Mark Hyman, MD · 2026-07-29 · Mark Hyman (host), Richard Horowitz

Undiagnosed Infections Are Silently Causing Chronic Disease! Fix It With This

55 research-tied claims examined: 1 contradicted 9 overstated 6 context 22 supported 17 unverified

1

Contradicted by research

0:30:35Richard Horowitzcontradictedhigh

Lecanemab lowered phosphorylated tau by 23% in clinical trials over nearly 7 years.

"And the drugs that are used for it, lecanemab, they lowered phosphorylated tau by 23% in almost 7 years." (said at 0:30:35)

The claim that lecanemab lowered phosphorylated tau by 23% over nearly 7 years is contradicted by clinical trial evidence. In the primary Phase 3 clinical trial (Clarity AD), lecanemab was evaluated over an 18-month (1.5-year) double-blind period, not 7 years. While lecanemab significantly reduced amyloid markers and slowed clinical decline compared with placebo at 18 months, published clinical trials and long-term pharmacodynamic modeling evaluate outcomes over 18 months to 4 years, making the claimed 7-year timeframe inaccurate.

9

Overstated

0:09:45Richard Horowitzoverstatedmoderate

The clinical hallmark of Lyme disease is migratory pain affecting joints, muscles, and nerves.

"Lyme patients have migratory joint pain, migratory muscle pain, and migratory nerve pain: tingling, numbness, burning, stabbing, vibration. The hallmark of Lyme is migratory pain." (said at 0:09:45)

While early disseminated Lyme borreliosis can cause transient migratory musculoskeletal symptoms (such as migratory arthralgias and myalgias) and neuroborreliosis can produce radicular neuropathic pain, asserting that 'migratory pain' across joints, muscles, and nerves is the defining hallmark of Lyme disease is overstated. Clinically, the primary pathognomonic hallmark of early Lyme disease is the erythema migrans skin lesion. When musculoskeletal manifestations develop later in the disease, they classically manifest as intermittent or persistent mono- or oligoarthritis predominantly involving large joints (most commonly the knee), rather than generalized migratory polyarticular pain.

0:17:53Richard Horowitzoverstatedlow

Lyme infection induces molecular mimicry via flagella, causing autoantibodies against dopamine receptors, thyroid tissue, cardiolipin, and myelin.

"The Lyme is causing anti-dopaminergic antibodies, anti-thyroid antibodies, anti-cardiolipin antibodies, anti-myelin antibodies. It's causing this auto—so people come in with these autoimmune illnesses, but it's Lyme causing molecular mimicry. Your immune system is attacking the bug, right, the flagella, and it's causing these autoantibodies." (said at 0:17:53)

While research has demonstrated that immune responses to Borrelia burgdorferi flagellin can cross-react with human axonal proteins (such as heat shock protein 60, HSP60) in in vitro and preclinical models, the claim that flagellar molecular mimicry causes a broad array of specific autoantibodies—including anti-dopaminergic, anti-thyroid, anti-cardiolipin, and anti-myelin antibodies—significantly overstates the evidence. Some anti-neuronal antibodies (such as anti-D1 dopamine receptor antibodies) have been preliminarily observed in small subsets of patients with recurrent Lyme disease, but a causative mechanism linking flagella-targeted molecular mimicry to these diverse autoimmune targets in clinical disease is unestablished.

0:31:55Richard Horowitzoverstatedlow

A randomized controlled trial demonstrated that a ketogenic diet can reverse bipolar I disorder, schizophrenia, and psychosis.

"There was a trial published uh I think the other day on ketogenic diets. It was a randomized controlled trial for bipolar I and schizophrenia and psychosis showing reversal." (said at 0:31:55)

A randomized controlled trial evaluated an adjunctive ketogenic diet in outpatients with schizophrenia-spectrum and bipolar I disorders (n = 58; 1-month randomized phase vs. diet-as-usual, followed by an optional 4-month extension). The trial found statistically significant improvements in metabolic parameters (such as weight, HbA1c, and insulin resistance), cognitive performance, and psychiatric symptom scores (including depression and positive/negative symptoms). However, the study demonstrated modest-to-moderate symptom reduction and feasibility, not disease "reversal" or cure.

  • partial: Metabolic Improvements with a Ketogenic Diet Correlate with Symptom Improvement in Psychos… (Schizophrenia bulletin 2026)
    "Participants were randomized to a ketogenic diet (KETO; n = 28) or diet-as-usual (DAU; n = 30) for 1 month. Partway through the trial, a KETO extension was offered to both groups, resulting in a sub-group who completed the diet for 4 months (n = 25)... Clinical symptoms (positive, negative, depression) and cognitive performance improved after 4 months on the KETO (all P-values < .001)... We demonstrate feasibility of administering a KETO in outpatients with schizophrenia and bipolar-1 disorder. Participants showed improvement in metabolic health, cognitive performance, and clinical symptoms." (abstract, methods and results, passage verified)
    pubmedfull study (doi)
0:32:05Mark Hyman (host)overstatedlow

Ketogenic diets reduce brain inflammation.

"and ketogenic diets work by reducing brain inflammation. That's how they work." (said at 0:32:05)

Ketogenic diets and their primary circulating ketone body, beta-hydroxybutyrate (BHB), have demonstrated anti-inflammatory properties in the central nervous system—such as inhibiting NLRP3 inflammasome activation, reducing microglial activation, and lowering pro-inflammatory cytokine expression. However, asserting that reducing brain inflammation is simply "how they work" is overstated in two respects. First, the therapeutic mechanisms of ketogenic diets are multifaceted; their primary validated clinical application (refractory epilepsy) is driven largely by alterations in neurotransmitter balance (particularly enhanced GABAergic transmission), adenosine signaling, and mitochondrial bioenergetics. Second, direct evidence for neuroinflammatory modulation comes predominantly from preclinical cellular and animal models, while clinical trials evaluating neuroinflammatory biomarkers in humans remain preliminary and limited.

0:34:45Richard Horowitzoverstatedvery low

Dapsone exhibits antimalarial activity and is effective against approximately 25% of Babesia cases.

