E207:Dr. Neil Nathan on Mold and MCAS with Dr. Tania Dempsey - Mast Cell Matters

Episode 207 May 28, 2024 00:57:34
E207:Dr. Neil Nathan on Mold and MCAS with Dr. Tania Dempsey - Mast Cell Matters
The POTScast
E207:Dr. Neil Nathan on Mold and MCAS with Dr. Tania Dempsey - Mast Cell Matters

May 28 2024 | 00:57:34

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Hosted By

Cathy Pederson Jill Brook

Show Notes

Dr. Neil Nathan is the leading expert on mold and mycotoxin illness, and in this episode he and Dr. Tania Dempsey discuss how mold can cause chronic illness and how to treat it.  They also discuss Dr. Nathan's new book, The Sensitive Patient's Healing Guide, available here from Amazon.  Dr. Nathan's other books and resources, plus information about working him, can be found at https://neilnathanmd.com/.

More information about Dr. Tania Dempsey can be found at https://drtaniadempsey.com/

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Episode Transcript

Jill Brook: [00:00:00] Hello, Mast Cell Patients and lovely people who care about Mast Cell Patients. I'm Jill Brook and this is our monthly episode of Mast Cell Matters, where we go deep on all things related to Mast Cell Activation Syndrome. or MCAS, with the help of our wonderful guest host, Dr. Tania Dempsey, mast cell expert, physician, and researcher extraordinaire. Dr. Dempsey, thank you for hosting, and who is our exciting guest today? Dr. Tania Dempsey: I'm thrilled to have Dr. Neil Nathan with us today. Dr. Nathan is board certified in family practice and pain management and is a founding diplomat of the American Board of Integrative Holistic Medicine and the founding diplomat of ICEAI. He has written many books actually at this point, has, has a new book that we'll talk about that's out. He has really been working to bring awareness of mold toxicity as a major contributing [00:01:00] factor for patients with chronic illness, and he lectures internationally on the subject. And and again, he has many books. One of, I think, his I think he has two really groundbreaking books, Mold and Mycotoxins, Current Evaluation and Treatment, which was published in 2016, and Toxic, Heal Your Body, and Mold Toxicity, Lyme Disease, from, from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities and Chronic Environmental Illness. He practices in California and has been treating complex chronic illnesses for probably over 25 years. Thank you so much for being here, Dr. Nathan. Dr. Neil Nathan: Thanks for having me. Dr. Tania Dempsey: All right, so let's, let's dig in. I've been so excited to, to talk and I want to, I want to start with just how how you became interested in mold and mycotoxin as, as as a reason why people are. Dr. Neil Nathan: How much time do you have? Dr. Tania Dempsey: Yeah, I know, I know. Dr. Neil Nathan: Let me give, there it is. I'll give you the Cliff Notes version. I was working [00:02:00] basically in pain management, running a hospital based unit, and we were seeing a lot of patients with what was then called fibrocytis, now called fibromyalgia. So I was treating a lot of people with fibromyalgia and chronic fatigue. And it was clear that although my colleagues thought that that was a psychological illness, they weren't responding to psychotherapy or psychometric drugs, so it was something more physical than that. And over the next bunch of years, we learned a whole lot of imbalances and dysfunctions in the body that clearly caused that and it was treatable. It wasn't a mystery. But as we began to work with it, we began to see patients who were sicker with those illnesses and not as responsible to, as responsive to the things we were trying to do. And so we learned that Lyme disease and mold toxicity were major players. And if we wanted to help our patients, we had to look for those things as well. And over [00:03:00] time, we began to realize that mold toxicity was a major trigger for mast cell activation. And, in fact, it was Dr. Afrin's book that opened my eyes to it. I think it was published in 2016. I read the book and went, whoa, this is phenomenal. This is a missing piece for all of us, for our patients with mold toxicity who are having trouble taking the things we wanted to give them. Those patients just couldn't do it. And so once I understood MCAS, it was a big player in helping us understand our more sensitive patients and how to help our patients with mold toxicity and Lyme move forward. Jill Brook: Can I ask the obvious question that probably all of us naïve people are thinking right now? I know you guys understand this so well and we're excited to learn it, but a naïve perspective what goes through my head is, isn't mold natural? Wouldn't we have evolved [00:04:00] with mold for like the last bajillion years and why would our mast cells get angry at mold? Okay? Dr. Neil Nathan: So mold is natural in the, our outside world. It is not natural in a house. In the house, it's a pathogen. It causes illness. Out in the woods, it's fine. It's meant to be out there. Never meant to be inside a house. So, first of all, not all species of mold are toxic. Some are, and many are not. But the ones that become toxic are the ones that are growing inside of our homes due to, basically, water damage. So, a horrific rainstorm that comes through the windows or walls or a leaking water heater or something that gets inside the walls or underneath grout and the tiles. When that begins to grow by itself within an environment that it's not supposed to be, it starts to make [00:05:00] mold spore fragments and toxins, and I can assure you our bodies don't like that. Jill Brook: So it's the novel man made materials that when they become the basis for mold... Dr. Neil Nathan: Well, it grows on almost all man made materials. It particularly loves sheetrock because the inside of sheetrock is compressed paper, and that's made from tree bark, which they don't get rid of the mold from tree bark before they make it into paper. They just shred it and compress it and powder it, and they make it into paper. And so, it's kind of like instant mashed potatoes, just add water. You have, if water gets inside which it can do more easily than people realize. Now you're adding water to an inert environment, and now the mold can