A Comprehensive & Practical Review of Mold Toxicity and its Complications

I had the opportunity to attend "A Comprehensive & Practical Review of Mold Toxicity and its Complications" held online on April 24-25, 2021.  This event was a wonderful collaboration between Neil Nathan, MD and Jill Crista, ND.

To learn more about Dr. Nathan, visit: https://NeilNathanmd.com

Don't miss Dr. Nathan's book: Toxic: Heal Your Body from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness

To learn more about Dr. Crista, visit: https://DrCrista.com

Get 10% off Dr. Crista's mold course for practitioners: Are You Missing Mold Illness In Your Patients?

Disclaimer: Nothing in this text is intended to serve as medical advice. All medical decisions should be made only with the guidance of your own personal licensed medical authority.

Disclaimer: This information was taken as notes during the training course and may not represent the exact statements of the speakers. Errors and/or omissions may be present.

Note: As this information may be updated as any errors are found, I kindly request that you link to this single source of information rather than copying the content below. If any updates or corrections are made, this will help to ensure that anyone reading this is getting the most current and accurate information available.

Neil Nathan, MD spoke on “Mold Toxicity: An Overview, Making the Diagnosis, Detailed Approaches to Treatment” and shared:

• As many as 10 million Americans have some degree of mold toxicity
• If you are treating Lyme and don’t look for mold, you are missing opportunities to help patients
• The inflammation triggered by environmental toxins and infections is now linked to many common illnesses
• Chronic inflammatory process involved in: CFS/ME, Fibromyalgia, Lyme, mold toxicity, PANDAS/PANS, ASD, neurodegenerative disease
• MCAS, Porphyria, methylation dysfunction, microbial reactivation, limbic and vagal dysfunction trigger or influence; these are the consequences of mold toxicity
• Patients often experience iatrogenic PTSD as a result of the invalidation they experience in the medical world
• New Models: Cell Danger Response, Horowitz MSIDS, Bredesen ReCODE, Biotoxin Pathway
• Each patient is unique; a rigid algorithm will not work
• Mold is more than mold: Fungi, Actinomycetes, Mycobacteria, VOCs, beta glucans, hemolysins, mannans, proteinases; an inhaled toxic soup
• Mold can lead to allergy, infection, or toxic effects; the toxic effects is what leads to biotoxin and inflammatory illness
• Toxic molds: Stachybotrys, Penicillium, Aspergillus, Chaetomium, Fusarium, Wallemia, Alternaria
• Sheet rock is made of compressed bark which contains mold species; getting wet is like adding water to instant mashed potatoes; mold species grow without natural opposition
• Inflammation from mold is an upregulated innate immunity; acquired immunity leads to allergy which can be additive to mold toxicity
• If you are growing mold in the body and are also allergic to it, this is not a good situation
• Effects of mold: Interactions with Lyme and viruses, MCS (limbic in origin), EMF sensitivity, food allergies, autoimmunity; mold makes everything worse
• With EMF sensitivity, think mold!
• Majority of patients will have fatigue and cognitive issues
• Symptoms that are more specific to mold toxicity:
• Joe Brewer found 92% with CFS/ME had mycotoxins and improved with treatment
• Mold toxicity: fatigue, weakness, muscle aches, cramps, pain, headache, sensitivity to light, tearing, blurred vision, chronic sinus congestion, cough, chest pain, shortness of breath, abdominal pain, joint pain, morning stiffness, cognitive impairment of all kinds, sensitive to touch, mood swings, appetite swings, sweats (often at night), difficultly with temperature regulation, numbness/tingling, vertigo, dizziness, metallic taste, static shocks, nausea, vomiting, and more
• Mold toxicity may look like: Fibromyalgia, Chronic Fatigue, “Atypical” MS/RA/Alzheimer’s/Parkinson’s, asthma/chronic sinusitis, anxiety, depression, depersonalization, cognitive impairment, mood swings, OCD
• Keynote symptoms: electrical shocks, ice-pick pains, paresthesias that are non-dermatomal (noise, forehead, chest, abdomen, mid back), internal vibration/tremor, increased sensitivity to everything
• With paresthesias, think mold and Bartonella
• Genetically susceptible individuals cannot make antibodies to clear mold toxin which leads to recycling of mycotoxins in bile via enterohepatic recirculation; the toxins remain in the body
• 3 main components of treatment: address exposures (home, work, school, car), use correct binders, and address colonization in the sinus and gut
• Mold toxins are ionophores; water-loving and fat loving; diffuse easily across membranes without needing to enter bloodstream
• Other toxins to consider: Chlamydia pneumonia, Mycoplasma, viruses, Lyme and coinfections, Pfiesteria, Ciguatera, Brown-recluse spiders, Cylindrospermopsis
• Mold toxicity produces a series of cascading events that explain the vast majority of things that happen to his patients
• Evaluation: MSH, VIP, TGFb1, C4a, VEGF, MMP9, ADH/osmo, cortisol, VCS, MARCoNS; also hormones, HLA-DR; he no longer uses these
• Has not found these tests to correlate as well in his patients as Dr. Shoemaker has
• Has not found HLA-DR to correlate to the potential for recovery from mold illness; majority of physicians no longer do this testing or find it valuable
• FACT/VCS testing can be helpful for screening and monitoring progress
• Testing your home: mold plates (floor of room for 2 hours), ERMI testing (vacuum), IEP
• Remediation may be expensive and may not work
• Patient cannot get well if they remain in a moldy environment
• HERTSMI-2 scoring system is available on SurvivingMold.com; scores under 11 are considered safe
• Urine mycotoxin testing has been the most accurate tool in his experience for exploring mold toxicity; becoming the more standard opinion
• Biotoxin markers can be helpful but do not tell you why; they are not specific
• Positive urine tests confirms the diagnosis; tells which toxins are present which helps to identify the best binders
• Can have mold toxicity and Lyme disease; or other concurrent issues
• ELISA testing via RealTime; LC/MS via Great Plains and Vibrant; very different
• MS is more theoretically more accurate but is very specific; ELISA testing measures the toxin and the metabolites
• Each of the labs measure slightly different mycotoxins; they do not measure the same thing the same way; both are excellent; measures both when cost allows
• Great Plains best for Ochratoxin/Mycophenolic/Citrinin; RealTime better for the other mycotoxins; pays attention to the higher value; if you only get one of them, RealTime is likely the better option
