 At just 19 Palmer Kipola received a life-altering diagnosis, a prognosis so dire her doctors thought she may never walk again. She had taken my parents aside and told them to prepare for my life in a wheelchair because that's where I was headed. Palmer has multiple sclerosis, an incurable but treatable autoimmune disease where your body attacks its own nerves. So what kind of symptoms were you having? This feeling of constriction like rubber bands around my torso, zapping jolts down my spine every time I bent my neck forward. For decades Palmer struggled. On top of that she had stomach issues that no one was able to help her with until she met with a functional medicine nutritionist who tested and discovered Palmer's gluten and dairy sensitivities. We did some gut healing, took out the bad stuff. The results were dramatic and swift. Within a week I stopped having that tummy trouble after eating and within one month I stopped having MS symptoms. Functional medicine shifts to focus away from just treating symptoms and aims to understand why those symptoms are occurring in the first place. According to the Institute for Functional Medicine its popularity is surging. Last year 276 clinicians became certified as functional medicine practitioners. That number expected to nearly triple in 2022. I like to define functional medicine as investigative medicine. It's really going deeper into the root causes of chronic conditions. Dr. Cynthia Lee, a one-time skeptic, now specializes in functional medicine along with being an internist. She believes it's filling a critical void where traditional medicine falls short. A lot of patients have symptoms like fatigue or dizziness. They will go to their primary care doctor and the doctor will order some screening labs and everything comes back normal. What additional tests will a functional medicine specialist run that a primary care physician might not? Testing might include nutrient deficiencies. Testing you know doing series of stool tests to make sure there are no hidden bacteria or parasites. Many treatments come back to the basics of what every doctor thinks is crucial for health. Eating right, exercising regularly and managing stress. Tenants Dr. Lee has adopted to manage her own health struggles. I developed an autoimmune thyroid condition after my daughter was born. It really forced me to begin to think about healing and medicine in a different way. Today you'll find Dr. Lee following a plant-based diet walking every day and practicing chi gong. Functional medicine takes a lot of personal effort and commitment so it is not just taking a pill. But for patients like Palmer seeing a functional doctor has been life-changing. So is this is this a new Palmer? Is this a different Palmer? This is a new me. I have more energy. I'm stronger, fitter than I was. It's changed my life not just my health. I mean I have to say that I'm on a prevention path now. It's given me not just my health back but my life back. So to be clear someone's calling themselves a functional medicine doctor or physician. They've gone through traditional medical school training much like I have but they may also choose to get certified in functional medicine from an organization like the Institute for Functional Medicine. Now currently visits and tests aren't typically covered by insurance but that could change in the near future and yes Craig I am a fun guy. Hey Dr. John I'm just curious are these doctors located all over? Are they easy to find? They are located all over and numbers have dramatically increased even over the last year and they're expected to increase even more. So they're not difficult to find typically you can go in the you know online and find them and they're fantastic. Dr. John Torres the all-around fun guy. Don't call him a truffle. Don't call him a truffle. I got it, I got it, I got it. Thanks so much everyone for watching. We've got an epic lineup tonight of speakers. We've got an awesome panel here. Amazing group of functional doctors, technology, activists for here for a league forward in medicine. You know our goal is to make it easy for practitioners to learn in community. This ecosystem that has been set up by the meetup groups we believe will be the future ecosystem of this evolved primary care network and it all revolves around you. Welcome to the Functional Forum. Thanks for joining us in the charge to accelerate the evolution of medicine. Please welcome your host James Maskell. Hello everyone welcome to the Functional Forum. This is the 99th episode of the show. Couldn't be more excited. We've got an incredible lineup of speakers tonight. We've got a topic that I know is near and dear to so many people's hearts in this community. We're going to be talking about biotoxin illness and endotoxemia. Definitely a hot topic and we've got the right guests here to share what's working in functional medicine and how you as a practitioner can get better outcomes or be part of a community that really helps people with these kinds of issues. We are live so if you want to ask questions you can go on to Twitter. You can go to hashtag Functional Forum. We'll have some time for questions all the way through. I'm super excited to have tonight Dr. Jeffrey Gland the godfather of functional medicine. We've got Dr. Jill Carnahan one of the leading educators and physicians in this biotoxin illness space and then we've got Dr. Jill Krista as well who is a leading educator and wrote the book Breaking the Mold and super excited to have them all here for today. Now this originally was going to be a little bit of a preview for this personalized lifestyle medicine conference May 13 to 14 in Chicago. Sadly or not sadly but excitingly it's completely sold out. You know this is obviously a hot topic and I think people are ready to come together back into community which is really exciting. So you know I'll be there with the cameras for that event and we hope to make it easy for those of you who can't be there. I understand there might be some some live streaming options coming because I think this is the earliest that this conference has ever been sold out so exciting times for all men and then also exciting. This is the 99th episode next month May the 2nd is the 100th episode of the functional forum when we started back in February 2014 didn't really know what we were getting into but over the last eight years you know what we're going to do on this show is really showcase sort of where we came from which you know Dr. Jeffrey Gland was a critical person in my education and really helping us understand the role of the micro practice and how we use a low overhead model to get more doctors in Dr. Saxena is obviously such a leader when it comes to you know operationalizing functional medicine and she's a great clinician too and then Dr. Angela LaSalle is the