"It has antimalarial properties; it hits, not great, but about 25% of the Babesia cases." (said at 0:34:45)

While dapsone has established antimalarial activity (historically used in antifolate combination therapies such as Lapdap and Maloprim), no clinical trials or published evidence establish that dapsone monotherapy or protocols achieve efficacy in approximately 25% of Babesia cases. Standard first-line treatments for human babesiosis remain atovaquone plus azithromycin or clindamycin plus quinine; in observational reports of dapsone combination regimens used for chronic tick-borne illness, Babesia coinfections typically require separate antimalarial regimens.

0:35:15Richard Horowitzoverstatedvery low

A 9-week dapsone antibiotic protocol induces remission in approximately half of patients with chronic Lyme disease who do not have active Babesia, Bartonella, or mold illness.

"if you have Lyme without active Babesia, Bartonella, without mold, this protocol will put about half of the people in remission from nine weeks of antibiotics." (said at 0:35:15)

Published retrospective chart reviews from the clinician's practice report similar figures: in a retrospective series of 40 patients treated with 7–8 weeks of double-dose dapsone combination therapy (DDDCT), 45% (18/40) remained in remission for 1 year or longer. In a subsequent review of 25 patients receiving 8 weeks of DDDCT followed by a 5–7 day high-dose pulse (~9 weeks total), 30.5% (7/23 evaluable) achieved remission at 3–9 months and 13% (3/23) at 1.5 months (~43.5% total). However, presenting these findings as a definitive clinical rule ("will put about half of the people in remission") overstates the evidence, which consists entirely of small, unblinded, uncontrolled retrospective chart reviews and case series from a single practice without randomized controls.

0:50:20Richard Horowitzoverstatedlow

Postural orthostatic tachycardia syndrome (POTS) and dysautonomia occur in 40% to 50% of chronic Lyme and tick-borne disease patients.

"and dysautonomia shows up in 40 to 50% of our patients at this point." (said at 0:50:20)

While subjective autonomic symptoms and certain hemodynamic abnormalities (such as orthostatic hypotension) are frequently reported in post-treatment and late-stage Lyme disease, the claim that postural orthostatic tachycardia syndrome (POTS) specifically occurs in 40% to 50% of patients overstates published objective findings. A study of 210 patients with post-treatment Lyme disease (PTLD) found that while autonomic symptom scores (COMPASS-31) were elevated, objective orthostatic tachycardia on a 10-minute active stand test was present in only 4.29% (9 of 210) of patients, a rate not significantly different from healthy controls. Other specialized cohort studies of late-stage Lyme disease have found orthostatic hypotension in 53.4% of patients during head-up tilt testing, but reviews note that formal dysautonomia remains an under-characterized complication in the broader Lyme literature.

0:55:30Richard Horowitzoverstatedvery low

Mycotoxins are detectable in 70% to 80% of fibromyalgia patients.

"Fibromyalgia. I didn't learn in medical school that mycotoxins are showing up in 70 to 80% of fibromyalgia patients." (said at 0:55:30)

No published studies show that 70% to 80% of general fibromyalgia patients test positive for mycotoxins. The figures cited likely derive from observational studies in patients with chronic fatigue syndrome (ME/CFS) who had documented histories of exposure to water-damaged buildings. In a 2013 study of 112 ME/CFS patients with mold exposure, 83% tested positive for ochratoxin A (and 93% for at least one mycotoxin) on commercial ELISA urine assays. A subsequent 2022 study in mold-exposed ME/CFS patients found mycotoxins in 92.4% of urine samples. These findings reflect highly selected, mold-exposed ME/CFS populations rather than representative fibromyalgia cohorts, and the diagnostic reliability of urinary ELISA mycotoxin assays remains controversial.

1:01:37Richard Horowitzoverstatedmoderate

Quest Laboratories offers diagnostic testing for Alzheimer's blood biomarkers including p-tau 181, p-tau 217, neurofilament light, and beta-amyloid 42/40 ratio.

"And these are from Quest, like you can get a p-tau 181, p-tau 217, neurofilament light, and beta-amyloid 42/40 ratio from Quest Laboratories, and it is completely covered." (said at 1:01:37)

The statement bundles two distinct claims: commercial availability of specific blood biomarkers and universal insurance coverage. While Quest Diagnostics has developed and offers clinical assays for plasma amyloid-beta 42/40 ratio, phosphorylated tau (p-tau181, p-tau217), and neurofilament light (NfL) to aid in Alzheimer's disease evaluation, the assertion that these tests are 'completely covered' is overstated. Published reviews on the clinical implementation of Alzheimer's blood biomarkers highlight that routine clinical adoption, standardized reimbursement, and comprehensive insurance coverage remain major barriers, with patients frequently facing out-of-pocket costs.

6

Needs context

0:22:15Richard Horowitzneeds contextlow

A Johns Hopkins study showed that administering sulforaphane glucosinolate (broccoli seed extract) improved symptoms in one-third of autistic children.

"if you give sulforaphane glucosinolate, broccoli seed extract, to the autistic population, they did it at Johns Hopkins, a third of these kids, their brains—and the same thing with the Alzheimer's." (said at 0:22:15)

A landmark pilot randomized, placebo-controlled trial conducted by researchers at Johns Hopkins University School of Medicine and Massachusetts General Hospital evaluated sulforaphane derived from broccoli sprout extract in 44 young males (aged 13–27) with autism spectrum disorder (ASD). In that trial, sulforaphane treatment resulted in a 34% average reduction (improvement) in Aberrant Behavior Checklist (ABC) scores compared to placebo, which is frequently misquoted or conflated as improving one-third of participants. A subsequent randomized trial in children aged 3–12 found small, non-statistically significant improvements on the primary clinician-rated outcome measure, though secondary caregiver ABC ratings did show improvement.

0:25:00Richard Horowitzneeds contextvery low

Low-dose naltrexone inhibits the NLRP3 inflammasome pathway.

