29. Navigating Mold Toxicity and Complex Chronic Illness with Dr. Jill Carnahan

[00:00:08] Hello everyone. Welcome to the Better Medicine Podcast. I'm Dr. Omar Akhter. Today I'm very excited and honored to be joined by Dr. Jill Carnahan.

[00:00:16] Dr. Jill Carnahan is your functional medicine expert, duly board certified in family medicine for 10 years and in integrative holistic medicine.

[00:00:25] She is the medical director of Flatiron Functional Medicine, a widely sought after practice with broad range of clinical services,

[00:00:32] including functional medicine consultations, nutrition consultations, chiropractic therapy, physical therapy, naturopathic medicine, and acupuncture and therapeutic massage.

[00:00:42] As a survivor of breast cancer, Crohn's disease, and toxic mold illness, she brings a unique perspective to treating patients with chronic complex illness.

[00:00:51] She specializes in searching for the underlying triggers that contribute to illness through cutting-edge lab testing and practicing personalized medicine.

[00:01:02] shape, shape, parade, Forbes, mind-body green, first for women, a Townsend letter, and the Huffington Post, as well as seen on NBC News,

[00:01:13] and health segments with Joan London, and Dr. Jill is media savvy and full of wisdom.

[00:01:18] Her YouTube channel and podcast features live interviews with many of healthcare's most respected clinicians,

[00:01:24] as she co-authored the personalized and precision integrative cardiovascular medicine textbook with Dr. Mark Houston.

[00:01:33] And her new book, Unexpected, Finding Resilience Through Functional Medicine, Science and Faith,

[00:01:39] is now available for purchase anywhere books are sold.

[00:01:41] She is the executive producer, film director, and is featured in a new documentary about her journey overcoming illness called Dr. Patient,

[00:01:49] Set to View Distributed this year.

[00:01:51] A popular and inspirational speaker and prolific writer, she shares her knowledge of hope and health and healing live on stage and through newsletters,

[00:02:00] blog articles, books, and social media.

[00:02:03] Her patients and fans alike are encouraged by her science-backed medical knowledge delivered with authenticity, love, and humor.

[00:02:10] She is known for inspiring her audience to thrive even in the midst of difficulties.

[00:02:15] Please give her Instagram a follow at Dr. Jill Carnahan.

[00:02:19] So, Dr. Jill, welcome to the podcast and thank you so much for your time today.

[00:02:22] Thanks for having me.

[00:02:24] I always love talking about health and healing and better ways to do medicine.

[00:02:27] So, I'm excited to be here.

[00:02:30] Yeah.

[00:02:32] Absolutely.

[00:02:33] So, you have such an interesting journey and you have seen things from the side of both the physician and the patient.

[00:02:42] And so, I'm curious if you can share with the listeners a little bit about your own journey through complex illness

[00:02:48] and how that gives you such a unique perspective when you treat these patients.

[00:02:53] Sure.

[00:02:53] So, I was born on a farm in central Illinois and really didn't know I was going to be a healer,

[00:02:59] but I had an interest in helping people.

[00:03:01] And when I realized that medicine would be a great route to do that,

[00:03:04] I grew up with, you know, organic farm and produce and knowing that our bodies had the ability to heal themselves.

[00:03:10] And so, I had a much more holistic perspective.

[00:03:12] My mother was a nurse.

[00:03:13] And, of course, before she takes us to the doctor, we try, you know, chicken soup and maybe herbal remedies.

[00:03:18] And then we were still very normal kids that went to the doctor.

[00:03:21] But there was a lot more that I knew that our body could do to heal.

[00:03:25] And so, I grew up with that philosophy, not really thinking that the conventional system would be a good fit.

[00:03:29] But then, as I really realized, I thought, well, why not go to medical school, learn the very best of reimbursement system that our country has to offer,

[00:03:36] but then also really try to challenge and grow the system, how we think about health and illness,

[00:03:40] and how do we get to root cause and reversal of disease?

[00:03:43] I didn't know that was called functional medicine.

[00:03:45] But then through my journey as a third-year medical student, I was diagnosed with aggressive breast cancer.

[00:03:51] So, that kind of turned everything upside down.