current head of integrative functional medicine at Parkview Hospital and so you know we're going to be sort of going to the past of you know what we've been able to achieve and then looking to the future for the next hundred and saying you know what will it take for large scale adoption of functional medicine inside the system so that it's affordable and accessible to all. Not much going on next time but we will discover that together so I'm really excited for that and speaking of communities the functional forum communities project is taking off I know there's a bunch of communities tomorrow night my meeting in Folsom California is happening that I go to there's also meetings in Austin Texas we've got new groups starting in New York Philadelphia Salt Lake City you know many different areas popping up leaders stepping up to build community in those local areas and super excited even Dubai had a meeting just the other day they sent us a picture and it looked like a jolly old time. All right so we're going to be talking about the functional forum tonight and functional medicine thanks so much to all of our sponsors we'll get to that shortly here in a minute but let's bring on the panel so Dr. Bland, Dr. Krista and and Dr. Carnahan are all here great to be here Dr. Bland and before we get into it that commercial that that segment shall I say I mean how long have you been waiting to see that on national morning television? Well James before I respond to that let me just respond to your fantastic intro and your history of this 99th edition going on to your 100th centenary edition. Your contribution to this field has been has been tremendous and I want to just acknowledge that and honor it because it takes individuals to build a community and individuals that have focused purpose staying power have to have courage to overcome criticism I can go on and on and on having had a few years myself and experienced in this field and I think your contributions to annealing this as a movement is to be really shouted out from the from the house top so I just want to thank you and I think this this this two other opinion leaders that I've had the privilege today to speak with both Jill's this is Jill squared actually probably Jill's in the fifth power these are two very powerful female members of our community and and it just represents the kind of quality and and the tenor of where this field is going to to see the skill in the in the excellence that both Jill Christ and Jill Carnahan represent so it's a privilege to be part of this now with your question let me get to that the key here that's a long-winded windup when I saw that program in NBC obviously I was aware of it being filmed and was as was I think anybody behind the scenes concerned about how things would be edited and what would end up on the cutting room floor and what would ultimately be projected to the public is you don't have any control obviously over the editing process and you never know exactly what the hidden agendas might be in in communications so I went with baited breath to watch this program and I had a little bit of hypoxia probably as it is it came on but I was overwhelmingly proud of the two representatives that they chose to interview and how they presented themselves and their their relationship to this this model that we started some 30 years ago to see if it had any stickiness and then of course Dr. Torres I couldn't have found a better ambassador remarkable personality very authentic deep experience critical thinker not accepting everything probably that comes across as plate but his advocacy for what we're trying to do in functional medicine was truly remarkable and I think it is reflective of the fact that this discipline is starting to mature now on the other side of the coin because there's always two sides of every street we've got some forces that we have to deal with that are trying to pull apart some of the fabric of this systems biology approach to health care trying to find ways of either degrading it or denigrating it or criticizing it and some of that force even comes within our own ranks in which people have I think started to use some of the concepts of functional medicine to their own advantage without kind of a circumspect view of the whole and so I think these are important critical times in our development of the growth and scalability of this model it's a model in need and I think you're doing such a great job in getting the message job but we all have a responsibility to be stewards as we move forward with this model to to make it straight as it can be and to be documented and to be properly supported and I am very confident when I have to see I see people like the two gels as our representatives that we will find that correctly forward absolutely yeah well said and I guess I guess before we jump into to the clinical side of things you know the last time you're on here last July you said something which is that functional medicine is not a set of therapies it's a way of thinking and I think Dr Lee actually kind of you know talked about that in that video so let's just take this to biotoxin illness you know because you hear people say as well well functional medicine is good for mold right so what is it about what you if you put those two things together why is the functional medicine approach what is the thinking process for it and why does it end up being good for this kind of condition well obviously i'm going to defer to the experts who are my two colleagues on this this panel but but I want I'll give a kind of a frame of reference for this one of the things that was asked of Dr Torres from the other announcers in the NBC program was what about testing and does it get covered by insurance and I think that there's this this view somehow that functional medicine is a is a kind of a technology that you plug in into an artificial intelligence equation and it tells you exactly what tests to do and exactly how you know what kind of therapies to come out it's all kind of compartmentals and and it's a retainized to the fact that it looks very therapeutically structured like you would a DRG a diagnostic related group or something that comes out of pathophysiology I want to to say that that's actually not what functional medicine is and I think you you you said it very nicely in your introduction James and that is it's a way of actually engaging the patient in a process of self inspection and an interrogative to try to trace through how they got to the place that they are in their lives of not feeling well and trying to find a way to understand the etiology of that from a timeline and a series of experiences that relates the genes to their life to their environment to their stresses to their diet and and so forth therefore this doesn't start out with testing and you know a lot of people