grow happily all by itself. And keep in mind that mold spores can last for centuries. They have [00:06:00] found spores in the tombs of Egyptian kings, and add water, and it grows. So, spores can persist for an incredibly long period of time just to add water. Jill Brook: Wow. Dr. Neil Nathan: You're looking at me as if, wow, I did not know that. But unfortunately the mold knows it. Okay, am I, am I answering your question? Jill Brook: Is it that, so it's not that the mold is different, it's that it has a different environment and maybe it has kind of these different conditions that let it grow faster and harder and close to where we're sleeping. Dr. Neil Nathan: Yeah, including, including inside of our bodies, so that if you are in a moldy environment for a period of time, and that will vary from one person to another, mold, and it's a good cousin, candida, can grow inside of us, particularly against what we call our mucosal interfaces, so sinus, throat, [00:07:00] whole intestinal tract, that's where it will grow. So, if you were in a moldy environment for a reasonable period of time and you go, oh, I'm in a moldy environment. I'm gonna get a new house. I'm gonna move. I'm gonna get into something safer. You may be taking the mold with you inside your body. So, many people who have been exposed to mold will go, well, I'm in a new home. I can't possibly have a mold illness. And the answer is, yes, you can. Jill Brook: Because it's like literally in your nostrils or something like that, that's what you're saying. Dr. Neil Nathan: So, I mean, I'm not out to scare you, just out to help you understand that mold is an insidious process. It is estimated that there are 10 million Americans currently struggling with a mold related illness, whether they know it or not. And mostly don't, by the way. And we're not talking allergy. Mold allergy is a separate, [00:08:00] well known issue. The concept of mold toxicity is relatively new. We first started writing papers on it about 20 years ago, and it still hasn't quite caught up in medicine. There are many physicians who go, oh, they never taught me about this in medical school. It can't exist. And it's, unfortunately, as we're talking 10 million Americans, we're talking epidemic here. So, it's very common, and particularly in the mast cell world, what I'd like your listeners to understand is, it is a major, if not the major, trigger for mast cell activation. So, if you have mast cell activation, and you haven't looked for mold toxicity as a player, please do, because mold toxicity is treatable. Hence, mast cell activation is treatable. If you look at mast cell activation as a stand alone diagnosis or illness, we can treat it. But you're going to treat it for the rest of your earthly life, unless [00:09:00] you get the cause or the trigger. And what I'm suggesting is mold is a major trigger. And just not to play favorites here, so is Lyme disease, by the way. It's another, it's another, it's another trigger. Really what's happening is these illnesses are an inflammatory process, and it gets the mast cells going. So, I hope this is an important takeaway, that if you have mast cell activation, please look for the cause. Another cause, by the way, that we're increasingly seeing is EMFs, electromagnetic exposures. With the shift from 4G to 5G, there's a profound increase in EMF exposure and I'm seeing a lot of people who have an exacerbation of their mast cell activation from their EMF exposure. Dr. Tania Dempsey: I have a question about that and then I want to go back to the mold stuff, but I do you think that [00:10:00] patients with mold illness and mycotoxin illness are more at risk for issues with EMFs? Do you see any correlation? Dr. Neil Nathan: Very much. I believe that mold is a major player in people developing EMFs. In fact, the majority of my patients who become EMF sensitive has been triggered by mold. And if we want to take a step backwards into, let's try to tie all this together. Mold, Mast Cell Activation doesn't exist in a vacuum. It is profoundly connected to two other major neurological systems in the body. What we call the vagal system and the limbic system. And those two parts of the brain are profoundly connected. integrated with mast cells. There are direct neurological connections to the mast cells, and it works both ways. So that this discussion, if I'm going to make it as [00:11:00] comprehensive as we can, should include the fact that we're talking about Limbic and Vagal Dysfunction with Mast Cell Activation as a combined entity, if you will. All three systems are very linked to each other in a profound way. So, if we're only thinking about treating Mast Cell Activation with the supplements and medications that we know work, sometimes they don't work that well if the patient's not dealing with limbic dysfunction and vagal dysfunction. And here's what's all connected. Mold toxicity specifically triggers limbic dysfunction and vagal dysfunction by its inflammatory process. The basic issue with mold toxicity is it triggers a prolonged, chronic, inflammatory response, and it is the inflammation that's triggering all of this. And here's the [00:12:00] good news. If you take what is causing the inflammation out of the picture by treating it, all of these things can improve dramatically. I know that's a lot. That's a lot to digest at once, but we can pick it apart now. Dr. Tania Dempsey: Yeah, no, no, this is a very important point and it's something that, you know, has to be, has to be discussed and talked about because there are patients who are listening to this who are not getting better and they're always wondering, you know, why, why am I not getting better? That you have to start looking at all these connections, all these pieces. And I use this analogy all the time, you know, the onion, right? You, you peel the layers away. And so you brought up, you know, I think these are three important layers that are literally like intertwined. Dr. Neil Nathan: Yep, absolutely. Dr. Tania Dempsey: And, and so when you think about so you mentioned mold as a driver of inflammation. Would you say, and, and I would say if I can interject, you know, that Lyme and other infections [00:13:00] can do a similar thing, right? They can, they can