The Bile and Mold Connection with Dr. Jill Crista

This is the One Thing Podcast and I'm your host, Dr. Adam Rinde. The One Thing Podcast brings together leaders in functional and naturopathic medicine to discuss actionable information that may unlock puzzles in the areas of gut health, brain health, metabolism and longevity. Please note these episodes do not replace.

The opinion of your doctor.

They are not intended to diagnose or treat any condition. Please discuss this information with your provider and discuss your own unique personal health history before adapting this information. Please subscribe to our episodes so that you can stay on top of the most current information in these areas of medicine. In today's episode I welcome on Dr. Jill Christa who is a naturopathic doctor, best selling author and internationally recognized educator on mold illness. Dr. Christa is the author of Break the Five Tools to Conquer mold and take back your health. She also provides online training for medical practitioners to help them become mold literate to efficiently and effectively identify and treat mold sick patients. In today's episode we specifically talk about the importance of bile and the biliary system as it relates to mycotoxin illness. We're gonna learn all things bile and some fascinating aspects of bile that I had no idea existed. We learn about how to work with bile and how to help the body and assist the body in eliminating mycotoxin illness. This is a very in depth conversation. I hope you enjoy it and without further delay, I welcome on Dr. Jill Christa.

Okay, Dr. Christa, welcome to the One Thing podcast. Thank you so much for being on here with me today.

Thank you very much for the invitation. It's really an honor to speak with you.

You're welcome. Yeah, so we got a chance to catch up offline here and it was great getting to know you better. I followed you on social media and listened to some of your lectures and I'm just really delighted to be able to share this time with you. Can you tell us a little bit more about your background as it relates to mycotoxin illness? And you know, the topic of the day which we're talking about is bile and the biliary system.

Yes, my favorite. I'm a true biophile. I've realized that's going to be my next comma after my initials. So I'm a naturopathic doctor. I was trained in Portland and then moved to Wisconsin where it is Lyme endemic community. Also a lot of toxicity. We have paper plants and GM plant and all these things poisoning air, water. So I became very interested in environmental illnesses and I knew about mold from school, sort of cursory like it's a big deal. It's a bigger deal than allergies. It's got some toxicity and maybe causes a weird Ms. Like picture. And that's about all that I knew. And so I was working with these Lyme patients and there was a small subset of them that just weren't getting better. So the classic chronic Lyme situation. And after working with them, they were, you know, these are hardworking, dedicated patients. That's who comes to see a naturopathic doctor. You know, the people that are willing to do the homework. And these guys were doing it 110%. And I could not figure out why are we only getting incremental improvement. It was so frustrating for all parties involved. And then in one of those patients, they found toxic black mold stachybotrys in his home since they predicted since they had remodeled their basement 12 years prior, which is a long standing mold exposure. Granted it was his basement, but you know, if you've ever lit a candle or incense or something in your basement and if you left it lit long enough, it's going to move into the other airspace of the house. So that's when I thought, wow, I wonder if the mold is part of what's going on here. He didn't have ms, you know, I mean he didn't have some of the things that I walked away from school thinking, yeah, he had a little bit of allergies. So I thought, well let's I'll start digging in and see what kind of allergy symptoms mold causes. When I got into the literature, I could not believe how much I was missing mold in this, in him. And also then I went and interviewed all the other patients that weren't progressing with Lyme. And mold was either a past or current exposure in every single one of those cases. And I was just blown all but one. There was one that we couldn't trace to mold and probably wasn't mold. It was probably something else. But it, it was just that, you know, mind blowing moment for me of like, oh my goodness, I've been missing mold. So that's why I named my I have a practitioner course that trains other practitioners how to test and identify test treat mold from a natural medicine functional medicine approach using both herbal medicine and drugs. And I named it Are youe Missing Mold? Because that's exactly what I had done for, you know, 10 years working with these Lyme patients. And I just felt terrible now that I understood what I could have been doing for them and really pushing. So that's how I got here, I also wrote a book on mold because then I got to have my own mold experience after having. I had developed a questionnaire because I'm very analytical. So I like to have a number and I like to have people fill it out every time so we can see am I making you better or worse? Or are you making you better or worse? Because they really do the homework. And I had all these tools for when I knew it was mold. And then when it happened to myself in our own home, I completely missed it was happening. And once the flood revealed itself, I was like, oh, my goodness, this is mold. And I went right to my protocol. I knew what to do. You know, it was just such a privilege to know that. And I felt very duty bound then to write a book for the public to just simplify everything into real people terms, put it into an order that I used clinically, that I didn't really realize I was using such an organized way of treatment. But until I sat down to write it down, I thought, wow, there's actually. I have kind of a system here. And so, yeah, then I wrote a book. So that's where I am now.

