Dr. Pejman Katiraei on Neurodevelopment Disorders in Children: Rational Wellness Podcast 442

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Dr. Pejman Katiraei discusses Neurodevelopment Disorders in Children with Dr. Ben Weitz.  

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Podcast Highlights

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Dr. Pejman Katiraei is an Integrative Pediatrician and his Santa Monica practice is called Wholistic Kids and Families.  He got his undergraduate degree from UCLA and he obtained his osteopathic medical degree from Western University and completed a pediatric residency at Loma Linda University and he has also completed two fellowships in integrative medicine.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

 

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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.

Hello, rational Wellness podcasters. Today we will be speaking with Dr. Pejman Katiraei. Did I pronounce that correctly?

Dr. Katiraei:  You got it perfectly.

Dr. Weitz:  Alright. A board certified pediatrician, an integrative functional medicine expert who specializes in uncovering the root physiological drivers behind the behavioral and neural development disorders in children.  Our focus today is on the interconnected systems that contribute to neurodevelopmental disorders, regression, sensory dysregulation, including gut health, immune imbalances, mast cell activation, mold and environmental toxicity, mitochondrial dysfunction, and neural inflammation. We’ll explore how Dr. Katiraei, if it’s okay, I’ll call you Dr. K–I’ve heard a lot of others call you that…

Dr. Katiraei: Pejman is fine too. I’ll be both.  We’re all just people.

Dr. Weitz:  Whatever you prefer. Evaluate children how he evaluates children through a systems biology lens, and how addressing hidden physiological burdens can dramatically improve function, behavior, and quality of life. Dr. Pejman Katiraei, Dr. K, is a board certified pediatrician.  He completed undergraduate work at UCLA. I also went to UCLA and then obtained his osteopathic medical degree at Western University. He completed a pediatric residency at Loma Linda University, and he stayed on as a teaching faculty for over four years. He’s completed two fellowships in integrative medicine and he’s got nearly two decades of clinical experience helping children with severe learning and behavioral challenges, and he’s in private practice in Santa Monica. Dr. K, thank you so much for joining us.

Dr. Katiraei:  Thank you for having me. It’s a delight to be here.

Dr. Weitz:  That’s great. So we’re seeing an epidemic of neurodevelopmental disorders and pediatric mental health challenges today.  What do you think are some of the factors that are driving this?

Dr. Katiraei: You know, it’s certainly a hot topic, right? And there are a lot of people asking questions and obviously no one knows the exact answer. I think when you step back and say, what is underlying a lot of these neurodevelopmental, behavioral challenges that children today have and it’s everywhere. And you know, a lot of providers, and I don’t know if you’ve seen it but a lot of providers that I talked to have seen even in the last five years, that there’s been a spike in the prevalence and severity of these neurodevelopmental challenges.  So when we step back and say, well, what the heck is driving this? You get down to basically, in my opinion, three core systems that, that are kind of the pillars of either allowing fantastic and optimal mental health to be there versus a lot of challenges. And that is the mitochondria, if you want to consider them a system, the immune system, and then the gastrointestinal tract. To me, those are the three pillars that when they become disrupted or distorted in whatever way, they then create multiple cascades of events in physiological abnormalities that then lead to, you know, presentations that look like [00:04:00] autism, right? Where the child is having difficulty socializing.  And you know, one of the challenges I have is a lot of times I see children given that label. But they’re able to make eye contact. They’re able to talk to you like they’re able to interact. But when you ask the parents, well, why did they give your child this label? They say, well, you know, he struggles socially because in school or other environments, he won’t interact with the kids.

Sometimes he does kind of little strange things. And you know why I bring this up is the challenges that are now presenting in the children have become. In some ways so complex that we just keep coming up with new labels. Right? And it seems like every year or two, there’s like some new label that we are coming up with or a diagnosis to explain what these kids are having.  But when you step back and say, why do these children behave the way they do? It boils down [00:05:00] to usually there’s a lot of neuroinflammation, right? Inflammation in the brain that is causing weird abnormalities and how they perceive the world. So you get sensory distortions where the child is overwhelmed by loud and crowded environments.  They have issues with clothing, they start having restrictive eating where they become very picky. On top of that, because of certain other chemical abnormalities you get changes in sleep patterns, you get changes in appetite. So there are oh you get changes in, in all of these different systems that then show up in a odd way, where then families say, well, what is going on with my kid?  And someone gives them that label. If we say, well, what drives that inflammation in the nervous system, right? If that inflammation in nervous system is one of the key factors, which I believe it is, and my entire practice is literally around identifying [00:06:00] this inflammation, figuring out what’s triggering it and taking care of it.

Literally that’s pretty much all I do. We get into environmental factors, right? Certain environmental chemicals and compounds and so forth could drive that, but also the gastrointestinal track, right?  You, you know better than anyone, and I’m sure most of our audience knows, like when the gastrointestinal track and microbiome become unhealthy, that triggers a whole lot of inflammation within the nervous system and.  Because the mitochondria are the stabilizers or essentially the foundation of cellular health, which then influences everything else. You, it kind of combines into that. And then if we take a step further back and say, well, what the heck is then causing this sudden rise?  That is where this, you know, as one of my friends, Patty Lemer just brilliantly put in a book, and her entire book is literally around this called  The Total Toxin Load.

