In Episode #46, Dr. Jill Carnahan interviews Dr. Terri Fox on mold toxicity, biotoxin related illness and mold exposure treatment.
Is There Mold in Your Coffee?
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 00:13
Hey everybody, great to see you again here! Today I have a special guest that I will introduce in just a moment. We're neighbors, so we're both here in Boulder, Colorado, and have been friends for quite a while and do similar things. But I always learn from my colleagues. Today we're going to talk about biotoxin illness.
Dr. Jill 00:32
I will introduce Dr. Terri Fox in just a moment. But before I do, just a few basic housekeeping things: You all probably know by now that we have a YouTube channel and a podcast that's going live. You can listen to this and all of my previous episodes there. If you just go to YouTube and search my name, ‘Jill Carnahan', you will find that. I would love to have you subscribe so you get notified if I do new interviews. You can also find me on the website, JillCarnahan.com, [which has] lots and lots of free resources. And if you're listening and you don't get my newsletter, you're missing out. I've got tons of free stuff: Blogs, recipes, products, and all kinds of things. It comes out weekly, and of course, we never share your information. The retail site is DrJillHealth.com, and you can find our Mold Detox Box there. We might talk about mold with biotoxin illness today and many other things.
Dr. Jill 01:24
So welcome, Dr. Terri Fox! It is great to have you here, neighbor and friend. I want to introduce you formally, and then I will ask you to tell us a little bit about your journey into functional medicine. So let me grab your bio here. Dr. Terri Fox is originally from Virginia. She went to James Madison University, where she completed her undergrad degree in 1991 and later served as the director of health care and health education for the God's Child Project in Antigua, Guatemala. This project provided educational scholarships for street kids and orphans from the guerrilla wars. This is where she received her inspiration to go to medical school. In 1996, she began medical school at the University of California, San Francisco, where she simultaneously trained in botanical medicine. I definitely want to hear more about that today, Terri. She studied with several master herbalists. She practices… how do you say this, Surya meditation?
Dr. Terri Fox 02:23
Dr. Jill 02:24
Okay, thank you. [It is] an ancient transcendental meditation that comes from Vedic scripture. Dr. Fox moved to Boulder in 2001, where she did her internship at St. Anthony's Family Medicine program in Denver. After her internship, she completed her board certification in integrative and holistic medicine. She then trained in functional medicine and now integrates Western natural botanical and functional medicine at her practice in Boulder. Dr. Fox, thank you for spending time with me today. I'm delighted to have you here.
Dr. Terri Fox 02:53
Thank you for having me!
Dr. Jill 02:55
You're welcome. And I start everyone out with, kind of: How did you get here? We heard the formal story, but there's always a little piece of heart and soul, and it sounds like Guatemala was like a life-changing adventure. So how'd you get from Guatemala to functional medicine in Boulder?
Dr. Terri Fox 03:10
Okay, that was kind of a long road. I had not planned to go to medical school. I was studying international studies in college, and I went and volunteered in Guatemala with street kids and orphans from the guerilla wars. Basically, we had an educational scholarship program where we put kids in school. They were mostly living in the trash dumps, so they were homeless. We had families that would take them in, and we paid them a stipend, and then we put them in school. If they kept their grades up, they won their scholarship.
Dr. Terri Fox 03:52
So we were trying to break that chain—the circle of poverty—by getting them educated. I was in charge of healthcare and health education for this nonprofit in Guatemala. I lived there for two years. I loved it. It was probably two of the best years of my life. I'll never forget all these kids that I worked with. They were just the sweetest things in the world. I was planning to get my master's in public health, and I worked with all these doctors, residents, and medical students who came down to volunteer for the project and got inspired by what they could do.
Dr. Terri Fox 04:36
I also had a mentor who was one of my greatest heroes and was doing the most beautiful work. She was an MD. She sort of took time out of what she was doing to sit me down and say: “All right, what are you doing with your life? Where are you going?” And I was like: “Me? Shoot, you care?”
Dr. Jill 04:53
Oh, I love it.
Dr. Terri Fox 04:54
I told her what I wanted to do and what my dream was, and she was like: “You've got to go to medical school.” I was like, “You're crazy.” She was like, “What's your hold-up?” I was like, “I don't even like blood!” She was like: “You'll get over that in the first two minutes. It has nothing to do with that. If you want to make an impact in the world and be able to do third-world medicine and make big changes, you're going to need to go to medical school.”