[00:03:53] I was kind of facing the battle of my life, and I went through surgery, radiation, chemotherapy, lost all my hair.

[00:03:59] So, in the midst of my medical training, I had a very important encounter as being the patient.

[00:04:05] And I feel like I learned so much through that experience, what it's like to face your own mortality,

[00:04:10] how to make decisions with all the massive amounts of data about what the right thing is,

[00:04:14] how to combine both conventional therapies and alternative integrative holistic types of therapies.

[00:04:19] So, that really changed my understanding at a different level.

[00:04:24] And then just six months after I was completely finished with therapy for breast cancer,

[00:04:28] I was diagnosed with Crohn's disease.

[00:04:29] So, this is all in the midst of medical school, really now part of my medical training.

[00:04:33] But it just allowed me to see from the patient perspective the kinds of complexities that patients face.

[00:04:38] And also just the, I mean, fortunately, I had hope through the whole time.

[00:04:42] I never lost my faith in my ability to heal.

[00:04:44] But how do we impart that to patients?

[00:04:46] And I think sometimes creating that container for hope and healing is maybe the most important part of what we do.

[00:04:56] Yeah.

[00:04:57] That's quite a journey.

[00:04:59] And I think it's the height of your medical school, which is the most stressful time in someone's life,

[00:05:04] to be diagnosed with these complex illnesses is just incredibly difficult.

[00:05:08] So, and I think one of the main things that I found incredible is that picture that you have side by side with you as a patient without your hair

[00:05:16] and then you as a practitioner.

[00:05:18] That's a very impactful picture.

[00:05:20] And I think that no one understands illness in that way when you're both a patient and a healer at the same time.

[00:05:28] So, yeah.

[00:05:30] I wanted to ask you a little bit about mold toxicity because that's a topic we're talking about.

[00:05:35] And for me, mold toxicity is basically, you know, it's very complex because one, we're never taught about it in medical school.

[00:05:44] And when you look, you know, when you get into the world of functional medicine as well,

[00:05:48] there is one is the theoretical aspect of what mold toxicity is.

[00:05:52] And then it's dealing with a patient population, which is really one of the most complex patient populations there is, in my opinion.

[00:05:59] And so I'm very interested to learn more about mold toxicity.

[00:06:03] But for the average listener, can you tell us a little bit about what are the basics of mold toxicity?

[00:06:08] What is it?

[00:06:09] And maybe what are some of the common sources with which we can get exposure to mold?

[00:06:14] Yeah, this is a really big deal because many people are suffering from, say, cognitive issues, subjective cognitive decline,

[00:06:20] issues with memory, focus, concentration, anywhere from in your 20s, 30s, 40s, and upwards into 50s.

[00:06:26] And sadly, we're seeing even with like Alzheimer's disease, there's more and more very young 40s and 50s being diagnosed with dementia or early onset cognitive issues.

[00:06:36] The number one symptom of mold is fatigue and cognitive issues.

[00:06:41] And so, of course, there could be massive other types of things that are causing that.

[00:06:45] But many people don't realize that their home or their environment is actually contributing to their symptoms.

[00:06:50] So what might you notice?

[00:06:52] First of all, you might notice that maybe I always take a good history, like a timeline.

[00:06:56] And often the history will tell I was doing fine until I moved to Boulder or until I bought this new house and there was a water leak in the laundry room.

[00:07:07] And so very commonly, people don't realize that when there's water intrusion from a storm through the windows, from an attic that isn't properly sealed,

[00:07:16] maybe a crawl space that has standing water or a dishwasher or a fridge line or a bathroom,

[00:07:21] or even someone who's in a brand new home where the construction, maybe they forgot to install a proper sealant or vapor barrier in the shower master bathroom.

[00:07:31] And as crazy as that sounds, it's actually way more common than we think.

[00:07:36] So many, many people are living in toxic mold and don't really even realize it.

[00:07:40] Mold has a really interesting thing.

[00:07:41] We taught in medical school about adaptive immunity, which is like our allergic system that responds to allergens in the environment or toxins or things like that.

[00:07:50] And mold absolutely causes an adaptive immune response, kind of an allergic response, especially the sinuses, the lungs.

[00:07:57] It even affects the gut.

