Maybe It's Not the Microbe. Maybe It's the Terrain | Dr. Bill Rawls, MD

What if chronic illness isn't caused by the infection everyone is trying to eliminate? On this episode of The Longevity Formula, Dr. Brandon Crawford sits down with physician, bestselling author, and chronic illness expert Dr. Bill Rawls, MD, to challenge one of modern medicine's core assumptions: that killing the pathogen is the path to recovery.

After his own collapse from Lyme disease, mold exposure, and burnout, Dr. Rawls abandoned symptom-chasing medicine to study cellular health, impaired autophagy, and what he calls "terrain." He explains why Lyme, long COVID, autoimmune disease, mold illness, and fibromyalgia may all trace back to the same broken mechanism.

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Transcript

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[00:00:00] Dr. Bill Rawls: My journey has taken me to see things very differently than most everyone out there. that is true of conventional, functional, everything. I mean, I've, put my foot in all of it and pulled from all of it. I think a big part of my focus is moving personally away from interventional.

Those interventional things won't work unless you build a foundation, that you have a person who is proactive, and they are taking the steps to build an environment inside of their body that promotes healing and get them to a point where they're receptive to everything that we want to do to take them to a higher level and if that's not there, all the other things that we do in medicine aren't going to work as well.

Now we're getting into a really good conversation, and this is going to be fun because it's not just about chronic Lyme disease, it's about

[00:01:12] Dr. Brandon Crawford: Hey, everyone. Welcome back to "The Longevity Formula." I'm your host, Dr. Brandon Crawford. Today is going to be intriguing, exciting.

I'm personally looking forward to it because whenever I was learning more about today's guest, Dr., uh, Bill Rawls, I began to go back in time whenever I would have certain conversations with my own mentor back in the day, and it really took me back, and it really started to ignite that initial passion that began to burn inside of me, whenever I started my career.

So, today we're gonna learn a lot, about some foundational health strategies. We're gonna talk about, why maybe going to the doctor and getting, you know, some prescriptions and all these different things, maybe that's not exactly the best thing when you're suffering from some type of chronic illness, and what we can actually start to do about it.

Dr. Rawls, thank you so much for joining us today.

[00:02:05] Dr. Bill Rawls: Oh, it's a pleasure. Thank you for having me

[00:02:08] Dr. Brandon Crawford: Absolutely. So let's kinda start to learn a little bit more about you so that the audience can understand where you're coming from. So if I understand correctly, you were an OB-- well, are, you're an OBGYN, right? That's your specialty?

[00:02:23] Dr. Bill Rawls: That, that's where I, I started. That was my, you know, it's, that's like career part one, and then I had career part two, and I'm kinda almost in a career part three here. So it's yeah, I've been at this for over 40 years now

[00:02:40] Dr. Brandon Crawford: Good deal. So take me back to those initial years, right? So you were working in the traditional medical model. Life was good. What initially happened? Like, what started to provoke you? What-- How have you gotten to this place?

[00:02:55] Dr. Bill Rawls: Um, yeah, health crisis. And, and it was my own doing, but I didn't see it at the time. And I think that's true with most people. There are things that are happening in our lives that push us into a c- place of compromised health, and we don't see it coming, and I didn't. And I should've been smarter. I should...

You know, my medical training should've taught me that. So, you know, I graduated from medical school, uh, 1985, and I went into OBGYN because it dealt with healthy people bringing life in the world. But very importantly, it was acute intervention, which is what we do in our medical system really well to this day.

You know, when somebody had an arrested labor or a tubal pregnancy or, you know, or an appendicitis, I could go in and fix that and save their lives and, and it was a great outcome. But w- you know, so what I d- wasn't attracted to in medical school is management of chronic illness because those folks never got well.

And it, and that was quite obvious at that point, so I basically ran from it. But back then, being an OBGYN meant being in a small group and taking call regularly every second to third night. And where I was practicing, that meant 24-hour call that you were responsible for labor and delivery, everything going on in the hospital, and if it was a weekday, a full day in the office too, 24 hours.

And then weekends, it was Friday morning till Monday morning. So in my 30s I could push through it, and it was kinda like, "Yeah, I don't really need sleep. I can just push through. Yeah, I'm strong. I can do this," kinda thing. So even when I wasn't on call, I was catching up for all the time I'd missed for all the w- work that I was doing, and so I wasn't sleeping then either.

I was averaging maybe four to six hours a night if I was lucky And just pushing every stress button. And it's like, "No, I'm strong. I'm tough. I can just do this." And one thing that was different about me compared to my partners, my partners could crash and go to sleep when they were on call, and they, you know, the nurse would drag them out, get them to deliver the baby, and they'd go back to bed.

I'm one of those people that if I had somebody in, uh, uh, on, on, in labor or in the hospital, man, they were on my watch, and my mind was on them, and I didn't sleep. And so doing that for 20 years up into my very late 40s, I was in trouble. I mean, I st- I lost the ability to sleep. But not only that, my whole body started breaking down, and it forced me to stop doing obstetrics.

So I did that for a while. I quit doing hospital call, but I wasn't getting better, and I didn't understand why. And nothing the conventional medical system had to offer seemed to be able to help me

it, it pushed me into a bad situation

[00:06:05] Dr. Brandon Crawford: I know you talk a lot about Lyme disease, right? And I definitely wanna go kinda down that path, right? I wanna learn more. But when, when you started to get... When you started to fall into your health crisis, okay, things started to change. How did your mindset start to analyze that as a physician?

