#182: Evan Hirsch, MD- Fatigue & Persistent Low Energy Related to Infections, Lyme and Mold

by Deanna Mutzel, DC


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About Evan Hirsch, MD ABOIM

Doctor Evan, as he is affectionately known, is one of the nation’s leaders and authorities on Chronic Fatigue.
He suffered with chronic fatigue for 5 years until he achieved resolution using the protocols he pioneered in his medical practice.
He has helped over a thousand people resolve their Chronic Fatigue and is now on a mission to help 100,000 more people through online courses and training of providers.
He has lectured nationally and internationally on topics in Integrative and Functional Medicine and is Board Certified in Family Medicine and Holistic Medicine.
When he’s not at the office, you can find him singing barbershop, listening to musical theater, playing basketball, traveling, dancing hip-hop, and spending time with his family.
Download his FREE book on the first thing you need to do to fix your fatigue – improve your sleep!
His mentors include: Jonathan V. Wright, MD, Alan Gaby, MD, Andrew Weil, MD, Mark Hyman, MD and Datis Kharrazian, DC.
He focuses on Fatigue, Autoimmune disorders, Food Allergies, Gastrointestinal issues, Dermatologic problems, ADHD, Autism, Methylation issues, Mold, Lyme disease and Environmental Medicine and Hormone imbalances (Male and Female) – Thyroid, Adrenal, Sex hormones.

Connect with Hirsch Fatigue

Lab Mentioned in this Episode

Medical Diagnostics Laboratory:

Byron White Protocols


EMF Freedom


Show Notes

02:19 First Steps:  Get a thorough health history. 95% of what Dr. Hirsch does will be based upon a patient’s health history. First morning fasting blood labs and urine labs are used to detect nutrient and hormonal deficiencies. Once these deficiencies are addressed, people feel better and able to tackle more difficult health challenges like getting rid of “the usual suspects”: heavy metals, chemicals, molds and infections.

05:09 Viruses: Dr. Hirsch uses traditional labs and also a broad spectrum panel from Medical Diagnostics Laboratory which measures the immune system’s reactivity to the bugs. Now we can look at the DNA of the bugs. The CDC says that labs are not necessary, instead use a clinical diagnoses, based off symptoms, because labs can often be inaccurate.

09:37 Treating Co-Infections: It is tempting to go after the big bug, like Lyme, first. However, the periphery infections, like Epstein-Barr or cytomegalovirus, need to be addressed first. This changes the environment, making it easier to treat the big bugs.

11:00 Changing the Terrain: When you remove the bug or the challenge, your immune system can work with you to remove the next one. Research showed that if you remove mold, the immune system may kill Lyme on its own. Our terrain is altered from many insults to our system like physical, emotional, mental, energetic and spiritual stressors, pesticides, herbicides, cosmetics and EMFs, disabling our immune system’s ability to adequately fight for us.

13:46 Endocrine System: The hormonal shifts of giving birth are huge stressors. It is the number one time when women get Hashimoto’s Thyroiditis and other auto immune diseases.  Sometimes hypothyroidism is caused by an iodine deficiency and can be addressed with supplemental iodine. Autoimmune hypothyroidism can be caused by bugs hiding in the thyroid. The immune system goes after the intracellular bugs, but must go through the thyroid to get to them, thus destroying thyroid tissue. Some of the infections feed off heavy metals, binding to them and making them harder to get rid of.

16:03 Reversing Thyroid Disease:  Bartonella causes large lymph nodes, effecting the thyroid. When the infection is treated, the thyroid kicks in. 80% of patients will work their way completely off their medication. Dr. Hirsch estimates that as much as 50% of hypothyroidism may be caused by bartonella. Symptoms of bartonella include pain on the bottom of the feet or planter fasciitis (even transient), muscle cramping in the toes, feet or calves, neck pain often leading to headaches, poor sleep, anxiety and depression, sometimes diarrhea and thyroid disease/Hashimoto’s.

18:18 Contracting Bartonella: You can get it from any infected cat. It can be sexually transmitted. It can be transmitted by anything that takes a blood meal, like a tick, a mosquito, chiggers, or fleas. You could have acquired it from mom while in utero.

19:43 Treating Bartonella: A PCR test looks at the DNA of the bug. Some specialty labs do this. Treatments are so specific that you will react, symptom improvement or die off, if you have bartonella. A small herxheimer effect shows that it is working, but a large effect challenges the adrenals.  To support die off, Dr. Hirsch uses glutathione and multivitamin IVs. His favorite tool for fortifying the immune system prior to treatment is smilax or sarsaparilla. The body likes small changes. Dr. Hirsch treats slowly with antimicrobials at night.

