Recently, I interviewed Dr. Jill Carnahan, and we talked about about her experiences overcoming numerous complex health issues, which is what her excellent book, Unexpected, is all about. If you would prefer to listen to the interview you can access it by Clicking Here [1].
Dr. Eric Osansky:
I am super excited to chat with Dr. Jill Carnahan, who recently released an amazing book. I listened to the audiobook. It’s called Unexpected. Dr. Jill goes into detail about her health journey. Let me go ahead and dive into Dr. Jill’s impressive bio here.
Dr. Jill Carnahan is a board-certified, integrative, holistic medicine specialist, known as your functional medicine expert, often referred to as the Sherlock Holmes of medicine for solving the cases of the most well-known medical mysteries.
Using state-of-the-art lab testing and biochemical analysis, she helps each patient identify the root cause of their illness by identifying nutritional or metabolic imbalances that may be contributing to their symptoms. Dr. Jill uses nutritional protocols and supplements, lifestyle changes, and medication to improve patient levels of function and always seeks to enlist the least invasive way to restore health and optimize healing.
She has also sustained a 5+-year waiting list as the medical director of Flatiron Functional Medicine, a widely sought-after practice. As a survivor of breast cancer, Crohn’s disease, and toxic mold illness, Dr. Jill provides a unique perspective to treating a variety of complex illnesses and has traveled the world sharing her knowledge of hope, health, and healing live on stage as well as through newsletters, articles, books, podcasts, social media. Her memoir Unexpected is out now. That’s what we’ll be chatting about. Thanks so much for joining us, Dr. Jill.
Dr. Jill Carnahan:
I am delighted to be here. Thank you so much for having me.
Dr. Eric:
I enjoyed listening to your book. It was great listening to your health journey, even beyond your health journey because you discuss your divorce. I saw this summer, you actually interviewed your ex-husband on your podcast.
Dr. Jill:
Yes, we have a lot to say about how you have a healthy relationship. He is in another relationship and engaged. I am so happy for him. It’s been a transition. We always say we didn’t do marriage so well, but we do business so well, and we have gone on to be great friends. That is so needed in our world, forgiveness and how we reconnect with other relationships that have changed over time.
Dr. Eric:
That is awesome. You have been through a lot: breast cancer, Crohn’s, toxic mold, getting a divorce. This really all started when you were young. According to your book, you were brought up on a farm, exposed to pesticides, took antibiotics, had your tonsils removed. A lot of people don’t tend to think about these things. As practitioners, we do, and we try to go back. I ask people commonly about antibiotic use and other things in childhood. You’re pretty confident that played a big role in your breast cancer diagnosis, maybe even your Crohn’s later on.
Dr. Jill:
This is part of the beauty and curse of medicine and being a medical detective. Ever since I had breast cancer at 25, I was like, why? Why did that happen? My last 20 years have been spent doing a deep dive into what factors contributed to my illness. What it’s allowed me to do, and you’ve had the same kind of journey, is really look at root cause medicine and what things contribute. I have no doubt that there were probably in utero exposures to chemicals, pesticides, and other things from the farm when I was young. A lot of these things are endocrine disruptors.
I don’t know if I mentioned this in the book or not. My sister had thyroid cancer. I had breast cancer at 25, and she had thyroid cancer at 28. Two girls, same farm, both endocrine-related cancers. To me, that’s even more evidence. Yes, genetics probably played some role. In my mind, genetics played the role in poor detox mechanisms.
The environment on the farm. This is just anywhere because nowadays, rivers and streams and pesticides are all over the place. Of course, in the farm environment, there is lots of those. Because they are endocrine disruptors, they act as hormones in the body. They can disrupt thyroid, breast, and prostate for men. At 25, I was diagnosed with cancer. Looking back, hindsight is 20/20. We can start to see the patterns.
What it’s allowed me to do is to look at patterns in my patients. “What of your lifestyle right now could be contributing to your chronic illness or potential future diseases? How do we reverse that?”
Dr. Eric:
Also, diet. You were also a vegetarian for quite some time as a teenager. It wasn’t a healthy vegetarian diet as you explain in the book. You were eating pasta and bread.
Dr. Jill:
Carbs.
Dr. Eric:
I’m sure that also didn’t help.
Dr. Jill:
I want to speak to that. In hindsight, I grew up on a farm. It was steak and potatoes. It was a heavy meat diet. I realized right away very young that I didn’t feel very well. Looking back, it was low stomach acid, so hypochloridria, which leads to difficulty breaking down meat, so it doesn’t feel good in your stomach.
