Healing Mold, CIRS, & Biotoxin Illness (Addressing Mold Controversies & Myths): Episode 6

Everybody, Dr. Jensky and I are having a great conversation answering questions about myths, about mold, myths about testing with Sears. Great conversation. Of note, there were some technical difficulties with the video, so you'll notice that Dr. Jensky's video won't kick into about five minutes. So hang tight. But it's a great conversation answering a lot of questions on some of the nuances, things that people don't quite understand. I go through, I call my mold myths. And the mold wars are the things that people have debated that we kind of talk about. So just to let y' all know, there's a little video glitch, but five minutes in, you'll see the videos kick in. So thanks a lot. Take care and hope you really enjoy this once. It's a great, great discussion. All right, welcome back, everybody. We are down to the last two episodes talking about chronic inflammatory response syndrome and mold related illness. We're gonna be going actually now into some of the more controversies behind this testing. How do you evaluate for mold? A bunch of things that are controversial that are out there on the Internet and social media. And so the first section we're talking about are the battlegrounds, the main battlegrounds, the mold wars is what I refer to them.

So.

And I'm sure we may even disagree on some of the things we might.

We'll see.

We'll see. We got to disagree on something, right? To make it, to make it fun, right. So the first question here is what are the main arguments? Before we go into it, sorry, make sure you put any questions below that you may have for us. We are, after this is done, going to be doing like a Q and A where we answer all the questions you've asked throughout this whole entire series relate to mold and biotoxin illness. So make sure you like, follow subscribe below, all those kind of fun things. That way when that episode pops up, you'll get notified. So you can watch it if you want to hear about the Q and A's or if you had a question to ask. So what are the main arguments for. Against using urine testing versus blood testing when you diagnose mold related illness? Chronic inflammatory response syndrome. So blood versus urine, blood versus urine.

So I can't really give an argument for urine. And I think that's the point of the question is that urine mycotoxin testing is not reliable. And the reason being is that it's not reflective of that person's environment per se. So in the setting of a sick building, it's not giving you information about that building. It might be giving you information about that person's diet and as we put in one of our posts, the moldy taco that they ate the day before or whatever consumption of moldy foods they may be having. But it presumes much. It presumes that they may or may not be able to detoxify these mycotoxins. Well, so it may under or over represent. It's not giving any insight into what's happening with their immune system from an innate immune response standpoint, inflammatory standpoint, it's just giving you some toxic numbers. And really it's missing the boat on the fact that this is a biotoxic journey and not a mold journey. It's not just about mycotoxins. There's bacterial toxins, there's VOCs, there's particulate matter, there's all these other things. So it's very monocular, it's misleading and it's not giving a ton of information with regards to the totality of what's going on with that person versus the reality of blood testing, which is really how the whole Shoemaker pyramid was built. So blood testing is clearly the more reliable of the two, solely based on the fact that all of the data is supported by blood testing. The reality being that when you're doing blood testing and you're checking peer reviewed biomarkers, you're seeing does this person have inflammation in that alternate complement pathway that we described through something like a C4A which is getting harder and harder to measure these days depending on the lab, or is there adaptive immune dysregulation on a TGF beta? Do they have hyperperfusion? Do they have evidence of leaky gut and tissue destruction? So you're seeing more of a clinical picture and you're allowing yourself to meet diagnostic criteria to say, yes, this person now has SIRS because they've met the screening criteria, they have a known exposure, they meet biomarker criteria and then it's response to therapy versus okay, collect your urine with some provocation, whether it be glutathione, whatever the soup du jour is, and oh, you got some ochratoxin A, oh you got some tricothacine, so you're a mold patient. Here, take this stuff. That's not really how it works. I mean, would you agree with that? Would you add or change to that?

I would. Well, I'd probably add, I don't disagree. A couple of additional things is the literature backed definition of it right now, according to the literature that's published with Dr. Shoemaker and Heyman. It's a three part diagnosis, right? Yeah, it's symptom cluster, which there's some people actually working on creating additional verified system clusters out there. Just fine. You look for the VCS secondary thing and then the labs. Okay. And that's actually the first, not the second part. Then there's the whole exposure, re exposure thing. When you're treating someone where, okay, someone's getting better, they get re exposed, they get re symptoms, you remove them. And that's more like the legal thing. If someone has a malpractice or legal.

Stuff, do they make case definition?

Exactly. And so I think the thing that is often forgotten is this world of seers. Chronic inflammatory response syndrome. It's getting bigger and bigger and bigger. And so I actually have, you know, emailed, reached out to Dr. Heyman a while ago asking because I'm seeing people with sibo we talked about before. Someone comes in with gut issues and they have little aches and pains, a little this nap. They're mainly gut issues. You diagnose their sibo, they can't get better and three months later they end up being a SIRS patient. You know how many of the endotoxins are being made in your gut? Because your gut makes is the biggest. Your gut makes more endotoxins than any environment you're going to be exposed to. I mean realistically speaking.

Yeah.

So all of a sudden are you looking at that? Is this person a vaccine induced Asia syndrome class slash seres? Are they a long covered person?

Are they chronic Lyme, Are they other tick borne illnesses?

And what I'm seeing is a lot of people who come in who get, let's say they get Covid, it reactivates their Lyme, Barton, Elesia, mono, Epstein Barr. Yeah. And then now they're, they're sick, they come, their series is positive. Then what was underneath all this was water damage building that they may have been exposed to 10 years ago. And that's the other thing, is that some of these exposures were a long time ago. And I think when you talk about the toxicity of a water damaged environment, the minority of that is mold and mold related. It's mainly actinomyces and endotoxins account for 80%. 80% of SERS is a water damage building. And 80% of that 80% is two things like 10 and endotoxins. So if you only look at mold, you're only, you're getting 16% of the totality of it or you're missing 84%. And so I think in some situations urine can be useful, but for chronic inflammatory response syndrome, which is a much bigger world than just mold. And then there's the issue of doing the provocation. How do you provocate someone like I've lived in, you know, had a, a house that had a Urmia 21. It hurts me too. Of about the same numbers, pretty high. And in the workplace, our previous place that had some issues in it and did my urine. My urine is fine.

Right.

Got a sodomy. So now did I have surgery? No. But I knew I was being exposed. Yeah.

But I did remember how sick I was.

Yeah.

And we did urine mycotoxin testing because this was way back then and it was like, I'm learning this and there's. I'm, I'm going to use all the things, right?

Yeah.

Especially because I was a pain in the ass. So it's like, just give this guy something to do. Right.

That was early on, before I fell in love with you, man. Yes.

So it was.

Did it.

Right. I'm not ashamed to say I did one of those tests. I mean, it's a big deal. Like these are well meaning practitioners that are offering these tests, but you can't really fully determine if someone's in SIRS A B. You shouldn't guide management based on that alone. But I did one and I was floridly in sers and mine was normal. And so how do you explain that? Well, my detox pathways were not open or I don't excrete or it wasn't mold in my case. So it goes way beyond that. It's way too monocular, it's way too limiting, it's way too misleading. And I think that people just need to understand that. We're not trying to say that people that are offering urine mycotoxin testing are doing anything wrong. But you need to expand out beyond that and understand that that is just a small piece of the puzzle and really not reliable and not in any of the research or peer reviewed literature that backs CSRs.

Because when someone comes in, they're sick and they're not getting better. And the C4A is like 12,000, their TGF beta is, you know, 8 or 10,000. And they have their ADH nosmolalities off regardless of everything else. You know, there's, you know, they fit three of the six of this.

Right.

The criteria. Yeah. And there's something at the bare minimum, something going with their innate immune system. And, and many of the practitioners and what I'VE noticed, like, this is just form kind of stuff who focus on your mycotoxin testing. Don't do Marcons.

Yeah.

Which blows my mind because there's so many of our patients I've seen who are stuck, and they. They know. And even early on, they've been crazy, been sick. And you just start treating the Marcons and they add the nasal, which is the nasal colonization that we talked about. Early, they start getting better.

Yeah.

So I feel like not only did.

It not skew markers, but then they treat their treat. So say you do urine mycotoxin testing, and it comes back positive. They're not getting the. The known binders either. They're not getting cholestyramine or wellcol or even mycobine. Some sort of natural version okra, beet extract. They get bentonite, clay, or activated charcoal. And what's that doing? It's probably gobbling up lipopolysaccharide in their guts. If they're feeling better, that's probably an indirect benefit and not necessarily mycotoxins. Or they're getting more glutathione to help flush it out, or they're getting itraconazole because it's being treated like it's a fungal infection or colonization. And it's just. It's.

It's.

It's a bit misleading is really the reality of it.

And these. Unfortunately, these patients, at least from the ones I see, I think we're getting them. They've usually seen four or five, six people already. Tend to be complicated. And it's typically not as simple as take a binder, treat the Marcons, and you get better. Yeah, it's usually. It's usually a process of working through nutritional issues. And there's usually some kind of trauma, anxiety, function.

Yeah. Big hormone imbalances. All that stuff.

They got mast cell going on. Stuff going on as well. And they probably got a little dysautonomian pots.

Yeah.

Maintenance, all the things. Yeah. So.

