Nutrition To Manage Mycotoxins with Dr. Jill Carnahan: Rational Wellness Podcast 197

Dr. Jill Carnahan discusses Nutrition to Manage Mycotoxins with Dr. Ben Weitz.

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Podcast Highlights

2:32   Dr. Carnahan was exposed to mycotoxins in 2015 after a huge flood that occurred in Boulder, Colorado and it caused mold in her office. She had a lot of respiratory symptoms, including shortness of breath, esp. when trying to run or walk upstairs. She had brain fog, including trouble recalling words and names and typing the wrong word when typing emails. She also had trouble with focus and concentration.  Mold for her also triggered a histamine/mast cell response resulting in rashes and hives and swelling of her lower extremities. She also had redness in her eyes and sinus congestion.  She had acne breakouts, including on her scalp.

Some patients exposed to mold, may have issues with their gut such as leaky gut and sensitivity to foods because the gut and mold will directly affect the integrity of the gut lining. Some people have electrostatic charge on the surface of their skin, because they’re sweating out sodium and they create a gradient or a battery on their skin.  Frequent urination may occur due to dysfunction with the secretion of antidiuretic hormone (ADH).  An enzyme called aromatase, which converts our testosterone into estrogen, is increased, so this may result in men having man boobs, weight gain around the middle, and decreased libido drive. Women will have excessively heavy periods or painful periods, or they’ll have fibroids, or endometriosis, or all kinds of things to do with estrogen dominance.

6:45  Mold can also be a contributor to Alzheimer’s Disease as Dr. Dale Bredesen has discussed, calling it inhalation Alzheimer’s from inhaling mycotoxins that enter the cribiform plate into the brain causing dementia-like symptoms. This seems to be more common in patients in their 50s, which is young for Alzheimer’s.  Here is Dr. Bredesen’s paper: Inhalational Alzheimer’s disease: an unrecognized–and treatable–epidemic.   Patients exposed to mold can also present with inflammatory bowel disease like Crohn’s or ulcerative colitis, because it causes inflammation of the gut lining.  Mold can also raise TGF beta, which is one of the drivers of autoimmunity.  Patients can present with MS, or lupus, or Hashimoto’s or Crohn’s and mold can be the underlying cause.

11:58  Some of the symptoms of mold toxins are common to many other conditions, so taking a careful history with a timeline of how and when symptoms developed can be helpful in making the diagnosis of mycotoxins.  You also have to ask the right questions, including how to discover if ther might be mold in their home or office. Questions could include:  So are there condensation on your windows? Have you ever had a washer or dryer leak? Does the washer gasket rubber smell when you open that up? Has your, you see under the sinks, the faucets, the pipes, the garbage disposal ever leaked? Do you have a tile or grout that’s discolored? Do you have leakage around the shower pan? Is it properly sealed?  You need to inspect the basement and also the attic.

17:03  Probably the best way to test your home for mold is with the ERMI test, which uses pcr analysis of the DNA of any mold in dust in your home. Dr. Carnahan recommends getting the dust sample from two feet above the floor so that you are not getting outdoor dirt trapped in the sample.  And you should wait 7-10 days after you have cleaned to allow dust accumulation. While not as accurate, you can get an idea from the inexpensive petri dishes you can get at Home Depot or Lowe’s.

19:10  There are various ways to screen and test patients for mold exposure, including a screening cluster symptom analysis and the visual contrast test (VCS). Dr. Carnahan recommends the VCS test available on Dr. Shoemaker’s website for $15, Survivingmold.com:  Online VCS screening test.  Dr. Carnahan noted that if she suspects mold is an issue until the test results comje back, she will give her patients a binder and some basic liver support, including glutathione or the precursors, like NAC, lipoic acid, vitamin C, glycine, and glutamine.  She finds it helpful to do urinary mycotoxin testing and she sees a good correlation with symptoms in her patients and she mentioned that there are three excellent labs that offer this, including RealTime Labs, Great Plains Lab, and Vibrant America.  And then there is blood work, including TGF beta, MSH, MMP9, antidiuretic hormone, and osmolality, and C3 and C4a, which can be ordered through LabCorp.  If they are not covered by insurance, these blood tests can cost thousands of dollars, so your patient can order some of these tests directly through Life Extension for about $400. These blood tests were pioneered by Dr. Shoemaker and they alert you that the patient has CIRS (chronic inflammatory response syndrome).




Dr. Jill Carnahan is a Medical Doctor who runs the Flatiron Functional Medicine clinic in Louisville, Colorado and has a specialty in treating patients with chronic diseases, including with mold related toxicity. Dr. Carnahan speaks around the world and lectures for the Institute of Functional Medicine.  Dr. Carnahan can be reached at JillCarnahan.com.  Here is a link to a free guide to mold toxicity for Rational Wellness listeners from Dr. Carnahan: https://www.jillcarnahan.com/exposed-to-mold-now-what/

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:                            Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates. And to learn more, check out my website, drweitz.com. Thanks for joining me, and let’s jump into the podcast.

So, our topic for today is toxic mold, its effect on our bodies, how to get rid of it, and how to get rid of it with Dr. Jill Carnahan. Exposure to mold and mycotoxins affects many people and is often an undiagnosed underlying trigger for many other symptoms and conditions.  Many people are unwittingly living or working in water damaged buildings, and this exposure can be causing many negative effects on your health. And not only can mold and mycotoxin exposure cause a host of symptoms that we will go into but it can also be an underlying trigger or root cause for many other serious health problems, including affecting our hormones, thyroid, adrenals, fibromyalgia, hypertension, heart disease, autoimmune diseases, Crohn’s disease, Alzheimer’s, and even cancer. When looking at a patient from a functional medicine perspective, we usually focus on likely underlying triggers and root causes of their health condition, and mold may be one that is frequently overlooked.

                                                Dr. Jill Carnahan is a medical doctor who runs the Flatiron Functional Medicine Clinic in Louisville, Colorado. Dr. Carnahan is one of the first 100 doctors certified by the Institute of Functional Medicine. Dr. Jill is a survivor of breast cancer, Crohn’s disease, and mold toxicity. That’s quite a lot to be having gone through in your life, Jill. Dr. Carnahan is a sought after speaker at conferences when we used to have conferences, and often teaches other health care practitioners the functional medicine approach, and she’s one of the most recognized experts about mold and mold toxicity, which is our topic for today. Thank you, Jill, for joining me today. And for me, thank you for letting me join you on your Facebook Live.