I was also zinc-deficient and B12-deficient, two things that are pretty critical. What we know about zinc deficiency is it can cause a lack of desire for taste in meat, or you don’t like the taste of it. Those things contributed to me deciding maybe I don’t need meat.
Of course, I wasn’t really schooled on what a healthy vegetarian diet is. I was 14 years old when I stopped eating meat. I gravitated toward carbs and processed foods. All I could get was processed soy, fake meat products. I joke because I say it almost killed me.
Up until I was 25 and diagnosed with cancer, I was not eating a great diet. Unbeknownst to me, I had Celiac. I was eating a lot of gluten and didn’t know that was contributing to inflammation. Lots of bread and pasta. Not a great way to be a vegetarian. Nowadays, people can do well with that, but you have to be very deliberate about how you get your B vitamins and protein. From 14-25, I was not deliberate.
Dr. Eric:
You were a vegetarian until the breast cancer diagnosis?
Dr. Jill:
Yes, for over 10 years. 14-25.
Dr. Eric:
Wow. After your diagnosis, was it a pretty quick change? Did it still take some time, like years later, when you started making dietary changes?
Dr. Jill:
What I also didn’t know is I was severely B12-deficient. I have some genetic mutations in my ability to absorb B12. When you take out the main source, which is meat, vegetarians/vegans are at risk for low B12. Most of them supplement because it’s hard to get enough B12 in a vegetarian diet. That is one thing we think about. I didn’t know this.
I was zinc-deficient, low stomach acid. On top of that, I was silent or undiagnosed Celiac, which means I was already having atrophy of the absorptive surface of the gut. I was going into this malnourished. That particular diet, for me, did not help at all.
Then I get diagnosed with breast cancer. I started looking at diet again. Didn’t make a huge change then. What happened was I got through three drug chemotherapy, which destroyed my gut. I already had a gut that wasn’t super stable, so it went to a really bad state after the chemo. Within six months, I started having gas, bloating, abdominal pain, bleeding, weight loss, all kinds of symptoms.
I remember one day I am in the ER helping a patient get their blood pressure, and I literally passed out. I was taken into emergency surgery for an abscess for early sepsis. I woke up the next morning with a surgeon saying, “Jill, you have Crohn’s.”
For anyone who doesn’t know what Crohn’s is, it’s an autoimmune disorder where your body attacks the gut lining. How weird that you had breast cancer and then Crohn’s.
Let me tell you a story. I had this undiagnosed Celiac, so already a damaged gut lining. The chemotherapy that I took, especially cyclophosphamide, Cytoxan, is known to damage the permeability, the membrane that lines the gut. It basically induced a much more severe form of leaky gut, on top of my already undiagnosed Celiac.
Then I had this gene I didn’t know about called NOD2, which makes me higher risk of developing Crohn’s. In this case, all it was was a hyper-responsive action to the microbial contents of my gut, spilling through the leaky gut into my bloodstream. That literally contributed to the Crohn’s.
In my mind, it’s the perfect storm: undiagnosed Celiac, poor nutrition, B12 malabsorption, probable dysbiosis, meaning abnormal microbes in the gut. You take a drug like chemotherapy that causes more permeability, dumping the bacterial coating in someone who is very susceptible to this immune/autoimmune reaction. Bingo, you have Crohn’s. It makes sense, doesn’t it?
The Crohn’s was my opening of the door into diet changes. I sat with a gastroenterologist after I found my diagnosis. I needed to know what it meant. He said, “Lifelong medication. Probably immune-modulating drugs. You may need surgery to remove part of your colon.” He was very depressive with his prognosis.
The last thing I said as I walked out the door was, “Doc, you know, I want to do whatever I can. Can I change my diet? Is there anything I can do?” He said, “Jill, diet has nothing to do with this.” I knew in my intuition that something didn’t sound right about that, even though I had no knowledge of a nutritional background then. So I started to go on a search to find answers.
That’s when I came across how a diet could potentially have something to do with it. I changed my diet. I got rid of gluten, processed foods. I completely revamped my diet. Within about two weeks, my symptoms of bleeding and pain were gone.
Dr. Eric:
Awesome. It’s sad. Even today, I get countless patients telling me that the endocrinologist told them that diet doesn’t play a role. Most of the people I see have Graves’ or Hashimoto’s or a non-autoimmune thyroid condition. Even if they don’t believe diet will play a role, why can’t they say, “It’s not going to hurt to eat a healthy diet, so you might as well give it a try?” Just to dismiss it, “No, diet definitely won’t help.” I am glad you made those dietary changes.
