 Hello everybody! If you were planning on joining us in about 20 minutes, we're a little early, but this is going to be recorded so you can watch it anytime and if you jump right in the middle you will be able to watch it as many times as you like. Just a little bit of housekeeping, you can find us also on the YouTube under Jill Carnahan channel. Please subscribe there and watch all the videos. We've got lots of mold experts and today is going to be one of my favorites with Dr. Sandeep Gupta and I will introduce him in just a moment. Please leave your questions in the feed and I'll try to follow those so if we get any live questions we can actually jump right in and answer those questions here on the podcast today. And again I think you know my background in mold this is going to be a really exciting and fun discussion as we dive deep. I want to introduce my guest in case you don't know him. Dr. Sandeep Gupta is a board certified general practitioner practicing in Australia's Sunshine Coast. I was actually supposed to go there this spring and of course with the pandemic I was not able to make it so I hope maybe next year I'll be able to be back and I think was the conference that I was looking at attending close to where you're at? Yeah it was just an hour away, Metagenics Congress in cancer I think it was. Excellent so hopefully next year or soon I'll be able to go. I've never been to your part of the world but I hear it's amazingly beautiful. He has a fellowship and master's degree in nutrition and environmental medicine and five years experience working in intensive care medicine. He runs a busy integrative medicine practice Lotus Holistic Medicine which you can find online and is your website go and give us your website if people want to find it. It's lotusholisticmedicine.com.au. Perfect so I if you want to read more his bio is there I won't spend any more time but we have become friends even across the world because of our common interest and our common friends and our common societies in this area and it's a worldwide problem and I'd love to start Dr. Gupta as far as your story just a little background and we all kind of have a story. I always joke that you know I didn't choose mold that shows me so tell us about how you got into this area of medicine. Yeah I think that's pretty right Dr. Gill. I actually was working as an intensive care physician here in Australia in Brisbane for around about five years. I was more dealing with post cardiac surgery cases and those kind of things but also you know some acute cases of sepsis but it was in a private hospital and really others although I had always been interested in holistic medicine when I was a medical student when I was going through my residency it had really been evident to me so strongly that I had to become a specialist and I had to become you know I had to really go into one area of medicine that was you know particularly advanced if you like and in intensive care was always thought to be one of the most advanced areas and so I naturally found myself into that area and I guess you could say that is probably one area in which modern medicine really shines because those acute cases where someone is going down the tube really quickly the technology and so on that's available in conventional medicine really thickens them up very quickly and so I do think that that that that type of medicine is very strong however I then had a a a health crisis of my own when I was in America and basically got a gut flu when I was traveling in Oregon in 2005 and I actually treated myself with Ciprofloxacin because based on the sensitivity that the bug had you know which is the usual thing you just pick the antibiotic based on what a bug is susceptible to but I had no idea that actually that could wipe out a lot of my gut flora and leave me really really debilitated so I flew home just literally the day after I took this antibiotic it was just a single dose and and I came home to to have debilitating headaches and virtually no energy I was just really I was all of a sudden like a chronic fatigue syndrome patient and I had no idea what had happened I went and saw one of the neurologists at the hospital where I was working and really I guess I was struck by the fact that he didn't seem to to really take into account anything that had happened and really what he suggested was prednisone 75 milligrams daily and he diagnosed me with cluster headache and you know I was total you know I of course prednisone has has its place and can be used in certain instances but in that particular circumstance I felt that hang on this is there's got to be another way here because you know this is definitely related to the antibiotics and there's definitely some imbalance that this has created that I need to rectify and so that led me just on a journey of starting to research and understand the microbiome I didn't know what the microbiome was at that point I didn't know what probiotics were I'd never heard it you know I thought Candida was just something that very very rarely will affect someone who was immunosuppressed or something like that so it started me thinking in a totally different way and getting an idea of balance in the microbiome and luckily I was able to fix myself up quite quickly using probiotics and getting off gluten and dairy I was eating quite a high carbohydrate diet at the time and and and really just bringing you know just some very simple solutions on that level glutamine was another thing that was very helpful so the major leaky gut going on so that really opened my eyes to the idea that there was a whole deeper concept of balance in the human body that could be you know could be understood and it started it started me to go even deeper so I started doing that fellowship in nutritional environmental medicine that you mentioned it took me about three years and it led me to just start thinking in every patient I saw what could be the possible nutritional and environmental factors that could be involved so rather than having a rheumatoid arthritis patient and simply reaching for the prescription pad it was more like okay let me start thinking so if my illness could have been caused by antibiotics and other and high carbohydrate diet and other things what could what could be some of the factors that could have led this patient who have developed this illness that may have not been brought out into the spotlight and the start word of it's kind of like you know I lacked confidence but then as I started looking and things started getting uncovered I realized hang on this I actually can do this you know this is actually a real and it's really beneficial way of approaching medicine and approaching health and just because some you know this person may have seen esteemed doctors before now that doesn't mean that I can't bring anything to the table just by asking the right questions and one of the textbooks I had actually gone through medical school had the I had a really strong statement on it which said more is missed by not looking than not knowing and isn't that so isn't that such a cool thing true it's so true because we don't have to know all the answers we have to know where to find the answers or know that we heard something about that somewhere that we can go digging deeper right because we don't know you and I we've been doing this a long time we're kind of experts in this field but I still don't have all the answers but I always know that there's people that I can talk to or ask or research that I can look at and help me to discover wouldn't you say I feel like a lot of times we're on the cutting edge of