Dhru Purohit Show - #217: How Mold and Environmental Toxins Damage Our Brain and Body with Dr. Craig Tanio

Starting point is 00:00:02 A lot of the symptoms from mold illness really come from neuroinflammation that comes from toxic exposure, from inhaling, really polluted air inside water damage buildings. Hi everyone. Drew Proud here. Today we're talking all things mold and environmental toxins with expert physician on this topic. Dr. Tenio, Craig Tenio, who is based out of Florida and runs a clinic called Resilier Health. he's going to identify a step-by-step process in terms of looking out for mold and identifying it and then most importantly how to get to the root cause. Stay tuned. It's a fascinating

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Starting point is 00:05:38 This week's guest is Dr. Craig Tenio. Dr. Tenio is the CEO and founder of Resilier Health, a medical group that uses a precision medicine approach to treat patients with complex conditions, including neurodegenerative, autoimmune, chronic infections, and environmentally acquired conditions like mold. His clinic Resolier Health is one of the only clinical groups in the U.S. that has an integrated indoor environmental professionals squad as part of the multidisciplinary practice and is launching an initiative to build healthy housing all around North America because of the public health issue caused by poor indoor air quality. Dr. Tiniot's training includes a BA in Political Science

Starting point is 00:06:29 from UCLA, an MD from UCSF, and an MBA from the Wharton School. He did his internal medicine training at the University of Pennsylvania where he was a chief resident and a Robert Wood Johnson Foundation clinical scholar. He's board certified in internal medicine. He's also received a certification from the Institute of Functional Medicine, and additionally, he's CIRS certified by surviving mold and a diplomat of the International Society of Environmentally Acquired Illness. Dr. Teneo is currently on a part-time faculty at both John Hopkins School of Medicine and Nova Southwestern School of Medicine. Dr. Craig Tineo, thank you for being on the podcast.

Starting point is 00:07:16 It's a pleasure to have you here. Yeah, thanks, Drew. I'm really excited to be on the show today. I love how we ended up connecting because I had put out a call to a few other practitioners that are in the space and somebody recommended you for your deep expertise when it comes to all things, brain and especially complicated situations. And I think mold is one of those things that's in that complicated category because there's just so much that is not known. I often think of mold as, you know, the early days of Lyme disease.

Starting point is 00:07:52 You know, people weren't even sure if Lyme disease was a real thing in the early days or was it all in people's head. How did you become to be an expert of complicated things, but especially when did mold specifically get on your radar? Yes, that's a great question. You know, if you had asked me 10 years ago that I would be taking care of patients with complex environmental illness and mold illness, I don't think I would have believed it. You know, it's been a bit of a journey. I think my whole career, I've been interested in how to improve

Starting point is 00:08:29 the care of patients with complex chronic conditions. And, you know, initially had been doing it, you know, more through the conventional side of medicine with really the last company that I helped to start and build was a group that took full risk global capitation for Medicare advantage. And we were building primary care centers in the inner city for a lot of patients who had been uninsured. But with my own health and with other friends around me, I could see that the integrative and functional medicine model could really make a difference, you know, far above and beyond conventional medicine. And when we started Resilier Health, and the whole name Resilier is a coin name to stand for

Starting point is 00:09:27 resilience, you know, our vision was, is we wanted to be a place in which patients with complex chronic conditions who weren't being served well by conventional medicine could come and get the right type of care and have both conventional and, have both conventional and integrative medicine integrated together because we could see a lot of patients have their primary care physician and they have an integrative doc and oftentimes those views are not merged well together. And we started Resilare Health and really focused initially around neurodegenerative diseases and working pretty closely with Dale Bredesen and his approach towards helping patients with cognitive decline in early Alzheimer's and then being down

Starting point is 00:10:13 here in South Florida, it just became so quickly evident that so many patients who had cognitive issues were also having significant, significant issues with mold exposure. And as a result of that, really, you know, just following patients' needs, you know, we started to build our expertise in mold. Help us understand. And I think a great place to start is what is the connection between mold and brain health. And then we'll talk about how mold can impact other areas of the body as well. Yeah. And so, you know, and I think one of the things that we'll, I'm sure, get a chance to go into now is

Starting point is 00:11:00 you know, kind of been a summary, you know, for, you know, what might be better called sort of toxic soup from water damage buildings. There's a whole host of things that are really causing the issue. But, you know, the big connection is that there are environmental toxins in the indoor air. And most of the time, they're getting to the brain by being inhaled through the nose and they're going through the alfactory nerve, which is, you know, we're finding out is the same pathway that COVID gets into the brain. And it's likely causing, if you look at the patterns of inflammation,

Starting point is 00:11:47 they track very closely to where the olfactory nerve goes through the brain. And so a lot of the symptoms from mold illness really come from neuroinflammation that comes from toxic exposure, from inhaling, really polluted air inside water damage buildings. And breakdown, we did a whole documentary series on the topic of neuroinflammation, but for those that haven't seen it, give us an understanding. What is neuroinflammation and why does it matter today in our modern world? So I think that neuroinflammation is really at the heart of two types of conditions

Starting point is 00:12:32 that have really vexed a conventional medicine for decades. You know, one is a whole category of fatiguing illnesses. You know, it's taken decades for chronic fatigue syndrome to really be accepted as a real entity. And, you know, many patients have suffered from that. And I think the heart of a lot of the pathophysiology of chronic fatigue syndrome is, is neuroinflammation. And then a lot of these medically unexplained symptoms,

Starting point is 00:13:11 I think come from neuroinflammation because if you start to have signals in the brain that don't work right, I think sometimes the patients interpret those as just symptoms that don't fit in a nice box from conventional medicine dogma. and then when you listen to patients and you understand what's actually happening in the brain, a lot of those symptoms do become much more understandable.

Starting point is 00:13:45 And help people understand a little bit that traditionally, you know, the spectrum of neuroinflammation that patients would be going through, it's not like you can just go and do a test always to discover it. You know, why is it that neuroinflammation is so tricky to sort of pin down, at least using the current sort of conventional model? Well, I think that, you know, we're in a period where the technologies to understand what's happening with the brain continue to accelerate and to explode. And so I'll give in an example.

Starting point is 00:14:26 There's a number of functional imaging techniques, either functional MRI or spectral scans or pet scans that have been available, most of the time they've been not covered by insurance and priced out of the reach of most patients to get access to. But the research has shown that when you look at the brain, in a lot of these conditions, there's a lot of activity going on. We tend to use a technology called neuroquant, which takes a special type of MRI and basically, basically takes the MRI image through a computer database and compares it to a control group of thousands of patients and basically does an anatomy lesson. It breaks down 154 parts of the brain and says, is it large or small compared to other people your patient's age? And the beauty of

Starting point is 00:15:26 the neuroquant now is, I'd say, five, seven years ago when we first started using it, it wasn't covered by insurance, but now probably about 70 or 80% of patients are able to get insurance coverage. And so they're able to get a pretty accurate snapshot of anatomy at a level that would take a radiologist about 12 hours to do on her own. And so that's not really happening without the addition of technology. And so I think the technologies are really starting us to get better insight to what's happening in the brain, and I think that will only accelerate. That's great. I have some questions about the neuroquant that we'll get to a little bit later on, but that's fantastic to see, because I think that's one challenge that a lot of people deal with

Starting point is 00:16:14 when they are suffering from any sort of challenges that they think that their brain health is being impacted, whether it's Alzheimer's or sort of like early, you know, sort of kind of cognitive decline or traumatic brain injury. And they'll often go to a traditional conventional doctor. And if they can't exactly identify something, if you're not exactly diagnosed with something specific, it can fall into this range of sort of subclinical. Well, we know something is wrong, but we just don't know what it is. So just you're off on your way. Right. And I think that we've gotten a real appreciation for the broad spectrum that there can be from neuroinflammation and what you can detect on imaging.