drive inflammation similarly. Dr. Neil Nathan: Some viral infections can do it, chlamydia infections, Mycoplasma infections other infections can do it. The key is whatever is triggering an inflammatory response. If it becomes chronic, then we're off to the races. Dr. Tania Dempsey: So, oh, I have, I have so many, I have so many questions that I want to, I want to pull this apart. Pull this apart even more. So, so let's talk about the, the vagal part of this, right? So how do you identify this in patients? How can they identify the patients? How can they address it? Dr. Neil Nathan: Okay, excellent questions. There are hints on a physical examination that the vagus nerve is not functioning properly. One is very simple that physicians look at it all the time. When you have a patient open their mouth and you shine a little light inside, the little thing that hangs down at the [00:14:00] back of the throat called the uvula. If you ask the patient to say, Ah, ah, ah, ah, ah, ah, ah. The uvula should be bouncing down with every ah, ah, ah, ah, ah, ah. But if the vagus is not perking properly, it will go barely down, ah, ah, ah, ah, ah. It's very obvious, and it's easy for someone examining the throat to see it. Another one, and it might sound a little bit disgusting, but it's not that bad, is the gag reflex will be messed with if, if the vagus nerve is disrupted. And so I will ask my patients by demonstrating first by taking my finger and sticking it down my throat, taking a deep breath. I'm doing it right now. And then you just breathe out. Now, when I tell my patients to do that, their first response is usually, I'm nauseous all the time. I'm going to throw up. [00:15:00] I shouldn't be doing that. And I'll say, I haven't seen it yet. So here's my wastebasket. If that happens, we'll take care of it. But just try. See if you can put your finger down your throat and the vast majority of them will go, they'll put their finger down and then nothing happens. They're not gagging and nothing is going on and then they put their finger down further and there's still nothing happening. They take their finger out of their mouth and go, whoa, I did not expect that. So, these are very simple things to do. Other things that would suggest vagal issues are, number one, the vagus nerve controls intestinal motility. So virtually any symptom that involves the GI tract, particularly constipation, but also gas, distention, bloating, heartburn, reflux, that could be a vagal issue and often is for many of our patients. [00:16:00] Again, because the autonomic nervous system is involved, we're talking people who, and you question them, they can't sweat very well. That's something that they have difficulty doing. So, the vagus nerve goes to the heart. It can cause palpitations if it's dysfunctional. It can go to the lungs. It can cause shortness of breath or air hunger. So, in the patient's story, there are usually hints that, yep, the vagus nerve is dysfunctional, and here's the good news. We can fix that. So, there are a bunch of processes that have been evolved over the last 20 years. In the early days, a lot of us, what we were doing is actually having people gag. Believe it or not, as disgusting as that might seem, it helps to put the vagus back on line. Humming, singing, gargling are all very [00:17:00] benign things that you can do to get the vagus working again. But those were the early things. We now have many more specific things that we can do. For example, one of my favorite devices is called Frequency Specific Microcurrent. It has some wonderful programs to reboot the vagus and do a whole lot of other useful things for the body. There are some new devices on the market that are called vagal nerve stimulators, and those can be very helpful. There's one called GammaCore, another one is called Apollo Neuro, one called Truvega. There are different kinds. My one caveat to people using it, do not use it the way the instructions come from the company that makes it. For example, Apollo Neuro, the instructions are to wear this device, which is a little band that vibrates on your wrist. You should wear it five to eight hours a day. Please don't do that. If you're [00:18:00] very sensitive, start with a couple of minutes once a day and work up from it. You can overstimulate the vagus. And if you do, you will not be a happy camper. There are, is a another device called BrainTap, which uses a combination of light and sound in a, you can wear kind of a virtual reality headset, which involves the light, and you can run different programs through that set again to reboot the vagus nerve. It's a it's a nice device and there are more but that's a good introduction, if you will, to a variety of methods to get the vagus back online. The more of these things a patient does, the more quickly and effectively they're going to put the vagus back online. Dr. Tania Dempsey: That's excellent, that's excellent. Thank you for, thank you for explaining that. And then, let's sort of jump to the limbic system. Right, because this is, they, they are connected, right? There is [00:19:00] a, a crosstalk. So, so talk a little bit about the limbic system and sort of the same way, like, you know, what, what are people looking for? How can we address it? Dr. Neil Nathan: So, the limbic system is a different part of the brain than the vagus. And by the way, the vagus isn't, we call it the vagus because that's the biggest, thickest, most important part. But it's actually a vagal system. The vagus nerve is intimately connected to the nerves next to it, like the 9th cranial nerve. The vagus is the 10th. The 9th cranial nerve is called the glossopharyngeal nerve. It goes to the throat and tongue. So, if our patients are having difficulty swallowing or with sore throats all the time, there may be a , a ninth cranial nerve piece. And it's also connected to, very directly connected to other muscles like the facial nerve and the trigeminal nerve so that we're dealing with a whole system here. I, I simplified it for [00:20:00] discussion, but I'm now complicating it. Switching my, switching my gears to the limbic system. The limbic system is a part of your brain that its main function is to control, monitor, and regulate two things. Emotion and