some of the discoveries even with mold related illness and ICI and some of the groups and doctors like you and I that are doing this work we're constantly discovering new ways and better ways to treat it absolutely it's it's like it's a it's a it's a process of discovery it's a process of inquiry that we do with the patient together and in a sense there's a humility there because we don't know what the answer is for any individual person but what I'm what I'm committed to doing and I'm sure you are too is just at least asking the questions asking the deeper questions could there be nutritional and environmental causes behind people's illness so so then I actually moved on and brutally changed my career from intensive intensive care wow great in general practice so I did kind of two fellowship programs at the same time and I then moved up to the Sunshine Coast here to just do what was called a rural term and all of a sudden fell in love with the place so I was supposed to come for one year and here I am 11 years later but in 2012 which was just two years after I moved here I had a nice flood really badly there was really bad floods at that time and my partner at the time was basically bedbound and you know she had to stop what she was doing at the time she wasn't able to work and I didn't understand what was going on I had no idea but I you know I could easily and clearly link it to the flooding event because the timing was exactly then so I really started asking myself how could the mold that had developed from this have affected her human body and around about the same time a patient came in and started telling me about Richie Shoemaker she said that she had watched a podcast with Dr. Richie Shoemaker and she had heard about something called the VCS test and colostyramine and so on being used and I I looked at her blankly yeah what are you talking about and she said I should look into it a little bit further and so I did and I went on to his website and found out that he had a physician training and so I contact I signed up for that straight away no questions asked and contacted his office it took I think it took kind of like six months to actually make a connection and then at 1 a.m. in the morning one one fine night I had a Skype with Dr. Shoemaker and he started talking to me and again and asking me questions about what my interest was and he he pretty much said I'm going to make sure you get certified and he said let's get started on this let's he said within one to two months he wanted me certified so he was like that was the fast track they sent me sent me the WHO guidelines and GAO guidelines on on water and dampness and I was like oh my god this is a totally new language yeah started and I was just I was just determined because it was someone you know someone close to me was suffering I was determined to learn it and so he started firing off C4A and MMP 9 and TGF theater and I was like it's one in the morning man but no world well it's funny because I love that you framed it in the beginning with I mean we both went to allopathic medical school in different continents but the same kind of training and I love that you started with intensive care trauma medicine these kinds of things are the best in the world what we trained in because if you have a car accident or you have a heart attack or you have a stroke you're going to want the best that we have to offer with that kind of medicine to save your life however we're not so good at chronic illness inflammation lipopolysaccharides and the gut which is part of your story um just that endotoxymic effect of a gut bacteria causing inflammation in the body and the leaky gut the permeability of the gut which years ago doctors our colleagues would have looked at us with you know crazy eyes what are you talking about and now it is well well documented the hyper permeability in the link with lipopolysaccharide and this this is linked to cardiovascular disease obesity you know um diabetes insomnia mood disorders all kinds of things that we see but all that to say things like auto immunity chronic inflammation mold related illness are not well um there's not one med for these illnesses and they actually often get worse if you just would apply that model of a med or a surgery so we really need to think outside the box for these things and I love that your story also emphasized usually we're up against I always say it's usually ourselves a close friend or family member or someone that we really care about that gets sick and we don't have the answers and so we're struck with okay how do we find a cure or find a help for this person that we care about that got sick so that's very very similar to most of our journeys now I'm really curious because of that intensive background I mean that's a phenomenal background and mold related illness has a lot of dynamics in the body whether it's you know tachycardia or um pots or those things do you feel like you're training in the hemodynamics and some of the stuff you did in the ICU at least that's what we call in the US intensive care um yeah same thing that they apply to some of the knowledge of the dynamics of the body in a mold related illness are there little pieces that cross yes definitely and then the main crossover areas is what we call sepsis and so in the in the area of sepsis so so a classic thing is someone gets a urinary tract infection or has an episode of pneumonia which is you know seemingly pretty mild and then all of a sudden they get really sick and um and and all of a sudden they're just poor bodies breaking down and people around them are going what happened you know and they're just like oh my mother's in ICU now and it's like you know you just had a little urinary tract infection so what happened there was that infection then led to a whole cascade of inflammation a whole cascade of cytokines and even once the infection has been treated that inflammatory uh pathway may not have gone away so that needs that basically needed treatment in and of itself and so often what would happen is the patient's blood vessels will get very leaky and so they needed to go on to uh norepinephrine or adrenaline or or some of these other inotropic medications very quickly sometimes they needed like 10 liters or more of ivy fluids in a single day just to because all of their fluid from their blood vessels starts going into the wrong places yes because their vessels are leaky they then get leaky you know leaky lungs and you know this is also a topical thing because it's what happens in COVID-19 patients will also become very ill they get something called AIDS where basically fluid fills up their lungs and all of a sudden they may need to go on to a ventilator and also they do get steroids as part of their treatment interestingly intravenous vitamin C is also a really important thing although that hasn't been adopted widely I don't think in ICUs but that's another really important part of the treatment is intravenous vitamin C along with steroids and along with vitamin B1 or thiamine are some of the really key things which has been shown by Professor Murray to be very helpful I mean he's now trying to trying to demonstrate it in large large trials and so on and most likely that's going to turn out to be one of the most helpful things because all of these substances help with inflammation and so I do think modern medicine is very good at dealing with sepsis but what I noticed is once patients were out of the ICU they would still often have symptoms they would have low-grade symptoms often they'd say oh you know I've got really achy joints or I'm really fatigued and you