Dr. Terri Fox 05:20
So I came home from Guatemala, and I hadn't done any of my science prerequisites. I had a couple of years in my 20s doing all the sciences and all the prerequisites. And I sort of was doing it like: “If I like it and it flows and it goes well, then okay. But if not, forget it; I'm going to get a master's in public health.” And it was kind of like my way was pretty lit from there. Everything worked out beautifully. I did really well.
Dr. Terri Fox 05:52
Then, I sort of wanted to go to naturopathic school because that's what resonated with me more than the allopathic model. And I think, in the end, I just decided that if I went to naturopathic school, I couldn't necessarily integrate Western [medicine] and do all of it. But if I did, I could handle the Western and get through medical school—your training—and integrate the naturopathic, the functional, the holistic, and all of that later. So, yes, I did it.
Dr. Jill 06:28
Wow, I love that. It's so similar because I remember thinking, “I have the heart of a naturopath.” I looked at chiropractic, naturopathic, and traditional Chinese medicine. That resonated 100 percent. Then, very similarly, I did a little mission work in Honduras. It was a shorter way, a shorter stint. But it was so similar in that I was like, “If I ever want to do anything like that, the allopathic medicine model is really a little easier to actually practice medicine in another country.”
Dr. Jill 06:28
So I joke about it, like, “I infiltrated the system.” And you did too, because we have these hearts that are way bigger in scope, in how we approach it, and probably in philosophy too. But I'm so glad we did because I feel like I got a great education. It's not like I tossed that out. I feel like that's the foundation of great diagnostic skills, and then we add to it. Our toolbox is bigger, which is amazing.
Dr. Terri Fox 07:20
Dr. Jill 07:21
So today we're going to dive into biotoxin illness. First of all, I want to just define it for you guys listening: Biotoxins—we put this big kind of garbage basket term that includes mold. That's one of the primary biotoxins. But this can also be from Lyme, Babesia, Bartonella, Ehrlichia, and all these other infections. It could be from really anything biologically that is a toxin—from infections or from the environment. These things cause a lot of havoc in the body. But what I'd love to know next is: How did you get into biotoxin illness? Do you have a story? Any experiences that brought you in this direction?
Dr. Terri Fox 07:56
Yes. I was drawn to functional medicine after residency and did all the functional medicine conferences and loved it. That resonated, along with my botanical medicine background—looking for the underlying dysfunction instead of treating the cause. In my mind, functional medicine took the natural world, the herbs, everything I'd studied, and all the stuff that you knew. I got really gritty into the science and the evidence with it. It was that combo that I was like, “Oh, it is exactly what I need!” Because I liked the woo-woo stuff as well, but not necessarily always in practice. So functional medicine was great.
Dr. Terri Fox 07:56
So I was doing functional medicine. I'm from Virginia, a very Lyme-endemic region. My brother first got Lyme. That was kind of my first time looking into it from functional medicine and holistic medicine and learning just a tiny [bit]. And then I don't know if you have this experience too, but doing functional medicine for fatigue and sleep and headaches and everything—all these chronic illnesses that we deal with—I felt like in the beginning, maybe 80% of my patients got better and 20% of them just wouldn't.
Dr. Jill 09:26
Dr. Terri Fox 09:27
You work on the adrenals, you work on the hormones, you get them sleeping, and they don't budge. Those all sort of turned out to have Lyme. So that kind of got me into the Lyme world. Then my son got really, really sick when he was 9. I think it started when he was 8 years old. It was sort of gradual. He was this seeking, fearless maniac, really active little boy. And suddenly he was stiff when he'd get up, and he'd stiff when he'd get out of the cars.
Dr. Terri Fox 10:07
He'd start walking down the stairs sideways, and I'd be like, “Do your knees hurt? What's going on?” And then he'd go, “No,” and he walked down then normally. I knew something was not right, but he would deny that anything hurt. So I started doing simple things on him. Like, “Maybe it's gluten” [or] “Maybe it's a food sensitivity.” The last thing I ever wanted was for it to be Lyme because, at that point, I was to treat Lyme [inaudible] in those patients.
Dr. Terri Fox 10:37
So, of course, it's in the back of my head: “I'm terrified of it. I don't want to test him for it yet.” So eventually I tested him for it, and it was positive. He has CDC-positive Lyme, as do I. It's not just endemics. I ended up taking him to see Dr. Harris. Have you met Steve Harris in California? Yes. So he treated him, and he was amazing. He said, “You have to get him tested for mold.” And this was, Jill, seven or eight years ago. And a Lyme doctor knew to test him for mold first. He gave me one of the, I think, old-school, RealTime labs. I did no provocation—I just had [inaudible] and then sent it in—and it was through the roof.