sensitivity. So, if you have developed sensitivities to anything, light, sound, touch, food, EMFs. This is where the EMFs come in. So by making the limbic system dysfunctional, you're directly potentially triggering an EMF sensitivity in that body. Just wanted to point that out, but any sensitivity to anything is limbic. It has a limbic piece to it. To add to that, now we're going to talk about the emotional piece. Anyone who has had anxiety, panic, depression, OCD, [00:21:00] depersonalization, derealization, all of those things are limbic. So, in most of my patients, they have both. Most of my patients will tell me, yeah, I can't be around loud sounds, light bothers me, I have to, I have to wear sunglasses out of doors little bits of touch that shouldn't bother me do bother me. Again, that's the limbic piece, and many of them are also anxious and depressed. And they didn't used to be. It isn't as if they've had a life of it. They didn't used to be. Or if they have had some degree of anxiety, now it is significantly worse. It's exacerbated. So that's how you kind of clue in to the limbic piece of it by history. Patients will literally tell me by their descriptions. Yep, you got a limbic piece. So there are several methods which are easily accessible. [00:22:00] The ones that I use the most are the Annie Hopper DNRS program. That stands for Dynamic Neural System Retraining. , Another system that we use a lot is the Ashok Gupta Amygdala Retraining Program. The word amygdala is another word for limbic, and he uses more of a meditational process to do this. And another one that I'm using quite a bit lately is Kathleen King's Primal Trust Program, which is combines some of both of those programs and expand [00:23:00] it a little bit. So, all of these are readily available online. They all come with support systems, with coaches, so that you can go online and get this retraining. And I want to tie it together with, if you have mast cell activation and you're not working on the limbic and vagal systems, please do, because your treatments, your supplements, your medications will be way more effective if the limbic and vagal systems are rebooted. Dr. Tania Dempsey: Yeah, I couldn't agree more. Absolutely. Dr. Neil Nathan: What I often say is if two, is if two physicians agree about anything, that's as close to truth as you're going to find. Dr. Tania Dempsey: Love that. And of course, if it's us two, you know, then for sure. So, so let's talk a little bit. I mean, I think that's a very important piece. I want to, I want to sort of switch gears again and, and go back to the mold [00:24:00] illness piece. And, and I want to understand I want to help people understand better the concept of mold and mycotoxins. You know, in the, in the mold world we sort of throw around both. But I want, you know, I want the audience to really sort of hear when we're talking about mold, what are they, what are they doing? What are they, what are they testing for? What are we, what are we actually treating? Is it the mold, the mycotoxins, or both? Dr. Neil Nathan: Yes, so first of all, mold is very complicated. Most people think about mold as kind of like a petri dish where something is growing on a plate and it looks pretty ugly. That's kind of what most people think of when they visualize what mold is. But when mold is growing in a building, there's really an inflammatory soup. It isn't just mold. It is mold itself, with its fragments and broken down pieces of mold, all of which are irritating [00:25:00] to the body. And a few mold species make mycotoxins, which are the toxins we're talking about here. Keep in mind that there's thousands of species of mold, and there's only seven or eight that are really toxic. There's a few more to be honest, but there's seven or eight that are known, named, that make the toxins that we worry about. So, all molds are not a problem, just a few very specific species. Then there are what are called ectomycetes. There are protein pieces and fragments like mannans and glucomannans. So, I think of mold generically as a kind of inflammatory soup. And when inhaled, it produces an inflammatory reaction in the body that the body often has trouble dealing with. Let me just talk about that for a second. Some people genetically are unable to [00:26:00] deal with these toxins and fragments and mold species, and some people can. So what we'll often see, let's say in a school, and schools are often moldy, unfortunately, because they leak, they don't have the funds to really remediate it properly, and the kids are getting exposed to mold, that not only public school, but in colleges, I get a lot of college kids living in the dorms that are made toxic by their, their living environment. So for those people who are genetically unable to process it, mold stays in the body and mold toxin stays in the body. It just doesn't leave. For other people, their ability to detoxify is enough that you could, you could have 100 kids in a, in a school, small school. And 25 of them may be sick, and 75 may be fine. So, as you could in a building, let's say you have a family of [00:27:00] four. One might be sick and the others are not. There's that tendency to blame the person who's sick, like, I'm fine in this environment, why are you sick? And it's not anybody's fault, it's just some people are more vulnerable to the toxins and unable to clear it as well as other people are. So it's a very common dynamic when people are exposed to mold that someone will say, I'm mold sensitive, I can't be there, and their family members will go, what's with you? That's I can do it, because, strangely, most human beings try to see the world through their own lens, and sometimes you have to get outside of your own lens to realize, well, I have my way of dealing with the world, and the rest of the world does as well. Jill Brook: Dr. Nathan, you had mentioned that inhaling mold tends to be the insidious way people get it. [00:28:00] Is that the only way that it can hurt you, or do you have to worry about eating mold or drinking mold or touching mold or things like that, or pretty much just breathing it? Dr. Neil Nathan: It's a very good question and it's not agreed upon but I would say the consensus is that most of us who work in this