How The Environment Impacts PANDAS/PANS

If a kid was raised in mold, then they never really got their normal immune system.

Hello, everyone. My name is Kendra Seymour, and I'm joined today by Dr. Jill Christa, who's going to be talking to us today about pandas and pans, specifically about some environmental factors that influence this condition that affects so many children and adolescents. So thank you so much for being here.

Thank you for having me. It's such an honor. Such an honor.

Yeah, I. I've read your book. You know, we've. We've talked before. I. This is a. A topic that personally impacts me and I'm passionate about. So I don't want to take a second from your talk because I know you have so much great information. So I'm going to let you just jump right in.

Okay. All right, I'll start sharing. All right. So who are the big four pandas and pans? Environmental bad guys. That's what I want to talk about today. The conversation on pandas and pans often is strictly talking about the infection. And so I wanted to bring awareness to the fact that pandas and pans is a setup that can happen in a kid where they have both infection exposure, but also environmental exposure. And so that's why I'm so grateful to change their foundation to let me talk about this, because it is so much about our air and what we're. What we're putting in our environmental exposures. So what we'll cover today is what is pandas and pans? How tummy trouble leads to brain flame. The last straw. This is the camel breaks the can or the. The straw that breaks the camel's backstory. Like many environmental and autoimmune conditions, we'll talk about all the other straws. And that is where the environmental exposure comes in and then what to do about it. For some reason, we're not shifting. There we go. This whole condition has really propelled a much needed paradigm shift in mental health. We in medicine have cut the head off and talked about the brain as if it's its own thing, and then the body like it's its own thing. What these conditions have helped us to really propel because those of us who've been treating chronic illness patients and Covid is really a great example of that, that a lot of people are getting experience with, is that what happens in the body can affect the brain and its function. Pandas and pans fit under an umbrella of autoimmune encephalopathies. There are other conditions under that umbrella as well, and they're a Little bit different in the thing that started it and possibly and a little bit different in their clinical expression. And so there are two different conditions. So pan does is pediatric acute onset neuropsychiatric disorder associated with strep, whereas pans has that same pediatric acute onset neuropsychiatric syndrome, but not necessarily did we have to find a strep exposure or proof of a strep infection. So the triggers for this, like I said, are infection, toxin and microbiome disruption. And the microbiome is our. We hear a lot about gut flora, so the majority of it is in our gut, but we have microbiomes on our skin in our sinuses. And it is the sinus gut microbiome that plays the biggest role in the onset of pandas and pans. So something happens where the kid is exposed to an infection, a toxin, and they had just the right microbiome disruption at a time when their immune system wasn't up for the challenge. And, and that's when it shifts. It's like a switch goes off where it turns into autoimmune. And that's when we see the acute onset. In a lot of my parents that I work with, pans can be a little more. It can seem like it's a little more gradual onset. There was an acute onset usually when they look back after a flu, typically it's after a flu or even losing teeth. But they weren't able. The shift in their kid wasn't severe enough to stop them from daily life. And so a lot of times then they'll look back and say, oh, now I remember. And it's kind of like this discovery moment of like, yep, that's probably when all of this started. So it can look gradual onset only because the neuropsychiatric expressions may not be severe enough to really draw anybody's attention. But that was the moment. So typically these have a relapsing, remitting pattern of about three months. And they have involvement at the brainstem and the basal ganglia. Definitely in the gi we see a lot of low grade abdominal pain with kids and possibly the kidneys. So that's where the immune assault is happening. But the symptoms can happen in various different ways. So the most common symptoms is separation anxiety. That could be from a parent, a pet, a bedroom, a bathroom, a bed, a chair. It doesn't necessarily have to be always from a person. Typically we're going to see it. If it's from the separation anxiety from parents, it'll be from one parent in particular. There's an inability to concentrate. So that acute onset might have shown up as not really paying attention in school or having a handwriting change. And maybe their handwriting started to drift toward the left side of the page or the middle start of the page. These are little things that we can see when we do the look back. Urinary frequency and urgency or urinary accidents are very common. And that's why I have the question mark. Is there something going on with the kidneys? And we see with mold, this is a really common symptom as well. So I think that that's one of them where we can start to say, I think mold is a bigger picture in this kid's story. We can see alterations in sleep, behavioral regression, hyper alert