Dr. Terri Fox 11:33
I had hints. There were weird, musty smells. I had people in, and I had people tell me everything was fine. There were parts of the story that were actually relevant for a lot of patients. One of the things that happened was that once I figured out that the mold on him was positive and I was trying to figure out where it was in the house, I had one person out to test the house. They found there was just a small little water leak in the attic space above his bedroom, and they were like: “Oh, you've just got to get that fixed.” I was like, ‘Okay.'
Dr. Terri Fox 12:10
So we actually went out of the country, the whole family, for two weeks. I had it fixed when I was gone. I got back, and he got so sick. He was in 9 out of 10 pain. He didn't get out of bed for six months. He had this horrific migraine that just wouldn't let up no matter what I did for six months. Now, looking back, you could tell me exactly what happened, right?
Dr. Jill 12:39
Dr. Terri Fox 12:40
They fixed the water leak, but they opened up the attic. Everything went everywhere, and I didn't know that remediation meant this whole other thing. It was awful. So then I got sick; he was sick. I ended up finding a mutual colleague who you know—John Bodie from Mold Pros. I think Dr. Hooper from RealTime gave me his name.
Dr. Jill 13:08
Dr. Terri Fox 13:10
Yes, Dr. Hooper gave me his name many, many years ago. I called him, and he came, looked at the house, and cut a hole in the vapor barrier—in our crawl space. This was in 2013. So now it's 2014, but it's right after the floods, and we thought we were clean from the floods. He cut the vapor barrier, and there were three feet of water under our entire house.
Dr. Jill 13:37
Oh, my goodness! I'll just pause here because there are some really important things. First of all, you and I are doctors, so we know this; we know better. Now we know a lot about mold. Back then, we didn't. But this is so common. And for a patient who doesn't have any idea, it's not the exception to the rule. And what you just said earlier about the remediation, fixing the water leak without containing it, and then taking care of the dust after remediation, I want to clarify for those people listening: This is such a key. Even with great remediation, if you have dust in your HVAC system and debris around the house from before it was fixed and you don't claim that, that dirt, debris, dust, and dead mold will still cause reactions.
Dr. Terri Fox 14:20
Yes. People get worse. They think they took care of it, and then they get worse.
Dr. Jill 14:25
It's like you blow it up. I was thinking: You blew it up. You opened it up. So, keep going. I didn't mean to interrupt.
Dr. Terri Fox 14:29
When you disturb it, it lets off. That's what it does when it's angry. It sets off mycotoxins and nanoparticles, and they go into the fibers of your drywall, your wood, and everything.
Dr. Jill 14:42
And your books, your clothing, and—
Dr. Terri Fox 14:44
Dr. Jill 14:48
Exactly. If it's behind a wall, Stachybotrys and Chaetomium are some of the worst of the black toxic molds. They're sticky, they're wet, and they like dark spaces. They will often be undisturbed behind a wall, with no visible evidence. I can't tell you the number of people who've said, “I've had an inspector—[or] one, two, three, [or] four [of them]—they all say everything's clean. Yet I know from their physical history that there almost has to be a mold issue. So when you open that cavity, you are letting all, you know what, break loose, because it then explodes and contaminates your entire environment. Say you know there's an issue behind the wall. You are better off waiting and not doing anything until you know you can get the right remediation in there and the cleaning.
Dr. Terri Fox 15:30
That would be great. I've told people that. I've said: “Don't fix it. I'd rather you leave it than have it done incorrectly. There are a few things you've got to trust me on, and one of them is that you can't just call whoever you've found on Google.” There are just a very few people who do the whole containment and remediation really well.
Dr. Jill 15:56
Yes. So back to your story. I didn't mean to interrupt, but that's so important and relevant to everybody listening. You opened it up [by explaining how] he got way worse and was in bed. Did you get sick at that time too?
Dr. Terri Fox 16:07
Yes. I was having migraines, anxiety, and insomnia. Between the fact that my kid is sick and [the fact that] I'm a doctor, I should be able to figure this out. And then the mold itself—I'm very mold-sensitive. So once we figured it out, we could begin the cleanup process. We had to move out and everything. Then we sold the house. I was like: “I'm out. I'm not living here.” I don't believe that with that amount of water in the house, we could ever clean this. So we moved.