field believe that the main nothing else comes close way of getting mold toxicity is by breathing in the spores, all right, from water damaged buildings. It's from our environment. The question about the relationship to food is an interesting one. There are some people who claim that, nope, you get your exposure through food, eating moldy food. That's suspect, and I'll give you a short study that I did a few years ago that might help explain that. It is true that we have in the medical literature examples of epidemics of mold toxicity caused by a silo of [00:29:00] grain that got moldy and a whole community ate that grain or a large batch of peanuts got moldy and it got made into peanut products. So that's documented. We know that if it really gets out of hand, yes, that's a problem. Although I wish the people that control the food in our world did a better job than they do. They do have some standards so that the amount of mold in most food is trivial. Trivial to the point that it's not going to bother you. Not everybody agrees on that. I'd say the majority of us do. And in terms of touching you, mold toxins can be absorbed directly through the skin, and absorbed into the body. And I have had patients who started to clean up mold without wearing gloves and get sick from doing so. That's possible, but it's fairly rare. So, I think the majority of [00:30:00] people work that way. The only study I'm aware of that's ever been done on this I did with the Great Plains Laboratory, which is a lab that measures mold toxicity, about three years ago. I took eight patients. It was a small study, and I acknowledge that that doesn't create medical fact. It was a pilot project, and we haven't expanded it yet. We took eight patients, and we had them avoid all potentially known moldy foods, for 10 days. Then we ran their urine test to measure what was in them. Then I had them pig out on those same known moldy foods for 10 days, and we remeasured their urine. Somewhat to our surprise, their urine mold toxin levels went down in seven of the eight patients eating moldy food. In one patient, one toxin, Ocretoxin, went up a little bit. So, the only study I'm aware of is that by pigging [00:31:00] out on potentially moldy foods, I have not seen, by measuring it, mold levels go up. So, it's not a definitive study. We need to do a lot more. To me, it gave some validation to the concept that most of the mold toxicity we get is from air in the, that we're breathing in, in a moldy environment. Dr. Tania Dempsey: Can I ask about the mycotoxin tests? So you are, you were doing this study to look at food exposure, but there are, you know, there are people who are getting these tests done, and they feel pretty confident, let's say they've had mold testing done on their home, that they're not currently being exposed to mold, but they have very high mycotoxins in the urine. So these questions come up. Could it be the food they're eating, right? And I think that seems very unlikely, and I agree with you. What else would explain that? Is it something from their past that they're carrying with them? Is that, is that something?[00:32:00] Dr. Neil Nathan: Several explanations for that. The big one is, if you were living in a moldy environment in the past you're carrying it with you. So, your house might be perfect, but you yourself are carrying it. But keep in mind, we can treat that. We can give you binders to pull the toxins out of your body, and we can give you antifungal materials to kill the mold that's in you, and you can bounce back from that. That is a major reason. A second reason is that the measurement of mold in buildings is highly inaccurate. Particularly what we call air sampling, which is the gold standard of the building industry. I'm about to say, at the, at the patient's detriment. The reason it's the gold standard of the building industry is that if you collect the air from the center of a room, which is what's done, and you measure the [00:33:00] mold spores in that air, here's the trick. Mold spores aren't in the center of the air. All mold spores are heavier than air and they fall to the floor. So, if you're measuring the air in the center of a room, it is the more likely than not that you will get a negative test, and that's why the building industry loves it. So that they can go into, if you as a tenant complain or if someone built your home, you can go to the contractor and they can go, I'm going to measure it and prove to you that whatever it is you think you have, you don't have. And so they'll do their little test, and it'll be negative, but you are not scot free at that point. If that was the way you tested it unfortunately, and you could spend a lot of money getting that test, unfortunately, that is not an accurate way to know if you're getting exposed to mold. Dr. Tania Dempsey: What is the best test? So, what should, what should patients be thinking about? Dr. Neil Nathan: Part of the problem is there is no best [00:34:00] test. There is no perfectly accurate test, but there are tests that can really point us in the right direction. What I like to do is start with a crude test, which we call mold plates, where you can simply get a plate, which is a petri dish that grows mold, take the top of the plate off, put it on the floor of the room, get the HVAC system on so you're stirring up the air in the room, you leave the plate exposed to air for two hours, put the top of the plate back on, and you watch and see what grows. If nothing grows after four or five days, great. But if after four or five days you're looking at a plate that is ugly, it's got obvious mold growing all over it, you may have a problem. Because toxic mold can grow on those plates, but also non toxic mold. So you need to have the plate analyzed by a lab that can tell us what's on that plate before you start freaking out. And [00:35:00] we can then measure if there are toxic mold species on that plate in any degree of excess. Okay, we do have a problem. The beauty of these plates are they're very inexpensive and you can put one in every room in the house, including crawlspace, basement, garage, attic, and you can really get a read for your whole house. If there are a few rooms, everything else is okay, that light up. You can