Dr. Weitz:  I’ve had her on the podcast before, Yes.

Dr. Katiraei: And that, that’s the whole premise of her book, the Total Toxin Load, which is, you know, over time we have just kept pouring more and more toxins into the buckets of these little kids. And then I believe COVID was, if you want to consider it a toxin, it derailed the mitochondria.  It damaged the gut. It triggered neuroinflammation, so it basically caused the bucket to become even fuller. And then my experience is in these kids whose buckets are ready to overflow, but maybe not there just yet, you add the exposure of mold or dampness. That just causes the bucket to completely overflow, causing these children to then have this, these weird constellation of findings in all kinds of different, developmental, behavioral, and learning domains.

Dr. Weitz: And this increase in these environmental toxins helps explain why we didn’t see this number of kids decades ago.

Dr. Katiraei: Yeah. Yeah, absolutely. 

Dr. Weitz:  It’s something unique to our present environment.

Dr. Katiraei: Yeah. And you know what’s been interesting is, you know, with me, I’ve been taking care of kiddos with mold for, you know, close to a decade now, and what I can tell you is the resiliency that kids have against these additional exposures, even in the last four or five years has changed, you know?  Seven, eight years ago, the amount of exposure and using mold as an example that had to be there to make the kids sick was actually significantly higher than it is now. Where now if there’s any moderately significant amount of contamination in the home. And why I bring up mold is, I mean, you think about how much [00:09:00] time kids spend indoors and if you have a chain smoker, imagine a chain smoker living in your kid’s wall, right in their bedroom or living room, wherever they are.  And this chain smoker is constantly puffing out smoke, except the smoke is a super biological toxins that derail the mitochondria, trigger inflammation in the gut, disrupt the microbiome, trigger inflammation in the nervous system, so it becomes this perfect additional load on all of the other susceptibilities, if you want to say that are there.  That then triggers the issue. But the amount of chain smoking, biological toxins that now needs to be there to cause your bucket to overflow in comparison to even six or eight years ago is significantly less because sadly, these kids have buckets that are way too full.

Dr. Weitz: Yeah, so the point you’re making, or one of the points you’re making is that it’s this cumulative load.  That you have a toxin, you have something [00:10:00] else, maybe a food sensitivity, you have stress, you have all these different things that contribute to stress on the nervous system and it’s like a bucket when that bucket overflows. And so if you could empty out part of that bucket and maybe the bucket’s only half full, you can withstand some sort of stress from an exposure to an environmental toxin. And it might not trigger anything. But if your bucket is filled close to the top, any extra bit of stress on the system is going to trigger changes.

Dr. Katiraei: Yes, a hundred percent that that’s exactly the case.

Dr. Weitz: And so it’s environmental factors that seem to be so important, but what do we say to the traditional pediatricians and researchers who say that these neural developmental disorders are caused by prenatal brain development differences that can be seen as early as the second trimester, that you can see changes in neuronal patterns in the brains of these kids, and therefore, these environmental factors really are not that important.

Dr. Katiraei: It’s a great question, and I think to answer that, we need to ask what shapes neuroplasticity, right? What? Regulates and shapes and controls neural circuits. And that’s the microglia, right? The macrophages, the immune, primary immune protectors of the brain. The microglia literally shape and prune and control neuroplasticity and that has been like really well established in the science.  And for everyone out there, if you literally just go type in to Chat GPT, grok, whatever you want to use, microglia. You know, neuroplasticity, microglia, neuro, [00:12:00] you know, synapses, et cetera, et cetera. Like this is something that has been really well established in the science. So then if you say, well, if that’s true, and I believe that is something that has been, you know, kind of proven beyond any doubt, if that’s true, then what the hell pisses off the microglia to then cause them to start having the weird abnormalities that then cause the circuit disruption. Right. Right, and that is when we ask, well, what would activate the microglia? Right? The microglia have two states. They have the M2 state, which is kind of chill, right? They’re regulated. They are really, in that case, in that state, they’re like the caretakers, right?  They’re tending to the garden. They’re appropriately pruning a branch here appropriately, pruning a branch there. They’re helping the circus form appropriately. When they shift to the M1 phase. And that is like they’re having a psychotic [00:13:00] break and now they’re taking a hacksaw or a chainsaw and literally just slashing shrubs, you know, tree cutting down trees, like they’re just slashing and burning the garden and everything is a big hot mess.