think oh you just throw a whole pile of different tests at a person and you'll get the answer it's really not the answer the answer is skillful intelligent listening and knowing how to ask the right questions the questions that relate to upstream problems that create downstream concerns and that's a different way of thinking about medicine and driving just to a diagnosis driving to a diagnosis is kind of the way that I was trained and more most traditionally trained health practitioners are trained it's all the primate the primacy is at the diagnostic level I think in the functional medicine model it's how you got there not what you call it that's the most important feature and and that relates not just to testing to find the answer but to find the process to find the journey and to engage in the the story that really is that unique patient story that helps you understand how to unravel the story to get to the true answer of how they got there so I hope I didn't dis confuse the issue but I really will turn it over now to the experts who really can better answer your question specific to world-related disorders. Yeah Dr. Cohnham why don't we go to you next like what is it about from your experience functional medicine I know this is a very like personal journey for you and how you ended up you know treating a lot of this type of care and treating a lot of these types of patients but what is it about the functional medicine toolkit and the way of thinking that you know makes it a good fit for the kinds of symptoms that come from an underlying pathology of environmental illness and particularly mold. Yeah and thank you for having me James and thank you Dr. Bland for your wonderful introduction I'm honored to be here. It's so clear as I listen 50 or more percent of the difference in functional medicine is number one presence and listening to the patient I really believe the healing starts when we're present with someone who's been discounted by the conventional community saying you're crazy taking antidepressants or it's all in your head because as we well know conventional medicine we're not taught the innate immune system and the response to mold we're taught it as an allergy so we're taught about the allergic response but we're not taught about the innate immune system response and now if anything has validated our finding it's the pandemic and COVID because it's an innate immune response to a virus right we're seeing some of the same patterns into all of us practicing functional medicine this pandemic yeah it was a very virulent aggressive virus but nothing new was here as far as yeah new cytokines new pathways but we've done this before guys right we were doing the same thing and to me it's a it's a incredible opportunity whether it's mold any complex chronic illness involving cytokines in an innate immune system which is I think 80 percent or more of the illness that we see nowadays it is a mystery to conventional medicine and they're trying to often a lot of the research I'm now seeing is like yeah we've known this in functional medicine for 10 or 20 years and they're bringing out a paper which is great because it validates what we do but back to the first thing number one sitting with a patient being present validating their experience and listening carefully is number one and that's where healing starts number two is when I say you know what I think I know what's going on literally most of the time I have tears sometimes I have jaw drops and I'm sure you feel the same Dr. Jill when I say confidently I know we can find answers I know what's going on and I may not know all the nuances but I know the general vicinity of innate immune dysfunction or chronic complex illness I know what to do right and the beautiful thing about the functional model is it could be a brand new rare disease in the realm of innate immune system dysfunction or autoimmunity I still know what to do because I know how the body works I know where to go with this and it could be something I've never heard of before we're in conventional medicine we have no clues we don't know there's no drug that's been you know developed for that condition but I still know if I know innate immune function and I know the pathways and I know the complex chronic inflammatory things and I know environmental toxicity I know what to do and that second thing so first of all presence and listening number two is hope because hope is starting is where the healing starts I literally had a patient today who did her dissertation on functional medicine and she surveyed a group of about 500 of my patients and my former patients she stood at the counter as I was checking out with their interior saying Joe I just wrote this dissertation you know what the core of this entire survey was why did you heal what happened with this type of medicine what was different every person almost to a T came down to the doctor listened she gave me hope and there was something different and honestly she said I wrote my dissertation in fact that yeah functional medicine has a groundwork and a framework but you're applying hope and your that hope gives the patient an opportunity to be heard and to be seen and that on a physiological level is where the healing starts now I can go on about the functional medicine pieces but that I believe is so critical as a foundation is that presence and hope that we bring because we have time and we listen and we have a I think all of us who go into this have a sense of curiosity that's very different it's why we went into medicine and we're listening for clues in every day number one I see miracles number two I I learn from my patients because I have that approach beautiful well Dr. Christ I wanted to ask you you know on the same lines you have your book break the mold and I know that you've been actually you know certifying doctors as being mold literate and I see as I go through that list I see there's a lot of naturopathic doctors on there you know what is it about the naturopathic framework that sets up doctors to really be able to have success with this with this type so with this type of issue yeah I think naturopathic doctors functional medicine doctors the way that we approach the body being an individual so it goes back to what Dr. Bland was saying about the journey so everyone comes into their mold exposure having lived a different journey that could be genetics that could be nutrition that could be chronic infections that could be previous mold exposures so I think that view of the body as it is the biography creating the biology so to speak and mold affects everybody differently so I tell my patients that's more the rule than the exception that you have everyone having a different experience from the same exposure because of all of those varied factors so I think it truly is just the way functional