You mentioned silent Celiac. A lot of people think of Celiac as “I eat gluten all the time. I feel okay, so I probably don’t have Celiac or non-Celiac gluten sensitivity.” You weren’t experiencing symptoms for a number of years.
Dr. Jill:
In hindsight, of course. I had severe eczema and skin issues, which usually relate to leaky gut. I had some intestinal permeability. The zinc and B12 malabsorption are both common with intestinal inflammation, which I didn’t know until later. I was very tired. I pushed myself hard, so I didn’t realize how fatigued I was. Probably from that B12 deficiency, too. There were lots of signs and symptoms leading up to this.
I like to tell my patients this. If we check the genetics, there is a DQ2 and DQ8. These are the high-risk genes for Celiac. You can ask this of your doctor, and it’s very relevant to thyroid disorders as you well know. If you have those genes, even a half copy, even if you never in your lifetime get Celiac, the lifetime risk. The average age of diagnosis of true Celiac is 55 years old.
As we know with autoimmune, you need a genetic predisposition, which is the genetics, like I had as well. You need an environmental trigger, like gluten over time. You need a permeable gut. When those three things are present, that is the triad of autoimmune disease. Celiac is a great example.
Say I have a patient with a DQ2 gene, a high-risk gene. You could go your whole life and never develop Celiac even though you are at 13-20% more risk. However, I think of it as a wagon wheel. In the center of that wagon wheel is that gene. One spoke is Celiac. The other spokes are Graves’, Hashimoto’s, rheumatoid arthritis, Crohn’s, lupus, and multiple sclerosis.
I could name any autoimmune disease and link it to that predisposition because we know that autoimmunity can come from that permeable gut and that constant barrage of microbial contents on the blood, on the immune system, creating inflammation that eventually ends in the body attacking itself. It can attack nerves in MS. It can attack the blood system in lupus. It can attack joints in RA. Any one of those things could be the outcome, even if you never get Celiac.
I say that all the time because people go, “Oh. If I avoid gluten right now, I could potentially prevent myself from getting an autoimmune disorder.” I say, “Yes. There is no guarantee, but you will definitely decrease that risk.”
If I could go back to my younger self and know all of this, I would have done my diet differently at 14 years old.
Dr. Eric:
You test genetics for Celiac for everyone. Do you also do a Celiac panel if they are eating gluten?
Dr. Jill:
The genetics are the predisposition you came into this life with. Like I said, the relevance is so important. I was shocked by the statistic that the average age of diagnosis of Celiac is not childhood, but 55 years old. That is a lot of decades of a barrage of the immune system before you actually become full-blown Celiac.
If you think of the lining of the gut like the shag carpet in your ‘70s bedroom, that shag carpet starts to get ruined. You don’t have true Celiac until it’s almost down to a hardwood floor. A lot of damage has to happen for Celiac. You could have anywhere in between where there is lack of absorption of B12 or zinc or other minerals. You could have manifestations of fatigue.
There could have been a connection to the cancer. I don’t think it was casual, but that whole immune inflammation, immune dysfunction certainly didn’t help me fight the cancer cells in my body.
In hindsight, all these things are relevant to tell the patient, “This is your risk. You have a choice today at 25 or 35 or 45 to change the trajectory of your illness.” If you know that, you can shift.
What you ask about is the Celiac panel. In addition, which I also do, you can test for anti-gliadin, or deamidated gliadin antibodies. IgA and IgG. IgA is the mucosal lining, so that’s an early responder. IgG is systemic immune system. I do that as well.
If you see that happening, that can either equal a non-Celiac gluten sensitivity, where they don’t truly have damage to the gut, but they are starting to have this very significant immune reaction to gluten. Or it could mean that they have full-blown ruining of that shag carpet that is leading to malabsorption and symptoms. It’s so core because I really believe that so many autoimmune diseases begin with part of this inflammation with our diet.
Dr. Eric:
My guess is if you do testing, let’s say the genetics are negative. Celiac panel is negative. It’s an autoimmune patient. Do you still have them avoid gluten? I’m thinking you do because it can affect the permeability of the gut and lead to other problems.
Dr. Jill:
What you are saying is you can have someone who comes in with no Celiac genes and no antibodies, so there is no known documented inflammation going on in the body. But, just like you alluded to, what happens is every single human post-prandial, meaning around four hours after we eat, with the consumption of gluten, it increases all of our permeability.