appearance, meaning their pupils are a little bit enlarged. Hyperactivity, inattentiveness, tics, learning difficulties, short term memory loss, aggression can happen, particularly if the kids also has a chronic bartonella infection. That's a tick borne infection. That also can be from dog scratches, cat scratches, little furry creature scratches. So hamsters, gerbils, all of those things can transmit bartonella. So again, they're, they're little clues when you're working with a panda's literate doc that they can say, okay, these symptoms kind of tie to, yes, it's this autoimmune disease, but what started it? And when we can treat the cause, we can then calm down the immune system. We see sensory alterations, hypersensitive to socks, seams, all of those things. Disordered eating, they get a fear of swallowing or a fear of germs in the food. And hallucinations can rarely happen. So I just put on here the diagnostic criteria to make the point that there is no test out there that can say yes for sure. This is pandas or pans. So we do have pandas criteria. Next we're going to do the pans. And I really just want people to know that if you have done a Cunningham panel and it's equivocal and that could have been more of a pans kid. The Cunningham panel, which is one of the tests we can do for pandas, is better at picking up pandas when it's strep and a little tougher to pick up pans in my experience. So some people will come to me and they'll say, well, we thought that my child had pandas or pans, but the testing was negative. And I just want to tell everybody it's still a clinical diagnosis. So it's based on clinical symptoms of what your kid is displaying. That's why these diagnostic criteria are so important. So if your kid fits into that. So in Pandas, there's five categories. It's the presence of compulsions or OCD and or tics. Typically, it has to be severe enough to interfere with the ability to function in daily life. In pandas, there's an age requirement between 3 years old and puberty of onset. In pandas, it's also acute onset and the added and or episodic relapsing remitting course, which is great because sometimes parents can't find the moment that it started. So if it has that relapsing remitting course, I hope that they'll add that to the pans criteria as well. Category 4 in PAN does is an association with group A strep, primarily if it's missed in the throat, which is missed a lot in rapid strep testing. So if it's found more in a throat culture, but if you can't find it there, but they still look like they have pandas, check their bottom, because a lot of kids have strep perianitis, which means strep around their bottom, and that needs to be treated aggressively. That can keep them sick. Category 5 is an association with neurological abnormalities such as tics. I put on here comorbidities, because things I'm seeing is anorexia, meaning not eating enough or filling up really fast, or fear of certain foods and certain germs. Urinary frequency. Mydriasis is those big pupils, insomnia and abdominal pain. And in a study of parents, it was found the abdominal pain is found more in boys than in girls. The pans criteria is four categories. They're a little bit different, but they look a lot the same in the kid. So this kind of like picking which diagnosis it is is kind of more for the doctors than it is for Joseph Heron. But it's Category 1 is an abrupt, acute, dramatic onset of OCD or severely restricted food intake. And again, it's strong enough that it's interrupting regular life. Category 2 is a concurrent presence of additional neuropsych symptoms that again, are severe enough that we can say this is something that we're noticing a definite difference in the child or the teen. And a lot of times we have teens in this category, so we could see anxiety, emotional ability, depression, irritability, aggression, and or severe oppositional behaviors. And you might be thinking, well, that sounds like a teenager. These are severe. So these are things that are not allowing them to get to school or to have social interactions. We can see Developmental regression or a sudden deterioration in school performance, some motor or sensory abnormalities that get really sensitive. And then maybe sleep disturbances, wetting the bed when they were already potty trained, or a teenager who starts doing baby talk. And then urinary frequency. I would think about mold in those situations where we see a lot of urinary symptoms. Category three is it's not explained for many other conditions. So we did all the rule outs. We tested them for strep. We didn't find any evidence of strep. Otherwise, we call them a pandas kid. And so we're going to call him a pans kid. And category 4 is no age requirement other than it has to be pediatric. And we also see those big pupils and generalized abdominal pain in that. But that's not part of the diagnostic criteria. It's just stuff that I see. But you would be amazed how many times parents in my practice are told that they need parenting classes. Trust me. And you guys know this, if you're a parent with hands and pans, you've tried everything before you went into the doctor. You wouldn't elect those medical bills just to be told you need parenting classes. You've probably tried everything. You've probably read every parenting book in the, in the library. This is not bad parenting. This is a body problem expressing as brain symptoms. So how does this happen? How does tummy trouble lead to brain flame? So I see this microbiome disruption being a