Great. Yeah. We'll put a link to your book in our show notes so people can end your courses. Of course. So thank you for that introduction. So we. One of the areas that I know that you mentioned you're passionate about is the bill area system and file, and it is such a key aspect of mold treatment. I think, you know, as far as general public and also practitioners, I think revisiting what the biliary system is would be helpful for this discussion, just because it's something that I think people don't think about quite a bit, and it's so crucial to our function and so many different aspects of our biology. So if you could just take us through maybe the overview of what the biliary system is and bile salts.

Yeah, you bet. And those that are listening don't see I probably have a huge grin on my face because I love this question. I love the opportunity to talk about bile. I feel like it's one of the most underappreciated, overworked fluids in our body, especially in our toxic times and even in our immune compromised time. So even in this coronavirus time, bile plays a role. Excuse me. So the primary function of bile is to emulsify fats. Why that matters is that we eat a lot of fat soluble nutrients, and so things have to be broken down so the body can absorb and use those nutrients. It can break it down into a little chunk of vitamin A or a little bit of vitamin E or those kind of things. The second function is that it eliminates toxins. And that's where it comes very important with mold toxicity, because mycotoxins are fat soluble or lipid soluble, and bile particularly eliminates lipid soluble toxins, either lipid soluble or something that has been made lipid soluble in the liver. But we already know that mycotoxins are very lipid soluble. There are lots of different types of mycotoxins, depending on the mold that someone is exposed to. But we know that all of them are lipophilic or love. Love fat and fatty tissues. The third function, though, that bile. That bile plays is all this non GI stuff that we didn't really like. Non liver, I should say, not non gi, but non liver. In the. In the gut. It does all kinds of crazy things that we never really realized it did. It recruits and secretes secretory iga, which protects the lining of the gut and is our kind of immune system of the gut. The first interface, it helps with probiotic adherence. I never knew that. So actually, if you have somebody who you can't get them, if they have sibo with mold or they have something else going on with their gut, I have found that now when I add a bitter or a cholagog, which means bile flow agent, to their. The exact time that they're taking their probiotic, that we're getting better adherence of those probiotics, we're getting better improvement with gut. You know, like, there's another one. Wow.

Yeah.

That's amazing. So the other thing that it helps to recruit lipase, which is part of what breaks down our fats. But lipase actually also has a mycotoxin degrading activity of its own. So some people, if they can't tolerate binders, sometimes I'll have them take lipase, because I'm like, well, we might as well break it down and denature it and make it not as toxic. There's an enterocyte activity in the gut, so it will actually encourage the enterocytes to the surface of the lumen, the inside lining of the intestine. So the enterocytes are the cell for the non practitioners. They're the. The cell lining the whole gut lining, from basically where you swallow to anus, you know, it's like the whole lining. So if there's bile there, it will encourage those enterocytes to come into the lumen. And why that's important for mold is the other thing we know about all mycotoxins is that they damage the lining of the intestines. So it's bile is your, it's a non drug way to combat that activity. It's also neurologically. I had no idea bile had a role in neurology. But if you think about most of our brain is fat, our nerves are kind of fatty tissue. It kind of makes sense that something that works in the fat realm is going to be important for nerves. But we've seen that it has anti apoptotic activity for neurodegenerative diseases. Meaning that, you know, if you have a Parkinson's or something like that, if you can help somebody get their bile flowing, you can actually preserve neural tissue. Crazy also reduces prion conversion. So that's a big one now because, you know, our colleague Dr. Greg Eckell is working very hard on kind of cracking that code. You know, what is going on with prion based diseases and Parkinson's and Alzheimer's and neurodegenerative diseases. And if someone has gummy bile and they're not moving bile, they may actually be converting more prions in their neurology. Bile also plays a role in the retina of the eye. And so some of these things, if you look at a symptom list of mold toxicity, it starts to make sense. We have vision changes. Yeah, I mean, Dr. Shoemaker picked up on that ages ago with his VCS test, the visual contrast sensitivity test. There's actually visual processing disorder issues with mold toxicity, but there's also retina damage and that is related to the mycotoxins gumming up that bile, so to speak. Let's see what else. I know I'm missing something else. Oh, diabetes. So it will reduce the endoplasmic reticulum stress. So basically it's that whole ox redox. So antioxidant status in the powerhouse of the cell associated with high glucose. So if you have a diabetic who is their hemoglobin, A1C is on the rise all the time. Just moving, making and moving. Bile can help protect the powerhouses of every cell in their body. It's so cool, isn't it?

