Again, let us briefly review how this system works. Fibroblasts make collagen. They do not make collagen unless they are told to do so. The ‘telling’ consists of a group of chemicals called ‘growth factors’(40 some-odd chemicals that act in concert, and which are housed in White Blood Cells (WBS’s) and in platelets). So, anything that impairs WBC function, or ‘distracts’ the WBC’s can effect this maintenance healing. Four things exert a powerful enough effect on WBC function to significantly effect healing in our patient population: a.) chronic infections—Hep B, C, D; Lyme disease; various other systemic viral infections; systemic candidiasis; and chronic bacterial infections. b.) significant food allergies/leaky gut syndrome. c.) Frequent use of NSAID’s (Advil, Aleve, Mobic, Celebrex, etc.) and corticosteroid medications (including those used to TREAT these painful problems, as well as post-transplant immunosuppression, treatment of auto-immune skin diseases, GI tract diseases, etc.). d.) Chemotherapy for malignancy. This effect generally wanes over time following cessation of treatment, but on occasion long term healing impairment effects are noted.