Starting point is 00:17:07 So sometimes a scenario might be where a patient comes to us and they have sort of plastic sort of mold exposure, multi-system, multi-symptom illness, and family members are saying, okay, well, she's sick, but I'm not. and we say, well, let's just talk a little bit. And we listened to some of the stories for the family members. And it turns out that many of the symptoms that they're having, they just attributed to aging

Starting point is 00:17:40 or just some of these nagging issues that were unexplained. And you do an image, neuroquant, and you see there's a lot of neuroinflammation. And when you address the environment issues, not only do you fix the initial patient, but many members of their family, a lot of the symptoms go down. And so I think there's a really fundamental question that we have to figure out with better research, which is how much is environmental exposure really contributing to a lot of

Starting point is 00:18:14 the different symptoms that patients present with? As you mentioned earlier, mold is sort of a stand in for a larger group of environmental issues, this toxic soup that is often happening from the buildings. We are getting poisoned by the buildings that we live in from water damage and the way that they're built and all sorts of other issues. What are some of the most common examples of issues or symptoms that people come into your clinic with who are suffering from either mold or this broader spectrum of toxic household soup. So, one very common set of symptoms are fatigue, just really, you know, profound fatigue that's oftentimes can be physical, but more frequently is just mental fatigue, you know,

Starting point is 00:19:15 cannot get through the whole day without taking a nap. and they don't know why. Another is really profound anxiety. We have patients who come in who have been seen by, you know, multiple psychiatrists or had a couple come in a couple months ago that both had been given a diagnosis of bipolar disorder and put on five or six psychiatric medications when most of their psychiatric symptoms disappeared within three weeks of moving out of the moldy environment.

Starting point is 00:19:54 So a number of sort of anxiety and emotional symptoms are present. A number of muscle and skin symptoms, including sometimes skin symptoms that can be burning parasizures or tingling in the arms and legs. there can be problems with blurry vision, where in particular, because patients can't oftentimes distinguish between gray and white contrast, they'll go to the ophthalmologists and be told, I have problems with my vision, and the ophthalmologists will test them and say, hey, you have a 20-20 vision, there's nothing wrong with your eyes, but when we test them with a visual contrast sensitivity test, they cannot tell the difference between gray and white very easily. And then there are some additional symptoms like urination, where patients are going to the bathroom

Starting point is 00:21:00 a dozen times or more a day. And that's usually caused because hormones that control urination are diminished. And an interesting symptom is static shocks. When you tell you, touch a doorknob. And that's usually caused because there's some problems with salt and water balance and you create a little bit of an electrical gradient. And so that's a very classic symptom for mold. Wow. So if somebody's getting shocked all the time, wherever they go and they're opening up doorknobs, that's a reason to pay attention to this category? That's correct. they're not just part of a Marvel movie, but it could be something with mold. Wow.

Starting point is 00:21:47 Take us through the, what's happening on a biological level that mold and this toxic soup of environmental toxins can be wreaking havoc on our body through all these different ways that you just shared. Yeah. So the biology can get very, very complicated. And I think one of the most exciting things that's happening is the research is really going down to the level of people's genes and how genes are getting turned on and off. But there are four or five, I think, critical points about what's happening in the body.

Starting point is 00:22:34 Now, I think first is that there are a set of people who have genomic susceptibility, meaning that I think there's likely a, you know, multiple genes that affect their ability to be sensitive to mold. And very likely those genes are along the pathways of how people detoxify. What you see is a, you see is a, ineffective immune response, a inflammatory response, and ultimately a problem with the mitochondria. And so that their mold is likely a trigger for this inflammation and response. And whether it's called sort of the cell danger response, Dr. Shoemaker has put a very, you know, a specific set of pathways together around what happens with mold. But you get this ineffective response that's very difficult for the body to turn off. It affects the brain, and in particular it affects the hypothalamus and the pituitary so that there are reduced hormones that ultimately prevent the response from being turned off.

Starting point is 00:23:57 And then the mitochondria themselves lead to problems with energy and problems with brain functioning. And ultimately, that can create neuroinflammation. But we will see in older patients, you know, significant atrophy over time. You mentioned older patients. We've had Dr. Bretteson on the program and you were instrumental in sort of that group of early case studies that were being done using the Bredesen protocol to treat cognitive decline. Tell us the relationship between mold, cognitive decline, and Alzheimer's, as you were talking about with patients, and some of the findings that you and the team at the Bredesen protocol

Starting point is 00:24:50 have found about the connection between mold and cognitive decline. Yeah. And so, So, you know, Dr. Bredesen has been, you know, pioneering in articulating a root cause approach to cognitive decline, that, you know, his core hypothesis is that we have to look at a number of different root causes that can cause something called amyloid precursor protein to either turn off or turn off. And, you know, there's a bit of a balance. And so ideally when patients are healthy, the seesaw is sort of tipped towards the balance where the body is able to create connections and synapses. And then when there's a tip the other way, it can destroy synapses. And when we look at all of the different root causes, and let's say,

Starting point is 00:25:52 There's a good certified Bredesen practitioner who's taking patients through the protocol. There's usually two major reasons now why people won't have success. The first reason is just not adhering to the protocol. It may be just too difficult for somebody. But the second is the whole host of toxins, what Dale calls calls type 3. or, you know, toxic Alzheimer's. And within that, there can be a combination of mold, chemicals, heavy metals, or infections. Usually when we go down and look at these issues, there's usually not just one, you know,

Starting point is 00:26:43 root cause. There ends up being a couple. And it's really hard for the brain to start to repair itself until, you know, that's there can be removal of toxins and the related inflammation out of the system. And unfortunately, that can be very hard for patients to do because when you're looking at some of these issues with environmental illness, the hardest step to take is the first step, which is addressing the environment. And that can be a very large barrier for patients.

Starting point is 00:27:24 And so, you know, just to kind of put it all together, toxin exposures, Dale thinks has been about between 50 to 60 percent of people with Alzheimer's have significant amount of toxic exposures. We find the same in South Florida and probably the number two reason why patients aren't getting better on the progress. recall is there's not a sufficient addressing of the toxins. Take the home and give us the big picture of where the most common areas. You're a physician and you're treating patients and you're helping them better with mold, but in a way you've had to become a little bit of an expert in sort of buildings, at least understanding where people are getting this toxic soup from in the first place, whether it be mold or some of the other components.