medicine naturopathic medicine the way that we approach the body as a journey and looking at the whole their whole history I 100% agree that that's where the the big medicine happens in both our learning about what might be going on but also their ability to finally express what's been going on yeah what are we just let's do a little experiment here let's do a little popcorn you can shout out you know in whatever order you want what what are the things that if you go into a patient you start having a conversation what what are the sort of trigger either symptoms or stories that would alert you to be like hang on a minute like I know what I've heard this before you know this sounds like mold so maybe maybe we could just pop corn off what are what are some some symptoms that you that make you think of this now that you've been in it for this long well let me let me jump in here quickly because I'm I'm the outlier the non-clinician in the group but I wanted to give umbrage to the world renowned clinical immunologist John Hunter J.O. Hunter at Bacolamy Hospital in London who has been looking at this mold enigma for many many decades actually and he wrote a very powerful article that appeared in the Lancet back in the early 80s in which he talked about food allergy or intrametabolic disorder which at the time were terms that probably most people who read the Lancet didn't fully appreciate and what he was trying to say is that people that experience problems with red wine or with different kinds of fermented foods or individuals that can't stand to be in in dark moist places are individuals who are responding to the secondary byproducts the metabolic byproducts of a unique family organisms called fungi because fungi actually have different metabolisms different genes so they have different metabolic processes and do bacteria but then do viruses um and therefore they produce a class of molecules that are uniquely different so-called biogenic amines and I'm getting pretty biochemistry here but I'll try to I'll shut up in a second so this class of molecules that they produce are in some in its instances seen as foreign molecules other they're memetic molecules that mimic other kind of signaling molecules that the body naturally produces so they can produce kind of like overloads of natural signaling neurotransmitter activities and that can block normal processes and neurological function and so they you might be can they might be considered in some cases neurotoxins and so when you start thinking about this these foods that contain these these families of organisms are not necessarily producing an allergic reaction they're producing a toxicological reaction that is unique to the genes that add individuals ability to detoxify and eliminate them so not everybody is the same in response some people can be in a room as boldly and they don't seem to have any clinical symptoms and another person may have overwhelming headaches and muscle aches and feel like they're going to pass out in the same environment so I think you have to understand the critter to understand its function to understand its impact upon the human and how it differentiates itself from other types of microorganisms so that's my my little lesson from the biochemist well that was the correct answer so well done actually Dr Chris I wanted to ask you I was watching a video that you put up about the difference between mycotoxin symptoms and spore symptoms and that there were sort of two combinations and both of those were coming together into mold illness could you jump into that because I hadn't really understood that before yeah so I think it's important to understand how mold can make you sick it's with the spores then the spores can break up into fragments and that's kind of what the CDC defines as mold related illness those are allergies, asthma, hypersensitivity, pneumonitis, things that have to do with your skin and respiratory system interacting with the spores and that's this much of mold related illness and then they go all the way to the other end of the spectrum and talk about infection so aspergillosis of the lungs but there's 80% of the mold related illness that's not accounted for by that narrow of a definition because mold also makes chemicals normal living mold happily living off-gassing mold makes mpa or mycophenolic acid which is what we make cell sept with that's how we keep organs in people once we've done transplants so you could be breathing moldy air and getting this powerful medication just by inhalation and then there's another one called mycotoxins and this is an intentional toxin that molds will make with the intention of harming another living thing so and also in a water damage building you're going to be getting exposure to soil bacteria like actinomycetes they make a secondary metabolite that's that's an antibiotic we have our very own ivermectin and tetracycliens rifamycins these are all made from this kind of bacteria so they're off-gassing is antimicrobial so if you're in a water damage building you have mycophenolic acid that's immunosuppressive you have actinomycetes metabolites which are antimicrobial and then you have a mycotoxin that has the intention to harm another living thing so it's just a it's I feel like a whole bunch of this I my saying is mold related illness needs a definition upgrade because if you just go to the CDC you're going to be missing the majority of mold related illness and you gave me that impression that it almost feels like it's a kind of a bell curve where both of those are very small and the middle of the bell curve is actually the biggest part would you say that's fair I think we all have our our selection bias from our patient population so for me that's fair but I started from the Lyme world so you know people with stealth infections and chronic complex illness I think there are quite a few people who are seeing conventional medicine for what the CDC would call mold illness and getting the antihistamines and things like that and getting better so they don't necessarily come and find a functional medicine doctor because they maybe are getting that exposure through work and so it's temporary whereas in a home environment that's where things get a little more dicey. Dr. Conahan you want to go a bit further into that I'd love to just sort of understand from you what you what you believe to be the sort of gold standard of diagnostics in this space too and I would just say I had never taken a mold test but I have taken one now because I came out a couple of episodes as a gout sufferer Dr. Bland knows because I've hobbled to his house before but yeah I took a mold test as part of that because my functional medicine doctor as well you know it could be that let's rule it out I was super grateful when I came back that I had zero mold I did the great