[00:07:58] But what we see as we deal with these complex chronic mold exposure cases is the innate immune system also responds.

[00:08:06] And since the pandemic, people have been much more aware of what that really is.

[00:08:09] When you hear the word cytokine, it's this immune signaling molecule that gets upregulated when there's an inflammatory insult like an infection or a toxin like mold.

[00:08:18] And then that innate immune system can cause this collateral damage as it gets turned on.

[00:08:23] And those cytokines start to cause leaky gut.

[00:08:25] They start to cause mass cell activation.

[00:08:28] They start to cause the cognitive issues, the mitochondrial damage, which leads to fatigue.

[00:08:32] And then they can even cause the body to turn on itself and create autoimmunity that's new, like lupus or Hashimoto's thyroiditis or even neurodegenerative types of conditions.

[00:08:42] So many patients may have gone to their doctor with complaints of cognitive decline or fatigue or adrenal issues or hormonal issues or autoimmunity and not realize that mold is the trigger that led them to that state.

[00:08:58] I was just saying.

[00:08:59] And you mentioned fatigue and cognitive issues being front and center.

[00:09:02] Are there any other red flags aside from kind of the timeline in terms of symptomatology?

[00:09:08] I know some mentioned like this electric shock sensation and various symptoms like that.

[00:09:13] Do you find anything else that makes your kind of red flags go up as far as mold goes?

[00:09:19] Yeah.

[00:09:19] So first thing is history because patients all the time on Instagram or somewhere, they'll be like, what's the one test for mold?

[00:09:25] And there is no one test.

[00:09:26] So a great history is the first thing because you're looking at where in the where when did you last feel well?

[00:09:32] Do you remember when you last felt well?

[00:09:33] And what's happened since then?

[00:09:34] And then we look at all those different things.

[00:09:36] Was it a move?

[00:09:36] Was it a stress?

[00:09:37] Was it a loss of a loved one?

[00:09:38] Was it a change in diagnosis?

[00:09:40] Was it a gut disorder or a food poisoning?

[00:09:43] So we look at that.

[00:09:44] So history is huge.

[00:09:45] And if the history involves an environmental change, that's always a clue.

[00:09:49] Or if the history involves a water leak or water damage or a storm or an intrusion or something like that, that's another clue.

[00:09:55] If the history involves multiple family members in the same environment having similar change in health, that's a clue.

[00:10:01] So those are the historical clues.

[00:10:02] And then we look at something called visual contrast testing, which can be done online or in a physician's office.

[00:10:08] And this is affecting the visual acuity in the small vessels of the eye to look at dark and light and detect the difference between the two.

[00:10:16] And this has been associated with biotoxin-related illness.

[00:10:19] So we can actually measure visual acuity.

[00:10:22] And if we see a worsening of that, that is a sign that we need to look for biotoxin illness.

[00:10:27] So history, visual acuity testing.

[00:10:29] And those are two free things, so we don't even have to spend money at this point.

[00:10:32] And then we'll often do innate immune system testing, what we used to call Sears labs from Dr. Shoemaker originally.

[00:10:40] I still do those.

[00:10:41] And they are none of them alone are diagnostic.

[00:10:43] But as a whole, if they're all abnormal, they can indicate the possibility of mold.

[00:10:48] Those would be labs from a typical lab like MMP9, VEGF, TGF-beta, MSH and osmolality, ADH, and even things like antigliadine antibodies.

[00:11:00] So we kind of look at those as the immune system and what's happening.

[00:11:04] I also use complement split products like C4A and C3A.

[00:11:08] And if all of those are abnormal, there's a case to be made for maybe a toxic exposure.

[00:11:12] And then one thing that's become real popular lately is urinary mycotoxin testing.

[00:11:17] There's three main companies that do that.

[00:11:19] There's Vibrant, Real-Time Labs, and Mosaic.

[00:11:21] And they each have advantages and disadvantages.

[00:11:24] No one test is perfect.

[00:11:26] But this can indicate exposure.

[00:11:28] But I do not like patients to say if they just have a mycotoxin test as positive that for sure there's an exposure.

[00:11:35] You really need to be careful about overdiagnosing mold exposure based on one urine test.

[00:11:40] There's a lot more to it.

