Mold Toxins and Chronic Illness with Dr. Sandeep Gupta: Rational Wellness Podcast 119
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Dr. Sandeep Gupta discusses Mold Toxins and Chronic Illness with Dr. Ben Weitz.
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Podcast Highlights
3:36 Dr. Sandeep Gupta explained that he fell into the field of mold toxins and chronic illness by accident based on a personal experience. In 2012 his home was flooded and his partner became ill from mold toxicity and was so sick that she was unable to function normally and was unable to do anything except lying around all day. He found out about Dr. Richie Shoemaker and he arranged to be trained by Dr. Shoemaker remotely. He ended up having to do the training at 1:00 or 2:00 am via Skype. It was a steep learning curve and Dr. Shoemaker sent him a 1000 page document to read to start with. It was a difficult learning process and now his goal is to simplify the concepts and information so that more patients and practitioners can have access to it.
7:45 Dr. Gupta explained that what tends to make him suspect that a patient may have an underlying mold problem and Chronic Inflammatory Response Syndrome (CIRS) is when they have a multi-system illness, meaning that they may have some superficial symptoms like cough or sinus congestion and also some bloating and abdominal pain and diarrhea, and also joint pain, and fatigue, and difficulty sleeping and some skin rashes, etc. Another clue is a lack of response to nutritional therapies, such as a typical set of Functional Medicine protocols. They are on a healthy diet. They’ve improved their gut. They’ve fixed mineral and nutritional deficiencies and improved their omega 3/6 balance, etc., and they are still sick. That’s when you start thinking there must be an inflammatory trigger.
12:35 When you have a patient who has done all these lifestyle things to improve their health and are taking a good regimen of nutritional supplements and they are still not well, this is when you should start looking at their history and see if there might be some environmental toxin like mold that is playing a role in their condition. You need to do an environmental history, but Dr. Gupta has found that if you simply ask someone if they live in a moldy home, they will tend to say no, because they don’t want anyone to think that they don’t clean their home. They might take that question as an insult. So Dr. Gupta found he had to be more subtle and ask questions like, how old is the building? Has there been a history of water events or hurricanes or flooding. Have there been any leaks in the roof or around washing machines or refrigerators or under the sink or in the bathroom or in the basement or in the crawl space? The other big thing is if how do they feel when they go away from their home for a period of time? If they feel better when they leave for a weekend trip, that would be a clue.
15:32 The next step is to do a thorough examination and look at their tongue, their nails, and at their skin. Do a brief neurological examination and ask them to hold their arms out straight and if they have a tremor, that may be a sign of an elevated TGF beta 1. If they sit on one of those lattice back chairs and they get up and they still have the imprint of the chair on their back for some time, that’s called dermatographia, and that could be a sign of elevated C4A, which could indicate CIRS. Dr. Gupta will also look for signs of Ehlers-Danlos spectrum disorder, by looking for signs of joint hypermobility.
19:15 The next thing to do is the Visual Contrast Sensitivity (VCS) test, which can be done online through SurvivingMold.com. Dr Gupta recommends having the patient do the test in your office, since it will be more accurate that way. If they fail the VCS test, that’s quite a strong indicator that CIRS may be present. If they don’t fail it, it doesn’t exclude it. And you need to check to see if they have above average eyesight, that’s the most common reason that they will still pass even if they still have CIRS. Then the next thing is the symptom cluster questionnaire.
22:03 Then you should do some lab work. You can order a nasal swab for MARCoNS (Multiple Antibiotic Resistant Coagulase Negative Staph) and the sample should be sent to Microbiology DX in Massachusetts. Blood biomarkers that are recommended include: 1. C4A, 2. TGF-beta 1, 3. MMP-9, 4. MSH, 5. VIP, 6. ACTH, and 7. ADH. If you have a positive visual contrast test and symptoms of CIRS and you have 3 or more abnormal markers, then you can make a diagnosis of CIRS and you can start them on a treatment program. Even though this indicates CIRS, which is an activation of the innate immune system, it’s not 100% specific for mold toxicity. That requires testing the home or having a mold sabbatical where the patient leaves their home for 5-7 days and feels better. If they feel a lot better while on the sabbatical and their symptoms are reproduced when they go back to their home, that is a strong indication of mold toxicity.
27:15 Testing of the home can be helpful, but it’s not perfect. Dr. Gupta recommends the ERMI test, which can be quite sensitive. But even if there is evidence of mold, we still do not know that that amount of mold affects that person. Also, if a person gets a test result that shows a lot of mold, it may send them into a panic that may make their symptoms worse. And we have to consider that mold is not the only cause of CIRS. We have to consider a similar condition, Mast Cell Activation Syndrome, that can cause some of the same lab results as CIRS. We also have to consider stealth infections such as Lyme Disease and its co-infections, Bartonella, Babesia, and mycoplasma. We also have to look for parasites and viruses and retroviruses. But mold is a really important and under recognized trigger for chronically unwell patients who seem to be resistant to care.
31:29 It makes sense to do a urine mycotoxin test for patients where you suspect mold exposure, such as the Great Plains MycoTOX profile. Some practitioners recommend doing a challenge, such as with glutathione 500 mg twice a day for a week prior to the test, since sick patients may have their mycotoxins sitting in their cells and not being eliminated so the test can detect them. But Great Plains recommends not doing a challenge prior to the test. And you also cannot exclude a food source of mycotoxins for the findings of the urine test.
34:52 Treatment should start with moving out of their home or office to get away from mold exposure or at least doing a mold sabbatical and leaving for at least 5 days. If you can’t move out or do a mold sabbatical, then use air purifiers and get the home remediated. It’s not a bad idea to do a liver detoxification program to make sure the liver is producing plenty of bile for the binders to work properly. Dr. Gupta prefers to start with the prescription binders, Cholestryamine and Colesevelam (Welcol), though he may recommend the nutritional binders later, like charcoal, bentonite clay, and Zeolite. He often recommends his patients do coffee enemas and liver gallbladder flushes. For the liver flush he will have them take Premier Research supplements Liver-ND and Gallbladder-ND first for about a month. Then he will get them to have green apples and then drink Epsom salts and then take a drink of olive oil and citrus, which will get the gallbladder to have a huge squeeze. If they are very unwell, though, this can be a very aggressive treatment and can make them feel worse. Dr. Gupta’s favorite binder is Welcol and he will typically do it until their VCS is normal. If their VCS test is normal, he will stop the prescription binders. At this point, he may do a urinary mycotoxin test and if it shows that they are still excreting mycotoxins, then he may continue with ongoing natural binder treatment.
