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Low SIgA and Why it Matters to Your Gut Health

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Low SIgA and Why it Matters to Your Gut Health

What is SIgA?

IgA is a type of antibody that protects against infections of the mucous membranes lining the mouth, airways, and digestive tract… it is your first line of defense on the mucosal lining and it makes up a majority of your entire immune system.

Some people have a genetic deficiency and present with low levels of SIgA and frequent infections.  Others acquire a low level after their intestinal tract becomes over-run with abnormal microbes.

SIgA helps to shape the composition of the microbes in your gut!

Extraordinary amounts of immunoglobulin A (IgA) are produced in your intestinal mucosa daily, it is known as SIgA and is secreted into the human gastrointestinal tract. SIgA production is driven largely in response to mucosal antigens (bugs or food) encountered by gut-associated lymphoid tissue (GALT).  It is clear that secretory antibodies are directed against at least two broad classes of antigens. The first is associated with enteric pathogens (the “bad guys” or infections) and their virulence factors, or things that the bugs secrete, like toxins.


The second broad class of antigens recognized by SIgA is associated with the intestinal microbes or commensal microflora (the “good” guys, like probiotics). In experimental animal models commensal bacteria are potent inducers of secretory antibodies; in humans, it is estimated that between 25 and 75% of intestinal bacteria are coated with SIgA.  This could explain why one of the most basic ways to improve levels of SIgA is to give a patient probiotics and saccromyces boulardii. 


There is also evidence from mice that secretory antibodies play an important role in shaping the composition of the intestinal microbiota, which in turn can influence your gut’s defense against invaders and enhance resistance to the intestinal infections.

  
Profound Role in Intestinal Balance and Your Health

So because SIgA can neutralize the “bad guys” and shape the “good guys” SIgA plays a profound role in intestinal balance and health.  SIgA is the main immunoglobulin in mucus secretions. The intestinal cells produce about 2-3grams of SIgA every day!  And production tends to peak in childhood and start to decline after about sixty years old.

This is our first-line defense against gut pathogens like bacteria, food proteins, parasites, fungi, toxins and viruses. SIgA antibodies prevent micro-organisms, food proteins and cancer-causing substances from binding to the surface of absorptive cells. Effectively, they attach themselves to invading bugs and trap them in mucus to prevent them from going anywhere!

The antibodies also ‘tag’ foods as acceptable to the body and this suggests why low SIgA levels can be a factor in developing and progressive food allergy and intolerance. Intestinal permeability is also related since, if levels are low, repair of mucosal tissues can be compromised.  This is often referred to as Leaky Gut and can coexsist with low levels of SIgA.

Certain SIgA antibodies have been shown to directly quench bacterial virulence, whereas others help with uptake of SIgA–immune complexes by mucosal dendritic cells and result in down regulation of pro-inflammatory responses normally associated with pathogens and allergic antigens.

In fact it is becoming increasingly evident that human health is inextricably linked to the gut microbiota, intestinal homeostasis, and mucosal immunity. IgA is at the centre of this dynamic. 

Testing your SIgA

Secretory IgA is quite independent of blood IgA levels so just because one is normal, doesn’t mean the other is.   SIgA can be measured in different ways, including stool and saliva. Levels can turn out to be low or high. Stool measurements have traditionally been based on sample extractions from animal models – it is hard to ask a mouse to spit! Salivary samples provide a systemic overview of circulating SIgA.

Ongoing low levels can help to explain why people can’t shift an immune problem like allergies, chronic skin conditions or infections. It can also explain why they find it hard to get rid of a microbial infection, too. Celiacs and those with IBD can have low levels and chronic stress has a major effect on SIgA levels. Certain medications can lower levels – including anti-inflammatories.   Other factors  includeviral infections (like Epstein Barr viruses), poor nutritional status, food allergies, ongoing stress. Interestingly some studies have shown variations in levels with gender and age – male patients often have lower levels.



* These statements have not been evaluated by the Food and Drug Administration. The product mentioned in this article are not intended to diagnose, treat, cure, or prevent any disease.   The information in this article is not intended to replace any recommendations or relationship with your physician.  Please review references sited at end of article for scientific support of any claims made.