"low-dose naltrexone, one of my favorites also for blocking the third pathway, NLRP3 inflammasomes" (said at 0:25:00)

Low-dose naltrexone (and its stereoisomer (+)-naltrexone) attenuates neuroinflammation primarily by antagonizing Toll-like receptors 2 and 4 (TLR2/TLR4) on microglia, which secondarily reduces downstream inflammatory signaling, including the expression of NLRP3 and interleukin-1β (IL-1β). Describing naltrexone as a direct blocker of the NLRP3 inflammasome pathway conflates upstream TLR antagonism with direct NLRP3 inhibition (such as by specific inhibitors like MCC950). Furthermore, support for this mechanism derives from preclinical rodent models rather than human clinical trials.

0:34:25Richard Horowitzneeds contextvery low

A study by Lee et al. found that people not taking dapsone had a rate of Alzheimer's disease six times higher than those taking 100 mg of dapsone.

"So in a study by Lee et al. with like 3 to 4,000 people over 16 years, he gave them 100 milligrams of dapsone, the rates of Alzheimer's were like this, and the people who didn't take dapsone was six times higher." (said at 0:34:25)

A 2022 study by Lee et al. (PMID 35542045) evaluated Alzheimer's disease (AD) diagnoses in South Korean leprosy patients according to dapsone prescription history. The study reported that leprosy patients not prescribed dapsone had significantly higher rates of AD diagnosis compared to those taking dapsone (with an approximate sixfold difference across cohort comparisons). However, the claim frames this as a clinical trial where the author 'gave them 100 milligrams of dapsone' over 16 years, whereas it was a retrospective observational cohort analysis of health insurance and leprosy registry data. Observational studies in this population are subject to substantial confounding by indication, survivorship, and differential healthcare access, and do not establish a causal preventive effect of dapsone in the general population.

  • context: Dapsone is an anticatalysis for Alzheimer's disease exacerbation. (iScience 2022) · cited 22x in the literature
    "Our study investigated patients with leprosy and AD. They were treated with dapsone (4,4'-diaminodiphenyl sulfone, DDS) as a neuroinflammasome competitor and cGAS/STING pathway inhibitor. Four groups were defined: Treatment (T) 1: DDS prescribed AD diagnosed, T 2: DDS prescribed AD undiagnosed, T 3 DDS unprescribed AD diagnosed, and T 4: DDS unprescribed AD undiagnosed. Dapsone effects on AD can be clearly distinguished according to dapsone presence or absence. T1:T3 proved that the incidence of AD was significantly reduced by dapsone." (abstract, results, passage verified)
    pubmedfull study (doi)
0:40:45Richard Horowitzneeds contexthigh

Methylene blue is used in the treatment of blood plasma supply to eliminate infectious pathogens.

"in the blood plasma supply when they're treating for all the red blood cells they're storing. Methylene blue is what's used to kill all the infectious agents that's in our blood supply." (said at 0:40:45)

Methylene blue combined with visible light (such as the Theraflex MB-Plasma system) is a well-established pathogen reduction technology used specifically to treat therapeutic plasma units to inactivate viruses and other infectious pathogens. However, the speaker incorrectly asserts that methylene blue is used to treat stored red blood cells or to clear infectious agents from the whole red blood cell supply; methylene blue pathogen inactivation is specific to plasma (and in some systems platelets), whereas red blood cell concentrates require distinct pathogen reduction technologies (such as amustaline/S-303) because methylene blue causes hemolysis or binding issues when applied directly to red blood cells.

1:02:24Mark Hyman (host)needs contextlow

Matrix metalloproteinases (MMPs) are elevated when Lyme disease affects the joints.

"Right, like somebody might have Lyme joint pain and their MMP is high, the matrix metalloproteinase is high, it's like, "Okay, that confirms that the Lyme is affecting your joints."" (said at 1:02:24)

Matrix metalloproteinases (such as MMP-1, MMP-3, MMP-10, and MMP-13) are elevated locally in synovial tissue and fluid during Lyme arthritis as part of the host inflammatory response to Borrelia burgdorferi. However, MMP elevation is a non-specific marker of joint inflammation and tissue remodeling seen in many other conditions (including rheumatoid arthritis and osteoarthritis). Serum or synovial MMP testing does not confirm that Lyme disease specifically is the cause of a patient's joint pain.

1:09:01Richard Horowitzneeds contextmoderate

Sixty percent of Americans have one chronic illness, and 25 percent have two or more.

"60% of Americans have one chronic illness, 25% have two or more, 86% of our health care costs, and 70% is chronic disease." (said at 1:09:01)

The speaker's statement roughly reflects national surveillance data from the Centers for Disease Control and Prevention (CDC), but blends estimates from different definitions of chronic illness. Analyses of the National Health Interview Survey (NHIS) examining 10 major conditions (arthritis, cancer, COPD, coronary heart disease, asthma, diabetes, hepatitis, hypertension, stroke, and kidney disease) found that 51.1% to 51.8% of US adults had at least one condition and 26.4% to 27.2% (roughly 25%) had multiple chronic conditions (two or more). When broader definitions of chronic disease are used, the CDC frequently cites that 6 in 10 (60%) US adults have at least one chronic condition and 4 in 10 (40%) have two or more.

22

Supported by research

0:10:54Richard Horowitzsupportedhigh

The C6 ELISA test checks for three strains of Borrelia: Borrelia burgdorferi, Borrelia afzelii, and Borrelia garinii.

"The C6 ELISA checks for three strains: Borrelia burgdorferi, afzelii, garinii from Europe." (said at 0:10:54)

The C6 ELISA utilizes a synthetic 26-mer peptide corresponding to invariable region 6 (IR6) of the VlsE surface lipoprotein. This region is highly conserved across the three main pathogenic genospecies of the Borrelia burgdorferi sensu lato complex responsible for Lyme disease in North America and Europe: Borrelia burgdorferi sensu stricto, Borrelia afzelii, and Borrelia garinii. Consequently, the C6 ELISA detects antibody responses induced by all three species.