44:39 Dr. Gupta may add some form of natural gut support to his patients to make sure that the mold gets excreted. He will check if the patient has parasites or mold or candida and, if so, he will typically use natural antiparasitic agents and natural antifungals. He also finds supplements of Betaine HCL and digestive enzymes very helpful. He will often work on the gut as the same time as they are taking binders. Towards the end of treatment after most of the exposure to mold is over and they have done enough binders and VCS test is normal and they have cleared nasal MARCoNS and other infections, and sometimes he will use ozone theory. The treatment for the MARCoNS is generally things like silver, an EDTA nasal spray, botanical nasal sprays like Biocidin, and then nasal probiotics using a product with lactobacillus sakei, which is the strain found in Kimchi. Some people just place a little bit of Kimchi in their nose, but this may burn. Then they are ready for the final phase of treatment.
50:05 For the final phase of treatment, Dr. Gupta will often recommend Vasoactive Intestinal Peptide (VIP), which is taken as a nasal spray. He will often have his patients get a special kind of MRI called a NeuroQuant, which is a computerized analysis of a brain MRI, and it looks at a number of different brain regions and compares them to age and sex match controls. If they’ve got shrinkage or atrophy of the brain, this can pose a risk for Alzheimer’s Disease, so we want to return that to normal and VIP can be effective for that. And VIP may also help to de-escalate some of the remaining inflammation. They may need to take VIP for several years. They may also benefit from brain retraining methods, such as the Gupta program designed by Ashok Gupta (the “other” Gupta) at GuptaProgram.com. There are a number of other brain retraining programs, including Annie Hopper’s DNRS system and the program from Norman Doidge, who wrote the book, The Brain That Heals Itself.
Dr. Sandeep Gupta is an integrative MD with a practice focus on mold and chronic illness, including the Chronic Inflammatory Response Syndrome (CIRS). Dr. Gupta has physician training certification with Dr. Ritchie Shoemaker in Chronic Inflammatory Illness and a Masters of Nutrition with Dr. Gabriel Cousens. Dr. Gupta is in practice in Maroochydore, Queensland in Australia at Lotus Holistic Medicine and he established a Physician Training program for learning about treating patients with mold illness at Mold Illness Made Simple and also atLotusInstituteHH.com Dr. Gupta is also a part of the Functional Diagnostic Nutrition group, which is dedicated to educating people about health.
Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com.
Podcast Transcript
Dr. Weitz: This Dr. Ben Weitz with the Rational Wellness podcast, bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field. Please subscribe to the Rational Wellness podcast on iTunes and YouTube and sign up for my free e-book on my website by going to DrWeitz.com. Let’s get started on your road to better health. Hello, Rational Wellness podcasters, thank you so much for joining me again today. For those of you who enjoy listening to the Rational Wellness podcast, please go to Apple podcasts and give us a ratings and a review. That way more people find out about the rational wellness podcast. And you can go to YouTube and see the video version of this podcast by looking at Weitz Chiro or searching for Rational Wellness podcast. And if you go to my website, DrWeitz.com, you’ll find detailed show notes and a complete transcript.
Our topic for today is mold and chronic illness with Dr. Sandy Gupta. Exposure to mold and mold toxins, mycotoxins, affects many people and often is a undiagnosed underlying trigger for many other symptoms and conditions. Many people are unwittingly living or working in water damage buildings. And this exposure can be caused by negative, can be causing negative effects on your health, including coughing, wheezing, these are some of the symptoms, respiratory symptoms, shortness of breath, skin rashes, headache, vertigo, fatigue, memory and other cognitive deficits, abdominal pain, nausea, diarrhea, so those are some of the GI symptoms, joint pain and muscle aches, increased urinary frequency, weight gain, electric shock type paints. There’s a bunch of others.
Mold or mycotoxin exposure can result in a chronic condition referred to as Chronic Inflammatory Response Syndrome. Quoting to an article written by Keith Burnstein M.D., who has studied with Dr. Richie Shoemaker, you have to have the following criteria before being diagnosed with Chronic Inflammatory Response Syndrome. One, you have the history, signs and symptoms consistent with biotoxin exposure. Two, you have a genetic predisposition to biotoxin related illness. Three, you have abnormal visual contrast sensitivity testing. And four, you have positive biomarkers on lab testing consistent with the neuro immune vascular and endocrine abnormalities that characterize Chronic Inflammatory Response Syndrome.
Dr. Sandeep Gupta is an integrative M.D. with a practice focused on mold and chronic illness, including the chronic inflammatory response syndrome. Dr. Gupta has physician training certification with Dr. Richie Shoemaker in chronic and inflammatory illness, and he has a master’s of nutrition with Dr. Gabriel Cousins. Dr. Gupta established the Lotus Institute of Holistic Health in 2017 to provide training in integrative medicine. Dr. Gupta, thank you so much for joining me today.
Dr. Gupta: Thanks for having me, Dr. Weitz.
Dr. Weitz: Excellent. So how did you get interested in studying mold and dealing with patients with mold toxicity?
Dr. Gupta: Yeah, I actually fell into this field more or less by accident, and it really started with a personal experience of water damage to a house in that my house was flooded, and I think it was around 2012 here in the Sunshine Coast of Australia. Basically, our whole bottom floor of the house was inundated with water and we lost quite a lot of possessions and so on. But more importantly, my partner at the time became very, very unwell. She was basically in a lying around most of the day, unable to function at all. Really, I couldn’t understand what had happened. I didn’t really have a good model for understanding that, and so I started researching, as would anyone who wants to help out a partner or a family member. And actually, a patient came in and finally told me about Richie Shoemaker and suggested that perhaps I could learn a little bit about Richie Shoemaker, and become certified, and help a whole bunch of people in Australia. And I thought, “Well, yes. I mean, why not?” I mean, I’ve got someone who’s really, really unwell from what appears to be a water damaged building, and I have nothing else I know, or you know, I had no one else I know to refer her to or no other real approaches. I contacted Dr. Shoemaker, and it took quite a while to connect actually to start with, and there was some logistic difficulties and so on. I ended up having to do the training at around 1:00 or 2:00 AM in the morning, I think I was telling you.
Dr. Weitz: Wow.