Did you initially seek the traditional medical model? Did it fail? Did you, like, or did you initially know, like, "Okay, this isn't, this is not the path. I've gotta figure this out"?

[00:06:37] Dr. Bill Rawls: Yeah. Yeah. Th- this is you know, all my reservations about how we were managing chronic illness came to be true. You know, I did testing on top of testing on top of testing, and there were drugs for symptoms. And I wa- y- it's almost like I wasn't sick enough to get a diagnosis. So I had a lot of symptoms of MS, but not quite enough to get the diagnosis.

I had cardiac manifestations, I mean, horrible. I mean, I had a cardiac cath, and they showed hypoxia in my heart, but my vessels were clear. My beat- my heart was skipping every second to third beat. And they had drugs to offer for that but couldn't really explain it. My gut was a wreck. It's like everything in my body.

My joints were horrible. Could it be rheumatoid arthritis? No, your ANA isn't quite, you know, you're, you're just not quite there yet. So I ended up with a diagnosis of fibromyalgia, and anybody with that diagnosis knows just doesn't really get you anywhere, and it's not gonna be a good life. So I was sitting at age 48, 49, going, "Is this gonna be life for good?

I mean, this is bad." So after all of that, I branched off and started looking at alternative medicine, became certified in holistic medicine. This was kinda pre-functional medicine. And I left the practices I was in. They, you know, I was asked to leave because I couldn't take call anymore, so I started a primary care office with this idea that I'm going to get well, and I'm going to help people get well when I get there.

I'm gonna, you know, everything that I learn, I'm gonna share And so I changed my lifestyle. I did a lot of different kinds of supplements. I worked on my sleep, and I was getting better, but I wasn't getting well. My joints were still erect. I had... Still had these cardiac manifestations that were really scary.

My brain wasn't do- you know, working properly. Fatigue, just waking up like I had the flu every single day of my life, and then still having to work. And on top of that, I ended up stuck in a moldy office building, so I learned all about mold, too. Seemed like everything that I needed to know, it happened to me.

And I kept thinking, "You know, there's gotta be something that's driving this. Something's holding it in place." And I kept coming back to Lyme disease and going, "You know, I got bitten by a lot of ticks when I was a kid. Could it be that?" And I finally found that I was carrying the bacteria and took antibiotics, several rounds of antibiotics, which made me sicker and wrecked my gut.

And then it was like, "Okay, this isn't working. Should I go to a Lyme doctor and get all these, oh, $100,000 worth of IV antibiotics and all this sort, sort of thing?" And, and it was like, you know, I just couldn't afford it. I mean, I was stuck in this practice, couldn't really leave town. I said, "I've gotta do something."

And I read about this protocol for herbal medicine for Lyme disease, and I was desperate. So with very low expectations, I said, "Yeah, I'm gonna try this thing." So I was taking handfuls of capsules, all of these things, and I started getting better, and it didn't wreck my gut. And over three months everything started improving.

I got back to about 70% in about, you know, three to six months, and I was able to function again. But it's like, how far can I take this, you know? And I'd stop the herbs. It's like, okay, that's probably enough. I don't need to do any more, and I'd crash again. And finally, I just started taking the herbs and really started working that formula, and over a five-year period, got at, re- eradicated every symptom.

And so I've been working that formula for now 20 years. I'm one year shy of 70, and I'm doing things that I didn't think I'd ever do again, like kite surfing still. And I've had some of the best health over the past decade that I've had in my whole life. So I've spent the past 20 years really understanding exactly what was going on.

And so not only did I come to understand chronic Lyme disease differently than most everybody out there, I realized that it's a window for understanding all of chronic illness, aging, and everything else, and it's been quite a journey.

[00:11:12] Dr. Brandon Crawford: It's amazing. So, I, I love the story, and I personally also had a, a Lyme and a mold story. And, you know, whenever I started to really suffer of course, I did all the testing and whatnot as well. I was in a moldy house myself. Was not aware of it until, you know, we started doing the testing.

I remember in-- So I actually did have a bullseye rash and then I had the high fever, right? So I, I did present with that acute Lyme situation. And I, you know, went and got the antibiotics, did the round but then, you know, symptoms just continued to pile up. And that's when I started to go, "Okay, something's not right here.

I've treated the microbe, but I'm still having symptoms."

[00:12:01] Dr. Bill Rawls: Yeah, but did, but did you treat the microbe?

[00:12:05] Dr. Brandon Crawford: Maybe not, right? There you go, and that's what we're gonna get into. basically I started to shift my focus. My thought at that point in time was I can't heal if I'm in this chronic stress physiology. And so I started to work with the functional neurology knowledge that I knew and then I was also working heavily in the laser industry as well, so I started to leverage photobiomodulation.

But really the target was to reduce stress physiology and allow my body to heal like it was designed to do, and that was kinda my path, right? So it sounds like you had the same situation where you came to the conclusion that, you know, maybe I don't only need to target the microbe, maybe I need to do something about the terrain.

So help me understand that process more, and then what you just said, maybe I didn't get the microbe. So what do you mean by alluding to that?

[00:12:57] Dr. Bill Rawls: Now we're getting into a really good conversation, and this is going to be fun because it's not just about chronic Lyme disease, it's about every chronic illness out there. And I think that's really important to recognize because when you look at the Lyme bacteria, it is one of many, many microbes that we define as stealth pathogens.

