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As the fungal organisms die, they can create significant inflammation. There can also be an allergic response to the dead molds. The use of a nasal corticosteroid to help reduce inflammation and make the treatment more tolerable has been discussed, but steroids are often best avoided in those with chronic Lyme disease. Other options that have been explored include the use of glutathione as a nasal spray which can help to reduce the swelling and inflammation of the sinus tissues.
Other practitioners have used similar approaches but with different compounds, such as the use of nystatin both orally and in a nasal spray or the use of a nasal spray made with ketoconazole, triamcinolone (a corticosteroid), and cromolyn.
Nonprescription nasal options that may be worth exploration include Physician's Standard Nasal Clear, Argentyn 23 Silver Hydrosol, ACS 200 Nasal Spray, Propolit Nasal Spray (propolis), Seagate Olive Leaf Nasal Spray, Happy Sinus with Silver, NutriBiotic Grapefruit Seed Extract Nasal Spray, and CitriDrops Nasal Spray. Nathan and Anderson have found that silver can often be a helpful adjunct treatment for those dealing with colonizing molds, especially in the sinuses.
To address fungal overgrowth in the gut, the first step is to consider and address the biofilms in the gastrointestinal tract. This is often initiated with Klaire Labs Interfase Plus or Beyond Balance MC-BFM. These are slowly increased and then followed by the addition of an antifungal. Itraconazole (Sporanox) is commonly used and again started slowly and increased as tolerated. Other useful agents may be voriconazole (VFend), caspofungin (Cancidas), micafungin (Mycamine), or posaconazole (Noxafil).
There are a number of herbal antifungal agents that may be considered, such as Byron White Formulas A-FNG and Beyond Balance MYCOREGEN. Anderson has used A-FNG as a multipurpose tool in that it both helps to support the body with removal of stored intracellular mycotoxins and serves to reduce fungal organisms in the body. He may use oregano oil or undecylenic acid.
The importance of having a strong detoxification program on board while attempting to reduce fungal populations is key to the success of treatment. A common symptom of undersupported detoxification while attempting to reduce the fungal colonization is depression. Metals and fungal organisms generally live in communities. As the fungal organisms are killed, this may release metals into the system. This is another reason why detoxification is so critical to consider as part of the broader treatment protocol.
Some practitioners have found coffee enemas a good option for mycotoxin detoxification; however, consideration should be given to the source of the coffee to ensure that additional mycotoxins are not being introduced into the system.
To summarize, the basic treatment model consists of removing the source of any environmental exposures, binding internal mycotoxins, and treating colonizing molds in the body in both the sinuses and gastrointestinal system.
Mold, Mycotoxins, and Candida
Candida overgrowth is another factor in systemic mycotoxin overload, as these organisms produce mycotoxins within the body. Additionally, as antifungal therapies are implemented to reduce the burden of candida in the body, the yeast can produce further mycotoxins in response to attempts to eliminate them. The more aggressively that one attempts to rid the body of candida, the more the focus on detoxification should be increased to help remove any additional mycotoxins from the system. Mycotoxins produced by candida include gliotoxin, which is known to suppress the immune system.
Another common mycotoxin produced by candida and other yeasts includes acetaldehyde, a metabolic product of ethanol. It irritates membranes and damages the liver. It explains why some people with candidiasis feel groggy or even drunk after eating sugar or carbohydrates which are then fermented in the gut by the yeast. Acetaldehydecan also negatively affect methylation.
In my discussions with Anderson, he has observed a connection between people living in the presence of mold from a water-damaged building and candida overgrowth. Treating candida is often far more difficult if the patient is still being exposed on an ongoing basis to other molds in the living environment. In a number of cases, Anderson has worked with patients who reported vaginal discharge associated with candida infection shortly after moving into a moldy home. Living in an environment with ongoing mold exposure leads to immune dysregulation that allows candida to overgrow in the body. Anderson has noted that abnormally high candida antibodies are commonly found in his patients.
While candida is technically a yeast and not a mold, it does produce mycotoxins that negatively affect health and thus needs to be considered in a treatment protocol. Fortunately, it responds to many of the same antifungal therapies used for the treatment of colonizing molds.
Exposure to mold in this water-damaged apartment in Miami, Florida, was the beginning of one young woman's long struggle with chronic illness. Most of the time, molds are not this readily visible, but they can be equally damaging to the genetically susceptible who are exposed.