really important, really important preceding situation to trigger into pandas and pans. We are more microbe than man. If you counted how many gut bugs, and in total cell count and in DNA, we are way outnumbered. So our gut bugs drive our bus, drive our body. And the tissues in the gut and brain are cousins. So whatever happens to the gut happens. The brain feels it. They have Similimum with it. So only a third of our brain is really for the thinking part. The other 2/3 of the brain is for immune. So when our gut gets affected, the brain gets affected. That's potentially two thirds of our brain that can light up and react to that. So what's lighting up and what's reacting in a pandas pan situation and in a lot of neuroinflammation, such as from mold exposure, such as from weed killer, is the brain microglia. These are the, I call them the monkeys of the mind because they can move around the neurons. I think of them as moving around the branches of the brain tree. And they clean up junk and then they, they will look for germs. We're not supposed to have germs in our brain. So they'll look for that. And if they see it, then they can respond by digesting it. So the gut microbiome plays a critical role in regulating these brain monkeys is they're talking all the time. So if the gut is inflamed, the brain will have potential potentiality to have more inflammation if the gut is disordered, if the microbiome in the gut is disordered, that's where we make the majority of our brain chemistry. The so then our brain chemistry will be changed and those brain microglia have different food than they're used to. They can't eat the right kind of brain chemistry food. So they're going to be more leading toward having too much dopamine and too much glutamate, which are very excitatory. And that's where we can get a lot of that inattentiveness and hyperactivity. So the when the brain microglia, I call them hashtag monkeys. When those monkeys get mad and agitated, because the gut's agitated, they fling poo. Monkey poo in the brain means inflammation. And one monkey can make another monkey mad and it can turn into this whole wildfire of inflammation. So we've seen that brain microglia. So the brain monkeys, that dysfunction in them has been implicated in a lot of neurological and neurodevelopmental diseases. We actually see that if we on purpose in mice, if we on purpose agitate those monkeys in the mind, it'll lead to OCD behaviors in mice, such as pathological grooming. If you have a kid with pandas and pans who's washing their hands repetitively, this is part of that, making that connection. Hyper, anxiety, social impairment, A lot of pandas and pans kids don't go to school because they don't. They know they're not working in the social system the way that they used to. They know something's different. This is related to the brain inflammation, which is related to the gut inflammation. So what we see too is once primed, that once a monkey's made mad, it will remain more sensitive to systemic inflammation, meaning body inflammation. So if you injure an ankle, if your kid injures an ankle, loses a tooth, plays sports and has some kind of injury and gets some inflammation in the healing, that can actually agitate those brain monkeys in the mind, which means more poo flinging. Why am I talking about all this? Because I want you to understand why the environmental things are why my top four bad guys are the bad guys, because they Affect exactly this system. So we know now that the gut bugs also determine autoimmunity. Autoimmune means self attack. And the immune system needs to be able to determine between what self tissue and what's other tissue. And we know other, you know, the body. Is the immune system supposed to like, leave, leave self alone and attack only the other stuff? Well, other is germs, bacteria, viruses, parasites, that kind of thing. That's easy to figure out. What's a little harder for the body to figure out? When the gut is disrupted and the flora is disrupted. Remember, we're more microbe than man. If that is disrupted, it starts to lose sensitivity to what is self. And then it can start to attack both other and self. And that's a big problem. So we see gut flora imbalances and we see gut barrier integrity issues. So now if the gut is leaky, the brain can get leaky and more things get into the brain, agitates the monkeys more. We know that there are microbiome composition changes, meaning less beneficial species and more non beneficial species in neurological disorders with known brain microglia involvement. So if our gut's a mess, our immune system can't tell the difference between self and other. And it'll attack both in the gut and also in the brain. So I hope you'll agree that the way out of this brain problem is through the gut. So what is the last straw? The last straw is the infection. This gets all the attention. Strep strap. Strep strap. Okay. And that's important because the last straw is that one infection that broke the camel's back. I mean, these fit that classic fable, it only breaks the camel's back, meaning breaking the brain because of all the other straws. And that's the part nobody's talking about. Well, very few doctors are talking about. I can think of a couple right now. Dr. Moorcroft, you're one of them. So the immune response travels from people say, well, why, why are we worried about nose stuff? So a lot of the things that we're talking about are respirable environmental exposures. Well, so we're breathing through our nose. What's the