And so you can have all the symptoms of chronic Lyme, but not necessarily even carry the Lyme bacteria. A lot of people don't realize that because there are so many things, and it's not just ticks. And fact of the matter is we're probably all carrying some of these. The evidence is mounting that we all have things.

So when you look at the Lyme bacteria, it is very stealthy. Its mission is not particularly making you sick. It is persisting in your body. And also, most people that I've come in contact with don't get sick around the time of a tick bite, so I think acute symptomatic Lyme disease is much more uncommon than we actually realize.

In your case there are reasons why people become symptomatic after a tick bite. Sometimes it is the load of bacteria, that the bacteria, the tick has been on a long time. Sometimes it's other co-infections that or have a higher potential, or together they have a high potential, or your body just was not in a healthy state when you got bitten.

And that happens too. So let's start with a really virulent microbe, something that can make you sick pretty fast. So you get a virus, and on top of that, you get a pneumococcal bacteria. That bacteria is very aggressive. It turns over every 20 minutes. It's doubling every 20 minutes. Somebody can get really sick really fast.

Antibiotics depend on very s- fast growth f- to work. So the, one of the mechanisms that Borrelia uses is it grows extremely slowly. That makes it a less of a target to the immune system. The immune system is looking for things that are growing fast. That's the threat. Things are turning over really rapidly, we need to get that.

That's gonna kill us pretty r- fast. We need to get to that. So, you know, ticks and-- ticks have been biting humans for a long time, so we have built-in immunity. When, when Borrelia comes on board, the immune system knows about it. It's going to try to clear those bacteria pretty quickly. But because it's growing so slowly, it doesn't see it as much.

Well, it also doesn't, isn't as res-- it isn't responsive to antibiotics. So Borrelia Doubling time, 20 minutes for pneumococcal bacteria, 12 to 24 hours for Borrelia. 12 to 24 hours just to double, so it's really slow. Also, Babesia, Cl- Bartonella, Anaplasma, Chlamydias, Mycoplasmas. There's so many things out there that follow the same pattern of slow growth, so that's one, they grow slowly.

The second thing is when I say slow, I mean they grow slowly. They, they replicate slowly, but they move pretty fast. Those little spirochetes, when they hit the bloodstream, they hit the ground running. They're trying to get through your system as quickly as they can. Now, if your body is in a state of of distress or poor health, then it's gonna hang around longer and start breaking down tissues and start growing.

That's what they do, you know? What, what bacteria do is grow. That's what they wanna do. But if the h- if the environment is hostile, in other words, the immune system is hot on its tail, it's going to, to invade tissues, your brain, your heart, your joints, everywhere, and it's going to invade cells. And this is really important.

So it, it... what it's doing is basically creating insurance, creating a reservoir, so it invades cells, and if the inside of the cell is healthy, it's a hostile environment, so they go dormant. So slow growth, and second to that, dormancy. Intracellular dormancy in tissues throughout the body. Different microbes invade different tissues, but a lot of bacteria, a lot of viruses, protozoa, yeast are doing this.

We're exposed to things just about every day, and most of them, we don't even realize enter the body. And not only that, things are right now, while we're talking, crossing over from our sinuses, our gut, and into our bloodstream, and they can do some of these things, same things. So they end up in our tissues, and they wait there, and as long as we're healthy, we're great.

But when you take call, and eat bad food, and don't sleep, and you stress your body over and over and over, they start reactivating, and they start breaking down your tissues. So it boils down to this, that people who get sick from mold, not like catastrophic, overwhelming mold concentrations, but the mold that we have in many houses, people who get Lyme disease, people who get a lot of different things are because they're vulnerable, so that vulnerability is cellular stress, and central to cellular stress is probably a word you know, autophagy So autophagy is the ability of our cells to regenerate and recuperate.

So without autophagy, our, our whole body would break down. So everything that happens in the body is due to the actions of cells. If your cells are stressed, they don't-- they, they burn out their mitochondria faster, they work harder, they don't do their jobs, and that's what symptoms come from. So cellular health and, and autophagy is central to health, but impaired autophagy is central to every chronic illness.

So very interesting when you start tying it all together. You know, you have, you have just sporadically seeded throughout your body, you have microbes that are there. And when your body becomes stressed, when aut-autophagy becomes impaired, it starts sig- sending signals to those microbes. So impaired autophagy and mitochondrial dysfunction are the signals that those microbes are looking for to start reactivating.

When they reactivate, they break down cells. The immune system starts attacking those cells, so we get that autoimmune component. And that is really the core of what chronic Lyme disease is, but I'm finding connections that we find that same scenario in virtually every chronic illness, and the evidence for that is adding up more and more and more.

So central to every chronic illness is impaired autophagy and very likely, in most cases, reactivated microbes. And it's different microbes for different people. That's why, you know, every, every chronic illness is a little bit different. But with chronic illness, we're treating the symptoms, we're treating the manifestations, but we're not getting to the root causes of the problem, so we're not making people well.

There are different ways of doing that. I did it with herbs. You did it with photomodulation. But what you were doing is restoring cellular health, reducing cellular stress, energizing your cells so your cells could fight back and regain control so that you could clear the active microbes and restore a state.