Dr. Gupta: Via Skype, once a month. It was a really steep learning curve, man. It was like… I didn’t know what he was talking about to start with. He was throwing acronyms like C4A and TGFBeta1, and MSH, and MMP9, and so… And then he sent me a few thousand page documents to read. Not 100, 1000 as far as I remember. Like the WHO guidelines, and the GAO guidelines, which is the Government Accountability Office guidelines for water damaged buildings. Yeah, I mean my motivation was big enough. And that’s the thing. To get into a new area, you need motivation, otherwise I guess it’s… I guess for most physicians, if you don’t have that motivation to learn new and innovative areas, you just stay to what you know and you just tell everyone, “No. No. There’s no problem with mold.”
But for me, I needed to have a major life situation happen to give me enough motivation to go and really take the time to speak with Dr. Shoemaker, read a whole bunch of documents, and take the time to just make a model for myself in my head. It was a very difficult learning process, to be honest. I think since then, I really tried to simplify the whole thing for my patients and also other practitioners, which is probably something we’ll talk about later. But it can be simplified quite a lot, and through that understanding or going through Dr. Shoemaker, I was able to offer a version of this protocol for people in Australia, and many people did find benefit, which was very heartening to see.
Dr. Weitz: That’s great. Yeah. It definitely can be quite complicated and difficult to kind of sort through. Hey Doc, I might want to suggest that maybe if you looked up a little bit we could see your face a little better.
Dr. Gupta: All right, sure. Yeah, no problem.
Dr. Weitz: Thanks. When you suspected a patient may have an underlying mold problem as part of their health struggles when you’re seeing patients in the clinic, what are some of the first things that make you alert to that possibility?
Dr. Gupta: One of the first things actually is just the fact that they’ve got what we call a multi system illness, and then I think you’re eluded to that when you’re talking about the symptoms that it wasn’t just one body system. And I think when you started talking about the symptoms, you first started off with talking about things like cough and sinus congestion and so on. And that’s what a lot of people relate to to this sort of problem you might get through mold, but that’s just really just a very superficial level you could say of symptoms. You know and…
Dr. Weitz: Oh I’ve got the mold, I’ve inhaled it, so it’s affecting my respiratory system.
Dr. Gupta: And yeah. I guess, pretty much anyone who’s exposed to enough mold will start getting those kind of symptoms, and that’s often just due to the colonization of the mold in the body. And even whether or not you’re genetically susceptible. However, that’s not CIRS. CIRS is when you have a whole host of bodily systems involved, and you mentioned the gut. You mentioned energy.
Dr. Weitz: And CIRS is the Chronic Inflammatory Response Syndrome. This is this chronic sequella of…
Dr. Gupta: Oh yes, thank you. Yes. Thank you. That’s the acronym, or even we’d even go further and call it CIRS because you get really lazy after a while. There’s many body systems involved. So if a person comes in and they say, “I’ve just got some bloating and I’ve got some diarrhea and so on.” Well, that’s not CIRS. That’s just one system. But if they say, “I’ve got some bloating and I’ve got some abdominal pain and diarrhea, but I’ve also got joint pain, and my energy’s gone, and I’m not sleeping. And I’m getting these funny rashes on my skin.” Okay, then that’s starting to sound more like it. That’s multiple systems involved.
Now, one of the second things, which Dr. Shoemaker doesn’t talk about as much, but it is really important is the lack of response to nutritional therapies. That’s a really important point that I’ve found through the years. And one simple thing is if basic nutritional medicine and Functional Medicine has already been instigated and it hasn’t been successful, in my view, that’s also a very strong point to the fact that there’s a lot of inflammation going on, and that’s blocking some of the pathways whereby functional medicine protocols would otherwise be useful.
Dr. Weitz: Right, so for example a patient comes in with fatigue, and maybe you do a nutritional analysis, and you find out they’re lacking certain nutrients, and you give them some extra nutritional support, and they still feel fatigued.
Dr. Gupta: Yeah. That’s exactly right. And so that in itself is a pointer towards it, the lack of response of other protocols. And so that’s another really important thing. And just the duration of time they’ve had it is also really important, you know? And so with patients who just come in and they’re quite new to the world of functional medicine, I will often still try simple things to start with. I look at their mineral balance, I look at their gut health, I look to see if they have parasites, et cetera. This is not the only thing I look at for sure. But the further they are along the functional medicine journey, the more I will start to look at CIRS earlier on and jump straight into that. So if they tell me, “Look, I’ve already seen 20 doctors including 12 functional medicine doctors. I’m on the best possible diet you can ever imagine. It’s totally… I haven’t eaten sugar for 20 years. I’m not on any grains. I’m on the basic supplements.” They pull out their supplement lists, these are all the tests I’ve had. And you know, you’ve had patients who come with a…
Dr. Weitz: Oh sure.
Dr. Gupta: Oh yeah. The water results, that figure, or that’s kind of a clinical side of CIRS, right there. So that means to me they’ve been through the mill of the standard Functional Medicine approach. They’ve already had their gut health improve, they’ve got their diet on track. Often they’ve had their mineral balance instigated and they’ve treated things like pyroluria, they’ve really got their… They’ve got biosis working a lot better. Maybe they’ve looked at their Omega-3 and Omega-6 balance, and all these things are coming in place. But they’re still not well. That’s when you start thinking, “Okay, you’ve got an inflammatory trigger here. You’ve got a big biotoxin problem most likely that’s preventing those biochemical pathways by which Functional Medicine would usually work to actually be effective.” And that’s where often in those patients I would jump straight into evaluation for CIRS or CIRS.
Dr. Weitz: Okay, so how do you work up your patients for that? What’s the first thing you look at?
Dr. Gupta: Yeah, so the first thing is just simply that we discuss it. Is it a multi-symptom illness or is it more single system? The other really important things is doing an environmental history, and it takes a little bit of practice because when I first started doing this, I used to ask people do you live in a moldy building? And universally the answer to that question is, “No, of course I don’t. What do you think I am? Some kind of person who doesn’t clean their house?” It’s almost taken as an insult. I realized one had to be a bit more subtle and start asking about the history of their home and their workplace. Firstly, how old is the building? Has there been a history of water events or tornadoes or anything like that that I guess you’d be asking about in America. We call them cyclones here in Australia. Or flooding events, has there been a flood in the area? Has there been leaks? Either of the roof, or white goods, such as a refrigerator, or a washing machine. Are they aware of any musty smells or any type of unusual odors in the house anywhere? And are there any areas of the house where they can see some patchy discoloration on the walls at all? And how about the crawlspace? How about the basement? Do they notice they don’t feel well when they got into those areas?