Yeah. All right, so next. So considering that mold isn't always the primary cause of sirs, what other factors in water damage, buildings contribute to the condition? So we kind of touched on that a little bit already, but. But again, I guess just to kind of reiterate and hammer that home like it's the bacterial component. Right.

Yeah. One thing I would actually add to that is when you look at the. When we did our terrain nicely, there's over 200 different glucomannans, particulates. And so there's a lot of stuff, particles in there that can be filtered out with a HEPA filter. Yeah. And so I think that's one of the things where something as basic as, you know, I'm not quite sure what's going on here, but this thing called a HEPA filter is going to remove 99.97% of the stuff in the air particulates. And over 99% of VOCs and toxins are actually attached to particles. So even though, yes, I know the HEPA filter doesn't necessarily move VOCs per se, because they attach to particles, you remove the vast majority of them. Like, something as basic as a HEPA filter is just. I feel like it's like a.

It's where HEPA filter wear.

Okay, great. Great question. In order to clean the air, you have to get laminar flow. And this is basic physics. And so laminar flow is a river. The river's moving. An air conditioner is conditioning there. It's just heating or cooling air to affect the ambient temperature, but it's not moving air. So it's like a. A spring pond. You get in the pond, water's not moving, but it's cold. It's freezing cold. Why? Because you got that really cold water coming in. So you need laminar flow, which means you need something in the room, moving the air in the room, which means usually a freestanding HEPA filter of some sort, putting some type of filtration HEPA filter. UV light on the air conditioner corals is important to prevent your air handler and conditioning system from being a source for mold. And no toxins, but it doesn't actually create filtered air in the rooms. And I think that's a misnomer a little bit as well that people focus on. I got my ducts cleaned and my.

I got my UV light, and it's only picking up what's passing through. And if you're not moving air, it's not all passing through the door.

We have in our doorways block laminar flow. So anytime you have a doorway, you need a filter on the next room. So that's where I. I don't know what your thoughts on this are, but I tend to focus on if you've got limited funds that everybody has 7, $800, a filter per room in their house to get like a HEPA with uv, with all the bells and whistles. I focus on just a good, you know, true, true, true HEPA filter.

Yeah.

Which you can buy for 120, $140 and then just have them in your Your bedroom, your kids bedrooms. And for us in our main living space, we have two in our main living space.

Yeah, same. We have, we have good HEPA filters in the H VAC system, and then we have air purifiers in the bedrooms. And then you want to get a HEPA vacuum. Right. So when you clean, that's the third component and it's an investment and it's not super expensive. So you have the ability to filter air, that which is being cooled or heated, and then you have the ability to create that laminar flow and filter it in each individual room or just the bedrooms, whatever you want to do. And then as cleaning and clearly drumming stuff up, you want to capture some of that as well. And that's where the hepa, a vacuum with a HEPA filter comes in as well.

So. And we probably will do a future thing on toxicity and toxins and things, but something I don't think we talked about. How do you clean your house? Because these people tend to also have chemical sensitivities. And one thing we've talked about briefly is how petroleum distillates, which are in many, many cleaning products, can bind to your membranes and your cells and actually be a trigger for some of this SERS stuff. What do you clean your house with?

Yeah, so that's the million dollar question. And the issue really, I'll tell you what I do and what's currently being done. But the issue is that the bacterial component with the actinomycetes being the main issue that we're seeing statistically, you had mentioned 80% of SIRS is water damaged building. And of that 80%, 80% is bacteria. The vast majority of that, almost 50%, is actinomycetes. And these are bacteria that are gram positive that move about the home and they originate in the soil or wherever they're coming from, and they can kind of move up into the main living room and they can cohabitate on your skin. And now you're kind of carrying them around. And it sounds like a horror movie, but the reality is that you need to be able to clean and then clean again and then clean again. And if someone's chemically sensitive, you can't just go nuclear. And right now, because the actino data is relatively newer, there's no standardization. And I know that Larry Schwartz and Shoemaker and Heyman and some others are working on some protocols and trying to figure out what the best solution to that problem is. But the way that we do it is purified water with white wine vinegar And a little bit of seventh generation dish soap to increase surfactant. So basically, you're making your own little potion of some dish soap, a little bit vinegar, some water, all diluted. You put it in spray bottles. You never want to dry dust because it's just moving stuff around wet, not saturate. And you're going from top down, ceilings, crown moldings, walls, and you're working your way down. And as it's accumulating dust, it goes into a Ziploc and it gets thrown out and you move on to the next thing, all the while with an air purifier running in that room, sometimes an air scrubber if you can rent them or borrow them. And then you go through and you hep a vacuum and then you move on to the next room. And that's how we do it. In my house, I've even used, in some cases, diluted vodka. I've even used diluted tea tree oil because we have plants. And so in the plant beds, you can spray diluted tea tree oil and not kill the plant, but can kill certain molds and bacteria. So you can spray that into the soil or on upholstery. There's a lot of different things out there naturally that aren't going to hurt you or anyone else in the home. But for me, the reality is it's something as basic as water, vinegar and a little bit of dish soap.

That's after all, use same thing. Yeah. And we have the we and we have people who just come clean our house from time to time. And we just say, here's our vacuum cleaner. Yeah, here's our cleaner. Please don't buy anything. Please don't bring your stuff from the other houses in our house. And it was actually in my mind, it's like, well, we're saving you cleaning stuff. We're saving you to show up and use our stuff. That was a little hard for me for them to get used to doing that. Yeah. But it's something I've battled with other places I've worked where it's like people come and overnight and they clean the workspace and they use fantastic or whatever stuff. And you come in the morning, you smell it, and you look in the toilet and this purple stuff in there, and you're like, oh, my gosh. So I provide to them, just like I try to provide for here as well. So people use our stuff, which is white vinegar, in our closet right there.

You can smell it. What else? How about the test? How about. I. I love this one. So how do environmental tests like the ERMI and the Hurts Me 2 help in assessing mold and biotoxin exposures in the homes. I mean, I would expand out, but just talk about the Swiffer testing and, and what that means, what it's testing, what we typically suggest to test, and the difference maybe between that and like conventional industry standard error testing or the plates or whatever people are doing that they think is beneficial.

I actually typically don't recommend patients do or may Hertz B2 testing, because what happens? You get the test and the question is, next, what? And the answer is, usually have a building biologist come out, look at your place. And because this testing will run you five to eight hundred dollars and the building biologist, at least in our area, is about 11 to $1200. For me, it's like, just have the person you have come out probably anyway, who can use a infrared gun, look at your walls, who can use a meter and check where there's moisture in your walls, who can look inside your air handlers. You know, typically that hurts me too, in urban testing at this stage of my career, I recommend to people when it's like trying to convince a spouse there's a problem going on, because what happens is you get the actinomyces and endotoxins and then the Ermi Herzp 2, which allows you like a Wollemia and what's in the duct and stachybotters and penicillin, Clarisporum and all that fun, those fun words. But ultimately it's like, okay, it's where is it? Like, you might be able to guess, you know, well, we got Walius is probably in the ductwork. And you know, if you have Stachybot or Catone, there's probably like stained water humidity somewhere. But besides that, it doesn't really help guide you. If you spend 800 bucks, you're already out of that money. So I tend to tell people, look, you just need to have someone come look at your house.

Do they? Do they do that? Because this might be our first point of contention, I see that logic and I agree with that logic. But most of my patients have a problem with that logic. When I say, hey, I think your house is the issue, get this person to come out and evaluate it. This is the person that we trust and we use an indoor environmental professional who's a PhD and does a phenomenal job. And ultimately I'm like, this is who you need to evaluate your home. And they're like, well, it's a new home or it's a newer home or my home's not a problem, or we've never had water damage or my husband won't pay that money for someone to evaluate the home or whatever the case may be. So I use the DNA PCR test, the Swiffer test, as a way of proving that, yeah, your home is the issue. And yeah, now you have to get that person to come out. Now I give them the option. I don't say do this and then that. I say, look, you can Swiffer it and we can see what it shows or you can have this person come out and some pick one or the other. Most actually do the Swiffer first for two reasons. One, they want some hard evidence that it truly is their home before they're going to pay somebody a lot of money to come out. Two, they feel better about the insight that they gain from whether it's a mold related issue or a bacterial issue or both based on what they see on the results. And the IEP that I use can culture both of those. So a DNA PCR test is over calling all the time. It's not going to miss anything, but it's going to over call. And so it's telling you the history of the house. So it doesn't mean that this is an issue right now, but it definitely means that once upon a time there was an issue or maybe this came in on your furniture or your clothing or whatever, but you're not going to miss anything. But it might unnecessarily scare people by how score high that score is. But then the IEP comes out and oh, your actino was high and your hertz me was high. I'm gonna go about and do my thing. And oh, by the way, I can culture for Actino and I can culture for mold and neither grow. So this is not an ongoing issue. This was a past issue or this one grew and I found this. This is an. So I feel like there's a lot of different ways you could do it. You could utilize any of these. But I get it from a cost standpoint, just getting someone, the inevitability of someone having to come out makes. Makes sense.

Yes. The thing. So what I experience in real life is I make my recommendation.

