In Episode #30, Dr. Jill and Michael Schrantz IEP discuss Mold Inspection strategies and how your doctor can work with indoor air quality specialist if you suspect mold.
View Environmental Analytics: https://environmentalanalytics.net/
Dr. Jill Carnahan is Your Functional Medicine Expert® dually board certified in Family Medicine for ten years and in Integrative Holistic Medicine since 2015. She is the Medical Director of Flatiron Functional Medicine, a widely sought-after practice with a broad range of clinical services including functional medical protocols, nutritional consultations, chiropractic therapy, naturopathic medicine, acupuncture, and massage therapy. As a survivor of breast cancer, Crohn’s disease, and toxic mold illness she brings a unique perspective to treating patients in the midst of complex and chronic illness. Her clinic specializes in searching for the underlying triggers that contribute to illness through cutting-edge lab testing and tailoring the intervention to specific needs.
Featured in Shape Magazine, Parade, Forbes, MindBodyGreen, First for Women, Townsend Newsletter, and The Huffington Post as well as seen on NBC News and Health segments with Joan Lunden, Dr. Jill is a media must-have. Her YouTube channel and podcast features live interviews with the healthcare world’s most respected names.
A popular inspirational speaker and prolific writer, she shares her knowledge of hope, health, and healing live on stage and through newsletters, articles, books, and social media posts! People relate to Dr. Jill’s science-backed opinions delivered with authenticity, love and humor. She is known for inspiring her audience to thrive even in the midst of difficulties.
Dr. Jill 0:12
Michael, it is such a pleasure to do this! I know we were together at the ISEAI conference this year online, and it was quite an event. We were both just talking before this about—wow!—it being like 12-hour days and so intense and so much fun. But it was an amazing amount of information. I always get excited talking to people like you because we have a common passion for helping patients who have environmentally related illnesses. So, welcome, welcome!
Dr. Jill 0:38
I'm just going to do a little housekeeping, and then I'll introduce you. Very basic here. If you want to find more YouTube videos, you can go to my YouTube channel. It's ‘Jill Carnahan' on YouTube. Michael has his own program; it's IEP Radio. And where can they find you for more information on what you've recorded?
Michael Schrantz 0:56
Absolutely, iepradio.com. If you go there, there's a wealth of information.
Dr. Jill 1:01
Awesome. Very cool. We just decided to do a co-recording here. We'll probably both end up having this on our shows, so you'll get that information in multiple locations. I want to just introduce Michael Schrantz. He's the founder and operator of Environmental Analytics LLC, a comprehensive indoor air quality consulting company that offers a wide range of services. There's his website, environmentalanalytics.net. You can find so much great information, a blog, and, of course, links to his podcast on all outlets.
Dr. Jill 1:35
But what I want to say is just personal about him. Here I'm a doctor for mold-related illness, and what I love to do is help patients—like my own journey—get out of a moldy environment and then get well after that. I always say I can diagnose you and treat you in the clinic, but nothing I do is really going to stick or make a massive difference in your life if you're still living in a really moldy environment. And that's just the truth. So I need people like Michael. I value him so much because of his expertise. What we're so grateful for at ISEAI is that we have someone like him on board, creating protocols, writing up the latest data, and really helping guide us doctors.
Dr. Jill 2:14
So today, what we really wanted to dive into was: How do we work together better? So whether you're a patient listening online and you want to have your doctor work with an IEP or understand more about what they do, or whether you're like me practicing and you're listening, if you're a colleague and you're struggling because in your area you don't have a great IEP, we will dive into that and what to do. I know that one of the great things about Michael is that he does virtual consultations. Before we dive into exactly what you do and some of the questions, I want to know your story. What got you into this, Michael? And how did you get to where you're at now?
Michael Schrantz 2:47
Dr. Jill, thank you for having me, first off. I was looking forward to this interview because it's going to be so rich for people who are in the struggle that you've identified. I'll try to give you the two-minute elevator speech. For me, it started… Actually, [it had] nothing to do with chronic illness. I was 16 years old and working for a local air conditioning company. I was at the bottom pole of learning about the basics of airflow. And of course, did I know that it would turn into what it is today? No. As I went through high school and college, I still didn't think I was going to become an indoor environmental professional. I thought I was going to be a cog working for some corporate company. But I just found a passion because, while I was doing that—the division of the air conditioning company had indoor air quality—we were out looking at things and trying to solve problems that people weren't able to solve. And it was a very rewarding thing where we would go out there and diagnose the home and figure it out. And then fast forward through getting certified and learning more and more about indoor air quality.
Michael Schrantz 3:51
What happened is that one day a lady by the name of Dr. Mary Ackerly came knocking on my door with a mutual client and said, “Hey, I saw what you did on this particular home, and I like it. Let me explain a little bit about the people that you're dealing with.” Fast forward five to seven years later, and it's been the most rewarding thing to be able to not only understand people who have chronic illnesses but [also] understand what the concept of low-dose environmental exposure means. Unfortunately, the traditional paradigm with a lot of the inspectors out there that even mean well are missing a lot of the low-hanging fruits because they don't know that those fruits are there.
Dr. Jill 4:29
Oh, I love that. So your initial interaction was kind of like what we're talking about now: How do we actually get together? And I'm sure Mary, who I love and appreciate so much… It was very similar to me. We realize our hands are tied if we don't have good people in the field. And we can learn, understand, and do little, tiny bits, like guide them. But we are not the experts. Again, by default, we have to learn a lot about it, and I've become just enough of an expert to guide them to people like you. I want to know more. Tell us what kind of training you've had or how you got to be what you've been. And what is IEP?—for people who've never heard that term. Let's go to the real basics.
Michael Schrantz 5:06
Okay, sure. So IEP stands for Indoor Environmental Professional. It's kind of a generic term. It's meant to be broad and all-encompassing for people who do environmental work. But I mean, it can cover a wide range. It's not just about mold. You can have people who deal with chemical exposures and that sort of thing.