What would cause the microglia to shift from one phase–Caretaker– to psychotic break arsonists destroy the garden, and that is some kind of typically infectious or microbial trigger because of toll-like receptors and all of these, you know, funny little pathways. That trigger this change. And what we know is when there is some kind of maternal inflammatory or infectious event, the risk of a child having increased, you know, neurodevelopmental challenges of whatever sort, including a SD, is significantly higher.  So once we start putting this together, then it brings us down to, well then what would trigger these microglia? [00:14:00] And that boils down to a handful of microbes. It turns out certain toxins, even air pollution can trigger microglial activation. It’s when you start looking at the material and then the data, you’re like, oh my God, how?  How in god’s good earth could air pollution and the particulates from air pollution, which do get into the placenta, right? Trigger that on top of that. It turns out that mycotoxins and certain microbial compounds that are released in these damp environments absolutely pass through the placenta, absolutely can trigger microglial activation. and can start that process of neuroinflammation before that poor little baby is born.  But. Clinically what I find in, so,

Dr. Weitz: So let me just stop you for a second. So I think the point that you’re making is that what is seen as genetic factors [00:15:00] leading to these conditions actually can be environmentally triggered even though they happen in the womb.

Dr. Katiraei: A hundred percent. And you know, if you just logically look at this, and a lot of people have said this like, genetics don’t change over decades.  They don’t even change over a hundred year time spans, right?

Dr. Weitz: But it’s interesting. Why do these researchers often say, oh, this shows that it’s genetic? Because it happens before the kids are out in the world getting exposed, but they’re getting exposed to environmental factors even while they’re in the womb through the mother.

Dr. Katiraei: Yeah, a hundred percent. And like this is the part that I think is unfortunate, right? You have a, we have a community of scientists that. For whatever reason are selectively only looking at part of the science. And if you just, I mean, literally anyone nowadays, you know, with any of these generative ais, could literally go do their own research.  And once you start digging [00:16:00] into the literature, it’s insane. Like, it’s all there. And plenty of data to, to really support how various environmental factors can absolutely change the neuroinflammatory response in a newborn.

Dr. Weitz: Yeah. It’s interesting you bring up the glial cells. I’ll be having a discussion with David Perlmutter in a month about his new book, which is about the glial cells.

Dr. Katiraei: Yeah. It’s huge. It’s huge. And I mean, they have become my primary focus in this population of kids. And, you know, it’s become my obsession to understand them and understand what triggers them and then also understand what we could do to help. But one of the things that I see is the babies are born.  The first sign of neuroinflammation is actually what I see as severe colic, and the literature also suggests that if a child has severe colic for [00:17:00] long enough period of time, the risk of developing a SD later on goes up two to 300%.

Dr. Weitz: Now, what do we call severe colic?

Dr. Katiraei: So severe colic there, there’s regular colic where the baby cries for a few minutes here and there, easy to console overall doing well. And then there are the kids who literally just could not be consoled for the life of them. The parents have to drive them around. They’re rocking them, they’re holding them, they’re bouncing them, they’re putting ’em on the dryer to help them calm down.  Right. And it’s not to say that if your baby has coic, they’re doomed. Right. It’s, there’s a pattern that I see over and over again in the consultations that I have with these families. So baby has severe colic where they will sleep for an hour or two, wake up crying, have to be held, have to be fed, and then instead of regular colic, that usually goes away after two to three months.  This persists well into five, six months of age. So it’s a very unique pattern that is different [00:18:00] than the conventional regular baby colic where they fuss and cry.  Usually these babies also start developing some degree of reflux. And that is, so the colic is the first sign of neuroinflammation because that is triggering changes in the microglia, and that changes part of the child’s response to the environment.

But also the elevations in histamine start causing abnormalities in that child’s circadian rhythm. And elevations in histamine is like taking 15 shots of espresso, except you’re a newborn, right? You just cannot wind down. You can’t calm down. And we see this in the older kids with a SD and like this is the part that’s so fascinating.  If you look at colic and you look at the disturbed and like sleep cycles of older children on the spectrum and some with pans, they actually look. Pretty much exactly the same. It’s just one is showing up in the newborn period. One is showing up when that child is [00:19:00] older, but it turns out it’s the same physiological event.  And how I know this is in a handful of kids that have had this early on, when I use certain compounds, natural compounds, to reduce histamine, to reduce microglial activation, the kids start sleeping again. So.

Dr. Weitz: What triggers the histamine increases the increase in mast cell activation. Is that a, is that an effect?  Is that an underlying driver? What, how does that end up happening in this cascade of events?

Dr. Katiraei: So in myopic view and I will admittedly admit that I, I am very biased here because this is the world that I live in.  What I see is environmental dampness, so water damaged buildings as being one of the most significant contributors to this.  Now, is it. The only contributor is that in all kids, obviously not, there could be multiple other things that could be [00:20:00] chronic infections that are there, there could be multiple other things, but,

Dr. Weitz: Heavy metals, other environmental toxins,…

Dr. Katiraei: Yeah. But the pattern that I see is, especially when there’s dampness.  The other thing that shows up right after, or almost at the same time is pretty severe reflux. And when I say that the babies, they’re health, normal babies will spit up, right? The little bit of formula comes out or milk comes out and they’re fine. Then there are kids that have such severe gastrointestinal inflammation, and this is the first sign of their gastrointestinal tract becoming disrupted, that they start refluxing and it’s like half the feeds that they have come up, they’re fussy, they’re crying, they’re in pain, and we start seeing early signs of food intolerances. So mom has to cut out dairy, mom has to cut out gluten later on when they’re trying to feed the child. The child [00:21:00] is now intolerant to certain foods so they can’t eat all the foods. And that is the first sign of now their gastrointestinal tract becoming disrupted because we know intestinal permeability leads to food intolerances. Right. And why I bring this up is these patterns start showing up.  The kids start developing sensory things. They start getting overwhelmed and loud, crowded environments. They become picky and they won’t eat all the foods. And this kind of goes on, the children sometimes start developing ear infections or other respiratory infections or eczema. So eczema being the gut, respiratory infections, ear infections being the inflammation typically from the environment.