Yeah.

And then they usually patients will usually get some random person online who comes on to support trapping.

Yeah. Or it's just a mole person. And so it's a multiple.

Yeah, well, it's a mole person who only does crawl spaces. So you look in the attic, they look in the crawl space. Looks great, they get encapsulated and that's kind of where it stops.

Or do air testing.

Or do air testing. You know, put things in perspective for every. And this is where the particulates kind of comes into play. For every mold spore that's in the air floating around. This can be 500 up to 500 particulates. So if you do a mold plate and it's positive and you got a lot, a lot of stuff in your house, probably.

Yeah.

If it's negative, you can still have a lot of stuff going on. And oh, by the way, you missed Actino and you missed endo. Right. So I wish there was an easy answer to that question. Personally, I make what I believe is the, my gold standard recommendation. The reality is usually it's a couple year process before people eventually get their house looked at. Yeah, some people are all in and they get looked at. And I've had someone I saw recently who did all the bells and whistles to his house. UV lights, encapsulations, just spend a ton of money doing great, start getting sick again. He had like a water leak that happened in his air conditioned, like the mother tube from his air conditioner got loose. So always paying attention to your symptoms as well, and sometimes you have to test and check again. I just rechecked my house not too long ago and it had been five years since the last time. And we've got some water issues in my daughter's bathroom that I didn't know about. Didn't know about. Yeah. Now I'm kind of like, it happens.

And like the other thing is, I think there's an assumption in the midst of this conversation that we're talking about owners of homes. A lot of my patients are renters and what are they going to do? And really, the more data they have, the better off they'll be. And so Swiffer tends to kind of play a role of, look what this shows. And even though you inevitably may get the green light from your landlord, to have someone independently that we trust come out and look at your apartment only or your house that you're renting only, he or she, the landlord is still going to ultimately go to his buddy that he drinks beer with and plays golf with who comes through and says the opposite. So those are situations that patients find themselves to be stuck in. Because if their house, apartment, whatever gets evaluated and it's okay, then it means it's the building proper, then what do you do?

Yeah.

And now that person's stuck and they, they have to Try to work their way out of the lease. Military housing is a big problem. I have a patient that I just saw today who's in the military protecting our freedoms. Her and her husband both, and they are dismissing the findings on her Swiffer test and asking her where her degree in environmental professionalism is. And ultimately they made enough waves where they let them out of the release and now they're able to find a new home. Like, they had to really push back for that. And that makes me sad. Like, that's frustrating. But that, that piece of paper that showed those numbers was, was really what helped them get out of that situation. So I think it's push, pull, whatever the situation is. As with anything personalized and precise individuals.

Whoever you're working with, asking these questions, because if there's a legal issue, then you want to do it and you want to have a chain of.

For sure.

Yeah. Which is a different thing altogether.

All right, how about what's. Let's. Let's go over the importance of binders. Let's talk. I like when you talk about lipid therapy. So let's discuss the importance of binders in lipid therapy, in the treatment of sers. What are the pros? What are the cons? Because the reason this is in the mold wars debate is because the whole binder thing, like, what's a true binder? And what does that even mean? And then lipid therapy is like kind of an indirect, newer way of kind of getting a person detoxified. So speak on that a little bit.

So that these biotoxins are amphipathic, which means they have two different charges on them, which allows them to float through cells pretty much on their own whim. They can go through fat and water. And just. Now, one of the things that's cool about your liver is your liver binds those things, makes them water soluble through phase two detoxification, and it puts on your bile, which is great. But then, because again, these are amphipathic molecules, they can be like, they can just kind of float back out. And the thing called the enter packet circulation, where your bile recycles 98%, which I'm like, how's this even efficient if 90% is recycled? Anyway, it works typically, usually, not all the time. What happens is your body just has a hard time getting rid of these molecules. And strangely enough, with colostymine and wellcol, they also help your body excrete petroleum based solvents and petroleum based chemicals. So there's actually great data on them actually helping and getting those things out of your system. And all the pesticides like Roundup, Groundup is mostly, if you look at the ingredients, it's 90, whatever, 4% inert ingredients of petroleum distillates. So a lot of these things we put in our environment minus the mold are actually these petroleum distillates that we get in our body. And these actually help preferably get those things out. Now it works better for the mold kind of stuff. So that's the reason why when you use a bonder like cold styrene first, which many people don't tolerate, then, well, cauld these days is the go to because it's more tolerable. People don't tolerate that. Then the next best data is on. You've mentioned this before, okra and beet fiber, but you want something like that that's going to actually help you. Now the lipid therapy is interesting because many people will get this herpes kind of reaction. It's a cytokine kind of response. They start detoxifying and they get worse, not better. You'll see this with Lyme patients as well. When you start treating some Lyme patients, you'll see this with your mast cell. You see this with a lot of our complicated patients. And part of that is that the detoxification process, in doing that stimulates cytokine production.

Intensification.

Intensification. Yeah, yeah, that's the tentacle, the fancy word, intensification center. And so the first lipid like I'm using Omega 3s is very nice for basically and usually we do that for a month before you reintroduce a binder. If someone has an intensification, basically blocks that whole inflammatory pathway down. That's nice. You can use things like SPMs, pro resolve mediators or what your body actually makes from omega 3s and that can be very helpful. Particularly people have a brain, brain fog. That's, that's like a, you know, there's part one, part two, part three. Lipid therapy. Yeah, that's more like a part three. Part one is like the binder and then part two are your phosphatidylcholine, which is like soap for all these amphipathic kind of molecules. The other thing that's interesting about phosphatidylcholine is it actually cleans out all your cell membranes. The sensiolin is actually a PC that's used by anesthesiologists in the hospitals. If someone gets anesthesia and they're basically anesthesia coma, they'll do an IV to flush out the anesthesia out of the brain and the nervous system. This is known in the regular medicine world. So we're doing that orally for helping our mold patients. It's great for liver detox stuff. Oh, by the way, biofilm issues. The primary phospholipid in biofilms is phosphatidylcholine. So all of a sudden, you're actually changing biofilms in the person's environment. Oh, by the way, all of our patients get stressed out and everybody's like, limbic, you know, vagal, all kinds, you know, sympathetic nurse. Didn't AWAI giving people certain nutrients, like high doses of thiamine, which probably won't talk about that during this thing, but phospho choline actually activate your parasympathetic nervous system, strangely enough. So it actually has a little bit of a blunting impact on our patients kind of trauma, which I feel like everybody's got a little bit of limbic kindling. The technical term limbic kindling or vagal nerve dysfunction. And so the PC really is nice for that kind of stuff. And getting a mixed PC that includes. And this is something that I don't really think a lot of other people besides Payman Shoemaker, I'm not sure if they. Maybe this was a Patricia Kane thing.

Maybe it was a little bit of both.

Yeah. I forget where I learned this one. You forget after a while what she is.

She does a lot of the phospholipid lipid exchange.

Yeah, but those are. But the phosphoethanoline and phospho inositol. Those are the primary phospholipids in your mitochondria. Yeah. And so when you're doing a PC, you want a PC that has all those in there, that just flushes it out. And there's additional things, like using tudco, which actually helps your peroxisomes burn off toxins, using butyrate. Give them butyrate. The interesting factor that I learned recently, your gut, if you eat the appropriate amount of fiber, will make between 30 and 50 grams of butyrate a day. So when I'm Giving people my 500 milligram capsule, I thought, you know, listen to Dr. King talking about two capsules three, four times a day. This is so much.

Oh, my gosh.

So then it's like, actually, it's not that much. Same thing with Tutka. You know, you might be using yoursore dottle. It's like, now liver patients who have primary bilio cirrhosis, you Get a liver transplant. The first thing you put them on now is your sedial, which is the medicalized version of TED care. Yeah, yeah.

Secondary bile salts.

Yeah, yeah.

So it's basically, it's the anti inflammatory, put out the fire component. Right. So you're adding some, something as basic as fish oil. And do you need to layer in the end product of fish oil spm, these specialized pro resolving mediators. Do you add some curcumin to bring some of that inflammation down. But then you have, you know, you can ramp up phase one and phase two detox. You put them on a specific. Easy, easy for me to say binder, like a bio sequestration acid like you said. Then you start to do this, this human oil change like you mentioned. And now all of a sudden they're actively detoxing, indirectly detoxing, repairing cell membranes, putting out inflammation. Like it just becomes kind of transformative. The key being that not everybody needs all those. Some people do, some, most don't tolerate all those. But now you have many points of intervention in a very complicated patient and you just walk down the line. Can't tolerate that next. Can't tolerate that next. And you have all these abilities to get that person better, regardless of what wall you hit. That's the power in the knowledge of all this information. Like when you and I first learned about this and you first started teaching me about lipid therapy. It was Cane, by the way. Although Heyman and Laval developed that lipid rescue product which is the combination of the different phospholipids. So they obviously do this too. But it was just, it was pretty transformative because I had a couple of patients where they couldn't do anything. Anything I gave them made them worse. And then it was lipid exchange and all of a sudden. And fiber and coffee enemas. And all of a sudden they're turning a corner for the first time in 10 years. It was like, I'm a miracle worker.