Michael Schrantz 5:25
Predominantly, a lot of the certifications that I acquired came through an organization called the American Council of Accredited Certification, or ACAC.org. And I carry a couple of certifications through them. One of them is a Council-Certified Indoor Environmental Consultant. Another one is a Council-Certified Microbial Investigator. And I carry a couple of other certifications, one of which is [from the] Building Performance Institute, which really is just trying to capture knowledge about how a building breathes, how it operates. I didn't go to a school of public health. There's not a formal degree program that I'm aware of that you can go to [for] a college or university level. I had to build upon multiple certifications to get to where I'm at today.
Dr. Jill 6:08
Yes. I know you are one of the best in the field. That's why I wanted to really bring people's attention to this, number one, the level of information that you have, especially with how you work with physicians and patients. What I see is a lot of people who've been in the field and maybe know how to find mold in the wall. They have no clue how it affects the human body. And maybe I can speak to that really quickly because we have these people called ‘canaries', and Mary and I, 90% of our office are patients that are super sensitive, and they have mast cell activation, so they're extra reactive. So what we deal with is this subset.
Dr. Jill 6:44
Say you have a house that has mold. You remediate it, and you find out the problem and the issue. There might be 80% or 90% of people who can go back in there, no problem at all. But what we end up having, between you and me, is this subset of really, really super-sensitive patients. And it's not always mold that's the issue. Tell us just a little bit about what else can be in the environment that can make this, whether it's dust or VOCs from other sources… Go through just a little bit of the spectrum because we always think about mold, but there's a lot more to it than that, right?
Michael Schrantz 7:11
There is. And to segue into that question real quick, I think that's the trigger. A lot of what we're working on is pioneering work. While there might not be a degree, what we're learning is from references, peer-reviewed studies, and consensus among peers of what we're seeing, what we know about sampling, and what we know about an exposure. The good news is that we are actually working in bed with a local university here, trying to create a program that will one day provide a certification or degree for IEPs because it is broad.
Michael Schrantz 7:42
To your question. A lot of the people that we work with have some sort of immune or inflammatory response to a whole host of things called a soup. And everyone knows that when we think of water-damaged buildings, we hear about mold. Mold is the celebrity surrogate that can represent a lot of different things, including bacteria that we sample for. But you also have other things, right? We have things like chemicals, [such as] volatile organic compounds. We have the general makeup of the home.
Michael Schrantz 8:08
Depending on what reference you look at, what you believe in from the standpoint of… Say, for example, CIRS. We know that high particulate counts in a home—it's not even limited to, say, mold or bacteria; it could just be the fact that your house was very dusty—somebody could have an inflammatory response to that. And now, with the segue of EMF, we're looking at those sorts of exposures. There is a soup of things that both the IEP and the clinician are presented with. We try to work together as professionals to say, “Is there any way we can narrow this down?”—because most people can't have you show up in your vehicle and do $50,000 worth of sampling. That's the struggle.
Dr. Jill 8:55
Yes. So I want to tell you [about] a clinical scenario that I might have. And then I want to hear how you would [handle it]. And even if you advise me, “Hey, Jill, next time you could do this” or that, I really am open. I want to hear it, because that's why we're here. Say here, I'm in the office with a patient. A typical patient that would come in is maybe a 45-year-old female who has started to have more fatigue, more headaches, migraines, and brain fog—it's this elusive term that is not medical at all. But it usually means trouble with word finding or a little bit more cognitive issues with memory. Sometimes they'll notice a lack of focus or concentration.
Dr. Jill 9:32
For me, when I was in the mold, what I noticed was that I could normally write a blog article in an hour, and then all of a sudden, with the mold, it took me longer to slog through. It was more difficult. The concentration it took to sit and read, write, or do the things that I used to do during the mold exposure just took me longer and [required] more effort. Like, my brain was tired. So brain fog is kind of this big term, and that's super common. I would say mental clarity, or brain stuff, is probably one of the number one things we see in a moldy environment.
Dr. Jill 10:00
But then it can have things like rashes, histamine, and more allergic responses to food. I've had heartburn via the MCAS reaction, where people go into a moldy home and have heartburn. So, again, this 45-year-old woman has a myriad of complaints. I look down her list. I'm like: “Ugh! This is concerning. I need to go down this pathway.” And I might look for metabolic issues, thyroid issues, adrenal issues—everything. And in my battery of tests, one of the things I typically do is [look for] markers in the blood that show inflammation. Then I will also do urinary mycotoxin testing. None of these are one-size-fits-all.
Dr. Jill 10:32
So then [there are] markers in the blood, things like TGF-beta, MSH, MMP-9, VEGF, and then C4a and C3a. If I see a pattern that's concerning for immune inflammation activation based on an external trigger and then I see urinary mycotoxins that are high, I say: “We need to make sure. We don't know for sure yet, but we need to make sure that mold is not in your environment.” So what I would typically do is say, “Depending on what you can afford, you might try just to get your brain around this.”
Dr. Jill 10:59
Sometimes what I do, Mike, is a little secret thing. And what it is, whether it's testing them for food allergies or testing them for mold in their environment… Even though I know, like an ERMI dust sample—we'll talk about it in a minute, and you can speak to that and the validity—they're not the best. They're just a tiny little sample of one little piece of the environment. It does not tell you—'yes' or ‘no'—there's mold. But it's one thing. They have control, and it's fairly inexpensive. And what I see that happens when I do that is they give me the report, and I'm like: “Oh my gosh, you have 30 Chaetomium. I don't like that,” or even 5.
Michael Schrantz 11:29
You're cheating. That's a low-hanging fruit, but I like it. It's very valid.
Dr. Jill 11:31
Right. Okay. So let's say there is [a level of] 200 Aspergillus. I'm still like, “Ugh!”
Michael Schrantz 11:36
All right, all right.
Dr. Jill 11:37
Right, okay. So then what I do is like, “Okay, look at this. You need to go deeper.” And then they'll call you. And sometimes it's the way to get them to buy in. And I would love to hear your opinion on this if you have other advice for me. But I feel like what happens is [when it's] on black and white paper, I can make an argument for them going deeper and getting the right inspection. In a second, I'll have you explain the dust plates and the ERMI sample. But if they do these [things], these are not the end-all, be-alls. And you and I both agree. I don't even use the ERMI score. I don't like it. It's not valid.