And obviously those antibiotics are not helpful. And then this pattern keeps going and keeps going. And then usually somewhere between a year to a year and a half. some kind of other trigger or burden or [00:22:00] stressor. It could be COVID, I’ve seen that, it could be an antibiotic, it could be a host of other things, and we’ll leave that for our audience to figure out what those other things may be.  But then there’s that straw that breaks the camel’s back and physiologically, the parents see all of a sudden a significant regression or significant worsening, where before the child was fussy, they did have some sleep issues. They were a little difficult to console, but they were still babbling.  They were still making eye contact. They were still engaging. And then those things disappear. And what I believe is that is the moment where the gastrointestinal tract loses the whatever remnant of integrity that it has, and there is, it passes a certain threshold, and that is when endogenous microbial compounds. It could be various Clostridium mark compounds. It could be lipopolysaccharides. We don’t really know, but it seems that there’s a moment when the gut really falls apart.  And that causes a secondary wave of microbial toxins.  And when we look at what is really good at disrupting the microglia and activating them through their toll-like receptors, that is lipopolysaccharides in various microbial compounds, right?  They are probably the most capable and potent toxin in triggering the microglia. And what I believe and what I see is the children’s guts fall apart that releases all of these toxins that causes another wave of even more inflammation in the nervous system, which then causes these poor children to essentially lose whatever milestones that they have.

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Dr. Katiraei:  So you’re talking about the fact that the gut has this lining, a mucosal lining that. Prevents toxins and certain other substances that we don’t want getting directly into our system.  It’s a barrier. That barrier gets broken, becomes more permeable. And then these toxins, including bacteria that dye. Give off toxins called lipopolysaccharides, and there’s a host of other toxins cyto, lethal distending toxins, and those toxins that get into the system then [00:26:00] create this inflammation.  So the breakdown of the gut wall, that increase in permeability is one of the factors.

Dr. Weitz:  Now somebody who’s listening to this discussion. Who’s a bit of a skeptic might say, well, there’s all these kids with these problems. Could they really all be getting exposed to mold? Is there really that much mold around?

Dr. Katiraei:  So the answer is yes. Okay. And again, I’m not saying that this is the only explanation, right, right, right. There, there could be a host of other things, like you pointed out the metals Lyme and Lyme co-infections can certainly be even from in utero, right? It could be passed on congenitally, so there could be other things, but I don’t see those other things as being as capable of triggering a lot of ENT inflammation, so the recurrent sinus issues, the recurrent ear infections, the recurrent respiratory infections. I typically don’t see that with these other [00:27:00] factors and those other factors don’t seem to be as capable of disrupting the gut the same way as these DAM environments.  And just to give you a tiny context. When you look at, where do most of our modern antibiotics come from? They come from molds, right? They come from mycotoxins. Right? So, and that, that’s just and sill being the first one. Yeah. Yeah, exactly. So yes they, it can, and then when you look at. This is from the U-S-E-P-A, if anyone wants to go look it up, one in three homes in the US are known to have water damage, and this is, you know, from probably a decade plus ago. With the building standards or lack of that we have now. And when you think of what is embedded in every single home in the US drywall, and then you ask, well, why is that a big deal?  Until you a look at, well, what is drywall made of? Drywall is made of calcium [00:28:00] carbonate with heavy paper, and then that heavy paper has literally mold spores embedded in it. So essentially what we have done is create. Every single home to be a chia pet, right. You just add water, you get mold, and it’s one of the misnomers that I think as a community we have not done a good job in, is when we say mold, it’s actually not mold.

Mold is the smallest part of the equation. The toxins that these more toxin, genic molds create the mycotoxins. They’re a small part of the problem. I believe, and Dr. Shoemaker’s been talking about this for decades, is the bacterial component of the dampness, the gram-positives. The gram-negative bacterias are actually the ones that are most dangerous because they’re producing in the environment.  Forget about in the gut, in the environment, they’re producing the lipopolysaccharides, they’re [00:29:00] producing. All kinds of different microbial particulates, microbial volatile compounds, and a soup of other biological toxins that we inhale that get absorbed into our bloodstream and affect our system, you know, throughout the as they go around and circulate.