It's like coffee enemies.

Yeah, like totally.

Okay, that's not my list of things here. There's some coffee enemas.

Yeah.

What about. This is weird. Yeah. Um.

Someone pushed back on you so much for that. I know.

I used to, like, there's so many things that I do now. Yeah. That I used to, I literally made fun of. Yeah. I literally said that is hooey. Yeah. Insane voodoo, witch, magic weirdo.

Take that somewhere else.

Nature path. Take it away. I'm. I'm Mr. Science. I'm Mr. Data Science. Whatever kind of stuff I'm just we're both Mr. Triple Board Certified, blah, blah, whatever. Now. We weren't then, but we are now. Yeah. So. But coughing on us, you know, I got turned onto that. You know, just the concept of it is that it's rectal insufflation. So it's activating your parasympathetic nervous system. And we did this back in the 50s and 60s with dogs to like, man, we did this. Actually, my VCU and anatomy. If you did this, where you did that and you watched the heart rate change when the dogs were in anesthesia. Things we don't do anymore. So you're actually flushing out a lot. A large amount endotoxins. Okay. So we're dumping them out. Okay. That thing, you're increasing bile production huge. You're increasing glutathione production by 800%. So we say like that this like makes a ton of sense and it.

Resets the microbiome to some extent.

To a little small degree. Yeah. And so it like makes sense. And it's interesting how in certain. What kind of turned me on. This was when I was studying the integrative cancer stuff. I think some places there are people for cancer patients who are on all kinds of stuff are doing these four times a day.

Yikes.

Yeah. No, a lot. So from. So it just kind of opened my eyes and I started using the patients. And then we talked about. You're like, you can try to tell.

Me to do it. I wouldn't, man. Like, I was down for anything that you suggested when I was sick. And it was the one thing I pushed back on until I did it. And it was. It was fairly transformative. And then like, I think you're kind of like this too. Most of the things that I suggest to patients, I've tried myself.

Yes.

And so it was like, how can I tell patients to do this? And like, keep a straight face and know that I was like literally pushing back against it. And once I did it, and I still do them from time to time, I mean, it's a game changer. Like, we went down. We had vacation in June. We went down to the beach. My gut completely got off. I got back. The first thing I did was a coffee enema. Within two days, I was back to normal. I changed. Nothing else. Like, it was that impactful. I was bloated, I was constipated. And then all of a sudden I was normal. One coffee enema. Like, it's pretty game changing.

I also like activated charcoal. Yeah. One thing I recently learned is that a Teaspoon of activated charcoal will cover the surface area that's equivalent to your small bowel. So literally like four capsules. Four double O capsules, yeah. Swallow them, you're going to get your whole entire small bowel covered with activation. I mean we did, I did my training in the er. Someone come with a drug overdose, you give them something like this big full back of charcoal.

You get 25 grams with sorbitol and 25 grams without. So if it's an adult, if it's a, if it's an adult and they come in with an acute ingestion, 12 times more, 50 grams of activated charcoal. And if they're not drinking it, you're putting in an NG tube and you're pumping it down.

They still do that?

Hell yeah. Yeah, man. Got to keep them alive. If it's an acute ingestion, you have to get it bound up before the stomach absorbs it, before the intestines absorb it. And you got to get.

The first is with or without fourth versus with sore.

You do both because charcoal is constipating.

Yeah, but which one do you do first? It doesn't matter.

It doesn't matter. You, at the same time, you don't want to give them too much sorbitol because then you're, then you're dealing with charcoal coming out the other end. Yeah, so you got enough problems with that patient. So yeah, it's still a standard of care. I mean it's something that I did throughout my career for 20 years in the ER. Anytime, intentional or accidental ingestion, if you caught it early enough, and even if you didn't like say you didn't know the timing of the ingestion, like in a patient that came in, obtained and you had to intubate them to protect their airway, you're going to put an NG tube in anyway and then you give them charcoal and you just assume there's something still in their gut. Like, especially if it's something scary like a long acting beta blocker or calcium channel blocker that's gonna cause a brady dysrhythmia and eventually cardiac arrest. Like you just gotta do your thing. We're digressing a little. So with regards to the binders, I think we went on that. All right, how about giving the complex nature of diagnosing. Sirs, how can patients ensure that they are receiving an accurate diagnosis? So we talked a bit about kind of what meets a case definition. How do you know, doctor, that this is actually sirs? I mean, you Just told me a lot about TGF beta and C4A. And you made me look at a vision test.

How do you know the diagnosis? And I like the numbers. So if someone fails their cluster analysis, that gives you a 95% chance right there of them being positive, which I would think would be good enough, but it's not in this world. Because in this world we have. You have the legal aspect of me telling you of a diagnosis that's not conventionally accepted. Yeah. So next level is the VCS aspect. Failing that. If you fail that, that gets you. I think it's like 98.6%. There we go. So. So that's. I thought that was good enough, but that's not. Then the lab testing to confirm that. If you do those, I think you. The 99.5% of like, we're sure about this and so we're really dagg on sure. And so you want to follow through those processes. I think if you only base it on exposure, which half the buildings. Every time we go on vacation, this is either my wife gets sick from chemicals in the thing or I'm freaking out because I walk in the building, there's mold in it. It's almost always one of those two things. So we're always exposed to it. But exposure doesn't mean illness. Marcons. I've tested positive for Marcons before. Felt fine. My C4A was fine. I've never ever passed my BCS, but I'm not sure what that means. Yes, I got my.

And then what about imaging? What about a neuroquant mri?

I mean, I. Neuroquant. That's a great question. I'm coming. I did a lot of them initially and then stopped doing it. I'm starting to do them again because I'm starting to get these patients that I'm really confused about. Like some of my Lyme patients and aren't getting better and I'm discovering that they have mold issues. And then one of my patients recently, we did a nerquant on him. He was a Lyme patient and the nerquant showed tbi. Yeah, tbi. And I didn't quite believe that. So we also did a GENIE test on the guy and the gene test came back tbi. And sers.

And sers. Yeah.

And his main issue was non resolving Lyme with like 5 band 4 bond. It's like it was CDC positive. Which means, you know, even a medical student would be all diagnosis. So. So one of the reasons why this guy wasn't getting better was because he had a TBI and sers. And it was really interesting because we, we talked a lot about his checking his house out and he reassured me that they never had our PhD friend come out, look at his place. So have you actually had to talk to him about that? Because we need to make sure that happens. But sometimes those tests can be really helpful. But those are not the diagnostic tests.

They're not, but they're helpful.

They are with complicated patients, cases that people aren't getting better.

And they were used to determine that VIP works. Right. So vip, which is the end product, like if you, if you are. Doc, if you are diagnosed with sirs, the next thing that you should be helped to understand is how do I get to vip or vasoactive intestinal peptide spread. Because I now understand that this is the antidote for what ails me and it's the only one that exists. So how do I get to this point? And then your doctor walks you through that, how that happens. And it's not linear and it's never quick, but the reality is, is that the corroborating evidence behind a neuro quantitative MRI that shows a classic pathognomonic volumetric change in that person's brain, which in English means brain damage due to biotoxins. VIP post VIP, neuroQuant MRI, normal brain. There's nothing in medicine that I know of that can fix that.

Are you doing where you sit right now with GENIE testing?

I like it. It's logistically difficult. I think it's complicated. I think it's still more so for research purposes. But in a case like that one, I think it was incredibly impactful and insightful and a game changer.

Well, I was asking you about that because I got this back in like waste.

Because you read, I looked at it.

Yeah. And I'm like. But it just. In that potential case, it made sense because I had a Lyme patient who wasn't getting better inbox for six months who was considering going overseas to get treatment there before. And so we got that stuff done and it came back and it was.

Like, ooh, really impactful information for me. The way that I work it, and my kind of gold standard is I work it up the traditional way, same as you. And I make the diagnosis same way. If they're a SIRS patient who is getting better, why do any of that extra stuff? Because we figured out what's going on. They're getting better. Their numbers support that. There's clinical correlation, yada yada, yada. If we hit a wall. Our job is to figure out the why behind that and create a window or kick down a new door or whatever the case may be. And in those situations when you're just seeing this patient. Marcon's positive. Marcon's positive. I had my home tested. I had my home remediated. I'm spending all this money. Frustration, frustration, frustration. There's gotta be something to offer or. How do you know? How do you know, Doc, how do you know? I was always told that I had chronic Lyme. This is a patient of mine. I was always told that I had chronic Lyme. How do you know that? It's water damage, building. Let's get a neuroquant. We got a neuroQuant. Six out of eight, water damage, building markers. Zero line markers. We got a genie. Zero line markers. Now, that person fully believed. And in order to heal, don't you need to believe that what you're doing is working? So there's the limbic component behind it. And everybody in these situations has limbic dysfunction, whether it was from childhood trauma or regular adult trauma or a trauma trauma like a TBI or the biotoxins themselves and the traumatic injury to the brain that they cause. Either way, that person's got some dysfunction. They have to believe that they're going to get better, and they have to believe that what you're doing is going to make them better. And they have to buy in. It also gives them the impetus to continue on in that treatment protocol. And so it's nice corroborative evidence, but, man, the before and after, with a brain that was shrunk, that's now volumetrically normal, or a genie that says, hey, this was never Lyme. It's actino and endotoxins. And yeah, they're hypometabolic, they're in sers, and their coagulation cascade is all awry and their brain's on fire and they have a lot of neurodegeneration and they have a lot of. I mean, it just gives a lot of cool insight in that way.