Dr. Jill 12:08
But I do look at the individual species, and if I see a pattern in one thing that's way off the charts, I'm like, “Where did that come from?” It just makes me question. But then I can usually get them to call someone like you, and then you come in, and then you can help the process. But what would your comments on that process be? What would you change or do differently? What would you advise us?
Michael Schrantz 12:27
You set the stage up very good for me. You tossed me a lob, so now I can swing away. I love this. I'm salivating. So what you did right—selfishly for me, from my perspective—is that you did the part of the clinician up front and you helped us. You were looking at cytokine activity or urine analysis, and you were trying to use biomarkers—again, nothing's black and white—to support the idea of, “Is my patient being exposed to some sort of exposure?”
Michael Schrantz 12:53
And for the sake of this conversation—because both of us know this could go on for weeks if we did everything—say it was mold exposure we were concerned about. The first thing I would do as the IEP is listen to [information] about the patient. So you've given us some information. “Here's my background. Dr. Jill came back, and she says that I have upregulation of these genes. She thinks that I'm currently being exposed. I'd like to take a look at that home.” “Okay, thank you. That helps me.” In other words, we're not necessarily looking for EMF. I'm not saying that you're blind to it, but our focus is definitely going to include mold.
Michael Schrantz 13:27
We would normally start with—after sitting down with the client and learning that information—a very good visual assessment. And it's the things that I've heard you talk [about] with a host of other wonderful people on your show. You're looking at the low-hanging fruits. You have a basement, a crawl space, the attics, the plumbing leaks, the landscaping, the swamp cooler, the HVAC system. And you're trying to see if there are any low-hanging fruit or issues that we can point at and say, “You don't necessarily need to sample this for me to tell you that you need to remediate it.”
Michael Schrantz 13:57
But the vast majority of times, people don't call me up because they have 20 square feet of mold growing up a wall and they just want me to confirm it. I don't get those easy ones. The ones I get are the ones where we either don't see anything or it's always this ominous, “Well, we had a leak, but it wasn't a big deal.” Or the classic, “I think it's a problem, but my angry spouse doesn't think it's an issue.”
Dr. Jill 14:23
Little did we know we'd be relationship therapists too, right?
Michael Schrantz 14:25
Oh my gosh! As Mary told me, you have to have an associate's degree in that just to have this because it's very real. And a big part of what I think is missing in professional practice is the heart, the love, and the ability to connect with healthy boundaries so that you can truly understand what this person is dealing with, or else you won't know how to communicate with them.
Michael Schrantz 14:45
But at the end of the day, you might end up looking at sampling. And I won't go eight levels deep with you, but [I'll give] a couple of basics. IEPs have tools they can use. And beyond any visual things—like a pair of eyeballs and a flashlight, an infrared camera, or the moisture meter that you're all familiar with—we do hear that there are different types of samples. I think the takeaway is: What can the sample help answer? So if you're doing qPCR analysis, and a lot of people know that as ERMIs or HERTSMIs, are you working with an individual who can look at it? If you get a chance, let me share my screen. I want to share something with you.
Dr. Jill 15:21
Michael Schrantz 15:23
But can they look at the data and maybe take control samples outside, knowing what they would expect to find inside this home? We call that normal fungal ecology. The term mold-free is misunderstood by too many people. I think what people are trying to say is that they don't want to have mold growing in their house, but they're going to have normal backgrounds from the outside.
Michael Schrantz 15:45
I'll share this with you real quick. For example, this is just a quick sheet of what I've taken of hundreds of qPCR samples, where the little gray columns you see flashing by are outdoor control samples. And I have a whole bunch of individual species, and I've been able to look at that. And you see what's normal. It's no different than people talking about spore trap sampling and comparing indoor to outdoor. Here's my point: You want to work with a professional who can look at the house and use tools that might be able to identify something that might not be able to be identified with other methods. I love petri dish samples. I think it boils down to: “What can you help answer?”
Michael Schrantz 16:28
If somebody does a DIY because they initially just want to see what's up, I don't have a problem with that. If you're working with a disgruntled husband or you just want to wake the people up to, you know, “Hey, you might have a problem here,” that's great. But when you bring in a professional, a professional is going to want to reference indoor with outdoors. We need to know what's normal. So it's using the tools to ultimately help isolate a problem.
Michael Schrantz 16:51
What if the master bedroom comes back elevated? One example of a thousand. Upon further reflection and investigation, you find out that the master bedroom had a crawl space access door, and there was a known problem that was identified in the crawl space. Is the reason why the master bedroom is elevated because of that potential area or something else? So it's working through the minutiae of the history and knowing what's there to figure out: Can an area sample like a QPCR, spore trap, petri dish, swabs, or tapes help answer the question? Or do we need to get into wall cavity sampling? Do we need to start punching into walls a little bit to see if we can locate the actual source?
Dr. Jill 17:32
Yes. Oh, there are so many questions that come to mind because I've got you here, and this is so great. So a couple of things. I want to go through what I would talk to patients [about] like questions. I want you to add if there's anything because, people listening, the first thing I find—I found this five years ago—if I just say, “Do you have mold in your house?” almost 100% of the time, I'm going to get a “No!” Or even better, “We've already had three inspections and they've all come back fine,” or five or more. This is so common. I call it denial because I went through that too. And there's a piece of denial, and then there's a piece of the reality that no inspector is perfect.
Michael Schrantz 18:08
Dr. Jill 18:09
Yes. And the same with physicians, right? We're trying to find answers with lots and lots of data, and it's not always easy to come to a really concrete conclusion. But what I look for are patterns. I know you do, too. We're pattern recognition detectives. So what we're looking for is: What do all the clues lead to? So when I'm looking at a patient, I get this all the time: “What's the one mold test?” There's no one mold test. There's no one environmental test. So whether I'm the physician or you're the environmental air quality professional, there's no one test and no one way.