Dr. Carnahan:                    Thank you, Dr. Weitz. I am delighted to be here. We had a little snafu because of scheduling, but I am so glad to finally be here and to talk to you about mold.

Dr. Weitz:                          Sounds good. So why don’t we start by perhaps maybe you could tell us a few things that are not commonly known about mold and mold toxins.

Dr. Carnahan:                    You got it. And I’m going to go into just a two second version or a quick version of the story because story always drives what I do. 2015 after the huge flood in Boulder in 2013, I realized that my office had mold in it, and it had been causing, which is some of the symptoms we’ll talk about for me respiratory issues. I had shortness of breath, trouble running, difficulty catching my breath when I’d walk upstairs. I had a more brain fog trouble with words and names. So finding like names and words of things. I’d say cat instead of dog or something like that. And I noticed when I was typing emails or letters, sometimes I would actually type the wrong word, too. Now, cognition problem solving wasn’t so affected, but it’s weird how mold can selectively affect portions of the brain.   The other thing I noticed was focus and concentration. So where I could maybe write a blog in an hour before it took me a little bit longer to really focus and concentrate and be productive. So all of those things and then mold can trigger a mast cell response. We’ll probably talk more about that and cause histamine issues. So for me, I had rashes and hives and I had swelling of my lower extremities. At the worst of it I had three plus pitting edema. It was really severe. I had redness in my eyes. I had congestion in my sinuses. I had more acne breakouts. I had skin lesions on my scalp. And I can go into more, but those are just a few of the things.

                                          Some of the unique things you ask about. Some people have electrostatic charge on the surface of their skin, because they’re sweating out sodium, they’re losing sodium, and so they create a gradient or a battery on their skin. So, it’s not uncommon to have electrostatic shocks when you touch metal or doorknobs or to actually break watches or computers if you’ve had mold exposure. That’s one of those really unique things. And another thing frequent urination, which is along the same lines because your body, the ADH, the antidiuretic hormone, which controls our hydration is dysfunctional. It goes very low so you don’t conserve water. So, you drink and you pee, and you drink and you pee. And a lot of these patients will get up during the night three, four, or five times to urinate at night during the day. And they’re walking around, they can be drinking loads of water, but they’re chronically dehydrated because they can’t maintain the volume in their vascular system.  Some of the other things that happen are there’s an enzyme called aromatase, which up regulates and converts all of our hormones into estrogen especially testosterone. So men will have man boobs, weight gain around the middle, decreased libido drive. Women will have excessively heavy periods or painful periods, or they’ll have fibroids, or endometriosis, or all kinds of things to do with estrogen dominance. It affects, like I said, mast cells. So, histamine reactions, more sensitivity to foods. And we didn’t even talk about the gut. But mold will directly affect the integrity of the gut lining causing leaky gut and causing more sensitivity to foods and more issues with the gut as well.

Dr. Weitz:                          So, tell us a few things that we didn’t know about mold and mold, toxins things that aren’t commonly discussed.

Dr. Carnahan:                    Yeah. So, did you know mold can cause increased risk of infertility in both men and women?

Dr. Weitz:                          Ah, interesting.

Dr. Carnahan:                    Yeah, and it’s interesting because a lot of our studies on mold come from… So, the animal livestock industry is a big one because a lot of the food can be contaminated with mold.  And so for the farmers who raised cattle, and pigs, and sheep, and all these animals that could have contamination in their food, they see a loss in the bottom line dollar when there’s mold contamination in the food because they don’t produce.  Their herds don’t reproduce as well.  So they have noticed fertility issues.  They have rashes, just like humans. They have gut issues, just like humans, and all kinds of things.  So you’ve seen these.  So in the animal studies, they’ll show these and then of course, it’s very, very similar in humans.  But there’s lots of research on mold contaminated feed in cows and pigs and all of these things, especially fertility.

Dr. Weitz:                          That’s fascinating because when working up a patient for fertility problems, I don’t think many people consider mold as one of the possibilities. We’re looking at thyroid. We’re looking at a whole lot of other things. Maybe toxins in general, but we don’t really typically think about mold.

Dr. Carnahan:                    Yeah, some of the other unique things. Alzheimer’s disease, Dr. Dale Bredesen works a lot with Alzheimer’s patients has written multiple books on the topic, and he claims that 1/3 of the patients that he sees have mold related Alzheimer’s. He wrote a paper about five years ago now called inhalation Alzheimer’s, and it was basically related to inhaling mycotoxins from mold going into the cribriform plate right into the brain and causing dementia-like symptoms, especially in someone who’s in their 50s. They’re so young for Alzheimer’s. I’ve had a case, for example, an attorney 55 years old, who all of a sudden can’t practice because of dementia-like symptoms, and it was all related to mold.   A few other unique things would be like I said, the gut issues. It can present with Crohn’s or colitis, inflammatory bowel disease, because it has a massively inflammatory effect on the gut lining. And so, some people will present with autoimmunity of other types as well. Mold can raise TGF beta, which is one of the drivers of autoimmunity. And so, if patients have that process going on, they might present with MS, or Hashimoto’s, or lupus, or Crohn’s, or colitis, and it’d actually be mold as the underlying cause.

Dr. Weitz:                          Interesting, interesting. So, a lot of the medical profession today, the conventional medical profession has traditionally been very skeptical of this concept of mold toxicity. Are they starting to come around to accepting that this is a common problem for patients?

Dr. Carnahan:                    Yes, just like mold this is a sticky situation, and it’s interesting because I’ve had even people almost angrily-

Dr. Weitz:                          I get the double entendre. They’re sticky in terms of possibly-

Dr. Carnahan:                    Exactly.

Dr. Weitz:                          … legal issues.

Dr. Carnahan:                    Yeah, exactly. And it’s interesting because I’ve even had patients on Facebook groups and things. They’re kind of angry because they’re like, “Doctors, why don’t you do something about the way that we can’t talk to our landlord, and there’s no regulations and the insurances aren’t reimbursing.” And granted, I mean, what I like to do is stay in my lane, which is I’m a physician, I take care of patients. I mean, what I do is I know the experts to deal with environmental issues like environmental air quality specialist, and I know enough to help them navigate that world. I think that’s important. But I’m not a person who can remediate your home. I’m not a person who can do the politics of talking to your insurance company.  Again, we stay in our lane, but I think we need people to have more awareness. I think it started way back. Mold is super common. Insurance companies know this. There’s about a fourth of all homes and buildings in the US that have some sort of water damage. And we could even expand it when I say water damage. What that includes is anything that’s… We used to have homes that were built of more stone or brick, and that’s very impervious to mold. Nowadays, we have these niduses that are basically like cardboard. So, our drywall or sheetrock, which is very, very commonly a source or a problem with mold.   If it gets wet, it’s the perfect growth substance for mold. And most houses now are more quickly constructed with these types of materials, then the materials that are used are more prone to mold. And then during the construction process, they can bring in wet woods that maybe have mold already starting to grow on them. Even during the construction process, depending on where it’s being constructed, it can actually rain in the house while it’s open and all of these things. And then as you build a house, you can have washers, dryers, you can have windows that leak, you can have poor construction, and more and more. There’s quick construction methods that aren’t as detailed and done well. And so, there’s more likely for problems even in new homes.