And also itself can be helpful because we have those markers that suggest the brain melting, basically generation. It's like that almost gives you a bigger stake to put in the ground because even with everything we do, sometimes it's hard for people to pull the trigger on. I'm gonna get my house looked at or I'm going to change my diet, where I'm going to. You know, it's because this is. This is hard because we're asking people to literally change their lifestyles and their environments for the bias to start, to remind us to start healing.

Yeah, 100%. Yeah. I mean, it's, it's, it's complicated and it's an investment, and so the buy in needs to be there. All right, so how can patients navigate the challenges of treatment protocols given the controversy among practitioners? You know, that's, that's kind of a loaded question.

That's one of the reasons why I wrote the SIRS blog series initially, like four or five, six years ago.

I can't tell you how many of my patients, like, are so impressed with that, by the way, I don't think I've ever told you that. Like, I, When I started that, when I diagnosed a new. I'm sorry I interrupt you, but when I diagnosed a new patient with SIRS and they didn't come in, it's becoming more, increasingly well known. So a lot of patients now already know a little bit about it and maybe say, hey, I think I have. And then we work it up in the right. A little bit. Gone are the days of someone being like, wait, what? Like that happens a little bit. But when they have a question and I explain it and then they have another question and they have another question, I send them to that blog and they don't get questions anymore.

That's awesome.

Thank you. Yes. And they really, like, I literally had one the other day say that put it in such terms that I can really wrap my head around it. And you wrote that years ago.

Well, when I was doing my shoemaker training, which is about a year. And you have to write a paper to present. So that was, that was actually, that's kind of my paper. I grew up to present that I kind of broke down into a blog series. Yeah. It also made it so that with other practitioners because, like, you know, the labs explain things. Because the reality is most people don't have access to me or you. I mean, we have limited. I'm not taking new patients right now. You're basically fools. So how do people walk through this themselves? Because 80% you can do yourself. Right. It's just you need the practitioner or the labs. And for some people, just getting out of the environment and doing binders can make a world of difference. We tend to get to people who've done that and seen five or six other people and, you know, so we tend to get the more complicated cases, but it's put out there basically for people to consume and use, you know. Yeah, it's not meant to Diagnose anything, Of course, because you can't diagnose anything unless you see a licensed practitioner. But it's educational purposes only. Right.

With regards to the controversy among practitioners, I mean, I think. Is that more so referring to the different camps?

Yeah, I think it's, I think part of it is just if you're trained, there's a, if you're trained as a nature path, you have a different perspective. If you're trained as a chiropractor, acupuncturist, you have a different perspective. If you train doing this, you know, 15 years ago versus three years ago, you have a different perspective. So there's just so many different. And because this is not, this really is not standard of care, like, people just have to realize this is cutting edge medicine. Though the first case was 1998 and the publications date back now over 20 years, this is still not accepted by mainstream medicine as a thing, even though the EPA talks about it. Okay. Which is the government talks about it. Yeah. The consensus too is actually the white paper is actually something that was written, presented that's like, to the government. Right. So. But still not. You're not taught this in medical schools. There's no medical university where it teaches us. And because of that, there's no like official government, ama, American Board of Physician stamp of approval.

This is what it is and this is what we do about it.

When I did my functional training at IFM and a forum, they didn't. They literally, someone said mold and that was about it. Someone said Lyme and that was it. Yeah, they don't, didn't even touch with the tip of a pulp, you know, because it's just too complicated. And so in that world, there's so many opinions and there's not like a central authority that everybody agrees on. So because of that, the natural courses are going to be confusing. And what I tell patients all the time is like, man, I shouldn't say, maybe I shouldn't be as free about this. Like, I, you know, after three board certifications and I'm still learning 20 some years later and being a clinical researcher, you know, publishing Lancet, being an assistant clinical professor at the local college, I have no idea what I'm doing. I can say that with the absolute confidence. Dr. Hugh I can say absolute confidence. I don't know what I'm doing. I'm super well educated, so I can with confidence say we're still just at the surface of how the human body works. I read a book. This is me diverging. I read a Book called the Fourth Phase of Water, and it blew my mind. Written, you know, eight or 10 years ago. We don't even understand how water works. Why does water expand 10% when you freeze it? You know why? When you put two glass panes between water, you can slide it, but you can't pull it apart. Right. Like, why when skiers hit water, if. When they're practicing, they'll break their ankles, but if you do, little bubbles, they go right through the water. Why is that? Because water has a structure, and light actually creates structured water along surfaces. It's called the exclusion zone. And this explains a lot of weird phenomena. We can't. We're still learning how water works, which.

We'Re made up of.

Just know, by molecules, you are 99.95% bimolecule number water. We also focus on, you have the 7%. You know Mass, you know water, but by molecules in your body, you are 99.95% H2O. So all of a sudden, the most important thing is the universal solvent for you, which, by the way, the universal solvent, you can actually use it to dissolve fat, which is strange because it's water. It's just. The point is, we're just. I'm just. I'm still learning how water works. Yeah. So to make a leap to leave. And I say, I'm an expert, you know, like, I'm the kind of like. So I say that and impatient. You'll laugh about it because you're like, man, if you know what's going on, then who does? Right? But the point is, like, it's that humility. And I'm always hesitant when someone's like, I know what I'm. You know, because it's like, really? Because I feel like I'm still.

Yeah. I started walking a lane. And they have convinced themselves that this is the be all and end all of what's happening without any ability to see differently. And I think that's when you start to lose sight. In my opinion, what separates us out and what brought us together is that we don't think that way. We might pick a lane based on subjective and objective data, but we're always amenable to making a U turn, taking over the road. I tell people getting out of that car and just walking.

Like I tell patients all the time, if I said something more than three months ago, you can no longer hold me to it. If it's been more than 12 weeks, I want to be a fly on the wall conversation. Because, I mean, I literally. I mean, the Patients, I'll totally change what I'm doing. I'll read an article, you know, the whole butyrate thing. Yeah, Well, I was studying with Dr. Gunau with the plasmalogens. One of the things I learned about was that actually desmothoxy curcumin, which is a type of turmeric extract, actually protects your brain, actually is a natural version of butyrate to protect your brain. So in your autistic patients, your Alzheimer's patients, your leaky gut patients have brain fog inflammation, giving them large amounts of curcumin. That's fat solving. It gets in the brain, can actually protect the brain from the endotoxins like butyrate would do if they made enough of it. Like that is such a cool fact. Yeah, like, and then I was reading some articles about curcumin with bopterin actually being studied in patients with MGUs, which is a pre multiple aluminum kinds of condition. Like reading something like that, all of a sudden now it's like, you got an MGUs, guess what? You're getting lots of, lots of curcumin. And this one stay was 2 grams. So we gotta do at least 4 caps a day. 4 day caps a day.

So.

So I'm still like, I'll learn something like a small factory like that. And I'm like, what's the downside?

There is none. And it's like you're always going to learn, they're always going to evolve. But I also like to always kind of go back to the basic foundational stuff too and like revisit what I think I thought I was really good at with this new knowledge and apply it so that you're taking a foundational platform and you're making it even stronger. So I always go back to gut. I always go back to hormone. I always go back to whatever those cases may be. And I just feel like that allows us to kind of build and be able to do things a little bit more simply. I think the term that Jeff Bland uses is simplexity.

Simplexity.

Take something very complex and simplify it. So simplexity, which I think is kind of cool.

I think one thing, this is a side note for the next question, that one of the things I'm re realizing, it's like being a professional athlete, professional soccer player, the people that are really good at their sport become experts at the basics.

Yeah, yeah.

They become perfect at catching, throwing, all this basic if you're a football player. And so in this world, I feel like we need to be really Good at the basics. Are you really eating real clean food? Like really? Yeah. Everything you put in your mouth only has a healing propensity. Are you. You have to detox. Clean water, clean food, clean air, clean environment. Are you really going to clean environment? You know, sleep quality. Are you actually in bed eight, eight and a half hours a night and then are you getting adequate sleep? You measure it somehow. You know, physical act. Like the basic things are so critical in people's healing process. Some. One thing I'm kind of re realizing is to Scotty, real food, clean environment. Yeah. Get accurate sleep, outside physical exercise. The foundations of functional medicine. And for many people, if they do that, Dubai takes care of the rest.

Yeah.

And so.

Yeah, I agree. Last one. What future directions do you see? This is a good one in research or treatment methodologies for mold related illnesses, or let's just say biotoxin related illnesses.

You want to start that one? While I think about it, I don't.