There’s a bunch of questions like that that can give some clues. Of course, that’s not definitive, but that can most definitely help. And the other big thing is how do they feel when they go away from their home for a period of time? And of course, very sick patients may well not be able to leave the house. They may not have done that for some time. But some people do travel and if they have for instance gone away from their home for five or six days, they may not have connected the dots, but they may be like, “Yeah doc actually I felt a lot better when I left my house and I went to that conference in Orlando a couple weeks ago,” Right? These are all clues. These are clues. And so I start with that side of things. There are some more specific symptoms. One of them is more like electric shocks or a vibratory sensation and other kind of more neurological symptoms are thought to be more specific for more toxicity. And so I ask about those. Also fevers at night is thought to be somewhat of a specific one. Do they get a lot of thirst and do they have excessive urination, that’s another one that’s somewhat specific, not 100%. So that’s the first part is just the history as with any evaluation.
Dr. Weitz: And what’s the next step after that?
Dr. Gupta: The next step after that is getting into examination, and as much as I think the examination is excluding other possibilities. I do a nutritional examination. I look at their tongue, I look at their nails, I look at their skin. I look to see if there’s obvious inflammatory signs. Now one really important sign that you do as part of that is ask them to stretch their arms. And if they have a fine tremor like that, that might be a… that may be a sign of elevated TGF Beta1 levels. So that’s a clue. There can be other things that cause it as well. There’s something also called dermatographia. If you can see that, for instance, if you have them sit on one of those lattice back chairs, and if they stand up and you can see they’ve still got the imprint of that chair on their back for some time, that’s also dermatographia, and that’s a sign of elevated C4A. So there is some little signs like that.
The other big thing is looking for do they have signs of hyper mobility. And hyper mobility or joint flexibility is part of Ehlers–Danlos syndrome and Ehlers-Danlos spectrum. And it also means that their arm span is longer than their height or their wingspan. And so you can measure that. But also just having a look at how far can they move their thumb, how far are they able to extend their wrists, and various other joints. If there’s a significant increase in the joint mobility, that’ll be a strong pointer towards an Ehlers-Danlos spectrum disorder. Some people are not actually that hyper mobile, but they just notice they’ve always had sore joints, and they’ve just got… they’re aware that there’s a history of Ehlers-Danlos. That’s actually very, very important. There are some other subtle signs you can do like looking for signs of mast cell activation.
Dr. Weitz: Let’s say if they have Ehlers-Danlos what does that have to do with it?
Dr. Gupta: That is actually a risk factor, a genetic risk factor.
Dr. Weitz: Okay.
Dr. Gupta: And particularly, actually for Mast Cell Activation Syndrome.
Dr. Weitz: Okay.
Dr. Gupta: But it seems it is for CIRS as well. Because one of the things that’s being described is that their collagen in their connective tissue is less well-linked, they tend to release more TGFB to one. So it’s more likely they’re going to have a high TGFB to one, but also it’s more likely they’ll have Mast Cell Activation Syndrome, which is like a sister syndrome to CIRS. And also what we call Postural Orthostatic Tachycardia Syndrome, or POTS. So there’s a bit of trifecta where Ehlers-Danlos syndrome, Mast Cell Activation, and POTS. It just points you in a certain direction of investigation. There’s also some specific treatments from Ehlers-Danlos, for some people are quite useful and effective. I find that very important to look at.
Dr. Weitz: Yeah. Interesting. Increases the risk for SIBO as well.
Dr. Gupta: Right. Yeah. That’s right. So there’s a whole bunch… Yeah. SIBO could also almost be put into that trifecta. There’s a really interesting recent paper actually where a patient with Ehlers-Danlos and had MCAS and POTS and SIBO, and was treated with antibiotics and intravenous immunoglobulin. We call that IVIG, and low-dose naltrexone. The combination of those, and it was reported that they made a complete recovery just by it.
Dr. Weitz: Wow.
Dr. Gupta: Yeah, which is actually quite difficult in those syndromes. So there is some interesting research going on in those, in that area. So anyway, moving down the CIRS line a little bit further. The next thing is to do what I call the Visual Contrast Sensitivity test, of the VCS test. And you can get one of those kits online from SurvivingMold.com. And patients can do that test online as well at that website, but in my opinion it’s more accurate if you have one in your office to use that in person. You get an idea and sometimes you can make some subtle adjustments to the test based on their eyesight and so on. I do believe it’s more accurate overall.
If they fail the VCS test, that’s quite a strong indicator that CIRS may be present. If they don’t fail it, it doesn’t exclude it. And you need to check do they have above average eyesight, that’s the most common reason that they will still pass, if they still pass the VCS test but they still have CIRS. Yeah, especially if they’re quite young and they’re in artistic and other professions. And I generally find females tend to have better eyesight in general for some reason. So that may be a reason that VCS is normal or at least a pass despite them still having CIRS. In the cases where it’s abnormal then it becomes a very useful progress marker because you need to follow it during the treatment and make sure it goes to normal. If it’s not abnormal, then it’s not as useful as a progress marker. In some cases, it’s very useful. In some, it’s not as useful unfortunately.
Those things I do, and then based on those, you can actually make quite a good assessment of whether they do have CIRS or not. There’s also a symptom cluster questionnaire you can use from Dr. Shoemaker where you’re looking at symptom clusters, and if they have seven or more, you generally want to evaluate them for CIRS, but really that symptom cluster just goes to the, just speaks to that idea that it’s very multi-system. So you can actually just do that evaluation. So if it’s very multi-system and they fail the VCS, you’re already looking that it’s highly likely they’ve got CIRS.
And I think Dr. McMahon, Scott McMahon, did a study saying that even with those things, and he also did, added something called anti-gravity testing where you actually will push down the shoulders of the patients and found which arm fatigued first. And if it’s the dominant arm that gets fatigued first, that was called a positive test. And he found with the combination of those three signs that it was somewhere around 95% accurate for predicting CIRS. So even just that part is very useful.
The next thing I would usually be to order some lab work. And in a Australia, it’s not quite as simple as in America. But basically… A very simple thing a functional medicine practitioner could do would be to order a nasal swab and see if the patient has a bacteria called MARCoNS, which is it starts for Multiple Antibiotic Resistant Coagulase Negative Staph. We send that to a Micro Biology DX in a Massachusetts. And then the thing after that would be to decide if one wants to do the classic CIRS testing and-
Dr. Weitz: What about the urine mycotoxin test?
Dr. Gupta: Yeah, so that… I was going to get onto that in a moment. Do you mind if I first just cover the blood biomarkers?
Dr. Weitz: Sure. Yeah.
