​Arthur Lewis, MD, IFMCP, BCN
233 Sopher Road
Titusville, PA 16354
3D brain-function mapping using quantitative EEGs
A quantitative EEG is a diagnostic tool that can be very valuable when assessing individuals who have a variety of neurologic, psychiatric, and/or learning disorders. It is performed by placing a cap on your head which has 21 sensors that send information about your brainwaves into a computer. The computer software is able to produce 3-dimensional images of the function of your brain. It divides the brain into 12,270 voxels (similar to pixels but in 3D) to give state-of-the-art high-resolution images of your brainwaves’ frequency, amplitude, and connectivity (i.e., how efficiently each part of the brain connects with the other parts).
This information is then compared with a normative database of quantitative EEGs taken from a healthy population. Those specific areas or networks of your brain which show sub-optimal brainwave activity and relate to your specific symptoms or needs are then selected for neuromodulation with neurofeedback training and/or neurostimulation treatments, such as transcranial direct current or alternating current electrical stimulation, pulsed electromagnetic frequency stimulation, and/or photobiomodulation using near-infrared LEDs. In addition, other functional medicine interventions are usually of great value in helping to address the root causes of abnormalities identified on the quantitative EEG.
3D brain-function mapping using quantitative EEGs
A quantitative EEG is a diagnostic tool that can be very valuable when assessing individuals who have a variety of neurologic, psychiatric, and/or learning disorders. It is performed by placing a cap on your head which has 21 sensors that send information about your brainwaves into a computer. The computer software is able to produce 3-dimensional images of the function of your brain. It divides the brain into 12,270 voxels (similar to pixels but in 3D) to give state-of-the-art high-resolution images of your brainwaves’ frequency, amplitude, and connectivity (i.e., how efficiently each part of the brain connects with the other parts).
This information is then compared with a normative database of quantitative EEGs taken from a healthy population. Those specific areas or networks of your brain which show sub-optimal brainwave activity and relate to your specific symptoms or needs are then selected for neuromodulation with neurofeedback training and/or neurostimulation treatments, such as transcranial direct current or alternating current electrical stimulation, pulsed electromagnetic frequency stimulation, and/or photobiomodulation using near-infrared LEDs. In addition, other functional medicine interventions are usually of great value in helping to address the root causes of abnormalities identified on the quantitative EEG.
What is Low Dose Immunotherapy?
Who can benefit from LDI?
Excessive inflammation is at the root of many chronic diseases. Low Dose Immunotherapy (LDI) can benefit those with an overactive immune system by helping to reestablish tolerance to different allergens, chemicals, and organisms. Our immune system may inappropriately attack substances that should not trigger an immune response, leading to food allergies and sensitivities, environmental allergies, chemical sensitivities, and autoimmune diseases. Furthermore, an overly reactive immune response to microorganisms in our body can contribute to chronic illness. The vast majority of the trillions of microorganisms which make up our microbiome are either harmless or beneficial to our health; however, sometimes our immune system gets out of balance and loses its tolerance to certain organisms which many people tolerate well, leading to chronic inflammatory illnesses. This can happen with organisms that can cause persistent symptoms, such as those related to chronic Lyme disease, Lyme co-infections, herpes, yeast, and acne, as well conditions caused by other bacteria, yeast, mold, and viruses.
Some of the Conditions Responsive to LDI
Acne
Anaphylaxis
Arthritis, such as rheumatoid and psoriatic arthritis, and osteoarthritis
Asthma
Autism
Autoimmune conditions, such as Crohn’s disease, ulcerative colitis, and multiple sclerosis
Candida/fungal-related illness
Chemical intolerances/sensitivities
Chronic fatigue syndrome
Chronic Lyme disease and co-infections, such as Bartonella and Babesia
Dermatitis
Eczema and psoriasis
Environmental allergies, such as pollen, mold, animal dander, dust mites, and latex
Endometriosis
Fibromyalgia
Food allergies and sensitivities
Herpes viruses
Hives
Interstitial cystitis
Irritable bowel syndrome
Migraines
Neuralgia, trigeminal and post-herpetic
PANS and PANDAS
Seasonal allergies
The Basic Concepts of Low Dose Immunotherapy
The goal of low dose immunotherapy is to retrain our immune system, restoring tolerance to foods, environmental exposures, tissues in our own body, and certain microorganisms which most people with a healthy immune system tolerate without ill effects to their health. LDI does not kill organisms but it alters the body’s overly aggressive inflammatory response to part of our microbiome through regaining immune tolerance. LDI does not weaken the body’s appropriate attack against pathogenic organisms which pose a true threat to our health. It is unlike immunosuppressive drugs such as methotrexate, Humira, and prednisone which block certain components of our immune system putting us at higher risk for infection. LDI targets only the specific antigens in your LDI dose which your body should not be reacting to. It does not promote tolerance to other organisms. Keep in mind that other functional medicine treatments may be needed in conjunction with LDI to achieve the best results.