• CSM is not a good binder for many of the mycotoxins; best for Ochratoxin
• Urine collection: challenge with glutathione for RealTime but not for Great Plains; can also use sweating, bath, hot tub for additional provocation
• Mold toxin interferes with the body’s ability to detoxify; can have a boatload of toxin in the body but not have the ability to excrete it
• Stop binders 3 days prior to collecting urine specimen
• If you get worse when provoking, stop and collect; don’t push through
• Initial results may not reflect toxin load; tip of the iceberg; often see levels going way up; 80% or more will have higher levels on second test
• Interpretation of Mycotoxin Testing when repeat testing shows higher results:
  • Re-exposure to mold
  • Improved detoxification
  • Excessive binding of toxin
  • Excessive killing of mold leading to more toxin release
  • Stimulating mold to make more mycotoxins
• Taking too many binders can lead to higher levels of urine mycotoxins on repeat testing
• Improved detoxification generally aligns with improved symptom picture
• Some are so toxic that they cannot mobilize mycotoxins; may need to test nasal washings
• Great Plains did a study of 82 controls and 103 mold patients; 51% of controls do have Ochratoxin but only average 1.6 ng/g while mold patients average > 18 (present in 85%)
• If the GPL result is < 7.5, it is not meaningful
• Negative test may mean:
  • Patient not mold toxic
  • Patient ability to detox is not compromised
  • Test does not measure their mycotoxin
  • The test is not accurate
• Precision Binders
  • Ochratoxin: CSM, Welchol, Activated Charcoal
  • Gliotoxin: Bentonite Clay, NAC, Sacc B
  • Trichothecenes/Aflatoxin: Bentonite Clay, Activated Charcoal, Chlorella
  • Zearalenone/Enniatin B – Bentonite Clay, Sacc B
  • Chaetoglobosin – not yet known, but seems to be addressed by other binders
• As binders move through the system, toxins can be dropped off and reabsorbed; too much binder can mobilize toxin faster than the patient can tolerate; need to get the dose right; high doses will commonly backfire
• Assessing the patient sensitivity and constitution can be helpful in determining binder dosing
• Binders should be taken away from food and other supplements by at least two hours; best at 3pm or evenings
• CSM best mixed with water or juice 30 minutes before a meal that contains some fat
• Constipation with binders is common and can be managed with magnesium and Vitamin C
• Diet: high protein/low carb; Keto preferred
• Yeast in diet such as cheese, vinegar, mushroom does not seem to matter
• Research suggests there is not a significant amount of mold or mold toxin in food; there is some; most experts feel it is trivial to the point that it does not matter
• Great Plains did a study with 8 people; avoided all moldy foods for 10 days and then consumed liberally; 7 patient’s levels went down when consuming moldy foods; one had slight Ochratoxin level increase
• If the patient improves notably with binders, binders alone may work; may not be colonized
• Most of his patients have colonized
• May need to add antifungals for sinus and gut areas; often starts with Argentyn 23 nasal spray and sinus antifungal / biofilm agent
• Brewer has found that consistent treatment leads to best results
• The antifungal needs to be tailored to the sensitivity of the patient
• Stronger patients may start nasal support with Amphotericin B; more sensitive may start on Nystatin; middle may be Itraconazole or Ketoconazole
• May used EDTA to address biofilms; no longer uses BEG spray; not uses BE spray
• Sinus and gut both need antifungal, biofilm interventions; and colloidal silver
• Vast majority of his patients have Candida; which makes gliotoxin; or can see elevated arabinose on organic acids testing
• For gut support, may use Nystatin or Itraconazole; with Argentyn 23; may use Amphotericin B; adds Beyond Balance MC-BFM-1 or Interfase Plus for biofilm support
• Probiotics can help for mold toxicity; Lactobacillus rhamnosus, casei, plantarum and Brevibacillus laterosporus
• Has not seen antifungals leading to resistance
• Glutathione is likely overused for mold toxicity; may be used intranasally, orally, or by IV but may worsen sensitive patients; use caution with glutathione
• Other options: Beyond Balance PRO-MYCO, MYCORGEN, TOX-EASE BIND; Byron White A-FNG, Biotoxin Binder, Biocidin Nasal Spray, IV PC, ozone sinus insufflation
• LDI can be helpful; as can transfer factors like Transfer Factor ENVIRO
• Pre-treatment: liver and GI detox, lymphatic drainage, kidney and skin detox, IV PC, DNRS
• For sensitive patients, consider limbic and vagal nerve work; important in patients where everything you do makes them worse
• MCAS is triggered in the majority of patients with mold toxicity
• Mold toxicity impacts hormones such as thyroid, ADH, adrenal, and sex hormones; treatment can be helpful but hitting a moving target when mold is still an issue
• Detoxification: individual genetics, gallbladder/liver, gut/kidney/lymphatics
• Pizzorno book “The Toxin Solution” has 2 week diets with specific focus for detox support
• Detox basics: avoid toxins, normalize bowel function, sweat; all about toxic load
• Treatment not only lowers mold toxin but other toxins that cannot be measured but impact health
• Bile Making Support: Acetyl-L-Carnitine, Calcium Pyruvate, Pantethine, oral PC, Ox Bile
• Bile Moving Support: Bitters, Globe Artichoke, Milk Thistle, Coffee enemas, ozone enemas
• Gut Detox: CDSA/GI Map, probiotics, kill pathogens, eliminate allergens, fiber, glutamine (?; can backfire and turn into glutamate)
• Liver Detox: supporting phase 1 and phase 2; Beyond Balance TOX-EASE GL, Milk Thistle, ALA, NAC, artichoke extract, I3C, apo-HEPAT
• Detox Adjuncts: FSM, lymph massage, oil pulling, rectal ozone
• Each mycotoxin is detoxified via specific detox pathways in the body; some foods and nutrients can enhance these pathways
• Glucuronidation is a primary pathway for many mycotoxins; quercetin, curcumin, resveratrol, CBD, ellagic acid, astaxanthin can support this
• In a complex patient, where do you start? Start with the pathology that explains most of the symptoms; mold or Lyme or both; start with mold
• May need to address limbic, vagal, MCAS, and improve detox before getting to treatment
• Must determine where the patient is in the CDR healing cycle
• Support for methylation and mitochondrial dysfunction will likely not work until the threat leading to CDR has been addressed; start with the primary cause
• Common mistakes: antifungals before binders, too high a dose of binders, starting before the patient has addressed MCAS, limbic system, and vagal nerve dysfunction

Jill Crista, ND spoke on “Mold Toxicity: An Overview, Making the Diagnosis, Detailed Approaches to Treatment” and shared:

• It is rarely just mold
• Mold is more than spore illness; fragments or “mold-othelioma”, mycotoxins, chemicals like VOCs, and biofilms
• Where there is living mold, there will be Mycophenolic Acid
• Mycotoxins are small enough to get into the alveoli; direct access to bloodstream
• Spores induce a reaction; mycotoxins suppress the reaction
• MCAS is an indication that you are moving towards invasion
• Actively living mold interacting with mucosa impacts mast cell homeostasis
• Fragments are 500:1 fragment to spore; can occur when dead/dried mold is disrupted; “mold-othelioma”; highly inflammatory; more than spores
• Mycotoxins secreted by spores and fragments; lipophilic (brain, nervous system, cell membranes, mitochondria); skin will be first to express and last to clear; can cross blood-brain barrier; many cross placenta; found in breast milk; play a role in autism and neuropsychiatric conditions; inhaled go to hippocampus and frontal lobe via olfactory nerve
• Mycotoxins deplete glutathione and cause mitochondrial damage; can play a role in interstitial cystitis; interfere with protein synthesis
• Lyme needs you alive to survive; same with viruses; want to mutate to be more gentle; mold would just assume compost you
• Mycotoxins impact the immune system; leads to lessened resilience; mycotoxins reduce the immune components that would protect us from them
• Gliotoxin has immunosuppressive effects across the board
• Mycophenolic Acid is not a mycotoxin but “offgassing” from living microbes; focus on glucuronidation; more frequent doses of EGCG from green tea or grape seed extract
• Endotoxins are LPS from buildings, humidifiers, CPAPs; endotoxins are bad news; body hears “we have bacterial overgrowth”
• When the body receives mycotoxins, the message is “I am out to kill you”
• Can see hypermotility from endotoxins
• Mold illness = spore symptoms + spore fragment symptoms + microbial outgassing symptoms + mycotoxin symptoms
• Consider: VOC, dander, allergens, rodent feces, gas leaks, formaldehyde, fiberglass, fragrance, PCB, insecticides, pesticides, EMFs, radon, heavy metals, endotoxins
• Can people be sick 25 years after mold exposure? Yes!
• Colonization of the sinuses and GI tract play a major role; sinus colonization is the seed
• We all have fungus in our sinuses; the problem is the mycotoxins from the nasal colonization; what shifted the message was an exposure to water-damaged buildings
• Mycotoxins are the smoke from a fungal fire
• Metal toxicity can play a role in patient symptoms; anxiety or GI symptoms that do not resolve with mold treatment
• Consider: glyphosate, PFAS, carbon monoxide, radon, trauma
• Infections: wandering may be Borrelia, hypermobility may be Bartonella, fatigue may be EBV, gastroparesis may be SIBO, pelvic pain may be Pseudomonas/Klebsiella, low grade flu/fatigue may be Mycoplasma
• Has a questionnaire to get insights into potential for mold illness; currently being validated
• Direct tests: urine mycotoxin (LC/MS), stool, NeuroQuant
• Indirect: urine mycotoxin (ELISA), serum mycotoxin antibody, WBC/CBC/T/B cell, VCS (VCSTest.com), NK Cell function (not just total), D (25 and 1,25; 1,25 can be an indication of low GSH as it rises), Liver/GGT, IgE/IgG mold, organic acids
• For urine mycotoxin, prefers to remove potential foods that may impact the test; sauna evening before/not morning of, no fasting
• Some have found that mycotoxins increase by 10-fold with sauna provocation
• Vibrant tested first morning, 6-hour, and 24-hour collection; did not change positive or negative results
• In her children, using glutathione with Great Plains led to a false negative result; not recommended
• Peels the orange: Avoidance, Fundamentals, Protect, Repair, Fight
• Avoidance of exposure is half the battle
• Mold patients are the most resistant to accepting the cause of their illness
• Fundamentals: circadian rhythm, sleep, hydration, digestion, movement, community, spiritual/energetic practice, healthy diet (low mold/mycotoxin diet has help her patients)
• Diet: remove items that will lead to Candida, items with mold, items with mycotoxin contamination
• Not anti-medicinal mushroom but brings them in later
• Protective foods: colorful vegetables (beets, artichoke, asparagus, radish, broccoli, Brussel sprouts, tomato, cabbage, celery, cucumber, bitter greens; every color band is important for mycotoxins), limited colorful fruits, organic beef liver, essential fats (avocado, olives, olive oil, seeds and nuts, eggs, fish), yogurt, butter, spies (curry, parsley)
• Eat: garlic, onions, scallions, chives, leeks, clove, cumin, rosemary, sage, thyme, oregano, basil, bay leaf, nutmeg
• Solution to pollution is dilution; of the toxin is fat, dilute with healthy fats
• Protect and Repair: dilute toxins, restore fat soluble nutrients, bioflavonoids, support systems of detox for mycotoxins, restore immune depletion
• Vitamin D for immune restoration; > 60 ng/ml; supports innate and adaptive immunity; upregulates MMP-9 (not good; could be a clue for need for MCAS support)
• Fatty antioxidants; melatonin is great for mold; protects liver and kidneys; great for brain fog
• Bioflavonoids; quercetin up to 300-600mg 2-3 times daily; liposomal is best; nettle is a quercetin ionophore; quercetin is a zinc ionophore
• Polyphenols; green tea; antifungal/bacteria/viral/toxin; 4-6 cups a day
• DHA, quercetin, and milk thistle daily is what she recommends for IEPs to minimize damage from mold exposures
• Explore mold in any cancer diagnosis
• Fight: once mold gets exposed to antifungals, it gets mean; needs to be long-term; not on/off
• Need to consider systemic and intranasal antifungals and biofilm support
• Holy Basil is one of the antifungals; reduces MMP9, can do as a tea; antifungal/biotic/oxidant/parasitic; 4 cups of tea per day or supplement; needs to be taken soon after steeped
• Garlic is antifungal/bacterial; protects liver and kidneys
• Thyme is antifungal/bacterial
• Neem is antifungal/viral/bacteria/parasitic; can help with Babesia; liver and kidney protective
• Spore-based probiotics can be helpful
• Intranasal; atomizers better than neti pot which is better than nasal spray; 6 months; twice daily; both nostrils; can cause nose bleeds; Xylitol can help with biofilms
• Intranasal options: essential oils, lauric acid, propolis, colloidal silver, ozone, xylitol, NAC
• Essential oils: Cedar, Rosemary, Ajwain, Holy Basil, Cumin seed, Tea Tree, Thyme
• Just because something is safe for the sinuses does not mean it is safe for the lungs
• Fungus is the fire; mycotoxins are the smoke
• Treat until negative for mycotoxins with no support
• Mold has an unsafe/involuting energetic; thank and release it

 These items were shared during the Q&A:

• Sadly, I had a power outage and missed the first few minutes of this Q&A. :(
• “No binders if you’re bound up”; need to open emunctories first
• Patients tend to be blocked at the bile induction; bitters, betaine HCL; start there for managing constipation; laxatives are missing the boat; consider the impact of the vagus nerve on intestinal motility
• Crista starts with food; insoluble fiber as a binder; Takesumi Supreme has been a helpful tool for some patients; Dr. Nathan also using more Takesumi Supreme than he used to; Dr. Jill has seen it help those with EMF sensitivity
• I3C is more specific for the mycotoxin pathway than DIM
• SIBO friendly fibers sesame, sunflower, and pumpkin seeds
• Crista says we have a severely deficient population; she does not worry about supplemental melatonin shutting down our ability to produce it; often slowly weans off if they have been on it long-term; LDN can help some get off melatonin
• Body makes melatonin out of serotonin by methylating it; eventually improving methylation will help with production of melatonin
• Spore-based probiotics are well-tolerated even in SIBO patients

Neil Nathan, MD spoke on “Elephant in the Room: Mast Cell Activation” and shared:

• Mast cells are a bridge between the immune and nervous system
• Mediators: histamine, serotonin, serine proteases (tryptase), proteoglycans (heparin)
• Over 200 mediators can be released from mast cells; including TGFb1
• Mast cells coordinate response to infectious agents and toxins
• In genetically susceptible individuals, mast cells may become over-excited or over-stimulated (up to 10% of the population)
• In mold patients, this may be an issue 70-80% of the time
• It is often thought of as an allergic construct, but is a defense mechanism against parasites and bacteria
• Symptoms can impact every body system
• Testing: total serum tryptase, plasma heparin or histamine, chromogranin A, urinary N-methyl histamine, urinary PG D2, Leukotriene E4, biopsy with CD 117 staining
• It is difficult to do these tests properly and get accurate results; the materials are transitory
• Treatment: reduce the production of mediators from mast cells with mast cell stabilizers, interfere with the mediators (antihistamines), counter unavoidable effects; find the trigger and cure it
• Vast majority are triggered by mold or Lyme/Bartonella
• Quercetin, Loratadine at bedtime (H1), Famotidine at bedtime (H2) can be helpful tools
• Mast cell stabilizers have to go into the body 30 minutes before you eat or the food will trigger MCAS
• Try a low histamine diet for 2 weeks; ~50% respond well
• Be careful with exercise which can trigger mast cells
• 20% of patients cannot tolerate quercetin
• NeuroProtek LP can be a helpful tool for those that cannot tolerate higher doses of quercetin
• DAO enzymes can be used 30 minutes before meals
• AllQlear (tryptase inhibitor) and Perimine are helpful tools
• PEA can be a helpful mast cell stabilizer; Vitalitus or Mirica
• The more of these materials the patient can taken, the quieter the mast cells will become; one is rarely sufficient
• Fexofenadine as H1 or Ranitidine as H2 (no longer available; now uses Famotidine) may be helpful; Ketotifen or Cromolyn
• Some probiotics produce histamine; be clear what probiotics might be making the problem worse
• Many probiotics degrade histamine
• The parasympathetic nervous system regulates mast cells; DNRS, Tai Chi, breathing, vagal exercises
• Treat the limbic system and polyvagal nervous system early on; the patient cannot heal if they do not feel safe
• COVID affects mast cell activation; anxiety, panic, and isolation of COVID has led to MCAS flares
• Forest fires as common in California contain materials that triggers mast cells; also has a PTSD effect of smoke; has made all mold and MCAS patients worse
• If patient is unusually reactive to food, supplements, medications, consider the possibility of MCAS and empiric treatment to allow the patient to make progress.
• Continue MCAS treatment until you cure the cause

Neil Nathan, MD spoke on “Mold Toxicity: The Relevance of Lyme Disease and Co-Infections” and shared:

• Symptoms of Lyme disease overlap mold illness
• Both stimulate the body to make cytokines
• Many colleagues treating Lyme do not recognize that mold may be the explanation for failure to respond to treatment
• Horowitz has found mold to be an issue in 70% of his patients not responding to Lyme treatment
• Bartonella, Babesia, Ehrlichia, Mycoplasma and others can be co-infections after a tick bite; “Nature’s Dirty Needle”
• IDSA does not recognize a post-infectious Lyme illness
• ILADS believes chronic Lyme disease is an epidemic
• Any tick (nymph vs. adult) can transmit Lyme
• 300,000 new cases discovered in the US each year; now 400,000
• EM rash in only 30%
• Only 17% with Lyme recall a tick bite
• The ELISA screening test is useless
• Best test for Lyme is the IGeneX ImmunoBlot
• Both Lyme and mold are “great masqueraders”
• Often finds mold and Lyme are contributing to chronic illness
• Bands 23-25, 31, 34 highly specific; 18, 22, 37, 39, 83, 93 are specific; non-specific include 41, 45, 66, 73
• Patients may be sick with chronic Lyme due to: higher spirochete loads, alternate forms, immune suppression and evasion, protective niches, co-infections
• Spirochete can be treated with penicillin or cephalosporin; can change to L-Form which responds to Doxy or Azithromycin; cyst form treated with Flagyl, Tindamax, or Rifampin; need triple antibiotic treatment
• Lyme can go intracellular, ligaments, tendons, CNS, eyes
• Detoxification is key in Lyme treatment as well
• Need to treat the weakened body systems; immune, hormonal, and nervous systems
• Put tick in plastic bag and have tested with IGeneX or another lab
• Borrelia, Bartonella, Babesia, Ehrlichia, Mycoplasma, Chlamydia, Viruses, and Candida all may play a role
• Bartonella may present with hallmark symptoms: burning pain on the soles of the feet; depersonalization/derealization, edema; striae
• Babesia may present with sweats, chills, fever, disconnection of the nervous system (know what you want to do but requires an unusual amount of brain work to have the focus to do it), frontal pressure headache, emotional lability/hallucinations/not myself, and more
• HPA axis can be disturbed
• Neurally-mediated hypotension or POTS
• Borrelia and Bartonella are slow growing; pulsed therapy may be helpful; need therapeutic drug levels; intracellular; Lyme growth cycle ~3 weeks; Bartonella ~2 weeks
• Have not seen herbal protocols alone work for vast majority of people with Lyme disease
• Buhner, Colloidal Silver, Salt/C, Cowden; all helpful though antibiotics are the mainstay
• Cowden, Buhner, Zhang, Byron White, Beyond Balance; these may help to push the organisms out of the cell so that the antibiotics and immune system can address them
• Borrelia may be an unappreciated cause of Alzheimer’s based on Alan Macdonald’s work

These items were shared during the Q&A:

• SIBO can be caused by mold; if you don’t treat the mold, you won’t have success in treating SIBO
• Functional medicine starts with the gut, but mold is an exception and has to be treated before working on the gut
• Mold can trigger motility issues and need to get the mycotoxins out to address the motility
• If someone cannot tolerate a supplement like quercetin, consider foods that are high in quercetin
• Nosebleeds and mucosal drying can occur with high dose quercetin
• Many Lyme antibiotics can be triggers for porphyria
• A lot of antibiotics are mycotoxins because they are so good at killing other living things
• Consider adding prokinetics in those with SIBO when using antibiotics for Lyme treatment
• Mozayeni is a leading expert on Bartonella; allicin and liposomal oregano came from Zhang’s persister cell research; both Lyme and Bartonella developer persister cells
• Crista likes Herbal Vitality for herbal tinctures
• Professional Formulas has a Lyme nosode which Dr. Crista uses to gauge whether or not the person is ready to start addressing the Lyme or needs more work first; if the remedy is provoking, then needs to do more mold work before the patient is ready for Lyme treatment
• Nathan likes the DesBio Series kits; if they respond strongly to light dilutions, they are not ready
• With vertigo, ensure there are no calcifications in the inner canals
• Vertigo can be related to Babesia; vibration with Bartonella
• FSM can be helpful for both internal vibrations and vertigo
• FSM can often do things that nothing else can do
• EMFs are a big deal; limbic retraining can be helpful; EMF remediation is needed and undervalued
• EMF sensitivity could be called “nature deficit disorder”; some have techniques for charging the body to make us less reactive to EMFs as well as other infections and toxicants; EvolutionaryHealing.world
• Rifampin for Bartonella treatment can lead to elevated LFTs
• Pulsing antifungals is not recommended; consistent use is what moves the needle
• POTS is an autonomic dysfunction; mast cell activation can trigger the ANS through increasing of inflammation; POTS treatment is vagal support as a primary tool; POTS and MCAS are separate conditions but both important
• Water without electrolytes that most people drink may contribute to dehydration; celery juice may be in part helpful due to being alkaline
• Fungal burden is often a trigger for sulfation issues; trace minerals, molybdenum, and addressing fungal issues can be helpful
• The bulk of the toxins are eliminated in the feces; particularly with binders; what is found in urine may be spillover
• Nathan finds that to optimize outcomes, he needs to have a conversation with the patient at least every 6 weeks
• Chlorella, charcoal, and clay are negatively charged and can be taken together. Welchol and CSM are positively charged and should not be taken together with negatively charged binders
• Nasal fungal cultures are notoriously inaccurate; in known fungal illness, positive cultures in < 10%; cannot assume that a negative is a true negative
• Crista treats the sinuses if there are mycotoxins still present in the urine; until they are gone
• If you have SIBO and mold, you have to address the mold to move the needle with the SIBO
• Mold and mycotoxins do predispose people to cancer development

Neil Nathan, MD spoke on “Limbic and Vagal Dysregulation” and shared:

• Patients can become stuck along the way, and these tools can be helpful to get around being stuck
• After a while, most mold and Lyme patients become limbically and vagally dysfunctional; becomes a stumbling block if not addressed early on
• For so many patients, this is the place they get stuck
• The expression of a face in an extremely important piece of information
• Stephen Porges proposed polyvagal theory in 1994; many vagus
• The vagus nerve has two branches; dorsal and ventral; may be “bi-vagal”
• Commonly think of the balance between the sympathetic and parasympathetic nervous system; for ill patients, sympathetic dominates
• Dorsal and ventral branches have evolved over millennia with sympathetic system
• Dorsal is the older; response to stress of a life threat by immobilization; “freeze”; unmyelinated; massive shutdown of the ANS
• Second defense is fight or flight using sympathetic nervous system
• Ventral pathway is myelinated and interacts in the brain stem with the structures regulating the striated muscles of the face and head
• Ventral vagus primarily to organs above diaphragm; dorsal primary below
• The vagus nerve is 80% sensory; information conveyed from the gut and heart to the medulla and forebrain via the insula which interacts with HPA axis, social neuropeptides, and immune system
• Ventral vagus is related to expression and experience of emotion
• Face-heart connection enables mammals to detect safety vs. danger
• When CDR is activated, the coordination between the two limbs of the vagus are disrupted; this can lead to POTS, PANS, and PANDAS which all have autoimmune components resulting from lack of normal anti-inflammatory signaling by the vagus
• The original trigger does not have to still be present to trigger a danger response
• Other cranial nerves like trigeminal nerve and facial nerve are also impacted; glossopharyngeal, spinal accessory
• Vagus nerve regulates intestinal motility
• Ventral – upper 1/3 of esophagus, pharyngeal muscles, heart, bronchi, and parasympathetics
• Dorsal – lower 2/3 of esophagus, stomach, liver, gallbladder, and intestinal motility
• Porges has created the Safe and Sound Program to treat the vagus nerve
• Virtually chronically ill patients feel betrayed by body, family, physicians and do not feel safe
• CDR tells us an organism that isn’t safe cannot heal
• Vagus nerve and limbic system work together to monitor the internal and external environment for safety
• Patients feel unsafe in their own body
• Vagus nerve and limbic system shutdown
• Often tied to inability to tolerate even the mildest of supplements or interventions
• Smoke from California files can trigger a PTSD and feeling of being unsafe
• Families become less supportive as medical professionals doubt the chronically ill patient’s experience and invalidate them
• Polyvagal Theory is a primitive response; neuroception; often consciously unaware of the stimuli
• We become hypervigilant and hyperreactive; much like activated mast cells
• Stanley Rosenberg’s “Accessing the Healing Power of the Vagus Nerve”; uses these exercises with most of his patients
• Can “say aah aah aah aah” and look for motion of the uvula; normal response is movement up and down; in many patients, it may barely move or move to the side
• Ask the patient to gag and see if they can and how easily; finger in throat; many patients feel like they will throw up; in many patients, nothing happens; there is no gag reflex
• Treatment: Cues of Safety, Safe and Sound, Rosenberg Exercises, Craniosacral Treatment, FSM, BrainTap, EFT, Peter Levine’s “Voooooo” singing or chanting, Datis Kharrazian gagging/gargling/ singing, breathing, meditation, yoga, Tai chi, DNRS
• Cues of safety start with the practitioner: voice, setting, approach, manner, facial expression, comfort level, reception area and staff
• Rosenberg: Basic, Half-Salamander, Full Salamander, Twist and Turn, Myofascial Release of the Back of the Head and Facial Areas
• Biodynamic Osteopathy can be very helpful; listening to the patient’s energy systems
• FSM has vagus, PTSD, concussion protocols; brilliant process
• BrainTap; another favorite technique; aligns with concepts of Norman Doidge; uses light and sound simultaneously; best to have the company select the programs for the patient
• EFT or TFT; tapping various points
• Limbic system includes amygdala, hippocampus, thalamus, cingulate cortex, and hypothalamus
• Limbic system controls emotion, sensitivity, cognition, energy, pain; sensitivity to light, sound, chemicals, EMF; any sensitivity is an indicator of limbic system dysfunction
• Limbic system regulates the sympathetic and parasympathetic nervous system
• First responder to real or perceived threats; protective gate
• Impairment will lead to inflammation and disorganization of circuits in the brain; mold and Bartonella are major players
• Pattern of distorted reaction becomes habitual and stuck
• Amygdala is about fear and danger
• Regulates autonomic functions like blood pressure and heart rate and temperature
• Neurons that coactivate at any given time will do so automatically with repetition
• Patients become sensitized and react to lesser and lesser stimuli; kindling; touch, sounds, light, food, and EMF
• Once in survival mode, the limbic system focuses on survival only; energy taken away from other processes; lowered detoxification
• DNRS and Gupta Program can reboot the limbic system
• If you don’t treat the limbic system and vagus nerve, many patients will remain stuck
• Need both; may not fully reboot with focus on limbic or vagal alone; need some of both

