Dr. Jill Crista explains aflatoxin exposure from moldy foods and water-damaged buildings, why it damages the liver and immune system, and how to test for it (requires a 3-day low-mold diet beforehand). Treatment focuses on supporting detoxification with glutathione, curcumin, fish oil, and binders.
Questions this video answers
Aspergillus flavus and Aspergillus parasiticus.
IARC Group 1 carcinogen (recognized human carcinogen for the liver).
Follow a low-mold/low-mycotoxin diet for 3 days prior; allow a 48-hour washout from dietary aflatoxin sources (e.g., peanut products).
As low as 0.1 mg (she also referenced common 4.5 mg dosing but noted many patients tolerate lower doses such as 1 mg).
Chapters
Hello, welcome to the Last lunch and learn of this week where we are talking about mycotoxins. So we've covered ochratoxin, gliotoxin, zearolanone, citrine, and now today is aflatoxin. And I've seen some requests from people to talk about the trichothecines and chattaglobacin and I'm happy to do that. I just don't know when in my calendar I can do a lunchtime for a lunch and learn. So we're checking on that and stay tuned. So sometime in April, hopefully we'll get that done. And these are being recorded. They are going to be posted on my website and on YouTube and here on Instagram. So if you are, you know, worried about not catching all the information, don't worry. This is recorded if I'm doing everything correctly on my end with the tech. Also wanted to say that I have fact sheets on my website. I have fact sheets for all the mycotoxins. We just don't have all of them necessarily up yet. But for aflatoxin, if you want to read along today, you can go to my website, drkrista.com-rcrista.com aflatoxin and you can download the fact sheet right there. And the fact sheet basically is covering what is aflatoxin? What molds does it come from? What color are those molds? What kind of material does that mold like to eat? What are the symptoms? And when I'm using with my patients, if you are a member, part of the membership, you get the fact sheet that has all of the doses on there that I'm using with my patients. You have to sign stuff to be a member that says it, you know, for my liability protection. So I'm sorry, I can't give all of that to everybody. But that is available if you are a member and if you are a practitioner. I have a much more comprehensive practitioner tech sheet for all of the mycotoxins as well, and also the non mycotoxin, mycophenolic acid. So that's part of the soon to be released updates in mold related illness course. All of those materials are included in that course and that's much more comprehensive. And again, I give more tools and doses and specifications, that kind of thing for that. So all about aflatoxin. Are you ready? When you think of aflatoxin, think liver. That aflatoxin is so hard on the liver, it's actually been classified as a, I want to say it right, a Group 1 carcinogen by the International Agency for Research on Cancer as a recognized human carcinogen for the liver. So it can cause liver cancer. That's kind of scary. And here's what drives me nuts. It's from an Aspergillus species of mold. So it's from Aspergillus flavis and parasiticus, which a lot of inspectors are saying to people. We see that all the time. That's not the bad mold. Don't worry about it. I'm here to tell you from the human side, these are molds that you need to remediate and get out of your building. They are not safe. They're not safe. I mean, I just told you that they make a mycotoxin that can cause liver cancer. So not to scare everybody, but just to protect you. You know, it drives me crazy when they say that, because just because it's not black mold or stachybotrys doesn't mean it's fine. All right, so what else can I tell you about it? It can cause hepatitis, cirrhosis of the liver. Even if somebody has never had an alcoholic drink in their life, they can develop cirrhosis from exposure to aflatoxin. Don't worry, there are things you can do about it. It also causes some lung effects in that the presence of aflatoxin in the air, when you're breathing it in, when that goes into the lung tissue, it actually enhances viral infection, viral replication and survivability of the virus. Fungi. So this is how we can end up aflatoxin. We talked about on Tuesday. That gliotoxin kind of opens the doorway to infection. If you have gliotoxin and aflatoxin combination, it opens a doorway to fungal and viral infection. You can imagine why in these Covid times, that's a big deal. We don't want that virus to be replicating and be able to survive longer in our lung tissue. No, no, no. So. So again, you can treat it. Don't get too freaked out when you're listening to me. I'm telling you all the problems and then we talk about the solutions. Let's see. Also is aflatoxin is correlated to virally induced cancers, such as if someone has had hepatitis B and they have aflatoxin exposure, they have a higher risk of developing the liver cancer. So I think that aflatoxin has a certain kind of thing that it's doing with viruses. It is also correlated to Epstein Barr virus reactivation. It's part of making the immune system forget it's ever seen that virus. And so it doesn't keep the virus, it doesn't keep a lid on the virus. And so the virus can reactivate and your body has to read refight that without the youth