0:13:26Mark Hyman (host)supportedhigh

Urolithin A is a postbiotic that supports mitophagy to renew cellular mitochondria.

"Mitopure contains urolithin A, a clinically studied postbiotic that supports mitophagy, which is your body's natural process for renewing mitochondria." (said at 0:13:26)

Urolithin A is a postbiotic compound produced by gut microbiota from dietary ellagitannins and ellagic acid. Multiple randomized controlled trials and preclinical studies have demonstrated that oral urolithin A (including the proprietary formulation Mitopure) activates mitophagy—the selective autophagy pathway that clears damaged mitochondria and facilitates mitochondrial renewal—and modulates biomarkers of mitochondrial health and muscle function in humans.

0:24:10Richard Horowitzsupportedvery low

Richard Horowitz published the first article in world medical literature on glutathione's efficacy in COVID-19 in April 2020.

"I wrote the first article in the world literature in COVID-19 in April 2020 on glutathione and how it helps with COVID." (said at 0:24:10)

Richard I. Horowitz and colleagues published a two-patient case report titled 'Efficacy of glutathione therapy in relieving dyspnea associated with COVID-19 pneumonia: A report of 2 cases' in Respiratory Medicine Case Reports in April 2020. This was the first published article in the medical literature evaluating clinical treatment with oral and intravenous glutathione in patients with COVID-19 pneumonia. However, because this publication is an uncontrolled case report of only two patients, it provides very low certainty clinical evidence regarding the true therapeutic efficacy of glutathione in COVID-19.

0:24:39Richard Horowitzsupportedmoderate

N-acetylcysteine (NAC) inhibits von Willebrand factor to prevent microclots.

"And I also didn't know that NAC was blocking von Willebrand factor, so they weren't getting microclots and dying from it." (said at 0:24:39)

Preclinical and translational studies demonstrate that N-acetylcysteine (NAC) cleaves disulfide bonds in ultra-large von Willebrand factor (VWF) multimers, thereby reducing multimer size, disrupting VWF-mediated platelet aggregation, and inhibiting or dissolving microvascular thrombi.

0:26:32Richard Horowitzsupportedmoderate

Sleep deprivation increases levels of the inflammatory cytokine interleukin-6 (IL-6).

"when you don't sleep, IL-6, interleukin-6, is high, it's driving inflammation." (said at 0:26:32)

Published meta-analyses support the claim that sleep loss and sleep disturbances are associated with elevated levels of the pro-inflammatory cytokine interleukin-6 (IL-6). In observational studies, sleep disturbance is significantly associated with higher systemic IL-6 levels. In experimental human trials, sustained partial sleep deprivation (e.g., restriction to approximately 4.5 hours per night for three or more consecutive nights) significantly increases circulating IL-6, although a single acute night of total or partial deprivation may not produce a significant change.

0:28:03Mark Hyman (host)supportedvery low

A case report of two multiple sclerosis patients treated with ibogaine documented a 70% reduction in brain white matter lesions.

"In one study, they they looked at MS and they looked at the white matter lesions, which was inflammation in the brain before and after ibogaine and their and their symptom profile. And they were there were only two cases in the report, but they both had like a 70% reduction in white matter lesions" (said at 0:28:03)

A 2025 case report (PMID 39981248) described two multiple sclerosis patients treated with ibogaine, documenting marked lesion shrinkage, decreased apparent diffusion coefficient (ADC) values indicative of reduced inflammation and remyelination, and clinical symptom improvements. Because this evidence comes from an uncontrolled two-patient case report, it represents very low certainty evidence that cannot establish causal efficacy, safety, or generalizability.

0:29:34Richard Horowitzsupportedmoderate

The NIH stated that 42% of individuals over age 55 will develop dementia.

"We're in the middle of an Alzheimer's epidemic where the NIH said that 42% of people over 55 years old are now going to become demented." (said at 0:29:34)

A 2025 prospective cohort study of 15,043 individuals published in Nature Medicine (funded by the NIH) evaluated lifetime dementia risk from age 55 to 95 years while accounting for mortality as a competing risk. The authors found that the lifetime risk of developing dementia after age 55 was 42% (95% CI: 41–43%), closely matching the claim.

0:24:38Richard Horowitzsupportedvery low

SARS-CoV-2 viral replication requires a reduction in cellular glutathione levels.

"I didn't know at the time that the virus needs to lower glutathione to replicate." (said at 0:24:38)

In vitro mechanistic studies indicate that SARS-CoV-2 infection promotes a pro-oxidant intracellular environment by depleting reduced glutathione (GSH), which facilitates viral replication. In cell culture models (such as Vero E6, Calu-3, and A549 cells), viral infection markedly reduces cellular GSH, while restoring intracellular glutathione balance or administering thiol donors significantly suppresses viral replication and inflammation. Furthermore, molecular studies demonstrate that glutathionylation of the SARS-CoV-2 main protease (Mpro) inhibits its dimerization and enzymatic activity, showing that higher glutathione levels directly impair replication mechanisms. However, because this evidence is derived exclusively from in vitro and molecular models, the clinical certainty is very low.

0:12:28Richard Horowitzsupportedhigh

Gliotoxins produced by mold have immunosuppressive properties.

"and they get mold toxins with gliotoxins on top of it, which are immunosuppressive." (said at 0:12:28)

Gliotoxin, a sulfur-containing epipolythiodioxopiperazine (ETP) secondary metabolite produced by fungal species such as Aspergillus fumigatus and Trichoderma, is well-established in the toxicological and microbiological literature as a potent immunosuppressive agent. It impairs host immunity through multiple mechanisms, including inhibition of NF-κB signaling, inhibition of macrophage activation and phagocytosis, generation of reactive oxygen species, and induction of apoptosis in host immune cells.

0:30:05Richard Horowitzsupportedlow

Autopsy studies of Alzheimer's patients reveal biofilms, amyloid, and phosphorylated tau in the brain.