know I'm just my brain's just not working like it was before and really in commercial medicine we didn't really have any answers for that part and you know that's probably where they needed a little bit of gut repair and where the you know where they needed to to look at any any lingering damage that had been done there and they needed to look at other triggers of inflammation you talked about bacterial you know LPS and so on that's probably likely to be the case because we know sepsis patients do develop leaky gut problems so there was a whole other world there that was that could also have been addressed if we knew about the science of integrative medicine so I it's really my utmost hope that at some point this comes into hospital medicine so we can be even more excellent you know it really is a great framework because when we talk about in mold related illnesses this environmental trigger and in a minute we'll talk about water damage buildings if you're listening how might you know what are some symptoms but just to frame it um what Dr. Gupta is talking about is we have these environmental triggers I always say it's like toxic soup in a water damage building and granted there's mold and the mycotoxins that that mold produces and those are very very small they're ionophores which means they go right inside your cells usually we get them through inhalation you can ingest them as well but inhalation is a primary route in a water damage building and then these go diffuse right into your blood stream and they are trichocytanes and ochrotoxins and aflatoxins and some of the list of the damage they cause trichocytanes have been studied for chemical warfare agents and they're kidney toxic which is nephrotoxic and they're toxic to the brain and the nervous system and they're toxic to all parts of the body and like you said they trigger these cascade of events called cytokines and inflammatory molecules and then those guys go on and create the damage I always like to frame it in like the flu or the COVID the virus itself isn't what causes the damage in the sense of that the virus is the trigger to trigger your own immune system to have this fight or flight reaction to throw out all the armed guards to try to fight its way out of that situation but that your own immune system's response is what actually causes most of the damage and that's the same way with mold and that's exactly what Dr. Gupta was saying in the ICU these patients they get inflammation from bacteria and again in water damage building there is bacteria there's yeast there's other fungi there's all kinds of things and these contribute to the milieu so let's talk about if patients are you know all of a sudden with the pandemic they're stuck at home and they're having more symptoms let's first talk about symptoms what are the common most common things that you see with mold-related illness and then we'll go into what do you do about it in your house or your office yeah absolutely and and often the symptoms are pretty subtle or insidious to start with in most cases and they can be anything from fatigue to insomnia to just feeling a bit more flat like a little bit more depressed than normal to getting joint pains or muscle pains or it can also be abdominal symptoms such as bloating or constipation and in some cases it's it's more local symptoms in the sinuses or the lungs where people could be getting nasal congestion or shortness of breath there are some more specific symptoms like if you're getting more of a vibratory sensation in the body or a sense of like a static electricity shocks that are happening a lot of the time that's pretty said that's pretty specific for mold-related illness the other thing that people often get is they start feeling like they're thirsty all the time and need to urinate all the time so sometimes it can be mistaken for diabetes because you get abnormalities in certain hormones called ADHD or antidiuretic hormone which can cause a similar kind of pattern to diabetes yeah this is real common you know after exposure patients will increase thirst in your nation and it's similar in the sense of the patients with hemodynamic instability that regulation system that we have is off balance and so instead of conserving water when you drink and maintaining hydrated in your vascular system two things happen that regulation called ADH which you mentioned it's kind of broken so you drink and you pee and you drink and you pee and you're actually dehydrated no matter how much water you drink because your body can't maintain the volume it needs to function and that can also lead to things like postural orthostatic tachycardia which is also called POTS where you have a very low blood pressure if you stand up quickly and your heart starts to beat very fast people can feel really dizzy or lightheaded when they're standing up and not be able to they maybe have to lay lie down to feel well or they can't maintain sitting or standing for long periods of time um there's something else that can happen in here and that's the mass cells can get angry and activated tell us a little about mass cells and why that's important to think about with mold-related illness yeah so that's something I've really only started looking at over the last two to three years and you'll recall we did a webinar about it maybe three years ago and uh and and one of the things I saw is some of the some of the patients who retreated from mold and CIRS would just react to everything and uh and and often they had a subtype of mold-related illness where they were getting a lot of flushing and burning and skin rashes and so on and they tended just to be very very sensitive often they were reacting to food that they were eating and uh and sometimes they could react to things as innocuous as water and so there was a subset there that I started to recognize where the the chronic inflammation appeared largely to be related to mass cells and often these patients would respond to being on a lower histamine diet and then getting on specific supplements or medications specifically aimed at the mass cells and so that could be simple supplements like chrysotone or um or or medications such as chromaline and ketotaphone or even antihistamines the H1 and H2 blockers uh and and you know often there was a bit of a it is a trial and error process that often needs to happen in order for them to find the right treatment for them to be able to switch off that mass cell response from long enough for them to then directly then go and address the mold but I am seeing that's a very very important component for many people's illness with mold. Yeah oh gosh I would totally agree with you it's it's been one of the biggest things it's um been the rate limiting factor the thing that stops people from getting well if we as physicians don't address it we can't really do the treatment protocols because often for example say someone's had a mold related illness they have pretty significant mass activation you try to give them glutathione and binders and these things and what you're doing is you're mobilizing the toxins and this is good because you need to excrete them but as you mobilize they can kind of get that re-exposure and it makes the mass cells incredibly angry. Just for fun I'll share it with you guys for just one second a screen share I just saw a article of Dr. Theoretis that shows this beautifully in a diagram so I'm just going to share it for a moment this is proposed diagnostic criteria and you can see their common symptoms brain fog diarrhea flushing headaches hives low blood pressure itching muscle pain palpitations and shortness of