Now, I wouldn't say you've eradicated the microbes, and I don't think I have either. But you're maintaining a state of high cellular health, and that is keeping your body f- healthy and functioning

[00:21:23] Dr. Brandon Crawford: That's great. So then is the goal then not to eradicate the microbe? We're not trying to do that. That's not the goal. We should not look to do that unless, of course, you have the acute signs of infection. I get it. You have a different situation. But if we're talking about this slow growth impaired autophagy, et cetera, getting rid of the microbe is not the goal, but rather improving cellular health, cellular mechanics, autophagy, all of these things.

That's what you're saying, correct?

[00:21:55] Dr. Bill Rawls: Yeah. You know, it's there are still things we don't know, right? That we don't chop healthy people up and look inside their cells very often. And, you know, we get a little bit of random content just from biopsies and autopsy specimens and things like that. And it's interesting that the, you know, in so many studies they've found these intracellular pathogens, but not only in humans.

You look in plants and animals and every other organism, and you s- you find these intracellular pathogens, and you begin to accept the possibility that maybe this is a normal state. So I think it's about balance. You know, we're not a, we're, we're not a sterile entity. I think that's important. We are an ecosystem.

And at one point, you know, when I was in medical school, it was assumed that our microbiome, which they really weren't using that word at that time, but that we had bacteria in our gut, we had bacteria on our skin, we had, you know, bac- you know, bacteria in our sinuses. But those were all behind walls, you know?

We had tissue barrier or, or linings and, and barriers that kept those microbes contained, and it was assumed that our tissues were sterile completely. But You know, just little clues in my career. It's like when you do surgery, you're in a sterile field, you're going out of your way to make sure that no bacteria are in the sterile, in, in the sterile field, and then somebody gets a wound infection and you do a culture and it's a lot of different kinds of bacteria, not just skin bacteria or skin-- or bacteria that you'd find in the environment.

It'd be like hundreds and hundreds of species. And it's like, where did those things come from? You know? So, well, yeah, and, and, and then just searching the scientific literature, realizing that maybe yes, you know, there, there... It, it's still we haven't proven it, but maybe we actually have a tissue microbiome.

And if-- the idea that we have microbes in our tissues, I mean, everybody knows we have Epstein-Barr, we have, you know, various kinds of things that exist there, and we know they exist in a normal-- dormant state in people that are healthy. So maybe there's a certain amount of that that is part and parcel of being alive.

It's like if, if a kid was born and it was never exposed to bacteria, it'd die very quickly because it wouldn't have primed its immune system. So, so where I'm going with this is that question of maybe some of that is normal, and as long as you're healthy, maybe that's okay. Maybe your relationship with some of these things is even symbiotic.

Now granted, you know, probably if I hadn't picked up Borrelia and Bartonella from tick bites and things like that, I'm not encouraging people to go out and be-- and get bitten by ticks by any means, and I try to avoid them like the plague. But still I've accepted that, yeah, maybe some of that is normal and our strategy should be to keep-- to maintain cellular health.

And that's so remarkably important

[00:25:22] Dr. Brandon Crawford: Absolutely. I, I'll just note for the listeners, I've got a rainstorm going on here, so if you're hearing thunder in the background, that's what it is. So i- this is a, a really fascinating concept, right? Because essentially we have a normal flora. We're designed to live with various bacteria, viruses, fungi, you name it, right?

We're designed to live with them. There's no way that we can put ourselves in a bubble and completely clear our system of all these things, and this is how we've evolved over the hundreds of thousands of years or whatever that timeframe is. And this is what really took me back into those initial discussions with my mentor Dr.

D'Onofrio. He t- he, he brought up Louis Pasteur versus Antoine Béchamp, right? And so Béchamp had the Terrain Theory, and Pasteur had the Germ Theory, right? And obviously, you know, everyone probably knows the germ theory won out. But it sounds like this is the continuation of that debate. Is it the terrain or is it the germ?

Am I right? Is that where we're at?

[00:26:34] Dr. Bill Rawls: You know, probably a little bit of both. I mean, there's definitely things that you can pick up that can make you really sick. And probably the biggest one was a big killer at the turn of the 20th century. Around 1900, the top cause of death was tuberculosis. And it was a chronic infection. But there's no doubt that people who became sick with tuberculosis, you look at the living conditions, and most of those people were in cities.

And the big factor there was they w- in big cities, they were burning coal for heat, for energy. So the coal soot and the coal smoke was just a constant health hazard, hazard that people didn't recognize. so I think there were some factors that were associated with the uh, you know, just poor health habits, poor health environment that, of that chronic tuberculosis.

So, I don't think that Borrelia and some of these things that we're exposed to from ticks are the level of pathogens that tuberculosis is. But even so, you pick these things up, and quite frankly, I may be carrying tuberculosis somewhere in my system.

I was exposed and test po- tested positive when I was a medical student. I did the rounds of antibiotics, but there was questions of does that completely eradicate it and say, do I have some little focus of tuberculosis in my body? And I've never had any issues from it, of course. Yeah, there are always pathogens out there waiting to get us, and what they want to do is use us as a host.

They want a platform to spread to other host, and they want to reproduce in our body, and to do that, they need food. And so food is the issue. So all the th- the things that we harbor at the highest concentrations are using food that we don't need. Our gut bacteria live off of food that is being processed in our gut, and our skin bacteria live off of oils on our skin that we secrete to moisturize or lubricate our skin.