Starting point is 00:28:18 So kind of walk us through the house a little bit and tell us why is it that the home is poisoning so many folks? And where would they find these toxins? Yeah. So now, Drew, I remember actually the time where we decided as a company where we really wanted to go deep into mold. and it was at the time of Hurricane Irma and myself and my partner needed to be, we needed to leave our house for about a week with the family and go up to Orlando

Starting point is 00:29:00 because they just had done a general evacuation of South Florida because of Irma. And, you know, when you're in a hurricane and surrounding bad weather for a couple of days, it just sort of the realization hit us that if you look at that this is a very preventable and foreseeable problem. And there are fundamental issues with how we build houses today that you can predict that maybe 30, 40 percent of houses, certainly in South Florida, will get mold problems if we continue the same. type of construction. And some of those construction flaws are, I think, number one, having bad drywall. Drywall, the way that most people purchase drywall is just a breeding ground, a petri dish for

Starting point is 00:30:04 mold. And so if any of drywall gets wet and is not dried out quickly in a day or two, it will become a place in which either mold or actinomyces can grow. And sometimes, unfortunately, for homeowners, that might be a leak that you don't even see. It could be a leak, you know, in the shower behind the tile, or it could be a leak in the dishwasher, you know, hidden behind the cabinets, or if there's water damage, it can be coming, you know, from a window from a window cell. So any place where there's ongoing humidity and heat and drywall can absolutely be a place in which mold can grow. Now, the other thing is in the tropics here, there can be an issue with humidity and how humidity is managed. We see that houses will do much better in the tropics with having positive pressure where the air

Starting point is 00:31:11 when you open a door, the air pressure actually pushes air outside of the house rather than in. And then the air conditioning unit can be a huge source of mold and particle exposures. And so we get often stories where patients haven't addressed their air conditioner for, you know, five or ten years. And you look at the coils and they're covered with, they're covered with mold. going further up north, basements are a common focus for water damage and problems. And oftentimes there'll be great finished basements where the kids are playing or it's a big great great room and there'll be hidden water damage behind there. So pretty much anything in which there can be water damage and then there can be substances

Starting point is 00:32:04 that bacteria and mold can feed on. are our sources. Now, I want to chat a little bit about sort of diagnosing and discovering that somebody's dealing with the mold issue, right? You talked about these unexplained symptoms, and I know at your clinic, you know, you guys spend a couple hours with people going to their whole timeline, not just for mold, but just any kind of thing that they're dealing with in their life. When you start to get into the brass tacks of actually seeing, is their mold present,

Starting point is 00:32:37 that's impacting somebody, how do you begin the process of using either laboratory or other techniques to discover that mold seems to be present? Yeah. So, you know, I think first as a clinician, I think it, there's just important to have awareness of it. And I've had several very fruitful conversations with patients' primary care. physicians where, you know, they were wondering why patients had these symptoms and, and they became aware of, you know, mold illness. And I think once you become aware of it and,

Starting point is 00:33:21 and see a couple cases, it does really, you know, it's like going through the rabbit hole, you you realize how much it's likely that environmental illness does contribute to patient symptoms. But, With the house, I think it's really critical to have the right type of assessment. And let's just take a case in which there's really high suspicion of mold. I think it's important to have a trained indoor environmental assessment professional on site to look. And that's really because I've gotten an appreciation that building biology and the whole work that IEP professionals do is very similar to medicine where there's not a perfect test. You know, everybody kind of tries to distill it to saying, okay, is this one test better or this test better? And the answer is no, we actually have to get a lot of different information.

Starting point is 00:34:30 We need to understand, you know, the construction and the age of the house. We need to look for signs of water damage. We then measure certain types of tests depending on the specific situation. And then we kind of put it all together. And that's really similar to what doctors do. They're just, you know, in some ways sort of building doctors. And I think we are one of the only practices where we've developed an indoor environmental professional group as part of the practice because we felt here in South Florida to get

Starting point is 00:35:04 the right answer was just critical. And so we now have certified professionals as part of that. But really getting somebody on site is important because I think one of the biggest insights in the last year has been that maybe the biggest issue in the house is not mold. It's actually, you know, bacteria and endotoxin and actinomyces. And Dr. Dr. Dr. Shoemaker has done some very interesting research that was published this last month that showed that when you looked at some very sophisticated transcriptomics testing to see what was causing inflammation, and then you did sophisticated testing in the house, you know, more times than not, the answer was it was bacteria rather than mold.

Starting point is 00:36:01 And so some of the mistakes that we see happen out in the industry is people just get an air sample. And if the air sample is negative, they're told it's fine in terms of mold, or they might put a petri dish out and just look for spores. But the bottom line with most patients is your body doesn't really care if the mold is alive or if it's a spore, if there's any kind of toxic soup or schmutz or whatever you want to call it, that you're inhaling fragments, and that's enough to cause inflammation. And so if there's a high suspicion, we really think it's critical to get the right type of indoor environmental professional in the house.

Starting point is 00:36:52 and a clear mistake can be for somebody to just rely on a home test. Now, obviously, not everybody can get an IEP there, and if that's the case, there are ways to get, you know, some more accurate testing than not. And could you share what IP stands for? Yeah, IEP is indoor environmental professional. Got it. So it's a little bit of a higher certification when it comes to indoor toxins and the ability to discover that.

Starting point is 00:37:31 Rather than just having, you know, often when people are going to buy a new home or inspecting a place, there'll be a home inspector who just will sign off and say, okay, there's no visible mold that we see here. So mold is not an issue. But this individual that you mentioned is going to be going a lot deeper. Is that how it works? Yeah, I think that there really are. sort of some different sets of regulations. You know, the most common set of regulations are just around real estate standards, you know, buying and selling a home. And I think that patients need to

Starting point is 00:38:04 get an IEP that is sensitive to health standards, that they know that if patients have mold sensitivity, the standards just need to be higher than the real estate standards. And, you know, what we find in many cases is a lot of the testing that can get done in the real estate standards are a little bit biased towards just showing that there's not a huge problem. And I think most patients want to know is there any problem? And so that they need a help of a qualified IEP to get there. Yeah, I often think about it as, you know, home inspectors are often, you know, requested upon by real estate agents, right? And the thing is, is that if you're an inspector who keeps on finding problems with 30 to 40 percent of buildings having mold, not just in South Florida,

Starting point is 00:39:03 but, you know, in North America as a whole, you're not going to get future business because they're like, that's the guy or that's the girl that keeps on finding the problems. And that's why it's so important that if you are an individual that's buying a new home, you need to have somebody that advocates on your behalf that you've picked because, you know, I was saving this for a little bit later in the conversation, but this seems like a good period of time. We can always jump around a little bit. But once you move into a home, especially if you've bought that home and there is a toxic soup problem, including maybe bacteria, but definitely mold, is remediation can be one of the

Starting point is 00:39:47 most difficult things that you do. Repairing that process, especially when you have it in the dry wall that might be the whole kitchen, you know, and you've already moved into a house, you'll spend, you could spend hundreds of thousands of dollars on remediation and still not end up at a place where you're completely sure if the home is habitable for you. Any thoughts on that that you want to expand on? Yeah. I love the way that you. you've framed the issue because I think this has been a situation in which my view has really changed a lot over the last two or three years. I used to think that if you had a problem in the house, of course, it could get fixed. And I think that for many patients, the best answer may be to

Starting point is 00:40:46 move out of the house rather than to fix it. And so that's that's really the headline. And why do, why do I say that? Well, I think that there's, there's a couple reasons why moving out might be better. If there is extensive mold damage, we're finding that the building biologies are not dissimilar to the microbiome in the human body, meaning that we'd like to be able to adjust it, but it may not be as easy to adjust as we think. So it's sometimes not as easy as just saying we're going to get rid of the issues and fix it. Some very detailed studies done in Japan have kind of shown that it's harder to move the building microbiome than we think. But the second, the second, is that especially in patients who are really sensitive, there is a lot of trauma that can happen

Starting point is 00:41:52 with when the remediation doesn't get done right the first time. And I think there can be a lot of damage done that gets in the way of healing in terms of multiple levels, multiple times of remediation. And when we find that they're big issues, unfortunately, that's oftentimes the case. And what we've started to do with patients is to have that discussion up front much more than we used to about. Is it just better to fix it for a real estate standard? Obviously, you're going to be ethical and you're going to disclose, but the real estate standards, I think, are quite different than the health standards, and then just find a better

Starting point is 00:42:39 place to move to. And I do think also with patients with Alzheimer's who might not have any physical symptoms from the mold, then it becomes, you know, that's quite a bit of a different situation than patients who have physical symptoms because sometimes those physical symptoms will come back when they're in the house, and at least that's a safety and protective mechanism, and that's not present in patients who have early Alzheimer's. And so I think there is a lot of situations now where it's important to get the right information up front and before pouring a lot of money into extensive remediation, you know, to have an honest conversation about, is it just better to move? And then finally, there are situations where you may not ever be able to fix the problem. And so what would that be?