big deal? And if we get a throat infection? Well, what happens is if you get a throat infection, the body will send the message down to our lymph nodes. I think all of us have had that. You know, when you get a sore throat, all this gets swollen and gunky. Well, then antibodies are sent back up to the throat to fight the infection, but also sent up to the nose because the Body knows their neighbors, right? They're right next to each other. And these can go right from the nose and irritate the brain monkeys of the mind. How is that happening? We're going to talk about that now. It's not only a strep problem. All intranasal infections, so every rhinovirus, adenovirus, Covid flu, strep, anything we can respire, that's infection, including mold spores, can generate this type of response that we know agitates the brain monkeys of the mind. So here we see a little diagram. You can see the germ is going into the child's mouth. That's how we get. And in teens, I will add mono, which is Epstein Barr virus gets into the throat. And now you see, the messengers are sent down to the lymph nodes in the neck and antibodies are made there. And those antibodies are sent back up to the throat and also up to the nose. And once they're in the nose, they can ride the olfactory bulb back and cause agitation in the brain and inflame. So this is what I call the elevator to the brain. So if you see that little blue germ down here, I don't know if you can see my cursor. That blue germ doesn't get up the elevator. So strep doesn't get up the elevator. But strep, in interaction with the mucous lining in our nose, sends out a bunch of inflammatory messengers. Those are small enough to take an elevator ride. And they can take that elevator ride up through something called the olfactory nerve. The olfactory nerve is one of our cranial nerves. It's one of the few places where we don't have a blood brain barrier, meaning there's no barrier there. And that's so that we can smell stuff, because smelling is a, as a way to stay safe. We can smell there's fire, right? So that once you get those inflammatory molecules in the nose, they can ride an elevator ride up to that olfactory bulb. And look at the yellow arrows. Once it gets down the olfactory bulb, all of the places it can go in the brain. And you see there are many arrows headed to the basal ganglia, which is the blue. Interesting looking. It almost looks like an ear. That gland is where we see a lot of the attack in a kid's brain with pandas and pans. But it's just bad parenting, right? These are things I've actually that parents came and told me. You just need to be more strict. Kids have tantrums. It's nothing to worry about maybe he's just a picky eater. Have you tried ice cream? I mean really. So what about all the other straws? This is the most important thing that I want you to take home. So I wanted you to understand how we got to the problem so that you understand how we get out of the problem. So the other straws are immune depletion, adrenal stress, and we're going to talk about the four environmental bad guys. Weed killer mold, EMFs or electromagnetic frequencies and mercury. So how to get out of it is this is my core 4 of treatment. We gotta tame the flame, we gotta beat the bugs, regulate the immunity and guard the gates. Guard the gates means we're going to restrict and protect any respirable toxicants and respirable infections as well as dental. So of the core four, this is kind of where we're talking about today is the prevention and the treatment of the environmental part. So weed killer number one bad guy for pandas and pans, also known as glyphosate, also known as Roundup. It was tasted safe for human cells, but not for the gut microbiome. So that kind of makes sense now it's a bacteria and it's susceptible to being impacted, actually dying from exposure to weed killer. So we see in emotional, neurological and neurodegenerative disorders, glyphosate is tied to intestinal dysbiosis means, dysbiosis means biotics or microbiome going the wrong direction. And they've been shown to impact the brain. In mice we see increased anxiety and depressive like behaviors. And low level exposure is linked to gut lining changes. So not only the, the bugs in the gut, but the gut barrier is affected with this. In animal studies it only took a teeny amount of maternal exposure to increase an incidence of autism. It also alters testicle development and testosterone levels. So there's really. It's a bad guy and we understand. Now if you understand the brain gut connection, the gut brain, microglia connection, there's really only one dietary invention, intervention, and that is no weed killer, just organic food. These kids have a lot of food, can have a lot of food issues. So if we start to talk about all these restrictive diets. Yes. Are there perfect things they could be eating for their brain health? Like walnuts would be perfect. Are there things we should probably keep them away from like, you know, sugars and sweets? Yeah. But if you have a kid who's not eating, this is one simple thing. You can just make sure they can eat whatever their cravings are Going for so that you can keep weight on your kid. Just make sure it's not sprayed with weed killer especially. And then stop using weed killer anywhere that children spend time. We've got to stop doing this. We're poisoning our kids guts and brains. Number two is mold and mycotoxins. I have so much to say about this. I could write a book about it, and it turns out I did. So the things that