Category: Gut HealthBy Jill Carnahan, MDSeptember 8, 201253 Comments
Tags: autoimmune diseasebacteriafungiIgAIgEIgGIgMimmune diseaseimmune systemleaky gutlow Iglow IgAlow SIgAmicrobesprobioticssaccharomycesSIgA
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Author: Jill Carnahan, MD

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Dr. Jill is Your Functional Medicine Expert! She uses functional medicine to help you find answers to the cause of your illness and addresses the biochemical imbalances that may be making you feel ill. She'll help you search for underlying triggers contributing to your illness through cutting edge lab testing and tailor the intervention to your specific needs as an individual. She may use diet, supplements, lifestyle changes or medication to treat your illness but will seek the most gentle way to help your body restore balance along with the least invasive treatment possible. Dr. Jill is a functional medicine expert consultant and treats environmental and mold-related illness as well

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53 Comments

  1. Stephanie says:
    August 30, 2013 at 9:17 am

    If someone has low SIgA, what should they do?

     Reply
  2. DocCarnahan says:
    August 30, 2013 at 1:09 pm

    Hi Stephanie,
    It’s important to find out why the SIgA is low and treat the root cause. I suggest finding a functional medicine doc in your area who does comprehensive digestive stool analysis. Often if the gut microbiome is imbalanced or there is an infection it will lower the SIgA. Other people are born with genetic deficiencies of IgA. Probiotics are helpful but treating the cause is essential.
    warmly
    Dr Jill

     Reply
  3. Fitness Kelly says:
    September 11, 2013 at 10:38 am

    What if SIgA is above normal? Mine is 76.149 on a range of 10.0-60.0 ug/ml (done by saliva test).

     Reply
  4. DocCarnahan says:
    September 11, 2013 at 3:40 pm

    High can indicate a chronic infection, like parasite or yeast. I suggest finding a functional medicine doctor to test the stool for infections and treat to balance your gut microbes.

     Reply
    • Fitness Kelly says:
      September 11, 2013 at 6:18 pm

      Thanks for replying! I do have an upcoming doctor appt.

       Reply
  5. Lauren says:
    October 16, 2013 at 7:35 pm

    My secretory IgA was recently tested via stool sample and came back as 10.6mg/dL and the reference range was listed as 54-204mg/dL. My doctor said that it was okay that it was low because that means there is no chronic infection; however, I have digestive issues and possible food sensitivities. I just want to be sure I understand this correctly. To me it seems that my IgA is low and could be a contributing factor to some of my current issues. Can you offer any insight?

     Reply
  6. Jill Carnahan, MD says:
    October 16, 2013 at 8:46 pm

    Hi Lauren, low sIgA usually means some chronic infection or dysbiosis or a stressed gut (food allergies, celiac disease, etc) Probiotics, saccromyces boulardii, and IgG or whey protein (if you are not sensitive to diary) may help.

     Reply
  7. Mew says:
    October 23, 2013 at 1:33 pm

    Very helpful! My ND was good at telling me what my low number meant, but seeing the explanation written out is very helpful at solidying the information for me. Thanks for the post!

     Reply
  8. Vanessa Kaufman says:
    October 17, 2014 at 7:50 am

    As a survivor of Stevens Johnson Syndrome, my health is beyond vulnerable. For over three years, I have followed a tight regime, isolating many irritants. My system considers most normal things toxic, responds intensely not limited to anaphylaxis. Being in the proximity of paprika, curry, peppers, cooked garlic/tomatoes, etc will cause violent anaphylaxis. Medications, supplements, foods, topicals, etc… all are huge problems. I am currently recovering from a SJS relapse caused by Xymogen ProbioMax Daily DF. I really was hoping to progress in healing yet have set myself back significantly. So, the solutions you mention are all unavailable to me. (Have not tried isolate saccromyces boulardii but don’t see why I wouldn’t react to that also.) Hoping you have some other insights. Desperate. (My mucus membranes have been destroyed; SJS burned me internally then externally.)