Dr. Jill 18:36
But I want to go back to the questions. So what I'm typically doing instead is the workaround: “So do you have a swamp cooler? Do you have any crawl spaces? Have they been sealed? Do you ever smell a musty smell? Have you ever had leakage from your sump pump in your basement? Do you have a basement? Do you have a sump pump? Is there concrete? Is there carpet? Is there tile? Is the tile loose? Have you ever had leakage in your toilet, bathrooms, or under your sinks? What about your garbage disposal? How about your washer and dryer? Do you have a front-load washer or dryer? Does it smell bad when you take the clothes out or when you open that up? If you looked in the gasket, is there black gunk in the gasket? What about your windows, are they sealed? Do you ever have condensation on the windows? Is there leakage around the windows? What about your attic? Is that connected to the airspace to your home? Are there dead animals in your attic? Are there urine issues with dogs or cats in your house or attic?”
Dr. Jill 19:24
So these are just some of the things that I think about because then you get them thinking. And they'll be like, “Oh yeah, my washing machine flooded, and it actually went through the floor and down below. And we just put some fans out and dried it out.” What would you say to that?
Michael Schrantz 19:40
My instant response in my head was a yellow flag, and it might be upgraded to a red flag. And it gets even worse. First of all, those little nuggets that you gave are brilliant, not just for clinicians that are listening but for patients and people that are wanting to learn more. Maybe they're struggling with their own justification to take the next step, which we can get into in a little bit. Or they have that disgruntled spouse issue, which unfortunately is more common than I'd like to admit to everybody.
Michael Schrantz 20:07
I think, at the end of the day, it's an assumption that's being made. “Yeah, but we put a fan on there. We have a little Honeywell fan that we bought for $10, and we blew out this wall.” I hate the expression, but the devil is in the details. I think that the act was great and valiant, and I'm so glad and happy that you were proactive. We talk about fears. We don't want to make a mountain out of a molehill, but we can't just ‘la-la-la-la-la' and act like there's nothing in that wall because you put a 10-inch circular fan on it [that is] blowing on it. There are so many different areas that could have stayed wet long enough for microbial growth, and that's ultimately one of your concerns as a clinician and an occupant: Exposure from that area.
Dr. Jill 20:47
Yes. Again, this is new to me, but I really start to understand—whether it's the lights on your ceiling, the can lights, or whether it's the outlets, or whether it's your attic space that connects or your crawl space—why is it important for people to understand the envelope of their home and keep that air quality as pure as you can and without interference? I'll just give you an example. In my current office, before I ever moved in, the office below me had a slight mold issue, and it got remediated. My office was perfect, but I realized that by actually sealing the outlets—all the wall space that connected between my office and any other part of the building—I have this, like, bubble of my office. And part of that is very deliberate because there's no air contamination from the other parts of the building. Why is that important from the attic, crawl space, etc.?
Michael Schrantz 21:36
Absolutely. I was trying to pull up another photo I wanted to share with everybody just because it will help. I obviously stole this here on Google from the EPA's website about leakage. We're dealing with the issue of a conditioned space versus unconditioned spaces. I'm sure that if you're an artist, you can explain this differently, but here's how I explain it: You have the most control in the areas that you live in and occupy. But there are a bunch of spaces in the home that you don't really condition or control—you don't vacuum them, you don't control the temperature or humidity, that sort of thing. Attic spaces are a big one. Crawl spaces are a big one. Interstitial wall cavities are a big one.
Michael Schrantz 22:16
Listen, our goal isn't to create a glass house for you. There are so many complicated issues that I don't know that we have time to get into the fact that almost every house that's got wood framing is going to have some percentage of lumber yard mold on it, and we consider this maybe normal. Here's my takeaway: If you can separate and isolate the non-conditioned spaces as much as possible, you have more control. To what Jill was saying earlier, you have can lights. And these arrows are not meant to be just one way; they can be two ways.
Michael Schrantz 22:46
[With] summertime in Arizona baking up that attic and getting that temperature nice and hot, you're going to have a driving force—all other things being equal—into the home through these penetrations. And that exists even from the crawl space to the home. So beyond identifying a source that is justified by a professional and needs to be remediated, you still try to minimize the communication from these areas. And I'm not talking [about] energy efficiency. That's a whole other thing. I just mean that from an environmental standpoint, if you can protect and seal off your environment as best as possible—there are some things we need to think about when we do that, like ventilation and how sealing up the house affects ventilation—you'll minimize the communication from these interstitial spaces, which can also serve as pathways for contaminants to get into.
Michael Schrantz 23:33
I had an issue in my wall. There was growth there. I never knew about it, but unfortunately, I had a very leaky wall, and it got underneath and it communicated in my home. You're not always going to know. We don't have ‘mold-ray vision'. So even with the best of practices, unless we rip that house down to the studs, we're going to be relying on ancillary data testing and visual evidence history. And in a situation like that, you may not be able to identify that so quickly. So thank God that, in your situation, you were on the latter end of your story. You were able to seal these things up, and all of a sudden it improved. Not a surprise.
Dr. Jill 24:06
Yes. Thanks for speaking to that. And you and I have talked about this before; you're never going to get a perfect space. There's mold—there's outdoor mold, there's indoor mold—and there will be some contaminants in our environment. But where is that threshold? And this may be our next area of discussion. So as a clinician, I'm saying, “How sensitive is this patient?” And “Do they have mast cell activation and other things that I can help moderate?” My goal is for them to be less sensitive like me.
Dr. Jill 24:35
Years ago, I was so sensitive. I could barely travel. Now I travel all over and get mold exposure, and it's not that big a deal. I mean, I just take some charcoal, and I'm better in a few hours. But it's not as big a deal as it used to be because I'm less sensitive. So the goal is to decrease the sensitivity. But usually, when you and I first see the client for you and the patient for me, they're incredibly sensitive. So we do have to figure out the big issues. We take care of them. You come in, find [the issues] and give them advice. But there may be some ways to ongoingly maintain their home and get it to a place where they can live, work, play, breathe, and survive in it.
Michael Schrantz 25:11
It's a great topic. It's always a tricky one. I don't think it's tricky with us just because of how we are, but a lot of people struggle with it. To me, it's like a bell curve—there are a lot of different analogies—like the return on the investment. And on the backside of the curve is that person who has known issues that you want to take. It's like triage. They have a moldy crawl space. They had a flood in the house—in their basement. I mean, you almost don't even need sampling, or maybe you do, and a professional is able to find it. And I presented on this in 2019 at the ISEAI conference—it's such a wonderful topic—what is the goal? I mean, really, the goal is patient recovery.