breath and brain fog is in like 95% of the patients so this is really really common to have um you know a lot of those symptoms so what about the building what do we do that's for us here at least in the US there's not a lot of great certified IEPs which is indoor air quality specialists that really really understand this illness and so there's a whole subset of remediators that can take away the mold but if they're not really careful in how they do that and how they maintain that environment how they clean up the environment after our patients um they tend to be sick or get sick or not do well so I'd love to hear your experience with that and um what you advise our patients to do. Yeah absolutely and I think a lot of my experience in this area comes from doing you know making the common mistakes and and it's so it's very easy to make mistakes in this whole area and that's one reason that having a really good source of information regarding mold illnesses is is is just you know can't be emphasized enough so one of the key things is you need to get a it's mold inspector or what we call an IEP who is familiar with CIRS and mast cell activation and basically chronic illness due to mold the reason for that is they then understand the idea that even small levels of mold and um and other types of microbial contamination such as bacterial contamination can keep the inflammatory pathways activated in someone with these illnesses and so if if someone doesn't understand this and they really are only understanding mold at a superficial level then they're not going to be able to firstly look for mold at a deep enough in a deep enough way uh and and to a thorough enough degree and secondly their recommendations are generally not going to be thorough enough to be able to eradicate mold at a comprehensive enough level for you to be able to recover so that's one of the first key points is knowing that all IEPs are not the same all mold inspectors are not the same and that if you take the time to cause a suitably qualified IEP then that time is is definitely worth the investment yeah I completely agree and I don't know about you I'd love to hear your opinion but for people when you know they come in my office sometimes it's the believability of if you just ask a patient you know do you have mold in your home 99% of them will say well no there's no mold in my house so you have to be a little sneaky about the questions and it's not really sneaky I just joke that way because you have to be very very good detective and say is there condensation on your windows have you ever had a leak in your attic or your thumb pump in your basement has there ever been moisture on the walls of your basement there's just so many questions that you can rattle off wash your dryer leaks leaks under your faucet in your sinks what about your shower showers the tiles are they are they porous there's porous tiles some of these most beautiful Italian tiles are quite porous and if they don't have the barrier behind them it goes right through if your if your contractor didn't build the house right I've seen many many many beautiful million dollar homes of master bath they're full of mold so just because you have a very nice home or a new home does not eliminate the risk but what I like to do is often either those plates or ermie test they are not perfect but it is one tool that we can use to get started for relatively inexpensive and sometimes I find like say a patient does an ermie test and I see 30 of ketomium gosh I'm worried that that's an issue and I can then say get an inspector to find out where that's at I'd love to hear is that similar to your approach to those kinds of things in the beginning yes definitely it all depends on on where the person is at and where the patient is at and also funds often plays into this in a big way of course yes and as you said you know to start with just even broaching the conversation is sometimes a little difficult because the way we've been taught in our culture that think about mold is mainly at a cleanliness level yeah sometimes people can almost take it that your question in their cleanliness right you start picking up mold and so need to sometimes take a different approach as you say and start asking more tangential questions around whether people felt unwell and in certain homes and then in the history we established that there appears to have been you know a history of water damage buildings and and there's been a correlation with symptoms often when people either come in with diagnoses such as chronic fatigue syndrome and fibromyalgia and so on this part of the history had never really been teased out and sometimes that when especially if you have enough time for a consultation and that's you know as a functional medicine doctor we often take a lot of time for our consultations because some of these little points take a little while to tease out and and the person may have never thought of it before but actually you know what that house I was living in that's where I started to get unwell and yeah it did have leaks how many times have you heard that yes all the time during the interview you're like well so yeah 2018 you moved and every sense then you've not felt well and your daughter and your son both have chronic sinus issues since then and your husband's brain fog so yeah it's like the light bulb goes on when this line of questioning is pursued and it's like hang on now that I think about it yes I was unwell in that that's when I got unwell and yeah there was a leak there and there was some musty smells and so on and it's like okay so this new place have you then moved the furniture with you and everything with you oh yeah we just took everything with us right so you can understand then that's why we've got ongoing activation of the inflammatory pathways so often in those cases you know having just doing a a ERME test or a plate test could be a reasonable place to start and then in some cases just doing some simple do-it-yourself remediation work can be a reasonable place to start so for instance if you have any porous goods that have come from a contaminated house then you need to either wash them if they're clothes or scan them and dispose of them if they're papers or just you know or just dispose of them if they're things like fluffy toys and lounge suites and mattresses unfortunately at this point although we're you know our movement we're exploring ways that we may be able to salvage some of these items at this point we don't have any reliable means for porous goods and you've just you've just got to dispense of those and then the not porous goods which are generally metal and glass and hard finished wood and so on you can generally clean those using a damp wipe and using a HEPA vacuum cleaner and sometimes just after doing all of all of those things you can then go ahead and repeat the ERME or the plate test and see are you starting to get to the realms of you know of of being a reasonably clean house or is there still some contamination there which may lead us to have to go and get an IEP for this new house in any case because most homes unfortunately have some form of water damage structural water damage to them that's the bad news here so in many cases there there is still going to be some underlying issues that need to be addressed and and getting an IEP who's really familiar with chronic illness due to mold will be really beneficial because they know how to look gently you know they're not going to just come in and tap a few walls and spray a bit of essential alright right they're going to actually come and really do a comprehensive