     Reply
    • Jill Carnahan, MD says:
      October 17, 2014 at 8:24 am

      Hi Vanessa,
      If you are not already doing, I suggest following a 100% organic, GMO-free, unprocessed paleo-autoimmune protocol to begin healing the gut/mucosa and immune system. You may also want to consider SLIT therapy to desensitize your immune system. Glutamine powder is helpful for rebuilding mucosal surfaces but as you already know use extreme caution with probiotics.
      warmly
      Dr Jill

       Reply
      • Aswini says:
        October 9, 2017 at 8:01 am

        Hi
        Glutamine powder is helpful for rebuilding mucosal surfaces but as you already know use extreme caution with probiotics.
        I couldnot understand this sentence. why should i use probiotics with caution? should not be taken along with glutamine? Kindly please explain.

        Thank you

         Reply
        • Jill Carnahan, MD says:
          October 9, 2017 at 3:33 pm

          You may take glutamine and probiotics together

           Reply
  9. Vanessa Kaufman says:
    October 21, 2014 at 6:20 pm

    This November, it will be four years detoxing from the offending drug that caused Stevens Johnson Syndrome. This trauma severely damages the mucus membranes; this is why I am interested in measuring SIgA. I have been following a tight nutritional regime for three years, not a deviation for over two. This recent relapse has me committed to bone broth again. My immunoglobulins are off; the more I learn I believe there is an amino acid imbalance too. How is saccromyces boulardii different from other probiotics in healing the gut? and is it dairy at the base? Much gratitude.

     Reply
    • Jill Carnahan, MD says:
      October 21, 2014 at 8:24 pm

      Hi Vanessa,
      Saccromyces boulardii is a probiotic yeast. Most are not dairy based and work well but should not be used in someone who is sensitive or allergic to yeast.
      warmly
      Dr Jill

       Reply
  10. Vanessa Kaufman says:
    October 22, 2014 at 6:21 am

    Thank you; I react to yeast.

     Reply
  11. megan says:
    September 27, 2015 at 12:27 pm

    I found out i have low SIgA. Testing was done maybe 5 years ago.
    My chiro assume its’ still low…
    Leaky gut, adrenal fatigue, lots of genetic mutations (COMT, MTHFR)
    LYME
    EBV
    HH6
    hashimotos (controlled with GF and anti inflammatory diet)
    candida
    possible mold exposure…
    help. LOL.

     Reply
    • Jill Carnahan, MD says:
      September 27, 2015 at 4:31 pm

      yes, could be any of these things… test don’t guess

       Reply
  12. megan says:
    September 27, 2015 at 3:26 pm

    also…
    my chiro put me on Saccromyces boulardi, if i have candid should i not be on this pro?

     Reply
    • Jill Carnahan, MD says:
      September 27, 2015 at 4:31 pm

      Saccro B is fine for fungal dysbiosis

       Reply
  13. Aanya says:
    October 3, 2015 at 1:29 am

    Hi Dr Jill!

    Loved the write up!

    I just found out that I have very low levels of SIgA (My level is <0.1 when the normal level is supposed to be 51-204 mg/dL). I live outside of the US and in a part of the world where functional medicine practitioners are non-existent. I'm hoping to schedule a consult with a practitioner in the US sometime next year but am wondering what I can do to support myself in the meantime.

    I've suffered from chronic skin conditions for about 10 years now and my diagnosis has not been confirmed but it's a possible overlap of eczema, psoriasis and pemphigus foliaceus (or so says the dermatologist). I also have multiple food intolerances (IgG mediated).

    My hair mineral analysis showed high levels of mercury, aluminum, barium and antimony and low levels of molybdenum. I also have low levels of vitamin C.

    I'm kind of stuck. Avoiding my trigger foods used to put me in remission but even that doesn't seem to help anymore. Like I said, I'm hoping to secure a consult with a functional medicine practitioner next year but am looking for ways to prevent further deterioration in the meantime.

     Reply
    • Jill Carnahan, MD says:
      October 3, 2015 at 6:04 am

      Hi Aanya,
      Yes, likely all of your conditions are related. The very first thing I would do is avoid gluten 100% in your diet. Second I recommend testing for dysbiosis with stool testing and breath testing for SIBO – then treat any infections that you may find.
      warmly
      Dr Jill

       Reply
      • Aanya says:
        October 3, 2015 at 8:30 am

        Thank you Dr Jill!