Michael Schrantz 25:48
But there's not a set line. It's not like Jill or I can say 14 spores of this species are good, but 15, and your arm is going to fall off. What we're looking for is an honest and trustworthy assessment of what that person feels is normal fungal ecology. I'd like to expand that to normal microbial ecology as we start looking at other things like bacteria. But the point is still the same, [which] is: What is normal for that home? And normal is your outside influences, [which] is primarily what we're talking about. Normal would not be mold growing and releasing structures and other contaminants into your home. That's not normal. So that's the goal.
Michael Schrantz 26:25
Now, whether or not—if I could go one step further—normal is good enough for that person, and assuming that you, the patient, or you, the clinician, feel that you've had trustworthy eyes on that home to give it an honest assessment, you start to wonder number one: “Could it be something that's not related to the mold?” just as an example. And the other thing is that maybe they're hypersensitive. I have lots to learn from you, Jill. If their bucket overfloweth and they have no room for any exposure, is it possible that the fact that they live surrounded by trees in North Carolina with a river that's 20 feet away [means] that the outdoor ecology is building up in concentration in their home, and for that individual—this is a question, not a statement—it's just too much for them? And is there a way that we can turn that sanctuary into more of a sanctuary, knowing that we haven't identified any actual growth in the home?
Dr. Jill 27:22
Oh, I love that you said that because we always have this narrow [view] of mold, which is definitely a big focus, but it's bigger than that. And I just think of two examples. One is after the World Trade Center and the contaminants that rained down after the fire in that building—literally, VOCs and everything you could possibly imagine. These people got really, really sick. Their respiratory tract was affected. I have a friend in Boulder who was there at the downing of the World Trade Center. He is still not the same—[his] immune system and respiratory system. And clearly, mold probably wasn't the main issue; it was all the other contaminants and the very fine particulate that got inhaled. So that was a situation where the environment was so massively toxic that it permanently affected some of these people.
Dr. Jill 28:03
The other thing I think about is after Hurricane Katrina and some of these hurricanes, where the environment in Louisiana or some of these places becomes so contaminated. And I see you're touched there. Is there anything you want to share? Like, just from the tragedy of…
Michael Schrantz 28:17
Well, we see it all. I'm fortunate to say I don't have direct family—I do have friends—who were affected by 9/11. But what you actually touched on right here has more to do with the general struggle. You get caught up in it. And we're human, too. And this is what you need—you need caring. We've got to harness it in too when you need us to perform, of course. But you need somebody who is caring because it does affect you. The good news is that you don't have to feel like there's no way out. Your body is resilient. You may not be operating in tip-top shape, but the fact that you're still alive amidst all these other exposures [means that] your body is battling many battles and winning these battles. You just need a little bit of help, guidance, and understanding.
Michael Schrantz 28:57
So where it's at for me right now is just understanding that a lot of people are stuck. Most people who reach out to me have kind of the same story as you. You're not the first person. You pray and hope you're the last person. And when you see the amount of money they've spent without getting anywhere… I don't care if the money was worth it; you're worth it. But they spend their tires, or they get bad information, or they go on social media groups that mean well but give unqualified advice on things. I've seen families uproot their lives and get divorces—I had one do it right in front of me—because of a bad ERMI score. And I don't care if it was a—fill-in-the-blank—petri dish mycotoxin dust sample. I don't care! It's not black and white, folks. We live around this stuff, and there is some normalcy to it.
Michael Schrantz 29:54
I think it's a matter of working with righteous fighters like Jill and I tend to be and trying to guide you through, “Okay, well, here's the low-hanging fruit.” We agree unanimously that this needs to be taken care of. And as you get on the other side of the curve, it is a process. This journey doesn't take weeks. And I want you to hear this. This journey takes months or years because you've been this way for… If you're genetically like this or you've been dealing with this for most of your life, I wish there was a light switch. And I'll tell you what: If Jill and I find one, we'll tell you what it is, and we'll have it on Amazon. But it might take time as you recover.
Michael Schrantz 30:25
And as you recover—we've all seen this before—your road to recovery isn't this: [making an upward motion]. Your road to recovery is a roller coaster ride, and you hope that you're trending good. And as you and your clinician are monitoring using those biomarkers that Jill mentioned earlier—or the urine, whatever cluster of symptoms, whatever that clinician really feels is a good marker for you—then we can adjust as environmental professionals: “How much more aggressive do we need to be? Do we want to improve the ventilation in the home? Do we want to add better filtration?” “You know what? I think it's time to get rid of those carpets now after all because they're reservoirs.” We don't just say ‘E' for all of the above on the backside of the curve. Let's deal with the obvious and tweak it as we go because there's no textbook that I can find that gives you a ‘how to do' in every situation and you'll be guaranteed success.
Dr. Jill 31:11
I love that. I knew we would get along so well. And people will be like: “Well, Doctor, do I have to get rid of all my books? I have a library in the house.” No. Store them away if you're concerned. Put them in plastic bins in your garage. You can always go back later. That's what I did. I had my whole medical school library. Later, I opened them up. They were still really reactive, and I thought, “You know what?” For me, it wasn't worth it to keep them. But that's not the decision you have to always make for the time being. And there are valuable things. You [can] just store them if you're concerned.
Dr. Jill 31:38
I love the stepwise approach because that's part of why the denial is there because it affects relationships. If one person doesn't believe you, you have to actually go up against that in your relationship in order to get well. That's a hard thing. I completely understand why there might be denial. Then there's also the denial of: “It's going to cost money and time.” And “Do I have to move?” Not everybody has to move. And I love your sensible approach because I couldn't agree more.
Dr. Jill 32:05
Speaking of social media, recently someone was very angry at me and cited me as someone who says that you don't have to avoid mold. I've never said that. I actually think that mold avoidance is a good starting place for the most part. We live where there's mold indoors and outdoors, so you have to become more resilient. The reason they said that was because our group, ISEAI, has been talking about the fact that there is trauma also associated with mold and exposure.