Yeah, it's really cool.

This is why I'm in love with this fluid because so many things it.

Makes me think if I'm listening to this and I had my gallbladder removed, I would be really triggered by this conversation.

I'm glad you say that. Yeah. Because I get that question a lot when people hear me talk about, if I do a little video blog on bile or something. I get these people, oh, no, I'm never going to get better from mold because I don't have my gallbladder. And what I've actually seen in practice is it's the people missing a gallbladder that get better faster. It actually, it's not the most naturopathic thing to say, but, you know, I remind those people and they wouldn't know. How would you know if you didn't go to medical school? Bile is made in the liver, so as long as you have a liver, you're able to make bile. Bile. We make about a liter a day of just bile. So think about the people that don't even drink that much water. You know, it starts to make sense, even just being dehydrated and mold makes you more dehydrated because it gets in the way of ADH secretion and the kidney's sensitivity to that. So people are very dehydrated, they lose more water than they drink. And so it starts to make sense of like, okay, I'm putting all these pictures together or these little pieces to get this whole picture of that. Hydration is core to all of this because our bile is about 95% water and we make a liter of it a day, and we need to do that to get better. So there's that. It's amazing. So, yeah, if you're missing a gallbladder, actually in my clinical practice, that the people that are missing their gallbladder, especially if they have Lyme and mold, tend to do better. And I think it's because, you know, of just the gummed up dehydrated bile, and then Lyme loves to eat that nutrient, so it'll hang out in the gallbladder.

Yeah. And I've actually learned recently that even with gallbladder removal, the cystic duct kind of takes over a little of the old gallbladder gallbladder function and forms like a little sort of pseudo gallbladder. So there is some storage that still can take place even after surgery. But yeah, it's really encouraging that even without a gallbladder that you could still have good bile function.

Yeah. And in that case, we're often trying to just slow it down, you know, to take full advantage of its effects in the gut. So, you know, that's again, insoluble fiber. Insoluble fiber. I'm a big fiber fiber person because of that. You know, just slow it down.

Yeah, yeah. Well, you know, since your area of interest is mycotoxin illness, it. It might be Good for us to just to hear the journey of the mycotoxin. So from start to finish and how that interfaces with ends, ends up being associated with bile.

Now that's such a cool idea. Okay, so most of my patients are coming to see me with mold illness because of a water damage building. You can eat them too. You can be eating moldy or mycotoxin contaminated food. But the majority of the people that I'm seeing, they become sensitive to those foods because of the water damage building. So most of the multic people I'm seeing, the journey of the mycotoxin is. The mycotoxin is in the air and maybe has gotten into their porous materials like their mattresses, their couch, carpeting, that kind of thing. So there's potential for dermal absorption. Dermally, we absorb mycotoxins the most efficiently out of any way to get a mycotoxin. So dermal is the biggest one. So if you think about, you know, a moldy couch and somebody, you know, summertime, you don't. You just have like a T shirt and shorts on or you're walking around barefoot, which we know as a naturopath. The soles of the feet are an extremely absorbable area of our body. So you're walking around on the carpet. If it's dermally absorbed, it goes into the bloodstream, it makes its way there. Because they're lipid soluble, it will get picked up in the lymph, lymph, and if you eat them, the lacteals, but dermally, eventually they move into the bloodstream if you inhale them, which is the most common. So that's going to be sinus absorption, lung absorption. These mycotoxins are so small, they're 50 times smaller than the spores that secrete them. And they're a chemical. So these can ride these ultra fine particulate in our air that get below our ciliary clearance area, so that gets right into the alveoli and can absorb through the lungs that way and right into the bloodstream. So think of polluted air then gets to the bloodstream. When it's a lipophilic or fat soluble toxin in the bloodstream, then it gets delivered to the liver to be detoxified. So it gets packaged up in bile. There's my favorite. And the kidneys also do some filtration because urine is a filtrate of blood. So the kidneys will do some work to detoxify also. And, and in my course I talk about the kidneys a lot Cause I think that people aren't really talking about them in this condition, and they get forgotten. And it's a very, very important organ system that takes a hit, the hardest hit, I believe, even harder than the liver. There's a reason why God gave you two kidneys. They're that important. So, yeah, the kidneys will get damaged, but they will also filter out the mycotoxins. And that's why we can find them in urine for. For a test. So let's consider the ones that didn't get cleared by the kidneys, and they're still in the bloodstream, they still go back to the liver. So the liver has to package into bile. That bile gets sent into the gallbladder or directly into the gut lining. So the lumen of the gut. And the idea then is we're supposed to poop them out. Unfortunately, we recycle 93% or so of our bile, which is really good for preserving fat soluble nutrients and things that we may not have access to all year long, so that we. We can eat them and store them when we have them available. Like carrot season, you get a lot of vitamin A. But not so good when we're in a toxic world, because now we are. It's. I call it the definition of detoxification insanity. Like, the liver has already processed it, it's already packaged it in bile, it's already sent it to the gut to get pooped out, and. And then the lacteals of the intestines pick it back up and bring it up to the liver to say, what do you want to do with this? And the liver says, I've already told you what I want to do with this. And then it has to, like, process it over and over and over again. And that's why we see a lot of liver toxicity, chemical toxicity, bile gumming. Because then eventually the liver just says, not now. You know, you hold onto it. We'll add other toxin to you. And so that bile becomes very concentrated with toxin. Mm.