Dr. Gupta: The blood biomarkers are the classic way of diagnosing CIRS. And as you mentioned with Dr. Keith Bernstein’s essay, those things that he’s talking about are the blood tests. They’re the blood tests. And so what he’s saying when he’s saying the typical blood test that show the typical neuro hormonal changes of CIRS, that means there’s an increase in the inflammatory markers. So we call them, they’re compounds that fuel the fire of inflammation in the body, and that includes C4A, TGF beta 1, and MNP9. They’re available through Quest and LabCorp, and there’s very specific labs for each one that’s recommended. There’s also another called C3A, but that’s generally only raised in acute bacterial infections, and I haven’t found that to be a very useful marker overall. And then there’s a number of different tests or hormones which are lowered in CIRS. And they’re basically compounds which put out the fire of inflammation in the body, but they’re too low. So it’s like you’re firefighters are not working. And so they include MSH and VIP and ACTH. There’s also another one called ADH or Anti Diuretic Hormone. That’s the typical pattern is that there’s a bunch of compounds that are elevated, and there’s a bunch of compounds which are lowered. Now…
Dr. Weitz: Does anybody have a panel putting all of those together?
Dr. Gupta: Yeah, I think Life Extension have like a panel. But they’re still only sending to LabCorp. And yeah. And so yeah generally speaking, I think, I don’t know anyone who’s put the panel of both of the… The Functional Diagnostic Nutrition group, or FDN, which I’m a part of, is looking closely at developing a panel for CIRS. And I think they now have developed a panel, which is again mainly through LabCorp, but we also have access to Quest for functional medicine practitioners. So that’s a classic thing-
Dr. Weitz: Okay. Can we just review those really quick one more time?
Dr. Gupta: Yeah sure. So there’s a bunch of markers that get elevated, that includes C4A, TGF-beta 1, and MMP-9. And then there’s a bunch of compounds which are lowered, which includes MSH, and VIP, and ADH.
Dr. Weitz: Okay.
Dr. Gupta: And so one other is ACTH. And yeah. I won’t go through which ones exactly are ordered through Quest and which ones through LabCorp because I think that just becomes too confusing. But the classics things is if you’ve got the other elements that Dr. Bernstein talked about in his essay and you have at least three or more abnormal markers, then you can make a diagnosis of CIRS. And you start people on the treatment program.
Now to be honest, it’s not 100% specific for mold toxicity. I want to make that clear. It really just shows that you have an activation of the innate immune system, and then you do need to do some more detective work. You do need to find out if the person does have a water damaged building, and you may want them to get an inspection of their building or at the very least, have a closer look at it. And in many cases, a very useful thing to do is to ask them to leave the home for five or seven days and do what we call a mold sabbatical. And ideally, they go camping. I guess that’s probably only amenable to certain areas of the U.S. more than others, and if they can do that, and go camping, and make sure they’re away from any water damage items. You don’t want to get them to take everything from their old house to the tent because that may be a source of exposure still. If they feel a lot better during that mold sabbatical, and then their symptoms are reproduced by going back into their home, that’s a very strong pointer to the fact that mold toxicity is a big part of this inflammatory response syndrome that they’ve got. So that’s very important.
Dr. Weitz: And do you recommend testing of their home for mold?
Dr. Gupta: Yeah, I do. I mean, testing… The thing is testing has its pros and cons, and it’s not perfect, but the ERMI test, which is a form of PCR testing is quite sensitive. But again, even with the testing, it’s still only a statistical number. You still need to find out is the person themselves being affected by that amount of mold in their home. And that’s why I found the mold sabbatical is very, very useful. And it also becomes the person’s personal experience. And there’s a couple of psychological factors here that don’t get talked a lot about a lot. But one is the fact that if the person can start to feel that they understand their body and how it’s responding to mold, I think that gives them a lot of power and feeling of, I guess off having control, having this syndrome in their… They’re able to get on top of it, basically.
However, if you get a test, someone gets a test that’s very, very high, often that can send them into panic. And the panic in a sense and that activation of their limbic system, that’s actually part of the whole inflammatory response. So there’s some subtle sides of it which have taken me a while to get a full understanding of. But one thing is you not only want to find out that they’ve got it and treat them, but you want to put them on a pathway whereby they start to de-escalate in terms of the panic associated with it, that there’s a sense of calm, and there’s a sense that they know what to do and they can go about doing it. And so, so it’s a bit of a way up. But I’m moving more and more towards the mold sabbatical as a way of working out how much mold toxicity. There is a bunch of other things like looking at Mast Cell Activation Syndrome. That can actually give the same kinds of elevations and lowerings of those markers that CIRS can. So it’s very much a sister syndrome, and the treatment is quite different. And then looking for stealth infections, such as Lyme Disease and co-infections, Bartonella, Babesia, mycoplasma, those things are very, very important. Also looking for parasites of different types, and then looking for viruses and retroviruses is also very important. There’s a whole grouping of causes, not just mold toxicity, but mold is a really important and under recognized one that’s often playing a part to some degree in most people who are chronically unwell and can’t get better.
Dr. Weitz: Cool. I’ve really been enjoying this discussion, but I’d like to pause for a minute to tell you about our sponsor for this podcast. I’m proud that this episode of the Rational Wellness podcast is sponsored by Integrative Therapeutics, which is one of the few lines of professional products that I use in my office. Integrative Therapeutics is a top tier manufacturer of clinician designed cutting edge nutritional products with therapeutic dosages of scientifically proven ingredients to help our patients prevent chronic diseases and feel better naturally.
Integrative Therapeutics is the founding sponsor of TAP Integrative. This is a great resource for education for practitioners. I’m a subscribe to TAP Integrative. There’s videos, there’s lots of great information constantly being updated and improved upon by Dr. Lise Alschuler who runs it. One of the things I really enjoy about TAP Integrative is that it includes a service that provides you with full copies of journal articles, and it’s included in the yearly annual fee. And if you use a discount code Weitz, W-E-I-T-Z, you’ll be able to subscribe for only $99 for the year. And now, back to our discussion.
Dr. Weitz: And then would the next thing you do would be to order one of these urine mycotoxin tests?
Dr. Gupta: Well, you can consider it for sure. And it’s actually something that’s just come onto the scene most, fairly recently. And there’s three different companies now that are offering it, at least three. Maybe there’s more by the time this podcast gets out. But the original lab was called Real Time Laboratories, and they were using an ELISA test for looking at subfractions of the mycotoxins in the urine. And then the second lab that came out is Great Plains Laboratory, and they used a different and more sensitive technology called mass spectrometry. And they seem to have a higher rate of positives and then now we’ve got Vibrant Labs, who’s also doing it.