Dr. Jill 32:29
Not only do we want to deal with the mold exposure—the physical, the mental, and the well-being—but how do you get this limbic loop of fear to stop going and making it worse? That's a relevant topic. It doesn't mean that we don't want people to avoid mold and get well that way. And mold avoidance is not a great term because you can't avoid mold completely. So that's just a misnomer. I still believe: Yes, get out of the moldy environment. You won't get well unless you get into a fairly clean environment.
Michael Schrantz 32:58
So two points. Number one, I don't want to forget, so I'm going to say it right now: Limbic system. But the first point is also: Honor health. That is the goal—we want to honor the health concerns. To your credit, when we were doing the conference recently for ISEAI, we were doing a little bit of Q&A. It's always tough when somebody throws you the question: How do you deal with contents? And you were my wing-woman and you helped me on a couple of things, one of which was mattresses. I thought you knocked it out of the park. When you look at the intimacy of the item and how much you might be exposed to it in certain situations—first of all, there's going to be a general agreement that you don't want to have a moldy bed—we don't just trip over ourselves without consideration of its history. People need to hear that.
Michael Schrantz 33:43
For those of you that say, “Well, well, they just said, ‘Get rid of everything.'” No, we don't say, “Get rid of everything.” Let's talk about it first and see what that item is, how easy or challenging it is to clean, and how you might be able to either get rid of it or get it out of your environment. The analogy you used was to store it in a secure location. Get it out.
Michael Schrantz 34:02
I use this analogy all the time, and for some people, it clicks really well: Your life—you're the patient who's struggling—is not X plus Y equals Z. Your life is X plus 99 other variables, [which] equals you. We are trying to remove the variables, the unknown ones, without you having to get a second mortgage or divorce, so that we can get you out of the fog that you're in and start your life. It might cost you a lot to throw away that $1,000 mattress—I don't got my handy-dandy calculator here—but I'm guessing you spend a lot more in treatment and other ancillary costs that we haven't even touched on.
Michael Schrantz 34:39
For the first part, just on contents, real quick, and I'd love to get your thoughts on this, is the limbic system issue, the PTSD, because I'll tell you, if people asked me, “Mike, in 2019, what was the biggest thing that you saw with the most improvement? Was it a special test? Was it a special remediation technique? Or what was it, Mike?” None of the above for me. The biggest thing was dealing with the limbic system. It doesn't get rid of your core diagnosis. You're still going to have CIRS if you have CIRS. But I saw people who I had worked with over months and years who, all of a sudden, took a couple of the well-known programs that are out there, and they were a different person. It was like their utility came back; the smiles came back. They were just a different person. Where do you see that falling into your experience?
Dr. Jill 35:34
Oh, I love that because, again, my experience… If I talk about my experience, it doesn't mean I think all my patients are like me. I treat people so individually. But all I have inside me is what I experienced, to go so far as to tell you: “This is what I felt.” And I say that because this was actually a massive ‘Aha!' for me personally to realize there's this tagging of trauma and mold. The mold itself stimulates through trichothecenes. This is science-based, guys. Like, this is not esoteric—you know, woo-woo. There is science that shows that some of these toxins that are produced by mold, called mycotoxins, will actually stimulate areas of the brain like the amygdala and the hippocampus. And we can actually see on MRI imaging and other ways where there's atrophy or hypertrophy in the different areas. Usually [there is] more hypertrophy of the amygdala, which is your fight or flight or scared type of response, and more hypertrophy of something like the hippocampus, which is memory and word finding. These are objective findings.
Dr. Jill 36:38
And what I realize is that in treating, we can get the environment clean, we can detox the patient—do all the things we need to do—but there's still a lot of fear around re-exposure and around their health. I experienced it way back five years ago. I remember being terrified of getting sick again or getting re-exposed. Just to validate you, if you're listening out there and have had mold, it is so hard. You get so sick, and you can't think straight. You are spending money that you don't have. There are so many things that are very difficult about this, and it is so mysterious. And because you look okay on the outside, a lot of times people don't believe you. There are crazy bits of this combination that make it a really difficult illness. So I have great compassion if you're struggling with that.
Dr. Jill 37:23
And I promise you—look at me, right?—I am not telling you it's all in your head. It's not in your head. But your brain has received a signal of danger. And that danger signal will keep stimulating your body and creating a cell danger response, which causes all kinds of havoc in your cells. And if you don't stop that signal and try to help rehab that signal to say, “Hey, it's safe, it's okay,” through some program…
Dr. Jill 37:46
There are hundreds of things you can do. Some of the ones you mentioned. DNRS is out there. Gupta's program [also]. And there are many, many other somatic-based therapies, craniosacral therapies, and even binaural beats, which is a type of music that can calm the brain. There are lots of things you can do. But any way that you address this over-activation of that fear response will help you get well. It's proven. I've seen it over and over. This is a chemical response that causes a fear response. So it's a real response. It's not in your head. But if you address that, you're going to get to the next level.
Michael Schrantz 38:17
Yes. It's not the crazy comment. It's not the psychosomatic comment. It's the opposite of that. It's actually saying, if you think about it from different perspectives, it's kind of: Because you've gone through the legitimate stuff you've gone for, you've created this new environment. It's just survival. This is how you've adapted—perhaps not in the best way. Anyway, it's yet another example of the challenges we deal with in trying to help prioritize both environmentally and clinically what makes the most sense on that bell curve for that patient to get better. At every step of the way, we know that you're spending money, time, and resources, and big word here: Trust. It gets overwhelming. You need to align yourself with people who, if they can't help you, can at least direct you to other professionals that they know can get the job done. And that's what I've found myself doing for the last two-to-three years exclusively.
Dr. Jill 39:06
Yes. So tell us a little bit. You actually get on the phone. Are you on Zoom, where you could have them walk you around the house? Or how does that work with your consultations?
Michael Schrantz 39:15
Yes. So, probably for the last two or three years, I've been doing a lot of Zoom/virtual. Actually, it's the same platform. I use the same microphone. Some people recognize it right now. But it starts a lot the same way. It's a questionnaire [for] client intake. Give me the history, give me the diagnosis, and give me the areas of concern. A lot of times, what I or my office manager will have them do is give us photos or short videos of the areas of concern. Yes, you're right; there are certain times where, if they have Zoom on their phone or laptop, they can come over and bring it. But to a little side tech issue: A lot of times we find that that's distracting and blurry, and the lighting is not right.