I think that's a really good point because, you know, the liver's already got so much on its plate. Yeah. It's literally is like a mile long. And then, you know, be. To be burdened with this. You know, that's why I think they call it toxic burden. Right.

Yeah. Right. Burden. Yeah, that's a really good point. Yeah. The use of that word is so apropos.

Yeah. Okay, so then someone who is starting to manifest the mycotoxin symptoms. The. The mycotoxins and their physiologic effect are just kind of running through them, like in recycling back into the. To the system 24, 7 without. Without help of getting it out.

Right, right. That's why there's a real emphasis on binders with mold treatment. Because the idea is that you're intercepting that bile recirculation, you're grabbing the bile. And so that's, I try to kind of clarify for people. There's a lot of confusion in the mold world about, okay, I found this mycotoxin on my test, so which binder do I take? And I'm like, okay, if it's from a water damaged building, you could take anything that binds bile. And so I actually went out to the literature that had to do with cholecystectomy, bile dump, diarrhea, bile ulcerations, because that's one problem. If your gallbladder is gone, you don't have anywhere to store that. So you're going to be dripping bile into your intestines even when there's no food or fat to pick up there. So people get, you know, these ulcerations. And so I went to the literature on that and found that, you know, just like Dr. Walter Kernan taught us, insoluble fiber is the best bile binder. And there was another study that found that steamed kale was very effective. It was like 30 to 45% effective compared to cholestyramine. But cholestyramine is a massively aggressive binder that also binds up your fat soluble toxins. And it binds up so much bile that you become nutrient depleted of the things that you need to make bile. Which is interesting because that's like glycine. So we see anxiety with mold toxicity a lot. How much of that is the glycine being eaten up in bile and how much of that, you know, so glycine deficiency and how much of that is the activity of the mycotoxin itself on the NER neurology? I don't really know, but I'd love to ask those kinds of questions.

Yeah, yeah. And you have a great post on your website that says like, what are we binding? Or what are you binding?

Yeah, what are we really binding?

Yeah, what are we really binding? Yeah, that would be good to just kind of go into that a little bit.

Yeah, I'm happy to talk about that because I think that the confusion then is people start to feel like they have to be perfect, but they're binding piece. And I wrote an article in the Townsend letter and I didn't even mention Binders. I just talked about food and somebody said, I'm so surprised that you didn't mention binders. You're harming people if you're not binding. And I'm thinking, I'm a naturopathic doctor. We do this by our basic treatment guidelines. The very first thing we do is you need to eat more vegetables and you need to get more fiber in your diet. All right. Voila. Yes. Do we need to go a little higher than that? Especially if we're going to be starting to poke the fungal bear in the body. Yeah, but I think it really takes the pressure off people when they realize it doesn't have to be a supplement. It can be a very inexpensive, you know, food based. Or it could be psyllium, husk bran fibers like oat bran, rice bran. Even if they don't tolerate the carb part of the grain, they can tolerate the bran part typically. So there's lots of ways to get the sibo. Friendly ones are like sunflower seeds, pumpkin seeds, sesame seeds. So there are ways to do this binding through food that's also nourishing you and not causing nutrient deficiencies. Now what happens though, if the person doesn't move stool very well? That's where it gets really into the cool stuff that Dr. Neal Nathan is doing in his research of the which specific mycotoxin is grabbed by which specific binder. Because there are chances where now that bile or that mycotoxin is denatured from the bile and it can be loose in the lumen or the inside of the gut. And so people might need those specific binders. So I found that in as long as I'm doing, you know, typical, I call it food fiber. So, you know, good food plus fiber, like up to two tablespoons a day of some kind of insoluble fiber as a minimum. And then if somebody is still very, very toxic, so they can't drive behind a car any closer than, you know, 50ft or something like that. They can't go into the, the aisle at the grocery store where all the laundry detergent is. Know, the dryer sheets, like they can't even go in that aisle. Okay. We're going to have to do some excessive, you know, grabbing of toxin for you. And also I, I use what's called pre binders, meaning the cholagogues and choleretics, which has to do with moving bile. So I start with bile.