Dr. Terri Fox 16:47
I moved into a place nearby, and my son started getting better almost immediately. He had some shifts on a couple of weeks of binders, and then he went on antifungals. We moved out, and then he got better. His nine-month migraine went away. It was amazing. It was incredible. It was a pretty quick recovery. He's a kid. He still had the Lyme things, and he still needed more rest, but he's also very driven. He's very athletic, so he was determined to get back in the game.
Dr. Jill 17:27
That's amazing. And what you mentioned here is really common too. I'm sure you see the same thing. I feel like there are tens of thousands of people walking around that have gotten bit by spiders, ticks, or some arachnoid that carried a vector like Borrelia, Bartonella, or Ehrlichia and they're fine. There's an important point here because what often happens is that someone's walking around, they have Lyme and they're fine. They don't need treatment. I think if we tested the whole population, we'd find 10 times the number of cases that we're treating because their immune system is robust enough to keep that bug in check, right? But then you throw a person like that into a moldy environment, like your son, who was otherwise robust and healthy. Mold is a known immunotoxin, so it weakens the immune state on many levels. Then that weakened state allows for these old infections to pop up and start causing symptoms. So what you just told us was that once he was out of the mold, the Lyme was less of an issue—almost a non-issue in some ways, right?
Dr. Terri Fox 18:24
Yes, and it's so funny and interesting to listen to you because that's almost the exact same speech I give my patients.
Dr. Jill 18:31
I love it!
Dr. Terri Fox 18:33
So I tell them, and I make up numbers here, but I say: “Imagine we did an IGeneX or a DNA connections test on a random sampling of the population of the Northeast; my guess is some 90% must have exposure and less than 10% are chronically ill. Why does Lyme take one person down and somebody else has a little febrile illness for a week or two and is fine?” So I always talk to my patients about Lyme and biotoxin illness. You want your whole system to be optimized, strong, and way up here and for the bugs to be dormant and on the ground and not active. And mold will sort of tip that system, I feel, more intensely than anything else. Now, gut dysfunction will, [along with] toxic burden, heavy metals, and all that stuff. But if there's mold, I feel like they'll never get better from the Lyme. Patients just Herx and Herx. So I always deal with the mold first in a Lyme patient.
Dr. Jill 19:42
Yes, I love that. We're so aligned. This is neat. So your son got better. You got better. You moved. Since then, [have there been] any major other exposures or incidents?
Dr. Terri Fox 19:54
Yes, I've had a few. I feel like those of us who are more sensitive and have had a big exposure, they tend to kind of follow us.
Dr. Jill 20:04
Yes, I know, right?
Dr. Terri Fox 19:54
All my patients are like, “How am I ever going to find a place?” I'm like: “You will. Mold is kind of everywhere. Your resiliency around it will get better.” And what I've really learned is that mold will still happen. Nothing is as bad as that. I have had some other big, bad exposures that were hard, but I know what to do now. I know how to take care of it. I know how to take care of myself. I know the signs and all of that. So it doesn't feel so out of control anymore. I know how to deal with that. My autonomic nervous system doesn't freak out if I'm walking into a moldy space any longer.
Dr. Jill 20:54
I love that. It's a similar pathway because I feel too that a lot of people say, “Well, is it possible to get well and still travel and do that?” And now, of course, with COVID, we're not traveling. In the last several years since my mold exposure—mine was mostly in 2014 and before—in the beginning, I was highly sensitive. It was hard to go to hotels and stuff. And now I've gone to Maui and had horrible mold exposures. I teach patients to find their symptoms so they know this is a mold exposure. Everybody's different. I'll get a little sinus pressure and a headache. I'll be a little more foggy or tired. If it's Chaetomium, I call it the narcoleptic mold because it makes me fall asleep—like, I literally have to.
Dr. Jill 21:36
Now I've been trying to figure out: What is it? I think it actually causes a little bit of POTS because I get orthostatic. For those of you listening, I get low blood pressure and I can't stand up; I've got to lie down. But it's weird because that particular one always causes me the same [symptoms]. It's a personality, I think. So it's like this signature of what it causes. So if you have been exposed, you can learn, like Dr. Fox and I have, what it looks like and how it feels to be exposed. And then I take charcoal, get hydrated, and maybe take a nap. Usually, if I'm not ongoing, only being exposed within hours, I can feel better. Of course, there's PC, and there's glutathione. What are some tricks you found when you did get exposure to get better quickly?