Know that I see future. What I would like to see is some other therapeutic intervention as the end product other than vip. I want to see other options beyond something that someone has to refrigerate, spray up their nose, is constantly trying to be outlawed by the fda that may or may not work for that individual. There's. There's got to be other. Like, I feel very limited when I have one solution. And the beauty of functional medicine is that there's many solutions to the many problems that we see and that allows us to treat all walks of life and that allows us to pivot when necessary. But in the most complex cases, sirs, although getting to that endpoint has lots of different treatment options, the treatment at the endpoint is the same. I would love to see if there were other things that could be discovered, maybe another peptide, maybe something else altogether that can help to get the mitochondria out of that cell. Danger response. Turn off the dysregulation of that, the transcription that's gone awry. Allow that person's inflammation and immune system to find balance, repair the brain in a way. Like in a way that VIP does all those things. I didn't have a chance to talk to you about this. This is definitely newer information. So I need to see the data first. But there is a chewable version of Vip now that PD Labs offers. I spoke to Ray Solano at PD Labs yesterday or the day before. I don't know the study, I don't know the dosing, I don't know side effects or efficacy. But allegedly, like the synapse LPT that they have, it's a nanotized lipophilized version of VIP that you chew that has the same efficacy as nasal vip, but I haven't seen that data.

Are you doing it four times a day as well?

No, it's allegedly a 200 microgram chewable that's scored. So you could break it into 100 micrograms for going slower. And you do one twice a day, which is 400 micrograms and the equivalent of eight sprays a day on the lower dose Vip. And for me, therapeutically, I get them to 12 sprays a day based on the literature. So it's undercutting that. I'm a little confused about it. It's not. You're not able to titrate and escalate as slowly as you can with the nasal spray, but doesn't need to be refrigerated. It's shelf stable, therefore you could buy it in bulk. You don't have to ship it overnight. So it's saving on cost. And so for me, it's a game changer logistically. But I tried to reach out to Heyman to see if he'll get back to me about, you know, he allegedly did the study paray and some pilots say with a couple of patients, that's kind of a game changer. So I guess I'm answering my question a little bit. But beyond Vip, the question would be, what else is there out there? And, you know, is there an easier way to kind of maybe get the genie and how will that translate and some of these other things. What do you think?

I mean, I think there's the question about the GENIE test and making it easier to get a whole. Making neuroquant easier to get hold of. I just, personally, I don't see that happening anytime soon because insurance isn't going to pay for these things.

Yeah.

So that's where that kind of comes in. I was hopeful about thymosin alpha 1 and its impact in combination with TB4, and the FDA kind of took that away from us. I just started using cerebralysin, which used to be standard for a lot of stuff. And in some of the peptide world stuff, it's approved for use overseas for Alzheimer's, traumatic brain injury, adhd. They're doing research with. There's some place doing research with it in the United States. I won't talk about because it's. We're not supposed to be doing that here in the United States for als. Okay. And we had access to that two years ago, and that was Taken away. So, yeah, I feel like we're fighting against the government.

C was taken away, and now it's a mitochondrial booster that really helped a lot of service patients.

Yeah. Yeah.

So these are a lot of pep for those of you. These are all peptides. So VIP is a peptide.

Yeah.

GLP1s are peptides. Insulin is technically a peptide, but because it's a longer molecule, it's classified as a hormone. But, you know, the reality is, is that peptides are game changers. And those that were very efficacious were removed for no reason whatsoever.

Yeah. And so that's where I. That's a little frustrating to feel like you get something cool, you figure how to use it, and you got the clinical experience, and all of a sudden the rug is like.

Kind of like the C4A.

Kind of like the C4A. Hopefully we'll be getting that back soon. Hopefully by the time this goes out, we'll be able to do it back here. So the company that we're working with seems very amenable to getting us back, so we're hopeful to see that happening. But where that question actually was, where I feel like, is I feel like this world of sirs is bigger than we think it is. Yeah. Because originally it was a water damage building and pfisteria and siguatera and recluse spider bites. And scorpions.

And scorpions.

And then it was like algal blooms. I know. Yeah. Well, like Red Todd. Yeah. That's not officially one, but I remember they used to happen a bunch of floor, and people get sick and all.

The Gulf Coast.

Yeah, for sure. And it's a similar process. We have pesticides, getting nitrogen. Getting into the nitrogen, not copper, but getting into the. The Gulf and causing these big algal blooms. But then it's like. Well, you can get overtraining. Sers. Okay. That's kind of cool. And then there's like, post Lyme sers. Pf. Post Lyme syndrome. And then there's the traumatic brain injury one. And then I read Dr. Yehosh Schoenfeld's book on Asia syndrome. Yeah. So all of a sudden, wait, some breast implants. And then the question is, was it the gelatin breast implants or was it all. I was actually reading this the other day. All the chemicals that are in breast implants, is it really the gelatin or is it just all the other metals, cadmium, and just different stuff they put in there. So it's one of those things. I feel like this is getting bigger and bigger and bigger. And that kind of just viral induced.

Sirs, AKA Long Covid.

Long right post Covid. Yeah, whatever. One of the patients with SIRS and they have this recalcitrant Epstein Barr. Recalcitrant Lyme. Yeah. And I have one patient's working with now who had a flare of her dysautonomia stuff and she's a mold patient. So I'm coming back with Art, Nell and Babesia. Yeah. And so it's like I feel like it's just getting bigger and bigger. We're finding out this is even bigger than we both think it is. Yeah. And so that to me is kind of exciting because now I'm like opening myself up. Someone comes in, they have these, the markers being more free with ordering a C4A when I can get me to get it back. And NMP9, a few labs on a patient if they're elevated going down this pathway, even if someone doesn't have the typical presentation, realizing your innate immune system is probably activated for maybe it's like an all immune disease where it's activated for years and years before they actually get the clinical symptomology. You know, what's it going to look like 10 years from now and the way it's been the last couple years. Actually one thing I actually asked Dr. Heyman with and he practices up in Aldi, Virginia, which is maybe a two hour drive from us. For a while there I was seeing a lot of patients, alpha GAL patients coming in with serious and I was like, is this a different version that tick bite induced mammalian sugar allergy that's in all kinds of stuff. And many of them actually were reserves patients as well had mold issues. Is this some other kind of rando kind of thing? And he said he hadn't really seen that, but I just kind of put that on the shelf in my head because I've been seeing patients coming with both of those, you know. Yeah. So I think the future is we're going to see this is way bigger than we even think it is right now. The whole SIBO thing we talked about, you know, there's not data on sibo, but how many of our patients come in with sibo? Yeah. You know, you talk about personally, you saw patients who came in like other SIBO patients and they're not getting better and then they find out actually they're sirs. Yeah.

You know, you back, you back into the diagnosis. They're not classic SIRS presentation. And then next thing you know they're a CSRS patient.

So I feel like it's a bigger.

Yeah, I agree. It's. It's just kind of everything. But that's why we do what we do. Right.

Yeah. So do you want to. I think a lot of these maybe let's keep on going, knock out the last of this.

Sure.

Because we already talked about the mold insular stings. We already talked about urine testing.

Can past exposures to mold or biotoxins contribute to current health issues despite living in a clean environment? That's actually seems like a basic question, but it's really poignant for people to understand that one. Okay, so try that one. You have a past exposure, you weren't aware of it, but now you live in a clean environment. Why do you still feel unwell?

Well, I think the question was you had a past exposure, you felt fine. I have a patient who brought to mind, played soccer for uva, great health situation, grew up in moldy house. Probably his dorm was moldy, feeling fine.

All the while, and now is in a clean space, but doesn't feel fine.

Well, no, no. So it was fine. Got exposure. Da, da, da. Had the genes, got in medical school, was hiking the Appalachian Trail, got a tick bite, got Lyme, got Hashimoto's, didn't get better, ended up working with me and it was sirs. And so he had built up in his system all these toxins, but because he couldn't clean them out very well and he wasn't doing lipids and binders, they just kind of sat there. He put a lot of wood on his fireplace, on his burn pile, whatever you want to call it, but no sparks lit it up. So you got the past exposure 5, 10, 15 years ago, but sitting there and since because you have the HLA DRDQ gene, you don't detoxify quite that well and you're just packed full of stuff because you're always being exposed to new things in the environment, you can't really detoxify really Well, I mean, when's the last time you sweat every day for five days straight? Profusely.

This summer.

Yeah.

Every day.

Yeah. Yeah. But not usually. But then it's unusual. Like, and that's a part of important part of salt and detoxification is through sweat. And so then you get that little trigger. And the trigger could be a vaccine, could be Covid, it could be breast implants, could be infected root canal from recapitation from 10 years before that finally did its little thing. And then you get the match the damage associated molecular pattern that makes the complement thing go Bonkers. And because there's so much wood there, it just goes. And all of a sudden, like, I can't believe that. Small concussion. Here we go. The small, small head bump. Now, why am I. Why, why am I pots inside an immune. Chronic fatigue and fibro from a small little. I actually saw a patient, this is before the pandemic, who got a concussion. Well, let me have got post concussive syndrome from Ryan. A. A roller coaster from the whiplash. And it was like, what was so unique about her? Another patient had got concussion. She was at Home Depot looking at cabinets, open door hit the back of her head, small thing. And it took her almost two months to recoup from that. And so what explains these kind of things? Yeah, it's like you have this stuff build up in your system.