Yeah. So I want to speak about that because, you know, the, the, the notion is, is that we're, we're assuming so far that the, the bile is being secreted well or being moved well and that it's able to get into the gut. And so how do we help the. How do we assure that the bile is actually secreting so we can actually get to the point of binding?

Yeah, that's such a good question. Because once I learned all the non GI things that bile had to do, it made it so much clearer for me to realize the person that's not making or moving enough. So if they're having a lot of vision symptoms, because we know it's part of the retina, if they're having blood glucose issues, so really unstable blood sugar, which might be too high, but it might be too low. So unstable. We know bile plays a role in that story. It's mild, it's a minor role. But you start to put this picture together. A lot of neurological symptoms. Okay. Now that picture is getting even stronger. And then all the GI stuff. So if, if we're running, you know, again with the probiotics, if I'm seeing that, okay, I feel like this person's taking billions and billions of probiotics and they still can't poop or they're not, you know, all kinds of different things that mold can do to the gut. Then I'm thinking, okay, we need to go up the chain a little higher. So those kind of, that quadrant are the four things that I kind of assess to see. I think we're not moving bile. And then I use things like bitters. Start there and see if that's enough. But a lot of people need just good old bile salts with their meal.

Yeah, yeah. So there can be like a deficiency of actually having enough bile and then there's can be like a problem with moving it. So you, you sort of approach both those angles and the situations. And so you're saying this, the symptoms that really jump out for someone who's having maybe core issues with that part of the dysfunction or visual and maybe blood blood sugar issues, or if they're just really pounding the probiotics and can't get a bowel movement going. That's kind of.

Yeah. And neuro neurological, which, you know, it's funny that somebody will say to me, oh, I had just terrible brain fog, my eyes aren't working. They're kind of like a drunk person. You know, like one of the posts I'm about to post here is breathe air, get drunk. You know, so if you're breathing mycotoxin laden air, you can get alcohols aldehydes all of the other things that mold makes and people actually seem drunk. It's sort of like an auto brewery syndrome where it's auto mycotoxicosis syndrome. So they, you know, same thing like brain fog, incoordination, vision issues and then their gut just isn't that we can't get a hold of it. With all the things that are reasonable. I would say that's kind of a, that's kind of a cardinal mold. Lyme, not necessarily together, but each of them is one of those things where when you've done everything reasonable and the person's not responding in the way that you've seen with other patients, like 85% of your other patients got better when I did this. We took away their food allergy, we added probiotic and things are better. And if you do that with multic people, things don't get better. And that's when I started thinking, okay, what's, there's something bigger here.

Yeah, yeah. So I really like how we've gone through this so far. And it's like there's even, you know, a step back from the bile is you know, maybe a time topic that we, for another discussion. But it's you know, just the getting, getting the mycotoxin to the, to the biliary, to the gallbladder, you know, or getting it out of the liver. So that's the whole detoxification topic. And I mean that's obviously such a core part of the treatment, right?

Absolutely, yeah. I mean the toxin has to be detoxified before it gets met with the bile. And that whole process is involving, you know, cytokine P450s, cytochrome cytokines. I've been talking about cytokines a lot. Cytochrome P450 and it has to do with glutathione and you know, being able to preserve your glutathione, you know, make it reduced again. A lot of people are so toxic they have glutathione, but it's not usable glutathione. So yeah, all of that stuff really plays into this. And that's when I like to use plants like milk thistle, which has been shown in studies to protect people. If you pre dose with my, with milk thistle before, you know, you're going to be in a moldy environment, it can actually preserve hepatocytes. Oh, wow, that's so cool. And when you look at what milk thistle does, it's that multiple mechanism of action thing. You know, it's preserving the glutathione it's, you know, reducing it. Again, it's helping with glucuronidation. It's helping with all these other parts that have to do with toxic disorders.

Yeah. And anybody who's had mycotoxin illness, like, you know, when you're walking into a moldy environment, it's. It's. You just never lose that. That sense.