[00:11:41] But those are kind of the ways that I assess history, visual contrast testing, blood work, urinary mycotoxins.

[00:11:47] And then environmental testing is also huge.

[00:11:49] And I'll have people do a QPCR test of the dust in their home.

[00:11:53] And if that matches the kind of mycotoxins that are showing up in their urine, then we have more of a case for an exposure.

[00:12:00] Okay.

[00:12:01] Interesting.

[00:12:02] Are you finding the visual contrast study to be very, very sensitive in this?

[00:12:07] In other words, are you going forward further if patients are negative on that?

[00:12:14] Oh, great question.

[00:12:15] So I think visual contrast like history is a screening.

[00:12:17] And I like to talk about that because so many people are overwhelmed by the cost of testing.

[00:12:21] And I want to give people two things that are free.

[00:12:23] It's a great history and a visual contrast test.

[00:12:25] So it's just like a doorway.

[00:12:27] If I have a suspicion hearing the history that, oh, maybe there's mold exposure, I will often do a visual contrast test.

[00:12:32] And if it's abnormal, I'm like, oh, there's more likelihood of mold.

[00:12:35] But if someone gets a negative test, it doesn't necessarily mean that they haven't had a mold exposure.

[00:12:42] Okay.

[00:12:43] And you mentioned the overdiagnosing of mold.

[00:12:45] And I think that that is very, very key because there's a tendency, even if you don't get any testing, where you just have these chronic symptoms, you can't figure it out.

[00:12:52] And the first thing to go to is, oh, I must have a complex chronic illness like mold.

[00:12:58] So what are kind of the way or what are the red flags rather that you see that make you think, okay, this is likely not mold toxicity is causing the symptoms.

[00:13:10] Whereas maybe a test like the visual contrast study or other tests like a urine test are suggesting so.

[00:13:16] Is there a way that you can differentiate that and make sure it's not overdiagnosed?

[00:13:21] Yeah, this is a great question because I do think you want to be careful.

[00:13:24] In my experience, especially right after my own experience with mold toxicity, obviously you get this understanding that's at a deeper level.

[00:13:31] And you're like, oh, my goodness, there's so many more people than we think affected.

[00:13:34] So by coming out of my own experience, I came with a lens that said, could this be mold?

[00:13:38] But I was actually very careful not to overdiagnose because I didn't want to have my lens influencing every patient who walked in the door.

[00:13:45] But what I've found over the past 10 years is more often than not, it actually is mold.

[00:13:51] And it's probably actually easier to underdiagnose it than to over.

[00:13:54] However, this is such a good point because there's many of the things that can look like mold.

[00:13:59] So other environmental toxins.

[00:14:01] And I always think of functional medicine as it's usually a combination of toxic load and infectious burden.

[00:14:06] So what I'm looking at is things like heavy metals, parabens, phthalates, PCBs, PFAOs, heterocyclic amines, persistent organic pollutants, and then also mold.

[00:14:19] So there's a whole body burden of toxic exposures.

[00:14:22] And then I'm also looking at infections like tick-borne infections, the 3Bs, Bartonella, Borrelia, and Babesia, super common.

[00:14:30] And then there's other things like Epstein-Barr, CMB, other herpetic virus families.

[00:14:36] And the viral load or the load of infections can also play into this.

[00:14:40] And then the thing that's kind of at the top of this is often mast cell activation.

[00:14:45] Mast cells are primordial cells that kind of defend against the world.

[00:14:48] And they can be triggered by toxins, by trauma, by mold, by infections, by exposures.

[00:14:54] And so if the mast cells are being overactive, they can cause a whole slew of symptoms.

[00:14:59] In fact, many of the mold symptoms are because of an overactive mast cell system.

[00:15:03] And that really is at the top.

[00:15:05] And you want to figure that out and treat that before you go deeper with the detox or with the infections.

[00:15:10] Because if someone is in a mast cell activated state, they won't tolerate a whole lot of treatment until you start to stabilize the mast cell activation first.

[00:15:19] Right.

[00:15:20] And I think that's a very important point.

[00:15:21] And I was coming to that where I wanted to ask you, how do we prioritize?

[00:15:26] Because the difficulty I think becomes is that a typical patient outside of a book will come to you with a variety of different symptoms, some gut issues, some mold-related issues.