Low Dose Immunotherapy Safety
In over 55 years of use and with hundreds of thousands of doses administered, there has been no evidence of anaphylactic or life-threatening reactions to low dose immunotherapy or low dose allergen therapy doses, even among individuals with severe allergies to components in the mixtures. In addition, there are no side effects when the allergens in the mixture are not allergens that are contributing to your illness. The LDI antigens are not known to induce new symptoms, allergies, or conditions. It does not weaken your body’s ability to fight infections due to pathogenic organisms.
Differentiating Symptoms due to Infections Requiring Antimicrobial Treatment from Symptoms Due to an Overly Reactive Immune Response to Microorganisms
Some organisms have features of both an active infection as well as a chronic immune-mediated response.
The Basic Protocol for Receiving LDI Therapy
LDI works by administering a very low dose of an antigen to which your body is overly reactive. This is done by placing a few drops of a very dilute antigen under your tongue. Treatment begins with weekly doses, each progressively stronger, until a dose prompts a significant change in your typical symptoms, generally within 24 to 48 hours after taking the LDI.
If you get to a dose where you experience a marked improvement in your symptoms, then the dose is adjusted until we find the right dose such that your symptoms are well controlled or gone for 1 – 2 months or longer. This is called the core dose. The core dose may need to be repeated initially as often as every 4 - 8 weeks, depending on when your symptoms start to return. The intervals between the doses often increase as immune system tolerance continues to improve. Over a period of time the core dose may only need to be given once or twice a year or not at all. You will not see any change in your condition during the LDI titration (increasing concentrations) phase until you are at or very close to the core dose. The effective LDI dose is different for each person.
If your symptoms significantly worsen after a dose, it indicates two things. First, the dose was too potent, and you will need to wait 7 weeks before receiving a lower concentration. Second, it informs us that LDI is very likely to help with the symptoms that worsened, as it shows your sensitive immune system is reacting to this antigen. Conversely, if you reach the highest concentration for an antigen and experience no change, it means this particular LDI antigen is not responsible for your symptoms.
When it comes to internal antigens (such as those involved with autoimmune diseases, bacteria, viruses, and yeast) and external antigens (such as food, pollen, and animals) it is not always obvious which antigens are causing your symptoms. Your symptoms may be arising from more than one antigen and for that reason it can sometimes take a number of months to see which antigens at what doses work best for you.
Detailed Treatment Description
After we decide on the best LDI antigen mixture, you will have your personalized antigens mailed to you. The antigens will arrive in small syringes, each carefully labeled to indicate the LDI antigen and the strength of the dose in each syringe. The labels are crucial for determining where to begin your treatment. Check the volume in the syringes upon arrival. On rare occasions air pressure can expand the bubbles and displace fluid. During the initial titration phase there should be 4 units of fluid in each syringe. When we are at or near the core dose, the dose volume may change. Please notify us if there is less fluid in the syringe than expected. Unless directed otherwise, you will start with the largest number on the label, corresponding to the weakest dose. For example, if your set includes doses marked as 12C, 11C, 10C, 9C, and 8C, begin with 12C.
When you're ready to take your dose remove the orange caps from both ends of the syringe and then carefully empty the contents of the syringe under your tongue. Hold it there for about 20 seconds to ensure maximum absorption, and then swallow. Over the next seven days, monitor yourself for any changes in your symptoms. This period is crucial for understanding how your body responds to the dose. If your treatment is for conditions triggered externally, like food allergies, you will need to challenge yourself with these triggers after 5-6 days. This involves intentionally exposing yourself to the trigger to observe any reactions. If you have a history of severe reactions, such as anaphylaxis, we will discuss safe ways to gradually expose yourself to these antigens. Pay close attention to whether your symptoms are the same, better, or worse compared to your usual reactions. This information is critical to determining the effectiveness of the dose.
After your observation (and challenge when indicated), compile a report detailing your experiences and any changes in your symptoms from your usual symptoms. Refer to the next section on the LDI Dose Report for guidance on how to structure your report. After each dose, wait for 6-7 days, then send this report as a portal message on your Cerbo MD-HQ web portal before proceeding to the next dose. When you get near or at your core dose these reports will become less frequent. Dr. Lewis will review your report and provide feedback or instructions typically within 24-48 hours on how to proceed with your next dose. This may involve adjusting the dose, repeating the same dose, or trying a different antigen. If your portal message includes other issues unrelated to your LDI report it may take Dr. Lewis more than 48 hours to respond. If you have other issues to bring up, it is best to make a separate portal message.