Yeah. And it's your body helping you. You know, I mean, it's that people can't sleep when they have mold toxicity. And it's the body saying, we're not safe. We're not safe. Get up, get out. You know, the whole, like, haunted house think, you know.

Yeah.

And it's your body really being smart. So the more we listen to those things and not. I see a lot of people beat themselves up for those reactions, and I feel like, no, that is your body being so smart, it doesn't want to do that ever again. Bodies have an innate drive to be healthy.

Yeah. Yeah. And so in one of the other episodes with Dr. Tessier, we talked a lot about, like, the evaluation and workup and labs and that type of thing. And I don't think we have enough time to go through that whole topic. And I would encourage people just to kind of circle back and listen to that episode. And it was really in depth about testing. Yeah. I would like to just hear if there's anything that you're doing that's new or on the. On the forefront of testing that you would like to add maybe to. For. For us to think about.

Well, I'm sort of on the. Because I'm dealing with people all over the world now. Once you write a book, you know, and so I'm trying to scientifically validate the questionnaire that I've been using in clinic for all these years. I did put it in my book. And any practitioners listening, if they want it, they can just go to my website, drkrista.com questionnaire. You can get it. What I'm trying to do is correlate these various ways of testing for people that can afford testing to the questionnaire and see if it has validity. If we're seeing that there's a number or the numbers that I created, this is just my creation, my little analytical brain trying to get a number. Do those correlate with what you're seeing, with their symptoms, you know, on the questionnaire, with what we're finding on testing? So that might be urine, mycotoxin testing. That's what I'm using mostly. So that's the. That's my next little thing. I'd also love to know the HLA status of those people and the genetic SNPs for detoxification of those people. So we can start to do some data crunching to find out, you know, what are these people actually expressing? Because the urine, mycotoxin is an excretion test. So if you have genetic snips that impair your excretion ability and detoxification ability, you may not be seeing a true test. I know that Dr. Tessier talked about that and yeah, I would highly encourage people, if you want to know more, to go back and listen to that podcast. It was awesome. Yeah. So the. What I'm trying to do is then create a questionnaire, a model that can be just filled out so that someone can say, okay, there are arrows pointing toward mold. Let's spend the money on the building part. So that's my.

Yeah, that is. That is so useful. I'm really glad that you're doing that because a lot of times people can only afford one aspect, either the evaluation or the treatment, and then let alone remediation. And so it can get quite costly. And so if we had a questionnaire that would help people budget and figure out where they can put their resources to get better would be very useful.

And it's a global issue. So, you know, someone in Brazil can't order a Great Plains lab. You know, I mean, they are if you're not in the United States or Canada. And I think they're. Great Plains is working with other, you know, European countries. But, you know, there's a whole world out there that's really struggling with this. And so I'm trying to create a, some kind of model or quantitative way that's scientifically validated against the mycotoxin test.

Okay. And so when people ask you, you know, a lot of times we'll get the question, am I going to get better? You know, is it even worth doing all this? Because it is a lot of work.

It is a lot of work. Yeah. I mean, it isn't. It isn't. I mean, some people, there's an occupational study done where half the people that got out of that environment got better, they had no residual. Of course, all they tracked was, I think they tracked allergy and respiratory symptoms. There were some side comments about other side effects, like GI type side effects, but they reported themselves as better just by getting out. So that's why in my steps, I know Dr. Tessier, too. Get out of the mold. If you can at all. That's going to be the most important piece. The people that come to me who've seen every doctor in the world and then they come work with me, they almost all are still being exposed somehow. If they've been doing this kind of a protocol where you actually also do antifungals, that's what's a little different. Side comments about other side effects like GI type side effects, but they reported themselves as better just by getting out. So that's why in my steps, I know Dr. Tessier too, get out of the mold if you can at all. That's going to be the most important piece. The people that come to me who've seen every doctor in the world and then they come work with me, they almost all are still being exposed somehow. They if they've been doing this kind of a protocol where you actually also do antifungals, that's what's a little different from my approach from like a Shoemaker approach or something like that. That, you know, the way I see it is that that continuum that Dr. Tessier talked about, the various, you know, Venn diagram thing, there's this continuum of being exposed to toxins that goes on long enough. The body starts to sense that threat and starts to convert your own healthy microbiome and sinu biome into a pathogenic biofilm which then can deplete the immune system of those tissues, which then can allow fungal invasion. So I see fungal overburden. I love that word, burden. Now I'm really thinking about that. That fungal burden in the body happen at about the second stage continuum. And so I treat all my patients who have had water damage exposure with antifungals. I am privileged to have plants to do that. I don't have to wait till I have a frank fungal infection to use a drug that has bad side effects. And I treat the sinuses and systemically so we get the gut biome as well and that, you know. So the way I'm seeing it is that if the fungus is the fire creating the mycotoxins as the smoke, just mopping up mycotoxins for a majority of the population and specifically those people with the HLA variation, they're not going to get better because you haven't put out the fire. Healthy people in that occupational study, they weren't living in it. They didn't take stuff with them. They were able to move the building. And those people could get better because mopping up the toxins allowed their immune system to, to reset the fungal balance in the body. But really sick people need that extra help.