[00:15:36] And even if we get it right about diagnosing mold and we haven't overdiagnosed it, the question then becomes, when do you start that intensive treatment and what do you do first?

[00:15:47] So you mentioned the mast cell.

[00:15:49] But I've had patients where they have like gut issues, for example, and there's also mold.

[00:15:53] But when we work with the gut issues first, they tend to get better.

[00:15:57] So in other patients, I guess it could be such that until you resolve the mold, they won't be fully better.

[00:16:03] But that's where I'd love to get a better understanding of what should be prioritized in this whole realm.

[00:16:10] I love this question.

[00:16:12] Such a practical thing because I do have a very clear order.

[00:16:15] So our limbic system responds to stress response, trauma, infections, toxins, very similar to the mast cell story.

[00:16:21] And so because of that, limbic activation, which is where we get our fight or flight triggered, is a really big deal.

[00:16:29] And for years, we weren't talking about that.

[00:16:31] Unfortunately, now there's so much talk about how do we stimulate the vagal nerve?

[00:16:35] How do we upregulate the parasympathetic system?

[00:16:37] How do we deal with trauma?

[00:16:39] And these are all ways to help regulate that limbic system.

[00:16:42] What people may not know is, yes, of course, if you have true trauma, if you have infection, toxin, your limbic system can get activated.

[00:16:48] And, of course, dealing with the old trauma, dealing with your limbic system, dealing with the mast cells is all part of that.

[00:16:54] But what many people don't know is just the inhalation of a toxin because our olfactory nerve is so close to the brain will trigger the limbic system through the nerve itself.

[00:17:03] So literally a chemical exposure, mold inhalation can actually trigger the limbic system.

[00:17:08] Even if we're like, I'm fine, I'm not worried about this.

[00:17:11] Even if we're so calm and centered in our system, literally there's a chemical activation.

[00:17:16] So what I've found is getting patients well who have mold-related illness or infections, the limbic system is number one thing.

[00:17:23] And I don't always do that myself.

[00:17:25] I send them to somatic therapists or trauma therapists or some of the programs.

[00:17:28] There's DNRS, there's the Gupta program, there's primal trust, and there's neurolinguistic programming, cranial sacral therapy, integrative manual physical therapy, transcranial magnetic stimulation.

[00:17:39] There's a ton of therapies and things that you can do for this.

[00:17:43] But you really have to have something in place for the limbic system before you go deeper into anything else.

[00:17:48] So that's number one.

[00:17:49] Number two is the mast cells.

[00:17:50] So there really is a mast cell component.

[00:17:52] And the consensus two criteria suggests that we have symptoms consistent with mast cell activation with more than two systems affected.

[00:18:00] So, for example, you might have a wheezing or respiratory symptom.

[00:18:03] You might have a skin symptom.

[00:18:05] You might have tachycardia for heart symptom.

[00:18:07] So more than two systems affected.

[00:18:10] The second thing is response to anti-mast cell therapies.

[00:18:14] That could be like histamine, H1 blockers, H2 blockers, mast cell stabilizers, leukotriene inhibitors, and layering those and getting a response.

[00:18:22] And then the third thing is actual lab values that indicate mast cell activation.

[00:18:26] But typical lab things that we used to check would be tryptase and histamine.

[00:18:30] And it's so much broader than that because those are just two mediators of hundreds that the mast cells release.

[00:18:36] And those mast cells may or may not be releasing tryptase or histamine.

[00:18:39] And the patient could still have a real mast cell disorder.

[00:18:42] So limbic system, number one.

[00:18:44] Mast cell disorders, number two.

[00:18:45] And then you start going into detoxification.

[00:18:47] And I always treat mold toxicity or detoxification first before infections.

[00:18:53] Because very frequently those infections are there popping up because of a weakened immune system.

[00:18:58] And if we get the mold toxicity out and the body burden down, sometimes the immune system can come back online and take care of those reactivation of infections.

[00:19:06] And you may not need to be aggressively treating the infections once you get that patient unloaded from the toxic burden.

[00:19:15] Okay.

[00:19:16] You know, detoxification is a very popular word as you can see these days.