Starting point is 00:43:37 For example, if you're in a condominium complex where the governance is from a homeowners association, there's just a logical awareness that the HOA board is not going to have the same kind of urgency to fix the entire building that a occupant of a condo might. And so sometimes there are, you know, common areas like hallways and entrances that just never do get fixed. And if those are really causing a problem for patients, I'm almost in all cases, we'll just say it's better to, you know, move out. What about testing when it comes to the individual and looking for mold or mycotoxins that are present inside of their body? There's so many different, as you mentioned earlier, there's no perfect test that's there. but what is the sort of, okay, I'll typically do this test, this test, this test, and these are the things that I'm looking for.

Starting point is 00:44:41 So maybe you can explain what mycotoxins are and then how you approach from all the gathering of the data of looking for the presence of this environmental soup and mold inside of the body. Yeah. So mycotoxins are toxins that are released by mold. There tend to be about, you know, dozens of different mycotoxins that can now be commercially tested. And, you know, mycotoxins can get in the body probably through, you know, multiple different mechanisms, you know, inhaling mold or fragments. You can ingest mycotoxins. There's a whole deep literature in the veterinary side of animal illnesses that are caused by grains that are poisoned

Starting point is 00:45:40 with mycotoxins. And there's a, you know, a lot of controversy right now about the use of urinary mycotoxins to measure and manage mold. I think first we need to understand that if bacteria and actinomyces and endotoxins are causing all of this inflammation, that first of all, if you do urinary mycotoxin test, you're not going to measure any of that. And so there's going to, you know, the Shoemaker paper argues that it's over 50 percent. I think we need, additional research to figure out how much it really is, but I think it's an important insight that if you're just looking for mold, you're going to miss a significant amount of cases. And we have to have additional research to figure out the exact numbers.

Starting point is 00:46:39 But with, so you're going to miss that with mycotoxins. The second thing is that if you're looking at testing, what is causing the problem? And in general, the biggest issues are around the inflammation and what's happening in the brain. And so if we have a budget, I would prioritize some of those tests over that. I do use urinary mycotoxins in a couple of cases, and that's, I think, primarily when there's a logic there around patients wanting to see that there's mold in their system. And if I believe that that will help to convince them to take action, I'll oftentimes do that. But it is lower on my set of testing rather than higher, because what I will often

Starting point is 00:47:37 times see is, you know, for example, in South Florida, there's a lot of mold in the air outside because we're part, you know, because of the Everglades and just the humidity. And so I suspect if you did mycotoxin testing on 100 patients with no health problems, that you'd see most of them have okra toxins that are elevated. And I haven't seen the research around that that hasn't been published to my knowledge, but I've seen enough people who are friends of patients who are worried about them having, you know, worried about themselves having mold and really didn't have symptoms, and they come in with an isolated high ochrotoxin. And so I think as any test, we have to really understand that there's false positives and false negatives. And I think the mycotoxins have to be

Starting point is 00:48:30 read the right way. So when you were talking about the, looking for the inflammation inside the body. So can you talk about some of those tests that are there? Yeah. And so the inflammatory markers, many of them are connected to the innate immune system, which is kind of the body's most primitive immune system. And many of those markers are signs that that immune system has been activated. And so, for example, C4A, which usually should be done. by National Jewish Center Labs. If it's elevated, oftentimes is a good marker that things are going on in the brain.

Starting point is 00:49:17 TGF beta is a marker that can be elevated in mold, but also can be elevated in other infections and cancer, so it's nonspecific. MMP9 is a marker that when it's elevated, we oftentimes think about histamine and mass cell issues as well. And then VEGF is oftentimes low. And that's a cytokine that actually decreases perfusion in the body. And when VEGF is low, we oftentimes see poor blood flow to the brain. And you can see poor blood flow to the hands and feet as well. So those are a couple of inflammatory markers. I think the important

Starting point is 00:50:04 thing to understand with all of those markers is that none of them are, you know, sort of perfect gold standard markers and that if it's elevated, it's only mold. There are other things that can elevate it, but they're extremely useful to put together the whole clinical picture. Exactly. And I think that's the key with your approach. And, you know, some of your other colleagues that are also in the space is that you're trying, to put together the best possible story, which also includes looking at the home or the apartment that the individual might be living in or the family. And then also their symptoms, when their symptoms started, the timeline of those symptoms,

Starting point is 00:50:51 and then, you know, the clinical testing that you can do on that side. And it's the combination of those all where then hopefully you can have a really strong hunch that mold and this toxic soup could be a challenge that then could be addressed. Once, let's say there is, you know, some discovery of some mold that's there. And just a reminder for everybody that's listening, it's often, you know, you have to lift up the panels under the sink or it's behind the shower. Like these are not very visible things, especially if somebody lived in the house before you and there was early signs of mold.

Starting point is 00:51:30 like we're all very good at getting rid of a visible mold in most cases, right? But it's the hidden mold that's behind things that then in a weird way is it's the perfect breeding ground for mold and bacteria because we've protected it from the natural elements, sun and these other things that would make it more difficult for mold to grow at the level that it's growing in when it's in this dark, cool area that, also has exposure to moisture. It's like the perfect feeding grounds. So let's say, you know, all those things are present.

Starting point is 00:52:09 There's mold that's present in the house. There's some neuroinflammation and some signs of clinical information. The patient's timeline starts up. Everybody's a little bit different, but in your head, if you could compartmentalize your approach, how do you begin the process of untangling from there? Yeah. So I think the most important part of the approach is to get them patients into a clean environment. And so if it's possible, let's say there's an issue with, you know, that there could be a long remediation, you know, trying to just get the patient out of the house completely for a couple of weeks.

Starting point is 00:53:00 can oftentimes be an immediate value because patients will see their symptoms go away, you know, not maybe not completely, but they'll see that it's resolved with being removed from exposure. I think it's really important that patients can see that. Can I ask a quick question about that? Sure. Do you, will you use that sometimes as like almost like a challenge test for them, like, hey, look, go away for two weeks out of your current place and like, do you notice your

Starting point is 00:53:36 symptoms reducing? Or have you ever gone on vacation away from a few weeks in the past? And you found that you've been better for a little bit than you came back and you didn't feel as good. Absolutely. That can be used as a diagnostic challenge. You know, I had a patient who has Parkinson's where. when they went from Miami to Colorado for a month, their hair actually changed from gray to black, you know, and sort of that kind of profound change in terms of differences with exposure.

Starting point is 00:54:16 So you don't usually get such, you know, that clear of a signal. But if that can be arranged, that's ideal, you know, one of the challenges just becomes, okay, well, how do you know that whatever place that you're going to is completely safe and that. But I think getting out of the environment is absolutely critical. And that's really the first part of any protocol. And so having that conversation with patients and just really getting alignment around that is, I think, the most challenging part of taking care of patients here. because, you know, there's a lot of immediate sort of pain and trauma that there can be with leaving the home or even thinking that the home is the cause of their symptoms. And there's, you know, oftentimes it takes people quite a bit of time to get their head wrapped around that.

