Immune & Chronic Inflammatory Health

If you’ve been told your labs are “normal” but you still don’t feel right, fatigue that won’t lift, inflammation that won’t quiet down, or a complex chronic illness that’s outlasted every treatment plan so far, this is the kind of work I do. We don’t start by chasing a diagnosis so it can be matched to a drug. We start by asking what your immune system and your cells are actually doing right now, and we follow that thread wherever it leads.

We Search at the Molecular Level. Not for a Label

Most medical workups are built to find a diagnosis: a name for what’s wrong, matched to a standard treatment. That works well for straightforward cases. It works far less well for complex chronic illness, pattern-resistant disease where the diagnosis itself can be incomplete, or where two patients with the same label need completely different care. Our approach starts with what your immune system and cells are actually doing, not with which box your symptoms fit into.

The Kinds of Complex Chronic Illness I See

A lot of what comes through this clinic falls into a handful of patterns of complex chronic illness: long-haul post-viral illness and long COVID that never fully resolved; chronic inflammatory responses that don’t match a textbook picture; complex pathogen-driven illness like Lyme disease and other tick-borne infections; autoimmune conditions that have been difficult to manage or even classify; POTS (Postural Orthostatic Tachycardia Syndrome) and other forms of dysautonomia, where your nervous system can’t properly regulate heart rate and blood pressure when you stand up; CIRS (Chronic Inflammatory Response Syndrome), often tied to mold or biotoxin exposure in a water-damaged building, where the immune system gets stuck fighting a threat long after the exposure ends; and cases where mitochondrial function (the cellular machinery that actually produces your energy) has broken down enough that fatigue becomes the dominant symptom, no matter what else is going on. If you’ve been told everything “looks normal” and you still don’t feel like yourself, this is often where the real answer is hiding.

Practitioner reviewing a complex chronic illness patient's health history during an initial assessment

Mast Cell Activation & Mastocytosis

This is one of the patterns I’ve learned to watch for specifically, because it hides so well behind other diagnoses. Mast cells are immune cells stationed throughout your skin, gut, and airways, acting like a built-in alarm system: when they sense a threat, they release histamine and a cascade of other inflammatory mediators to respond to it. In Mast Cell Activation Syndrome (MCAS), those cells fire too often and too easily, without a clear trigger, sending that alarm cascade through the body in response to things that shouldn’t set it off: certain foods, temperature changes, stress, exercise, even strong smells. Mastocytosis is a related but distinct condition where the body actually produces too many mast cells in the first place, so there are simply more alarms installed than there should be.

Both conditions tend to produce a scattered, hard-to-pin-down symptom picture (flushing, hives or itching, GI upset, rapid heart rate, brain fog, headaches) that gets worked up one specialist and one organ system at a time, often for years, before anyone connects the pattern. If that sounds familiar, it’s not an unusual story in this clinic.

Confirming it means testing the right markers at the right time: tryptase, and depending on the clinical picture, urinary mediators like N-methylhistamine or prostaglandin D2, and reading them in the context of your actual symptoms, not in isolation. From there, treatment ranges from mast cell stabilization and targeted antihistamine strategies to identifying and reducing the specific triggers driving your flares.

Psychoneuroimmunology: Reprogramming the Mind-Immune Connection

This is becoming a core part of my practice, and it’s a shift a lot of medicine still hasn’t caught up to. Psychoneuroimmunology (the study of how your brain, nervous system, and immune system talk to each other) isn’t a fringe idea anymore. It’s a well-established field, and it says your psychological history isn’t separate from your physical immune function. It’s a direct input into it.

Adverse Childhood Experiences, or ACEs (abuse, neglect, household instability, or chronic fear experienced before age 18), are one of the clearest examples. Large population studies, starting with the original CDC-Kaiser ACE Study, found that people with higher ACE scores have significantly higher rates of autoimmune disease and chronic systemic inflammation decades later, as adults. Childhood adversity doesn’t just leave a psychological mark. It leaves a measurable immune one.

Here’s the mechanism in plain terms: early, prolonged stress reprograms the HPA axis, the signaling chain between your brain and your adrenal glands that’s supposed to turn your stress response on and back off again. In someone with significant early adversity, that axis can get stuck set too high, for too long. Your nervous system stays in a low-grade threat state, and your immune cells stay primed to inflame, long after the original threat is gone. Add in reduced vagal tone (the vagus nerve is your body’s main “calm down” signal to your organs and immune system), and you get a body that’s biologically bracing for a danger that ended years or decades ago.

I take this seriously as clinical data, not background color. A trauma or adversity history is as real a finding as a cytokine panel, and reprogramming that mind-immune paradigm, addressing nervous system regulation alongside the immune and cellular workup, is now a standard part of how I approach complex, chronic cases in this clinic.

How This Workup Is Different

Standard immune testing usually stops at antibody titers: a snapshot of whether your immune system has ever encountered a particular trigger. That tells you something happened. It doesn’t tell you what your immune system is doing right now. Cytokine profiling and immune cell activity testing go a layer deeper: cytokines are the signaling proteins your immune cells use to communicate with each other, and measuring their activity, along with how specific immune cell populations are behaving, gives a real-time picture instead of a historical one.

We run this kind of testing through LabCorp, Cyrex, Vibrant, and Diagnostic Solutions, among others, and we’re constantly evaluating new testing strategies as the science evolves. The goal isn’t loyalty to any one lab. It’s getting you an actual answer.

We also work with patients who want a natural-only approach and with patients who prefer a hybrid model that includes conventional treatment. Both are welcome here, the testing and reasoning stay the same either way.

What to Expect

New complex chronic illness cases get up to 90 minutes of face-to-face time. We go through your full history together: what’s been tried, what’s worked, what hasn’t, and just as importantly, what’s never actually been tested. Sometimes that’s enough on its own; a different perspective on familiar data turns up an answer that was there the whole time. Other cases take more: going back to the basics, building a new plan from scratch, and in some cases, questioning the original diagnosis itself. I don’t take that lightly, but I won’t leave it unexamined if the evidence doesn’t line up.