[00:19:21] I'm curious for the layperson, how do you differentiate for people out there what is considered, you know, the Instagram type of detoxification of just a cleanse or something like that versus the type of detoxification you're talking about with mold?

[00:19:37] For the average person that may not know the difference between the two.

[00:19:42] Yeah, there's so many popular channels and influence out there talking about master cleanses and this and that.

[00:19:46] And those just are not well scientifically validated.

[00:19:50] And often you might go to a spa or retreat for, you know, 10 days in January to do this detox and massage and sauna.

[00:19:57] And those are all good principles.

[00:19:59] But I love what you're saying because what really happens with detox is you get daily habits that help your body get rid of chemicals.

[00:20:07] And we're all swimming in toxic soup.

[00:20:09] The number of chemicals released in the environment is 350,000 or more.

[00:20:13] There's so many toxic chemicals that aren't really well regulated.

[00:20:16] So the truth is we're all swimming in toxic soup.

[00:20:19] And once we kind of realize that, then we need to just find for our lifestyle, for our ability, what can we put into habit?

[00:20:26] And I start with daily simple things.

[00:20:28] And I always love to say it starts pretty simple, accessible to everyone.

[00:20:32] And that's think about clean air, clean water, clean food, and then clean mind and clean body.

[00:20:38] So clean air, 80% of our environmental toxic load comes from the air that we breathe.

[00:20:41] And we need to make sure we have a good air filtration system, that we're getting clean air into our homes where we're sleeping and living and working, and that we are really taking care of that air quality.

[00:20:51] I feel like standalone air filtration with HEPA filter and VOC is critical nowadays for all of us.

[00:20:57] I even have one in my car, a really, really good quality air filter.

[00:21:01] I have multiple at home, multiple at work.

[00:21:03] So air quality.

[00:21:04] You can also replace your furnace filter with a very high MERV rating so that you're getting some of them even have charcoal so that you decrease the contaminants through the fire.

[00:21:11] The furnace says that runs.

[00:21:13] Clean water is just going to be making sure you have good quality reverse osmosis or similar filtration system at home.

[00:21:20] And the water that you're drinking, trying to avoid plastic water bottles.

[00:21:24] Those microplastics are becoming much more of an issue.

[00:21:27] And then clean food is just really trying to find local, organic, non-GMO, whole foods, not processed, absolutely essential for the core.

[00:21:36] And then I've added clean mind and clean body because sometimes emotions like loneliness, anger, jealousy, patterns of thinking, neuro-linguistic patterns that keep us held hostage can all really affect not only our microbiome, but our immune system.

[00:21:52] And assessing those mindful habits.

[00:21:56] And then implementing things like prayer, meditation, meditative walking, connection with people, social connection.

[00:22:03] Those are all absolutely crucial.

[00:22:04] And then clean body is just the things that we might do like infrared sauna, red light therapy, Epsom salt baths, dry brushing, maybe colonics or coffee enemas.

[00:22:13] All the things that help keep our liver, our gallbladder, our bowels, our urinary tract, our kidneys functioning and detoxifying.

[00:22:23] Yeah.

[00:22:23] So really a whole person approach as best as we can.

[00:22:27] Very important.

[00:22:29] So I do want to ask you when it comes to the world of supplementation, there is so much out there.

[00:22:34] And when we talk about detoxification and more along the realm of binders and so on, can you just talk through what are some of the categories that you use and what are some of the best approaches?

[00:22:47] Maybe it may be hard to talk about the number of supplements that one might need, but what are the main principles of supplementation or medication?

[00:22:56] Yeah.

[00:22:57] So if you think about what happens is when we get, so let's take mold, for example, mold secretes mycotoxins.

[00:23:03] Mycotoxins are often smaller than 2.5 microns in diameter, which means they can go directly into our alveoli, directly be transported into our blood without even any barrier because they're so small.

[00:23:12] So often these things like PFAOs or parabens or phthalates or VOCs or mycotoxins go directly through lungs or through skin or through exposure into our bloodstream and then they accumulate in our tissues.

[00:23:26] And understanding that, we got to move backwards, mobilizing things out of our tissues back into the bloodstream where the liver and the kidney can filter it.

[00:23:33] And this is why we, the principles of supplementation.