Michael Schrantz 39:51
So to me, the biggest takeaway of the virtual consultations that we've gotten in terms of positive feedback is the quarterbacking, the education, and the guidance when they don't know where to start. And many times it's clients who reach out to us and say the classic: “We've had two professionals give us different opinions, and one is recommending $50,000 with the work. The other one says there's not a problem. We'd really like you to give your opinion.” And I am by no means… I admitted—first one to raise my hand—not being perfect. That's what I'm surgical at doing—being able to at least acknowledge the information.
Michael Schrantz 40:31
We do know about chronic illness. But at the same exact moment, being able to say, “Well, we don't know this, and here's why… However, let's honor health and what the ultimate goal is, and let's find a way that fits your finances and your logistics.” I can't tell you the number of times when people will send us in their questionnaires and at the bottom they'll say, “Please don't say anything, but my husband doesn't believe anything in this.” I will tell them: “If it's at all possible, please have that husband show up.” And it's classically an engineer background because they have nothing to defend. I want to listen to their concerns, and I want to give them that science. They want to know more about the methodology of the testing. They want to know about: “What is CIRS? Is that some bar napkin idea that you or Jill came up with?” We give them the science, and that way they understand that this isn't some guy selling snake oil. We acknowledge what we know and what we don't know.
Michael Schrantz 41:23
Folks, if you're that husband that's listening and doesn't believe anything, this is not a test code that you get prescribed with conventional medicine. You are off the grid dealing with chronic illness and functional diagnostic medicine things that are new, that are paving the way, that are identifying the thing that 50 years ago your old man told you just to shut it up, take an Advil, and quit your complaining. We're learning more and more, and you have incredible people like Jill, who's been there and who can help you get out of the weeds when it's not black and white. Because sometimes we deal with people who think that in order to have a problem with mold exposure, it needs to be that 20 square feet of mold growing up the wall I mentioned earlier.
Dr. Jill 42:01
Yes, yes. And like you said, it's not always the case. Sometimes it is. Let's go to after. Say they found the 20 feet up the wall. They took out the wall. They did everything right. To me, the reason some people can't stay in that remediated home is the aftercare. It's like after surgery: What do you need to do? I want to talk a little about that because I think that, for me, has been a big eye-opener in getting them to a safe place in that remediated home. What would you recommend for a small particulate clean HVAC system? What would be your order of operations after remediation to make sure that that home is the cleanest it can be for that patient?
Michael Schrantz 42:36
Sure. To me, if I'm hearing you right, the term is: How can we create and/or maintain sanctuary at that point?
Dr. Jill 42:42
Michael Schrantz 42:43
That's helpful. There are four—if I do my math right—fundamental things that we will talk about with people to do. One of them depends on where they live, for sure. That is certainly housekeeping, removing reservoirs. This is an issue of cleaning, dust cleaning, vacuuming, damp wiping, dry wiping, and getting rid of reservoirs if possible, like carpets and rugs. Rugs are easier to deal with. Listen, I don't like to walk on hard floors that much either, so I get it. Then, of course, the next level we talk about is filtration. There are all sorts of options there. There's portable filtration.
Dr. Jill 43:16
Quick question on the first one. I'm sorry to interrupt, but what about plants or water features? What would you say?
Michael Schrantz 43:23
It goes back to that equation issue where you'll have somebody raise their hand and say, “Well, we saw this thing from NASA that said that it's good at removing certain VOCs.” And I go, “That might be the case, but your clinician is telling you that you're having upregulation of your genes from mold, and I see a planted tree in your living room. So let's minimize the variables, and let's get it out of that environment for now. If you want to be a green thumb after the fact, let me honor that. I'll buy you… ” You know, I try to humor them and say, “I'll help you with that.”
Michael Schrantz 43:49
And water features are the same thing. They're prevalent, especially larger features for biofilm production. And let's be clear: We're not saying just because you have biofilm production that you're automatically going to have an exposure, but it's kind of an elephant-in-the-room concern to answer that question. When you get to filtration, it can either be portable systems, whole house systems, or what you might have under your air handler. Some people have a standard one-inch filter. They'll upgrade it to a more robust, higher-MERV-rated filter. We can get into some of those details after I give you the overview.
Michael Schrantz 44:26
Portable systems—we're familiar with the sleuth of them. I'm a big fan of air filtration. I'm more hesitant to initially recommend purification only because of what we don't know. And I've interviewed a company on IEP radio. I think they have wonderful products. It doesn't change the variable equation that we talked about. And then we get into mechanical ventilation. Mechanical ventilation is properly bringing in air mechanically when you feel like that house that you just got done sealing up is built too tight and you need to help remove contaminants that won't otherwise be removed with the former two methods. Those methods are the big boys.
Michael Schrantz 45:07
The one thing, of course, is moisture control. If you're in a humid climate—let's pick on Florida—you're going to likely have to have some sort of additional mechanical dehumidification system to regulate those moisture levels because, with the exception of a few cases, your air conditioning system is not going to be able to get you to that target relative humidity of somewhere between say 40 and 50%. So that might mean getting supplemental dehumidifiers. Some people roll their eyes and go: “I don't got time to deal with that. I don't want to have to work with that.” So they'll look at getting whole-house dehumidifiers that they can integrate into their system. When you do those four things—and again, your example was that you've already dealt with known sources on the inside of the home—I think that's a great starting point to maintain that sanctuary.
Michael Schrantz 45:59
Where the minutia starts to come pouring out is that every home is different, and you might have other underlying issues that need to be addressed first. What if they cleaned up the mold in the crawl space but didn't address the moisture that was getting in there in the first place to make that happen? It sounds to me like they may need some drainage improvements, and I would be helping them get on that before I have them upgrade their mechanical ventilation system in a mold complaint. So it depends.
Dr. Jill 46:25
That's so helpful, Michael. And I think you kind of mentioned it in the very beginning there because that was so thorough. But one of the things I find is that after the remediation, getting a really, really deep—we call it small particulate clean—
Michael Schrantz 46:40
Oh, I see.