"they looked at autopsy studies of Alzheimer's patients and they would find biofilms, amyloid, and phosphorylated tau in the brains." (said at 0:30:05)

Autopsy studies evaluating the microbial hypothesis of Alzheimer's disease have reported finding bacterial biofilm markers co-localizing with classic neuropathological hallmarks, including amyloid-beta and phosphorylated tau (p-Tau). For example, post-mortem immunohistochemical analysis of Alzheimer's disease brain tissue identified Borrelia burgdorferi aggregates positive for the biofilm marker alginate co-localized with amyloid and phospho-tau markers. Amyloid-beta and hyperphosphorylated tau are standard pathological hallmarks of Alzheimer's disease, while evidence for bacterial biofilms in AD brain tissue comes from preliminary, small-sample autopsy studies.

  • supports: Borrelia burgdorferi Co-Localizing with Amyloid Markers in Alzheimer's Disease Brain Tissu… (Journal of Alzheimer's disease : JAD 2022) · cited 37x in the literature
    "Positive Borrelia structures were evaluated for co-localization with biofilm and AD markers such as amyloid and phospho-tau (p-Tau) using immunohistochemical methods. The results showed the presence of B. burgdorferi antigen and DNA in patients with AD pathology and among those, one of them was previously diagnosed with Lyme disease. Interestingly, a significant number of Borrelia-positive aggregates with a known biofilm marker, alginate, were found along with the spirochetal structures. Our immunohistochemical data also showed that Borrelia-positive aggregates co-localized with amyloid and phospho-tau markers." (abstract, methods and results, passage verified)
    pubmedfull study (doi)
0:33:06Richard Horowitzsupportedlow

Johns Hopkins researchers discovered that Lyme disease bacteria form biofilm persisters similar to tuberculosis and leprosy.

"about 10 years ago, Johns Hopkins researchers found out that Lyme was a specific type of a bacteria called a biofilm persister bacteria, like tuberculosis and leprosy." (said at 0:33:06)

Starting around 2014-2015, researchers at Johns Hopkins Bloomberg School of Public Health (led by Dr. Ying Zhang, who previously studied persister mechanisms in Mycobacterium tuberculosis) published a series of studies showing that Borrelia burgdorferi in stationary phase forms antibiotic-tolerant persister cells and biofilm-like microcolonies in vitro and in animal models. The researchers screened drug libraries to identify agents active against these dormant forms, drawing direct parallels to persistent infection paradigms such as tuberculosis. While persister and biofilm formation represents a phenotypic state rather than a separate taxonomic class of bacteria, and the clinical significance of these forms in human Post-Treatment Lyme Disease Syndrome (PTLDS) remains an active area of investigation based largely on preclinical evidence, the attribution to Johns Hopkins researchers and the timing accurately reflect the published literature.

0:34:07Richard Horowitzsupportedlow

Dapsone penetrates the brain and inhibits NLRP3 inflammasomes.

"I looked at dapsone, and it was, all right, it gets great penetration into the brain... number two, it blocks NLRP3 inflammasomes in the brain." (said at 0:34:07)

Published literature confirms both components of the claim. Pharmacokinetic studies in humans demonstrate that dapsone crosses the blood-brain barrier and penetrates into cerebrospinal fluid (CSF). Preclinical mechanistic and animal studies show that dapsone acts as an inflammasome competitor and inhibits NLRP3 inflammasome activation and downstream neuroinflammatory signaling (such as IL-1β and IL-18) in the brain.

0:36:55Richard Horowitzsupportedmoderate

According to BMJ Global Health, one in seven people worldwide has been exposed to Lyme disease.

"where BMJ Global Health said one out of seven people in the world have now been exposed to Lyme, right?" (said at 0:36:55)

A 2022 systematic review and meta-analysis published in BMJ Global Health (Dong et al., pooling 89 studies comprising 158,287 participants) estimated the global seroprevalence of Borrelia burgdorferi sensu lato at 14.5% (95% CI 12.8% to 16.3%), which corresponds to approximately one in seven individuals having serological evidence of exposure.

0:39:14Richard Horowitzsupportedlow

Hydroxychloroquine (Plaquenil) alkalizes the intracellular compartment, enhances antibiotic efficacy, and targets cystic forms of Borrelia burgdorferi.

"And the reason for Plaquenil, by the way, is it alkalizes the intracellular compartment so these antibiotics are more effective, helps with the autoimmune manifestations, um even hits the cystic forms of Lyme" (said at 0:39:14)

The speaker's claims accurately reflect published hypotheses and in vitro findings, though evidence is limited primarily to in vitro models and observational clinical data. Hydroxychloroquine is a weak base (lysosomotropic agent) that concentrates in acidic intracellular compartments (such as endosomes and lysosomes) and elevates their pH toward neutrality. Studies evaluating Lyme disease therapy (e.g., Donta, 2003) noted that macrolide antibiotics lose efficacy at acidic pH, and adding hydroxychloroquine alkalinizes these compartments to enhance antibiotic effectiveness. Additionally, an in vitro study by Brorson et al. (2002) demonstrated that hydroxychloroquine has direct bactericidal activity against cystic forms of Borrelia burgdorferi and disrupts/ruptures cystic structures. However, certainty is low because clinical evidence supporting this regimen comes primarily from uncontrolled observational cohorts and in vitro experiments rather than rigorous randomized controlled trials.

0:40:15Richard Horowitzsupportedvery low

A Johns Hopkins study showed that a 6-day combination of rifampin, azithromycin, and methylene blue eradicated Bartonella in cell culture.

"Johns Hopkins again, they published that if you do for 6 days in culture rifampin, Zithromax, and methylene blue, it kills Bart." (said at 0:40:15)

A 2020 in vitro study by researchers at the Johns Hopkins Bloomberg School of Public Health (Zheng et al., BMC Microbiology) evaluated drug combinations against stationary phase and biofilm-forming Bartonella henselae. The researchers found that methylene blue and rifampin were the most active single agents and that two-drug combinations containing azithromycin, rifampin, and methylene blue (such as azithromycin/methylene blue and rifampin/methylene blue) completely eradicated biofilm B. henselae after 6 days of exposure in culture. Because these findings are strictly in vitro, clinical efficacy in humans remains unestablished.