But w- things that get inside our body and our tissues, our cells are the food, our tissues are the food, and that's why they're pathogens. Pathogens do harm by breaking down our tissues and cells, and that's why they're a threat. So anything that has that potential is defined as a pathogen. It has to be defined as a potential disease-causing organism.

And yeah, maybe we would do better without those things in our body, but, you know, it's just, we've, it, it's just looking like that may- maybe, yeah, we have to build up that terrain, and we have to keep ourselves healthy and our body healthy just to stay ahead of that.

[00:29:32] Dr. Brandon Crawford: I remember when I was in school, we all did nasal swabs, right? And then we cultured, you know, what was growing in our nose and our sinus cavities and everything. And mine came back with a population ni- of Neisseria gonorrhea, and I was freaking out. I was like: "Oh my gosh, what's going on?

I've-- I don't have any symptoms." You know, and, and my professor she was a, she was a medical doctor, and she was like: "Perfect. This is a great example. No, this is a normal flora. There's a small population of people where, you know, this is in them and it's not a big

[00:30:06] Dr. Bill Rawls: Yep

[00:30:07] Dr. Brandon Crawford: So I was the example for the class at my expense, but it's interesting. That's okay. So, I like that you brought up autoimmunity because this is something that is a big focus in our practice just really because so many people that we work with, the demographics that we work with, have a high degree of autoimmunity, and so specifically in the brain and nervous system.

And so w- it, it, it's not uncommon for me to start working with someone and, you know, if they tell me that, you know, they had a sudden onset of symptoms or something like this, I'm gonna do autoimmune panels and whatnot. So how does this story start to fit in with that story of neurological autoimmunity?

And that can be anything from PANS, PANDAS, PATANs neuro- neurodegenerative conditions, et cetera, right? 'Cause I think these stories are connected.

[00:31:04] Dr. Bill Rawls: They, they are, and it's really interesting that when you look at the kinds of cells that various kinds of microbes invade, then the story starts to come together. So we know in MS, the body is attacking the o- oligodendrocyte, the my- that is the myelin sheath that... Or a Schwann cell, depending on where that nerve happens to be in the nervous system.

I found a study that documented that Borrelia can invade oligodendrocytes, the cell that has the myelin that wraps around the nerve cell, and go dormant inside that cell and stay dormant for a very long time, and then reactivate. And so just that idea that you've got this, and then you have a situation where the body's in stress, the immune system's in turmoil, and you have microbes that are emerging from these cells and breaking them down, w- what would stop you from thinking that the immune system might attack that cell to get rid of this pathogen?

You know? So it, it's really kinda two and two. It's, it's simple conclusions. So we're moving toward that conclusion that this is part of the problem. And you know, autoimmunity has been well documented in chronic Lyme disease in every... in virtually every chronic illness, but it's not necessarily to the level that it tips the markers for autoimmunity.

But, you know, just, just briefly on that, I mean, you look at ANA, you would think, okay, you either have a positive ANA or a negative ANA, and that's how it's presented to a lot of people, and that's false. ANA is a range, and so there's an arbitrary marker that defines it as positive, but under that, well, it, it implies that everybody has some autoimmunity going on all the time, and it's only when it gets to a high level that we define it as a disease. So it's an arbitrary thing. But interestingly, PANS and PANDAS, this was an interesting... Streptococcus. I was looking for evidence, could this same invasion of cells, dormancy explain PANS and PANDAS?

And I actually found a study that found that Streptococcus Can invade cells and go dormant when conditions are unfavorable. So that wasn't known before, but it really starts to explain that, that condition that children are treated with antibiotics, you know, and, and then they go off the antibiotics, and they have a resurgence of symptoms, and we couldn't figure out why does-- why are we not eradicating the strep?

So the strep can actually go dormant inside cells, wait out the antibiotics, come right back again. But there was another thing. There's something called a Trojan horse mechanism that Borrelia and most, many microbes use, that they invade white blood cells, and that gives them passage over into, across the blood-brain barrier into the brain where they can invade other cells.

I found that Streptococcus was also doing that, which is really fascinating. So this same mechanism that we're looking at for chronic Lyme explains pandas, explains MS, explains a lot of different kinds of things

[00:34:40] Dr. Brandon Crawford: That's interesting. I wouldn't have thought that strep would've been able to elicit that similar mechanism, right? Because I w- I would think that the immune system would do everything it can to keep strep out of cells. That's new to me. I, I haven't heard that theory. That's very, very interesting. So then in these situations and this is the conversation I have with people all the time, right?

Is we'll do testing and they'll come back with, you know, e-elevations in IgG antibodies to Epstein-Barr, strep human herpes six, like all these different things, right? And people start to freak out and they go, "Oh, do I need an antibiotic? Do I need..." You know, and I'm like, "N-no. What we need to do is we need to address your cellular health.

We need to address your neurological integrity. We need to improve how your immune system is activating or not activating, and, and we need to get more to the foundational root cause here." And it, and it works. Sometimes it works, you know, quickly, sometimes it takes a very long time but we've been quite effective with that.

And I, I've always been very fascinated with herbals. I love herbals. I l- I use herbs a lot actually. But I'd like to kinda get into maybe some of your favorite herbs, some of your strategies. Like is are herbals still like your preferred tool? Like where do you- how do you help people navigate this story, I guess is what I'm

[00:36:03] Dr. Bill Rawls: getting at.