relate to pandas and pans. Mold can make mold itself as a spore is problematic because it induces allergic reactions and mast cells on that nose elevator. And that will reduce the effectiveness of our barrier here and also allow too many things to ride up that elevator. But mold also makes these things called mycotoxins. They're purposefully made toxins that are meant to harm the other fungus around it. We aren't necessarily the targets, but we get all the negative side effects, which is toxic to the brain and the nervous system. It opens up our blood brain barrier, gives a leaky brain. If we have a leaky brain, guess who the cousin gets finds out is the gut. And the gut will get leaky. So it can go both directions. It causes immune deficiency, which sets the stage for autoimmune deficiency in starting an autoimmune disease. Toxic to the genes, it'll make your immune system more wimpy genetically, and it's toxic to the gut and the microbiome. So these, this is like mold is trying to move in. So the toxins are meant to encroach on territory so it can spread its own species to that area. And that's how we get colonization of the sinuses and of the nasal passages and of the gut. So this, as far as what to do about it, you've got to get out of mold. That's the number one thing. And here's a little idea like this is if you're still in mold, every time you smell, every time you inspire, you are taking on chemical load. This is something people don't really understand. Smelling is a form of physical contact. Molecules go up through our nose and they go onto that nasal, that open nerve. And as you can see the little red dots up there, they can soak right in. Mycotoxins are lipophilic, meaning they, they soak in. They don't need carrier protein or an ascort or anything like that. So the more of that air you're breathing, the more you're absorbing that can potentially ride that elevator right up to the brain. So this is part of the limbic system. This is part of our safety monitoring. Smell is such an important part of that that we want, you know, the body wants to keep that channel open. And we will under breathe if it senses a toxin, but we won't necessarily smell it. Mycotoxins don't have a scent. So we could be taking on and taking on and taking on that burden. And kids are particularly susceptible because they have juicier, fattier brains. That's what we want, a juicy fat brain. And all of this. Mycotoxin irritation can trigger microglial activation. So the brain microglia. So you must get out of mold. I do understand that a lot of people are not in a situation where they can. And so I have some support there. There's nine things that you do need to know if you are still in mold that can help you when you do get out, that you don't have to have this be a lifetime problem. You can recover much quicker. I also will plug my book. It's very easy to follow. I on purposely made things very simple. I put doses in there, things you need to caution. And then if you're treating for your kids, if kids are not, you know, they're not in the teen world, teens can pretty much do everything in the book. But if you're working with kids younger than teen, there are modifications that you need to make from the book to make sure that it's safe for your child. So that's. I have a course called Molding kids for that. The main thing is getting out of mold. So number three, EMFs, I call them EMFs, meaning they're external, they're from outside of our body. We make internal or IEMFs when we exercise and they're really wonderful for our body. But if you are immune deficient, mold toxic and your guts a mess from weed killer, even exercising can overload the system with too much EMFs. And so we need to mitigate or reduce how much external EMFs we're exposed to so our body can keep moving. We're designed to move. Movement is what clean, cleanses our system. Kids, they'll, they'll get ticks sometimes to release inflammation. That's what's happening. Their body is saying h, I got to move. There's backup in the system. So if we can reduce the external EMFs or electropollution, then they can move in more symbiotic ways and we can make sure that they're cleaning up their system. We're not getting that blockage of electrical systems and we get less neurological problems and Less tics. So what we see is the external EMFs mess up electrolyte balance in the nervous system. So this can alter signaling that can cause the looping that kids will get into a limbic loop or that's where tics can happen too. And this will broadcast outwardly as cognitive changes primarily. We might see nervous agitation and then those repetitive behaviors. And a lot of these kids, what do we do? We want to help them distract from the intrusive thoughts. So we give them a screen, something to entertain them, to take their mind off things. And then that alone can become screen addiction. And now we've got another source of emf. So there are mitigation things that you can do. Grounding every day in nature is so important. Nature is the original charging station that's so, so important. So getting outside, even if they are sun sensitive, wind sensitive, it can feel like you're being the meanest parent ever to make a kid who has all those sensitivities get outside. But they must, must, must. If you live in the city, this doesn't have to be go to the park. This can be sit with a tree. This can be notice the clouds. This can be notice the wind if they're not wind sensitive. Nature is all around us. It can come in all different