and the strength of a young immune system. So that's how we can see virus reactivation. Hi, Dr. Urban. Very nice to see you here. All right, so we have if it's allowed to be converted into its. So it becomes more toxic as it gets metabolized. So we really want to press and support the phase two type liver metabolism. But if it's allowed to be converted to its. Metabolite, we'll just say intermediary metabolite. It can cause so much oxidative stress that it can cause gene changes. So it's considered a mutagen. It's going to be able to mutate RNA and DNA. Not a good mycotoxin. It can come from an indoor environment. I just want to comment on this, that there is chatter that aflatoxin is only from ingested dietary sources. It may be. And we see higher rates of the liver cancer and things in people who are eating high aflatoxin diets. And that's usually going to be not necessarily in a westernized culture. So no matter where you are in the world, you could be watching this if you're eating a lot of, like the Mandingo people in Africa, I have some friends that are part of that area and they, they grow a lot of peanuts there for subsistence farming. And the peanuts get very moldy and they're eating that moldy peanut and that's causing some kidney and liver problems. So we do have some exposure to aflatoxin in our diet. But in most of my patients eating a westernized diet, if they are having aflatoxin type symptoms, it's from their water damage, building exposure, it's from their environment, not their diet necessarily. Okay. So it is metabolized in phase two through glutathione pathways. So this is one that I'm very, I am very targeted with the detoxification helping glutathione because we know it's a high risk for liver injury. And the liver is doing the processing and the liver needs glutathione. So glutathione is part of my aflatoxin detoxification protocol for this particular mycotoxins. They're secondarily hydroxylated in the gut. So you're going to need to also support gut tissue and gut methylation, gut flora. So we can see, you know, people who will need a little extra probiotic and for this one I like to use the spore based probiotics first to lay a rebalancing foundation. What spore based probiotics do is they, they create the milieu of balance so your body can choose what probiotics. Probiotics to nurture, what commensal species to nurture rather than like replacing. And then if I have somebody who's very histamine sensitive, then I'd like histamine targeted probiotics like Seeking Health has one called Probiota Histamine X that's really nice to do in combination. So since we know it's going to go through the liver and then it's going to go through the gut, it's really wise to support both of those areas. Alright, so overall health effects, did I talk about? Oh, it's also a teratogen, which means it can cause birth defects in pregnant women. There's a high risk for pregnant women to become anemic and also have a premature birth, which we know is hard around baby and lungs and things like that. And also miscarriages. So I talked about yesterday. I am so, so pushy with pregnant women to get out of the mold, do whatever they need to do. Even if the whole family can't go mom, pregnant moms have to get out of mold exposure. Okay, so overall the health impacts are toxic to the liver, carcinogenic to the liver, toxic to the kidneys, carcinogenic as a whole. Especially if there's a corresponding viral, chronic viral situation, Mutagenic, which means they change, it changes the genes. Teratogenic, which means it can lead to birth defects. Immunotoxic, toxic to the immune system, neurotoxic to the nervous system and the gut nervous system. So it can lead to more motility issues in sibo development and toxic to the heart. Yeah, we see it all the time in the building, so don't worry about it. No, no, no, no. Okay, so Aspergillus flavus and parasiticus, they tend to be light green. That's their like steady state color. So if you're looking at a whitish to light green growth on drywall or something, that's typically going to be these Aspergillus species. But any mold can be any color depending on what it's eating. These like flooring, carpet, plywood, drywall. Loves the drywall. The paper on insulation, ceiling tiles, anything paper, cardboard. Cardboard stored in basements or in damp attics, humid attics, modified wood products such as OSB board and leather and also can grow on concrete. Now it's not technically growing on the concrete. It's eating the dust of the concrete. Concrete can host mold no matter what anybody tells you. We've tested this in multiple houses with my patients, and in my own house when we had mold, we found mold on the concrete. It's the dust part. And so if it's humid enough and you have dusty concrete, it can grow mold. What are the signs? We can see darkening of the urine, and that's because the liver isn't clearing out bilirubin. And symptoms are fatigue, insomnia, anemia, progressive inflammation. So aflatoxin is highly correlated to sirs, Developing chronic inflammatory response syndrome, metabolic acidosis. This is something you can see on a CBC or a chem panel. Accelerated aging. It enhances the oxidative damage of aging, reduced immunity, brain fog, or even cognitive decline. Incoordination, headache, eye fatigue. It's a big one for aflatoxin. And difficulty reading