        I’ve been gluten free for several months now and my diet is almost 100% AIP compliant (the only exception being organic brown-rice which I seem to be okay with). I’ve also done stool tests which show no dysbiotic flora and fair amounts of beneficial flora. I haven’t done the breath test though so maybe that should be my next course of action. If an infection is found can it be treated using regular antibiotics (by a normal physician) or would a functional medicine practitioner treat it differently?

         Reply
    • Jill Carnahan, MD says:
      October 3, 2015 at 6:05 am

      Just came across this study today Immunoglobulin A deficiency in Celiac Disease in the United States

       Reply
  14. Gala says:
    April 23, 2016 at 6:19 am

    Hi Jill, Thank you for your article. I am wondering what you know of rectal ozone insufflation? My stool test showed SIgA at 22 (in a 400-800 range) I have dealt with chronic anal fissures that are triggered by too much fruit, sugars or alcohol, or sometimes just seems out of the blue. I have never been constipated so it is not a local trauma issue. I have tested for blastocystis h. and followed the Paleo diet with all sorts of herbs and probiotics with not much improvement. I am now taking s. boulardii and seeing such positives from it in regards to the quality of my stool. Do you think the rectal ozone will help the healing of the mucosal tissue (or be too irritating) while helping the body to irradicate any pathogen that might be the underlying cause? Thank you!

     Reply
    • Jill Carnahan, MD says:
      April 23, 2016 at 6:32 am

      I don’t recommend rectal ozone

       Reply
  15. Gala says:
    April 23, 2016 at 6:19 am

    Will it destroy the beneficial bacteria? Is that why you do not recommend it? Thank you.

     Reply
  16. Mzra says:
    July 2, 2016 at 4:03 am

    Hi,
    I have a severe low SigA. and I have a stomach cramps and bloating and also unstable stool.
    are they related to low siga? because my colonoscopy test result was normal. every thing was normal except low siga. What may cause low siga?
    regards.

     Reply
    • Jill Carnahan, MD says:
      July 2, 2016 at 6:55 am

      Hi Mzra,
      Low IgA may be a consequence of dysbiosis rather than a cause….
      warmly
      Dr Jill

       Reply
  17. Lynn C Richards says:
    July 8, 2016 at 1:25 pm

    Hi Dr. Carnahan,

    Do you recommend stool testing of secretory IgA or saliva testing? Is one better than the other? Also, can you recommend some specific labs that provide kits for both saliva as well as stool testing?

    I’m getting ready to do a baseline test then see if I get some improvement in the sIgA levels after taking anti-microbial herbs. So an easy-to-do before and after test (that is reliable) would be great!

    Thanks!
    Lynn

     Reply
    • Jill Carnahan, MD says:
      July 8, 2016 at 7:56 pm

      Hi Lynn,
      I recommend serum IgA and stool secretory IgA. I do not rely on salivary testing.
      warmly
      Dr Jill

       Reply
  18. Lynn C Richards says:
    July 9, 2016 at 9:09 am

    Hi Dr. Jill,
    Thank you for this answer! Can you recommend some specific labs with kits for the stool secretory IgA?

    If I get a couple of names, my physician said she would set up an account and get me a kit.
    Thanks!
    Lynn

     Reply
    • Jill Carnahan, MD says:
      July 9, 2016 at 12:21 pm

      Hi Lynn – Genova Diagnostics and Doctor’s Data are both good companies to use
      warmly
      Dr Jill

       Reply
  19. Lynn C Richards says:
    July 12, 2016 at 12:56 pm

    Thank you so much for helping patients via these emails! I appreciate the caring that goes into that.
    Regards,
    Lynn