Yeah. Yeah. I th- I think this is this is where defining what I'm talking about is really valuable because when you talk about herbs, you're talking about a really wide spectrum of things, anywhere from, you know, culinary herbs we put in our food, which do have medicinal properties, all the way to herbs with very strong drug-like effects.

So here I'm-- what I use in my life and my practice, and what I've been focusing on, is herbs with adaptogenic properties. And this is separate. So I'm not pr- using herbs like was widely used in traditional herbalism. So, you know, in, in those cases, it's very much like conventional medicine and, and that's where conventional medicine comes from.

It's like you have this symptom, okay, I'm going to give you this herb or these herbs to try to block the manifestations of those symptoms. So there are certainly herbs that have drug-like effects, St. John's wort, kava, many, many others, and I occasionally use those, but that's not the big focus of, of what I'm trying to do.

And then at the far end of the spectrum, there are, there are herbs that really do have strong drug-like effects to the point of being near poisons, and that's actually where a lot of our drugs originally came from. So most of our drugs are designed to block manifestations of illness, including symptoms, inflammation, et cetera.

And a lot of that, at least half of that, came from these really potent near-poison herbs. So I'm at the other end of the spectrum. So I'm dealing with herbs that have virtually no drug-like effects, and what that means is they have low potential for toxicity, which me- and people can take them for a long time because they have such, you know, it, it...

They're not doing they're not affecting or manipulating pathways in the body. So what these adaptogenic herbs are doing is blocking cellular stress, and that's how they, they do their benefits. So a true adaptogen is an herb that contains chemicals that feed back to the hypothalamus and lower stress hormones.

So there are a lot of true adaptogens. Rhodiola, ashwagandha. Ashwagandha is probably the big one that most people are recognizing now, but also reishi and cordyceps, which are actually medicinal mushrooms, similar properties. They do that, but they also increase our resilience and stress. Well, how do they do that?

Well, they protect our cells. They protect-- So when we take an herb, we're not taking a single chemical like a drug or an antibiotic. We're taking the, the plant's defense and regulatory system. So plants are multicellular organisms. They have to protect their cells just like we have to protect our cells.

They don't have a cellular immune system, they have a chemical immune system. But they also use chemicals to solve problems, to protect cells, to regulate cellular functions. So when we take an herb, we're basically getting all of that. And so when we take an herb, we're getting robust protection from free radicals and oxidative stress.

We are getting protection from radiation. There are a lot of herbs that protect from the harmful effects of too much carbohydrate. So they're protecting our cells, they're protecting our mitochondrial functions at multiple levels. But a big part of what they're doing is antimicrobial protection.

So an herb is providing protection antimicrobial properties against a wide spectrum of bacteria, viruses, protozoa, yeast, and this has been well proven in, in the scientific literature. But the interesting thing, and I found a study that proved this also and why I had the effect that I did, is it's selective.

There's an intelligence about it. So when you take an herb, it's selective for pathogens. It doesn't wreck your gut. In fact, I found that herbs are much better at balancing your gut flora than probiotics are by a wide margin. So it doesn't generate resistance. Antibiotics, a million people die every year of antibiotic resistance from overuse of antibiotics.

Save them for that acute bacterial infection that's turning over every 20 minutes. Somebody's gonna die if you don't have that. Herbs aren't gonna fix it So no resistance, and they protect cells that allows autophagy to function. So instead of, like, stimulating autophagy, they're basically allowing autophagy.

So they're boosting autophagy in cells throughout the body. So that's kind of the perfect thing. We are protecting cells, allowing them to recover, and not just, you know, our c- our heart cells and all of our other cells, our immune cells, too. So it's interesting that if you look at a lot of herbs rhodiola or, or cordyceps, reishi some of my favorite antimicrobial herbs, Japanese knotweed, cat's claw, Chinese skullcap there are good studies showing that they reduce anti-inflammatory cytokines, the things that are driving the immune system to, to wor- overwork.

So I was like, "How are they doing that?" I mean, how are they turning on these switches and changing these messengers? They're doing it because they're protecting cells. And when you tex- protect cells in the body, there's less turnover, which means less inflammation. The immune system doesn't have to work as hard.

It's bringing down that microbe load of the active microbes. Not eradicating the ones that are still dormant, but it's getting rid of the active ones. So it's, it's calming that system by reducing stress so things go back to normal. Your immune system can work again. It's really great

[00:42:22] Dr. Brandon Crawford: it truly is. I love your discussion, how you talk through herbals. It's brilliant. Why are, why aren't physicians not really catching onto this? Because like... And I know some are, but like you said, there is research it is safe, it is effective. But as soon as someone starts to talk about herbals or supplementation or something like this, they kinda get labeled and they kinda get shuffled aside and they, you know, the, the narrative is, "Well, that's not real medicine."

And do you think that we're making headway on maybe overcoming that, or is there something larger at play here that's holding it back?

[00:43:01] Dr. Bill Rawls: My entire platform is changing the conversation. I intend to do that with everything that I have left in my body because I think it's so important. What we're up against is a system that is for a better word, arrogant. That our system is built around pharmaceuticals, and pharmaceuticals have a very targeted effect.

And so that's what our physicians are taught to use. Most of, of medical education is indirectly or directly funded by pharmaceutical companies. I mean, a medical school is a losing proposition. And so the education to have a medical school comes from research, and that research is paid for by pharmaceutical companies.