Now, if you are perfectly healthy, with no sign of autoimmunity, no joint pain or brain fog, you feel amazing. Probably not a big deal. I don’t know about you, but for me, the patients who come to see me are not that class. They have multiple autoimmune diseases, sometimes chronic complex disease, sometimes unexplained brain fog, migraine headaches, joint pain, etc. Thyroid disease is rampant. Probably 8/10 of my patients have hypothyroid, Graves’, or Hashimoto’s, or some form of thyroid disorder. Because at least for me, that’s not the population I see. I really ask almost all of my patients to be gluten-free, most of the time dairy-free, and sugar-free. That is a core. I’m sure you’re similar.
Dr. Eric:
Yeah. I was going to ask you about dairy. You do have to avoid gluten, dairy, and sugar. Do you currently still avoid dairy? I know you avoid gluten. But dairy permanently, or do you sometimes have it?
Dr. Jill:
No, it’s been 20+ years now. I’m very stringent on my diet. I just feel so good when I’m eating clean. I am 99% grain-free. Maybe twice a month, I will have a little quinoa. That is the only exception. I’m completely dairy-free. All cow’s milk dairy of some types. Free of all sugar. I don’t do a lot of nightshades. There are a few other odds and ends. I don’t do soy or corn.
This is another story. I definitely had significant bacterial and fungal overgrowth in my gut. Part of my healing completely from Crohn’s was dealing with that. Specific carbohydrate diet or candida diet, these are two separate diets. They are some of the ways we decrease those microbial overgrowths in the gut. I found years and years ago that those diets worked. A low glycemic, low grain type of diet. Soy and corn aren’t horrible, but in the U.S., they are so often sprayed with glyphosate and often triggers for immune issues. They are in everything, so we get so much immune exposure to them.
The broader elimination diet would be gluten, dairy, egg, corn, soy, sugar, alcohol. That is a lot more, but that is also a little bit more expanded to include the most common allergens we have in the U.S.
Dr. Eric:
You had candida overgrowth and SIBO.
Dr. Jill:
Yes. Just in case someone who is listening who has Crohn’s or colitis, we do a conventional lab on a conventional panel with a conventional doctor called IBD Risk Score. What it does is checks among other things Saccharomyces antibodies. This is brewer’s yeast. If it’s positive, it contributes to a prognosis that is worse with Crohn’s. When I started to understand this, I found out that 80-90% of Crohn’s patients have an underlying fungal component. It’s tested with the antibodies. That is conventionally indicated with severity scores.
This is part of my healing, but even in my Crohn’s or colitis patients, if they have any evidence on organic acids or bloodwork of antibodies to candida or signs in the urine of metabolites of yeast or Saccharomyces, that antifungal regime, whether it’s a low sugar diet, caprylic acid, and gallic acid, oregano, I use all of those things in order to treat and heal patients from inflammatory bowel disease.
Dr. Eric:
That works with both Crohn’s and ulcerative colitis?
Dr. Jill:
Yes. The main difference there is Crohn’s is systemic. You could have ulcerations all the way from the gut/stomach to the end of the bowel. There is more systemic manifestations. Ulcerative colitis is more localized. Localized ulcerative colitis often needs some sort of topical or enema treatment that is anti-inflammatory in that local area. Typically, they both can be driven by SIBO and SIFO. If you find the root cause, you can often reverse.
I don’t think I mentioned this, but 20+ years ago, I was diagnosed with Crohn’s. I was told it was incurable. I don’t have Crohn’s any longer. There is no evidence of it. That is something the medical system doesn’t really understand.
Dr. Eric:
If you went back to the doctor and got diagnosed, which you probably didn’t do, they would blow it off.
Dr. Jill:
Right.
Dr. Eric:
You also had a toxic mold exposure. If you could talk a little bit about that, as well as how common it is. In your practice, I’m guessing it’s a lot more common. I don’t know if you have any data on averages. I know there is genetics. 25% of people have the genetics that make them more susceptible, having difficulty clearing the mycotoxins from their body. What do you see in your practice when it comes to mold?
Dr. Jill:
Mold is super insidious. Let’s do a 30,000-foot view for a second. You and I deal with complex chronic disease. I think Mark Hyman, our colleague, said I am the doctor of last resort. He’s the one who people come to. I tend to see a lot of people like that, too, who have been to a lot of places. The conventional system has failed them, and they still don’t feel well.
The biggest framework is complex chronic illness is usually a combination of toxic load and infectious burden. These old infections like EBV or tick-borne infections or mycoplasma, these underlying infections inside of a weakened immune system that is not keeping them under control.
And then the toxic load. Of course, phthalates, parabens, pesticides, endocrine disruptors, glyphosate, Roundup. All these things. Also in that bucket of toxic load is mold and mycotoxins. Mycotoxins are the chemicals produced by molds to protect themselves. These are smaller than particulate matter 1.0 or even 2.5, which is the size of a virus. We can inhale them into our lungs. They don’t need transport. They can go directly into our bloodstream through the villi.