Mycotoxins and Electromagnetic Fields
Another interesting consideration in the treatment of mycotoxin illness is one's level of exposure to electromagnetic fields. Dietrich Klinghardt, MD, PhD, has discussed research from Europe which has shown that molds react in a defensive manner when exposed to high levels of EMFs; in so doing they release up to 600 times more mycotoxins. EMFs led to faster proliferation of the molds themselves. Thus, implementing mechanisms that reduce ongoing EMF exposures may be a supportive intervention when dealing with systemic fungal colonization and mycotoxin-associated illness.
Nathan and Anderson have each noted that one can have both mold toxicity and mold allergy. Each of these may need to be treated separately in order to fully address the broader mold illness. Immune therapies such as low dose allergen (LDA) injections can be helpful in those presenting with an allergic response, or an overreaction of the immune system, to the molds.
Desensitization may be approached using sublingual drops that are personalized to the specific patient. Some practitioners have used homeopathic remedies such as Allergena Mold Mix, bioAllers Allergy Treatment Mold/Yeast/Dust, Professional Complementary Health Formulas Household Dust/Mold Allersode or Toxic Fungi-Mold Nosode, Energetix Myco-Chord, Physica Energetics Myco-Tox, and others.
Mycotoxins in Foods
While food-borne mycotoxins may not be as significant as those from ongoing environmental exposure or persistent fungal colonization, they are another consideration for those dealing with mycotoxin-associated illnesses. When someone is already burdened by an overload of toxins and a likely weakness in detoxification capacity, anything that can be done to further reduce exposure to additional toxins is a worthwhile consideration. Some have suggested that food allergies and leaky gut syndrome may be associated with the consumption of mycotoxins in foods.
Click here to view a partial listing of organisms that may produce mycotoxins.
Some of the more common sources of mycotoxin-contaminated foods include corn, wheat, barley, rye, peanuts, sorghum, cottonseed, some cheeses, and alcoholic beverages such as wine and beer. Sugar can both be contaminated with mycotoxins and also feed mycotoxin-producing fungi that may already inhabit the body. Other foods that may be affected by mycotoxins include oats, rice, tree nuts, pistachios, Brazil nuts, chilies, oilseeds (seeds that yield oil), spices, black pepper, dried foods such as fish and fruits, figs, cereals, coffee, cocoa, beans, peas, and breads. Fruits such as apples, pears, grapes, and apricots and their juices may be a source of mycotoxins. Coconut oil, while delivering many health benefits, is a potential concern if sourced from dried coconuts; thus purchasing a high-quality product may be important.
Milk, eggs, and meat may be indirectly contaminated through mycotoxin-contaminated feed consumed by the animals. This is another reason that grass-fed meats are a superior option, as mycotoxins rarely grow on grass, and thus the concentration of mycotoxins in the fat of grass-fed animals is generally lower than in their grain- or corn-fed counterparts.
According to the Bulletproof Executive's Dave Asprey, 52% to 91.7% of green coffee beans are contaminated with mold. 50% of brewed coffee beans may be moldy. Decaffeinated varieties are more likely to have mycotoxins, as caffeine protects coffee beans from mold. Coffee may be one of the most commonly used food products that can lead to an ongoing source of mycotoxin exposure. In fact, Asprey has created "Upgraded Coffee" with particular attention to the entire production process to minimize the potential for the presence of mycotoxins.
Temperature and humidity are important factors with regard to how foods are stored throughout the production process. These affect the likelihood of mycotoxins' being present in the resulting food products. Though there are standards in the food industry and limits on mycotoxins set for safety, food contamination with mycotoxins is a worldwide problem.
Food-borne mycotoxins may be a factor in ongoing gastrointestinal inflammation. Consumption of moldy foods or mycotoxins may be an increased risk factor for conditions such as irritable bowel disease. While there can be many factors involved in leaky gut syndrome, it has been suggested that fungi and mycotoxins may have the ability to damage the intestinal lining, which may lead to increased intestinal permeability and further exaggerated immune responses and to increased inflammation.
Making wise food choices both in reducing potential sources of mycotoxins consumed and in reducing sugars and other yeast-promoting foods should be given adequate consideration in those dealing with the effects of molds and mycotoxins.
Broadening the Horizon May Lead to Big Rewards
When it comes to the treatment of chronic Lyme disease, it becomes more and more apparent that many of the symptoms that patients present with are often not caused by Lyme alone. There is tremendous overlap in the symptoms associated with Lyme disease, heavy-metal toxicity, and mold and mycotoxin illness. In order to optimize patient outcomes and regain optimal health, broadening the horizon in chronic Lyme disease evaluation and treatment often pays off with big rewards. Here's to your health!