Starting point is 00:55:17 And then would you like to go more deep into the home or what we're doing clinically? Just want to. Yeah, yeah. I think big picture, it would be good to go through the different buckets that are there. So the first one is you're trying to minimize the future exposure by getting them to a clean environment. So let's move to the clinical section and talk about that a little bit. Yeah.

Starting point is 00:55:41 So I think on there, there really are, you know, if we can get the environment solved. And usually the environment is not just removing. but really getting people aligned on that taking care of the environment is going to be important in the long run. Now, then the next piece is really just getting a lot of the foundations sort of right, which oftentimes there's inflammation that we have to deal with and the use of free fatty acids is really critical. There are fatty acids that can help with neuroinfluenced.

Starting point is 00:56:24 inflammation, like resolvins or specialized pro-mediators, the use of phosphatidyl colonin is oftentimes very helpful. The use of buterate, which is a short chain fatty acid, can oftentimes help the guide. So getting free fatty acids there, oftentimes we'll see patients who are really sensitive. And if they're sensitive, it's really important to not start binders. right away because people will react in a very negative way. And so we do some careful work to understand how sensitive people are. And then there may be issues like mass cell activation

Starting point is 00:57:08 or multiple chemical sensitivities that are that we need to deal with. Increasingly, we're finding that, you know, patients are just seem to be getting more sensitive. And, you know, sometimes people will come in with, you know, EMF sensitivity or, you know, they'll have inflammation from high levels of iron. So we just look pretty broadly for other types of sources of inflammation. We find that a very good solution for the neuroinflammation is a compounded prescription called synapsin, which can be taken through the nose. And oftentimes, helps a lot of the symptoms of neuroinflammation. But we'll try to do a number of these things

Starting point is 00:57:57 before we start people on binders. And then at that point, you know, so that period of time might take, you know, a month or two or, you know, usually. Oftentimes people will come in having read stuff and they'll be really ready to be on binders. right from the start because they're saying and thinking, I just got to get the mold out of my system.

Starting point is 00:58:26 And we have to do some education to explain why we really do need to prepare the body to be able to handle binders. Then the next part of the journey is really to try to get a lot of the toxins out of the body. We're appreciating that there are different. metabolic pathways that help the body to detoxify. We do both pharmaceutical options like holostiramine and well call and natural and nutraceutical options as well that can oftentimes complement that. And then there's a matter of fixing a number of the biochemical markers of inflammation. Each one of those, there can be some stepwise treatment that's needed.

Starting point is 00:59:21 And then the final part of the treatment is usually helping the mitochondria directly or doing some approaches to neuroplasticity that can really help to heal the brain and restore function. But it's really important to understand it's a stepwise approach and that that approach will take some time. It can take 12, 24 months if people have had. symptoms for years and years, it may take even longer. And so, you know, and that's where some of these cases are, are, can be really complicated in that sometimes you'll have somebody who clearly has just pure mold related conditions. It's very clear that the environment is 90% of the issue. Other times, you'll see that patients have other issues like maybe a viral

Starting point is 01:00:19 chronic fatigue syndrome, where mold has just exacerbated things, but after you treat it, they'll get back to where they were before. And then another type of presentation that we're increasingly seeing is people got exposed to mold or siguitara, and they had mold-related illness, but it turns out they had reactivated Lyme or Babesia or some other chronic infection because mold really did drop their immune systems capability. And those are probably the trickiest cases to figure out. Yeah, and increasingly I hear also the other way that a lot of people who think that they have a recurrence of lime are actually dealing with the mold issue that happened to our friend Dave

Starting point is 01:01:06 Asprey, the founder of Bulletproof. They thought it was primarily Lyme that was impacting him, but it was mold that he was dealing with at the time. What do you think have been in the last especially couple years since you have your pulse on what's happening right now and the mold movement is still small in comparison to a lot of the other areas of medicine that have a lot more funding and a lot more development and a lot more people working on it? What do you think have been the biggest advancements that have really helped move progress forward and helping patients get better in the last, you know, few years.

Starting point is 01:01:50 Yeah. So I think, I think first this whole issue that it's not necessarily mold, that insight, you know, I think Dr. Shoemaker's paper that shows that other things besides mold can be, driving a lot of the inflammation, I think, is a very sort of disruptive paper because it's going to make everybody look, you know, sort of at their preconceived assumptions and say, what, you know, what do we need to do different? And so, for example, if actinomyces and bacteria really are a big issue, then a very logical question is, okay, is colostyramine and

Starting point is 01:02:40 well called the right way to get out actinomyces and endotoxins out of the body. And I think the answer is that nobody really knows if those are the right treatments. But just the insight that it's not just mold, I think is quite important. And one question for you on that one clarifying question that I didn't get a chance to ask earlier. Sure. These bacteria is the thought process that these bacteria that are there, that the primary source of contamination is also still the homes. So just like mold can develop and, you know, we can find in these different areas, is that the idea of this bacteria? And if that's the case, you know, are they feeding on the same sources of things as mold is? Yes. So, for example, a bacteria that's called sort of actinomyces. So actinomyces is really fascinating

Starting point is 01:03:38 because if you start to look at it closer, it's actually the bacteria where most antibiotics have actually come from. So that, you know, it's kind of been this factory of producing very biologically active compounds that the pharma industry has been working with for 50 plus years. So, but actinomyces compete with molds in the same environment. And there are these studies that show that actinomyces can really move rapidly in the house and just kind of take over the spaces that mold used to be in. And so they're competing for the same environment that molds are. And I think the key thing with actinomyces and endotoxins that people listening to this podcast just need to understand is if there's a negative mold test that,

Starting point is 01:04:37 That may not be enough anymore to say that the house is safe. You know, what we're tending to do in our indoor environmental assessment programs now is we will collect samples that can be sent in for DNA for actinomyces and endotoxins, but we'll just hold them. And then if the mold tests are negative, then we'll send it in if there's a high enough suspicion because a lot of these tests are still pretty expensive and we don't want to, you know, unnecessarily run extra tests, but it's really important that that's looked out for in the assessment because if there's not realization from it, you know, people can be getting

Starting point is 01:05:22 a clean bill of health when the, in terms of their building and that's not the, that's not the case. You know, I think the second advances are really looking into the whole area of the cell's metabolism and what's happening at the level of gene expression. And, you know, there's been a whole movement in biology to really look at, you know, what's called metabolomics or transcriptomics. And without getting into the technical side, you know, what we can, you know, now have the ability to do is to see how the system works at the cell level and then go deeper and to say which genes get turned on and off. And this whole area, you know, which is called

Starting point is 01:06:12 computational biology, because it usually requires computers to kind of look at the whole level of expression, I think we're really seeing that there are problems in the cell metabolic area that are quite profound. And so many times, patients with mold and other fatiguing illnesses have been presenting with profound fatigue and having a very hard time to convince practitioners

Starting point is 01:06:44 that their symptoms are real. But when we look at these metabolic signatures, we're seeing that at a very fundamental biological level, many things are really being turned down at a at a profound way and you know i can't tell you how many times we have patients who come in in here you know they've been seen by 10 20 30 physicians and they you know they break down crying because we we believe their symptoms and they've been told it's in their head and we say it is in your head here's the neuroquant to show what's happening in your head. It's not just, you know, a psychosomatic. And then, you know, what Dr. Shoemaker has been

Starting point is 01:07:33 able to make available now, most of these metabolomics and transcriptomics were research studies, but it is commercially available now a test called Jeannie. It's costs, you know, kind of in the high hundreds of dollars. And it looks at messenger RNA. And what we can really see now, at that level is we can see that there's problems with the mitochondria, that what's happening is that the genes that turn the mitochondria on and off are actually in the nucleus, and some of those genes get flipped on. We can also see that how the cells are working are impaired. And there literally is a process that we see in cancer cells called Warburg physiology that oftentimes happens with patients with mold.