Dr. Weitz:                            Yeah, I’ve actually heard a similar problem, and this is especially the case for some reason in California. They tend to build the homes so air tight that there’s no ventilation. So, in between the walls, if there was a little bit of moisture, that venting would decrease the likelihood for mold, but they make them so airtight that any moisture in there is more likely to cause mold. So you can have poorly constructed homes. You can have homes that maybe are too tightly constructed.

Dr. Carnahan:                    Yes, that’s 100% true. In fact, I talked to a highly paid investor in New York City that was part of the LEED certification. So this is a certification that certifies the greenness of the buildings. So the kinds of processes, the building materials that are recyclable, and the air tightness, the efficiency of the building. And what’s happened in some of these buildings, not all of them, but they’re super efficient. And by nature, they are very sealed from the external environment. And so, that breathability of the building can be an issue because I’d rather be in 100 year old log cabin, and I wouldn’t in one of these super airtight, efficient buildings that has no airflow.  Some of the times when you have a patient with a mold in their environment, just opening the windows and getting a little airflow to dilute. We always hear this. I’m not the original, but dilution is the solution to pollution, which means as soon as you get some outdoor air in there are you to fan bringing some airflow in, that will automatically decrease the toxicity of your internal environment. So, that can be part of the solution.

Dr. Weitz:                            So when you are going through some of the symptoms of mold that you had, and a lot of the symptoms that other patients get, they’re they’re common to many other conditions. So when you have a patient that presents with some of these symptoms, what really alerts you to the thought that they might be dealing with mycotoxins.

Dr. Carnahan:                    Yeah, I love this question, Dr. Weitz because one of the things patients always say is, “Oh, it’s so expensive to see a functional doctor, or a functional chiropractor, or to see… to do all the testing.” I would say that just by taking a great history I am usually 95%, maybe even 99% accurate on where the direction needs to go. And if I think there’s mold involved, and that’s just a history, which granted the office visit is part of the expense, but it doesn’t take a lot of expensive testing. So usually I know before I do the test the direction I’m headed, and my office staff jokes with me because my batting average is like 100%. It’s like, so far, there’s not one person that I’ve suspected of mold that hasn’t had the lab results to back it up. But the questions are important.  So let’s go through a few of those. I’ll often ask, when did you first start feeling poorly? Because the timeline in my mind is so critical to 10 years ago, 20 years ago, five years ago.  Oh, when we moved into that new house, that’s a big one.  And if the other family members also have some symptoms, they may present differently.  The daughter may be perfectly fine.  The son may have depression.  The dad may have congestion, and the mom may have chronic fatigue and fibromyalgia.  So it could present highly differently among the individuals with some of them being less affected.  And that’s because there’s a genetic variance in our ability to get rid of these antigens, these toxins from our body.   So, say the mother is extra symptomatic, she might have more difficulty in tagging and getting rid of these toxins from her body.  But all that to say it can be variable, so history is key. And then I’ll ask them if I just ask someone, “Do you have mold in your home?” Everybody says, “No, I’m fine.” Or they might have a musty smell but it’s like mildew, and that’s just not true. So first of all musty smell is VOC, volatile organic compounds released from mold so there is an issue if there’s a musty smell somewhere.

                                                Second thing is you have to ask the right questions. So are there condensation on your windows? Have you ever had a washer or dryer leak? Does the washer gasket rubber smell when you open that up? Has your, you see under the sinks, the faucets, the pipes, the garbage disposal ever leaked? Do you have a tile or grout that’s discolored? Do you have leakage around the shower pan? Is it properly sealed? A lot of people don’t know some of these really expensive types of tiles that go in beautiful multimillion dollar homes and bathrooms are actually quite porous.  So if your contractor has not put a vapor barrier or a sheet between the tiles and your wall, you can have… I just saw a beautiful multimillion dollar home was loaded with mold in the master bath nothing visible.  And what happened is that slapped up tiles right up against drywall with no barrier and these are permeable tiles and after eight years, there was massive black mold all underneath there and there was nothing visible.  The bathroom looked beautiful.  So, all of these kinds of things, and then basements. So there’s crawl spaces. If there are earth crawl spaces where there’s damp moisture, and that is venting into the home. If you have a sump pump that’s open and then closed, and there’s water that standing anywhere in your home. If you have water that seeps in through the landing, and there’s no barrier there where you get condensation or water into your basement, there’s so many different ways this can leak in. Attics can be a big place. So if the attic isn’t sealed, and there’s lots of heat and condensation, those can be a big place, too. So, part of the is looking for the problem. And then also eventually a good remediator will seal off your wall cavity from your home environment so that you’re not getting that air from the crawlspace, from the attic, or from the in between walls to exchange into your home.

Dr. Weitz:                          Interesting. So, have you ever had a patient, for example, as a way to test if they’re dealing with mold? Have them just go out of their home for a while, take a mold vacation?

Dr. Carnahan:                    Yeah. So, often, I’ll just ask the question. Nowadays, no one’s going on vacation. But before I would ask you, have you been to vacation or gone for 10 days or seven days or a period of time, and did you ever feel better? Now, interestingly, I’ve had a couple situations. One patient of mine, I always suspected mold. She had recurrent colitis and fatigue, and she had infertility, amenorrhea. So, she stopped having menstrual cycles. She’s in her 30s. So, she’d be normally cycling, infertility, and then the colitis and fatigue. And she had a condo in Winter Park in the ski area, and then her home in Boulder. And she always said, “Well, I feel poorly at both locations.” So then you’re like, “Well, maybe no mold.” She went camping for 10 days and she said, “Dr. Jill, my colitis went away. My fatigue was amazing. I didn’t feel fatigued.” And of course, her cycles didn’t start back in that 10 days, but a lot of symptoms improved. We found out both through ski home and her home in Boulder both had mold. So, she had to leave both places.