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Case Study 1: Patient is a 37-year-old woman with the diagnosis of chronic fatigue syndrome who had not responded to any previous treatment. Testing for Lyme disease was negative. In May 2013, ochratoxin was 1.4 ppb, aflatoxin was 0, and trichothecene was 0.25 ppb. On cholestyramine, chlorella, clay, and charcoal alone, she improved 70%; reporting that she felt better than she had in years. Upon retest, she showed no ochratoxin or aflatoxin, but her trichothecene level increased to 0.4 ppb, which may be an indication of further detoxification under way. She was then placed on Sporanox with amphotericin B and EDTA nasal sprays and will be seen soon for follow-up.
Source: Dr. Neil Nathan
Case Study 2: Patient is a 50-year-old woman who presented four years ago with Lyme disease, babesia, and bartonella. She did fairly well with antibiotic and herbal treatments, realizing improved energy and cognition and fewer joint pains and headaches. Improvement was estimated at 70%, though she was not back to full health. In May 2013, urinary mycotoxin testing revealed ochratoxin 1.4 ppb, aflatoxin 1.4 ppb, and trichothecene at 2.34 ppb. She was treated with cholestyramine, charcoal, and clay as binders along with nasal amphotericin B/EDTA and oral Sporanox. In January 2014, she felt significant improvements in energy and cognition. Her headaches were virtually gone. Retesting showed aflatoxin was 0, trichothecene down to 0.05 ppb, while ochratoxin had increased to 3.64 ppb. The increase in ochratoxin may be the result of the antifungal therapies’ leading to an additional release of mycotoxins from dying fungi or the body’s ability to better detoxify and excrete previously stored mycotoxins.
Source: Dr. Neil Nathan
Much of the information in this article is the result of conversations with Neil Nathan, MD, and Wayne Anderson, ND, in addition to information from various conference presentations and online resources.
Informational Sites from Doctors and Practitioners
Dr. Dietrich Klinghardt: http://www.klinghardtacademy.com/images/stories/neurotoxin/NeurotoxinProtocol_Jan06.pdf
Dr. Lisa Nagy: Mold and Mycotoxins: http://lisanagy.com/acatalog.php?id=1
Dr. Ritchie Shoemaker: http://www.survivingmold.com
Dr. John A. Tafel: Detoxification: Mold and Mycotoxins Protocol: http://www.drjohntafel.com/?page_id=617, http://www.drjohntafel.com/?page_id=619
Dr. Jack Thrasher: Toxicology of Mycotoxins: http://www.drthrasher.org/page36.html, http://www.drthrasher.org/page7.html (Recommended Physicians)
Laboratories and Pharmacies
ASL Pharmacy: http://www.aslrx.com
Alletess Medical Laboratory: http://www.foodallergy.com
EMLab P&K: http://www.emlab.com
RealTime Laboratories: http://www.realtimelab.com
Tennessee Mold Consultants: http://tennesseemold.com
Brewer JH, Thrasher JD, Straus DC, Madison RA, Hooper D. Detection of mycotoxins in patients with chronic fatigue syndrome. Toxins 2013;5(4):605–617. doi:10.3390/toxins5040605. http://www.mdpi.com/2072-6651/5/4/605.
Brewer JH, Thrasher JD, Hooper D. Chronic illness associated with mold and mycotoxins: is naso-sinus fungal biofilm the culprit? Toxins. 2014;6(1):66–80. doi:10.3390/toxins6010066. http://www.mdpi.com/2072-6651/6/1/66.
Guilford FT, Hope J. Deficient glutathione in the pathophysiology of mycotoxin-related illness. Toxins (Basel). 2014 Feb 10;6(2):608–623. doi:10.3390/toxins6020608. http://www.ncbi.nlm.nih.gov/pubmed/24517907.
Hooper DG, Bolton VE, Guilford FT, Strauss DC. Mycotoxin detection in human samples from patients exposed to environmental molds. Int J Mol Sci. Apr 2009;10(4):1465–1475. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680627.
Videos and Podcasts
Nathan N. Mold, Lyme, and coinfections. Gordon Medical Associates. http://www.gordonmedical.com/unravelling-complex-chronic-illness/radio-interview-with-neil-nathan-md-mold-lyme-and-coinfections.
———. Mold toxicity. Mendocino Coast Television. http://mendocoasttv.org/cdhWellnesslecturemoldtoxicitydrnathan1.html.
Additional Useful Resources
Bennett JW, Klich M. Mycotoxins. Clin Microbiol Rev. Jul 2003;16(3):497–516. .