That is significant because we could be for 5-10 seconds in a moldy building and start to have symptoms because it goes so quickly from the airborne sensation into the villi into the bloodstream. It’s very quick. People can tell right away if they are exposed if they are sensitive.
Back to my analogy of complex chronic illness. Mold is a big deal because it’s often hidden. People often don’t know. They just know they haven’t felt well since moving into a house. It’s often location-based, environmentally-based.
About one in four people have the genetics where they have innate immune inflammation related to mold that can cause all kinds of damage and symptoms and diagnoses. But usually, in a household, some of the people are infected more than others. It can be very confusing. You can have one or two who are fine, no problems at all. Then you have a father and daughter who are incredibly sick. It could be respiratory symptoms, like chronic sinusitis, sinus issues, pain in the eyes, sore throat, trouble breathing, asthma, allergies. It could also be systemic. Probably the most common thing we see is fatigue, brain fog, and cognitive issues.
This is relevant when you ask about statistics. Dale Bredesen, who does a ton of work with Alzheimer’s and reversing Alzheimer’s, he’s one of our colleagues. He talks about percentages. He has been saying for years that one in three cases of early onset dementia is related to mold. That is staggering. That is 33% of people with early onset dementia. Early, meaning 40s and 50s and maybe early 60s, not the classical Alzheimer’s. it’s very significant.
I was just with him a couple weekends ago. He for the first time said 80%. His percentage is going up. I have been used to him saying 30%. This is younger people who are presenting with dementia and cognitive decline.
I say that because typically people come to their doctor and might have a new diagnosis of Hashimoto’s or Graves’ or another autoimmune condition, or their cognition isn’t sharp, or they are waking up with a lot of pain, or they are having exhaustion with no cause. Granted, there is other things we look at. If everything else is coming back negative, over and over again, the environment can play a role. Mold, I see all the time.
One of the questions I hear is, “My grandmother had mildew in her shower. Is mold really that big a deal? Why is it worse now than it was 20, 30, 40 years ago?” There are a couple things. First of all, in the ‘70s, we knew that mold could grow in houses, and we started putting fungicides or antifungal, anti-mold substances in standard paint. When you paint the inside of your house, it probably contains an anti-mold and fungicide. That all sounds well and good.
What happened is just like what we have seen happen with antibiotic resistance, as we give it more to livestock and humans. We have these superbacteria that we can’t treat. Mold is the same way. It’s really smart, and it has outsmarted some of those fungicides. When we have indoor microbial growth related to mold or water damage, very frequently, it’s aggressive, puts out more mycotoxins than we used to see.
If you think about construction nowadays, it’s often more porous materials. Things are put up much more quickly. Maybe less quality in some cases. The surprising thing is a lot of people are having trouble with mold in new construction. It’s not always an old home.
Dr. Eric:
If someone just moved into their home six months or a year or two ago, obviously, if they have any type of noticeable water damage, it could be a problem. It could still be hidden even if it’s new construction?
Dr. Jill:
Yes. I keep hearing stories. This is my world, so I hear all the stories. Things like they installed brand new cabinets. When they drilled into a wall, they drilled into a pipe. No one knew about it. That pipe leaked into the wall for months or years until they realized that mold was growing behind the wall in their kitchen.
Anyone who has ever had a leak under the sink, a leak from their fridge, water leaching into the wall or near the fridge. A washing machine that leaks. A bathtub that overflows. A shower that wasn’t properly installed.
We think about grout as being protective. But grout is porous. If you don’t water seal and properly install a shower with grout in the sealant, it’s porous. It will go straight into the drywall and create a mold issue.
One thing I learned is a year and a half ago, one of my neighbors’ fridge lines leaked into my wall, down into my condo. We had a major mold issue. Ever since then, I disconnected the water line from my fridge. It’s not worth it. I make regular old ice cubes in the freezer the old-fashioned way. For me, it’s not worth having that water source that could leak in my wall ever again. I, probably no matter where I live, won’t ever hook up my water line to my fridge in the future just because of that risk.
Dr. Eric:
That’s interesting. We don’t have that on our current fridge, so we don’t have to worry about disconnecting it. At least I don’t think so. We don’t have water from the front.
Dr. Jill:
Then you’re good. I ask about air filters, water filters because clean air, clean water, clean food is one thing I say all the time.
“I have a fridge filter.” Fridge filters are not cutting it. They are pretty minimal in terms of the quality of filtration you want anyway. I would never rely on that as your sole filter for water in your house.