ways. It doesn't mean you have to be in the woods. And then as much as you can mitigate having those devices off the body. And if they do have to have some kind of screen with them to distract, I think about the dentist. If they have to do X rays, they always put this thing over you, right, to protect you from the X rays. Ems are like that too. We can't see them, but they can impact us. So with some of my families, what we do is we use some of the barrier devices. So a mat on their lap, or if they're holding it, if they lay back and they have their device right here on their chest. And you can put a pad there so that you know that it's bouncing off the pad and away from the child's core organs. Turning WI fi off at night is really important. And then protecting where you sleep. So having sleep canopies for your child to make sure that you're doing something to mitigate any WI fi, especially if you're in a city or a high rise. Those are really important things to do to manage where you sleep. Be careful of the gadgets. I highly recommend testing, not guessing on some of these things. And these are resources that I trust for EMF safe technology. Mercury is Number four, we get the main place where we can see this as an acute onset of pandas and pans is right after a kid has a filling, if they had a filling with anything with mercury. So, so mercury got a bad rap in silver and amalgams, which it should have, and in thermometers. So we've taken it out of thermometers, but we're, we haven't taken it out of kids mouths. I don't understand that. If it's too dangerous to have in a thermometer that the child might bite, why would we put it where they do bite? Doesn't make any sense to me. So. And so what they did is they just changed the name of it. They're not mercury fillings anymore, they're called silver fillings or they're called amalgams. They still have mercury in them. So the main thing is no mercury in any child's mouth ever. We can also get it through vehicle exhaust. This is how it's getting into the water systems and how it's affecting certain seafood. Usually it's the bigger fish because they've eaten lots of little fish and that accumulates the mercury. The health effects is it's a neurotoxin. So again if we're putting it up here, right where the kid can breathe it in all night long, or when they eat and disrupt that filling that's going right up into the brain and is a toxin of the brain. It reduces immunity of the oral cavity, the sinonasal cavities. And that sets the stage then for more brain microglia access and irritation. And it disrupts the gut flora. Lots of studies on these things. So, so what's the solution? Never put mercury in a kid's mouth ever, ever, ever, ever. Now what if you already have a kid who has one in their mouth? They do need to come out. They must come out. But big asterisks only with a trained dentist. Because once you disrupt will release a lot. So they have to have something called a dental dam and oxygen. And we need to make sure that if we're doing it, we're not releasing a bunch of mercury that could get into the kid's brain. Air filtration is really important for mercury if you're in a high exhaust area. So there's not only for mercury but for particulates. So there's something called PM 2.5. Mercury can be part of that particulate dust. So I'm a big fan of air filtration. If you're in a city place or if you're somewhere like one of the families that I was working with, their apartment complex where they had their fresh air intake was right next to a restaurant that would take deliveries in the early morning hours. And all of that exhaust was coming up in their fresh air intake and it was polluting the indoor environment. So this is found with good inspectors. They can test these kinds of things. And air filtration made a huge difference for them as well as like educating the drivers, like, don't leave your truck running, beer poisoning, the whole environment complex. So. And then to reduce seafood exposure, I love the environmental Working groups consumer Guide to Seafood. I put the link there for you. Better to eat smaller fish than big fish so that you get less mercury. I want to go back on the air filtration also for mold. Lots of. There are lots of really good air filters out there. Like IQ Air is wonderful Austin Air, but I like Intellipure because they zap the filter at the same time as they're filtering the air so that filter can't become a mold petri dish all on its own. I have a whole YouTube video about that. If you want to know what questions to ask, what factors to take into account when you're shopping for an air filter, and you can check that out, I think it's. Do you know how to pick an air filter? I think it's what it's called, something like that. So I just want to remind you guys, once you get the education you got this, you are empowered. You can take care of your kiddo. There are lots of great resources. The Pandas Physician Network, if you're a physician. But they also have great resources for families. The foundation for Children with neuroimmune Disorders has a fantastic continuing education where they're training more Doctors. And then Dr. Angela Knapp is a colleague of mine that did a whole series of Facebook live interviews. And I have an interview with Dr. Andrea. I'm sorry, not Dr. Andrea Nakayama, a 15 minute Matrix interview where I lay out my whole protocol in very short order. And then of course, my book. So there's my Pandas and Pans, the Four Bad Guys of Environmental Exposure presentation.