23:51 Adrenal Support during Treatment: Prior to treatment, Dr. Hirsch likes to ensure that the immune system, nutrient levels, adrenals, thyroid and sex hormones are robust. He is a huge fan of licorice root, but may opt for the gentler eleuthera.

24:56 Smilax: It is a blood cleanser. It is a weak broad spectrum antimicrobial. When bugs are dying and releasing toxins into the blood, Smilax sweeps it up, puts the through the liver and helps the liver get it out. Herxing or die off is a buildup of “crap” on the liver that the liver cannot process through. It produces a cytokine storm.

25:57 Herxheimer Effect/Die off Help: Infrared sauna is beneficial. It also kills infections.  If you feel worse from your sauna, you are doing too much. Start at 5 minutes 3 times a week and increase by a minute each week. Start small with exercise. Later in treatment, Rolfing, massage and breaking up biofilm can be done to release the “crap”.

28:06 Dr. Hirsch’s Fatigue: During his medical school residency, his wife had fatigue for 3 years. When he started his practice and became a father, he became fatigued for 5 years. He is now 80 to 90% better.

32:09 Sleep: Dr. Hirsch fixes sleep issues by giving supplements in the morning: adrenals, thyroid, iron, and B12. Often, we are not sleeping because of a circadian rhythm problem. Exercise in the morning can help to train the circadian rhythm. Menopausal women may need progesterone to fall asleep and estrogen to stay asleep. Infections are active at night and can affect sleep.

33:55 Antimicrobials: Dr. Hirsch uses no pharmaceuticals for killing bugs. He prefers Byron White Products. Herbs work better on the bugs, work better with the immune system and have fewer side effects. Oxygen/Ozone therapy, rectal or sinus, is used to get rid of infections in the sinuses. It kills bugs and boosts mitochondria.

36:54 Ketogenic/Low Carb – High Fat Diets: Dr. Hirsch is a big fan of Paleo and Keto.  He asks his patients to eat meat and vegetables (mostly vegetables) and sees great shifts in lab panels.

37:41 Lyme and Lyme Co-Infections: There is a Wack-a-Mole process. You beat one down and another co-infection becomes stronger in symptoms.

43:03 Mold: 50% of all homes in the US have water damage. Many of these have mold. If you can easily smell mold, you may have mold in your sinuses. An ERMI test looks at the DNA of the mold. Urine mycotoxin testing tests for mold toxins produced inside the body. If you don’t get rid of mold, you cannot get rid of your other infections. Mold hijacks the immune system.

45:27 Treating Mold: The number one treatment is removal from the environment. Sometimes you have to leave your house and your belongings. Often, you feel much better when you go on vacation, because you are away from the mold, or EMFs, or a sick workplace. Our humid Pacific Northwest environment nurtures the mold in our bodies, so drier climates may make you feel better.

47:49 EMF’s: EMF’s break the strands of your DNA. Your immune system reacts to them, compromising your immune system. EarthCalm and EMF Freedom are Dr. Hirsch’s go-to companies for EMF prevention products.

50:27 Baby Steps: You must address all of the causes. You must be diligent. You must go slowly, or it is too overwhelming. Be gentle.

51:25 Dr. Hirsch’s Morning Routine: First thing, he meditates for 30 minutes in his sauna using Holosync, an audio technology used with headphones. He does some burpees, has breakfast and takes his daughter to school. Dr. Hirsch tries to keep his phone away from his body.

54:16 Dr. Hirsch’s Favorite Nutrient: His choice is colloidal silver. It fights infection.

55:34 Dr. Hirsch’s Elevator Pitch: He would talk to them about the dangers of gluten. It damages your intestine every time you consume it. It is not just about reacting to it. It increases autoimmunity and inflammation in the body. He favors coming off gluten and moving to a paleo diet.

  1. Fantastic episode! I learned so much – as always from your show. I have a question: when Dr. Evan was talking about Eleuthero root, was he suggesting taking it after a heavy detox or before to support the body?

  2. Really enjoyed the episode!! One question – do you know which “Smilax” Doctor Evan uses (particular brand or which species)? I’ve heard that Smilax glabra is especially good for clearing toxins from the brain, but is more difficult to find. But, I know there are other species of Smilax out there, and didn’t know if one was best for general die-off support. So, I would love to know which particular Smilax tincture or capsules he likes… Thanks!

  3. Thx! Very helpful info. 2 questions: 1) when you mention “getting rid” of infections (e.g., EBV), so you mean shifting it from active status to latency, or is it possible to totally eliminate it (and others like herpes and CMV) even from latent status? 2) You mentioned using serum testing for most everything except sex hormones. What do you use for measuring sex hormones? Thank you.

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