examination they need to be doing moisture readings and moisture mapping of the house they ideally fire infrared cameras can be very helpful and then they will do you know they'll take a very hard thorough history just as we do you know when we're assessing patients the similar thing applies to an assessment of a home they need to have a history of where any leaks may have occurred and to look at those areas it would much more you know with a much more thorough eye if you like and then often sampling is the last part of their of their assessment where they may do air and or surface and or early testing and then further elucidate what problems are in the house yeah they've got what a great overview and there are now virtual I know we both belong to the ICI group and that's a great resource so it's International Society for Environmentally Acquired Illness.org so ISEAI.org and there are IEPs like Michael Shrance and Larry Schwartz and Greg Weatherman that do virtual so they can you know look in and and sometimes they're just advising you of who to have on the ground they call it boots on the ground kind of people that might come in and again this can get expensive so you can start with small things I love that Dr. Gupta said so there's a couple scenarios one would be like you have mold black stacky batteries behind that wall most mold is not visible so just because you can't see anything does not mean it's not there and the big thing before you do a lot of cleaning you want to make sure that there's not some massive mold hiding somewhere because that no amount of cleaning will take care of that issue however if it's just been an old house you brought belongings from an old moldy house and there's not any massive hidden sources behind a wall what Dr. Gupta is saying is that you could possibly get rid of porous items clean the ones that you can and then do usually have patients do some sort of a fogging and then a fine particulate clean or a small particulate clean and then cleaning the duct so you're getting a really really thorough clean because the dust in the particulate from dead mold that's left behind can still trigger the immune system so this is the frustrating thing it's just because you get rid of the wet bulk stacky batteries doesn't mean what's left behind that contaminated the air can't still make you sick and this is why we we have to deal with the patients who are in this environment and often very triggered by it and even by the remediation so that's remediation let's dive into just a little bit little bits of treatment now i want to say we're here to talk about your course and in the in the last 10 minutes or so i want to be sure and give you time to do that so as you're listening one of the reasons i brought Dr. Gupta on is i believe in his work his labor of love with the mold illness mold illness made simple too right yeah we will i already put a link here i'll make sure you guys i'll have that link but he has done i don't know how many years you've spent you put a lot of effort into this course haven't you yeah yeah well the the original version was released four years ago so we probably started working on this myself and came up right around six years ago and this probably ties into the discussion we've been having is that often when people find out that for instance their home may be contaminated or maybe it's a workplace there's a massive amount of overwhelm there's a lot of anxiety and it's you know people can get stuck because it feels like it's just impossible to to move forward you know it feels like that the expenses are just never ending and to be able to then make the decision to remediate your house or to move that's a really really big one and to be able to find a proper doctor or practitioner to be able to treat you all of these little decisions just seem very overwhelming especially when you yourself are not feeling well and often you know and oftentimes people's brains are just not really able to make decisions as well as possible and a lot of the info that's out there in this area although there are some simpler things coming in now uh but originally a lot of the info that was out there in this area of mold illness was extremely complicated in my view and it was you know it's great it's great info but it's not necessarily the info that someone with a really foggy mind is going to be able to understand and so you know when we went through our position training and so on uh you know we were able to get through all of that but you know if there had been an easier path for me I would have much preferred to have taken that you know like you said 1 a.m. with tgf beta and mmp9 and yeah that was not the easiest path the one that I took there you know that was just like getting into all of these hundred page documents and then slowly trying to find a gem in there where it would then you know on page 99 it would probably explain why not just go straight to the information that's needed so mold illness made simple is really just an attempt to do that it's just an attempt to go straight to this is what you need to know and nothing else kind of thing so you know we first start talking about what is inflammation just that really simple concept and we've described it as a silent fire in your body so just like the icu patient who had sepsis and starting to get a few joint pains and some fatigue when they're back in the ward they're still going all the fire has been put out to a large extent they've still got the embers of inflammation going on there and that's why they're sick they've still got inflammation and so it's the same thing with people who have had a massive exposure to mold there is a silent fire of inflammation going on in their body and this relates to something called cytokines cytokines are proteins that the immune system creates they like bullets if you like that that the immune system is creating to try and eliminate foreign agents but they're just not they're not very effective in a sense and and really what we need is a proper acquired immune response to take place but that generally doesn't take place with people who have a certain genetic predisposition to mold-related illness so instead they get this chronic inflammatory response and that can lead to symptoms of almost all systems of the body and as I say that's what we explain in a lot of depth in part one of the course and then we go on to talk about buildings because if you don't get your building right and you don't deal with that side there's no use going and having treatment would you say um Dr. Jill that's what we're absolutely right doesn't work as well and so so that's that's some real key and as I said we started to allude to some of the the the basic considerations when you're looking at dealing with your building so first thing was make sure that you find an IEP who's really really properly qualified so there are also certain certifications that we go over but they understand chronic illness due to mold then the second thing is finding a remediator if you decide to do remediation is finding a remediator who properly understands CIRS and has proper methods for remediating the building that you know that basically stand up discreetly and so we also talk about questions that you can ask a mold inspector and questions that you can ask a mold remediator make sure that you're getting the proper help and I personally believe that even just for that little piece the force is worth it because if you you know if you make mistakes in that whole area and for instance you just get you know get someone around the corner from you who's who's a general who's just