Dr. Weitz: Interesting. And in addition, one of the things we’ve done in building homes is trying to have homes that are more energy efficient, and that means making sure they’re sealed. By sealing the outside of your home, you don’t have the breathing ability, you don’t have air circulating between the walls.  And if some moisture gets into that area, you’re gonna have mold building up much more quickly than if the home was more permeable, if there was air circulating. So making these airtight more energy efficient homes is another factor in this. [00:30:00]

Dr. Katiraei: A hundred percent you nailed it. And you know when you add that with now, sadly, more shoddy building standards. I’ve had homes, you know, expensive homes, like multimillion dollar homes. Two years out they’re starting to have issues because a window didn’t get flash plop properly. One of my best friends, their home, the balcony wasn’t flashed properly, so every time it would rain, the water would go from the balcony into the walls.  Into the ceiling, and then it created literally more than half the home, and that was like a 2-year-old construction. So it’s that. And then again, if we add the bucket of these kids are already full, so their ability to handle any additional toxic load is significantly less than what we had 20 or 30 years ago.  Forget about, you know, even five or 10 years ago, the picture starts coming together and then when you put it all together, it’s like. Oh it’s actually no wonder why so many kids are struggling. [00:31:00]

Dr. Weitz: Interesting. I, is there a better substance to use in drywall? Is there alternatives out there?

Dr. Katiraei: You know, it’s something that actually one of my friends he is working with the Department of Defense to see if they can start developing such.  So there, there are certainly people that are starting to look at this and ask the question of. You know, what can we do? Because sadly we know military housing is notorious for having, you know, water damage. And I see that also with a lot of rental properties, right? They’re just, no one is investing the money or time to keep up these homes, right?

So a little leak here, who cares? Or it is not a big deal. It’s not a big deal. And then our environmental standards, the lack of certification and really, maintaining a high level of accuracy with our environmental assessments, that’s another problem, right? Well intending people who have been trained to think one way come in, they take literally one or two [00:32:00] samples from inside the home.

They take a sample from the garden, and then they say, well, garden has more mold than they inside of the house. Therefore, there is no mold. Therefore, there is no problem. Have a nice life. And you just think about that logically, like, wait, what? But literally that’s what we’re doing. It’s not that we’re breaking it down to the species, right?  It’s not, they’re saying, oh, there’s a, to a small pike, a spike in this toxic tox inogenic mold that wasn’t really there outside there could be a problem. They’re not doing this. Literally, it’s total mold outside has to be. More than inside. And that equation, simple equation is all they’re using to say if there’s a problem or not.

Dr. Weitz: And then look at all the floods you see in the news all the time and these hurricanes and these other environmental factors related to climate change that are leading to that’s gotta drastically increase the risk for mold. [00:33:00] Absolutely.

Dr. Katiraei: Absolutely. There, there’s one study that I know of where they, they looked at certain areas that were affected by climate change and hurricanes, and the prevalence of mold in those homes was about 45% with, I believe somewhere around 20, 25% having severe contamination not just a little bit like severe significant contamination.  So, yeah, absolutely.

Dr. Weitz: So. What kind of testing do you like to do for your patients?

Dr. Katiraei: I wish there was a perfect test that I could say, oh, this is the test we can a hundred percent rely on all the time. Right? There is no such thing. And that’s another fundamental issue. What I do like to do, I mean the first thing I believe is we have to piece together the picture, right?  If a child was born, they started having colic. They started having reflux. They had a bunch of ear infections, or child was doing fine, right? They were doing fine [00:34:00] until three or four years old. But then weird things started happening and that correlates with when the family moved. Or the child started school because 20% of schools have mold as well.  Right. So it doesn’t have to be in the home. I’ve seen it in the schools. I’ve seen it in a parent’s car. So if the child started having issues, at a certain point we need to ask, well, what could that have been? If the suspicion is there. So as we piece the story together, and that’s part of what I do with every single family.

We spend an hour, sometimes hour and a half piecing together the story of how did this all come together. And I’ll give you an example. There’s this dear family that I was talking to, both parents or physicians. Their beautiful boy, when he was around 14, they moved to a new home. New home. And within about a six month to a year time, he started developing all of these issues. Severe ooc, d, severe anxiety, can’t even leave the [00:35:00] house. Mom is literally trapped in the home because his separation anxiety is off the charts. He doesn’t sleep like literally. They have to give him Ativan. And even with that, he doesn’t sleep well, like severe issues.  And it turns out that is when they moved into their home. And, you know, as I was talking to them, they were like, yeah, you know, we did see that the, you know, some of the things buckling and there, there have been some leaks and, you know, et cetera, et cetera, et cetera. So first of all, the clinical suspicion has to be there.  Once that’s there, what I like to do, if we can draw blood, is use immune reactions against the molds to see if that child has had exposure. Are these tests a hundred percent accurate? Absolutely not. Generally speaking, are they more accurate than other tests that we have? I would say yes. So

Dr. Weitz: like for example urinary mycotoxin testing.