Dr. Terri Fox 22:20
Well, one thing I tell my patients is that the alarm bell is a gift. Once you're hypersensitized, you won't stay that hypersensitized. But the last thing you want to do is end up in another place that's moldy and get really sick for two years before you figure it out. So, think of that hypersensitivity and those alarm bells: They get nervous that they're never going to be able to enter a building. But really, that's a helpful alarm bell. You're not going to end up where you were. You're going to take your binders, and you're going to get out of there. But what do I do? I love IV phosphatidylcholine and glutathione. If I were to have a good exposure somewhere else, I'd probably get an IV when I got back. I travel with binders just in case. I try not to stay in the moldy space. Then, when I get back, I'll do a lot of glutathione, transfer factors, and the whole thing. Then it clears a lot quicker.
Dr. Jill 23:29
I love that. Again, I haven't traveled for a while, but I bought a travel fogger. It's like a little portable fogging system. So if I were ever in a room and I couldn't leave, I could fog it, and it'd be a little clearer. So that's available if patients want it. So let's talk about the approach. Let's say someone comes in and we think they may have mold exposure. How would you approach basic confirmation testing? And then let's talk a little about treatment.
Dr. Terri Fox 23:59
Okay. Am I allowed to say the names of the labs?
Dr. Jill 23:29
Dr. Terri Fox 24:09
I prefer RealTime labs. The reason is because I do it provoked, so I do an IV of phosphatidolcholine and glutathione, and both of those things pull out mycotoxins—the toxins that mold creates—[and] neurotoxins into the urine. Then I have them wait an hour and then give the urine sample. The reason for that—for the listeners—is just that people who detox mold well don't get sick from that. They're not the ones ending up in my office. So if I just do a urine sample, if they're detoxing it well and pulling it out in the urine, they're probably not going to get as sick from it as the people who genetically don't pull it out well.
Dr. Terri Fox 24:59
I used to have all these patients, and I knew it was mold. They knew they had an exposure, and they had all the symptoms. I would do the test, and the test would end up being negative. Then I finally learned that if I did the IV first, somebody who was negative and would have an ochratoxin would have 10 or 12 after an IV. So that's my preferred way of doing it. It's not cheap between the IV and the test. So I prefer that one. If they can't do that or it doesn't work to get an IV, they don't live nearby, or whatever, then I also use the Great Plains labs urine mycotoxin [test]. I like that one a lot too. And I use that on kids because I don't want to force them to do an IV.
Dr. Jill 25:45
You can get an OAT test too, which is an organic acids [test]. I like that you can get those two together.
Dr. Terri Fox 25:49
Oh yes. You can get them both, yes.
Dr. Jill 25:55
I don't know if you use them, but Vibrant has a mycotoxin [test] too.
Dr. Terri Fox 25:59
Vibrant—a little bit. I've used it here and there. I don't have a ton of experience with it yet. Are you using it?
Dr. Jill 26:04
I am. I'm really liking it. I feel like I get a little bit more accuracy on the Chaetomium and Stachybotrys than I do on the Great Plains or RealTime.
Dr. Terri Fox 26:12
Dr. Jill 26:14
But I'm playing with all of them. They're all good tests. If you're listening and your doctor uses one, they're all good as long as you know what you're doing. I agree that with RealTime, you need to provoke. Great Plains says don't provoke. Vibrant says you probably don't need to. Vibrant is actually the most sensitive, so you could get a false positive, meaning you don't really have mold illness but you're catching such sensitivity for maybe… we talk about food exposures. Usually, these are not food exposures. You and I know that. So I think the error with Vibrant is that it's so accurate. Could it be picking up people who really don't have a lot of toxicity?
Dr. Terri Fox 26:44
It's so sensitive—a little less specific?
Dr. Jill 26:14
Dr. Terri Fox 26:44
Okay. But you're enjoying it. How does it compare price-wise?
Dr. Jill 26:53
I think they're all the same except that RealTime might still be a pinch higher.
Dr. Terri Fox 26:58
They went down on their pricing.
Dr. Jill 26:53
Oh, perfect, okay. Good, good.
Dr. Terri Fox 27:03
And then, if the patient has insurance coverage, I'll do some of the biomarkers. So I usually do a C4a and an MMP-9. I'll do a C3a too. Then, depending on their insurance and what I'm thinking, I might add the VIP, the MSH, and the TGF-β1. The main reasons I do those—two different reasons: One is that if their insurance is good, I can follow C4as that were through the roof and MMP-9s without the patient having to pay a whole bunch and get some data points to see how we're doing. Because this always takes a lot longer than patients think or that I wish that it would for them, or even what I think it's going to take sometimes, you don't want to have to repeat one of those mycotoxin tests.