Yeah. It was just while you were talking, I was getting a little image of Dr. Crinian standing up saying like, avoidance, Avoidance, avoidance.

That's exactly it. Yep. Avoidance, Avoidance. Avoidance. The first three steps. It's so important. It takes up the first three steps. Absolutely. Yeah. So when someone asks, can I get better? Absolutely. Yes. You do need treatment. A lot of people do need treatment more than just, you know, avoidance. And I think that the other thing is if there's been a secondary issue that has been the mold has caused, that's a little more difficult because now we're chasing two boulders down the hill. So we've got to get to the mold one and we have to get to the autoimmune disease or the cancer or the Ms. Or, you know, all of these different things. Dementia. There's a strong correlation between mold exposure and Alzheimer's. Dr. Bredesen talks about this. If anyone's not familiar, he is a genius and he's working on a new definition of Alzheimer's called inhalational Alzheimer's, which has to do with inhalational toxin based Alzheimer's. And we see that those little tau proteins in the brain make very, very good sponges for mycotoxins. So are they a cause or are they a effect?

No. Yeah, I guess you could. You want to think about any fat tissue. Right. Or fat.

Right.

Fat laced organ.

Yes.

Obesity. Leptin resistance.

Yeah, Yep. And cell membranes.

Yeah.

Mitochondrial membranes. You know, like these are ultra small and they can impede that phospholipid bilayer. They actually harden the raft. There's these, the lipid. I'm sorry, the liver hepatocytes have these lipid rafts that are sort of like a discretionary layer. You know, they can determine who goes in, what goes out. Those rafts get very hardened and they get resistant to absorption of nutrients that we need and excretion of waste. And that's all happening at the cell lining and the mitochondrial lining. And that's mycotoxins.

Wow.

Not so.

Yeah, definitely. So if there was like one moment or one concept that you learned in your career that kind of related to bile or related to mycotoxin that like really shifted, you would do. Do you have anything like that where you had just like a moment where it was like it shaped your practice.

Oh, wow.

Something you learned.

That's an interesting. I think, going even one step up the chain, the secretion. Anyone's not familiar? He is a genius and he's Working on a new definition of Alzheimer's called inhalational Alzheimer's, which has to do with inhalation of stomach acid. I remember when I learned about that. And then that starts the whole cascade of digestion has. Oh, my goodness. You know, that's why this and this and this is happening. You know, the reflux is so often because somebody doesn't have enough stomach acid, which was just, you know, that so really appreciating how important it is that how we eat, the state of our mind when we eat, not just what we eat, because that determines our stomach acid and that starts the whole cascade down below. So, yeah, I think I started with stomach acid and now I've moved down to bile. Yeah, I remember that being kind of a mind blowing thing. And then it really helped lock in how important that was for the, the whole chain. That again, you know, when patients come to me, well, I've seen this doctor, this doctor, I've gone off these foods. I'm like, well, have we done stomach acid? Have we done betaine, hcl? And sometimes they just needed that pump primed again.

Yeah, it's. It's so connected. It's connected to so many things like the vagus nerve function is connected to stomach acid release and stomach acid release signals the, the pancreas and the digest, the whole digestive process. So it's.

Right. Insulin. Yeah, I didn't even think about that.

Yeah, yeah, it's. It's really nice to hear that because I think a lot of times we are. We just kind of jump through these core, jump over these core needs when we're trying to get better, when it's like sometimes we're just overlooking some really foundational stuff and stomach acid. You're right. It's like so essential.

Yeah. And. And what's our, you know, like the. What is it? The third most grossing drug right now is PPIs, you know, and it's just. Whoa. And we're learning so many horrible side effects of those drugs. And I just. Yeah, there's something there.