Dr. Weitz:                          So what’s the best way to test your home for mold?

Dr. Carnahan:                    Yeah, so this is also a tricky one because there’s a lot of inspectors and remediators that don’t really like ERMI testing. But what I like about that is… So, ERMI testing, what is it? You can get a dust sample of the dust in your home. If you do this, the couple rules about it are you want to get it from two feet above the floor. So you’re not getting like outdoor dirt and stuff trapped in. So maybe it’s shelving or door handles or kitchen cabinets or things like that, or shelving in your living room or like behind me here. But you wouldn’t want to get on the floor itself. And then you want to wait seven to 10 days after your cleaner so that you actually have some dust accumulation. And you can collect the sample yourself and send it in.

                                                There’s Environ, MentaBiotics, I’ll have to get the name for that for sure and post it, and then there’s Micrometrics. There’s a couple companies that do this. And then you get a read back of the PCR, the DNA of the mold that’s in your dust. And even though that’s not perfect, and I actually don’t use the ERMI score, I just look at the individual molds, I can often tell if there’s a big issue because if there’s 30 of Chaetomium or Stachybotrys on that test, that’s a big problem. Even if there’s five of some of those really toxic molds, it’s a big issue. So, I will often look at that. And then that can tell us, do we need to get an inspector in or look further. Ideally, everyone would have a complete inspection, but that can be costly. So, I’m always weighing the balances of the cost. And I do still feel like ERMI is good.

                                                And then there’s those little plates, the petri dishes you can buy at Home Depot or Lowe’s or any store. And you can put those out in your house. And here’s the cheap and easy way. You don’t even have to send them in. If you just want to get stalled, you can set them out for 24 hours, and then cover them. You can put them in different rooms, and then you let them grow. I think the kits are like seven to 10 days. You can look at the colonies. If there’s zero to four colonies growing of anything at all, that’s pretty normal. If there’s five to eight colonies, that’s a moderate problem. And if there’s nine or more, that’s a big issue. So even though that’s not perfect, these are little very inexpensive ways to test, to start the process.

Dr. Weitz:                          Cool. So how do you test the patient for mold? What’s your workup? In terms of testing?

Dr. Carnahan:                    Yeah, so like I said, I don’t want to forget history because that’s free and a good clinician can ask the right questions. And then two things that are also free in my office. I have a screening cluster symptom analysis where I have them check off boxes, and there’s a scoring system that tells me if there’s more likelihood of mold or not. And then the second thing is a visual contrast test, a VCS test. you can do these online for free, or Dr. Shoemaker’s site, survivingmold.com has another one. I think it’s five or $15. That’s the one I actually prefer but they’re both excellent. And in my office I  actually do this in-person. We have an actual visual contrast board and my staff knows how to do that.  And that will test for this visual acuity.  What happens is when we have biotoxins from mold, they affect our retina and our retina’s ability to differentiate black and white lines.  And so, you’ll actually, these are little circles of black and white lines at different angles.  And so, as you do it, you hold one eye closed, and you say, “Oh, it’s left, right, central and left, right.”  And if you miss those on on some of the smaller lines and increments, there’s a more likely chance that you have had a biotoxin exposure.

Dr. Weitz:                          Do you ever start to treat a patient as a result of history and maybe a questionnaire or the visual contrast test without doing lab testing?

Dr. Carnahan:                    Yes. So, I didn’t get to lab tests, so I’ll get there next-

Dr. Weitz:                          I know. We’re going to do that next.

Dr. Carnahan:                    So, yes, let’s say someone comes in, and they have a positive visual contrast. They’re highly symptomatic. It all started when they moved to this home, there’s a musty smell in the home. And then three people in their family are also sick. I’m like, “Okay, there’s a high likelihood.” What I know to be true is they’re going to eventually need to get away from that exposure, remediate or do something. But in the meantime, some sort of a binder, which we can talk about, and some basic liver support, things like glutathione or the precursors, like NAC, N-A-C, lipoic acid, vitamin C, glycine, glutamine, those can all be helpful, and they’re pretty safe for all of us. Especially, start low doses and workup. So I’ll often start a detox protocol no matter what, and you ask about other testing.  I do use urinary mycotoxin testing. There’s a lot of controversy about that. But I do believe after five years of doing this on many, many, many patients, thousands of cases, I see a very good clinical correlation. There’s three labs that do that right now. There’s RealTime Labs. There’s Great Plains Labs, and there’s Vibrant Labs, and they’re all excellent. There’s different variances depending on them, and I do have my favorites. But those all are good test companies to use. There’s bloodwork. So, there’s things like TGF beta, MSH, MMP9, antidiuretic hormone, and osmolality, and even C3 and C4a, and those are serum labs that can be done in any lab. Right now I use LabCorp, but you can use typical hospital labs will sometimes do them. It’s a little tricky to get some of them on Quest, but it can be done as well. But those are options. And those are the [crosstalk 00:22:13]-

Dr. Weitz:                          What do those labs actually tell us?

Dr. Carnahan:                    Yeah, so there’s a term that Dr. Shoemaker came up with called CIRS (chronic inflammatory response syndrome). And it was his way of describing this inflammatory response from a water damage building and all the inflammagens. And when I say inflammagens, I’m broadening it. There’s molds clearly and mycotoxins, but both bacteria can grow there, and other things like methyl brevi, and algae, and Candida can all be in a water damaged environment. So, it’s not always just mold. But all of those things can trigger an immunological response in the body. And it’s not just the mold attacking the body, but it’s actually the mold causing immune activation.

                                                It’s very similar to COVID and the virus with this aisle six response in this immune activation that causes collateral damage and side effects. It’s very, very similar. Both the virus and then things like lipopolysaccharide, gut toxicity. So leaky gut can cause this, and so can mold. So many, many things causes inflammatory response in the body. And when I mentioned those labs is basically looking at all these inflammatory cytokines, and saying are many of these that are common to mold active or abnormal? And if most of them are abnormal, it paints a picture for more likelihood of mold being part of the picture.

Dr. Weitz:                            So, here’s a question for say a practitioner like myself who’s a chiropractor. When I send patients out for certain labs, I’m assuming they’re not going to be covered by insurance. You might have different experience as a medical doctor, but we’re assuming most of the time it’s not going to be covered.  And let’s say I have a patient who’s a little bit cost sensitive.  If I was going to choose between the urinary mycotoxins, and these blood biomarkers, what do you think is the best bang for your buck?