your eyes. Like just poop out with reading. Chronic sinusitis, hepatic pain. I'm sorry, liver pain or fullness, not hepatic. Loss of appetite, nausea, maybe some vomiting, Dysbiosis, sibo. Jaundice from liver damage. Hepatocellular carcinoma is highly correlated to the point of causative with aflatoxin. Chemical sensitivity, toxic metal accumulation. The pathway that aflatoxin needs to go through the phase one and phase two pathways are utilized for getting heavy metals out as well. Or toxic metals. Sorry, Lynn. Patrick. I have to say toxic metals, not heavy metals. Not all of the toxic metals are heavy. So toxic metal accumulation, steroid hormone imbalance, meaning the gender specific hormones. So testosterone, estrogen, progesterone, pregnenolone. Those can get thrown off. It's probably dh, EA as well, from the adrenals. Just because of their location. Co location with the kidneys, Miscarriage or preterm birth. And stunted growth in children. Yikes. Right? Okay, so we'll start talking about what do we do about is correlated in human studies with malnutrition and stunted growth in children in third world countries. All right, first I want to answer some questions and we'll get to what do we do about this Scary, scary Mycotoxin. That's actually what I call it in my doctor course when I'm introducing the mycotoxin section. It's called scary, scary Mycotoxins. Because they are. All right, what are my thoughts on low dose naltrexone? I love low dose naltrexone if your body can tolerate it. I am a huge Fan. A lot of times multic people are going to need an ultra low dose. I use this a lot with Pandas and Pans kids. And we start at very low doses for these kids because they're hypersensitive to medication because they have a leaky brain. So we use doses as low as 0.1 milligrams. So a lot of multic people can't start at the 4.5. And there's no. That's kind of an arbitrary number, actually. There's no reason you have to get up to the 4.5mg of low dose naltrexone. A 1mg if you're tolerating, that does the trick. The key with naltrexone is it takes six to nine months for it to do the upregulation. So. So you're better off doing a low steady dose than a higher dose that you have to pulse on and off. That's not going to. That's not going to meet the needs. Okay. Yesterday I mentioned binders aren't necessary imperative to heal from mold. Does that apply to those with the HLA doctor as well? Yes, because the HLA doctor is not as important as we've been led to believe. In my patient base, everybody attracts their different patient base, but in my patient base it's been more critical of how do they sulfate there if they have methylation, I'm sorry, if they have genetic SNPs for sulfation, so the SUOX and the CVS SNPs for glucuronidation, for glutathione S transferase or SOD methylation, somewhat, because I think that we're clearing the metabolic waste products through the methylation pathways. Not necessarily because we're necessarily detoxing through the methyl pathway, but the byproducts of it. So I found that those sorts of SNPs, the detox SNPs, oh, and histamine. So if you have problems with Those sorts of SNPs, like the DAO enzyme or something like that, those are going to be more, what I don't want to say problematic. I don't want to put that kind of juju out on anybody, but those are the ones where we're going to need to up regulate those systems a little bit better. So I haven't seen that the HLA has a whole ton to do with getting better. I have lots of people who have the quote dreaded genes that when we supported them with the tools that I use in My book, you know, we protect their organs of detoxification and their nervous system. We repair the damage from the mycotoxins. We get rid of the fungal compound colonization and overgrowth in the sinuses and in the, in the gut. People get better. So don't take on. Don't put what is. There's a phrase from Pulp Fiction like don't put that evil on me. Don't put that evil on yourself. That's just a situation that you need to just a tiny bit more support. What I have seen with the hla, you know, the quote dreaded gene people is they're slower to respond to mold exposure. So they're going to be the one that they get sick. But they don't recognize it. Not like an allergic person. The really high allergy people are the most protected because they get an allergic reaction. They're like, ooh, this is a moldy building. I got to get out of here. The HLADR people tend to be a little slower at having a response and so it can take a little while for you to notice that you're in a moldy situation. So I just talked about mthfr. Could aflatoxin also come from antibiotics? I'm assuming that's what the it is. I have not seen that. Would you worry about aflatoxin in a person who eats peanut butter daily? I do take a peek at the diet with aflatoxin. So I have a mycotoxin test prep sheet that you could get off of my website. If you could scroll down to the bottom, there's a link called handouts when I'm doing urine mycotoxins. So if you're doing the mymycolab blood test, you don't need to worry about dietary intake. But because the urine is an excretion test, what you eat could show up in the urine. So I have my patients go on a low mold, low mycotoxin diet for three days before taking the urine mycotoxin test. That's the only way that we can take out that possible weakness