Dr. Katiraei: Yep. So you like urinary mycotoxin testing? I [00:36:00] know my dear mentor, Dr. Nathan, you know, recommends this, and I believe in adults, they’re a very useful tool. You can get false positives from the foods that you’re eating, right? So if you eat too much gluten, dairy, peanuts, et cetera, you can get false elevations in the little kids.  Why I stopped using them. Is when kids become really toxic, it seems that they lose the ability to push the toxins out into the urine. Ah, so I had interesting plenty of kiddos where like horrendous levels of confirmed contamination, like to the point where the family had to move out kind of stuff.  You results look completely normal, like to the point where it’s like, oh, there’s nothing going on until it’s like, oh my god this home needs to be condemned kind of stuff. So. That’s why I’m not a big fan of the urine mycotoxins in the kids. Urine organic acids, which is kind of checking the biochemistry.  And certain companies like Genova, Vibrant, Mosaic do check for fungal [00:37:00] markers, and there are plenty of people that question how accurate these fungal markers are. But basically this is like the fungus and the molds leave their own biochemical footprint. And these urine tests are looking to see if those footprints are there.  50, and I know these are tests that are used in the functional integrative community all the time. At least 50%, maybe a little higher, close to 60% of the time, a child can have significant exposure. And these urine tests don’t show signs of fungal imbalance. So if any family out there listening, if they’ve ever done an organic acid and outside of their aose.

The tartaric acid, or some of these other markers were elevated, even if it’s tiny elevation, that tiny elevation could be a sign that the child has had exposure, and that exposure changed the fungal makeup of their gut resulting in this abnormal result. So with all of that [00:38:00] said, you know, the tool that seems to be most helpful right now in assessing exposure to me is immune reactions in the blood against environmental molds or against environmental mycotoxins, mold, toxins.

Dr. Weitz: And which company are you using for that?

Dr. Katiraei: So the only company that holds the patent for the mycotoxin antibody testing is my Myco lab. And their testing is actually pretty accurate. About, I’d say 10, maybe 20% of the time you get a false negative. And I believe the reason for that is the immune suppression that these children have, because if the immune system is suppressed, it’s not producing antibodies appropriately, which some of these kids have.

Dr. Weitz: And mold tends to lead to immunosuppression.

Dr. Katiraei:  Yes, sir. Absolutely. Absolutely. So if you’ve got that right and you check the immune system and the immune system doesn’t show a reaction, it’s not because the child wasn’t exposed, [00:39:00] it’s because the immune system is asleep at the job. And with the, there’s another company called Allot Tests, A-L-L-E-T-E-S-S, and I have no financial affiliation with either allot tests I like because.  It’s a little bit cheaper. So if finances are tight mic, my micro lab, I think is a better test when families can’t afford the $400. That’s a two. The all test is a $200 test that looks for IgE reactions against molds, which are very uncommon. So for those families that have had their kids’ allergy tested and the doctors are like, your kid doesn’t have mold, you know, have a nice life only five to 10% of the time, I see those being positive.  And there’s a study that. Demonstrated pretty much the same thing. They check for IgG, so that’s the delayed immune re response. The cool thing with allot tests is they also check for iga a against some fungus and molds. And why that is [00:40:00] helpful is if you see an IGA reaction, that means that fungus is irritating some mucosal surface.  And in theory you can say, oh my gosh, there’s probably some degree of colonization or fungal dysbiosis driving that. That was a lot.

Dr. Weitz: Yeah. No, that’s good. And and then if you suspect that there’s mold, toxins, mast cell issues where do you start?

Dr. Katiraei: The first thing is to really understand what’s going on in the environment.  Because if you don’t, and let’s say there is ongoing active exposure, right? And typically how that shows up is the child’s nervous system is on fire. Like that example that I gave with that young man. In those cases, [00:41:00] typically. Regardless to what you do, the child will continue to be inflamed. And it’s like playing a gap game of whack-a-mole.  You try something, it kind of works only to fail later. So understanding the environment and helping to control or address whatever exposures there is pretty significant. And the analogy,

Dr. Weitz: you mean if there’s mold in the home? Yes. Trying to correct that if move out if you have to or get it ameliorated.

Dr. Katiraei: Yeah and you know, sometimes it’s just one. Done leak somewhere, right? It’s one bathroom that’s leaking into one area. And I’ve had families where there, there’s one family. Their beautiful young lady, 14-year-old, severe pans, like off the charts, anxiety, couldn’t leave the house nauseous, tired, like literally couldn’t function.  It turns out that the laminate flooring that was in her bedroom and in part of the living room. And laminate is [00:42:00] basically plastic, right? So it traps moisture. It hadn’t been properly installed, and literally there was visible black mold under that laminate flooring. Family ripped the floors out, cleaned it up, and within three or four weeks of just getting rid of that they didn’t even touch the rest of the home.

Literally by just getting rid of that, she’s already doing a thousand times better. She’s going out, she’s painting her nails. She’s got, she got a haircut for the first time in a few years. She’s hanging out with her friends. She’s chipper and I bring that up because. I think this is an important note to touch on.