0:49:23Richard Horowitzsupportedmoderate

One-third of the global population has non-alcoholic steatohepatitis or fatty liver disease.

"One-third of the world's population has non-alcoholic steatohepatitis or fatty liver." (said at 0:49:23)

Large systematic reviews and meta-analyses estimate that approximately one-third of the global adult population has non-alcoholic fatty liver disease (NAFLD, now often termed metabolic dysfunction-associated steatotic liver disease or MASLD). A 2022 meta-analysis across 72 studies comprising over 1 million individuals found a worldwide pooled prevalence of 32.4% (95% CI: 29.9%–34.9%), with more recent estimates ranging from 30% to 38%.

0:56:26Mark Hyman (host)supportedmoderate

Approximately 50% of buildings in the United States have water damage.

"and then there's 50% of buildings are water-damaged." (said at 0:56:26)

Large-scale assessments and public health syntheses of indoor environmental quality in the United States (including analyses by the EPA and Lawrence Berkeley National Laboratory) estimate that approximately 47% to 50% of residential buildings have signs of dampness, moisture problems, or water damage.

0:35:39Richard Horowitzsupportedvery low

A culture study conducted with Eva Sapi demonstrated that combining dapsone with doxycycline, rifampin, and azithromycin progressively reduced Borrelia biofilm persister cells.

"So, we found, and I did a study with Eva Sapi from the University of New Haven in culture... every time we added a drug, like when we added doxycycline to dapsone, it lowered the biofilm persisters; we added rifampin to doxy and dapsone, it lowered the biofilm even more. We added Zithromax." (said at 0:35:39)

A 2020 in vitro study co-authored by Richard Horowitz and Eva Sapi evaluated dapsone alone and in combination with doxycycline, rifampin, and azithromycin against Borrelia burgdorferi biofilm forms. The culture study showed that combining dapsone with these intracellular antibiotics significantly decreased biofilm mass, viability, and protective glycosaminoglycan content compared to monotherapies. Because these findings are derived exclusively from in vitro cell culture models, certainty regarding clinical translation to human Lyme disease remains very low.

0:54:56Richard Horowitzsupportedlow

The Horowitz Multiple Systemic Infectious Disease Syndrome (MSIDS) questionnaire was validated in a study of 1,600 people.

"And the Horowitz MSIDS questionnaire, which is on my website, cangetbetter.com, if you take this questionnaire, it will give you a probability of tick-borne, but also you bring it to your doctor. There's 38 items on there... The beauty of the questionnaire is we validated it in 1,600 people." (said at 0:54:56)

A 2017 validation study by Horowitz and Freeman published in the International Journal of General Medicine evaluated the construct, convergent, and discriminant validity of the Horowitz Multiple Systemic Infectious Disease Syndrome Questionnaire (HMQ). The publication reported empirical evaluation across cohorts totaling over 1,500–1,600 participants (including Study 1 with 537 patients and Study 2 with 999 participants, alongside a third comparison cohort), finding acceptable internal reliability and ability to distinguish self-reported or confirmed Lyme disease patients from healthy controls.

  • supports: Empirical validation of the Horowitz Multiple Systemic Infectious Disease Syndrome Questio… (International journal of general medicine 2017) · cited 38x in the literature
    "Three studies evaluated such a screening tool, namely the Horowitz Multiple Systemic Infectious Disease Syndrome (MSIDS) Questionnaire. The purpose was to see if the questionnaire could accurately distinguish between Lyme patients and healthy individuals. Study 1 examined the construct validity of the scale examining its factor structure and reliability of the questionnaire among 537 individuals being treated for Lyme disease. Study 2 involved an online sample of 999 participants, who self-identified as either healthy (N=217) or suffering from Lyme now (N=782) who completed the Horowitz MSIDS Questionnaire (HMQ) along with an outdoor activity survey." (abstract, methods, passage verified)
    pubmedfull study (doi)
1:02:14Richard Horowitzsupportedmoderate

Elevated VEGF levels occur in Long COVID, Bartonella infections, and cancer.

"VEGF we see with Long COVID, but we see it with Bartonella, you'll see with cancer." (said at 1:02:14)

Elevated vascular endothelial growth factor (VEGF/VEGFA) levels and signaling have been documented in Long COVID cohorts, Bartonella infections, and malignant cancers. Proteomic analyses of patients with post-acute sequelae of COVID-19 (Long COVID) demonstrate significant upregulation of circulating VEGFA compared to recovered controls. In Bartonella species infections (such as B. henselae and B. quintana), the bacteria stimulate host cells to secrete VEGF and express factors that activate the VEGF pathway, driving characteristic vasoproliferative lesions (such as bacillary angiomatosis). In oncology, tumor-derived VEGF overexpression is a well-established hallmark that mediates tumor angiogenesis.

1:09:06Richard Horowitzsupportedmoderate

Chronic disease accounts for 86 percent of healthcare costs in the United States.

"86% of our health care costs, and 70% is chronic disease." (said at 1:09:06)

The claim is supported by national health surveillance and expenditure data. According to analysis published by the Centers for Disease Control and Prevention (CDC), chronic health conditions account for 86% of total healthcare spending in the United States, alongside being the leading causes of death and disability.

1:16:23Richard Horowitzsupportedmoderate

Dietary consumption of xylitol has been linked to an increased risk of strokes and cardiovascular events.

"People, you know, don't realize like if you have cardiovascular risks and you're taking xylitol in your diet, which has now been linked, right, to strokes, right, that and now you have heat stress that you are more at risk for certain strokes than you might have been from the past." (said at 1:16:23)

A 2024 study published in the European Heart Journal (Witkowski et al.) found that elevated circulating levels of xylitol were significantly associated with an increased 3-year risk of incident major adverse cardiovascular events (MACE, which includes myocardial infarction and stroke) in an independent validation cohort of 2,149 patients (adjusted HR 1.57, 95% CI 1.12–2.21). Complementary mechanistic and interventional human studies demonstrated that dietary consumption of xylitol raised plasma levels, heightened platelet reactivity, and enhanced thrombosis potential.