Thank you so much for that. I. I really appreciate everything that you're doing for this community. And I do want to add too, for anyone listening, if you go to changetheairfoundation.org, Dr. Christa has done two interviews with us. One about mold, and we get into a little bit about her book. And then another one, we get into deep dive about her, her latest book, the Pans and Pandas one. So check those out. But what I love about what you did today is you really laid out those four factors and while they may seem overwhelming, they're in our control. Right. We can take, start taking steps for each of these. Right. And I think for anyone listening, I, I have a child that was diagnosed with pandas. I know, Dr. Krista, it's affected your family personally. We understand and we see you and we know how overwhelming it can be. But once you understand and I love that you said that, that these things, you know, once you have the information, you can start taking the steps and it's in your control. I, I do have kind of a follow up question, something I want to circle back to because you and I have spoken in a previous interview about the importance of getting out mold out of mold, whether that means moving or remediating correctly. And again we have resources during the summit and on our, on our website for people to learn more about that. But for some kids, getting out is not enough. Right. And they need some supports. But you mentioned something about colonization and I wonder if you couldn't speak to that just a little bit more because I think sometimes parents think, well, I remediated the mold or we moved. But for some kids, colonizations at play. Can you just tell us a little bit more about that?

Great, great question. Thank you for asking that. Yeah. So you can become the moldy building yourself. So you can leave the moldy building or you can remediate it appropriately and you still are being exposed to the same biofilm that was in that building. And that how that happens is that it's kind of a continuum I think about. So when we're first exposed to mold and mycotoxins, the first reaction is the sinuses and the nasal passage gets inflamed and, and makes a little more snot and a little more inflammation to just deal with it. You know, it tries to, to clear it out through. There's not. And that inflammatory reaction gets the natural flora of those sinus passages going. What's going on? Why is everybody so upset? You know, so they kind of get on alarm a little bit. And when you're not exposed to a toxin, this whole area acts like a completely commensal village. Like everybody's helping each other out. They have different needs and different jobs and it's really balanced and it's for the benefit of the whole. The microbiome of the sinuses. Once you get that little tweak of inflammation, everybody's like what's going on? You know, like that I, I, you know, there's inflammation and now my neighbor isn't acting like they used to act. And so maybe I should start locking my doors and maybe I should start acting a little inflammatory. So this, in this little bit of inflammation turns into a lot of inflammation and that wears down the immune system of those passages. And as we get too much inflammation, not enough immune system, then when you get those spores coming onto that passage rather than getting digested by the village, it's like, oh, no, no, you don't belong here. We're just going to digest you and make you into, you know, little molecules that we can all use for food. Now those can take root and they do. And now your own flora says that makes me really upset that that mold spore is camping out in my yard. So I'm going to start making some toxins of my own. So you can get personal toxins. So your own endogenous mycotoxicosis from your own naturally existing flora, which can be fungus, can be bacterial. So we get mycotoxins, endotoxins, all of these different bacterial toxins and VOCs and things like that are happening from your own flora. And it actually causes you to have toxic breath. And over time, if that's gone on over time. Over time, over time, then those spores have a grand opportunity because the immune system is completely exhausted to start to become infection. So it's, it's more rare that we will see aspergillus infection. I actually have, I'm finding, you know, toxic black mold, especially since COVID I'm finding toxic black mold on sinus swabs. So it can happen with decibotry, but it's going to be more likely the fast growing ones like Aspergillus and penicillium that can make it in our sinus passages. But typically that's going to be a later stage situation. Or if a kid was raised in mold, then they never really got their normal immune system and they'll be the kid that has what they call the allergic facies, which is a kid who has like very narrow face and elongated nose and maybe mouth breather, that kind of thing. Because the body's saying, no, no, no, don't breathe up here, don't breathe from your nose. We got toxins up there. Just breathe from the mouth where there's not colonization. So it's the body being really smart, really wise, that colonization or the infection is way down at the end. Colonization is probably the majority of what People are dealing with.