Starting point is 01:08:28 And then really importantly, we can see that many of these things can be turned off when patients go through a whole protocol, which may include a peptide called vasoactive intestinal peptide. And so, you know, this test used to be really much more of a research test. It was a lot more expensive three or four years ago. the costs continue to go down. I hope is that the cost will go down another 50% in the next year or two. And we've done about 40 or 50 genies.

Starting point is 01:09:05 And what we've been able to see is that there can be some insights from that test that you might not get from other testing. So sometimes we can see that patients are being actively exposed, even though they've tried to take the necessary steps. And that's a critical insight. It can show that sometimes there's underlying infection or your blood clotting mechanisms have been activated. It can even show that rather than having mass cells,

Starting point is 01:09:41 that almost every cell is producing histamine. And so, you know, it really is the future of medicine. and it can be a useful tool in the right context. You know, where we try to stay on the cutting edge, not on the bleeding edge, you know, we like to say. You know, and I do feel that Jeannie is quite useful. Another change that I think is going to make quite a bit of difference in this area is what's happening around COVID research. In December last year, Congress allocated about $1.1 billion for research into long COVID and post-COVID syndromes, which, you know, with the exception of a couple of major, you know, body systems looks almost exactly like chronic fatigue syndrome and the whole host of fatiguing illnesses. And my suspicion is that the research in this area is going to unlock a number of insights

Starting point is 01:10:53 into chronic fatigue, myelomyelomyelitis, mold-related illness, neurodegenerative illness. Because when you double-click down and look at the metabolics, you know, there are a whole host of pathways that look almost identical. And, you know, with good science, there's going to be multiple competing theories. but the biggest social issue has been, there's been a huge mismatch between the amount of disability and illness that there has been in the population and the research dollars attached to it. And so this really is the first big slug of money going into fatiguing illnesses. And I think that it can be potentially game changing.

Starting point is 01:11:43 No, I think it could be absolutely huge. And, you know, there's a lot of debate that's out there right now, even some places even saying, does long hauling exist? You know, there's been some criticism in the media. And then there's people that are feeling it and going through it. And I often think of it just like the mold conversation. You know, these people are experiencing something. There's probably a lot of layers. Excuse me. These folks are experiencing something there's a lot of layers to what was going on. It wasn't that they were completely maybe healthy before. They might have been dealing with some stuff.

Starting point is 01:12:20 And it just really shows you if there's any lesson out of all this is that we as a society, a world community, but especially here in the United States, illnesses are getting increasingly complex and we're sicker than ever before. So it's not as cookie cutter as we used to see it in the past. Now, the social context of illness is critical in these settings because, you know, I think when you look at the history of fatiguing illnesses, you know, chronic fatigue syndrome, there's been some version of it described all the way back to the 15th century. And there's almost always there's been a higher preponderance of women rather than men. And so if you ask yourself, well, what are the biases that we have that have led to this? I think, you know, one bias is clearly a sex bias.

Starting point is 01:13:16 You know, I think in that oftentimes women were not believed, and that's a real problem. Another bias has been that our challenge has been, there hasn't been objective measures of fatigue before. And now there are. And there was a very good editorial by Kamaroff, who's a physician in the Brigham, who's been looking at this for about 20 or 30 years. And, you know, he just listed out the, you know, the ways in which you can objectively measure fatigue and diagnose chronic fatigue syndrome. It was one of the top 10 articles in JAMA this last year. and there are very objective ways to kind of put your hands around it. But the amount of suffering that patients go through because they're labeled as psychosomatic is profound.

Starting point is 01:14:13 And if you double-click around psychosomatic and say, well, what proof do the people who are claiming these people have psychosomatic conditions, you know, what can they show? you pretty quickly find that it's a circular loop. There is no objective evidence to show that somebody's psychosomatic. And in fact, most of the DSM criteria go away if you're able to show that there's an objective physical sign of a root cause of a psychiatric illness. So I think a lot of patients have been profoundly miserved in this area. And the medical profession really needs to get its act together on fatiguing illnesses as a whole, of which I think mold and environment is a big subset.

Starting point is 01:15:09 Yeah, it's a growing subset. It's good to get more attention because it also brings in this component of, there's this quote, and it says, I don't know who originally came up with it, but it's been around for a while, is that the absence of evidence is not the evidence of absence. because you can't find what this patient is dealing with doesn't mean that they're not dealing with something. Correct. And I think what, but what is quite different today than, you know, 20, you know, years ago is that, and, you know, this is one of the reasons why, you know, I went into this area, you know, about a half a decade ago is, if you look, if you look,

Starting point is 01:15:55 look at what's happening in the basic science literature, there's real objective evidence of disease. And it's not making it into the realm of clinical practice guidelines, you know, looking at up-to-date, you know, in terms of a medical textbook, there are social and and business and political reasons why that adoption is slower. But it is a science-based way of looking at things. And what really needs to happen is the research needs to get translated into better research around evidence. But the science is really there that the vast majority of patients with,

Starting point is 01:16:51 fatiguing illnesses have profound, you know, metabolic disturbances. And having a lot of family members that are doctors and most of my family coming from the world of health care, you know, there's so many pressures that are on clinicians, doctors, nurses, the whole group that's there. And it's hard enough to just keep up with the basics and the onslaught of demand, especially in the context of everything that happened last year. But we really do have an education challenge, right? a dissemination of the education that's out there. There was that famous study that showed that it takes often, even when the literature

Starting point is 01:17:28 is pretty clear, as it is with certain categories like nutrition, it takes 12 to 17 years for it to ultimately end up, you know, if you're lucky in, you know, a hospital system or your local family, you know, physician's office. That's right. And, you know, I think that sometimes, you know, that same research is showing. that if their financial incentives, for example, if the health system makes more money off of something, then that adoption curve usually gets accelerated. But I think what happens in these kind of situations is, you know, the most important is probably time, you know, to really

Starting point is 01:18:10 take care of patients right with these complex issues. It takes a lot of time initially to really understand everything and to develop that relationship and our health system today is not wired to create that amount of time. And, you know, a prior company with Medicare Advantage, we were able to take, you know, the typical amount of time that a Medicare patient spends with the primary care physician might be a total of, you know, two hours a year, you know, and we were able to triple or quadruple that. So that was sort of eight hours. But sometimes, you know, these patients like the ones we're talking about might need three or four hours in the beginning. And unfortunately, our insurance-based system isn't doing that. I am very hopeful that that can happen with the

Starting point is 01:19:04 right innovation, you know, because there really needs to be just one type of health care for everybody. And we need to get some of these ideas and innovations into medicine. in general. Is there a case study or two that you feel comfortable sharing to really give people a sense of what's possible when these things are addressed? When we go in, we look at the building, we start personalizing the approach with medicine and addressing some of the root causes that are there with people that are dealing with mold, some of this bacteria, the toxic soup. We get the toxins out and address some of the neuroinformation. Is there a case study of somebody you worked with that you feel comfortable sharing? Yeah. So let me just describe a patient who I've been working

Starting point is 01:20:04 with for about four years. And I feel comfortable doing this because we've talked before that she would be comfortable, you know, releasing some of the, you know, the details of the case. But she was somebody who was a Montessori teacher who had been working in moldy environments. And really over about a five or six year period had noticed really decrease in cognitive ability, really hard for her to do her job. And at the time that we saw her, not only did she have really profound, you know, cognitive impairments and problems with attention and focus, but she also had really high amounts of autoimmunity. Her thyroid antibodies were in the, you know, thousands and two thousand sort of levels. And she had a Lyme disease that was, you know, clearly documented through.