[00:23:36] So first of all, mobilization is often done through things like glutathione and you can take glutathione liposomally, IV, you can inhale it through a nebulizer.

[00:23:44] There's many routes and it does enhance our levels if we get the right source.

[00:23:49] However, you can still raise your glutathione through things like exercise, through things like mindful meditation, through things like taking precursors like N-acetylcysteine, lipoic acid, selenium, glycine, glutamine, vitamin C.

[00:24:04] All of these things help raise those levels.

[00:24:06] And what that does is help that mobilization process because our liver is always filtering our blood.

[00:24:11] And through phase one and phase two, it takes a toxic metabolite, transforms it into water soluble.

[00:24:16] It excretes it into our gallbladder for storage.

[00:24:18] And then that gallbladder squirts that out into our bowel.

[00:24:20] So then the other principle we often use is binders.

[00:24:24] Binders have an electrostatic charge and can include things like clay, charcoal, glycomannin, cholestyramine, well call, and many, many others.

[00:24:31] And these things will have a charge, a slight charge where they actually pull out that bile acid toxin load and escort it out through the stool.

[00:24:40] If we don't have binders, our enterohepatic recirculation is about 95% effective.

[00:24:45] So that bile with the toxic load can just get reabsorbed into the gut.

[00:24:50] So interrupting that with a binder is very, very helpful.

[00:24:54] So raising glutathione by multiple methods.

[00:24:57] Supporting the liver, things like melt the soul, super powerful for supporting the liver.

[00:25:01] Chologogs, which are bile acid secretion, things that allow more bile acid secretion.

[00:25:05] And then using binders are some of the core principles for detox.

[00:25:11] Okay.

[00:25:12] Very interesting.

[00:25:12] And I assume you're doing this in conjunction with everything else that you mentioned earlier, all the lifestyle things, even nutrition, the environmental things.

[00:25:23] And then right after that or along with that come the supplements and binders, correct?

[00:25:30] Yeah.

[00:25:30] And you mentioned the gut and then also the environment.

[00:25:32] So those are all like supplemental things.

[00:25:33] But one of the core things is mobilization usually involves movement, sweating, sauna, Epsom salt baths, dry brushing, all of these things that can actually help castor oil packs move the toxins out of our tissues into our bloodstream and then get filtered and get out of our body.

[00:25:49] So like infrared sauna is one of the key principles of detoxification.

[00:25:52] And I recommend people find a way to incorporate that into their lives.

[00:25:56] For me, it's about once a week after work.

[00:25:58] And ideally, maybe it'd be more like three times a week, but that's what I can do.

[00:26:02] And that's what I can do.

[00:26:02] So it's better to have a regular habit like once a week sauna than it is to have, you know, I do it for two weeks and then I forget to do it for a month.

[00:26:09] So I'd rather have someone do once a week sauna regularly than to do it for an intense two weeks and then stop.

[00:26:16] So habits are where it's at for detoxification.

[00:26:22] Interesting.

[00:26:23] Okay.

[00:26:23] I do have one question for you that is a bit more on the personal side.

[00:26:27] As a physician, I was curious if you've had patients that, you know, with all your experience, everything that you have to treat patients, have you had patients that you're doing everything right, but they're just not getting better?

[00:26:41] And if so, how do you kind of deal with that as a physician?

[00:26:44] That's more of a personal question for myself.

[00:26:47] So this is a great question because I see it all the time and I've been doing functional medicine for over 20 years.

[00:26:52] So I've seen a lot, a lot of patients.

[00:26:54] The first principle that I see is in the beginning, 20 years ago, patients had less complexity and less toxic load and they got better quicker.

[00:27:02] So what I'm seeing now, especially in the last four to five years, is there is more complexity to the situation as far as how many chemicals we're exposed to, how many diagnoses we have, how many symptoms patients have, how many infections.

[00:27:15] So there's more complexity and it often takes a little bit longer.

[00:27:19] And when we do all the right things, a decreased toxic load, clean air, clean water, clean food, the right supplementation, the right root cause treatment, if needed, treat infections, and people still aren't getting well.

[00:27:31] A couple of things.

[00:27:32] First of all, back to the mold situation.