Neil Nathan, MD spoke on “Other Diagnostic Issues: Heavy Metal Toxicity, Porphyria, Cervical Trauma Fibromyalgia, Jaw Dysfunction “and shared:

• Need critical thinking skills; does the diagnosis fully or mostly explain the patient’s symptoms
• Porphyria discussion is about secondary porphyria; treatment is very different from everything else; much more common than what is recognized; this is not the rare genetic porphyria
• Involves metabolism of heme and a build-up or porphyrins inside and outside the cells
• Can have a profound effect on detoxification and energy metabolism
• Some of the antibiotics for Bartonella or Lyme can trigger secondary porphyria
• Anxiety, panic, OCD, irritability, restlessness, paranoia, nausea, vomiting, abdominal pain, paresthesia, tremor, burning, abnormal sensations, tics, tachycardia, hypertension, fatigue, weakness, dysuria, pelvic pain, SOB, edema, dizziness, visual symptoms, confusion, reactivity to the sun, sun rashes, insomnia, puritis, Fibromyalgia, chest pain, sweating, peripheral neuropathy, hallucination, seizure
• Presents like a Herxheimer on steroids; Herx is 1-2 days; this can be weeks
• Close association between Chlamydia pneumoniae treatment and secondary porphyrias; cpnhelp.org
• Transient in the body and difficult to catch in urine
• Collect urine when feeling the worst; cover in foil; refrigerate
• LabCorp does a good job with testing
• Surprising number of patients have a secondary porphyria
• Treatment: high carb diet, high oral fluid, avoid red meat/milk products/alcohol, glucose (dextrose) tablets but avoid fructose and sucrose; IV dextrose is best, high dose HB12, folic acid, charcoal, GABA, hydroxychloroquine
• IV Dextrose will often calm down an attack with one treatment
• Buteyko breathing to increase CO2 can be helpful
• It is difficult to treat mold, MCAS, and porphyria as the treatments are so different; when flaring, the porphyria treatment is the priority
• Heavy metal toxicity becomes a bigger issue when one is in a CDR; the metals accumulate
• Large percentage of patients have heavy metal toxicity
• Once the CDR has been treated successfully, the heavy metal detox will occur naturally
• Major issues are mercury and lead
• Heavy metals are not circulating in the blood and urine; they are in tissue
• Blood, urine, and hair are all poor testing options
• Mercury is bound to brain and nerve tissue
• Need to use a provocation tool before urine collection to get more accurate picture
• Mercury may be treated with DMPS, DMSA, chlorella, C, garlic, QuickSilver IMD Protocol
• Lead toxicity: cognitive issues, impaired language, processing speed, eye-hand coordination, verbal memory, visual memory, Parkinson’s, Alzheimer’s, CVD, hypertension, renal disease, COPD, reproductive disease, ADHD/defiant disorders
• EDTA or DMSA provocation for lead testing
• Cervical Trauma Fibromyalgia; often a whiplash injury that leads to ongoing spinal inflammation
• FSM can remove the persistent inflammation
• Jaw dysfunction can explain stuck limbic/vagal dysfunction; jaw out of alignment leads to constant autonomic dysfunction where the body cannot find balance 

Jill Crista, ND spoke on “Detoxification: Basics and Details” and shared: 

• Detoxification is done throughout here entire process; when you add antifungals, you need to have prepared the body using detoxification tools
• Detox tools that have to be swallowed can be a problem in those with GI issues but also where most of the toxins are found
• Mycotoxins are lipophilic and fat soluble; similar to BPA and plastic
• Mold gets mean when you start to fight with it
• Detox before/during/after antifungals
• Killing increases the release of mycotoxins
• Mycotoxins are inspired, absorbed, carried via the blood, liver/kidney, lipid-rich tissue; can go anywhere and bioaccumulate
• Ingested mycotoxins may remain in the lumen or may enter via enteric absorption; eaten mycotoxins are not just a gut issue; impacts kidneys, brain, immune system, mitochondria
• Detox: emunctories, cofactors/coenzymes (core nutrient deficiencies; B, C, E, trace minerals), nourish detox, add fat, add bitter, catch bile, ECM, cellular/mitochondrial, energetic the whole time; never just mold
• Going into cellular detox before opening emunctories is the best recipe for a bad outcome
• ECM addressed with lymphagogues
• Bile: emulsifies fat, eliminates toxins, non-liver (supports SIgA, surfactant, retina); 1 liter per day; 95% water; 10:1 PC:cholesterol; ~93% recycled, bile salts are bile acids conjugated with glycine and taurine, induces lipase which is shown to degrade mycotoxins
• Bile is sequestered by binders to reduce recirculation
• Liver and bile duct make new clean bile if you have the raw materials
• Long-term binders can deplete nutrients
• PC, cholesterol, fat soluble nutrients, glycine, taurine can all be deficient
• Binders adsorb – weak binder
• Avoid constipation; no binders if you are bound up
• Pre-binders: bitters, cholaretics, cholagogues, lipase
• Cholagogues: stimulate bile secretion and flow, increase SIgA, probiotic mucosal adherence, increase pancreatic lipase secretion, protect intestinal barrier, increase peristalsis
• RX cholagogue options: Actigall, Ursodiol, TUDCA, Deoxycholic Acid (Kybella; in aesthetic medicine)
• First binders: insoluble fiber, 2-5 grams/day rice bran fiber; flax, chia, rice bran, oat bran, psyllium (least to most constipating)
• Charcoal, clay, chlorella; she does not like Sacc B if they can’t stay off sugar/carbs; can perpetuate the message of “someone is moving in”
• Botanical binders: kale, collards, mustard greens, aloe, okra; steamed better than raw for binding; Saag for mustard greens
• Nutritionally deficient seem to do best on Cellcore
• Taurine is a tool for improving intracellular hydration, blocks mTOR pathway
• Aloe is an immune modulator, boosts humoral immunity, anti-inflammatory for mucosa, binder for aflatoxin, inner fillet for polysaccharides, whole plant is laxative
• Fasting for 12-18 hours to switch to fat fuel source; intermittent fasting, gives the body a break; eating leads to more LPS that create more inflammation
• 3-5 days of Bieler’s broth
• Milk thistle: blocks penetration of mycotoxins into hepatocytes; DHA does as well; promotes regeneration of the liver
• Turmeric: antioxidant, hepatoprotective, nephroprotective, epigenetic protection; can cause some Herxing
• Globe artichoke: bile flow, detoxification
• Glutathione can be helpful for fat soluble toxins; not always good for sensitive patients
• Some companies are using GMO soy for their liposomes and should not be used; QuickSilver and Empirical Labs are good
• Different forms can have different reactions; oral, suppositories, IV
• Glutathione may deactivate gliotoxin
• FSM can be used for: calming limbic system, dysautonomia, pain, antihistamine, sleep, energy, GI motility, liver/kidney, joint health
• Loves Peloid therapy; mud therapy; nourishing detox; enzymes/probiotics; https://moorthanmud.com; can lead to a massive sweat with resulting improvement of symptoms
• Castor oil packs: lovely detoxifier; packs or rub-on; liver, lymph, glymphatics
• Lymphatic massage can be very helpful
• Sauna: no proof that mycotoxins are excreted via sweat; work on organs of detox before starting sauna
• Mold can be a problem in steam saunas
• People can detox/offgass and the next person can take on the toxins
• Coffee enemas: support the liver; prefers left side where Gerson says right side; can be helpful to start with water only; 3.5 times less caffeine absorbed than from oral administration
• Homeopathics: drainage, isopathy for mold/mycotoxins, nosodes; does not use the mold/mycotoxin isopathy early in treatment as it can be provoking; starts with mycotoxins first then mold later
• Likes to use homeopathic Vasopressin or homeopathic VIP
• IV: PC, ALA, C, Curcuma, GSH, ozone, peroxide
• Sarsaparilla/Smilax known to bind endotoxins, reduce inflammation

