Time to understand a more complex picture.

Your experience deserves careful attention.

Persistent symptoms can affect your work, relationships, and daily life. Care begins with taking the time to understand your experience, health history, and the questions that remain unanswered.

Assessment & testing options.

We review your previous investigations, treatments, and relevant exposure history, then discuss appropriate next steps. The assessment considers other possible explanations for symptoms as well as your specific concerns about chronic infections and environmental exposures.

The meaning and limitations of proposed tests should be explained before testing. A result is considered in the context of your clinical picture.

• Chronic infection & tick-borne illness testing. Tests selected around symptoms, exposure history, and the suspected organism. Validated assays and their timing matter; a result is interpreted alongside your clinical assessment.
• Mold toxin & colonization testing. Discussion of exposure-related concerns and assessment for fungal colonization or infection where clinically indicated. Urine mycotoxin tests are not validated for diagnosing illness caused by indoor mold; a positive result does not establish that mold is causing symptoms.
• Heavy metal testing. Exposure-directed testing using appropriate specimens and validated reference ranges. Findings are reviewed before considering treatment.
• Environmental toxin testing. Targeted consideration of specific environmental or occupational exposures. Detecting a substance does not, by itself, establish toxicity or explain an illness.
• Plasmalogen testing. Specialized testing of these membrane lipids may be discussed with attention to the specific assay and clinical question. Its use to guide general chronic illness treatment remains investigational.
• Comprehensive physical examination. A hands-on assessment guided by your history and symptoms, with further evaluation or referral when findings call for it.

Learn more: Tick-borne illness testing · CDC ↗ · Mycotoxin test limitations · CDC ↗ · Plasmalogen testing · Mayo Clinic Laboratories ↗

Treatment options & ongoing care.

Complex care is an ongoing process of assessment, discussion, and adjustment. Your symptoms, response to care, and priorities help guide the next step.

• IV & oral antibiotics. Considered when a bacterial diagnosis and clinical indication support treatment, with an individualized medication, route, duration, and monitoring plan. Persistent symptoms alone do not establish an ongoing bacterial infection.
• IV antimalarials. Assessment of the specific medication and diagnosis being considered. These are not general treatments for chronic symptoms; any off-label or investigational use requires a separate discussion of evidence, risks, and alternatives.
• IV phospholipids. Discussion of specialized phospholipid infusions, the proposed purpose, and the evidence and uncertainties for your situation.
• IV chelation. Considered for appropriate indications, such as certain confirmed metal poisonings, with relevant laboratory monitoring. Chelation is not a general detoxification treatment.
• SOT therapy. Supportive oligonucleotide therapy is an investigational option. Published research is preliminary, and effectiveness and long-term safety for chronic infections have not been established. It is discussed separately from established infection treatment.
• Targeted nutraceuticals & antimicrobial botanicals. Individualized options reviewed for their intended role, available evidence, medication interactions, tolerability, and follow-up.
• Clinical nutrition. Practical nutrition planning that considers dietary intake, nutritional adequacy, symptoms, and the demands of daily life.

We work through the purpose, evidence, potential benefits, risks, and alternatives for each proposed treatment. Your care plan is revisited as findings and your response evolve.