a general mold inspector but they're never dealt with chronic illness patients most likely you're going to have to end up going and duplicating all the work you've done before you're going to have to go and get another inspection you're going to go and have other remediation done and so it's best to just get it right the first time and that's why it's so important to have the right information yeah how many times have you heard patients come in had one two three four inspections and they're all normal I don't have mold and then you find out there's a huge issue or even worse oh we had a remediation and I'm still sick or we had two things you know major remediations and I'm still not improved that's sadly not the exception to the rule yeah that's right it's so common that people have had problems in this domain and then this can drag on for years and years and years and what you know during this time you're depriving yourself of the opportunity to have a clean building and to have got better so basically having really good information about proper qualifications of a mold inspector and remediator are really important and also just understanding what not to do so one of the big things is when you if you decide to move from a contaminated contaminated home then you've got to treat your possession you can't take the contaminated possessions with you as as we said before you know we've got to you've got to look at those porous possessions even though they they may be very you know very sentimental to you you've got to deal with them in some way even if that way is putting them in a plastic box and sealing the plastic box and taping it up for a later time that's still way better than just having them out in the air to then contaminate the new house so there's a whole bunch of considerations when it comes to buildings and and then we also then get into the treatment which I think we were going to jump into a little bit now so there's a whole bunch of different steps that are really important with treatment but probably the most important one is binders would you say I agree yeah yeah and so binders you know they can be pharmaceutical or they can be natural and so in this version of the course we really expand this whole area of binders and talk about all of the natural binders we do talk about colostyramine and local and how they can be used but we also talk about bentonite clay and zeolite and and also the combinations that are out there like toxin's bind and and ultra binder and so on and how you can use your micro toxin testing in some cases to decide on the precise binders and detoxification supplements that that you may care to use or you know whether you just decide to use a more generic kind of protocol which these days we generally recommend that even if you're using colostyramine and local that you at least use one natural binder in there as well so that you're getting a more comprehensive scope it's not just picking up your ocratoxin so we go into that in a lot of depth and then we talk about some of the other the other steps of the original shoemaker protocol probably the most important one is vip nasal spray yeah which for some people is still very very useful uh it doesn't help everyone but for some people that's just you know it tends to it's just a real key for them it's almost like it's a key just fits their door and all of a sudden you know they're just the inflammation that's going down majorly and in other cases it really you know it doesn't have a major symptomatic effect and I guess that just shows how unique everyone is how different everyone is and then the other things we cover now is is also fungal colonization and that's a new piece that I've added in this course wonderful wonderful if you'd like to share uh you're welcome to share some of the slides on your course too I bet yeah sure really do that so we'll just go ahead here and perfect there we go okay so really I've covered a lot of this we talk a lot about how uh how water damage can happen to a building but there's so many different ways you know it can be microbial growth in a bathroom it can be due to waterproofing or so many other different problems and so as we said before you can decide to do it do it yourself test or have a proper professional inspection done which if it then indicates water damage or mold growth and you've got a multi-system multi-symptom almost then all the signs are there that you may well have c-iris or mast cell activation syndrome and so there's a number of tests you can do and we do cover all of those in this course and it's a much more broad view of the testing in this course so we talk about the urinary and nasal mycotoxin testing and um and also the fungal stool testing uh which is is still available with various labs such as cell GI map and we also talk about how you can do nasal fungal and bacterial cultures with microbiology duox and then we do still cover the inflammatory and hormonal markers that can be done with question lab or so well if you've got an insurance plan that covers these these tests then in many cases that's a great idea you can still have these tests done and I think now Dr. Joe will do them pretty much all with lab core is that right okay great and and then but they can point to certain abnormalities and particularly in a legal case I've found that those tests tend to be very helpful and then the organic acid test that's a test that I'm using more and more when we talk about what some of the markers are on there that tend to indicate that you'll colonize or affected with and then we also talk about neuroquant which is which is a very useful test if it's available in your area and we also talk about June so there's a full list of tests that can be done however it just depends on on your particular case and on your particular budget I do also make the point that you know in some cases you can just get treated with minimal testing you don't necessarily have to do extensive testing you can basically know if you're convinced that you understand the fact that mold is affecting your health and you want to just basically treat your building and then go through a treatment protocol in many cases you can actually do that without a whole lot of testing but on the other hand and particularly in legal cases or in cases where you want more information there was a whole host of tests available and so just just tracking back a little bit we've already I think we're already kind of alluded to the fact that getting away from the water damage building exposure is the single most important step in getting better and if you do that you're halfway there in terms of in terms of recovery generally speaking the second thing we want to have it mentioned here is if you have muscle activation it's probably best to address that first would you say Dr. Jill yes absolutely yeah so so we could add an extra step in here so if the muscle activation is present go ahead and treat that first with a low histamine diet and supplements or pharmaceutical agents for that and then thirdly then get on to binders such as colostyramine, rock coal, charcoal, sway, zeolite, kytosan, etc and as I say that can be generic or that can be according to your testing and then the next thing is to consider whether you've got umbral colonization and or macron colonization and really we're thinking of this in a more broad sense now really just thinking about the nasal biome and not so much fixated on the idea of macrons being the sole problem and so we talk about some of the different agents that can be used such as colloidal silver and or EDGA, antifungal meds such as nystatin