Dr. Jill 28:04
And we know that's measuring excretion. So, say you get a patient, you diagnose them, and you're treating them by helping them excrete so that for six months—
Dr. Terri Fox 28:14
It goes up [inaudible].
Dr. Jill 28:14
Yes, it's going to go up. And then patients are going to be confused. I mean, we can explain it. We know what's going on. But I don't even do it those first six months again unless they beg, and I say, “Well, it's going to be higher if we're doing the right thing because you're excreting.” So, just if you're listening, you've got a higher test after doing the protocol, and you're like, “What's going on? I'm getting worse.” No. You're measuring excretion, so it's really critical here to understand that.
Dr. Jill 28:37
And then the markers you mentioned—I just want to clarify if you're listening—she said C4a, C3a. I love those. Those are split complement products that show an active level of inflammation. And C4a, in particular, is usually good for recent acute exposure. Those can definitely go up and down within weeks. And then some of the other CIRS markers are TGF-β, MMP-9, MSH, ADH, osmolality—I still like to use those if possible—and VIP. I think those are the main ones. But I agree, they're often covered, and they can be super helpful to follow as the patient recovers. But they take a long time.
Dr. Terri Fox 29:13
Yes. And if they're not covered, I usually don't bother unless the diagnosis is iffy. So if they get a negative mold test and they know they had a big mold exposure and you're really suspicious, then the C4a becomes really helpful, [as is] the MMP-9 and some of the others. And then I'll have them do a CIRS questionnaire. So if the C4a is up and then this CIRS questionnaire and there's a known mold exposure, I'll usually go ahead and treat them and start with the real benign parts of treatment just to [inaudible].
Dr. Jill 29:46
I totally agree, because the great thing about mold detox: It's detox. We all are toxic, and there's almost no harm. I mean, people have asked with the Mold Detox Box, “Can I use it if I have heavy metal toxicity or if I have just general environmental toxicity?” The truth is, the basics of detox, which we'll talk about in a minute, cover detox. So usually, you don't hurt someone by helping them detox better, even if they don't have mold.
Dr. Terri Fox 30:10
Yes, I agree.
Dr. Jill 30:12
So then, what would you do? Say you have someone, you have all the markers, and you think they have mold illness. What would be your basic protocol to get people well?
Dr. Terri Fox 30:21
Yes. Well, I'd like to preface that just by saying that every patient is different. They have a different genetic ability to detox biotoxins and mycotoxins. So there is a basic protocol, and then there are all the different variations for all our very unique patients. But first of all, you always have to get them out of the moldy house, of course. And that can sometimes be the very hardest part of the whole journey. I use the different strains that show up on the test result. If I have a good mycotoxin from any of those labs, I do binders specific to the different strains. I usually do BEI. I do the itraconazole EDTA antifungal nasal spray from Hopkinson or one of the other pharmacies.
Dr. Terri Fox 31:25
I don't add in biofilm stuff until the very end because I find that for some of them, it'll tank them, and they're not ready to open up biofilm yet. When I start the binders, I have them start one at a time and find their dose. So [I'll] work their way up slowly. For example, if they have some trichothecenes and I want to start some activated charcoal, I'll have them just start with one capsule or even less and make sure that feels okay, and then go up to four if it feels good and the system feels better. But as we've all seen in some patients, if you mobilize too much, things begin to actually excrete, but they move around, and people get sicker. So you always have to be careful with that percentage of the population that has to go really slow and take very small bits. So yes, I do binders for the different strains. Do you want me to go through which binders [inaudible].
Dr. Jill 32:30
Yes. I was going to say that people would love to hear that. So you mentioned trichothecenes and charcoal. I do the same. Is there anything else you would do for the toxins?
Dr. Terri Fox 32:37
Yes. For gliotoxin, I use mostly bentonite clay. For ochratoxin A, I try colestyramine, especially if that's their biggest one. If there's a lot of it, and it's not just a little, I try colestyramine. I'll offer them both the drugstore variety with the nasty [inaudible] or the clean compounded stuff. If they can't tolerate it and not everybody can tolerate colestyramine, then I switch to OptiFiber Lean or I'll do Quicksilver's Ultra Binder. Two heaping teaspoons. It's kind of a big dose. And that'll usually do it for ochratoxin A. For example, if I have a patient who doesn't have a positive mycotoxin test but has an elevated C4a and a history and all of that, I might start them on something more like G.I. Detox that has a little bit of everything or the Ultra Binder that has a little bit of everything. But if I do have a good result, I try to target the binders.
