#114: Jill Carnahan, MD- Mold Toxins & Mold Testing & Explained

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Jill Carnahan, MD

Dr. Jill Carnahan emphasizes an integrative holistic approach to wellness using both conventional medicine and evidence based complementary therapies. This medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle. She emphasizes the therapeutic relationship between physician and patient and seeks to give her patients a full range of healing options with an emphasis on healthy living, nutrition, and disease prevention.

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www.jillcarnahan.com

www.facebook.com/flatironfunctionalmedicine

www.twitter.com/DocCarnahan

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Show Notes

1:31 Dr. Carnahan’s Mold Exposure:  Boulder Colorado has a dry climate that is great for people with mold sensitivity.  In 2013 there was a flood in Boulder.  A year after the flood the mold in formerly flooded buildings began to grow. Dr. Carnahan discovered that hard way that she is part of the 1% of the population that is genetically sensitivity to mold. She had never had asthma, yet it was so pronounced that she had to stop running and became short of breath walking the two flights of steps to her office.  She also now caught every bug or fungus that came along.  As a functional medicine doctor, she knew something was wrong with her immune system.  She was diagnosed with a severe immune deficiency.  She knew that mold was the issue, but she delayed testing.  Her health continued to decline. Six months later she tested positive for mold and mycotoxins, a toxic secondary metabolite produced by mold.  Black mold from the flood was discovered in the basement of her office building.  When she discovered the mold, she never returned to the building and sold everything that she had left there.  No one else in the building was ill.

6:47 Why the Delay in Testing for Mold?  If we test positive for mold exposure sensitivity, it would result in dramatic change and loss.  Things made of porous materials, like fabric or books, cannot be cleaned well, and you need to give them up.  Nothing can replace your health.  It is worth giving up everything to have good health.

8:53 Is Anywhere Safe from Mold Toxicity?  No matter where you live, there is the potential for flood and water damage.  Even buildings in very hot dry climates can have mold from the condensation from air conditioners.

13:17 Mold Sensitivity Genes:  LabCorp and Quest are Dr. Carnahan’s favored labs for HLA-DR Typing.  The results need to be interpreted.  Dr. Carnahan is able to do this with a Rosetta stone from Subject expert, Dr. Ritchie Shoemaker.  There are two “dreaded” genotypes for mold sensitivity, 11-3-53 and 4-3-52.  When Dr. Carnahan suspects mold sensitivity in a patient, she checks for these.  If her patient does not have either of these, it is highly unlikely that they will have a systemic immune inflammatory response from mold.  It is estimated that 1% of the population has one of these two genes.  Celiac HLAs are related to mold HLAs.  It is the misprocessing of antigens.

14:49 HLAs, Pac Man of the Immune System:  Those of us with mold sensitivity get sickest quickest and stay sickest the longest.  HLAs are in the immune system checking and sampling and identifying antigens, like a Pac Man.  People with this chronic inflammatory response syndrome have generally had Lyme, Epstein-Barr virus, or some other infection that triggers the misprocessing of antigens.  The immune system should be able to respond to infections and toxins and be able to take care of them.  When our HLA are dysfunctional, they can over-react to something that is not toxic. In the case of mold, it over-reacts, but your body cannot easily rid itself of the toxin.
17:28 HLA Testing Details:  For new patients, Dr. Carnahan orders Celiac HLA and HLA-DR typing for Celiac, and HLA-DR for mold, Lyme and other biotoxins.  Celiac HLA typing, checks DQ2 and DQ8. People with two SNPs for DQ2, two SNPs of DQ8 or one DQ2 and one DQ8, have a high probability of problems with gluten processing.  They may never get Celiac disease, but gluten can create inflammation and trigger autoimmunity.  Autoimmunity and mold go hand-in-hand because of the inflammatory cascade.

19:50 The Possible Benefit of This Over-Reactive Immune System:  Sometimes Dr. Carnahan has patients who say that they have not had a cold or flu for years.  They may have some sort of virus, but their immune system is so dysfunctional that they are not symptomatic.  Cytokines in our immune system react to an infectious illness and makes us feel feverish, headache, tired. It is called a cytokine storm. Sometimes it is not the threat causing our illness, but our immune system’s response to the threat. People, who don’t have this cytokine reaction, are more prone to have these HLA types. Their immune system is so dysfunctional that it isn’t rallying a proper response.