or apheterosil, nasal sprays and then we also talk about how to treat GI colonization with fungus using antifungal meds or herbs and then lastly we talk about inflammation correction and particularly the rural area of rural inflammation and there's a whole host of things that can be used for this including for the low amylose or various versions of an anti-inflammatory diet with varitrile, curcumin, lindic and vagus support this is a really important area I'm going to touch on quickly and this is one of the longest lessons actually in the new version of course and I think it's about one hour and 20 minutes we cover all of the systems of limbic system retraining and and also methodologies for vagus system support and this has kind of become more and more this has come to my awareness more and more that this whole element of the limbic system needs to be addressed in cases of mold or at least in many cases it needs to be addressed and if you are able to add some limbic system retraining into your whole process that actually reduces a lot of the inflammation on the neurological level which will help your healing in a very great way and so it doesn't mean that that we're saying the illness is just in your head right it means well in one sense it is in one sense there's an actual physical inflammation component in your limbic system of the brain so it's very physical and that's something that you can't address with a you know a very structured progress process rather for limbic system retraining so there's dnrs that's that everybody with mold related illness needs to look at this because it's a trauma and whether we like it or not that mold exposure even if we're like oh i'm going to be fine and no i'll get well like even if you have a great positive attitude and you're well adapted and you've done therapy even so this type of an illness is so different in that it actually attacks your limbic some people call it limbic loop and it's this limbic loop a fight or flight so you're subconscious when you get exposed is actually re triggered every time and so you have to do something to kind of calm the system down and say hey it's going to be okay and this is through that limbic stuff you're going to do you describe in the course yeah so that i think again just for that chapter alone i think the course is worth it just to really understand why limbic system retraining is recommended in almost all patients with this illness and to also just look at the different options well so there's gnrs the group the program this a nrs reset there's a whole bunch of them and so we hope you look at the different options we also look at somatic psychotherapy modalities for people who really want to go deep dive deep and look at releasing some of the trauma that they've had from the past so there's a lot of info in there and then we also talk about various other supplements you can use we've talked about the ip uh synapses another type of nasal spray that's often used which uses a compound called nicotinamide riboside as well as ginseng compounds from ginseng which are the really really ancient herb that's been used for a variety of things and then we talk about vitamin d lithium lion's mane all sorts of different supplements that can be used to support the the you know rebuilding of your neurological system because often there is some degree of damage that it goes to your neurological system so there's a lot of information about this as well so jumping right into it that's okay dr jill so the the course basically now is 17 hours so it's increased from about eight hours and the basically they're animated lectures with the slides on the screen with my beautiful australian accent and there's nine modules now and basically 30 lessons so it's not it's not run at at any particular time it basically can be completed totally at your own pace which i think is important for uh ci res and chronic fatigue patients because sometimes you have to pace yourself in terms of energy and sometimes you know you can then this way you can choose when you're when you have a day where you're actually feeling better and you have good energy levels and you're you're able to take the information because i know sometimes you have days where you're just not able to take anything at all so it's totally it's totally done at your own pace however it's good to make a schedule of you know of what sort of time period you want to do it on your own i think it's really important that you know it's not for everyone really this course is just for people who really want to take the time to learn this illness and and properly go through the information perhaps over a few months time and dr gupta we had a question right as we're talking about is this for practitioners or patients i'm hearing this is definitely for the patients but i am assuming doctors who don't know anything about it it would be excellent for them as well yes yeah we've had that feedback so far we've had a lot of practitioners including doctors do it and i think as i said you know i would have thought of this i mean much better pathway to learning about mold because really once you have those simple those simple concepts down we can easily then add the more advanced medical information afterwards that's all that's not difficult in my view but i think the key even for physicians is to just get the really core basic information down pat like this bit about you know how do you screen for cirs how do you diagnose cirs we cover that all in part one and as i said in part two i think that the information on water damage buildings is probably the harder information to come about and that's where we really talk about this idea of water damage building testing and the basics of remediation and what should happen during a remediation process personally as a doctor i think i've found that that has been the information that you know hasn't been that easy to lay my hands on and i really had to go digging for a lot of disinformation going into things like the ic rc guidelines and so on right and yeah and then lastly how to just find and maintain a healthy home again that's information that's not readily out there and available so this is this is kind of we've disturbed a lot of information from a variety of different sources including scientific papers and so on so i think for a physician looking as a starting point all the references are also in there so i think for a physician they're probably more likely to go and then look up the references and and and actually download some of those references so that they don't have the scientific papers on hand and so that's basically that's the way in which they can have a much more scientific uh form of investigation into this illness but i think that the same information applies yeah and uh in many cases i also find physicians who are doing this course are interested in this course have someone they know or they have patients who who may be suffering from this illness and so the the practical focus still tends to be quite helpful for them you know in terms of just some of the simple practical tips that we that we include so yes i would definitely say that that for a physician if you're just starting off with this illness i would say this is absolutely a very good way to go and then lastly in the bonus module we're still included this time the lesson one we talk about how you can actually use biomarkers such as c4a and mmp9 can determine whether you have or what a damage building and what i mean here is that you can actually use them as a provocation test so we talk a lot about something called a mode sabbatical in this