     Reply
  20. Stephanie Stultz says:
    July 20, 2016 at 9:30 am

    I can’t thank you enough for this informative article!! I mentioned it this morning on the Facebook SOLVE ME/CFS Initiative site. I’ve had severe ME/CFS for 14 years and have done so many protocols and taken so many supplements, but still am disabled. As you know, no one has any idea YET what the cause is, let alone a ‘cure’. I still subscribe to the theory that I have to keep addressing anything ‘underlying’ in this 62 year old body! Recently I decided to ‘go back to the beginning’ and see what I missed (as well as the doctors) and realized that in 2003 my SIgA was highly elevated, but by 2007 it was virtually non-existent, a score of 11 with a reference of 400-800 (Diagnos-Techs Expanded GI Panel). So your article reassured me that it’s not likely the cause is genetic. I realize that no one addressed the SIgA, only the yeast, Blastocytis Hominus and a myriad of overgrowth of bacteria. We did completely eradicate the B.H. with Oil of Oregano and got the yeast candida completely under control, although it took about 2 years and a dozen different targeted protocols. I don’t have any food allergies and no pronounced food sensitivities (been tested numerous times) and tested negative twice for Celiac, which is a positive. I think however, I’m going to add the Saccharomyces Boularii and Glutamine Powder to my regimen before I spend the money once again for all the G.I. Tests. Thanks again.

     Reply
  21. Val says:
    September 4, 2016 at 8:06 pm

    Which brand would you recommend?
    Would you take probiotics as well and which brand as well? I have candida so would I treat that first then add it these?

     Reply
    • Jill Carnahan, MD says:
      September 4, 2016 at 8:10 pm

      Hi Val,
      I prefer Xymogen ProbioMax daily DF 1 daily or Klaire Labs Ther-biotic Complete. You can order from Xymogen directly using code: DrJill and last name Carnahan.
      warmly
      Dr Jil

       Reply
  22. Candice says:
    December 10, 2016 at 1:55 pm

    Hello!
    I have a low secretory IGA of 14.2. I have had constipation since I was 5 with recurrent body aches and headaches. Recently I have been trying to eliminate constipation since there is so much more info available these days!. I was tested to have blastohominus, strep and candida, and hashimotos. I have already been eliminating gluten and sugars and dairy for some time. Recommended treatment is a mainly meat/veggie diet for 10 weeks with a parasite cleanse. Low carb diets can worsen Hashi motos and I did have an exacerbation from this in the past. Also eating has become a full time job for me to maintain weight with these restrictions despite healthy fats. Will it be harder to fight parasites with low IgA? Is the low carb diet necessary to Eliminate these issues? I worried about creating more harm than good…Please let me know your opinion. Thanks!

     Reply
    • Jill Carnahan, MD says:
      December 10, 2016 at 3:09 pm

      Hi Candice, I suggest trying to find the root cause of your constipation and treating that…. candida, SIBO, or hypothyroid are all possible causes.

       Reply
  23. Leonardo says:
    March 6, 2017 at 3:40 pm

    Hi, I did a comprehensive stool test and the results showed dysbiosis and candida overgrowth. Other tests showed that my secretory IgA levels are extremely low. Can dysbiosis/candida lower our secretory IgA? I have leaky gut and multiple food sensitivities.

    Thanks!

     Reply
    • Jill Carnahan, MD says:
      March 6, 2017 at 5:20 pm

      Hi Leonardo – short answer is yes!

       Reply
  24. Patty says:
    May 13, 2017 at 5:55 am

    Hi Dr. Jill,

    I have elevated SigA, determined via a saliva test. I am treating SIBO and Candida, and have also been diagnosed with Hashimoto’s. It sounds as if both elevated SigA and low SigA mean kind of the same thing? I’m kind of confused about it and what should I be doing to address it. Is it just something that should normalize as I bring my body into a better balance? Thank you!

    Patty

     Reply
  25. Mandy LaGreca says:
    August 10, 2018 at 9:52 am

    Hi Jill,
    Are you aware of any studies that compare SigA before and after taking immunoglobulins, as well and determining if it improves oral tolerance? I am unable to locate actual studies.
    Thanks!

     Reply
    • Jill Carnahan, MD says:
      August 10, 2018 at 11:24 am

      Hi Mandy – you can search PubMed for studies. I do believe there are some small studies using Serum derived bovine immune-globulin

       Reply
  26. Pingback: Intestinal Parasites in Children - A Gutsy Girl
  27. Myriam says:
    July 6, 2019 at 1:23 pm

    Thanks for this excellent article. I recently had mine show up as 4 when the low range for the stool test is in the 500’s. This may explain my chronic childhood illnesses and ongoing digestive issues. What is the genetic SNP for low SIgA?