Dr. Carnahan:                    Yeah, so the urine… Well, first of all urinary mycotoxins I do on almost everybody. And again, you have to know… First of all, what you have to know is, it is excretion. So number one, you could have a patient who is so toxic, they’re not excluding, and you get a false negative with nothing in the urine because they’re so toxic they’re holding on to it. And you’re like, “Oh, they’re fine, and they’re not fine.” So, that’s one thing. Number two, if you start treating a patient, you’re actually pushing that detox pathway and you want that to go into the urine and be excreted. So a lot of patients after two months will be like, “Dr. Jill, can we retest the mycotoxins?” “I guess, we can if you want, but guess what, it’s probably going to be higher, and we want it to be higher because you’re excreting.”

                                                So, as a physician or a patient, you have to know when you’re testing. I will as a rule, unless a patient absolutely begs or demands to be retested. I won’t test before six months after treatment and even then the levels might be higher. So knowing what you’re doing and then mycotoxin testing range from three or $400. So while it’s not cheap, if you have to, one thing it kind of guides. And now we have more data on the types of binders and treatments and pathways for each toxin. So that will actually say I have ochratoxin versus a T2 toxin or gliotoxin. I might use different binder and different pathways for that. So, that actually guides my treatment. So, that’s my number one test. But again, you have to know what you’re doing because it’s not perfect. You have to know you’re measuring excretion. Number two-

Dr. Weitz:                          By the way, where’s the best source for that connection between specific binders for specific mycotoxins?

Dr. Carnahan:                    Yes, so Dr. Neil Nathan has written about it a little bit. And he just posted some work on his blog. And then in his book, it’s also available, I think, in a chart with the binders. Beth O’Hara who’s an expert on mast cell has done some work as well with the pathway. So I think in her website, she has it posted as well. And I think that’s mastcell360.org. If you just search Beth O’Hara and M cast, you’ll find her website. And of course, Neil, Nathan, as well. He’s an MD. Those are some good sources of that information.

Dr. Weitz:                          Great.

Dr. Carnahan:                    What about for patients who can’t afford it?  So, first of all, I do often get it covered.  Not always, and if it’s not covered, it’s really… These are thousands of dollars.  Like the LabCorp can be so expensive, so you’re right. But there’s a trick Life Extension has navigated a discount with LabCorp.  It’s called the mold biotoxin panel.  You can go on it as a patient, order it yourself. It’s usually three or $400 depending on if it’s on sale or not. So, still rather… I mean, there’s hundreds of dollars, but way better than thousands of dollars. And a patient can actually order this themselves. So that’s a way that I’ll do it if I want… And it’s only five of the markers, but it’s pretty helpful if that’s all I can get. It’s a way cheaper price for the patient to get it directly from Life Extension.

Dr. Weitz:                          And that’s basically not measuring the mold, but it’s measuring whether you’re reacting to the mold, right?

Dr. Carnahan:                    Yeah. And again, it’s kind of this… If I had a million dollars for every question that I had was what’s the one test for mold? We get that all the time. What’s the one treatment or the one test? There’s there’s no one test. But kind of again, so I look at the-

Dr. Weitz:                          Or the one pill.

Dr. Carnahan:                    Yeah, the one pill, the one test, I wish we could give it to you.

Dr. Weitz:                          Well, actually, there was just another study about the polypill. The medical profession has been wanting this one pill that everybody could take that would promote your long term health.

Dr. Carnahan:                    Gosh, if we only had that, but you and I practice individualized medicine. There’s no one size fits all.

Dr. Weitz:                          Of course.

Dr. Carnahan:                    I have a lot of colleagues who have protocols, and I have no disrespect for them. But I have resisted so hard. I really truly don’t have a protocol. I do some of the same things depending on the situation, but every patient is individual, and I like to treat them that way. So, we talked about testing and cost. And then your last question. Let’s see, you’d asked about the direction to go depending on… Oh, if there was one test? Yeah, there really isn’t.

Dr. Weitz:                          I know. Okay. So, what was I going to say? So, let’s get into treatment. So, obviously, the first thing they have to do if they’re getting presently exposed to mold is that they somehow get out of that environment.

Dr. Carnahan:                    Yeah, and let’s talk a little bit about this. Because the confusing thing is if you have a remediator that is not aware of the sensitivity of the types of patients that we see.

Dr. Weitz:                          So, a remediator is somebody that you pay who comes to remove the mold, and they have a specialty in that?

Dr. Carnahan:                    Yes, yes. And they’re often called… So, there’s a bunch of nuances in the industry. IEPs are indoor air professionals, and for example, I’m on the board of iseai.org. But there’s no… This has nothing paid. But it’s a great resource. It’s all free. It’s internationalsocietyforenvironmentallyacquiredillness.org. So, I-S-E-A-I.O-R-G, free resources, free professionals that have been trained in mold. If you’re looking for some resources, that’s a great place to start. And there’s blogs and things on there. It’s a nonprofit. They teach physicians, and I just love mold and I love teaching, so I’m part of them just for that sake. But that’s a good resource to start with. And same with survivingmold.com, which was Dr. Shoemaker’s website. He has a lot of free resources and literature there if you’re wanting to start on the journey, but back to remediators.  So remediators, indoor air quality professionals might be someone that either virtually or in person looks at your quality of air, and they’re beyond the scope of just mold. They might look at radon, they may look at EMFs, they may look at a broader spectrum of air quality. Remediators in the mold industry can be a varied batch. I like to joke it’s like used car salesman. There’s some wonderful ones and there’s some not so wonderful ones. And so, you got to know who you’re dealing with because you might get five different answers from five different mediators.  The main thing is number one, they have to have containment and negative air pressure so that the rest of your home doesn’t get contaminated while they break down that wall and take out the mold. Number two, if they’re not wearing personal protective gear, that’s a problem. They don’t know what they’re doing because mold is super toxic, even to someone who doesn’t feel it over the time, over years.

Dr. Weitz:                          And by the way, protective gear doesn’t mean one of those really inexpensive masks that they get from Home Depot. It really should be… Yeah, a high intensity… What’s it called? A ventilator, or?

Dr. Carnahan:                    Yeah, and nowadays we know because of COVID, the N95, that’s a minimum. And I’m talking N95s with the charcoal filters like the painter would use.

Dr. Weitz:                          Exactly.