get a more accurate test called an ERMI test, E R M I, which will analyze the dust in a room for 36 species of toxic mold more accurately, and you can get a really good read on what's in your environment. So, again, experts disagree on this, but most of us have felt that that's the most accurate way to really understand, am I living in a moldy environment? Because here's the deal, you can't [00:36:00] get well from mold toxicity if you are living in a moldy environment, unfortunately. That's non negotiable. Sorry about that, but. Jill Brook: There certain symptoms that tip you off that somebody is struggling with mold, or can it just be any mast cell symptom at all? Dr. Neil Nathan: Well the answer to that is yes, and because it's an inflammatory process, almost any symptom you can think of can be mold toxicity. In the same way that Lyme disease, almost any symptom you can think of, in the same way that mast cell activation, almost any symptom that you can think of, can be mast cell activation. So, I mean, the common ones, almost everybody has fatigue to some extent and cognitive impairment. And then we may have psychological issues like anxiety, depression, talked about that a little bit before. Respiratory symptoms, shortness of breath, cough, chest pain, neurological symptoms, paresthesias, [00:37:00] gastrointestinal symptoms of every variety, sinus conditions. So almost any symptom you can think of could be mold toxicity. There are a few that really get your attention. So one of them is certain types of pain. Either electrical pain sensations, or what's called an ice pick pain. If someone describes that to me, I'm thinking mold. Many of our patients have a perception that they are vibrating or tremoring internally. Can't see it, but they feel it. It's quite unpleasant. And it can be in any part of the body or all over. That's either mold, or Bartonella, and sometimes EMF can do that as well. Um, so, certain descriptions point you in that direction. You know, for a mast cell patient it's really easy to get a urine [00:38:00] mycotoxin test and separate it out. Meaning, we have to get some testing to, to know, okay, to what extent is this mast cell activation, to what extent of this is mold, and that varies from one patient to another. If there's a mold piece to it, I certainly want to know that, A, because it means I need to be treating it, and B, I need to factor that into the timing of what I do when I do it. Dr. Tania Dempsey: So, so let's say you find it. Um, then what's, what's the next, what's the next step for this patient? Dr. Neil Nathan: Okay, so, if a patient has mold toxin in their urine, and it does not belong there, If it's there, forgive me, it's pretty simple. If you're putting mold toxin out in your urine, it's coming from your body. It's like, where did that come from? It came from me. So it's there. There's three [00:39:00] steps to treating mold toxicity. The first we've talked about, you need to evaluate your home or work for whether or not that's safe. You're not going to get better if there's mold in your environment. Second, we've learned enough about this to know that there are certain binders, many of them quite benign, that can pull the toxin out of the body. And we have learned that certain toxins are much preferably bound by certain materials. So the binders are simple things like activated charcoal, bentonite clay, chlorella, the probiotic Saccharomyces boulardii. And then there are some more elaborate medications we have as well, but there's some pretty simple ones. And what we give depends on the toxin we find in their urine. So, if you have ocrotoxin in your urine, which a lot of our patients do, the best binders for that are charcoal and a couple of medications, which are called Wellcol [00:40:00] or colistyramine. For other binders, like say aflatoxin or tricothecine and there will be no quiz at the end of this discussion on these, on these, on these, on these weird, on these weird names. Those are best bound by charcoal, clay, and chlorella. If you have gliotoxin or zeoralanone, those are best bound by bentonite clay and Saccharomyces boulardii. So, it's not a willy nilly thing. Depending on what's in your body, we prescribe these specific binders that we know will pull that out of the body. Now, if your exposure to mold is relatively recent, that varies from one person to another, you might be able to pull the binders out without needing to give antifungals. So if you just have toxins in you, for some lucky people, they take the binders, they're great, they're, it's, they're healed. So, treatment is over. [00:41:00] For many patients, unfortunately, the concept of mold toxicity is not well known in medicine, and many people don't get to us until years later. And at that point they've not only got the toxin in them, but they've colonized. Usually the sinus and gut area, they will need to treat the sinus and gut areas with antifungal nasal sprays and antifungal oral materials to get rid of it. So that's a three fold process of how we treat. And my take home message is, every single thing we're talking about today is treatable. So, this is not like, oh my goodness, what am I going to do? The answer is, find someone who knows how to do it, and get going. That is the message I want to deliver. There is hope. Jill Brook: Is this a slow process or what? Is this something that takes days, weeks, years? Dr. Neil Nathan: It usually takes a year or more to get mulled out. [00:42:00] If you haven't colonized, you can get well in six weeks, three months. But honestly, I don't see that very often. I did when I first started practice, but as I got kind of known for doing this work, people who knew what they were doing would send to me their more complicated patients, and all of them have colonized. So... Dr. Tania Dempsey: yeah. Dr. Neil Nathan: I haven't seen someone who hasn't colonized in a long time. So, it's a year or more. This is not a quick fix, like treating Lyme, not a quick fix. But if you plug away and you keep going at it, it is treatable. Jill Brook: Dr. Dempsey, can I ask how, how many of your patients you see that you think mold is relevant to? I know that Dr. Nathan probably sees the most complex of the complex nowadays because everyone with