Dr. Jill 34:03
I love that and I totally agree. It's been great to kind of start to get more and more data. And I know that with ISEAI, which we're both part of, they're going to do some studies on specifically… We just talked about the companies that do urinary mycotoxin testing, and we're just giving our opinions. That's all. These are great labs. So any of the labs are good. But what we're hoping to have, if you stay tuned, is actual data on the head-to-head comparison in the same patients and the same population so that we can know which one is actually more accurate because, at this point, we don't. We just trust that the lab is good, and they give us decent results to proceed. But there may be one of those companies that's a lot better than another.
Dr. Terri Fox 34:40
Right, right. And I use transfer factors. Do you use the Enviro transfer factors?
Dr. Jill 34:46
I was just going to ask. The Enviro, I really like for the mold.
Dr. Terri Fox 34:48
I like that. I think it works great. And then I use drainage remedies for all my mold patients. So kidney-liver labs and detoxification to help [inaudible]
Dr. Jill 35:00
Do you like Pekana or what kind of brands [do you like]?
Dr. Terri Fox 35:03
I use Pekana. But I don't necessarily have any preference. They're all great. Anything that's going to open up all your detox. I always talk to my patients when they're this sick and they've got neuropathies, chronic fatigue, fibromyalgia, and all these things. And a lot of times, in the mold patients, you sort of know there's some underlying Lyme because they have the flu, migratory joint pain, and maybe some air hunger and things like that. “Okay, this is addressable, but let's treat the mold first and see what happens.” So, I forgot what I was saying.
Dr. Jill 35:44
You said some of these have Lyme, but let's do the mold first. And the drainage is huge because, like I said—
Dr. Terri Fox 35:51
Oh, yes, the drainage. So, I like the Pekana, but there are a lot of different brands that do organ detox. Oh, what I was saying was that I always sort of say between the Lyme and mold, biotoxins, neurotoxins, and mycotoxins, plus we live in a very toxic world, the total toxic burden is like falling over and onto the floor at this point. You have to kind of get it up off the floor before you might even feel that much different. So the binders are doing that, and all that stuff is doing that.
Dr. Terri Fox 36:23
And then part of it is opening up the channels from the other side so that you can just begin pulling everything out. So that's our binders pulling it out in the stool. And glutathione will help to detox it so we can get it out in the urine and the stool. So the drainage remedies are not so specific for mold, but they kind of help with everything and [are] just beginning to open up your detox channels. I use glutathione. I've been using glucuronidation support a lot more lately, [but] not in the very beginning. If they don't get where I want them to get to or as quickly as I think they should be moving or getting better, I add it in.
Dr. Jill 37:13
So I'll just stop for a second and give a little, tiny tutorial. [With] our liver—you've probably heard me say this before, and of course, Dr. Fox knows this very well—[there is] phase one [and] phase two. You have a toxin that's converted into an intermediate, and then that intermediate is converted by phase two into something that's excretable. But if we get stuck with that intermediate between phase one and phase two, people feel way, way worse. So something like glucuronidation, which is part of phase two, something like calcium deglucorate or support sulforaphane can actually help that phase two so that people don't get stuck in the in-between that's actually [even] more toxic than getting it out of the body.
Dr. Jill 37:48
Dr. Jill 37:50
Fantastic. I can't believe how fast our time is going. But before we go, I want to talk just a little bit about limbic activation, trauma, and mold. If you address that, I feel like that's the next level that we're seeing for healing. So for people listening, what often happens is that it's such a traumatic thing, and it's a physiological trauma. So even if you're emotionally stable and don't have depression, anxiety, or other disorders, mold can be incredibly traumatic. It can cause kind of a PTSD to our systems where we get another exposure and we get this… And then it also affects the brain, the ability to self-regulate, and the amygdala. So is there anything specific you found helpful for kind of downregulating that fight or flight response? How would you address that with your patients?
Dr. Terri Fox 38:34
Yes, so I find that for most of my patients who are chronically ill and have been sick for a long time, this is sort of critical to their healing path. And it's starting to become clear that maybe it needs to get added in earlier than I have been or that a lot of us have been adding it in. The way I describe it to my patients is that there's a cellular memory and there's a feedback loop. So if you've been sick for years when you go into a moldy environment and then you walk into a movie theater or a hotel room, your entire nervous system sends off these alarm bells. And then even if you get right out and you're probably fine and barely had exposure at all, sometimes that feedback loop and that cellular memory are enough to have the whole body think that it's under this much stress again and that it's got this big exposure.