This isn’t doom and gloom. Oh my God. I mean, part of why I’m driven to have these conversations and take care of these families is the beautiful transformations that become possible, right? Where we think like things like a SD or whatever else are just lifelong conditions. Well, they are lifelong conditions if you never take [00:43:00] care of where the source of the inflammation and dysfunction came from.

But when you do and you help the child’s system start rebuilding itself, dramatic and really beautiful things come. I have multiple, you know, kids that I can think of right off the top of my head with severe level three a SD and like the poor kids who couldn’t function headbanging self-injury.

Couldn’t go anywhere. Couldn’t take him to the restaurant, couldn’t take him to the church. Freak out every time they go out. Took care of the exposure, did a few things to detox them, and now they’re going to church, they’re going to restaurants. You know, are they totally normal? No. But has their quality of life improved dramatically?

Absolutely. And this is the most wonderful part of this conversation where it gives families. The possibility of finding some explanation for why their kids are struggling and gives them something that they can take an action on to take care of it. [00:44:00] And that is to me, you know, the wonderful part of this, there’s hope, there’s healing, there’s profound transformations that are possible.

Dr. Weitz: So what kind of detox strategies have you found to be effective?

Dr. Katiraei: So before I, I detox to kids. I first stabilize them because I find when they’re not in a stable place and they’re still acutely inflamed, everything becomes significantly harder. So with the stabilization, I use certain. Supplements like DAO enzymes in ric and I’ll sit.  There’s a substack that I have out there that has all of this spelled out if you want to include that. So

Dr. Weitz: DAO enzymes are an attempt to stabilize the histamine mast cell factors.

Dr. Katiraei: Yes. And by reducing the histamine in the gut, that allows the gut immune system to calm down because histamine acts as a pro-inflammatory agent within the gut.  There’s a compound a [00:45:00] supplement that has PEA polymethyl, if I’ve said that correctly. PEA actually is a really wonderful mast cell stabilizer within the gut and within the nervous system. Luteolin, which is something Dr. Theo her has talked about a lot and done wonderful research on, is another wonderful compound that also helps stabilize the mast cells within the gut and nervous system.

So I usually start with just those, some zinc and d. And see if I can get things to calm down. And why I don’t do anything right off the bat is sometimes, especially if there’s citric acid or other flavorings or other compounds, those additional compounds actually become triggers to the immune system. So you muddy the waters up.

Once that is on board one of the things that I’m finding to be really helpful, and this is something Dr. Fry has been talking about, richer Fry has been talking about for eons, is [00:46:00] using big doses of folinic acid and certain other B vitamins. It turns out that when you don’t have enough folate in the nervous system, your ability to break down histamine is also compromised.

So pushing some of these vitamins in a gentle yet. Significant fashion sometimes helps reset that. B six is really helpful. And then with that, I bring in some magnesium three eight, which also can help these children calm down because it activates gaba. So I do a few of those things, watch and see how the kid does.

And with this hopefully processed foods, food colorings, you know, all the junk gluten, dairy are also controlled. If the child starts doing better, which I’d say 60 to 70% of the kids who have the mild degrees of immune activation due and the 20% that have the severe sometimes need more heavy duty things like peptides or keto OFin or chromin [00:47:00] or more.

Intense levels of immune regulation, but once the kids start doing better, that’s when I think binders could be super helpful. Right. But one of the things that’s fascinating about binders is if we ask, what are these binders binding? Right? And not to say that they wouldn’t and cannot be binding mycotoxins and certain other things within the bile, but what I believe.

The binders do is they actually start binding the lipopolysaccharide. So, so all of the toxins that are within the gut, right, produced by the bacteria that were leaking through, right, that we talked about early on, that triggered the next wave of inflammation. If you look at chlorella. Citrus pectin, activated charcoal bentonite cholestyramine for those that have used the pharmaceutical that Dr.

Shoemaker talks about. If you look at all of these and others, every single one of these [00:48:00] is to some extent, either highly capable or moderately capable of binding the bacterial toxins that are in the gut. And what I think happens is when we use these. Yes, they do bind whatever mycotoxins that are floating around and other things.

But what they also do is while the dam is still leaking, they basically start trapping the toxins that were in the gut and preventing them from going into the circulation, which helps these kids start doing better.

Dr. Weitz: Interesting. What about using something like serum bovine immunoglobulins because those are known to bind to LPS?

Dr. Katiraei: I love it. I absolutely use those a lot of the time. N-acetylcysteine, once the kids are doing better, is fantastic because it reduces oxidative stress and starts boosting glutathione. One of the things that. I have become a huge fan of [00:49:00] is the AOL antifungals sometimes even Nystatin, which is, you know, non-absorbable produces dramatic changes and that is.

If you look at what else is triggering the inflammation from within the gut, it’s the fungus, right? The fungus go out of balance, candida goes out of balance. They become another trigger for inflammation, and by just controlling them, sometimes you’re able to downregulate the inflammation. But what’s so fascinating about Itraconazole Fluconazole.