Dr. Carnahan:                    And ideally, they have a complete suit. And sometimes in the severe cases, they’ll have complete, their own air supply. That’s a little less common, but I have known situations where they’re so bad that they are completely, almost like an astronaut type of get up with their own oxygen and own air supply. And then, the basic thing behind remediation is, if you have… You might look at my study here, and there’s no visible mold. There isn’t mold in my condo, but there’s no visible mold, there’s no issue, but I might not smell it or see it. And so, patients are confused because they’re like, “There’s no mold in my house. I don’t see anything.” Most of the time, it’s not visible.   So, it might be behind this wall because there’s a pipe that burst, and it leaked into my home or in my basement and caused damage behind the wall that’s not visible. So you might not see it, you might not smell it. But those toxins released from the mold could still go into your air supply. So say that’s the issue, the remediator would have to come in, put off plastic Visqueen, put up negative air pressure common, and take out that piece of the wall, replace it. And that’s not the end of the story because number one, they have to do that appropriately. And then after that, you need to clean your vents and clean your house because that mold has been spewing toxins into your environment. And that dust left in your house, that’s what we checked with an ERMI test can still cause illness in someone even after the main mold source is gone.

                                                So typically, what I recommend is get a remediator, get the source out, get the crawlspace fixed, get the attic fixed, get the sump pump fixed, seal the windows, do the work.  Then number two, clean your HVAC system if you have one because that’s been circulating toxins and dust, and you clean that first. And then number three, a small particulate cleaner or somewhere where you have someone completely… There are instructions for this. You can get it from your IEP. You can do it yourself or hire someone, and they literally wipe down every surface of your place. And then you want to get rid of porous materials if you’ve been really affected. That would be like the books behind me.  I don’t really love to tell people to get rid of everything in their home. I don’t think that’s the right way to do it. But a lot of times those porous materials like paper, or things that you can’t clean easily will continue to make you sick. So if in question like say these books behind me, you could store them in a plastic bin while you get well and then go back later and open it up and see. And then after the small particular clean, some people will do a fogging, or they might do the fogging with an enzyme and then a small particulate clean in that order.

Dr. Weitz:                            Before we get into the rest of the treatment, I wanted to bring up a point of confusion that sometimes comes up when I discuss this topic with patients. So there are some related conditions that are different. So you can have exposure to mycotoxins just like you were talking about. You can also have fungus growing inside your body. It can be growing on your lungs, it could be on your skin, it could be under your fingernails, it could be in your vagina and other organs. And then you can have fungal overgrowth in the GI tract like Candida. How related are these? How should we think about these?

Dr. Carnahan:                    Oh, I love this because this is one of those kind of secrets where I’ll see people who have been to five, 10, 20 other doctors, and they’re still not well, and understanding that you can be colonized or infected with molds, or with fungus is really part of the puzzle. There are some doctors that teach that that doesn’t exist. Well, there’s tons of literature to support the fact that you can have Aspergillus, and the sinuses in the lungs, in the gut. I mean, it is very well documented. This is not anything new. In fact, some diseases like multiple sclerosis, they’re using antifungals and having great success because it’s so common to have fungal colonization.

                                                So, let’s talk about the difference. [crosstalk 00:34:10]. Yeah, it is and there’s a lot of articles. A neurologist friend and I sometimes talk about this, how big the fungal burden. So the first thing I want to talk about is just the mycotoxin exposure. So you can have exposure to mycotoxins where they don’t grow in your body, and they can cause the immune damage and the cytokine storm and you can be very, very sick, but not be colonized. And some of the ways to differentiate would be you can do urinary organic acids, and there’s something called furans that come in the urine that show Aspergillus or some other types of species. You can do the urinary mycotoxins, and if they’re coming out in your urine, you’ve probably had an exposure and have been partially colonized as well. So, there’s these things.

                                                And again, then you have to figure out is it sinuses, is it gut? Systemic antifungals can treat both sinus and gut, but topical you might use Nystatin which treats locally in the gut, it’s very effective. Or you might use something like grapefruit seed extract in the sinuses. And again, you’re treating locally. So you can do everything from sinus sprays. You can do nebulized antifungals, which goes to the lungs. Or you can do oral herbs and medications for the gut, or for the whole entire system. And things like Aizawl drugs, fluconazole, voriconazole, ketoconazole, atroconazole. Those are all systemic antifungals. They can be toxic to the liver. So you absolutely want to work with a doctor who knows what they’re doing. But in some cases, they can be life saving because if someone’s colonized with fungus in the gut, that’s an issue.

                                                Now, the other thing you mentioned is SIFO or small intestinal fungal overgrowth super common, hard to detect, often it won’t show up in the stool, but it will show up in the urine. Or it might show up with serum Candida antibodies or saccharomyces antibodies. And this is a big deal because both the mold toxins and the yeast metabolites like acetyl aldehyde, they will further weaken the immune system. So part of this balance is the mold tends to weaken immune system. And yeast in general is opportunistic. So what that means is it takes advantage of a weakened system. If you have a really strong robust immune system, you’re probably not going to have a fungal colonization issue. Nowadays with EMFs, with poor diet, with stress, with isolation, all these things, many of us have a weaker immune system. So, it’s very common to see colonization with Candida and other things because of our weakened systems.

Dr. Weitz:                            Cool. So what if a patient does have say fungus under their nails? Is that at all related to systemic fungus or mycotoxins?

Dr. Carnahan:                    Yeah, so this is interesting on two fronts. The technical name is called onchomycosis, which is [inaudible 00:36:46] fungus. If you’re looking at the real discolored toenails, or thickening, or the sloughing that is often that fungus. Two things, often the periphery, the extremities, if they’re a little cooler due to either dysfunctional thyroid or adrenal, then you can have more growth there because just that slight degree change in temperature in the periphery will enhance the ability of fungus to grow. So there might be a thyroid or adrenal issue contributing.

                                                And then the second thing is systemically that can be a sign of systemic fungal overgrowth as well. So I’ve seen actually Nystatin is supposed to be a drug that treats just the gut locally, not systemically. But in certain cases I’ve seen because of reservoirs in the gut, if we treat with Nystatin sometimes the nails will actually improve, which isn’t supposed to happen.

Dr. Weitz:                            Interesting. What about if you use your mold mycotoxin removal strategies, which we’re going to talk about it in a minute. Do those also help with fungus under the nails?