course and a mode sabbatical is when you get away from your building and generally go tent camping or go to a building that you know is safe for two weeks or more and then you come back and reexpose yourself to the building that you're in again and all of a sudden sometimes what happens is you can notice a correlation between your symptoms and that building that you never notice before well the other thing that you can add to this is you can actually draw blood while you're away on the mode sabbatical for c4a and ntg fbdo and mmp9 and so on and then draw it again maybe 24 hours after you then reexpose yourself to the house and in some cases you then see a big jump and that can be very helpful to then confirm once and for all that building is contributing to your patient's health and you know i think that that kind of information can be very very helpful especially when you're making having to make a decision on to whether to remediate or remediate or leave her i had a little similar i went to maui last year and a massive mold in my hotel and now i know what to do so i mean it still made me a little ill but i got out of it i got through it pretty quickly but when i got home a week and a half later i did my c4a and it was about 4 000 so it was clearly confirmation that i had just gotten out of the mold there in maui so interesting to and yeah yeah that's right so there's a whole bunch of different ways in which you can use these biomarkers and some of the other tests and then listen to we talk about the psycho-emotional stress of mold illness and and the trauma that people experience through it and and how limbic retraining and vagus nerve stimulation techniques can be extremely helpful as part of your recovery so in listen three we talk more of as a special interest area we talk about crs and co with 19 and the the connect them is there and really put to beg this idea that that crs patients are at greater risk because at this point it doesn't appear that there's anything to suggest that if your crs is well managed that you're at greater risk of this illness but we do talk about some preventative things you can do including vitamin d etc and then lastly unless and for we talk about other causes of multi system multi symptom illness because we don't the other side of the coin here is although we're saying that mold is huge as a problem for chronic illness you know it's it's often the most overlooked thing and one of the most important things we also don't want people to get so caught up in it that they overlook other important causes and so we also then talk about things like cibo which dr gill talks a lot about in her podcasts and also pyroleria maybe metal toxicity parasites these are just some of the things we think about every day with functional medicine and you know it's it's important that we keep these in the greater net of our illness and we don't just focus on mold alone that we keep a broad keep a broad net i think is a good way to put it well this is um absolutely amazing that you know again the first course was great this is uh this is times 10 or times 100 with the quality and the amount of content you have here i and if you're listening live today there's a link below that you can check out there's also a code that dr gupta's yes so graciously given us to share with our listeners so you get a hundred dollars off which is quite a big deal for the course i mean this is just an incredible deal dr gupta i know this is a massive amount of work and so much great information and this is a great great price for our listeners well i sincerely think it's worth it if you're feeling from this illness i think there's really no question because clear information needs to be feeling clearer you feel clearer needs to less overwhelm and less limbic system activation once you feel clear you can get some confidence and then you can start to move forward one of the things as i said one of the things that my heartfelt desire is the outcome of this course is that people may be able to use it to help move forward towards recovery and and that's really that's really the intention behind it is is that you can really feel that there's a path forward for you and this is not the end and realizing that not only can you recover from this illness but often there's a really big life shift that happens afterwards on on recovering from mold on this often there's a lot of different personal transformation and meaning that comes of this and often people can find that the life that they're living after recovering from mold on this is way more fulfilling than the one they lived before and and and i really mean this and i have seen this in a number of cases yeah i love that you say that that's definitely my story i i'm writing right now my book and it talks about some of the story and that's actually a part called the awakening there's this piece that happens that really really shifted my life in many ways and it was started with mold related illness so i can relate to that on on so many levels well gosh well thank you for your time today dr gupta this is just incredibly informative i really encourage you through listening to check this out i think it's a phenomenal resource and again i know how much time and energy and effort you put into it any last comments or things that you'd like our listeners to know no i think just reiterating this idea that there there is a you know there is a bright new world on the other side of this illness when you're right in the middle of this i think if someone had come up to me and said i you know you're gonna find amazing meaning after some point of this i would you know i would kind of um wouldn't believe them or i'd i'd tell them you know that they just had no idea how severe this whole thing was and you start making steps towards recovery and you start walking in the right direction all of a sudden you know you find that all of the things that you do start compounding and i really also want to to tell people if anyone's been caught up with this idea that they have the dreaded gene or that they you know that they unless they find a perfect house they'll never get to recovery just to let go of some of those ideas that were really floating around in the world in the mold world uh sometime back really one of the key messages we'll mention here is it is possible for everyone to recover and even if it's difficult even if it means living in a tent for a little while there is a way forward and i want you guys to take that in and really feel that uh that there there is a solution here and you're going to be able to find it one of the keys is to find some really good clear information so this course is here as an option for you if you want to do it as we say you just need to go to the website dr jill will also post a specific link uh below in the in the facebook page and you just can go in and and and click on sign up and use the that coupon code where it asks you and you have a coupon code and that's going to run for the next 48 hours or so so i really want people to be able to access this information so we've made it very affordable so i really hope that you consider this option and and and hopefully benefit from it yeah well thank you for uh getting up early in that side of the world and joining us this morning and this afternoon for us and for us in the us if you haven't got out to vote i just want to encourage you to have a little bit of time um to do that today thank you so much dr kukda as always it's a pleasure to have you on today thanks dr jill it's great talking to you and um look forward to doing another call some other time you got it