How often do you see colonization in your patients?

Typically, almost all the time. Okay. Yeah.

And how you suspect it then, like when. When the environment is fixed or they're in a healthier place and they're not starting to get better. Is that when you suspect colonization or is there a specific test you run?

Yeah, so they're all the above. But where I got this idea and it kind of created my theory of like, oh my goodness, this is colonization was Dr. Joseph Brewer's study in 2013 where they tested the sinuses, lungs, brain, gut, skin of healthy people and then sick people who had been affected by a water damaged building. What they found was that, lo and behold, everybody has fungus in their sinuses. So the mere presence of it is not important. What's different between the healthy person and the sick person who's been affected by a water damaged building is that the healthy people had no mycotoxins in the washings of their sinuses, none in their gut, none in their lungs. The sick people did. So that's when I realized I was like, oh my gosh, this is endogenous. This is a flora imbalance sending the message that we know that fungus wants to move in and so we are acting offensively at the risk of harming the whole in order to keep this boundary as tight as possible. So when I see urine mycotoxins, without provoking, just if somebody is spilling mycotoxins in their urine and they've eaten a low mycotoxin diet for three days, so we know it's not from their diet. I know they're colonized. Is a very easy way to tell. Not necessarily. Is that test perfect by any means, but, you know, especially in a kid. So we're talking pandas and pans. They tend to do a better job of expressing when they have a problem. An adult can get more and more worn down and their excretion ability can get reduced enough that we don't see anything, even if they have mycotoxins on urine. But also if I'm seeing an IGE and an IgG positive serum, so meaning blood mycotoxin. With my myco lab, I know they're colonized and they need antifungal therapy. And it wasn't until Dr. Brewer's study that I added the intranasal treatment as part of my general protocol, which might be adding probiotics and it might be using really strong anti congoles. You know, it just depends on where you are in the spectrum. When I read that study I was like, oh, my goodness, this is sinus causation. When I added the sinus treatment, people got better so much faster. It was like. So it was unbelievably faster. The point where people started, like, their hair went from gray to dark. And, you know, I was like, oh, my gosh, I was missing this whole thing. Yeah. And then we can also do swabs. I like Microgen dx. It's a. It's a PCR test, so genetic test. And they use next generation sequencing. So it's a more. It's precise. That doesn't necessarily mean that that's a bad thing because, you know, everybody has fungus in their sinuses. But if I'm picking up DNA of the same species that we're finding in someone's house or their former house. So one of the water damaged species, like an Aspergillus or a Penicillium or a Willemia, a Komium, A Trit. You know, Stachybotrys. If we're seeing that on a nasal swab, we know that we have a colonized person. They need treatment. The nose.

Yeah. I mean, it's when you frame it, like, your body becomes, you know, the moldy water damage building. I think people, it kind of goes, oh, I get it. And. And thank you so much too, because I love the title of your latest book, A Light in the Dark. Like, there is, like, hope there. And I know people listening, it just. It seems insurmountable. And I know you're big on that message of hope and not to give up. And so to the parents listening out there, I want to echo your point. You got this, right?

Got this. You got this. You just need the information and the support. So get the information. Build your dream team of practitioners, and you totally got this. You can help your kid.

Yeah. Thank you so much for joining us once again. We so appreciate your time and your knowledge and your experience.

Mm. I'm so deeply honored to be invited. Really, thank you for letting me be part of this cause.

Absolutely. And for everyone listening, thank you so much for joining us. If you found this helpful, do me a favor. Head on over to changetheyearfoundation.org Sign up for our newsletter if you haven't, and if you enjoyed this talk in particular, don't forget to check out our other two talks with Dr. Jill Christa, because they are some of my favorite and filled with lots of great information you.

Won'T want to miss.

We'll see you all next time. Thank you so much. Bye. Bye.