Dr. Terri Fox 39:46
So you get all your symptoms back, and a lot of that's triggered by your anxiety and your fear around, “Oh no, I don't want to get sick again,” which is the adrenal sort of limbic, vagal—you know, that whole thing. And there's that feedback loop that eventually has to get addressed, I feel, for the ones that are really chronic and have been doing this for a long time. So I like DNRS. I recommend that a lot. I recommend the Gupta program. I'm just learning about all the cool information on vagal retraining and healing. I know there are some great books on it. Is there a program to refer a patient to?
Dr. Jill 40:41
That's a great question because there are [things] like vagal nerve stimulators. Not that I know of. There's not, like, one program. Often, I'll use a somatic-based trauma therapist to some professional who walks them through EMDR, thought field therapy, or brain spotting. But totally, you're right. I don't know that there's one. And if I find one, I'll put a link here.
Dr. Terri Fox 41:05
So that was my last thing. I actually still recommend a lot of EMDR and brain spotting. And that's because some people will do a lot better if they're handheld and they're walked through. And I just happen to know some incredible providers in town who are so good at EMDR, and that can help break those patterns really well. So a lot of times I'll do that too.
Dr. Jill 41:32
We are so lucky because you and I do this all the time, and there's two of us. And there are more people in our area. In some places, there's no one who knows how to treat mold. So we're so lucky that we have each other here and many other colleagues who do this. And I love hearing you because, almost every step of the way, we're so aligned with how we're approaching it. It feels really familiar—the same exact kind of thing.
Dr. Jill 41:55
We also have a ton of resources in Boulder, Colorado, for somatic therapies. You name it; it's probably here in some form. I even found that craniosacral therapy and some of these can also be really helpful. Like, the DNRS program—amazing! But you go, you commit; you do the program. And sometimes, for the type A's who are already a little OCD from the mold, it's one more thing to do.
Dr. Jill 42:19
And it's great. But I love these passively receptive things like binaural beats, craniosacral therapy, and even just massage like human touch, and some of these things that are a little bit more gentle and receptive to calm the nervous system too. Very cool. Any other tips, tricks, or things that you would like to leave the people listening with? If they've been exposed to mold and they're struggling, what would be your parting words of advice?
Dr. Terri Fox 42:50
If you've been exposed to mold, some of the things I would say is don't think that you're crazy; less than a quarter of the population is sensitive to mold. So you could very well be very sick from your house and nobody else in the house is sick. You can go to ISEAI, the organization that Jill and I are both members of, and look for a practitioner in your area. But don't think you're crazy. Have faith; you can get better. I actually personally think it's not at all the worst diagnosis in the world. I think it's fairly easy. I mean, it's a complicated protocol when you really get into it all, but I think it's fairly easy to treat in the sense that people get better pretty quickly as long as they're not currently exposed. And yes, and just have faith that you'll find somebody who knows what they're doing with mold. And people get better.
Dr. Jill 43:52
I love that because I agree. It feels like it's an overwhelming thing. If you're listening and you're in the midst of it, you're like: “You guys are crazy. This is so hard!” We've both experienced it, so we know how hard it is, but we're on the other side. I can still tell when I get exposed, but it doesn't take me down. I don't feel like it's been a permanent thing that has caused a handicap. And that's exciting because I can tell you [who are] listening if you're experiencing it now that there's hope. And the same with Dr. Fox. So where can people listening find you or find [out] more about you? Where's your website? Where's your home—
Dr. Terri Fox 44:27
Yes. BoulderHolistic.com. And then I have an Instagram and a Facebook page. Do you want me to just send those to you?
Dr. Jill 44:36
Yes, I will send links. And yes, please, if you aren't following both of us on Instagram and all that, we'll make sure to get you guys the links. I don't know about you, Dr. Fox, but that ends up being a lot of where I put the fun information, the blogs, and stuff. So if you're not [inaudible] newsletter—
Dr. Terri Fox 44:51
Yes. [inaudible] social media a lot. I've had a lot of phases where I get it and then I stop.
Dr. Jill 44:57
Well, it's kind of the same, right? People are using it; it's a great way to get information out. But I don't love being on there. So yes, I agree with you. Awesome. Thank you for taking time out on your Tuesday afternoon to talk to us and I'll be sure to include those links. And thank you, everybody, so much for joining us today.
Dr. Terri Fox 45:14
And, Jill, thank you so much for the work that you do and how committed you are, for the support, the research, and all the things that you do for all the other professionals in our community who are doing what we do.
Dr. Jill 45:26
Thank you so much. I appreciate it.
Dr. Terri Fox 45:29
* 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.