of the lab. The challenge with that lab. So yes, I would. If you're eating peanut butter daily. So far on my testing, I have not met a non moldy peanut. So not that there aren't any, but if you have high aflatoxin and you're eating peanut butter every day, I would go off the peanut butter for three days. There's a 48 hour washout period for aflatoxin. So your body will, if you ate it dietarily, it will stop Clearing in the urine after 48 hours. So go off of it for three days, then take the test. And then, you know, is this from my building or my diet? Is leaving items outside for a period enough to kill mold spores? No spores. The only way to kill a mold spore is to break it. Now, some UV light can do that, but it has to be very concentrated, Very, very concentrated. And often all it will do is make that spore dormant. As long as the spore is whole, it is dormant, not dead. And this is another problem that's going on in the inspection and remediation world is they say, oh, that mold's dead. It's not growing. There's no hyphal growth. That doesn't mean anything. Spores are made for survival. They've been around on the planet longer than we have, so they have it figured out. They just go dormant and they wait until the next moisture source hits. So if you have dry dead mold that's still left in its colony under a bathtub, under tile, under a toilet, on subfloor in the attic. Attic is a big one that they'll say, oh, no, don't worry, I tested it. There's no hypha growth. It's dead mold. Don't worry. All you need is a humid day above 50% and that mold can start growing again. Removal of the source mold is the most important part of remediation. And I'm not a building expert, but I know that because I've seen patients get stay sick and stay sick and stay sick because they were told that their mold was dead and it was just dormant. So check out Hemichael Rubino for remediation tips and for inspection at Mold Finders. For more information on building stuff, could I mention your support for trichothecenes? Yeah, I'm going to do one on trichothecines coming up. How do I know if you are. How do you know if you are handling glutathione? Ended up with blocked biliary tree bile duct. Was hospitalized with cholangitis. Yeah, this is a big one. The gallbladder and the bile duct get really inflamed with mold. And that's why I have the order I have in my book. It's really important that you do things in this order so that you don't end up exactly where you ended up. And I'm really sorry to hear that. The, the bile duct itself can get very inflamed. And the things I have in the, the reason I have the, you know, avoidance obviously is the first thing. But then fundamentals it starts, starts to give you the break from the foods that might be irritating it and a supportive diet that will help you reduce inflammation. And then we do the things that protect that organ before we start pushing too much on the detox. So obviously you are not handling glutathione. Typically the I'm not handling glutathione reaction is a headache or spaciness or 8 people feel not achy but like big time, big time fatigue that they'll just feel like, oh, I think I'm hurting from this glutathione. So then it's too much. How do I know? And I might tolerate it. I don't feel any symptoms and don't know if it mobilized too much. Is this the same person that had to have the. Oh yeah, yeah. Check my book if you haven't already. It has all the steps to make sure to protect you. Have I noticed swollen tongue with mold? Yes. Also with dental infections. What to do if you can't tolerate milk thistle? Why might this be? Milk thistle really induces a lot of detoxification. So then I start my patients with selenium. Milk thistle is very naturally high in selenium and so it's also doing a lot of other things at one time. So then we can just pick and choose that selenium which helps you make your own glutathione. It's a necessary trace mineral for glutathione formation. So then I start my patients with a little bit of selenium and we work into the milk thistle. Hi. Hi. Growth hormone low sun on GH injections. Looking for natural options. That's a very complicated question. That's very case based. If a child is needing growth hormone, you know, if they're testing low enough to need the injections, I do not mess with that. There's too many things that can go wrong if you don't have growth hormone. Do I have a pandas pans doctor referral list? I don't, but who does is the neuroimmune.org neuroimmune foundation. They have a wonderful, wonderful continuing ed that they do every May. And then the Pandas network, they have lists. If you're looking for a mold literate doctor who may also know Pandas, you have to go to my mold literate certification list for your area and then check with the neuroimmune or Pandas network to see if they do mold and Pandas pans. How do I protect the detox organs? Oh my Goodness, all kinds of ways. First of all is bioflavonoids. Bioflavonoids, Bioflavonoids, bioflavonoids and specific bioflavonoids for aflatoxin. Let's talk about this is green tea. You hear it a lot. Two to four cups a day. Protects against aflatoxin induced cell injury to the liver and kidneys. Like just green tea. But make sure your green tea is mold free. So you can use mountain rose herbs, green tea or traditional medicinals. Both are testing for yeasts and