Bulletproof Executive's Dave Asprey: Mycotoxins. http://www.bulletproofexec.com/?s=mycotoxins; Get stable energy and perform better by avoiding these: http://www.bulletproofexec.com/bulletproof-video-get-stable-energy-perform-better-by-avoiding-these; The molding of the world part 1: how we made mycotoxins into the health disaster they are today. http://www.bulletproofexec.com/mycotoxins-in-america; How to biohack the ultimate healthy home: part 3, with Bulletproof Exec Dave Asprey. http://www.bengreenfieldfitness.com/2014/03/mold-in-your-home; Why bad coffee makes you weak. http://www.bulletproofexec.com/why-bad-coffee-makes-you-weak.
Dr. Shrader's LDA: a dramatically effective immunotherapy for allergy. http://www.drshrader.com/lda_therapy.htm.
Food Safety Watch: Lawley R. Aflatoxins. Feb. 1, 2013. http://www.foodsafetywatch.org/factsheets/aflatoxins; Ochratoxins. http://www.foodsafetywatch.org/factsheets/ochratoxins; Trichothecenes. http://www.foodsafetywatch.com/public/983print.cfm.
Forsberg NE. Mycotoxins and immunotoxicology. Oregon State University, Department of Animal Sciences. http://www.omnigenresearch.com/file_download/9/mycotoxins_and_immunotoxicity_11_04.pdf.
Liposomal glutathione (and research articles on mycotoxins). http://www.lipoglut.com.
Mold-Survivor.com: Lillard-Robers S. Symptoms of fungal exposure. http://www.mold-survivor.com/symptoms.html; The toxic effects of fungal exposure. http://www.mold-survivor.com/assoc.illness.html.
Whitlow LW. Evaluation of mycotoxin binders. Dairy Cattle Nutrition UW-Extension. http://www.uwex.edu/ces/dairynutrition/documents/myco-maryland-binders.pdf.
Information is not intended to treat, diagnose, cure, or prevent any disease. Nothing in this text is intended to serve as personal medical advice. All medical decisions should be made only with the guidance of your own medical authority.
Scott Forsgren is a health writer, advocate, and coach. He is the editor and founder of BetterHealthGuy.com, where he shares his now 17-year journey through the world of Lyme disease and the myriad of factors that it often entails. He has been fortunate to have written for publications such as the Public Health Alert, Explore!, Bolen Report, and Townsend Letter. Scott expresses gratitude for the information shared by Dr. Neil Nathan and Dr. Wayne Anderson in support of this article. More information on his work is available at http://www.BetterHealthGuy.com.
Neil Nathan, MD, is a medical doctor at Gordon Medical Associates in Santa Rosa, California. He is a gifted physician and healer who is always excited about the next opportunity to learn something new that might benefit his patients. He looks at each patient "as an opportunity to discover which component of healing might still be missing." He specializes in Lyme disease, chronic fatigue syndrome, fibromyalgia, thyroid conditions, chronic illness, chronic pain, and autism. His healing toolbox includes tools such as chelation, craniosacral therapy, Frequency Specific Microcurrent, homeopathy, hormone balancing, nutrition, prolotherapy, trigger point injection therapy, and more. Dr. Nathan is a graduate of the Pritzker School of Medicine. His highly rated book Healing Is Possible: New Hope for Chronic Fatigue, Fibromyalgia, Persistent Pain, and Other Chronic Illnesses is available on Amazon.com. More information on Dr. Nathan is available at http://www.neilnathanmd.com and http://www.gordonmedical.com.
Wayne Anderson, ND, is a naturopathic doctor at Gordon Medical Associates in Santa Rosa, California. He has been in practice for 33 years. He integrates mind and body patient care with the strengths of alternative and conventional medicine. He tailors a program unique for each patient to meet their specific needs. His focus on patients with chronic illness led him to the realization that chronic Lyme disease was an important part of these conditions. He has a deep understanding and mastery in the treatment of chronic illness and always strives to learn new options to help his patients. His toolbox consists of tools such as protocols for Lyme disease and mold illness, naturopathic medicine, detoxification, leaky gut syndrome and dysbiosis protocols, functional medicine, autoimmune therapies, multiple chemical sensitivity protocols, hormone replacement therapy, and more. In preparing for this article, Dr. Anderson shared his excitement and passion for his patients in saying, "We are so right there. We are so close. The brass ring is just outside of our grasp." Dr. Anderson is a graduate of the National College of Naturopathic Medicine in Portland, Oregon. More information on Dr. Anderson is available at http://www.wayneanderson.com and http://www.gordonmedical.com.