planes and I took the gluten fire on and all that stuff so what do you use in your office and what is the sort of range of diagnostics that you've used obviously starting with the history and then going into you know other kind of lab testing you got it and I just want to thank Dr. Bland you brought together what I learned at like 12 years old the biogenetic means I've always had that issue never knew what it was until recently you know that last decade or so love that you brought that research to play because it's so common to have both histamine intolerance and mold sensitivity illness and all these things played together I always say functional medicine is quite simple it's a toxic load infectious burden at the core almost all of my chronic patients have either a toxic load or infectious burden and they're playing on one another because the toxic load in our environment is weakening our immune system so things that shouldn't really cause illness I would say like low virulence Epstein bar and Lyme are actually very low virulence compared to a bolivirus which can kill a person in two or three days those types of chronic viral infections and even yes even tick-borne infections like Lyme are quite low virulence they hang around a while and they don't kill people quickly but what happens is those infections even though they're chronic and low virulence in the face of a weakened immune system will become a really big problem so you always have to look at these two sides of things because I believe there's people with chronic infections that don't need aggressive treatment if you can strengthen their immune system and get their toxic load down where they come back up and do what we're supposed to do which is fight viruses, fight infections, fight tick-borne things and actually keep them at bay for example of course Varicell is a great one because it comes back as shingles if you have a weakened immune system so just a framework and thank you Dr. Krista I love how I've heard you talk before too and I love how you frame that because we have such a narrow frame from our training in spores and it really is so much deeper and microbial VOCs are really at the core those are the mycotoxins. One other comment before I go to testing Dr. Maskell James is that I think that on that huge conundrum of the mycotoxins I believe and this is just my clinical experience and observation and hearing about some small studies with things like EMF actually triggering mold to produce more mycotoxins there was a small study with a router that was one was shielded sorry a petri dish of mold and they were measuring the mycodoxin production from this mold one was shielded from the router a household routine router and the other one was not the one that was not shielded from the household router produced 600 times the amount of mycotoxins so I really believe as we get into the city environments we have more threats to that microbial I mean the mold is made to survive right so it throws off toxins in a threatful situation and I think part of the issue is not that there's that much more mold although there could be it's because the mold is filling the threat of our environment and producing more toxins and I really believe that part of the toxicity we're seeing and then we throw in in the 70s these anti-fungal paints in homes as a standard so we kill off the weak ones just like antibiotic resistance and all of a sudden we have these super molds and we've this incredibly toxic things like starchy butt trees which I think are way more toxic than your grandmother's mildew in the shower so testing I'll go into that gosh there's so many ways to do this and I really like to start with things that are cheap and easy for patients which is a great clinical history what I was going to say earlier James about your question about what where do we go with this is environment matters it's the number one thing with mold so the questions you want to ask are when did you last feel well and when you moved or changed environments did you feel differently and do you feel better when you leave the house or go on vacation because some of those really basic questions make such a difference because you can identify this is an environmental source not an internal source and toxins can be both exotoxin external like mold and metals and all these chemicals that are in environment or internal like endotoxins or toxins from byproducts of yeast or fungi and we have to determine with our clinical history is this endo or exo testing I do use urinary mycotoxins I know there's lots of controversial around that but I feel like they are a great way to kind of collaborate with the clinical history I still use visual contrast testing again it's not diagnostic but it's a great screening tool that's free so I like free for the patients so great history and the screening visual contrast tests are two ways to start and then I also use a lot of innate systems cytokines and immune testing because although each one by themselves doesn't diagnose mold mmp9 tgf beta msh and now all these new cytokines I mean I do lots of cytokine panels il4 il5 il6 tnf alpha et cetera I'm testing these in my patients because I know based on those if they're more prone to mastel activation if they're more prone to mold related illness and so I look at all of those things in conjunction and there's there's more things you can do too but uh those are a great place to start I'd love to hear Dr. Krista too if you have any testing that you like for me yeah the only one I will add is the the my mycolab serum mycotoxin antibody right now that is the only one other than the vcs that can kind of tell us if the person is currently being exposed so if their ige is positive then we know they've been exposed to a degree that that matters to their immune system because everybody's exposed in some small way so they've been exposed to a degree that is enough to alert their immune system and get them to make antibodies to it in the past two to four weeks I say two weeks to my patients but Dr. Campbell says we can count on four weeks because toxins are different than infections but my comfort level is two weeks because my patients are trying to figure out am I still exposed you know I did my remediation work is my rescue apartment um a healthy apartment for me and so I like to use that one in that case and also with the vcs because that does if they're both looking bad then I can have some assurance that they need to find tell their insurance company they need a new place to stay for their rescue thing yeah that's really fascinating you know something you said Dr. Conhan really stuck with me and I want to ask you Dr. Blount about it I don't know if you remember that the webinar that we did right at the beginning of the pandemic with Dr. Ari Vajdani for PLMI and he had on one of his