Hi!
David had been diagnosed with seronegative rheumatoid arthritis at age 42 after developing severe joint pain and swelling that migrated between different joints. Despite aggressive immunosuppressive therapy, his symptoms persisted, and he experienced increasingly troubling side effects from the medications.
“I feel caught between impossible choices,” he explained during our first consultation. “When I take the medications, I get some relief but feel terrible from the side effects. When I try to reduce them, the pain becomes unbearable. Isn’t there something we’re missing?”
This question—”what are we missing?”—drives much of functional medicine’s approach to inflammatory conditions. While conventional medicine excels at categorizing and managing inflammatory symptoms, it often stops short of asking why the inflammation began in the first place.
For David, a deeper investigation revealed what multiple rheumatologists had missed: evidence of persistent Lyme disease with several co-infections, likely contracted during extensive hiking in New England years before his symptoms began.
This finding wasn’t entirely surprising. Research increasingly shows that many cases of “autoimmune” arthritis may actually represent the immune system’s appropriate response to persistent infections—particularly those that can evade standard detection and treatment.
Hidden infections that commonly drive chronic inflammation include:
Stealth Pathogens These microbes have evolved mechanisms to evade detection:
* Borrelia (Lyme disease) can change its outer surface proteins to avoid immune recognition
* Bartonella can hide inside cells where antibiotics can’t reach
* Mycoplasma lacks a cell wall, making it invisible to certain immune defenses
* Many viruses can remain latent for years before reactivating
Persistent Biofilms Some microbes create protective structures:
* Bacteria form communities encased in protective matrices
* These biofilms shield the microbes from both immune cells and antibiotics
* Standard treatments often fail to penetrate these defenses
* The protected microbes release inflammatory compounds chronically
Dental Infections Often overlooked sources of inflammation:
* Cavitations (hidden jaw infections) after extractions
* Chronic low-grade infections around root canals
* Periodontal disease creating systemic inflammatory effects
* These can persist for decades with few obvious oral symptoms
Chronic Viral Reactivation Dormant viruses can reactivate under certain conditions:
* Epstein-Barr virus (the cause of mono) can reactivate during periods of stress
* Herpes viruses (including HSV-1, HSV-2, HHV-6) can drive neuroinflammation
* Cytomegalovirus has been linked to vascular inflammation
* These reactivations may not present with typical viral symptoms
With a clear target identified, David’s treatment plan shifted dramatically:
Phase 1: Immune Support (Rather than Suppression)
* Specific antimicrobial herbs targeting his identified infections
* Immune modulation to support effective pathogen clearance
* Biofilm disruption strategies to address protected colonies
* Detoxification support for microbial die-off reactions
Phase 2: Tissue Healing and Repair
* Targeted anti-inflammatory approaches for symptom management
* Nutritional support for joint tissue repair
* Gentle movement protocols to maintain function without increasing inflammation
* Gut healing to address intestinal permeability caused by infections
Phase 3: Prevention and Resilience
* Ongoing immune surveillance and support
* Stress management to prevent viral reactivation
* Environmental optimization to reduce total inflammatory burden
* Strategic supplementation for continued tissue healing
David’s recovery wasn’t overnight—which is typical with infection-driven inflammation—but followed a steady trajectory:
* Within two months, his “flares” became less frequent and intense
* By six months, he had reduced his prescription medications by half with his rheumatologist’s supervision
* After a year, most of his joint pain had resolved, and his inflammatory markers had normalized
* At 18 months, he had resumed full physical activity with minimal limitations
“What strikes me most,” David reflected during our follow-up, “is that all those years, we were suppressing my immune system—when my immune system was actually trying to fight an infection. Once we addressed the real problem, my body could finally heal.”
David’s story illustrates why functional medicine investigates the “why” behind inflammatory conditions rather than simply categorizing and suppressing symptoms. By identifying and addressing hidden infections, we can often resolve inflammatory conditions that haven’t responded to conventional approaches focused solely on symptom management.
Next week, we’ll explore how environmental toxins drive chronic inflammation—and why reducing your total toxic burden can create breakthrough improvements in inflammatory conditions.
You are invited to join Perks of Wellness
In person, Quantum Surfing: An Energetic group session. Come get energy work done is a group setting, by donation. Wednesday, October 13th at 6:30pm. You can sign up by responding to this email or calling the office. See our Meetup group or go to Perksofwellness.com for more information.
Ask the Doc, a virtual Q&A for 30 minutes. Each month come and ask your questions are a particular topic, join the free conversation. This month we will be looking at Inflammation Drivers (Live Q&A) on, Wednesday, October 21st at 6:30pm. The Meetup will be online, the Google Meet link will be emailed the day of to anyone who RSVPed. RSVP in the Meetup group or responding to this email.
Inflammation Drivers will be on Wednesday, October 28th at 6:30pm. The Meetup will be online, the Google Meet link will be emailed the day of to anyone who RSVPed. RSVP in the Meetup group or responding to this email.
🌐 **Join Our Community:** I’m also excited to announce the launch of our new virtual Meetup group, Perks of Functional Medicine. This group is dedicated to exploring the world of functional medicine and getting to the root causes of your health issues. Whether you’re a seasoned health enthusiast or just starting your journey to wellness, there is something here for everyone. Join us for informative discussions, workshops, and events that will empower you to take control of your well-being and live your best life.
Meetup Group (https://www.meetup.com/perks-of-functional-medicine/)
P.S. If you found this tip helpful, keep an eye on your inbox. I’ll be sharing more valuable insights to help you take control of your health each week.
Be Good to Yourself,
Dr. Brian Perks DC, MPH
Perks of Wellness
2333 First Avenue #105
San Diego, CA 92101
(619) 238-0345
drperks@perksofwellness.com
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