Dr. Eric:
I use reverse osmosis. What do you like?
Dr. Jill:
I am going to mention this because this is so significant. I am in the state of Colorado. They recently tested our water supply a year and a half ago. Every single water body tested tested above the legal limits of PFAs, polyfluorinated compounds like Teflon. These are forever chemicals. That means the half-life, we can’t even calculate. I think 50 years is underestimating it. Probably hundreds of thousands of years, we will still have these chemicals in our environment.
If you’re not filtering your water in some form, you are behind the game. You’re getting chemicals in your body guaranteed. Tap water is no longer safe. Then what do you do?
Reverse osmosis. You could put whole house filters or under the sink filters. Those are amazing. They are kind of costly. They take a little bit to install. As they are pulling out those chemicals, they also deplete minerals, so you get a more acidic product. But it’s a great way to do it. You just to need to make sure you are replacing those minerals in your diet or as a supplement.
You can now get some really good fridge or standalone countertop filters that do a great job and are less expensive for someone who is in an apartment or smaller space. Nowadays, there are even good filters that come in water bottles, so you travel and take that with you. I always travel with a regular stainless water bottle with a filter inside if I am going places to save on clean water.
Dr. Eric:
How about spring water out of a glass bottle, like Mountain Valley Springs?
Dr. Jill:
As long as you know your source, and they test for toxins, I think you’re in good hands. The downside is water supply here in Colorado, from good mountain sources, has been contaminated with PFAs.
To your point, reverse osmosis is the best. Carbon filtration, which can be as simple as a handheld thing in your water bottle, is pretty darn good even for PFAs and other toxic chemicals.
Dr. Eric:
Getting back to mold. Do you test your patients with urinary mycotoxin testing? Do you have them test their house for mold, doing ERMI testing or using plates? How do you determine if mold is a problem? You probably know by looking at them, you have seen so many patients, so you have a good idea. I imagine you still do some testing.
Dr. Jill:
This is the million-dollar question: What is the one test for mold? Unfortunately, there is no one. There is a little bit of a scenario I can say. History is important. Even if you’re just listening, and you think, “Ever since I moved into this house, changed workplaces,” If there is a story that you can tell that your change of environment caused you to become ill. Maybe six months later, there is a little delay. Or a year later.
My example is there was a flood in 2013 that flooded massive parts of Boulder. My office building was damaged. Didn’t know it. About 6-9 months later, I started having symptoms because there was mold growing in my office building. That time frame fits really well with this kind of damage.
History, stories are important. You can online for free do a visual contrast test. This tests your visual acuity and the small retinal vessels in your eyes. These little vessels can be damaged by biotoxins. If you’re having trouble with that test, you could be exposed to mold. That’s one more thing.
Test-wise, I still do the markers like TGF-beta, MMP-9, EGF, MSH, and osmolality. ADH, antidiuretic hormone. Those are trickier to interpret. They are innate immune markers, and they don’t diagnose mold. You need to see a pattern, but if you see all of those abnormal plus a history of mold plus an abnormal visual contrast, there is a likelihood that mold is in the mix.
Urinary mycotoxins, this is not a perfect science. People are like, they should test that. It doesn’t always indicate exposure. There are some caveats.
There are three main labs that do testing: Real Time Labs, Vibrant Labs, and Mosaic Labs. They are all very different technologies, so you cannot compare one to another. They all have different thresholds. Because this is such a new science, even the labs will tell you they don’t know what’s toxic or not.
Now, do I use those in patients? Yes, I do. I use it as part of the bigger picture. I wanted to say that because that is the easiest thing to go out and get done. You could very well have mold. Just because you have positive urinary mycotoxins, it could be that you were excreting from years ago when you had an exposure. There are other answers. It’s a better idea to look at the whole picture and use that as part of your diagnostics, but don’t leave your home because you have a positive urine mycotoxin test.
Dr. Eric:
It’s interesting what you said. I heard Dr. Neil Nathan say he uses two tests. He has a practice where he sees mold patients, and he uses Real Time Labs and Great Plains, which is now Mosaic Diagnostics. Just because one isn’t necessarily reliable.
Dr. Jill:
I agree 100% with Neil Nathan on that. It’s so easy to go out there and be like, I just tested positive. There are so many factors to take into consideration.
For example, someone I know has mold. We will talk about environment as well. When a positive urinary mycotoxin test came back positive, we started detoxing. Six months later, we tested, and their levels are higher. They started to panic. I say, “Wait a second. We are measuring excretion. We want you to be excreting. I would expect in the first 3-6 months for it to go high.”