slides he had sort of like a list of six factors and it was like depending on your six factors you'll either get a bad case of of covid or you'll get you know you might not even know you had it and I remember the second one down was the expo zone and so you know what you were saying there Jill just sort of like this interconnection between toxic load and what do you say infectious burden Dr. Blount where do you see the most sort of from your perspective and the science of that conversation and sort of this interrelationship of I guess external toxins in the environment and how do they play off each other and creating chronic symptoms well I think first of all that anyone who's listening watching this is being really gifted with two of the most forward-looking and thinking people in our field in this area this you know often goes without a reference point a person doesn't know how privileged they are to be be getting this information from two people who have spent so much time really digging into this field and really ferreting out answers and and understandings that were not present before so I want to acknowledge the uniqueness of that and secondly I want to say that in the context of environmental illness and how that interfaces with complex chronic symptoms that patient present with this is a very very enigmatic area in medicine and I think the reason it's enigmatic is because we have not had discrete diagnostic criteria like you would look under a microscope or you would you know take a scan and you would say oh yes definitively without question that person has blank when a person is acutely toxic when we call it poisoned you can do an after the fact just a pathology you can look at their liver and liver cells and you can see how those cells were damaged like if they had toxic mushroom ingestion but in the chronic state it's really hard to understand exactly how to piece together the complex symptom profile with a person's environment which is so complex to begin with and it differs because they might say well gee I'm living in the same apartment as my partner and my partner doesn't appear to be having any problem so why am I having a problem so it's this complex gene environment physiological interconnection and that's that's the both the mystery and the excitement about functional medicine because the functional medicine model is not deterred by that complexity it doesn't just try to produce a simple answer to a complicated situation it tries to find an answer to the complexity because out of the complexity becomes a simplexity right and it's that simplexity that is the the driving force for the functional medicine model if what is the reward for the countless hundreds of hours that these clinicians spend to go back and open their textbooks again and look look at all the stuff they learned earlier from the different lens and come up with a new way of evaluating patient presentation so I think that this concept of expozone the concept that we have these receptor sites on ourselves and pick up information from the outside world and translate them in the inside function how that relates to things that are called pathogen associated molecular patterns or damage associated molecular patterns and how that translates to health and disease outcomes is a new frontier of medicine it's this is like a decade old so we are early adopters and you're seeing pioneers and when you're listening to the Dr. Jills here Jills to the fourth power so it's really a privilege to hear their their perspective Thanks Dr. yeah Dr. Chris to let you just to I guess finish up from your other point like so now you've diagnosed someone and you actually have to work out okay how are we going to fix this and if it's in their environment like it's in their home you know then there's some next steps so maybe you know Dr. Christy you can share sort of like what your playbook is and do you have like handouts and sheets that you give to patients to say like hey this is going to be like a serious disruption in your life for a minute and you're going to have to take it seriously because I think part of the overwhelm for patients is just kind of like this isn't something you can supplement away right this is something that your home is poisoning you slowly and the implications of that and what needs to happen to resolve that can be quite like shocking Yes and there are there are two factors working against the acceptance of the information there's that first relief like Dr. Carnahan was saying when they they feel like oh my gosh there's an answer and then when they learn what the answer is is wall goes up that you know in all of the environmental medicine patients that I work with mold sick patients are the most resistant to mold being the problem and I'm talking compared to someone who has lead tungsten cadmium heavy metal toxicity they can be very hard to move but the mold sick patients are they avoid the topic and I think that the second thing that comes against us is kind of to to riff off of what Dr. Blaine was just saying is that we don't have randomized controlled trials in mold related illness that involves mycotoxins because of medical ethics we can't purposefully expose someone to known carcinogens to radogens you know we can't do that just to figure out what works we're doing it to animals and that's what's nice about having a naturopathic and functional medicine background and approach is that we can look at those animal studies and kind of do our own clinical translational medicine to determine okay we know turmeric works but what kind of dose works in a human we kind of know that already because we're working on other types of toxicities so that the complication is I don't want it to be mold because it's going to mess with my world and my doctor says there's no randomized clinical controlled trials on this so it's not a real thing so now I don't have to really accept that this is a real thing so that's part of why I started scaling and you know putting my big girl panties on and getting out on the internet and talking about this because it was so hard to work against that that barrier and I'm just so grateful for people like Dr. Carnahan that are out there have a youtube channel and are talking about it Dr. Nathan has written books you know it's so great to have those third party people that we can say this isn't just me here's check out this expert you know this person is going to tell you that it's real so having those kind of resources are really important to to help convince your patient and particularly your patient part patients partner who's not as sick that this is a real thing or maybe they're landlord or maybe they're their boss who has to move them out of their building and then handouts handouts handouts like crazy and then experts in buildings that's one of my soapboxes is