These items were shared during the Q&A:

• Some may need to start with less than an hour a day of DNRS and work up over time
• Sacc B can lead to reactions in sensitive patients
• Mag Phos cell salts can help with nocturnal leg cramps; magnesium gel; spicy or hot can open circulation to the muscles; “Hot Shot”
• Best to start by testing for most likely priorities; testing for and treating secondary issues early on may not move the needle; “don’t let your lab think it out for you”
• Dicken Weatherby, ND for functional blood analysis
• You do not need to treat everything; the body will regain balance and then manage many secondary factors on its own
• Great Plains OAT test can point to the potential for fungal overgrowth; markers 2, 3, 9; not perfect
• Nathan has not found retroviruses to play a major role in chronic illness
• Jill feels that parasites are often a factor in her resistant to treatment patient cases; Dr. Nathan has not seen it in his patients as a primarily issue
• CSM and Welchol generally taken 30 minutes before a meal with fat; to make it easy, Dr. Nathan suggests taking CSM or Welchol with food
• Sacc B does not need to be taken before food; can be taken with food
• Quercetin can be more effective when taken in foods; bioflavonoids need to be in liposomes or combined with a plant or food that is high in quercetin like onions; can combine with nettles (which is also a mast cell stabilizer); QuickSilver has a liposomal quercetin; works better for the brain than a capsule
• The stimuli from the internet, TV, computers, cell phones, etc. have a profound effect on the sympathetic nervous system; disconnecting from them can be very helpful to remove the stimuli that are keeping patients from getting well; this is not an EMF discussion but an information discussion; do what quiets you down, not what amps you up
• Meditation is a great tool, but it is not the right tool for limbic system and vagal nerve issues
• Using Betaine with H2 blockers can help to address the potential problems from reducing stomach acid

Neil Nathan, MD spoke on “Hormone Dysregulation: Adrenal, Thyroid, Sex Hormones and ADH” and shared:

• Mold, Lyme, Bartonella trigger CDR; interfere with hormonal communication
• Adrenal deficiency: DHEA, cortisol, mineralocorticoids
• Pregnenolone is a precursor to DHEA
• DHEA: fatigue, tiredness, asthenia, “don’t feel like myself”, cognitive impairment, decrease libido, recurrent infection, depression
• DHEA-S is the storage form and does not always reflect the serum DHEA levels; better to test unconjugated via Quest
• DHEA is contraindicated in breast, prostate, or hormonal cancers; side effects: acne, facial hair, sleep disturbance
• Cortisol deficiency: fatigue, exhaustion, tired, chronic allergies, amenorrhea, recurrent miscarriage, hirsutism, obesity
• Cortrosyn stimulation testing was historically used; now more common to use saliva cortisol testing due to cost; max cortisol at about 8am
• If not making enough cortisol, small doses of Cortef can be very helpful
• Mineralocorticoids: unusually low BP with fatigue, dizziness with postural changes; treated with Florinef or Midodrine; treatments are often time-limited; often 2-3 months
• Thyroid deficiency: fatigue, exhaustion, tired, constipation, temperature dysregulation, hair loss, dry skin, menstrual abnormalities, cognitive impairment
• Over time, patients respond less dramatically to the same interventions; other more important components were at play (Lyme, mold toxicity, other toxins)
• Once stuck in a CDR, patients do not respond to these as well, but they are still worth trying
• Adrenal and thyroid deficiency go together; if you have thyroid deficiency, you may need to also treat adrenals to make progress
• Measure: TSH, free T3, free T4, thyroid autoantibodies, rT3
• Temperature 4 times a day for one week with glass thermometer; low associated with thyroid deficiency; if average < 97.8, many have improvement with T3
• Thyroid makes rT3 to prevent conversion of T4 to T3;
• Synthroid (T3), Armour (T3 + T4), Cytomel (T3), long-acting T3
• Hypoglycemia: fatigue, weakness, brain fog, tachycardia, diaphoresis, shakiness, full-blown anxiety
• 3-5 hour glucose tolerance test; treat with high protein/low carb diet, snacking at intervals, chromium picolinate; MCT and coconut oil in equal amounts throughout the day to provide ketone bodies
• Patients make too much insulin which drops their blood sugar
• Magnesium deficiency: fatigue, exhaustion, tired, muscle cramps/spasm/pain/weakness, depression, cardiac arrythmias, cognitive impairments, insomnia; physical treatments don’t “hold”
• Chronic illness leads to magnesium deficiency; extremely common
• Intracellular magnesium level is best option; scrapings from under the tongue; exatest.com
• May need IV magnesium for severe deficiencies
• Prefers magnesium taurate
• Testosterone: fatigue, tired, decreased stamina, muscle weakness, decreased libido, erectile dysfunction, depression; best results with compounded BHRT cream
• Caution in younger patients as testosterone may shutdown production for years; Clomid may be a better tool
• Estrogen: hot flashes, night sweats, mood swings, depression, insomnia, fatigue, cognitive impairment, heart palpitations, vaginal dryness, decreased libido
• 80% estriol, 10% estrone, 10% estradiol; replace to match balance
• Genova Basic Hormonal Assessment has been a very helpful tool
• ADH from Shoemaker’s work: frequent urination and insatiable thirst
• Low ADH with normal osmolality common; may be that lab measurements are leading to overdiagnosis; rarely sees need for Desmopressin; does not measure ADH as it is so inaccurate
• Food allergies: mold, Lyme, Bartonella trigger food allergy
• Symptoms: fatigue, arthritis, dysuria, cholecystitis, bronchospasm, allergic rhinitis, eczema, cognitive difficulty, myalgia, enuresis, IBS, IBD, sinusitis, psoriasis
• Generally delayed reactions; IgG/IgM; up to 72 hours after ingestion
• Elimination diet: cow milk, wheat, corn, citrus, sugar, coffee/tea/alcohol for 1 week; most will notice a difference if they are allergic
• Finds the ELISA/ACT LRA test from Russell Jaffe to be most helpful