Starting point is 01:21:10 multiple different labs. And we worked through a process like we talked about before where we addressed the environment, we addressed the mold, and then ultimately did treat Lyme and then address the neuroplasticity. When we did a cognitive test initially that showed that her scores on a percentile level were in the fifth percentile, you know, to other people her age, there was problems with memory and concentration and processing speed. We saw that in the front parts of her brain, the size of the frontal lobes were about in the tenth percentile, and the hippocampus, which is the memory area, was in the 20th percentile. After kind of going through the whole protocol, which

Starting point is 01:22:07 took a good, you know, two and a half years or so, and there was some fine-tuning. Her memory is now back at the 95th percentile. The front part of her brain has regrown back to about the 30th percentile, and she's back at work kind of at full functioning, you know, if you will. So we've kind of seen that the brain can reheal itself. and, you know, but that the path to doing that does take a, you know, a period of time. And she had a number of things that were in place for success. You know, she had a very good supporting, you know, friends and family network.

Starting point is 01:22:51 And she was really willing to do, you know, all of the activities necessary to have success. How about in the category of cognitive decline, maybe even some of the early Breitzen protocol patients you worked with. Anybody that you worked with there that was facing significant decline, obviously mold, bacteria, toxic soup, those are only one part of it. There's so many other things that are there. There's the high levels of blood glucose and insulin production. There's potentially the heavy metals, you know, which I know the Bredeson protocol addresses, but maybe mold was one of the components that are there. Any sort of anecdotal stories you have of people who've gotten better that you've treated in that category? Yeah. And so I think on that when it comes to

Starting point is 01:23:40 cognitive impairment and toxins, I think it's important for people to understand that sometimes the presentation can be so different than mold, even though that mold can be a big instigator. And in many of patients who have mold exposure, they'll have all of the bio-oer. markers that are elevated as younger patients, but they have no physical symptoms of it. It's just purely cognitive issues. And why that's the case, quite honestly, I don't know. And I don't think that it's been really documented. It may be that their chest ends up being more inflammation chest in the brain and not the rest of the body. And it may be in a part that doesn't create physical symptoms. Not clear at all, but it's a pattern that's really been seen by many people.

Starting point is 01:24:38 But I think with on the on the whole issue of cognitive decline, there are a number of lessons that have really been learned by the network of clinicians. And, you know, and brief editorial that here I think the way that will get more advancement in this. area is that if people are actively participating in this, we should all be gathering our data together and reporting it in a real world registry. We've set up a foundation that has an IRB that to collect the data and our plans is actually to make it open access. We don't want to have proprietary data. We think if you're taking care of patients in these areas, things will work quicker if we can all submit our data and then I think it would be much more

Starting point is 01:25:37 powerful to report on here's a thousand consecutive patients in 10 practices in the area of cognitive decline. It's worked for other areas like cardiology and cancer registries, I think, are a great idea. But with the inside of the network of clinicians who've been working, on cognitive decline. I think there are a couple of huge lessons. The earlier you can intervene, the better. People will just do tremendously well if they have some cognitive impairment in their 50s or early 60s, and there's not a lot of brain atrophy. We can, I think, absolutely bend the curve and create a situation where it's a cognitive decline is not progressing to Alzheimer's. I think that opportunity is really there.

Starting point is 01:26:37 I think in terms of cases, I remember a gentleman who was in his 60s, who had been running his company and was told I had been seen by about five or seven neurologists before he saw us and was told, you know, he really needed to step down in his company and, and just sort of prepare for, you know, going in a nursing home. And he was 63. And, you know, it turned out that there ended up being a huge amount of chemical exposures. You know, we have this syndrome now that we're calling, you know, golf course dementia. You know, people come down to Florida. They live near the golf course and there's huge amounts of chemicals being sprayed on the golf course and and and some of those levels were you know compared to the 95th percentile they were 500 to 700 percent higher than the

Starting point is 01:27:37 95th percent house so very high wow you know there were problems with heavy metals there there was some mold exposure but it wasn't the major issue there was there was lime And there was a lot of, you know, gut issues as well as some problems with homocysteine and some hormone issues. And just kind of going through the approach of, you know, getting the lifestyle right, addressing the environment. And, you know, in these cases with the environment, you know, we had to really get into them. him and his wife didn't really want to change. They didn't want to stop going to golf courses. So we had to kind of really talk through, okay, well, when are you going to go on the course?

Starting point is 01:28:28 What are you going to do about your shoes? You know, and just really kind of work through how to minimize exposure. And, you know, we try to take a practical view. You know, some might just say, hey, you should never go to a golf course. It's an environmental, you know, a problem. But we absolutely want to meet patients where they are. And so we worked with them on that. You know, the chemical exposures went down, you know, dramatically over a 18-month period,

Starting point is 01:28:56 down to the 50th percent. And this gentleman was able to get back into his company and run it. And, you know, with a good succession plan, but, you know, was able to function at a good level. And, you know, and I think that the whole issue of toxic, and Alzheimer's, and especially how they can potentially have synergistic effects. You know, needs a lot more research. But it's quite clear to me that having a root-caused approach to addressing cognitive decline is going to be the way that we're going to address this issue.

Starting point is 01:29:41 And, you know, we're starting to see it in conventional medicine. There's a group led by Dr. Isaacson out of Columbia Presbyterian that's looking at a precision medicine approach towards the prevention of Alzheimer's. You know, the things that aren't in their protocols are around toxins, environmental exposures, and chronic infections. You know, those are really the blind spots of conventional medicine. But, you know, I think that the science is sort of pushing us in this direction. And we just have to, you know, kind of, I think with the other issues with environment,

Starting point is 01:30:20 sort of recognize that it's not as much of a science issue as it is a political and a liability issue in why the research isn't happening. And when you say a liability issue, can you just expand on that a little bit more? Well, you know, so I spent about a dozen years as a partner at McKinsey and Company, and had a chance to really work with a number of clients in the for-profit sector, in the social sector, in the not-for-profit sector. So I got a good sense of sometimes the challenges that happen with change. And when, you know, in regards to mold, what we know are clear facts are the following.

Starting point is 01:31:10 You know, mold was in the 90s described. as sick building syndrome. And within 24 months of the first reports of sick building syndrome, many U.S. government agencies were sued by their own employees for having problems with indoor air quality. And the biggest suit and the biggest offender

Starting point is 01:31:35 was the Environmental Protection Agency. So you suddenly get into a potential issue of liability. When you look at mold issues, you know, in many cases, there are multimillion-dollar, you know, are multi-million dollar, you know, class action lawsuits. But after the lawsuit happened against the EPA, within a three or five-year period, there became caps on mold exposure across the industry, you know, to try to limit the exposure that, that, landlords have. But it's, all of this is being debated in the courts. And I do think that the,

Starting point is 01:32:22 the whole issue of liability is an effective barrier to getting any of these insights adopted into conventional medicine. I couldn't be specific about where that's happening, but it's just sort of more of an observation that there's increasing evidence in the literature. But there's, you know, not as much funding in here. And I think what we need to do is just shine a bigger spotlight on it. But I think that before, you know, in terms of building health, we can really see that building health and indoor air quality is absolutely a public health problem today. And it's really a preventable public health issue. You know, the World Health Organization, you know, estimates that indoor air pollution in general is, you know, one of the top two or three preventable drivers of chronic disease.