[00:27:34] I can't tell you how many times I have suspected mold.

[00:27:38] They've done an inspection.

[00:27:39] Everything comes like clean or they do multiple types of things and they really tell me and I believe them.

[00:27:44] Hey, everything's good.

[00:27:45] And I cannot tell you the number of situations like that where we eventually find there was a missing piece.

[00:27:51] There was mold.

[00:27:52] They didn't know where it was.

[00:27:53] Someone missed it or however that happened.

[00:27:55] And at the end of the story, mold ended up being in their environment.

[00:27:59] So the first thing I always ask is, are we missing a mold exposure?

[00:28:03] Because as crazy as that sounds, it happens a lot.

[00:28:06] And mold can be very difficult to detect.

[00:28:08] And even despite great infections, it's not uncommon to miss a source of mold.

[00:28:12] Number two would be our own belief system about healing.

[00:28:17] Sometimes a illness can be beneficial and we don't know it.

[00:28:20] It's a subconscious thing that is keeping us in a state.

[00:28:23] For some reason, it's beneficial.

[00:28:25] So asking those questions, getting a good therapist, and then doing the work around old trauma and patterns of thinking.

[00:28:31] Because often we get stuck because we have a pattern of thinking that is no longer serving us.

[00:28:36] And again, I'm not the somatic expert, but I know plenty of people who are.

[00:28:39] And I'll often send the patient to do some of those somatic-based therapies, EMDR, thought field therapy, brain spotting, neurolinguistic programming, and so many others.

[00:28:50] Because those are the ways that we get unstuck from the subconscious patterns that are driving our...

[00:28:55] It's almost like a computer program, right?

[00:28:57] It's driving our system and we don't even know it.

[00:28:59] So until we examine the subconscious patterns, we can't really move out of that illness.

[00:29:08] Yeah, all very important points.

[00:29:10] I think the last point also is a way that patients stay in the sick role and that they identify so much with their illness that that's just...

[00:29:18] Even if they get better, I feel that they're so married to that illness that they just feel in that state.

[00:29:25] So a very important point.

[00:29:27] Maybe as a last, I want to ask if you had any messages for those struggling with mold toxicity or they just found out they had mold toxicity.

[00:29:35] Any maybe last words for them?

[00:29:39] Yeah, so this is a difficult thing and it can be totally overwhelming.

[00:29:42] And I find that even in my own situation, seven, eight years ago when I got mold toxicity, there's a readiness.

[00:29:47] There's a denial that kicks in, which means sometimes you're not ready to face the fact that mold is causing your illness because it often involves change in your environment, costly remediation or something that just feels a little overwhelming.

[00:30:02] And so not only do you have the treatment can be expensive, overwhelming, a little bit difficult, but at the same time, your brain is overwhelmed from the mold.

[00:30:11] So it makes everything worse.

[00:30:13] So if you're in the midst of this, I would just keep putting one step in front of the other, get a professional who can help you navigate that.

[00:30:20] And a great organization, nonprofit that has not only environmental experts, but doctors that are trained in mold is ICI.

[00:30:28] That's International Society for Environmentally Acquired Illness, ISEAI.org.

[00:30:33] It's nonprofit.

[00:30:34] And they have a clearinghouse of sheets and things that are helpful to get started.

[00:30:38] And also if you're looking for a doctor who's trained, that's a great place to look because they're going to know a little bit about mold and you might find someone in your area.

[00:30:46] And I guess the last thing is there's always hope.

[00:30:48] I mean, I've been sicker than sick, thought I was going to die, cancer, Crohn's, mold-related illness, and many other things.

[00:30:54] And one thing I never lost is the belief or hope that I could get well.

[00:30:57] So I've never been sick enough to not believe that there was something else possible, even in the midst of the darkest times.

[00:31:03] So I think the most important thing I'd leave you with is no one is past the point of hope.

[00:31:08] So no matter how sick you are, how much you've dealt with, you can always get well.

[00:31:15] It's a very important message, and I really appreciate those words.

[00:31:18] And so, Dr. Jill, thank you so much for joining.

[00:31:21] I really appreciate your time and your expertise.

[00:31:24] You're welcome.

[00:31:25] Thanks for the work you do, and thanks for having me on.