Yeah. And the thing is this, it's like they can be avoided. And that's the thing is there's so many different alternatives that people just need to learn about in certain cases, obviously. And I've said this on other episodes, that PPIs are designed for a specific condition, you know, where, you know, there's like maybe precancerous lesions or other problems in the gut where they actually really have a solid place but just to be used for, to calm the gut, you know, it's just kind of. But we can do so much better. Well, I'd like to get to, you know, hear some maybe a take home message or take home point and then love to go into hearing a little bit about your, your current practice or your current programs that you're offering and just give some information on how people can follow you.

Sure. So a take home point I think would be that realizing that mold illness is also a toxicity based illness, not just mold allergy. I'm really on the mission. And again, those that listen to Dr. Tessier's talk, we're on this mission to expand the definition of mold illness past allergy. You know, you can have a negative IgE mold allergy test and still be terribly mold sick. So I think that that that would be a good take home. And then for the course that I offer, is it, like I said, called are you missing mold illness? And it's geared toward primary care providers. To give you the full mechanism. I go over each mycotoxin that we can test for today and its affinities in the body. So it really helps you understand what specific treatment you need to be engaging for that person. An example is ochratoxin is very hard on the kidneys. We know that that's gonna happen. And so we might do more kidney support, COQ10 that kind of thing for somebody who has ochratoxin. So. So try to give you the full understanding of what all mycotoxins do like glutathione deficiency, mitochondrial dysfunction, protein synthesis, inhibition, the kind of things that tie them all together. And then we go through each individual one, go over some testing and some of the limitations of the testing that's out there. Urine mycotoxin testing is definitely not without its issues. And then we go through a treatment, an order of treatment. So a therapeutic order. We're very much into therapeutic order as naturopathic doctors. But that really helps guide the what do I do first, what do I do next? You know, and of course first is avoidance. And then go through the nutrients and botanicals and drugs that might be useful in treating. And I might be one of the only people recommending. Well, now I'm seeing it more often, which is really cool. But recommending things like tuka and bile salts and that kind of thing for mold toxicity. So it's really cool tools we have out there.

Great. Excellent. Well, thank you so much for being with me today and you shared so much great information. It's great to just really talk to a real pro and to hear how you think through things. And thanks again for being with us.

Thank you very much. It's really, really been an honor. Thank you.

In our next episode, we'll speak with Dr. Angela Cortel. Listen into this special preview of the next episode of the One Thing podcast.

I'm here with Dr. Angela Kortal, who's our next guest on the One Thing podcast. And we're going to get to know her a little bit. So Dr. Kortal, who had the biggest influence on you becoming a naturopathic doctor?

Well, I had a number of mentors and doctors that I definitely looked up to through, through my education and early practice. But just on a very down, down to it answer is that my, my family and my husband is what contributed to me becoming a naturopathic doctor. Because without them I would for sure have not finished school, not opened my practice. I, I joke but kind of, kind of serious about how I would have died of starvation at some points if my husband wasn't feeding me and taking care of me and my family. Everyone supporting me is how I got through it.

Wonderful. Okay. And what will we be learning together during our interview?

Well, I am very passionate about not ending the conversation when someone says you just have joint pain and to live with it or take this medicine and live with it. I'm all about looking beyond that. Looking at do we really understand what's going on from even just a purely diagnosis basis, is there more to be uncovering about where the pain is coming from and what can we really we as patients do in our day to day life to not just improve that whatever the source of the chronic pain is, but really to change the future, to change the trajectory.

Excellent. And what is currently on your reading list?

Oh gosh, I got a lot of random things. I have quite an eclectic list. I have a, I just started a book about, it's a novel and about, about a woman set in, in Russia at the turn of the 19th century. I have a few mycology books because one of my hobbies is, is going out and foraging and identifying and cultivating mushrooms and, and I'm looking forward to diving back into a couple of books that I haven't read for a few years because now kind of post launch I'm taking more time to do more hobbies like reading and one of one of them I want to go back through. So right up here, these are not props, these are real books on my bookshelf is, is the old Hackett, George Hackett book from the 50s, ligament and tendon relaxation, which is what I would consider like the original book of prolotherapy.

Very cool. Okay. And what is something you personally do to stay healthy?

I am, I have always had a very high priority to my sleep schedule through my nine years of school, undergraduate, medical school, I never pulled an all nighter. Sometimes I had to get up kind of early for, for 8am tests. But I am definitely a minimum nine or I would say eight hours a night person. And, and I do, I do not compromise on that. My husband knows. I'm like, oh, it's 9:30. I'm, I'm getting ready for bed now. I'm going to bed.

Well, that's great. That's so inspiring. So. Well, thank you for answering those questions and we look forward to sharing your interview with us next week.

Wonderful. Looking forward to it.

Thank you so much for tuning in.

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