doctors need to know our lane we are very good at bodies knowing the individual story of a building buildings are as individual as bodies are and so hiring experts I really hammer on this one with my patients because a really good mold inspector not only will find it when it's there and that's one of the risks is that if you have someone that doesn't know what they're doing and they rule mold out now you have later a cancer diagnosis a dementia diagnosis an ms diagnosis something that takes a lot more effort to reverse or to impact that inspector also can help them get insurance coverage they can help navigate the remediation so I 100% recommend that everybody in this situation gets some sort of building consultation expertise in addition to the treatment that I'm going to be working with them on and then just you know handouts like crazy nasal options for mold diet handouts you know all of the things I'm glad you mentioned that actually and it's one of the areas I think that we've had success in the the functional forum communities is that you know if I'm a mold inspector I want to know every functional medicine doctor in town because chances are I'm going to get a lot of business from that and the mold remediation is no joke and I also have friends who have like you know tried to do a DIY remediation it hasn't worked out so well so I I definitely agree with you although that can be daunting especially if you live in a sort of a damp part of the of the country Dr Kanhann you refer to as a pioneer I guess the pioneers often take some extra arrows so what's it been like being on the front of this and have arrows come your way as you've been out speaking about this in the YouTube channel and all the content that you make well I have seen a huge shift and I'm sure you've seen this too Dr Jill I feel like there is such a like 20 years ago oh I remember I was in a conventional medical system integrative director and the rheumatologists and the gastroenterologists that were treating these conditions they would be like oh my gosh you know what kind of quack is this over here Dr Jill but what would happen over time is their patients would go back and they were better and they would be like what did you do well I saw Dr Jill what did what did she do can you tell me and then little by little and I never I never like I spoke to the choir who wanted to hear it but I never went there and tried to push my agenda what I wanted to do was show results so I've always been someone who and the other thing I love and I know like Dr Bland I feel like you have led our community in this way is I am conventionally trained and I am so proud of that because it's a system that has been great for you know you have a cox dinner a stroke or a heart attack and you want a conventional doctor and that system is still the primary reimbursement system and everything in our world so what I've tried to do in my 20 years of doing this is how do we bridge instead of create diversity and again I think Dr Christy you do such a great job especially in your world and we've talked about that before I I love learning from my naturopathic friends because so often you guys bring new ideas and think that we weren't trained so it's like bringing these two things together with great science and great results and so way back 20 years ago what I would do is show the results the patient would go back to their primary or their original doctor or their specialist and the results would tell for themselves the story so that's how it started and now I feel like things are shifting to where there is like again the today's show just shows there's an interest now because we've just gotten on a pandemic where there wasn't great answers and people are curious and they're wanting to know what they can do and they're starting to take ownership and the levels the playing field has been leveled 50 years ago physicians were held up on a pedestal they're no longer and that's fine but it's very different patients coming in today because they question us they question they bring their own research like I said I learned so much from patients bringing in protocols or their own research and I'm open as long as it's scientifically valid and makes sense and safe and so there's this level playing field and there's also people who are considered experts that are online with no degree at all so you know it goes both ways I won't go into that but I think the good news of this all is that patients are looking for answers themselves and they're not requiring just a paternalistic physician to give them a protocol and follow it blindly anymore and that's good for us because we can come alongside this interest so the original question was I think as things move forward we're getting less flack and we're getting more curiosity from the general public and from our colleagues and I'll tell you one last story here 20 years ago I'm in med school and I was the crazy one I had an integrated medical club first of its kind at Leola medical school they thought I was insane I was bringing a massage service in Nadropath and Chiropractors because I wanted my colleagues to learn there was other options and here we are conventionally trained nothing like that had ever happened they thought I was crazy well now five ten twenty years later I get calls all the time from people I went to medical school with kind of tibidly saying Jill my husband has MS or my son has seizures is there anything you could help him with do you have any ideas and the tide is turned because they see any conventional doc that is trained that way when they get an interest in something bigger or greater or more in depth is usually when something happens to themselves or someone they love and they don't have the answers and we've all been there but that's what gives our platform more ability to bring this because there are a lot of places where conventional medicine doesn't have great answers and that's where we can shine absolutely Dr. Christo any like analogies or tools or resources that you've used to sort of get the patients head in the game as to like what's ahead of them for a full reversal of this issue because it's not a simple it's not you know it's the difference between you know an acute Lyme infection and dealing with chronic Lyme you know these are very different animals and I think getting the patient set for the task ahead have you found ways to to engage them so that they're you know inspired and excited but also you know ready to fully participate in their health for the next you know for forever but particularly for the next let's say three six nine twelve months yes and it's it's interesting you said forever because a lot of times this is the gift in this is that people start to pay attention to their health and it may actually be the thing that prevents something even more