molds. Interestingly enough, there were some research done on purple rice bran, which I'm thinking is a high bioflavonoid rice brand, not just regular old brown, although brown is still a bioflavonoid, it's still a color. But purple rice bran being used in animals, protecting their. It was protecting the animals from the gene mutagenicity of aflatoxin in their food that was so cool. So if you can get a hold of brown or purple rice bran as your binder, then you are feeding two birds with one seed. Also. So bioflavonoids did I talk about. Oh, berries, leafy greens, beets, bell peppers and the whole Brassicaceae family. Also protecting the organs of detoxification is good old fish oil. DHA is specifically protective for the hepatoprotective meaning liver protective for against aflatoxin exposure and chemo protective meaning it's protecting the chemistry of detoxification in the liver, which is so cool. So I had mentioned I use glutathione with aflatoxin. I also use dha, which is one of the portions of fish oil. I'm typically using a high DHA, lower EPA kind of fish oil and these have specific aflatoxin protective actions. However, a lot of molds that people can't take in those good fats because the bile. We were just talking about that the bile in the bile duct is really gummed up. So you want to make sure that you're using a highly absorbable dha. I like a light health formulas. Full disclosure, I'm part of that. I'm the medical director for them. And the reason I like it is because I get to choose the formulas that are right for multiple. So I like theirs because it's in the natural triglyceride form which doesn't require as much of a healthy bile. Biliary situations, you can be on binders, you can be, you know, mycotoxin loaded and still get your good fats in, which is the same problem for vitamin D and the same problem for vitamin A. I like Genestra's emulsion, which is emulsified and then liposomal. D is the form that I use with multic people. Do I think nystatin is a good enough pharmaceutical antifungal or do you prefer a more systemic one? Really depends on your case. I'm sorry, that's a personal medical advice thing. I can tell you when I'm using pharmaceuticals, I always keep the herbs on board. I start with herbs and I add the pharmaceutical if needed. You can get better from mold without a pharmaceutical antifungal. I'll say it again, you can get better from mold without an antifungal pharmaceutical. But you do need to be using antifungal herbs in a farm away in a big way, not just like, oh, I ate a garlic clove today, that's my antifungal. That's a great place to start in the beginning, especially if you're really hurting from antifungals. But we've got to move you up from there. So the herbals I'm using three, four times a day. That's the key with herbs. They metabolize like of action. So you're, you're spreading, you're casting a wide net. So you need to repeat, repeat, repeat that dose. So I keep her herbs on board. Like garlic. Garlic really helps reduce drug resistance. That's the problem with antifungals. If you're not using them long enough and if you're not using them in conjunction with something that's going to prevent resistance. A lot of the fungi Candida aspergillus are resistant to the drugs that are out there. But when you combine them with herbs like garlic, you can actually make the bug more susceptible to the mold. Super cool. If mold shows up on a skin prick allergy test, do they have it in the body? Not necessarily. That just means you're, you're having an allergic type reaction. Typically that's people who have been exposed to mold spores and spore fragments. And if you want to learn more about that, I do. I did do a lunch and learn on mold spores and I did a lunch and learn on spore fragments. And I talk a lot about the mast cell and allergic reactions. You can have a completely normal mold allergy test and still have mold related illness. That only tells you that you're having allergic reaction to mold. That's it. All right. If someone has mold colonization that's untreated, is it possible once treated, they'll feel well and be okay in the environment they were initially sensitive to. As long as that environment has been remediated appropriately. Yes, yes. But it's the remediated appropriately part that's hard. Oh my goodness, we are already at time. Let me see if there's anything else. So for aflatoxin, we had the question about protect and repair. I like curcumin or turmeric and resveratrol. They both have really specific aflatoxin protective actions. And also to other mycotoxins we talked about this week. And I like a product that's a liposomal called curcuma resveratrol. It's by empirical labs. It's so well tolerated. It's so easy to take. It's like I have patients say I crave this. Like this is so yummy, I can't wait to take it. Now I'm an herbalist, so of course I have a weird taster, but that's just an easy way to get to get it in. And one last plant that I really like for aflatoxin is red sage or salvia militariza. Does the liver protection and the kidney protection as well. So that's aflatoxin gang. And that is our last lunch and learn mycotoxin for this week. Stay tuned for I'll post when I'm going to be talking about chattaglobacin and trichothecenes. And thank you so much for spending your lunchtime with me. I hope these were helpful. Thanks. Bye.