Sometimes, it goes down. But sometimes, you are getting your body to get rid of a toxin that was stored in the tissues. For the first six months or so—this is one reason I don’t retest right away—you will get these values that sometimes go up. It’s not always a bad thing if they are really excreting that toxic load.
You mentioned environment. I want to mention this quickly. Once again, it is by far the best to get an inspector who knows what they’re doing. So many areas in the U.S. or outside of here don’t have great quality inspectors who know what they’re doing.
If that’s the case, I will still often recommend patients do a dust sample. It used to be called ERMI, But the data for ERMI, the way they do the diagnostics on that test is not very well validated. The technical name of ERMI is called Q PCR, quantitative PCR, meaning they check in the dust that you send in for DNA of mold in that dust. That is a very valid technology. What you’re doing is a historical snapshot of your home.
I still do a QPCR in my condo once a year just to check in. I do it for my workplace. I think it’s a great place to start for patients who want to know if there is an issue.
Say you have one that has loads of Chaetomium or a very high Aspergillus score. You need to find where that’s coming from. It’s not the end-all be-all. It’s an affordable way for the average consumer who maybe is trying to figure out if they should hire an inspector to start the process. Because I have seen hundreds of them, I often have my patients do that to look at that with them. Sometimes, we can look at the types of mold in the dust of their home, look at their results, and if it matches—it doesn’t always—you have a pretty good case for their exposure and where it might have come from.
Dr. Eric:
One more question with mold. You mentioned in your book supermolds. What is a supermold?
Dr. Jill:
Classical molds, Aspergillus, Penicillin, it’s where we get our antibiotics. These are not good. They cause more allergies, sensitivities, inflammation. There are some molds out there, like Stachybotrys that are just really nasty. They secrete a type of mycotoxin that has literally been studied as a chemical warfare agent. It’s been known to cause nephrotoxicity, damage to your kidneys; lung pulmonary toxicity; neurotoxicity to the brain and nervous system; and I could go on and on. Almost every system can be severely damaged.
Some of these mycotoxins have literally been used to develop drugs that are immunosuppressants for organ transplant. For example, mycophenolic acid is a mycotoxin produced by some of these toxic molds that is used to make a drug called Cellcept, which is used in organ transplants to cause no rejection. They basically shut down their immune system.
This is important because the molds are bad enough. They are spores, growing, throwing out these things. Say you remediate a place and have dead debris. I always think of it as a dried flower arrangement. If you flicked it with your fingers or blew on it, and you shattered it into these pieces because it’s dried and dead, you could have dead, dried mold debris particulate that could still stimulate immune inflammation. This is why it’s so important to clean up after you remediate.
You could also have the production of the mycotoxins that get stuck in paper and other porous materials in your home or clothing. Even though that’s not the mold itself, and you might have removed the mold, if you still have those really toxic trichothecenes hanging around in your home after you remediate or whatever state of the process you’re in, they can cause some very severe immune and other issues in your body.
Dr. Eric:
That’s why some people have to throw out all their books when they have a mold issue.
Dr. Jill:
Yes. I’m so careful because we have seen patients who go into panic. There is another side of this that’s post-traumatic stress. It’s so stressful to have mold. The chemical reaction of mold, inhaling it through your nose, can trigger amygdala, the fight or flight system. Almost anyone who has had a significant mold health issue has a little bit of PTSD. Even if it’s the chemical.
The reason that’s important is because you really want to downregulate the trauma related to mold. Because there is a lot of online groups that say, “Walk out of the house. Leave everything. Sell everything you own. Get rid of it. Go to the desert, and avoid mold.” Some really sick patients have gotten well that way. Mold avoidance is a real thing. It is a part of my protocol. You’re not going to get well with any number of supplements, IVs, or protocols if you have a massive mold exposure.
But the bottom line here is it doesn’t mean you have to throw everything out. That’s really important. The worst types of things are porous materials, like paper or books. What I always recommend is if you have scrapbooks or photo albums. I have a library behind me. What I recommend is if you consider those to be potentially contaminated, buy some plastic bins from Walmart, put all of those porous materials in them, seal them, put them in your garage or somewhere out of your house. Keep them sealed away as you’re getting well.
Then in six months or a year, you can open that up, see if you react. You will know. You will feel fine or have an immediate headache or sneezing or some issue. That’s a great way not to throw everything out. If you feel like you need to separate them out, you can put them in a contained area in plastic bins for a while until you’re ready to take a look at them.