In general, I think the test has been found to be somewhat useful by many of the practitioners. Although, again, it’s not a perfect test. And I want to really emphasize this fact. None of the tests are perfect in CIRS. And really there’s a lot of clinical acumen that needs to go into it, and nothing really substitutes for just the clinical experience of working with people with the syndrome. So yes, you can do a urine mycotoxin test. Great Plains is often the lab we recommend. Some people are recommending different forms of provocation, such as using glutathione, 500 milligrams twice daily orally for a week before hand, and or sauna or hot baths. You can do that. It still hasn’t been well tested. Great Plains themselves are not really recommending that you do the provocation.
Dr. Weitz: Yeah, in fact they’re recommending that you not do that.
Dr. Gupta: Yeah. That’s right. That’s one little point of controversy. But I guess the problem is that some people, some of the sickest patients will be negative, and so the idea is that if you can provoke them. And you know Dr. Nathan I think is one of the advocates of that, then it’s more likely that because the problem with the really sick patients is they’re not moving their mycotoxins. They’re just sitting in the cells causing inflammation. And so that’s one of the problems with it is that a negative result may actually mean that the patient’s quite sick from mold and not able to clear it. And maybe we’ll find other methods of provocation in future.
But the other part of it is that you can’t totally exclude a food source to the mycotoxins that are in their urine. I think it’s very important that the person is on a very clean diet, like a mycotoxin free diet before you ask for that testing. And then if you see, and a small amount of ochratoxin, maybe up to eight or 10 is still fairly normal and I think could be put down to just overall daily exposure from food and general incidental exposure if you like. If you find that the levels are a lot higher than that and you’ve got a number of other mycotoxins, that may be a pointer to where the presence of mold toxicity, either present or past.
Dr. Weitz: Okay.
Dr. Gupta: Yes, that definitely is another test that can be done, and it’s interesting, but I want to emphasize it’s not perfect.
Dr. Weitz: Right. So now what about the treatment?
Dr. Gupta: Yeah, so once you’ve decided that mold toxicity… I’m going to sort of separate the two things. The first one being mold exposures and mold toxicity, and when I use that term mold toxicity, really what I mean is that firstly you’ve identified that they’re being exposed to mold, and there’s clearly a symptomatic response to mold. Okay? If they’ve got mold toxicity and they’ve got CIRS, then using a modified version of the Shoemaker protocol is still quite useful. So there’s different… Basically, what Dr. Shoemaker found is that the pharmaceutical binders were the most effective. I’ll actually track back a moment first before I go onto binders. The first thing and the most important thing is that they get away from the source of mold exposure.
Dr. Weitz: Right.
Dr. Gupta: That’s actually the first thing.
Dr. Weitz: And that’s probably difficult for a lot of patients.
Dr. Gupta: Yeah. It is. It is. And that’s why, for instance, if you get them to do mold sabbaticals, maybe you can get them to do a number of mold sabbaticals. One thing is it becomes their personal experience. And I think that’s really important. Somehow that seems to have a more beneficial effect on the psyche than just seeing like an ERMI test that’s off the charts and a urine mycotoxin test that’s off the chart because it’s sort of… It’s just… I don’t know if you work with patients that have this. It’s just something that’s quite confusing and panic inducing for them because they haven’t really necessarily personally had the experience that mold’s got anything to do with their symptoms, but their tests are saying so. So it creates this huge disparity and panic.
While on the other hand, if it becomes their personal experience and they go and do a mold sabbatical, they feel heaps better, they come back and they notice a reproduction, they can start to… What often happens is their sense of smell starts to improve and they start to smell it all of a sudden. Then you’re starting to get… They’re starting to get it, personally. And it’s not so much… They’re not so much in panic around it. They can be pretty confident that they’re being affected by mold and simply they understand then what they need to do is get to a place like the place that they went for the mold sabbatical. Now it may not be living in a tent, and I think that has some negative psychological effects for most people. But it means getting into a home that’s much, much safer.
In some cases, it may mean using air purifiers and different types of air purifiers for sometime as an intermediary step. And maybe even the new home that they get to if they’re not able to have their current home remediated, may need to have air purification running all the time. But the key is you need to basically be in a house that’s not fundamentally water damaged.
Dr. Weitz: Right. And now you were about to say something about binders as one of the treatments. I’ve heard a number of practitioners recommend doing some sort of liver detoxification and support for bile secretion as a precursor before using binders. What do you think about that concept?
Dr. Gupta: Yeah. I think that’s pretty sound because binders need to bind onto the bile. And if you’re not producing much bile, there’s nothing for them to bind onto, very simply.
Dr. Weitz: Right. Now I guess there’s different kind of binders, but some of the binders are bile acid binding resins, right?
Dr. Gupta: Yeah. That’s right. They’re more the pharmaceutical version, and as I started to say before, Dr. Shoemaker and his research team found them to be the most effective, Cholestryamine and Colesevelam was marketed as Welcol in America. But it’s actually known by different names around the place. They are generally the most effective, especially if someone is still getting exposed to mold.
The other method… There are multiple other binders, and some people do have bad troubling side effects from these, particularly if they have Mast Cell Activation Syndrome or multiple chemical sensitivity, they may not be able to tolerate hardly any Cholestryamine and Colesevelam, and it’s very important to start with a low dose and build up. And I think Dr. Neal Nathans kind of introduced that idea to the mold community, and I think it’s very valid. Start low, build up, and don’t go any further than a dose that starts causing significant reactions.
Dr. Weitz: Now at the strong pharmaceutical binders are creating symptoms, might it make more sense to start with some nutritional ones first?
Dr. Gupta: Yeah. There’s no problem with doing that. I generally don’t find they’re very effective if they’re still being massively exposed to a water damaged building. But yes, there’s basically charcoal, bentonite clay, Zeolite, and various others that have been trialed. And some people also select the binder based on the urine mycotoxin test. And generally my approach, and you could say to some degree I tend to get some of the more serious patients, but my approach has been to use the pharmaceutical binders to start with, especially in the first part of their treatment when they’re still often being exposed to quite a lot of mycotoxins. And then once their VCS test has become normal, that was the point in which the old Shoemaker protocol you would stop using binders totally, I might consider doing a urinary mycotoxin test at that point to see if it appears they still have a number of different mycotoxins in the system, and then consider having ongoing natural binder treatment.