the worst mold problems goes to him, but as you seeing sort of maybe a representative [00:43:00] sample of MCAS patients, how often is mold an issue, do you think? Dr. Tania Dempsey: It's a very high number. I mean, I, there's no question about it. Mold, you know, when I think of the sick patients that, that come to us who have they have MCAS, but they're not getting better we we're, I always talk about, you've gotta figure out the triggers. There are other triggers that I think about. I think about, you know, breast implants and other implants and other materials that are inside their body. So there are lots of other triggers to think about, excipients, but number one and two on my list, or maybe number one, and they're just parallel to each other, is, is mold and infections. And those are, those are just, they come up constantly and, and not uncommonly together. So I have patients who I think had underlying Bartonella or Lyme, but their mold exposure is actually what uncovered their immune system actually got suppressed. And so, you know, sort of chicken or the [00:44:00] egg, which came first and sometimes there are layers of things that have been happening. The mold exposure knocked them all off and now we're dealing with all those things together and trying to figure out how to address it. So no, it's a huge issue. This is why I was so excited to have Dr. Nathan on because this is I think it's a, it's an epidemic. Dr. Neil Nathan: It is. And although we're focusing on mold I am remiss for not as Tania is talking about, bringing up the fact that there are thousands of environmental toxins that can also be doing it. So, it's, mold is the easiest one to measure. We can't measure many of these toxins. If we could, we'd probably all be freaked out about what we're getting exposed to. But mold is the easiest to measure and, when I treat it, in the way that I'm talking about, people get better. So there's a direct correlation between having mold in their body, treating them, getting the mold out and now they're well. So I've seen hundreds [00:45:00] of patients with mast cell activation get well to the point they don't need to take supplements if we, if we fix the trigger. So I, I just can't emphasize enough, and Tania's helping me, this is really important to look deeper. Not just sit with, oh, I have mast cell activation. That's why I'm sick. Yes, that's true. And what's causing it? And that to me is a central question here. Dr. Tania Dempsey: And it's something that we have to, that, that I'm always thinking about when my patients come to see me. Every visit is, is thinking about are we missing any triggers? Have we gotten everything? Is this the right path? Are we on the path? Is it just mold? Is it, is it infection? Is it something else? And again, like that onion analogy, you just, you have to keep peeling, peeling the onion because, you know, our mast cells are, are, our front line of defense, right, to the environment. So they can react to, [00:46:00] to lots of things. And it's just figuring out which, what's really affecting your mast cell specifically. Dr. Neil Nathan: So I could segue from that comment into into talking about my new book. Dr. Tania Dempsey: I was just going to ask you about it. Please. Dr. Neil Nathan: There's a reason for the segue. So I'm really excited about my new book, which is simply called The Sensitive Patient's Healing Guide. And it's about patients who have become sensitized, like we're talking about, and to help them understand what's going on. And so I was very, very fortunate that I have 20 top experts in this field writing chapters in the book on the piece that is, they are most expert upon. I wrote about a third of the book myself, and then I have a lot of friends in this field and they were very nice about, about writing chapters. So it helps patients to understand what is going [00:47:00] on in their body. So we have chapters on the limbic system written by Annie Hopper and Ashok Gupta. And we have a chapter on the vagus written by Steve Porges, who is the researcher who put that on the map and so on. I have Rich Horowitz wrote a chapter on Lyme and Bartonella as a sensitizing triggering agent and so on. So we talk about why that happened. Then we talk about the triggers and how to treat those triggers. And there's a lot of less common triggers that some of my experts got into as well. For example, there are structural triggers in the body, meaning injuries to the body of a variety of sort will profoundly affect these issues. So many patients will respond well to osteopathic manipulation, for example. Lymph flow in the body gets very sluggish in our patients. Getting the lymph flow mobilized is very, very important. The jaw [00:48:00] is a particularly sensitized area of the body. The body has prioritized our level of safety and comfort when our teeth come together properly. And when they don't, the body freaks out and goes into a hyper vagal limbic state going, I've got to somehow get my jaw aligned properly. That profoundly affects the body and sets people off and a lot of folks don't realize. Yes, you have TMJ, but that might actually need to be treated sooner rather than later to allow your body to quiet down. Oxalates can be an issue as a sensitizing factor. Salicylates can be a factor, a sensitizing factor, withdrawal from medications, particularly SSRIs or benzodiazepines, can fire up the system and, and really make it difficult to get better. So, and there's more. So, what I'm excited about is I, [00:49:00] I don't know that there's been a book like this before for sensitive patients that would help them to understand it's not in your head, this is a real illness, and it's treatable. And because so many of these folks have been told forever, smell. I can't smell what you're smelling. Our sensitive patients have an elevated limbic system, direct connection from the limbic system to the olfactory system. So, yes, yes. My mold patients have an exquisite sense of smell in the sense that you may have heard of mold dogs that can detect mold in an environment. Well, some of our patients probably not as good as a dog, but they get pretty sensitive about being able to do that, and the other people in their environment will go I don't smell