21:31 Symptoms of Mold Exposure:   Symptoms include fatigue, brain fog where you cannot concentrate, focus or complete a task easily, and memory issues in the form of finding words.  NeuroQuant, SPECT MRI, or a functional MRI, all show changes in the brain from the mold.    Instead of seasonal allergy responses, people with mold sensitivity have super-reactive mast cells and are in a constant histamine response with allergy symptoms.  Your skin is a detox organ, so you might have new onset acne, sores, lesions, and/or scalp issues.  Joint pain is common because it is an inflammatory response. Tingling, shortness of breath, sinus congestion, and blurry vision is also common.

24:12 Symptom – Prone to Static Shock: Mold affects the pituitary access to the extreme.  One of the hormones in the posterior pituitary is antidiuretic hormone, which controls our saltwater balance, so another symptom is constant thirst that is unquenchable, dry skin, dry eyes,.  The antidiuretic hormone is affected when MSH, another hormone that regulates the hypothalamic access.  In mold illness, this almost always drops.  That regulates cortisol, adrenals, thyroid, and antidiuretic hormone.  Because antidiuretic hormone is low, you are drinking lots of water and have more salt on the surface of your skin.  This makes you prone to static charge.  One of her patients complained that he would break electronics.  Watches, cell phones, and computers would all stop working in a short time.  He found that his entire attic was full of mold.

28:47 School Buildings Commonly Have Mold:  Courthouses, schools and older buildings often have mold.  Dr. Carnahan has treated numerous teachers for mold.  She finds that mold is epidemic in schools.  Remediation of mold is an expense schools cannot afford. If the mold is bad in a school building, it would mean tearing down the building, which is not an option. Should you suspect that your child is reacting to mold; they can undergo the same testing as an adult.

30:46 Biomarkers of Mold:  The CRP or ESR inflammatory markers will be normal for those of us with mold reaction.  CMP, basic metabolic kidney/liver, will be normal.  CBC, most of the time will be normal.  Routine labs will be normal.  Because labs come back normal, many are deemed to have a psychiatric illness, especially when they experience another symptom of mold exposure, rage, anger and sudden deep dark depression when exposed to mold.  Dr. Carnahan does HLA typing along with testing of leptin and adiponectin which will show early signs of insulin dysregulation. Mold reaction brings on insulin resistance.  Dysregulation of cortisol blocks insulin from entering your cells. Your pancreas can be affected from the toxins, causing elevated lipase or amylase. You can have poor production of pancreatic enzymes and poor production of insulin.  You can even become diabetic even when they have no family history.

32:51 Symptom – Sudden Weight Gain:  People can put on 50 pounds from mold exposure even with decreased caloric intake and increased exercise. Because of the insulin resistance from the imbalance of leptin and adiponectin, these people cannot burn fat.  They are metabolically so dysfunctional that typical dietary interventions do not work.

33:28 Mold and Blood Profusion:  Mold exposure sensitivity decreases blood flow to your tissues. VEGF shows capillary tissue profusion.  Early in the illness, this increases, causing new blood vessel growth.  Dr. Carnahan, a runner, would have decreased profusion in her legs, causing lactic acid to build and sometimes her lower legs would go numb.

34:25 Mold Exposure Sensitivity and Autoimmunity:  VEGF causes TGF Beta to rise.  TGF Beta is a master puppeteer in the immune system that regulates autoimmunity, impactingTreg cells, and t17 cells.  High TGF Beta suppresses Treg cells, decreases core antigen presentation, and affects MSH which effects cortisol, leptin, ADH and much more.  Most people with mold exposure have high TGF Beta.  This leads to autoimmunity because there are no Treg cells to keep the body from turning upon itself.

35:45 Mold and the Endocrine System:  MSH biomarker is low late in the illness.  It is a master in the endocrine system, in the pituitary and hypothalamus.  This will affect ADH (saltwater balance and hydration), profusion and TGF Beta, no regulation of the cytokine storm, and dysregulated cortisol.  It also affects female and male hormones.  Early on, there will be a tremendous upregulation of aromatase.  For men, this means that they have low testosterone because they are using their testosterone to make estrogen (man boobs and weight gain around their waist).  Taking more testosterone will just make it worse.  In women, aromatase causes harmful estrogens, causing painful periods with heavy bleeding, fibrocystic breasts, endometrial fibroids, endometriosis, and dysregulated menstrual cycles.