Dr. Weitz: So what’s your typical course of treatment for the binders? Do you start with-
Dr. Gupta: Yeah, so let’s say it’s six months on Welchol. Welchol’s actually my favorite now. I think it’s much better.
Dr. Weitz: Will you automatically say we’re going to do six months and then reassess?
Dr. Gupta: Well no, I won’t say we’ll do six months. I’ll say let’s start this and let’s see how long it takes your VCS test to be normal and for you to be away from a water damaged building.
Dr. Weitz: And if they say is it going to be for a couple of weeks, what do you say?
Dr. Gupta: I say yeah, welcome to the real world.
Dr. Weitz: Okay.
Dr. Gupta: Wakey wakey. Unless they’re not in a water damaged building, but that’s very few.
Dr. Weitz: Right.
Dr. Gupta: Yeah.
Dr. Weitz: Okay. And then do you support the liver in bile secretions in some way as part of…
Dr. Gupta: Yes. Yeah.
Dr. Weitz: How do you do that?
Dr. Gupta: Well one thing I do really recommend is the use of coffee enemas.
Dr. Weitz: Okay.
Dr. Gupta: And that’s the main way that I use because basically when you’re doing the coffee enema regularly, it causes your gallbladder to squeeze and release bile. It’s actually been shown endoscopically that there’s an increase in bile secretion and it appears to increase glutathione or one of its enzymes, glutathione s transferase, very significantly. I actually find that to be very, very effective, and more effective than actually giving glutathione in fact.
Dr. Weitz: Do you give glutathione as part of your protocol?
Dr. Gupta: Sometimes. Not usually though. Not usually.
Dr. Weitz: Okay.
Dr. Gupta: It’s not a standard part of it. I would say if they do the coffee enemas, I would not do glutathione specifically. I would just get them to do that, and then often if they take the binders just a little before doing a coffee enema, then they get pretty much assured that they’re going to have enough bile there for the binders to bind onto. That’s a very useful way. I know other methods have been used and utilized. I don’t know if you yourself use other methods to get the bile moving.
Dr. Weitz: Yeah. We use herbal bitters and a lot of times we’ll use glutathione and some other liver support, milk thistle.
Dr. Gupta: Right.
Dr. Weitz: I think sometimes we’ll actually do a two week liver detox and make sure they’re… Clean out some of the other toxins that might be in there and make sure their liver detox pathways are working well.
Dr. Gupta: Yeah. I think that’s perfectly valid as well.
Dr. Weitz: And maybe we’ll use phosphatidylcholine as well to support bile flow.
Dr. Gupta: Yeah. I think those things are also useful. They’re just not part of my thing. But I do get them to do the coffee enemas and liver gallbladder flush which does include some of those things. And because their liver and gallbladder is often very affected by this whole syndrome.
Dr. Weitz: How do you do your gallbladder flush?
Dr. Gupta: Well, there’s a whole protocol, but it basically includes having some herbs for about a month first. The ones I use are the premiere research liver ND and gallbladder ND, and then get them to have apples on the morning of the… quite a few green apples, and then drink Epsom salts, and then they take a big drink of olive oil and citrus. And that gets their gallbladder just have a huge squeeze. Some people who are not well, that can be very aggressive and can make them quite unwell. For others who are strong, it can speed up their progress quite a lot. I do that from time to time, but it’s not so routine. I try and just gently, and just gently using the coffee enemas and doing gentle binders will be more tolerable for the majority of patients.
Dr. Weitz: Yeah. Do you do some sort of gut support? And in particular, some of these binders can be very constipating?
Dr. Gupta: Yes. Absolutely. And one of the thing is to start with is to just make sure that they don’t have a gut full of parasites, or a gut full of mold, or fungus, or candidas. And that’s really a separate problem to CIRS. So mold colonization is not something that was described in the original model of CIRS, but certainly I’ve found that some patients can colonize and have a significant fungal infection. Generally speaking, I use natural antiparasitic agents and natural antifungals to try and clear that. Sometimes there might be use of some pharmaceutical antifungals. However, I think just trying to support the gut that way and then
Dr. Weitz: Will you do that at the same time as having them on the binders?
Dr. Gupta: Oh yeah. Yeah. You can mix the two for sure. I mean, definitely. But you generally use a lower… To start with, as I say, you just go low and start slow. But also things like betaine HCL and digestive enzymes and so on can be extremely useful.
Dr. Weitz: Ox bile.
Dr. Gupta: Yeah, all that kind of thing can be extremely useful because people’s digestion is often very impaired by the inflammation that’s going on and just all of the different factors that are going on in their body.
Dr. Weitz: Yeah. And then when do you recommend the use of vasoactive intestinal peptide?
Dr. Gupta: Well that’s towards the end of treatment.
Dr. Weitz: Okay.
Dr. Gupta: You generally want to make sure they’re out of any exposure to water damage buildings, or any significant exposure I guess. It’s very hard to be 100% away from any exposure. And that they’ve been significantly bound in terms of the mycotoxins and other elements of the water damage buildings, or they’ve had enough use of binders, VCS tested normal. There’s another thing that we still look at, which is the nasal MARCoNS, which, generally, you want to have eradicated. That’s not 100% ruled out. We have found that in some patients, you can’t eradicate that easily. Using more VIP early in those patients, and co-existing it with, or co-prescribing it with the MARCoNS still present hasn’t been a major problem in our group of patients, even though that was a caution that was given by Dr. Shoemaker and his group.
And then the other thing, I think, it’s very important to have already addressed steal infections. And that includes parasites, that includes fungal infections in the body, and that includes bacterial infections such as Borreliosis, Bartonella, Babesia, mycoplasma, Rickettsia, Erhlichia, it’s another whole vegetable or alphabet soup. And then also viruses and retroviruses are very important to address as well. And that’s something that’s only quite recently come into my awareness. And so once you’ve done a lot of that, sometimes ozone therapy can be extremely useful. Dr. Raj Patel in California really put me onto that idea that using that in patients and at that stage of the treatment can…
Dr. Weitz: What type of ozone do you like to use?
Dr. Gupta: Well, I just get people to get their own machine and to do their own insufflations like ear insufflations, and nasal insufflations, and rectal, and so on. And that can be a very useful adjunct, and also using herbal treatments. In a minority of patients, we still do find we have to use antibiotics, or antiparasitics, or antivirals that are pharmaceutical. But that’s not a main…
Dr. Weitz: What’s the treatment for the MARCoNS?