Jill Crista, ND reviewed “Case Presentations” and shared:

• Comprehensive plan: avoidance, diet, bioflavonoids, good fats, bile movement, fiber binding, detox and mitochondrial support, immune support, antifungals
• Starts with insoluble fiber and food and only zeolite/charcoal and other binders as needed
• A healthy person may take 3-6 months to get symptoms from mold exposure
• Empirical Labs liposomal Curcumin and Resveratrol is a favorite
• Manuka honey is antibacterial and can be helpful with biofilms
• Often sees Candida overgrowth as the molds/fungi know they are being hunted
• AST/ALT should be between 10 and 30 (lower = nutrient issues; higher = stressed liver)
• Skin itchiness can be a clue for fungal overgrowth
• Often sees higher mycophenolic acids as you start addressing the first layer of mycotoxins; detoxifying
• Probelle for toenail fungus
• C-PAP machines can be sources of mold and endotoxins
• SoClean ozone system can be helpful for cleaning
• Nat Sulph 200C can be helpful for long-standing TBIs
• Worsening constipation can be a clue for Candida overgrowth
• Likes to use Holy Basil as an antifungal when MMP9 is high as it also helps with MCAS
• Propolis nasal spray can be antifungal and antibacterial
• Low albumin could be a clue for kidney stress
• Air sample testing designed to protect landlords, not patients
• Statins are a mycotoxin
• Can dilute lipophilic toxins with EVOO; up to 1 TBSP 4 times a day
• Many need emulsified versions of vitamins like A and D for better assimilation

These items were shared during the Q&A:

• Patients will work very hard to try to convince their doctor (and themselves) that mold is not their problem
• Re-exposure is a common explanation for why patients are not moving forward with their healing
• Gaia Swedish Bitters, Wise Woman Herbals Bittersweet Elixir, QuickSilver Bitter X or Bitters No 9
• Treat the mold first, then the Lyme or Bartonella later; many patients will not be able to star treating Bartonella until the mold is addressed
• Crista does use antibiotics for some cases if needed; even depleted people may need a high-force intervention
• Nathan has seen a few patients that could not handle mold treatment until Bartonella was addressed; uncommon, but take the patient as they are
• Rupatadine is an H1 blocker and platelet aggregation blockage; in histamine person, artichoke might be used to help liver and detox, but if not tolerating enzymes, Rupatadine can be used to help with histamine
• The binding part of the okra is when it is dried and powered; Frontier Co-Op; does not use a tincture for purposes of binding
• Okra does bind ochratoxin specifically
• Nathan mentioned okra combined with beet
• Cranial osteopathy can be helpful for vagus neve in children; FSM is great; Safe and Sound was designed for children
• Peter Koshland of Koshland Pharmacy has a number of good trainings on hormones and testing
• Crista uses Herbal Vitality for Thyme tincture
• CPAP machines can be tested with an IEP or Hayes Microbial Consulting via a swab
• For sinus application of garlic, Allimax has a nasal product
• Biocidin, NAC may have application for sinus treatment
• Many patients have joint and muscle pain with stains even with CoQ10
• If someone has a flare with Rosenberg’s exercises, they are usually overdoing it or doing it too long
• Chlorella, charcoal, and clay are negatively charged together and used 1-2 times a day 2 hours away from food/supplements/medications; Welchol and CSM should be taken with food along with Sacc B and not mixed with other binders
• A lot is written about deficiencies from binders; Dr. Nathan rarely sees this in practice even in patients that have been on them for long periods; massive amounts of CSM can be a problem
• Urine mycotoxin testing may be repeated every 4 months
• There is no hard fast rule that a person without a gallbladder needs ox bile; it is still being made but just not stored; may need more frequent lower amounts of binders; bitter and other tools are the same
• Significant drops in cholesterol may be related to environmental toxicity such as metals or mold
• Low alk phos, BUN, or creatinine may be signs of a good functioning kidney; not an immediate thing to worry about; low alk phos could be tied to low zinc, but zinc supplements do not seem to consistently bring it up; may need to add melatonin or quercetin as an ionophore; Dr. Crista considers mold when she sees low BUN and creatinine; consider kidney support
• Thiamine or Benfotiamine can help with tachycardia at night; B vitamins can impact sleep and are best taken in the mornings; perception of a normal heartbeat could be a T3 deficiency
• Looking at SNPs can be helpful later in course of illness; not while in CDR/survival mode/toxic/infected
• You cannot tell from SNPs alone whether people need methylation support; functional testing such as Health Diagnostics is a better way to explore
• Occasionally, peptides will work when someone is still in CDR 1, but more often than not, they will not respond until they get out of the CDR 1 stuck phase; has seen some benefit from TA-1, TB-4, and BPC 157, but timing is everything
• Taking binders with food may not be optimal, but patients still seem to improve if this allows for better compliance
• Washing in essential oil and Borax can help to get mycotoxins out of clothes from a thrift store
• SaunaRay has independent EMF testing of their saunas
• Nathan finds PEMF can be helpful for energy; like anything, people can be sensitive; it is an adjunct; not a primary treatment by itself
• May not want to use Sarsaparilla if a patient has an active/untreated SIBO

Disclaimer: While I attempted to accurately represent the statements of the various speakers, it is possible that the above contains errors or inaccuracies. If you have any corrections to the content listed above, please Contact Me.