I, I ate  Continue reading…

By: Dr. Matt Lewis D.C., DACBN, CFMP®

To the uninformed, the term allostatic load probably sounds more like a setting on your washing machine than a symptom of stress, but if your doctor suspects allostasis, he or she is telling you that your body may be picking up the tab for your stress-filled life.

Allostatic load is a culmination of all the overtaxed pressures in your life, whether that be work related, the result of relationships, health fears, and even past traumatic events that keep cropping up despite our best efforts.

These issues are bad enough by themselves, but then you toss in a diet that features too much sugar or salt, a caffeine habit that keeps you jittery all day, 24-hour news reports that feature no good news, and what you end up with is allostatic load.

Allostasis is a process that includes the release of stress hormones and neurotransmitters within the body. Each of these stress responses take a toll on your physical condition, which in turn only adds to your allostatic load. The end result of this stress buildup? You become sick.

In recent years, many doctors and health practitioners have suggested diet and exercise as a holistic means of relieving stress. And on the surface, a strict diet can make perfect sense. Where it goes wrong — especially when your allostatic load is at a high level — is the accompanying increase in Continue reading…

By: Dr. Matt Lewis D.C., DACBN, CFMP®

If you enjoyed Part I in our series about hormone replacement therapy (HRT), today’s post will complete the picture, especially with respect to what’s involved in HRT itself.

Hormone replacement therapy involves taking one or more sex hormones — estrogen, progesterone, testosterone. While we use the term “sex hormones,” these hormones are also important for heart, brain, bone, and immune system health and for mental health. Having adequate, balanced hormone levels along with healthy hormone receptors, reduces the risk of cardiovascular disease, diabetes, breast cancer, prostate cancer, and dementia. Optimizing hormones reduces risk factors for many of the chronic conditions that increase with age.

Hormone Replacement Therapy Doctor Lewis Tampa

HRT can be delivered via different routes, including oral (pills), injection, topically (creams or patches), or inserted into the skin as tiny pellets. The mode of delivery is determined with your doctor based on your specific needs and preferences. Pellet therapies injected into the skin can be done every three months in your doctor’s office. Pills or creams are administered daily and do not require any Continue reading…

By: Dr. Matt Lewis D.C., DACBN, CFMP®

Hormone replacement therapy has gotten a lot of press over the years — both good and bad. It all started in the 1960s, when women in their 40s and 50s were prescribed estrogen to alleviate the symptoms of menopause — hot flashes, night sweats, irritability, and mood swings. Then, studies appeared, showing estrogen promotes growth of the uterine lining, which increases the risk of cancer, so doctors began recommending the addition of progesterone to protect the uterus.

However, instead of providing patients with bioidentical estrogen and progesterone, pharmaceutical companies created a synthetic form of progesterone called progestin (which they could patent) and started combining it with various forms of estrogen — synthetic or derived from animals.

Hormone Replacement Therapy Doctor Matt Lewis

At about this same time (the late 1990s), theories emerged suggesting hormone replacement therapy (HRT) would be helpful for preventing certain age-related diseases in older women, and doctors began prescribing it for women in their 60s and 70s. However, in 2002, a large federal study by the U.S. National Institutes of Health called the Women’s Health Initiative linked the leading HRT medication, Wyeth’s Prempro, with an increased risk of cancer, stroke, and blood clotting. As a result of that study and others, many doctors and women abandoned hormone replacement therapy or now use it only to help alleviate symptoms during menopause.

The truth is that hormone replacement therapy is safe and effective for both men and women, as long as it is done right. Doing it right involves addressing other underlying health issues first and then using bioidentical hormones instead of Continue reading…