It's a past pretense. It's the filling of that toxic bucket. Yeah, well, you. What you describe as the match or the trigger, I say to patients is you overflowed your bucket. You've been filling your bucket up all along. All these toxins in your proverbial bucket. And everyone's bucket is different, and their ability to empty that bucket is different. In the case of the HLA drdq, you don't empty your bucket really well, if at all. So the garbage man doesn't come to your neighborhood, and you just collected garbage. Now you're a hoarder of garbage. In this case, toxins. And each of these little events that you're maybe not feeling in a profound way is filling that bucket up. And then there's some event that eventually, as benign as it may feel, punishment doesn't fit. The crime overflows the bucket. That, to me, is the moment that you're flipping into SIRS because before that, you're on your biotoxic journey, and you're biotoxic and you're toxic, and you might be inflamed, you might be immune imbalanced or polarized, but then all of a sudden, you overflow the bucket. And you're in SIRS now, mitochondria cell danger response. And you're in dysregulated transcription. And you have all these genes that start to get upregulated and downregulated and all the downstream effects of that, and now you feel like complete crap, and yet you may not be exposed at that time. And that's really hard to wrap your head around. But when you explain to the patient as you flipped into sirs, and then you're stuck in SIRS until someone who knows what they're doing gets you out of sirs. The key is to not have any more toxins taken on or more damage to what's already damaged. That, and it becomes a diagnosis of hindsight. How many of your patients, when they start to understand it, go back and say, I remember when. This is when I flipped into my autoimmunity. This is when my gut shut off. This is when I started getting skin stuff. This is when I started having dysautonomia. And they're correlating it to these past events where they're literally drawing in their mind the timeline of now. That all makes sense to me. Type of scenario that happens all the time.

I mean, it happened with my wife, who 15 years into it, we're like, oh, you know, the. One of her triggering events was an AMILAB at the medical college, Virginia, and being exposed formaldehyde for six months straight. Horrible anxiety. And she thought her anxiety was getting better as she worked through grad schools. It was just that she was getting further and further and further away from an amulab.

I didn't. I. I stopped going to gross anatomy lab. And I didn't know why, but my body told me not to go because it didn't feel well when I was there. And I would show up for the tests and that's it. I would study from a textbook at home. And I talked to my lab partners and said, I'm not showing up. And they just thought I was a deadbeat. But the reality was it was making me sick, man. It was making me sick. And I didn't know why, but my body knew and it was telling me. And so I just stopped going. And I would show up for the test and I would do them, but I was.

You still got A's in the test too, didn't you?

Yeah, I did.

You're one of those guys.

It's all right.

Photographing, bimmering, man. Oh, but it was horrible.

But I get it now. Like that formaldehyde, it was bad.

So that's. Well, I think. And this is also. I think I have a theory. I think one of the reasons we're seeing a lot of stuff now in America versus other places in the world and other times. There's many, many reasons. But I think one of those is that the average American now consumes 12 grams or less of fiber a day. In Sub Saharan Africa, they're consuming 80, 90, 100 grams a day. And fiber's natural. Is nature's mold binder. It's also Nature's endotoxin extruder. It's also nature's way you feed for butyrate to protect your brain. It's like this magical, magical sauce, right?

Yeah.

And so, and you know, none of us get. I mean, I work to get 40 or 50 grams a day. It's hard, you know, it's really hard to cheat.

I put 20 grams in my smoothies. I put 20 grams in my smoothie every morning.

Really. So that's going to be 6 tablespoons.

I use sun fiber, which is partially hydrolyzed, Gordon. And it's flavorless. It mixes really easily. Doesn't mess with your gut. If you have sibo or dysbiosis. I find it to be incredibly benign. And it's awesome.

I need to get some that too before I leave.

It's my go to. And so I. My hack is every morning. My smoothie, it's got flax in it, it's got chia in it, it's got sun fiber in it.

We have that here, right?

Yeah.

Okay.

I'm just putting fiber in it. I put lipid rescue in it. And so my smoothie's loaded with all the goodies. And then lunch, if I eat it tends to be something vegetable based or bar with nuts and seeds, more fiber. And then dinner is clearly protein, healthy fats and a bunch of vegetables. So every day I start by getting a smoothie that's full of protein, healthy fat and mostly fiber.

So a few extra question, this is a great. We have not talked about what are the real costs and benefits of moving versus remodeling a home?

Gosh, pick your poison. I mean, the reality is I'll just, I'll tell my personal history and that might answer the question. We were house shopping. We were not happy with the market. We looked at a place, we looked at others. We went back to this place, we looked at others and we finally went back to this place and said, you know what? This is the best we're going to get in the market right now. My wife has a really good eye for interior design and seeing the potential of a living space. And I think that's probably meant to be her calling, which she's not done. But she could see what it would be and I could just see what it was. And I trusted her and we moved in and bought the place and we were sold by the realtor and the inspector. This place is tip top, one of the best places I've seen, blah, blah, blah, only to find out that the crawl space was a Complete travesty. And we didn't. We weren't disclosed that there was water damage and there was plastic down there, but it was not encapsulated. There was not a dehumidifier. And it met code. It met code, Met code. And there was a massive mold, actino and endotoxin issue. So I had the trifecta. And at the time that we started working together, we didn't really know much about the bacterial stuff. So that was all kind of anecdotally determined. But I had to have my entire crawl space remediated and encapsulated. And I have a ranch house, and so it's almost 3,000 square feet, which means it's all crawl space. And we looked at each other like we just bought this place, like, are we going to do this or what? So we committed to that thinking, like, this is the only thing we're going to have to do. And a year went by and my numbers were off and my wife wasn't feeling great. And I'm now diagnosing my daughter with six celiac, which I believe was triggered by our environment. And we found more mold, and it was in one of the bathrooms and a little bit in the attic. And so now you're having the conversation with, do we go nuclear and just leave this bleep show, or do we do everything at this point and commit to what was a starter home and make it our forever home and control the narrative? And that was what we chose to do. But that's a hard decision because this wasn't our forever. It wasn't the place where we were like, this is where we foresee ourself being for the next 20 or 30 years. But we've now created a situation where we have to make it that. And we're okay with that because we love our home and we know it's safe and we feel good about it. But 50 unexpected thousand dollars later spread over the course of four years, we had to do that between a crawl and a bathroom and an attic and other things. So that's a really hard question to answer in the situation with an individual that presents that to me. I always say, what's the guarantee that the place that you move into isn't exactly like this or worse? And what's the likelihood, depending on the market, that you're going to be able to get an independent inspection before someone else puts their money down on it, or do a Swiffer and get the turnaround before someone else says, here's some cash, I'm Going to take this out from underneath these people's feet. So you have to pick and choose your battles and say is this a place that we can find ourselves to love and that we're going to commit or do is it so bad we can't afford to do all the remediation here and we do the acute issue, we can't afford the preventative stuff to prevent future issue and then we move out and make it someone else's problem and then ultimately find a place that we hope is better. It's a really hard, hard question to answer.

I think just from a pragmatic standpoint. Right now the current starter home medium house price is about $420,000, which is insane. Crazy.

Yeah.

So you sell a house at 6% 6 times for 20, 24, $25,000 just to sell the house. So all of a sudden you're out 25000 bucks and you haven't really done anything.

Yeah.

And so then if you go somewhere else you have to do all the things you talked about. So really they actually. We did my mold training with shoemaker. They actually had like a math sheet that went through this and actually the math was part of the true stuff and like it just makes sense to remediate from just a pure mathematical standpoint. There are some cases I had one individual who their house. They had a mold inspector come out which is the reason having someone come out with a guy can be helpful. And they had no Tyvek wrap on the house. The house wasn't wrapped. I mean so you would tear off all of the vinyl. Yeah, that was a wash. Another patient they had. They had their. They had their place encapsulated. They had encapsulated. But those totally encapsulated wrong. So what happened? The whole house had gotten flooded. It was. It was just with stuff. It was just really, really bad, you know. So when there's situations where you find something, it's like. So another patient actually they lived in a Masonite house, which I didn't realize was a thing house in the house. And they were Masonite, which is like that pressport stuff. And so it just was all so. And then they had vinyl put on it. So the whole exterior of the house was moldy. Basically like not getting wrapped. It was just this Masonite thing. So. So there's our situations when you find gotta walk away. You gotta like be like, hey, this meets code. This is okay according to like the state Virginia, whatever, but it's not okay for my health. And you just have to, like, sell and move on. I think typically, though, it makes more sense to remediate. Yeah. Because just for the standard kind of stuff, you're gonna spend again, 6% that you're gonna lose 6% on, just. But then you pay for moving.

It's an investment in your health. If you're there with a family, everyone is getting better because of that. And like, that was the way I looked. I didn't expect to spend this money. But, you know, we had our crawl done and it was. It was encapsulation, four egresses, two sump pumps, a dehumidifier, all the insulation pulled out, put back in. And this was 10 years ago, maybe 11 years ago. And to this day, it's still pristine, as if they did it the weekend before.

Where is this? My house. 10 years.

Yeah. When the remediation was done.

Okay. That long?

Yeah. Yeah.

Wow.