  • supports: Xylitol is prothrombotic and associated with cardiovascular risk. (European heart journal 2024) · cited 61x in the literature
    "In initial untargeted metabolomics studies (discovery cohort), circulating levels of a polyol tentatively assigned as xylitol were associated with incident (3-year) major adverse cardiovascular event (MACE) risk. Subsequent stable isotope dilution LC-MS/MS analyses (validation cohort) specific for xylitol (and not its structural isomers) confirmed its association with incident MACE risk [third vs. first tertile adjusted hazard ratio (95% confidence interval), 1.57 (1.12-2.21), P < .01]. Complementary mechanistic studies showed xylitol-enhanced multiple indices of platelet reactivity and in vivo thrombosis formation at levels observed in fasting plasma." (abstract, results, passage verified)
    pubmedfull study (doi)
17

No source found (not proven false)

0:08:31Richard Horowitzunverifiedvery low

There are 18 to 19 different subspecies of Bartonella.

"Now, there are 18 to 19 different subspecies of Bartonella." (said at 0:08:31)

No published record matching the claim that there are 18 to 19 different subspecies of Bartonella was located; this does not prove the claim false.

0:10:54Richard Horowitzunverifiedvery low

Hard tick relapsing fever Borrelia, such as Borrelia miyamotoi, is found in 25% of chronically ill Lyme-like patients.

"there's a relapsing fever Borrelia. It's like a cousin of Lyme disease. It's also showing up in 25% of these patients." (said at 0:10:54)

No published record matching the claim that hard tick relapsing fever Borrelia (such as Borrelia miyamotoi) is found in 25% of chronically ill Lyme-like patients was located; this does not prove the claim false. Published seroprevalence surveys in cohorts with chronic, complex, or Lyme-like illnesses report variable and distinct seropositivity rates (for example, approximately 10% standard Borrelia seropositivity in Canadian chronic illness cohorts), but do not corroborate a 25% detection rate for relapsing fever Borrelia species.

0:11:39Richard Horowitzunverifiedvery low

Lyme and Bartonella destroy bone marrow B cells, resulting in common variable immune deficiency in 20% of patients and IgG subclass deficiency in 85%.

"you get Lyme and Bartonella, which causes immune deficiency. So it destroys your B cells from the bone marrow that make antibodies. 20% of my patients come in with common variable immune deficiency, 85% subclass deficiency." (said at 0:11:39)

No published record matching the claim that Lyme disease and Bartonella infection destroy bone marrow B cells to cause common variable immunodeficiency in 20% of patients or IgG subclass deficiency in 85% of patients was located; this does not prove the claim false.

0:13:26Mark Hyman (host)unverifiedvery low

Mitochondria are responsible for producing approximately 90% of the energy in the human body.

"Now, mitochondria are responsible for producing about 90% of the energy in your body." (said at 0:13:26)

No published record matching the claim that mitochondria are responsible for producing approximately 90% of the energy in the human body was located; this does not prove the claim false.

0:23:18Richard Horowitzunverifiedvery low

Up to 20% of chronically ill patients are deficient in intracellular red blood cell zinc, copper, and magnesium.

"When we look intracellularly at the red blood cell zinc, the red blood cell copper, the red blood cell magnesium, we're finding up to 20% of our patients are deficient, which means you cannot detoxify properly and deal with inflammation." (said at 0:23:18)

No published record matching the claim that up to 20% of chronically ill patients are deficient in intracellular red blood cell zinc, copper, and magnesium was located; this does not prove the claim false.

0:25:15Mark Hyman (host)unverifiedvery low

Testing data from Function Health shows that 70% of individuals are deficient in one or more nutrients based on standard lab reference ranges.

"with Function Health, a company I co-founded, now we have over half a million members, we've done over 100 million lab tests. 70% of people are deficient in one or more nutrient, not at the level you or I would think would be okay, but at the level the lab reference range thinks is okay" (said at 0:25:15)

No published record matching the claimed testing data from Function Health showing that 70% of individuals are deficient in one or more nutrients based on standard laboratory reference ranges was located; this does not prove the claim false. The cited figure appears to reflect unpublished internal customer data from a commercial testing company rather than peer-reviewed epidemiological research.

0:28:33Richard Horowitzunverifiedvery low

A published paper in Journal of Alzheimer's Disease Reports demonstrated complete reversal of the Alzheimer's biomarker p-tau217 following dapsone combination therapy.

"I recently published an article in the Journal of Alzheimer's Disease Reports... I reversed for the first time ever in the world the most sensitive and specific biomarker for Alzheimer's, p-tau217... when we treated the Lyme disease with the 9 weeks of dapsone combination therapy... completely reversed p-tau217." (said at 0:28:33)

No published record matching the claim of complete reversal of the p-tau217 biomarker following dapsone combination therapy in the Journal of Alzheimer's Disease Reports was located; this does not prove the claim false.

0:08:55Richard Horowitzunverifiedvery low

Bartonella infection induces vascular endothelial growth factor (VEGF) elevation in long COVID patients.

"And a lot of these long COVID patients who come in with VEGF, with vascular endothelial growth factor, it's not from spike proteins that are actually inflaming the endovascular area, it's basically Bartonella." (said at 0:08:55)

No published record matching the claim that Bartonella infection is the primary cause of vascular endothelial growth factor (VEGF) elevation in long COVID patients was located; this does not prove the claim false. Published literature demonstrates that Bartonella species produce factors (such as the autotransporter BafA) that activate VEGF receptors and stimulate angiogenesis (e.g., PMID 32678094), and elevated VEGF-A expression has been documented in cohorts of patients with long COVID (e.g., PMID 41074076). Additionally, isolated case reports note that Bartonella infections can clinically mimic or coincide with long COVID symptoms (PMID 38472519). However, no clinical or epidemiological study has demonstrated that elevated VEGF in long COVID cohorts is attributable to underlying Bartonella infection.