Dr. Eric:
That’s great advice. People don’t have to panic and throw everything out. Just put it in bins. Get reexposed in about six months, and see how you react then.
Any additional tips? You already gave a lot when it comes to reducing toxic burden with clean water, related to the mold. There are air filters. I imagine you recommend infrared sauna therapy.
Dr. Jill:
This can be overwhelming. Even listening to me, “Dr. Jill, I can’t do all of this stuff.” Start with simple things. Clean air, clean water, clean food.
Clean air, 80% of our toxic load comes from the air we breathe. You should have an air filter in your bedroom. Ideally, you want to have a classical filtration system that filters the larger particulate. Within that filter, make sure there is a VOC, a volatile organic compound filter, or particulate matter 2.5 or 1.0. Those are the really tiny particles. Usually, that means the core of that filter has charcoal, clay, or some absorptive material. There is a ton of brands out there, but get a good one that has that technology. That’s clean air. At the very least, in the bedroom.
Clean water. We talked about reverse osmosis and other ways to filter your water. You should be filtering your drinking water at the very least if you don’t do a whole house filter.
Clean food. Choosing organic whenever possible. Non-GMO, locally sourced, as close to home as possible. Grow some of your own things, even if it’s just herbs on your balcony. That is all super important. Eating things that don’t have a lot of unpronounceable ingredients. Very basic, whole foods is where it starts.
Other things you can add on: Infrared sauna is a powerful way to detox. You can either go to a gym or get your own sauna. You can get a sleeping bag sauna or a little envelope sauna tent that you sit in. These are less expensive ways to use a sauna.
Epsom salts baths, I’m a huge fan of those. I do them almost every night myself. That magnesium sulfate is a powerful detoxifier.
Castor oil packs on the liver and gallbladder can be incredibly helpful. All you need is organic castor oil and organic flannel. Put that on your liver, maybe with a little bit of heat from a hot water bottle or something similar. That’s wonderful for the detox system.
Lymphatic drainage, you can do rebounding. You can do vibrational plate exercises or technology. You can do dry brushing before you shower. This is one of the reasons why the cold plunge is so popular because it’s wonderful for lymphatics. Even if you don’t have a cold plunge pool, you can just end your shoer with 30 seconds of cool water from your neck down, and that gives you the same effect.
Dr. Eric:
One thing I should add, which I’m sure you agree with and don’t think you mentioned, even if you have to do it gradually, as far as cleaners and cosmetics. If you don’t want to switch to all-natural right away, I know it can be overwhelming, especially when you are already focusing on food, air, and water. But I would recommend the products you’re using on a regular basis, if you have a spray that you use every day, if you are using 409 to spray the household, use a natural cleaner. On your own, you can make a concoction that doesn’t cost a lot, too. I agree with everything you said.
I remember when I was young, my mom would spray these air fresheners all over.
Dr. Jill:
You have those plugins or things like that? Not good. I won’t tell you where, but a common area in some place where I frequent had these plugins, and I literally snuck around and pulled them out. This is toxic! People don’t realize it. They just think they’re freshening the air, but they’re putting in VOCs, which are not good. Those are hormone disruptors, too.
Dr. Eric:
I know we could go on for easily another hour chatting about this. Is there anything else that I should have asked you that I didn’t ask you? Anything burning before we wrap it up that you wanted to say? Any last words of advice for those dealing with any type of chronic health issue or trauma?
Dr. Jill:
No, I am just delighted to be here. I love the work you are putting out in this world. It’s so great to be with you.
If you’re out there suffering in some way, be it autoimmune or a cancer diagnosis, or even a loved one with early onset dementia, you name the issue, there is always hope. You’re already here, so you’re actively learning about your health. Continue to dive in. There are so many resources now for you.
Sadly, we can’t expect our doctors to do the prevention anymore. Our system is designed for calamity and stroke and heart attack and car accidents. It’s not well designed to heal and help us optimally thrive. That’s up to you. But we’re here to help you. Go out there and do the next best thing.
Dr. Eric:
Where can people find out more about you? If you could give your website. Where can they get your latest book Unexpected? Anything else you want to lead them to?
Dr. Jill:
My website is JillCarnahan.com. You can find the podcast, the book, online resources, products we love. Everything is there. I have written a blog every week for the last 10 years. Any topic you want, you can search there and find it.
If you want the book, go to ReadUnexpected.com.
Dr. Eric:
Wonderful, thank you. This was awesome. Appreciate you taking the time to chat about your health journey. As usual, I always learn things, and I’m sure the listeners did. Thank you so much, Dr. Jill.
Dr. Jill:
You’re welcome, Dr. Eric. Thank you for having me.