Dr. Gupta: The treatment for the MARCoNS is generally just things like silver, an EDTA nasal spray, sometimes using botanical nasal sprays such as as the Biocidin can be quite useful. And then actually using nasal probiotics after that’s done.
Dr. Weitz: Interesting.
Dr. Gupta: Treating it more and more like the-
Dr. Weitz: Nasal probiotics. That’s a new one for me.
Dr. Gupta: Oh right, yeah. That’s actually been quite successful. Well it’s a lactobacillus sakei product.
Dr. Weitz: Okay.
Dr. Gupta: So that’s something which is the strain that’s found in kimchi. So if people want to be really brave, you can put a little bit of kimchi juice in your nose but I think it burns.
Dr. Weitz: You definitely won’t smell like anybody else.
Dr. Gupta: So we’ve used a product called lacto sinus that contains this probiotic.
Dr. Weitz: Oh really?
Dr. Gupta: And get people… And that’s just like a powder. And you get people to put that on like a cotton bud and just apply that into their nasal passage. That doesn’t seem to irritate nasal passages. Treating it more holistically now, think of it as all nasal microbiome just as we think of the gut microbiome.
Dr. Weitz: That’s great.
Dr. Gupta: So we’re not as focused just on one bug. It’s more the entirety. So yeah, I think that’s very important. As I talked about, there’s other stealth infections. If you can eradicate them or at least them into a state in which they’re not causing major immune disfunction, that’s very, very useful. And then we often instigate VIP treatment at the end. One of the things about that is also to try and normalize their NeuroQuant scan, which is something I briefly spoke to you about.
In many of these patients, we get them to do a scan called NeuroQuant. That’s a computerized analysis of a brain MRI, and it looks at a number of different brain regions and compares them to age and sex match controls. And if they’ve got significant shrinkage or atrophy of the brain, we really want to return that to normal. It’s the same thing that they can have significant areas of swelling or hypertrophy as well. We also want to return those to a normal size as part of the treatment. We believe, and Dale Bredesen agreed with me that if they’ve got ongoing shrinkage in their brain, that could actually pose a risk for Alzheimer’s disease in the future. That’s why in some cases I actually give VIP for several years
Dr. Weitz: Interesting.
Dr. Gupta: Yeah, to try and get all those brain areas normal. And then it also just helps to de-escalate any remaining inflammation that’s there.
Dr. Weitz: This brain neuro, this MRI NeuroQuant, is this something that the average MRI lab will offer or is it only special MRI labs?
Dr. Gupta: It’s something that an average MRI lab can offer if they want to.
Dr. Weitz: Okay. Okay.
Dr. Gupta: Because they have to get connected to Cortechs Laboratories in San Diego, and they have to get the arrangements in place. They need to get the settings. But basically as far as I understand, almost any MRI machine can be configured to do NeuroQuant, and they just need to get in touch with Coretechs Laboratories and be able to send their images to that laboratory and have it converted to NeuroQuant and be able to receive the results. And often, Dr. Shoemaker said it’s only something like $50 or $60 in addition to a standard brain MRI, so it’s not very expensive. In Australia, it’s usually about $500 for the whole scan, and some people can get some kind of rebate on that, insurance rebate. It’s quite useful overall. I mean, it’s not absolutely essential, but if people can have it done, if they’ve got full-blown CIRS, it is very useful. And we want to see that their brain has come back to normal. And part of this also can be looking at brain retraining methods as well. And that can include things like the Gupta program, that’s another Gupta by the way, Ashook Gupta. That’s not me.
Dr. Weitz: Okay.
Dr. Gupta: In the U.K. who’s created a system, which I think is very, very useful. And I’ve been in touch with him closely, and he’s… That’s something that people can find online at TheGuptaProgram.com. There’s another one. There’s various other neuro retraining systems-
Dr. Weitz: Wow, the Guptas are taking over the world.
Dr. Gupta: Yeah. There was actually something called the Gupta Empire I’ve heard. Maybe it’s coming back. If you read Indian history. Anyway. DNRS is another system created by Annie Hopper that can be quite useful. There’s a whole bunch of other things people can do. I’m very much into people doing psycho emotional work as part of this. Often the trauma of CIRS has a very significant effect, and it can also bring up past trauma. I’m a big fan of them doing that kind of work as well. Really, we try and take a very holistic approach.
Dr. Weitz: There’s also some protocols that chiropractic neurologists can use as well.
Dr. Gupta: Okay. What are they exactly?
Dr. Weitz: It has to do with eye exercises and other simple exercises that help to retrain the brain. There’s a whole program that’s been taught. The chiropractors go through this chiropractic neurology program.
Dr. Gupta: Okay. Great. So yeah, look at all different practitioners have different tools. I think just because all of them haven’t been studied, that doesn’t mean they haven’t been studied in grandiose controlled trials, that doesn’t mean that they have no value. I think some of the other methods to help retrain the brain, and you know, this guy Norman Doidge who has the whole program, he wrote the book, The Brain that Heals Itself. Some of those methods can be quite useful. One’s also called firelight, where people put a fire infrared device in their nose, and there’s a little head. I guess it’s almost like a little helmet that delivers far infrared light to the brain. That can be also very useful for healing the brain effect. A couple of additional little pointers there that can be helpful for getting the brain back to a more normal state of functioning. That’s one of the areas that often takes a little bit longer for people.
Dr. Weitz: Cool. Excellent. So this has been a very interesting discussion Dr. Gupta. Thank you for sharing with us. How can practitioners get a hold of you and find out about your programs?
Dr. Gupta: Yeah, so the website-
Dr. Weitz: Not just practitioners. Patients as well.
Dr. Gupta: Oh okay. Yes. Patients who want to find out about our clinic, the website for our clinic is LotusHolisticMedicine.com.au. So that’s LotusHolisticMedicine with no W .com.au. And also check out my online course, which is www.moldillnessmadesimple.com. And that’s spelled the American way for any people outside the U.S. M-O-L-D madesimple.com, and you can also check out my institute at LotusInstituteHH.com. Stands for holistic health.
Dr. Weitz: Oh okay.
Dr. Gupta: We’re actually doing a face-to-face training here on integrative medicine in general. But really it’s about dealing with a complex and toxic patient. That’s going to be in Sydney in October. I’m very, very excited about bringing in some of the new insights. I’m dealing with these complex patients to some of the practitioners of Australia.
Dr. Weitz: Cool. Excellent. Great. Thank you so much and I’ll talk to you soon Dr. Gupta.
Dr. Gupta: Thanks for having me Dr. Weitz.
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