So the whole system becomes biased by that. And so, you know, when you come out of four years of medical school, that's what's in your toolbox. You know, your little black bag has drugs in it, nothing else. Because... And, and, and so, you know, it goes back to 1932. So at that point in time, the A- AMA was the s- the licensing body for all physicians in the United States.

So it hadn't gone statewide. You know, at one point it was national. And they sent out a decree that for physicians to maintain a license, they would restrict their practice to Pharmaceuticals and surgical procedures only, nothing else. So our research into electrical modulation and a lot of things that were going on way back then were stopped cold.

And we did no research into pharmaceuticals. And that sounds really harsh, but I understand their motives. What they were trying to do was standardize medicine so that doctors in Texas and New York and North Carolina and California were all using exactly the same things. And you have to understand that at that point in time, most all of pharmaceuticals therapy and medical therapy was acute intervention.

And it was a time that we were, you know, it wasn't much longer after that that we developed antibiotics, that we started developing vaccines, that we had better pain management, better, you know ... And, and so we were building that basic pharmaceutical toolbox for people to manage acute intervention, which was a big deal because that was the big problem.

You know, people were suffering, and we saw a way that we could help that. It wasn't until the 1970s that we started actually looking at the, this idea of people chronically ill. How do we manage all this chronic illness that we're actually starting to see now, now that people are living longer because we've saved them from trauma and infections and, you know, we've done all these acute interventions and now people are living longer, they're getting more chronic illness.

How do we fix that? Well, so we started creating drugs, but the drugs were built for acute intervention, and you can't manage chronic problems with acute intervention. That's the problem. And but it's how our system evolved, and I think it's going to be really hard to change. So I think we ought to let the medical system do what it does best, acute intervention, but they shouldn't be managing or, you know, chronic illness.

We need better societal norms of educating people about how to s- how to take care of themselves, how to stay healthy. But you know, through my lifetime the message from the medical system has been, "Hey, do whatever you want. Go eat whatever you want. You know, just b- have a ball, and when your s- body starts breaking down, don't worry, we're gonna fix it for you."

And, you know, and it's a pretty hollow promise that we found just doesn't really work And we need to learn, we need to start teaching people how to take care of themselves again so they don't get sick, so they don't have to rely on our medical system. Our medical system isn't broken. Our medical system is trying to solve a problem that it's not equipped to solve

[00:47:36] Dr. Brandon Crawford: Very well stated. Very well stated. Interestingly, I-- you-- as you were talking through that scenario, I, I used to work in the pharmacies pharmacy system. I would work in compounding pharmacies. I was actually accepted to pharmacy school and then had a, you know, big moment in my life where, you know, essentially God told me, "That's not your path."

But I used to work with this pharmacist, super nice guy but he was rather unhealthy. And I remember his, his wife would always pack him a lunch every day and it would be healthy. You know, she was trying to help him lose weight, and he would throw it in the trash every day and send someone out to get a hamburger or something like that.

And I finally got up the courage and I'm like, "Why are, why are you doing that? Why are..." And he goes, "Oh, tho- there's a pill for that. I can just take, I can just take my Lipitor. I can just take..." And I'm like, "Oh my gosh, this..." And that was a big moment in my life when I was working in the pharmacy. I'm like: What am I doing? This is the mindset. This doesn't work. It was just so blatantly obvious, but he was so convinced that, "No, I can do whatever I want. I can eat whatever I want. I can just take a pill for whatever symptoms develop." And it's so wrong.

[00:48:49] Dr. Bill Rawls: Yeah, it is crazy. Back in the middle of when I was in my struggle, you know, when I was in my 30s back in the '90s, There was this thing going around that do we really need sleep? And I bought into that, you know? It's like, do we really need sleep? Can't we just crash, get four hours of hard sleep? That's enough.

You know, we don't really need to, any... And think of all the extra time that you would have in your day, and I bought into that, and it was a bad choice , you know? So, it's you know, but, and despite of all of it, I, I w- I often say, though, you know, despite all the things that are happening in our world that are, are threatening our health, now is the best time to be healthy.

We have better opportunities for being healthy than we ever have had in the history of humans because we have knowledge. You know, we know the factors that are making us sick. We know it's what we eat, what environment for environmental toxins and toxic substances we're exposed to, whether we sleep, whether we exercise and move, and just this microbe factor, really understanding that.

I can tell you exactly why people get sick. I mean, that was part of what I, I gravitated toward in my practice. I went through a phase that I was doing a lot of functional medicine labs and that sort of thing, and I found that, yeah, most of the time it really wasn't helping me because it was testing for dysfunction in the body.

So, where I found made the most difference was spending the time with the patient and understanding why they got sick. Not how they're sick, why they got sick. What kinds of factors came together in their lives? And generally, that gave me the obstacles that the person would have to overcome. And often it started back to when they were a child. You know, "Did you have a lot of infections? Did you have a lot of antibiotics as a kid?" And a lot of times, you know, things started then. But just going through their lives and finding out, and I was able to always pay, piece together exactly why someone became sick.

And once they start understanding that, they realized, "Okay, these are the things that I have to change." And it's, it's very profound. The person says, "Okay, yeah, let's, let's work on these things," you know? And I would work on each of the different variables, and we'd take them to a different place. And then using the herbal therapy was an accelerator.

And I, I did some work with red light and some other kinds of things. So, there are modalities that enhance the healing. They enhance autophagy and they enhance that healing process to get people there faster, so, you know, so that, that, that pathway isn't quite so laborious.