Dr. Carnahan:                    They can. Again, the gut is a lot of times the reservoir. So if your gut is full of yeast and fungus and you remove that, sometimes you’ll see the nails improve. Again, the nails are not… There’s not a lot of blood flow there and it’s on the periphery so it’s cooler, so they’re hard to treat. And typically docs who treat them are going to treat them with three months of a heavy hitter antifungal, and even then it might not clear it. So I always want to look at the terrain because of the terrain, if it’s a weakened immune system, poor thyroid function, poor adrenal function, you want to fix those first or at least in conjunction with the nail fungus because to me, that’s just a symptom of something bigger.   The other thing that can correlate with it is blood sugar issues. So, if you’re diabetic, uncontrolled, those blood sugars will make fungus more happy and growing because they love sugar. So, that’s another piece of the puzzle. If your blood sugar is not controlled, you want to work on that, in addition to working on the nail fungus.

Dr. Weitz:                            Yeah, I know that you recommend a low mold diet as part of the treatment plan. Maybe we should talk about that.

Dr. Carnahan:                    Yeah. So, this is, again, there’s some controversy among other doctors, do you really need a low mold diet? I find the less exposure to mold even in your diet while you’re getting well will help. And maybe the bigger thing is histamine. So there’s also a low histamine diet. And a lot of patients who have had mold exposure, they have mast cell activation and more sensitivity to histamine. And if that’s the case, they’re going to be very reactive to things like fermented foods, bone broth, aged meats and cheeses, leftovers. Those are all high histamine, so that can be an issue for patients as well.

Dr. Weitz:                            Interesting. So what constitutes a low mold diet?

Dr. Carnahan:                    Yeah, so this would be like, berries can have mold on them. Like I said, blue cheese, anything with visible mold or growth. Similar way leftovers or things that have left out, and then nuts and seeds and grains can be contaminated. I have a suspicion that one of the reasons that paleo and grain free diets are so popular is because grains are one of the most highly contaminated food sources of mold. And in fact, a lot of our data on the gut is from African children where their grain supply have been contaminated with mold, and they got inadvertently fed moldy grains and they developed a leaky gut and even sometimes villous atrophy, which is the same thing you see with celiac disease.

Dr. Weitz:                            And is that because the grains are stored in these silos for periods of time?

Dr. Carnahan:                    Yes, I grew up on a farm in Illinois. So, I know a little bit about grains and storage.

Dr. Weitz:                            Yeah, I’m a city boy. So, I have no idea what really goes on, on farms.

Dr. Carnahan:                    You’re right. And so I grew up… And it’s funny because I had horrible allergies as a child to corn and soybeans, which was the main crops. Now looking back, I feel like I understand this so much more. I might still have been sensitive to the corn and soy, but what I believe Dr. Weitz is it wasn’t just the corn and soy, it was the molds and fungus that were growing on the corn and soy. I mean, I would literally have my eyes almost swell shot from allergies. I think I was really sensitive. And then you store them a little bit damp. Part of the purpose of the grain bins is to dry the greens out because they have to have a certain moisture content to be sold. So this is kind of wet and damp grain sitting in huge bin and there is massive mold growth.  Again, there’s levels… What’s sad about the United States is our levels of tolerability for mold toxins on grains is actually quite high compared to Europe. So, for example, coffee and chocolate are things that often contain mold as well. And there’s a European standard of coffee and if it’s above a certain level, they won’t accept it into the country. Guess who gets those leftovers that aren’t accepted? We accept them in the US, so our coffee, our typical Starbucks coffee I hate to say for all those of you love Starbucks it’s got mold in it. I know now. I drink a really clean brand called Purity, and I’m so cleaning my diet that if I get a cup of Starbucks, I don’t feel well. I can tell immediately that sense of headache or not wellness/

Dr. Weitz:                          And a lot of processed foods. Things like jellies all have mold in them, and there’s so many foods that contain small amounts of mold that we’re not aware of.

Dr. Carnahan:                    Yeah, children’s apple juice. You’ve seen those videos.

Dr. Weitz:                          Oh, yeah, horrible. Basically, anything that comes in a squeezable, plastic kind of container, don’t eat it.

Dr. Carnahan:                    Yeah.

Dr. Weitz:                          So let’s talk about the rescue mold protocol. I know Richie Shoemaker talks about using some of these prescription bile binders like Cholestyramine. Do you use those?

Dr. Carnahan:                    Yeah. So, I’ll talk real quickly about treatment protocols and the gamut. And I also want to mention I have on my website, again, I’ll link it here, and then for your podcasts, we’ll give you a link. The low mold diet is there. You can search my website, jillcarnahan.com. If you want to know exactly what’s on it, it’s there. I also have a free mold guide. I’ll make sure your listeners as well as mine have linked to that. Most of my listeners already have it. It’s all free. But lots of the stuff if you don’t remember the details or want more to read, it’s all on my website. So, you can go find it there as well.

                                                So, treatment, so basically, you’re thinking about first of all out of a source of exposure, which we just talked about, and then you’re working on getting your body rid of these toxic levels of mold and detoxification. So you’re focusing on liver support. We mentioned glutathione. Not everybody tolerates glutathione, and glutathione has to be recycled by NAD, so I’m a big fan of NAD as part of the protocol. Sometimes not the initial part. And if you can’t tolerate glutathione you can use precursors, and acetylcysteine, vitamin C, glycine, glutamine, lots of different things. I almost always put people on milk thistle or some other liver support, sometimes bitters, those will help the liver, gallbladder.

                                                And then binders, binders are key. There’s many, many types of binders. Dr. Shoemaker is real heavy on the prescription drugs and binders. I actually don’t use those as much because I find some of the natural binders work well and are a little more gentle. I will say with Ochratoxin, cholestyramine tends to be very effective. So that’s the kind of toxin that if they have a very high level of Ochratoxin, I might consider cholestyramine. But in general, I like clay and charcoal and chlorella. There’s also glyco maintenance, there’s zeolite, there’s silica-based binders, which are also great for heavy metals. But I get really good results with clay and charcoal, pretty simple stuff. So, supporting liver, clay and charcoal. Now, while you’re doing this, you’re doing a complete functional medicine approach. So, if they need probiotics or gut support or brain support or adrenal or thyroid support I’m doing all that as well.

Dr. Weitz:                          I know some docs say before you even go into a detox protocol. If they have leaky gut, and a lot of patients do, you should work on fixing that first because otherwise they’ll reabsorb the toxins.

Dr. Carnahan:                    Yes, yes. And there is a point too, if someone has really bad mast cell activation and permeability issues. Sometimes I found I agree with you and I’ve done 20 years and started with the gut and love the gut. But once in a while if you don’t get that mold level down, the gut won’t heal and you get stuck. So if you’re getting stuck with gut protocols, I would go to the mold and make sure you’re addressing that at the same time.