it, this is, this is in your head. Which is, as a general rule, if you're smelling, or feeling, or hearing, or seeing something, with rare exception, don't doubt [00:50:00] that. Trust what you're perceiving, it's real. And if the people around you can't get behind it, it's find someone who can. Dr. Tania Dempsey: That's great advice. So important. Thank you so much for, for writing that book, putting that book together, getting it out there. Dr. Neil Nathan: I'm excited. It will be released at the very end of April and it's available now by pre order on Amazon, but it will be fully out by the end of April. Jill Brook: And we'll put a link in the show notes. Dr. Neil Nathan: Thank you. Jill Brook: I have one more question from Team Patient, because I know there's so many patients out there who are desperate to feel better ASAP, and sometimes we are even in denial about this mold thing, because it sounds like a big, expensive undertaking, looking at our homes and stuff. Is there anything that is reliably good for a mold patient? Like, if somebody out there is saying, just tell me where to live. Like, if I move into a new apartment in the [00:51:00] desert, is that pretty likely to be free of mold? Like, is there anything, if someone just wants to get into a reliably mold free environment and see how they do for a couple weeks, like maybe one of those what do they call them? Symptom sabbaticals or location sabbaticals. Is there any place that is, like, reliably good or is mold sneaky enough that it is even hiding, like, in deserts and stuff? Dr. Neil Nathan: There are places that are better than others. But nothing reliably, I mean, there are tons of mold patients in Arizona. When it does rain, the buildings aren't, aren't built to withstand the precipitation that others are. So they, their buildings tend to leak more than others because they're really sloppy about it. It's like, well, we're in the desert, but, but it rains. Dr. Tania Dempsey: HVAC systems are a huge problem. Dr. Neil Nathan: Yeah, very. Yeah, very much so. If you, if you use a freezing air conditioning, [00:52:00] you're going to get condensation of water inside the HVAC system, and that's a setup for, for that. But if, as a general rule, going to the Southwest has helped some of my patients who have done that, hasn't helped all of them. So, there's no place on the planet that I'm aware of that doesn't have mold. Sorry about that. There are places that are better than others. And also, I'd like your listeners to know that if you're taking a sabbatical, you might leave where you are for a couple of weeks and not get better. And that doesn't mean you don't have mold. It means it's growing in you and you're taking it with you. So I would estimate maybe a third of patients who leave their moldy environment get better when they leave and, [00:53:00] and then when they go back to their house, they get worse again. That's a pretty clear statement to them that, yep, you got it, and it's in your home. By no means does everyone fall in that category. That's not an inexpensive way to figure out whether or not you have mold or not. If it works, great. Yeah, you got it. It's not going to work most of the time. Sorry. Dr. Tania Dempsey: And, and I'll, again, I'll add to that, that sometimes, so we know, we said mold is a huge issue, but there are these other environmental toxins and other things that in the environment that may be also triggering the patient. And so, they may leave, not get better, but really it's because the toxins they're being exposed to in these different locations are the same even though there's no mold. So I think it's just become, it's just really tough to... Dr. Neil Nathan: Right. Dr. Tania Dempsey: out, piece apart. Dr. Neil Nathan: Excellent point. There are so many other toxins in our environment that can trigger that. You know, a common one is formaldehyde, for example. [00:54:00] A lot of building materials are made from formaldehyde and it outgases very slowly. So you could have a brand new building and it shouldn't be, have mold in it, but it might have other chemicals that need to outgas before they can comfortably be in that situation. So, I'm sorry we live in a complicated world. I don't have simple answers for you, but I want to emphasize everything we're talking about today is treatable, meaning you don't have to be sick. The vast majority of people that we've treated have gotten well. Dr. Tania Dempsey: When people get better, at least in my experience, and I'm curious about your experience, do they get, they get less sensitive. The sensitive patient becomes a less sensitive patient. Dr. Neil Nathan: So, you don't have to stay sensitive. As the limbic system settles down, as the mast cell system settles down, as the vagus settles down, you, you, [00:55:00] and this would make sense neurologically and cellularly, that it, you get better. So, one of the questions my patients ask me, which, which is, if I get the mold out of my body, am I always going to be this sensitive? And the answer is no. Dr. Tania Dempsey: Excellent, excellent points. I'm so, I'm so glad to have to get this information out there. Thank you for helping us and educating us. And yeah, I think I can't thank you enough for the work that you do. Dr. Neil Nathan: Okay, thank you, and right back at you. Jill Brook: And again, we will put a link to your book in the show notes. So I'm excited. I'm so excited to get that book. And Dr. Dempsey and Dr. Nathan, just so much for this amazing information and all that you do to help all of us sensitive patients. I mean, just hearing you say, you know, believe your senses is so heartwarming. But this has been incredible information. We're so grateful for your time and your expertise. Dr. Neil Nathan: You're very welcome. I only hope that this [00:56:00] information can help people who are struggling out there. Jill Brook: Hey listeners! Well, that's all for now, but we'll be back again next week with a normal episode of the POTScast, and we'll be back again soon for another episode of Mast Cell Matters with Dr. Tania Dempsey as our special host. So thank you for listening, may your mast cells be good to you, and please join us again soon.

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