Is these azos have really powerful and rather remarkable anti-inflammatory properties. So they’ve been looking at them in cancer research and all kinds of other things, and through multiple PA pathways, they actually start downregulating the inflammatory response. Especially within the nervous system, and I, for one, am convinced that they are probably one of the most useful [00:50:00] anti-inflammatories for the nervous system.

And I’ve had kids where we start them slowly, but we titrate them up. And within two to three weeks of being on these antifungals when it’s done properly, so you don’t just throw it in, you know, kid is still living in mold, their diet is garbage, right? You can’t just throw it in and do a Hail Mary and hope it helps you get everything plugged in.

When the time is right and it’s used for the right child at the right time, it’s sometimes weird how helpful it is. Children that were aggressive, irritable, struggling to make eye contact, struggling to connect, sometimes literally within a few weeks, they calm down. They’re much more able to regulate their sensory issues, calm down.

They’re able to connect more and. The there, one of the most beautiful things is it seems that by downregulating, the microglia. [00:51:00] These azoles start changing dopamine pathways, serotonin pathways, oxytocin pathways, and why? The oxytocin piece I bring up, we know that’s fundamental for human connection.

I’ve had several kids and I experienced this myself, so I can say firsthand that this. This seems to be true because I witnessed it in my own nervous system. Oxytocin starts working when inflammation calms down, and the ability for a human being, myself included, to be able to connect with others and be able to experience.

That flavor of life, if you want to say, right? It’s like going throughout your entire life, eating bland chicken every day and not knowing that, that is your experience, right? You just, you eat it and you’re like, okay, this is what life tastes like. Right? And you build ideas because everyone else is like.

Ooh, wow, this is so delicious. So in your head you are like, Ooh, this is so delicious. Right? Even though the ex emotional [00:52:00] experience isn’t there. And when you look at a lot of people that are on the spectrum they have this flat affect, right? They’re we speak in almost like a robotic way where there isn’t emotional context behind what we say.

You know, we say we love you and in our minds, we really do mean we love you. But that, that ping of. Joy and love that most normal people experience when they experience love, literally doesn’t fire in someone whose nervous system is inflamed. And with these AOLs, what’s really. Amazing is when it drops down the microglia, I think it’s the microglial tone and allows them to go back to that M two phase.

A lot of these pathways start working and I’ve seen it where children that were, you know, labeled as a SD are now the ones. Wanting to connect with other kids. They’re wanting to make friends, they’re wanting to go on play dates. They go to their mom and they give them a hug for the first time, and they [00:53:00] genuinely look and say, I love you.

And it’s just, I mean, I can’t tell you it’s the coolest thing you can possibly imagine to see happen when these children, you know, I think for me, it’s all of these kids have this ability, right? This is human innate. Capacity. It’s as I’m sure you know, with your background, our job is to take away the garbage that prevents that capacity from showing up.

Right? And the, these azos are one of the things that take away some of the barriers that allow these children to express or prevent these children from expressing their love in connection. And that innate gift, that innate ability starts shining through. And it’s the most beautiful thing ever.

Dr. Weitz: That’s great.  I see time is running out, so let’s bring this to the close despite the fact that I had about 20 more questions. So I want to thank you very much for joining us on the Rational Wellness [00:54:00] Podcast and bringing us your insights about how interconnected the gut, the immune. The mitochondria and the developing brain are how can listeners and viewers contact you and engage your services?  And then you have a book that’s gonna be coming out soon, right? 

Dr. Katiraei: I do, I do. I’m in the process of writing a book. It’s, I think it’s going to be called Autism Redefined. That’s the working title, and it’s literally around this very conversation with a lot of information that families can use with any provider that is open to working with them to.  Literally identify these exposures, control it and work through the healing process to get their kids into a healthy place. So that’s hopefully going to come out late next year. Where they can find me is my clinic website is wholistic kids with a w, so [00:55:00] W-H-O-L-I-S-T-I-C kids. If they type in my full name, my Substack is there and some of the protocols that I’ve published before or out there.  So families can start using those to start seeing what’s going on with their kids. And I’m also on Instagram with the holistic kids handle.

Dr. Weitz: That’s great. Thank you so much, Dr. K.

Dr. Katiraei: Oh, my pleasure. My pleasure. Thank you for having me. And thank you for hosting this conversation. And you know, I hope that the time we spent it will help inspire some families and individuals, you know, who have been struggling to save, my God, is this my kid?  Is this what’s happening to my child? Because that’s the best thing, right? If what we did through this conversation helped. Some families or individuals have a healthier and brighter life, then everything was worth it. That’s great.

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Dr. Weitz: Thank you for making it all the way through this episode of the Rational Wellness Podcast.  For those of you who enjoy listening to the Rational Wellness Podcast, I would very much appreciate it if you could go to Apple Podcasts or Spotify and give us a five star readings and review. As you may know. I continue to accept a limited number of new patients per month for functional medicine. If you would like help overcoming a gut or other chronic health condition and want to prevent chronic problems and want to promote longevity.  Please call my Santa Monica Weitz Sports chiropractic and nutrition office at 310-395-3111 and we can set you up for a consultation for functional medicine and I will talk to everybody next week.