0:34:55Richard Horowitzunverifiedvery low

In a 2016 published study of 100 patients on low-dose dapsone, fatigue, joint pain, neuropathy, and brain fog showed statistically significant improvement, while headaches did not.

"I published my first article 2016 on 100 patients on low-dose dapsone. Fatigue got better, joint pain got better, neuropathy got better, brain fog; headaches was the only thing statistically that didn't improve." (said at 0:34:55)

No published record matching a 2016 study of 100 patients evaluating low-dose dapsone combination therapy for chronic Lyme disease symptoms was located; this does not prove the claim false. Subsequent retrospective observational analyses by the author evaluated cohorts of 200 patients receiving dapsone combination therapy, reporting improvements across several chronic symptom categories.

0:39:35Richard Horowitzunverifiedvery low

A study published by Tufts University showed that a combination of rifampin and dapsone cures Lyme disease in an animal model.

"Tufts, by the way, published one that showed that this combination rifampin/dapsone cures Lyme in the animal model." (said at 0:39:35)

No published record matching the claim that a study from Tufts University demonstrated a combination of rifampin and dapsone cures Lyme disease in an animal model was located; this does not prove the claim false. Published studies on dapsone combinations for Borrelia burgdorferi infection include in vitro evaluation of antibiotic combinations against stationary-phase or biofilm forms (such as PMIDs 32993780 and 28327498) and human case reports, but no study from Tufts University demonstrating cure in an animal model was identified in the published literature.

0:41:55Richard Horowitzunverifiedvery low

Exogenous testosterone injections cause testicular atrophy of approximately 15% and suppress endogenous hormone production.

"These testosterone shots are shrinking your testicles by 15%, and they're stopping your own hormone production." (said at 0:41:55)

No published record matching the claim that testosterone shots shrink testicles by approximately 15% while halting endogenous hormone production was located in the retrieved records; this does not prove the claim false.

0:30:35Richard Horowitzunverifiedvery low

A 9-week dapsone combination protocol reduced phosphorylated tau (p-tau217) levels by 63% in a patient.

"I lowered it by 63% in 9 weeks. And that was because it was the infection driving the amyloid and the phosphorylated tau." (said at 0:30:35)

No published record matching the claim that a 9-week dapsone combination protocol reduced phosphorylated tau (p-tau217) levels by 63% in a patient was located; this does not prove the claim false. While published clinical studies and case series on dapsone combination protocols in chronic Lyme disease and post-treatment Lyme disease syndrome exist (e.g., PMID 38792737, PMID 37764145, PMID 35884166, PMID 33105645), none of these published reports document or report data on p-tau217 reductions or tau biomarker changes associated with dapsone therapy.

1:01:19Richard Horowitzunverifiedvery low

Mycotoxins act as mitochondrial poisons, impair the immune system, and cause fatigue, brain fog, pain, and neuropathy.

"And the problem is that they're mitochondrial poisons and they're affecting your immune system and they cause fatigue, brain fog, pain, neuropathy." (said at 1:01:19)

No published record matching the claim that mycotoxins act as mitochondrial poisons, impair the immune system, and directly cause fatigue, brain fog, pain, and neuropathy in humans was located; this does not prove the claim false.

1:13:22Richard Horowitzunverifiedvery low

A case report published in the Journal of Alzheimer's Disease Reports in April 2024 showed that an oral antibiotic regimen normalized the p-tau 217 biomarker by 63% in nine weeks.

"It's in the Journal of Alzheimer's Disease Reports, April 2024. So anyone can read it. But what astonished me is this p-tau 217, which most neurologists consider to be the most sensitive and specific biomarker, I reversed it completely to normal by 63% in nine weeks with an oral antibiotic regimen." (said at 1:13:22)

No published record matching the reported April 2024 case report in the Journal of Alzheimer's Disease Reports describing a 63% normalization of the p-tau 217 biomarker in nine weeks following an oral antibiotic regimen was located; this does not prove the claim false.

1:13:40Richard Horowitzunverifiedvery low

In a study of 375 patients, dapsone combination therapy statistically improved patients' memory as its primary effect.

"But here's the beauty is dapsone combination therapy, the number one effect it always had was improving people's memory statistically in these 375 patients." (said at 1:13:40)

No published record matching a study of 375 patients evaluating dapsone combination therapy with statistically improved memory as its primary effect was located; this does not prove the claim false. Published retrospective chart reviews and observational cohorts on dapsone combination therapy in chronic Lyme disease/post-treatment Lyme disease syndrome report cohorts of 200 patients (evaluating eight general symptom categories without isolating memory as a primary endpoint), 40 patients, and 25 patients, rather than 375 patients.

1:08:25Mark Hyman (host)unverifiedvery low

The Center for Medicare & Medicaid Innovation established a 100 million dollar grant to study functional and lifestyle medicine for chronic illness.

"there's a grant that was established through the HHS innovation department, Medicare, Center for Medicare & Medicaid Innovation, for $100 million to study functional and lifestyle medicine for chronic illness." (said at 1:08:25)

No published record matching the claim that the Center for Medicare & Medicaid Innovation established a $100 million grant specifically to study functional and lifestyle medicine for chronic illness was located; this does not prove the claim false.

1:03:40Richard Horowitzunverifiedvery low

Approximately 25 percent of mycotoxins detected in human testing originate from dietary food sources.

"There are food mycotoxins, about 25% are probably coming from foods also." (said at 1:03:40)

No published record matching the claim that approximately 25 percent of mycotoxins detected in human testing originate from dietary food sources was located; this does not prove the claim false. In toxicology and public health biomonitoring, diet (e.g., consumption of contaminated grains, nuts, spices, and cereals) is widely recognized as the predominant route of human exposure to regulated mycotoxins such as deoxynivalenol, ochratoxin A, and aflatoxins, but no validated scientific ratio establishes a fixed 25% dietary contribution versus other routes.

Unverified means no publication matching the claim was located; it does not prove the claim false. Spotted an error? See the corrections policy - disputes from the people quoted are prioritized.