     Reply
    • Jill Carnahan, MD says:
      July 6, 2019 at 8:43 pm

      I don’t know a specific SNP for low sIgA in stool. There may be one for selective IgA deficiency which is diagnosed by low serum levels of IgA

       Reply
  28. Sheila says:
    August 13, 2019 at 5:05 pm

    Hello,
    Can slgA go down quickly after a violent episode of vomiting, and not eating well for a few weeks due to the recovery? I have never had digestive issues but in July had a severe stomach something that caused a lot of vomiting. Afterward I “tanked” and was so tired I ran an EBV reactivation test and DID test positive for that. Because I have never had food/digestive issues I wonder if this could have suddenly came about? My levels came back “sub 5” on the Data test. Thank you for this informative post.

     Reply
    • Jill Carnahan, MD says:
      August 14, 2019 at 11:09 pm

      SIgA can respond to infectious triggers and go up or down

       Reply
  29. Jennifer Kelly says:
    June 21, 2020 at 9:47 pm

    Can a person be born with a low IGA?

     Reply
    • Jill Carnahan, MD says:
      June 22, 2020 at 11:06 am

      Hi Jennifer – yes, selective IgA deficiency tends to be a life-long diagnosis

       Reply
  30. Jennifer Kelly says:
    June 21, 2020 at 9:52 pm

    I forgot leave this comment, no one in the family has low IGA just my mother.
    She started having problems at teens developing infections, her health fell down in her mid 40s now dealing really hard time right now she’s 56.
    She a person be born with low IGA?

     Reply
  31. Ken says:
    December 16, 2020 at 12:01 pm

    Hi, just had a sIgA score of 64 µg/g with a range of 100-1200 µg/g from a lab in Germany stool test. Is that a fairly low score or not to bad

     Reply
    • Jill Carnahan, MD says:
      December 21, 2020 at 10:03 am

      Hi Ken,
      Your sIgA is low and I recommend supportive measures such as bovine immune globulins and saccharomyces boulardii
      warmly
      Dr. Jill

       Reply

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Dr. Jill
Dr. Jill will help you search for underlying triggers contributing to your illness through cutting edge lab testing and tailor the intervention to your specific needs as an individual.
  • Address:
    400 S. McCaslin Blvd, Suite 210, Louisville, Colorado 80027
  • Phone:
    (303) 993-7910
  • Fax:
    (303) 993-4674

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  • Dr. Jill interviews Dr. Susan Sklar on Burning Mouth Syndrome https://t.co/8KZIFDYJt7 via @FacebookWatchyesterday
  • Dr. Jill interviews Dr. Terri Fox about a Functional Medicine approach to Biotoxin Illness https://t.co/4wjq0TxPdp via @FacebookWatch3 days ago
  • RECIPE: 30-Minute Chicken Meatball Tacos https://t.co/CfAUcFfjHz8 days ago
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Jill Carnahan, MD
Jill Carnahan, MD

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| Dr. Jill works as a functional medicine consultant in conjunction with your current health care team and is not considered a replacement for your primary care physician. She requires all new patients to have a primary care physician to cover emergencies and routine care and screening.

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Flatiron Functional Medicine Newsletter
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Flatiron Functional Medicine Newsletter
Join Dr. Jills' health community today and receive health tips, recipes and recommended products for a healthier you!
Join today and get Dr. Jill's Paleo-licious Snack Ideas for free! We promise never to share your email with anyone.
Functional Medicine Newsletter
Join Dr. Jills' health community today and receive health tips, recipes and recommended products for a healthier you!
Join today and get Dr. Jill's Paleo-licious Snack Ideas for free! We promise never to share your email with anyone.
Flatiron Functional Medicine Newsletter
Join Dr. Jills' health community today and receive health tips, recipes and recommended products for a healthier you!
Join today and get Dr. Jill's Paleo-licious Snack Ideas for free! We promise never to share your email with anyone.
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RESOLVE YOUR MOLD EXPOSURE SYMPTOMS
Dr. Jill's long-awaited Miracle Mold Detox Box is finally here. This handcrafted and researched bundle includes all of the crucial pieces you need to release and flush out toxins in 30 days.
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