Dr. Jill 46:41
Right? There are companies that come and charge a lot of money for that. I believe you can do this yourself or get someone [to do it] as long as you give them good instructions. This is not a difficult thing; it's just a detail thing. Is that right? Would you comment on that?
Michael Schrantz 46:56
It is. When you said remediation, in my mind, I was thinking that the cleaning and everything else had been done. I get to walk [inaudible].
Dr. Jill 47:00
That should go with it, right? So you're right. A good remediator will actually include cleaning, right? But not all.
Michael Schrantz 47:06
Right. A [person with a] newer aged, chronic illness-aware, new paradigm way of thinking would probably talk to you about whole-house cleaning. Unfortunately, we'll save it for another interview. There are politics involved and other things that might be specific to the areas they're working on. But here's the takeaway: The small particle cleaning that you're talking about, you're right; you don't have to have a professional do it.
Michael Schrantz 47:30
Beyond any additional costs, it's going to be a matter of logistics. Can you physically do it? I don't really want somebody who's got CIRS, as just an example, to be doing the work. But there are a couple of different DIY small particle cleaning [methods] that involve a process of misting to drop particles out of the air followed by rounds of cleaning that a person can probably get done in their house for less than $1,500 compared to a professional who might bring with them that experience and that efficiency. Some of this requires that you move contents out of the home. I'm looking at your screen right now. Those books would have to be moved out.
Dr. Jill 48:10
All those books.
Michael Schrantz 48:11
Yes. When money is an issue, what I would recommend clients do is look at these options. But do yourself a favor: If you're going to spend the money, reach out to an IEP like myself. It doesn't have to be me. There are plenty of people on ISEAI's website—we can talk about that in a second—that you can reach out to. Let them be your quarterback and make sure that whatever process you're doing is not only seemingly appropriate but that the timing of it is appropriate. You get done telling me that you're going to do a kitchen remodel a week later; why don't we wait until the remodel is done? So there's that quarterbacking.
Dr. Jill 48:45
Amen! Yes. That has to come last after you… Not last, last. Tell me, maybe I'm wrong on this, but HVAC systems—shouldn't those be cleaned simultaneously before you do the small particulate?—because that's just going to disperse. Am I wrong?
Michael Schrantz 49:02
No, you're right. It's just because HVAC systems get their own topic to discuss about. It's one of those things where there are challenges with duct cleaning. But yes, if you're going to do duct cleaning—let's just assume that was the decision to be made—I would normally have them do that before they do the final clean because you know there are going to be little onesie-twosies that are going to escape out of that.
Dr. Jill 49:22
Okay. Because that's what I tell patients, I want to make sure we are aligned with the order. This is all a perfect world [scenario]. It doesn't always go like that. Well, good. As we wrap up… First of all, I just want to acknowledge that I love your heart, Mike. I love what you bring to this. I love the passion and the purpose because you are so above and beyond just the technical details. You've clearly shown us here even in the interview, but I just want to acknowledge who you are as a human being, your character, and what you bring to this. And that is so rare, and we appreciate you so much! So thank you.
Michael Schrantz 49:58
That same compliment has extended your way. I've seen tears, and that's what's missing. Our job isn't to fall apart on the job site; our job is to care. If you can't empathize, at least sympathize and be able to realize the struggles these people are going through because it's a cadence that you have to figure out with these patients. You just can't come all in there all militaristic with all the wealth of information and think that everyone's going to jump in line behind you. So, thank you for your kind words.
Dr. Jill 50:28
You are welcome. So let's share our mutual organization, ISEAI. We're both on the board. It's a great, great nonprofit group with physicians, IEPs, and information. It's really geared towards teaching the clinician. So if you're a clinician, you should join. But if you're a patient or client, you might find resources there or people to call. Go ahead and give your website again, Mike, where people can find you, and anything else you want to say about that.
Michael Schrantz 50:58
Yes, absolutely. A couple of quick things. If you're wanting to reach out to me professionally: EnvironmentalAnalytics.net, not .com, and you can reach out. You can look at all the information, [including] my background. There's a contact page. That's how we filter in 99% of our clients because we want to honor your concerns and not get you lost in the phone calls and all of that.
Michael Schrantz 52:40
For free resources [on] hot topics—we've talked about air conditioning, we've talked about remediation; those things are covered; great interviews—iepradio.com. Take a look up there. It doesn't just have a video cast where you can see us talking and bringing up references and all this good stuff. There's also a podcast, so you can listen in your car. Also, there are references. A lot of times, it's like: “What study? You keep claiming a study.” Well, I've listed it there for you. So there's a dedicated page for you to reference it, in case you are a data-driven person and you want that science.
Michael Schrantz 51:56
And then, finally, I'll plug ISEAI. For those of you who are looking for resources… Actually, let me do this real quick with you. Right here is a find-get-help page. This is from their website, ISEAI.org. You click ‘Help'. You go here. You can find people who are members—clinicians and IEPs—who might be in your area and help you. For the clinicians who are wanting to build a network of professionals—an IEP, if you already have one, God bless you. If you don't and you're looking for guidance, consider reaching down to a couple of professionals that are on here.
Michael Schrantz 52:34
Some of these professionals provide virtual services, and they can guide you and help you build that network. There's a great free resource on how to pick an IEP—a free document available, high-level stuff for free—to explain a little bit more about IEPs. ISEAI is doing the best it can to teach people as rapidly as we can, but to honor the science and not get ahead of ourselves. And that's what I love about this organization.
Dr. Jill 53:00
Me too. And Michael, we are so fortunate to have you as part of it. You've just been spearheading these efforts, and I'm beyond grateful. So I want to publicly acknowledge all of your work. Thank you so much for your time today. [It was] better than I had hoped. We'll have to do this again. So I hope you all enjoyed this. You can re-listen here. You can check out IEP Radio for more, and you can also go to my YouTube channel for more videos. I will be sure to include the links we mentioned on Facebook Live as well. I'll hop in there in a few minutes and make sure those are all included. And thank you so much for joining us today.
Dr. Jill 53:32
Thank you, Dr. Jill. Appreciate it.
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