Guidelines for Obtaining the Best Results
In order to get the best results the initial testing phase requires patience and precision, as determining the right doses for each antigen can be a meticulous process, especially when multiple antigens are involved. Accurate feedback from you is crucial for identifying the most effective dose(s). One challenge to keep in mind with LDI therapy is that heightened focus on symptoms following each dose might make the symptoms appear to be more intense. When this happens it can prevent us from finding an effective dose to control your symptoms. Before attributing any worsening of your symptoms solely to the LDI dose, consider other potential factors like stress, physical trauma, allergies, medication changes, or hormonal fluctuations. It's crucial to differentiate between actual reactions to the treatment and coincidental changes in your condition. Try to avoid any significant changes in your diet or any new therapies at the same time you are adjusting your doses of LDI.
Your input will be necessary when it comes to choosing the initial antigen concentration and deciding how quickly we move through the dose levels. If quicker results are your goal, we can begin with stronger doses and move more rapidly through the titration process. However, this approach carries a higher risk of symptom flares. A flare is defined as a significant worsening of your usual symptoms beyond what you might experience on one of your bad days, usually starting within 24 – 48 hours of your LDI dose, indicating that the dose was too high. Conversely, a more cautious approach with weaker starting doses and more gradual titration might take longer but reduces the risk of intense flares. People with severe symptoms and/or a history of sensitivity to low doses of other therapies, supplements, drugs, or other antigenic exposures need to take the slower more cautious approach.
The LDI Dose Report
Carefully follow the instructions below for efficient and effective support. Please be concise. Lengthy symptom descriptions can complicate understanding and may lead to incorrect dosage titration. You are the only one who can accurately determine if your symptoms are better, worse, or the same. What follows are some examples of what to include in your report.
The LDI Dose Report Example and Instructions
A. Dose Information
Date taken: 8/1/2023
Dose name and concentration: Yeast 17C
Overall response:
Better (if you experienced a noticeable improvement in your condition beyond what you might expect to experience on one of your better days, especially if it occurs starting within 24 - 48 hours of your LDI dose.)
or
Worse (if you experienced a noticeable worsening of your condition beyond what you might expect to experience on one of your worst days, especially if it occurs starting within 24 - 48 hours of your LDI dose.)
or
Same (if the symptoms you have had that week are within the range of what you usually experience. If you are unsure if your symptoms have changed over the last week it is fine to report “Same” because when you are at or near the core dose any change you are experiencing is usually not subtle or difficult to appreciate and you will usually begin to experience a significant change within 24-48 hours of your LDI dose.)
If your condition is essentially the same as what is typical for you, do not complete the rest of this report.
B. Symptom Details: Your focus needs to be on any significant changes in your symptoms rather than a description of your symptoms.
1: Primary symptom name: Fatigue
Significant change from your baseline? Better
Percent better or worse than your baseline: 50% better
Date change first noticed: 8/3/2023
How long did the significant change last? 4 days
2: Symptom name: Anxiety
Significant change from your baseline? Same
Percent better or worse than your baseline:
Date change first noticed:
How long did the significant change last?
3: Symptom name: Right hip pain
Significant change from your baseline? Better.
Percent better or worse than your baseline: 70%
Date change first noticed: 8/2/23
How long did the significant change last? 6 days
C. Other Recent Factors Potentially Impacting my Health
Try to avoid any significant changes in your diet or any new therapies at the same time you are adjusting your doses of LDI. However, if there have been changes our office needs to be aware of those changes in order to know if any symptom changes are due to the LDI or something else.
​
For example:
If there have been no new factors which might be impacting your health, just report “None.”
Other possible scenarios worth reporting:
I just learned a few days ago that my father has cancer.
I was in a car accident on August 5 and had a concussion.
I was in the emergency department on August 7, diagnosed with a strep throat, and started on penicillin.
You need to wait for a response from Dr. Lewis before taking your next dose. There is no harm in waiting more than 7 days between each LDI dose. You will not take your next dose less than 7 days from your previous dose.
How Much Does LDI Cost?
The cost is $175 for 5 doses of the LDI. This includes Dr. Lewis’ reviewing your portal LDI Dose Reports and providing portal message feedback regarding directions for each subsequent dose. It also includes the preparation and mailing of your customized LDI doses. If Dr. Lewis tells you not to take some of the doses which were mailed to you due to a flare in your symptoms or due to the need to fine tune your doses, your new doses replacing the unused doses will be provided at no additional cost. If an office visit, telemedicine visit, or phone call with Dr. Lewis is needed, you will be charged at our usual rate for these services as listed on this website.