Dr. Weitz:                          Yeah, it’s always a question of this is a root cause, and that’s the root cause of that, and what’s the root cause of that?

Dr. Carnahan:                    Yes.

Dr. Weitz:                          So, let’s see what else? I think we’ve pretty much covered most of the things. What about air purifiers that remove mold? Is there a best one on the market?

Dr. Carnahan:                    Yeah, so there are some that are out there. And there is a specific name that is eluding me at the moment. But I’ll give you some examples, Airwise and Molekule. And what they do is they actually can neutralize the toxins in the air. And they can actually, they’ve shown to improve air quality, so it’s almost like it’s an air modifying the air quality. However, there’s a caveat with that because when mixing that type of device that can produce some ozone when it reacts with the molecules in the air. So someone like me with a history of the lung sensitivity, those kinds of air filters actually would irritate my lungs. That’s not common with everybody, and those are really great air filters. So I’m not saying those are bad or wrong, but if you have any sensitivity with the lungs you might be hypersensitive to the little bits of ozone they actually produce when they combine with the air molecules.   I tend to use the ones that are just filtration and they have a HIPAA filtration and a BOC filter. Those would be like Austin Air and IQAir. So, and Airwise and Molekule are the other types. They’re all good, and they’re all different. I have Austin Air 2 here in the condo, and 5 at the office, and I’ve just loved them.

Dr. Weitz:                            On the average, how long a protocol does it take to remove mold? Is it reasonable to think that patients are going to get significant benefit from a month? Do they need three months? Does it takes six months? Does it take a year?

Dr. Carnahan:                    Yeah, so great question. Because people can be frustrated with the timeline. I usually say six to 18 months is kind of this average. I have [crosstalk 00:46:53]-

Dr. Weitz:                            Of through treatment that whole time.

Dr. Carnahan:                    Yeah, yeah. And again, not that you can start to feel better in two months, but it’d be really unusual for someone to just turn around in a month or two, it takes some time. Especially, if you’ve been significantly impacted, and depending on the amount of time, and I’ve seen sometimes it’s two years, but not that you’re not making progress. It’s interesting. One of the things that I developed with Quicksilver is the Mold Detox Box. So yeah, you can go molddetoxbox.com to find out.  Now, this is not for everybody, and it’s a fairly… I mean, it’s an aggressive, great treatment. So if you’re on the super, super sensitive side, you either want to go really slow products one by one because it will detox but it’s a 30 day kit. And I didn’t do that because I thought the 30 days would cure everybody. But what we wanted to do is put everything you might need for the detox all in one package for 30 days. And so, I think about it that way, but I’ve had to clarify a lot because people are like, “Can I get well in 30 days?” And it’s like, “No.” I mean, you might be able to get a significant handle on it, but it’s usually six months minimum, and then sometimes a lot longer.

Dr. Weitz:                            And so, a lot of times when we’re using herbal protocols, we’ll rotate the herbs. On a detox protocol for mold, if you have something after the first month that seems like it’s helping do you just stay on the same protocol, how do you decide when to change things?

Dr. Carnahan:                    Yeah, so again, history is so good because I’m always checking in, and I will tell them to start things individually. So start things one by one and see if there’s a reaction or a problem. And sometimes it’s dose. So binders can be something that… Basically with binders, you’re grabbing from the bile these toxins that are stored after they’re thrown from phase one, phase two into the bile from the liver, and you’re pulling them out through the stool, that’s a great way to detoxify. So if a patient is having trouble tolerating it, often we’ll have to go to a quarter teaspoon or an eighth of a teaspoon or a pinch to get them to tolerate. And what’s happening is on the way out as they’re pulling those toxins out of the body, they can get re-exposed. So you have to factor that in to how you dose since sometimes you’re doing very small increments. So, it doesn’t mean that the detox failed, it just means go slower.

                                                I am not a big fan… There’s herxheimer reactions or things that happen when you try to treat an infection, you have massive die off of an organism. You can also have a herx reaction when you’re trying to detoxify. And I’m not a huge fan of pushing through those kinds of reactions. To me that’s like, there’s always this concept of mobilization of toxins and excretion. So you’re mobilizing metals or toxins from mold or toxins from infection, and then you’re trying to get them out of the body through the urine, through the breath or lungs, through the sweat, through the stool, all these ways that we get them out of the body. And if you have a reaction, you’re probably mobilizing faster than you’re excreting. So, my job then is to slow down the mobilization and increase the excretion. And that can be done with things like infrared sauna. Just increased hydration or electrolytes, alkaline water or mineral water, things like Epsom salt bath at night, dry brushing, castor oil packs, even coffee enemas, those can all be helpful for excretion.

Dr. Weitz:                            So, if a patient has a reaction, and they say, “Oh, I can’t take that.” The answer is, A, it’s not necessarily that you can’t tolerate, it’s just the dosage. So, we need to dial way back on the dosage, go with a very small amount, and slowly bring it up.

Dr. Carnahan:                    Yeah, there’s three things. You could be allergic to something and not tolerate it, period. That usually will get worse over time instead of better. And some people just know, no matter how low of curcumin I take, I don’t tolerate it. Number two, it could be dosage dependent. So as you go very slow and very small, and you’re mobilizing not too much for excretion you’re tolerating, and then over time you tolerate more. And number three, you could actually have a deficiency of NAD, so you’re not recycling glutathione, so every time you take it, it becomes oxidized, and causes more toxicity. Or you could have a limit of B12, and you’re trying to take methylfolate and not working. So there’s really is an order of operations, and I find even for myself years ago there was a lot of things I didn’t tolerate that I can tolerate now. That’s a sign that that toxic load is decreasing.

Dr. Weitz:                          Cool. I think that, I think we really covered it. Do you have any final thoughts?

Dr. Carnahan:                    No, but thank you for coming on. Thank you for doing the interview. It’s really fun to talk about mold. And I think we did really cover a lot of the areas that people might have questions about with mold. If you have any questions, I’m going to be sure and link Dr. Weitz’s site so you can know more about him. And all the things I mentioned with the Mold Detox Box, and my free blogs, and all that we’ll make sure and link those as well, so you can stay tuned.

Dr. Weitz:                          But by the way, what is your website?

Dr. Carnahan:                    My website is just jillcarnahan.com. And then drjillhealth.com is where you can find products and the Mold Detox Box, and that kind of thing.

Dr. Weitz:                          Awesome. Thank you, Jill.

Dr. Carnahan:                    You’re so welcome. Thank you so much.


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