I've been back since 2012. We moved into a new apartment, which is probably all VOCs. Then I moved into a fan house, which was moldy, and we moved into the house I live in in 2014. So in the fall would be 10 years. And then bone dry did it, and it's still pristine to that day. And so it's like, to me, that was a good investment.

Yeah.

But it's just one of those things. You got to pick and choose your battles.

So this is going to be our last question as far as myths and issues and et cetera, et cetera. I think it's important, you know, why might throwing away personal belongings not be necessary for most people dealing with mold exposure?

Yeah. This is a hard question because sometimes.

People come in like, I'm will throw my stuff away. I'm gonna throw my personal belongings away. I'm gonna throw my stuff away because it's all contaminated with mold. Yeah. I can't take it with me.

Yeah, I don't believe in that. I think that if there's been. I think again, it's case by case, but I think the general consensus, at least my opinion, I didn't do that. And we're fine. And so does that mean that everybody's going to be fine? No, we did not have extensive water damage. We had a humidity issue in the crawl space. It wasn't encapsulated, and so mold grew. It wasn't like a tree fell and, you know, hit our roof and water came in or there was a leak somewhere. So I just feel like if there's extensive water damage and a lot of things got wet and a lot of things were moldy. Like in that case, certain things probably do need to be thrown out because they can't necessarily be remediated or detoxified in the right way. But the reality is that if you're addressing the acute issue and you're addressing prevention of a recurrence and you do the deep clean the way that we talked about and you're purifying the air. And for us it was like we did, we took all the kids stuffies and we took all the bedding and we took all the clothing and it all got washed in hot water with borax and everything else and everything got wiped down. Air scrubs and air purifiers. We didn't have to throw everything away and we did fine in that way. I mean, what are your thoughts on it?

Like when someone says they're that sensitive, automatically go to. This person has vagal nerve dysfunction.

Yeah.

Multiple chemical sensitivity. This is actually a brain based response very similar to like emf. When someone's been in a molding environment, Lyme and now they're reacting with the electromagnetic fields and like their cell phone. Like yes, you can live on earth and get a trailer and live in the middle of the. Not some desert somewhere. Yeah. But that's not at that stage what's going on. And that's where understanding multi chemical sensitivity and you know, I always wonder how much of which one's vagal and which one's limbic, you know, but limbic dysfunction, which is more. The more synth kind of stuff that these are people, like their nervous system is so on fire that the smallest exposure elicits a similar physiologic response. And that's a, that's a real phenomena that we see with our patients. And I feel like for those people, that's what's going on. And so you might need to remove yourself from the environment for a while and then work on your healing process, Work on detoxification, work on your protocol, but work on brain retraining.

Yeah.

Because there's people. Unless it's almost like the whole VIP thing. If you don't switch that off, then you get another hit while you know going to some friend's house and you have the whole thing all over again. And so that's what I automatically go to. Yes. There are situations where it's like you're, you're like, like a fire. If you have a massive fire in your house, everything's just done, right. Yeah. If you have something crazy like a tree fall in your house and just Rains in your house for like a month straight, then, yeah, probably you just dump it. All right. But if it's a standard thing, you find, like, one of my patients put her stuff in storage and found that when she went to storage, she reacted when she. And she was like really bad. Hypermobile pots. Anomia. She actually had this thing called autoimmune autonomic ganglionopathy, which was a different kind of cyanomia. That whole GI tract stopped working. And I first saw her, she had a PICC line in and couldn't. Couldn't eat any food. It was just pretty bad off. But even to this day, she still has some sensitivities to things. And they'll put her in flares and. Actually just diagnosed with a Barton owl. So her story goes on. Her story goes on. But she's doing great. Amazing now compared to what she was four or five years ago. But with her sensitivity and a lot of the patients. It's a marker that your brain is in survival mode. So much so that the small scent, small smell, whatever, it's going to go on higher. Like some of the mast cell stuff. You know, there's a. With. There's a mold aspect of mast cell where you get a little small hint, and people just break out in a rash. They get sick, nauseated, they have GI symptoms just from the smallest exposure. Yeah. That is part of that nervous system survival thing that gets dysregulated. And that's where it's hard because, like, how much of this is, you know, primary allergy, secondary allergy, whatever, and how much of it. That's where it gets. It's part of the healing process. And that's where you get into people working with people. Two or three years to say, yes, I know everything's clean now we need to retrain your brain. So I feel like with some of those patients that are really super sensitive and their environment's like 50 times cleaner than it was when they got sick. Right. Doesn't make sense why your crawl space is encapsulated and you don't. You clean with Seventh generation and all the things we talked about, but you still smell a little smell. And it takes, like, a week to get better. Right? Yeah. Those people, that's. That's.

That's hardwired. It needs to be rewired.

Yeah, exactly.

It's. At that point, it's. It's DNRs or Gupta or Alex Howard or Primal trust or breath work. Colotropic breathing options.

Yeah, yeah. And for those people, like, you can throw everything away and do that, but it's not going to address the brain stuff. Yeah, that's where I feel like people have to like understand that that's.

That's the obstacle that I think I hit a lot in these patients is like the explanation and convincing that that needs to be done. Because people will push back on a lot of the woo woo behind some of that, but the importance behind that can't be magnified enough. The other issue is that the few that sink their teeth into it, they will get worse before they get better. And if they don't kind of pace themselves and.

Or push through.

And I'm not saying everyone should just push through all the time. That then becomes a roadblock to their healing and you got to get creative there. But. But yeah, that's. That's a huge component to this process.

I've had several patients. I had one patient. I'll stop. So she. Horrible Dysautonomia pots. She's like 20, 29. You look at her, looks super fit, super attractive. Come in the office and just put her hands on the. She almost passed out to walk in the office and people in the lobby kind of look at her like she looks super healthy, super fit. Like it's obviously psychological issue. Horrible, horrible. Dishonor. Me in a bad relationship with someone who's narcissistic and abusive and so had a lot of things going on. Nothing worked for her. Yada, yada, you know, try this, try that herbals treat, some lime thing. Eventually she's like, I need. The relationship was very, very abusive. She got out of it and went to Yogaville for a month, which is this place around here, and came back a month later. She was. Looked amazing, was on all of her medications and she. She was on midodrine at one point in time and Adderall and spironolactone. She actually had a prolactinoma when she was in Hawaii. Went to Hawaii for a while to try and make the relationship work. And they did MRI there and they have. She had a pituitary adenoma at that point in time. So she came back like her, her basically breast discharge, you know, and so that all went away. And I'm like, well, this is weird. I re. MRI'd her on the pituitary. I know. Yeah. I'm like, all she, all she did was go to Yogaville. Yeah. And it was just kind of like not to say that's the case for.

Everybody, but that's huge. That's impactful.

It's it's like, okay, but her situation. And she had to remove herself from that situation. I have other patients. Have I. One individual patient. She was actually in her, her 70s and she had a very bad relationship with her mom. Very verbally abusive, emotionally abusive. And I was like. And I. That's a point in time. I kind of watched a little bit of Dr. Phil and I was like, I. Dr. Phil did it. I was like, you just need to drive down. Your mom is dead. Like, you need to drive down to your mom's grave, need to yell at her, curse her, tell her everything she did wrong and you forgive her.

And she was so resistant to that.

And about six months later, she eventually did it. And to see her come back, her total Persona changed was almost like there's this thing that she need to get off and she couldn't get it off. And that's part of this individualized, personalized journey. Like, what made me tell her that? I don't know, maybe this kind of weird thing to say. You know, I was just, just, you know, again, Dr. Phil in it, kind of sort of. But. Yeah, but. But for her, that was like in some of these patients, they've had that past trauma that they remember or don't remember. And sometimes it's just their illness is their trauma. Yeah. And so that's where part of this journey, you have to individualize it and people have to be open to it. And sometimes it means you have to work with someone a couple years seeing you before they're like, you know, I think Jinsky, I think maybe I will do whatever, you know, do the coffee in a month or, you know, that the primal trust or whatever, or the NeuroBioFeedback or the DNRs or the EMDR or the tapping or the free release technique or the somatic therapy or, you know, the list goes on and things that can be done. So.

I agree.

Cool. So that is it for some of the things we felt were battlegrounds, controversies and sers mold related illnesses. So hopefully you enjoyed everything. Hope this was helpful. So please ask your questions below. At a later date, we're going to be actually going back to answering questions people post on social just to kind of round this up. Our goal for this was this to be a reliable place that you could come find information about sirs to just be educated about it. And if you have a loved one that has this illness that could kind of help walk them through it and help you understand as well. So we put all these things together in combination with this, with our with our blog that you actually mentioned. I feel like this is a really good resource for people just to learn about, to share with friends, because I feel like we probably hit 90, 95% of all the things that are to talk about and talk through and think about.

I don't think so. I can't think of anything we missed. But if you all do, please let us know, because we're happy to talk about it and we're even happy to expand on some of the things we've already talked about to clarify. The whole point is education here. The whole point is for us to take something very complex and try to make it easier for you to understand in case you don't have access to a provider like myself or Dr. Hartman, so that you have the ability to start to heal, because everybody deserves that.

Everybody take care, be well, and we'll talk to you soon. Thank you.