[00:51:49] Dr. Brandon Crawford: yeah, I could talk for hours on the mechanisms of photobiomodulation and how that can help reduce stress response, improve trophic factors, increase neuroplasticity, and all the different things. Before we sign off I did wanna bring forth a question that I think a lot of my listeners are going to be asking.

Does this same strategy and narrative apply to long-haul COVID? Are we seeing the same thing play out? Can the same strategies be taken to give these people relief?

[00:52:20] Dr. Bill Rawls: Yeah, these complex chronic illnesses that we're seeing I always put the cellular status and impaired, so autophagy is the center of it. People get long COVID, people get mold toxicity, people get chronic Lyme always because they're vulnerable. So you have to address those vulnerabilities. Why do they have impaired autophagy?

And when you look at long COVID it's not just SARS virus, it's reactivation of other microbes. And typically people are tested for the things that doctors know how to test for. So they typically test for Epstein-Barr, and almost invariably it's reactivated. But if they start digging, "Okay, let's test you for Lyme disease.

Oh, you've got some of these microbes too." Well, yeah, you picked them up when you were at an earlier point in life, and they're reactivating too. So when you look at long COVID, fibromyalgia, all of these different chronic illnesses, what you're talking about is a person who is in a state of vulnerability and impaired autophagy, and that has allowed various kinds of microbes, not just the SARS virus, to reactivate in their system.

And therefore... And, and people reach what I call the boiling point. So say you, you know, you picked up things, and maybe you picked up some things that other people didn't pick it up that make you a little more risk of chronic illness than others, but they're there, and you become vulnerable. Your cells start to become stressed.

You reach a point where, you know, the cellular stress is driving microbe reactivation, which is enhancing the cellular stress, which is driving more microbe reactivation. And that a- that point is where illness becomes chronic. It becomes a self-sustaining process. And at that point, it's going to take more than just improving your diet, getting more sleep, all of those kinds of things to get you well.

You're going to have to have some things ideally to decrease that microbe load, but also you know, energize your cells, improve mitochondrial energy, protect your cells from stress so that you can get back down below that state and your body can start getting a handle on it again. So yeah, I, I don't use diagnosis in the same way that a l- a lot of providers do.

Diagnosis is most valuable for acute illness. You have a high calcium, and you have all these weird symptoms, and they find a parathyroid gland, a parathyroid tumor, and you know, that, that's the diagnosis, and they take that out. You break your leg. We need to know where it's broken. So for acute intervention, the diagnosis is important But you look at chronic illness, it's not one thing, it's a lot of things going wrong 'cause the body is, the autophagy is impaired throughout the body.

The body's breaking down. So then you have microbe reactivation, and that can manifest in different ways for different chronic illnesses. So I like to know why the person's ill, what's going on in their body, what's driving these symptoms, because what a diagnosis in chronic illness does is define drug therapy, which is only going to treat the manifestations of the illness, not the causes.

And so it's a different way of thinking

[00:55:51] Dr. Brandon Crawford: I've thoroughly enjoyed this conversation. I believe that your mission is truly noble, right? You've taken a stance that I'm sure you have plenty of arrows in your back but this is a conversation that needs to continue. So I applaud you. I'm very thankful for your work. What you're saying is very congruent with my own thought processes, and like I said, this was initially brought to me, you know, similar concepts gosh, 17, 18 years ago when I started my career. So again, I thank you for that very much. Is there anything more you wanna tell the audience before we sign off here? How can they learn more about you? Where can they go?

[00:56:33] Dr. Bill Rawls: Sure. Yeah, I, I do a lot of education. This is-- Like I said, my mission is changing the conversation of getting people thinking differently providers thinking differently. You know, some, some, some conventional providers are warming up to these ideas because they're getting frustrated because what they're doing isn't working.

So thank you for the opportunity. It's, it was very much appreciated, and that was a great conversation. That was a lot of fun. People can find me at rawlsmd.com. There's a lot of valuable information there. I work through a company called Vital Plan, vitalplan.com. I gave up clinical practice several years ago to build programs that help walk people through these kinds of situations.

Just, changing, changing the whole idea, the whole approach because sometimes if you're really ill, you know, having somebody to hold your hand and walk through those things... And I don't see it as, as a standalone or separate from a provider. I think everything that you're doing is fantastic. But, you know, if people aren't building that environment that promotes healing, promotes autophagy inside their body, all the other things that we do aren't going to have as much impact.

So if I can get people thinking different, acting different, and just looking at life a little bit differently, then I can make a big impact in the world.

[00:58:03] Dr. Brandon Crawford: Absolutely. This is an important conversation. I wanna highlight that. So if you know someone that is ill, they're suffering, they have some kind of mystery thing going on, their labs are normal, they can't think right, they can't get out of bed, whatever it is, they need to hear this message. The reason that Dr. Rawls is here today, the reason that I'm doing this today, is because we're trying to help people. That's the mission. So please like, share, subscribe, all the things. Get this message out there because that's the goal. We need to help more people, and people need to understand that there's options out there besides what's being given to them in the traditional care model.

So again, thank you for your time, Dr. Rawls. It's been very fun. I, I've enjoyed this conversation a lot. I, I really want people to hear this message, so I'm gonna do whatever I can to help promote this. So again, thank you so much. It's been a pleasure

[00:59:04] Dr. Bill Rawls: Oh, thank you