Starting point is 01:33:22 Now, most of their data is around indoor air pollution when it comes to, you know, fires and smoke in buildings, you know, and a lot of things in the developing world. But the, if you look at building standards, there is so much that could be done to design a healthy building. So, for example, you talked about water damage that's invisible. Well, if you build a building right from the start and you put in little sensors, you know, next to any pipes that can detect humidity for a very small fraction of the cost of the building, you can pretty much monitor any leaks that are behind those walls. So why wouldn't we do that? You can replace dry water. You can replace dry that is prone to creating mold infections.

Starting point is 01:34:18 And you can, there is mold resistant drywall. It's slightly more expensive, but it's not that much compared to the overall cost of the building. The whole issue with air conditioners and the HVAC systems, there are some really elegant design solutions to get rid of a lot of the duct work and to make it highly clean-cleanable if there is a problem going forward. And there are a lot of design options in terms of healthy, you know, low-chemical ways to build a house. And so there have been some attempts to

Starting point is 01:35:04 create healthy housing. You know, there is the Well Institute. There are a whole host of people who have done it on a bespoke basis, you know, just by the ones for clients who are well off. Now, we're excited here that I think there can be a real movement around healthy housing. And our intention at Resilare Health is to try to get that movement to happen in South Florida because we see the need every day that, you know, our patients are looking for housing that is health, it has a healthy air. And, you know, to be quite honest, I think everybody, every citizen, you know, around the globe deserves to have healthy indoor air. And so I'm very optimistic that there are technology and innovation ways that we can start to move the market in the right

Starting point is 01:35:59 direction. It would be terrific to have regulatory processes as well because it would accelerate things. But I do believe that there's a way to get housing accessible for maybe, you know, 5% more than the cost of, uh, of, uh, of, uh, traditional house. And you could probably get it to be cost neutral if you just reduce the square footage. So there's, you know, I think a lot of ways to solve this for our patients and, uh, and, and for our citizens. And while we wait for that, for those that are listening now and whether they live in a, a condo, they own their own home. They're paying attention to mold. Maybe they're not, they don't think that they're dealing with it yet. I want to talk about prevention for a little bit.

Starting point is 01:36:45 If you are in your current sort of home complex, whatever it might be, what are, and not just with mold, but just with the indoor air toxins, bacteria, what are some simple things that everybody could do today that could support the process of prevention? so we don't end up with a situation, 5, 10, 15 years down the line after a hurricane hits your area or leak in the roof where you now are struggling and playing catch-up with dealing with mold. Do you have any tips in that area? Yeah. So I think, let's say let's just kind of take a situation where somebody is known to be pretty sensitive

Starting point is 01:37:34 and just they've moved to a, you know, a new house or a reasonably, you know, a new house. I think, first of all, I think in buying a house, there definitely are some criteria that make a house less likely to have mold issues, you know. So there's definitely some features about the design that, and, you know, we have a bit of a checklist for, you know, people who are buying a house, you know, how to, you know, assess that. And it's, it's primarily around, you know, drainage and, and, and how the house is put together. There's quite a bit of difference if you're in humid areas versus non-humid areas. If you're in non-humid areas, and it's great to be able to get fresh air to come inside. You know, if you're in a warm tropical

Starting point is 01:38:27 environments, that can really be a problem, especially if people keep the air conditioning, you know, going full blast because the humidity can create a problem. And so having positive pressure there is better. Having low humidity is important. With air conditioners, there's a lot that can be done in terms of getting heifer filtration into air conditioning or doing you know, some type of treatment of the air that I think can be quite helpful. Even basic steps like having a place for people to put their shoes when they come in the front door so that they don't track mold and dirt from the outside can be a huge help. Having a hepa vacuum can be a huge help.

Starting point is 01:39:19 And so I think it's there, these are little tips that all add up and can be and can make a different. And, no, I think with the COVID epidemic, you know, so many people spent a large amount of time in their house and indoors. And, you know, the data really now is that probably, you know, 80% of the time we're breathing, we're breathing in, you know, indoor air and as opposed to outdoor air. That's a problem on two levels. We need to get outside more. but this whole issue of indoor air quality, I think, is going to increase. There's going to be a spotlight on it, you know, based on what's happened to COVID as well. No, it's good.

Starting point is 01:40:05 I think that's more attention that can go in this area, the better, because as you had mentioned, it is a low-hanging fruit and could have all sorts of implications on our health for the long-term. Dr. Tenio, this has been a fantastic conversation. I feel like we covered a lot of different layers, and very specifically, when it comes to the topic of mold and also other environmental toxins that are causing no inflammation, cognitive decline, and sort of unexplained symptoms that people are dealing with today. And there's a lot of people that are suffering. I'm sure you get outreach from all over the world.

Starting point is 01:40:48 of people who are just looking for hope and looking for an answer. For anybody that feels that they, you know, for anybody who's ever felt that there might be suffering from this, but struggles with sort of being hopeful that there are solutions that are out there. Is there any final words that you want to share with them? Well, with mold is that people can get the right combination, of steps correct to be able to follow the treatment protocol, we seeing improvements in 90% plus of people. So it is a highly, highly treatable condition. And so I think that's really

Starting point is 01:41:35 important to understand. And so I do think there's absolutely a lot of hope. I think sometimes the biggest issues are that, you know, the hardest steps are a first. with the environment are really getting that right. And that can be very difficult. But there are ways to really work that through and that can be solved. And, you know, we're always happy to be of help to either practitioners or patients that have these issues. Fantastic.

Starting point is 01:42:10 Well, I would love for you to just share a little bit more about where people can find you, the clinic, whether or not, you know, I know a lot of people will be listening to this and think I'd love to work with a doctor like yourself. If you guys are taking on new patients, we'd love to get the plug in for everything that is your ecosystem. Yeah. So I think that people can get a hold of us on our website, which is Resilair Health.com, R-E-Z-I-L-I-R-Helf. And we would be happy to talk to any, you know, potential patients or practitioners. We are growing. and hiring, and so we're excited to be able to collaborate with people. Also, in terms of collaboration, I just would like to emphasize two things. If there are practitioners who are

Starting point is 01:43:05 listening to this that are interested in collaborating on getting data, you know, in terms of, you know, cognitive decline or fatiguing illnesses, you know, we have two IRB registries that we have been launching and are looking to, you know, add patients and practitioners to that. And then finally on the whole area of healthy housing, if anybody's listening to this and as passionate about it as we are, you know, just feel free to connect with us because, you know, the more people who are interested in this area,

Starting point is 01:43:43 the better. Absolutely. I couldn't agree more. It's an area that needs more attention. needs more funding, but like all areas of life, whether it's with medicine or creating a safer world in some capacity, it just starts off with a few passionate people that bring attention to it and start to be a beacon of light that attracts more individuals to that area. So thank you, doctor, for being one of those individuals who is bringing awareness, education, and hope to so many people who are suffering.

Starting point is 01:44:18 Thank you so much for having me on here, Drew.

Dhru Purohit Show - #217: How Mold and Environmental Toxins Damage Our Brain and Body with Dr. Craig Tanio

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