37:45 Mold and Your Thyroid:  TSH will be normal and free T4 might be a little low, but you will be profoundly symptomatic for hypothyroid.  The toxins prevent receptors from recognizing the thyroid hormone.  Giving high dose thyroid can make this worse.

39:09 How Common is Mold Exposure Sensitivity?  Dr. Carnahan believes that mold exposure is far more prevalent than current estimates.  People are getting sicker and she believes it has to do with our high toxic burden from our chemical exposure. In the 1970s paint manufacturers began placing fungicides in our paint to retard mold growth.  It killed off some species and caused other more toxic molds to takeover. In addition, buildings have little external/internal air exchange.

40:42 Mold and Electromagnetic Radiation:  In experiments, a dish of mold, shielded from Wi-Fi and other electromagnetic signals, grows little mold.  By placing a router next to the mold dish, it produces 600 times the amount of mycotoxin production.  She speculates that mold inside your body and in your building will produce more mycotoxins in an environment with lots of electromagnetic radiation.

42:13 Mitigating EMR Exposure:  Dr. Carnahan does Earthing.  A few times a week she goes barefoot.  With Earthing, you connect your body to the electronics of the earth.  She also does her best to make sure she is not in an EMR triangle of her computer, router and cell phone.   She also uses a harapad EMR shield when using her laptop on her lap.  She never puts her cell phone to her head, using either speakerphone or earbuds.  Cordless phones are worse than your cellphone for EMFs.  Klinghardt has a number of shielding mechanisms available.

45:13 Reducing Mold Toxins:  You need to find where the exposure is and you need to get out.  Sometimes it can be remediated, but for someone who is super sensitive, dead mold can be as toxic as or even more toxic than live mold.  Throwing bleach on the mold can make things worse.  It breaks up the mold and sends it into the air.  You can test for mold spores, but you cannot test for mold mycotoxins.  When mold feels threatened, it produces VOCs, volatile organic compounds.  Getting out is your number one priority.  Get tested. Get professional remediation.  Use a good air purifier.  Dr. Carnahan recommends IQAir, and the one she has in her home and office, the Austin Air Healthmate Plus which filters the VOCs.  One unit filters 1500 square feet.  Do some earthing. Get outside. Open your windows for some air exchange.

47:05 Your Belongings from a Moldy Building can Make You Sick:  All belongings in the same building as mold will have mold spores on them from the air within the building.  For Dr. Carnahan, it was her paper patient charts from her old office.  They would make her sick. She ended up scanning the charts and starting over.  Books are also problematic.  Clothing can be washed.  Within a water-damaged building there is more than mold.  There are bacteria, fungi, and mycotoxins.  All of these disrupt the immune system of someone who is susceptible.

49:08 Binding Toxins to Eliminate from your Body:  When treating the immune system, Dr. Carnahan begins with glutathione.  Glutathione helps your body deal with toxins, and it gets trashed when you are exposed. It is restored through precursors like vitamin C in large doses or IV.  You can take oral or IV glutathione.   N-acetylcysteine and alpha lipoic acid are also important to take.  Also important are binders.  The drug, cholestyramine is effective and inconvenient.  It has to be taken 4 times a day and has side effects of heartburn, gas, bloating, and constipation.  As you improve, you will see a better score on your VCS test, which is a visual contrast study of dysfunction.  You can go on line and do this as an early test. Instead of cholestyramine, Dr. Carnahan opts for more natural treatments and has successfully used clay and charcoal.  When you bind the toxin, you get re-exposed to them. You have to be prepared for reactions from your body during detox.  You may feel sicker before you get better.

51:33 Dr. Carnahan’s Morning Routine:  She is up at 5 a.m., maybe earlier, and takes charcoal and electrolytes.  Then she is ready for Bulletproof Coffee.  For her first hour or two of the day she scans emails and the latest research, sharing some of it on social media.  Then she runs, does weights or some other type of exercise.  Then it is shower time and off to work.

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