serious down the road because they're now engaged I love systems I'm a very analytical person so when I sat down to write my book I thought how do I treat mold and it came out to be an orange and the idea being that the an orange you've got to peel the outer orange layer and then that white fluffy layer before you can get into the sections and so the idea is that there are kind of five steps I take someone through and the first would be avoidance because as Dr. Blan said you know you can't get better if you're not in your if you're not out of mold and so that needs to be done as close to a hundred percent as possible just like you would peel an orange you would peel all of the outer orange achy part before you would think about eating it the white fluffy part is fundamentals and then the sections inside is protect repair and fight so that's kind of my steps that I take using individualized medicine with any to those steps because everybody's avoidance is going to look different some people have to go on a very strict therapeutic diet for a while and some people can do fine just getting out of the mold we see in in occupational studies that 50 percent of people that leave that moldy building do just fine so I always make sure to tell people that that's part of that hope thing Dr. Carnahan was saying 50 percent of the people are fine so look at your body's potential here so when we do avoidance and fundamentals fully then we pick and choose the few tools that are protective like Corsitin, resveratrol, good fish oils and then we pick things that are reparative like glutathione and things that will help repair the liver like milk thistle and then we go into the fight the reason I have fight at the very end is that I did it wrong in the beginning I used to when I was finally working with these Lyme patients and like oh this is mold I didn't understand mold as I got into the research I realized mold colonizes you okay so now we need to use antifungal herbs I went right into the antifungals and in some cases union pharmaceuticals because I was with Lyme patients who are on a lot of antibiotics and I made people really really sick and it turns out that mold gets mean once it knows you're coming for it it will start to kick up its production of mycotoxins so we have to prepare the body to be ready for that extra toxic load and I send patients to Dr. Carnahan's website all the time for coffee enema supplies you know things like that that detoxification is so important because it sets the stage so when you do get to that fight phase you have some immune modulation going on some detoxification some bioflavonoids protecting cells and then they can conquer the mold that's kind of my steps Dr. Carnahan have you found ways to you know to to share you know I'm sure with your functional medicine strategy there's some similarities there right but like how do you get the patients in the game to realize like we can't go after the mold yet we're going there but this is what we have to do first how do you how do you facilitate that sort of like delayed gratification in patients well sometimes I just say my story because I was delayed six months before I would admit it so I know at a personal level that denial and second thing that I know Dr. Cristen I both agree and I've talked about before in some of our interviews is this limbic system piece that I don't want to miss addressing because it's so profound and really you can almost not get to the layer of the physiology until you dress the limbic system I don't know why but mold is a massive threat to the limbic system so I don't know the physiology behind how it affects the brain but I know 100% of my patients that are affected by mold have some sort of trauma response and it's that limbic activation I believe it's a physiological real like a measurable response I don't think it's just something that's in their head and this limbic response causes amygdala activation and the fear and threat and so as they're dealing with this number one their brain is not functioning at all because when you get the limbic system activated frontal cortex shuts off and that's your decision maker that's your executive function that's your ability to prioritize a protocol or a plan so I even remember back in the day when I had mold illness I thought I was functioning fine and I look back and like it is a wonder I didn't do something dangerous because I was not functioning well in that time and what I realize now is that limbic activation blocks frontal cortex so even the understanding of what the diagnosis is and then also when they get another exposure dealing with it dealing with that there's a lot of the blocks are part of that limbic response so the number one thing we have to do is give them some limbic solutions these could include you guys are probably real familiar with things like anne hopper's dnrs gupta program um beth o'hara has a new program um i'd love dr christie view of others and cranial sacral um as sometimes neuro linguistic programming trauma work somatic work emdr there's so many things even um bironal beats or sounds steven porges has a program and i could list 20 things and i give them a hand out with links to those resources so they can get some of those on board i say it's like a smorgasbord or a buffet you do not have to do all of these and when they're in that shock a fighter flight sometimes some of the programs like dnrs is real um familiar with a lot of people but it's a it's a commitment to an hour a day and that might be too much for them so i say go get a massage go get cranial sacral therapy let something passively start to help your limbic system calm down because number one thing is safety and mold is a threat on every level to a patient's safety it's their home it's their brain it's their body and i really believe part of the complexity and toxicity of mold is that it's a threat to the very safety of the core person being so addressing that limbic response is kind of how you can get past that to get to a treatment because often these people will be like reactive to water i mean some of them can be so reactive you came and start a protocol and um that would be one thing i think and then second layer mass selectivation which if you talk to some of the experts dr theothea readies dr lauren zaffron written extensively and published they will tell you the number one trigger for mass selectivation is mold and they're in a conventional research setting so those are two things that i think are important as well yeah there's so many um interesting thanks for sharing all of that it's incredible uh to to get that sort of download because um i know that that's part of the complexity is is dealing with how it you know it affects all all the different systems you know dr glenn it seems like it seems like uh you know um the few you know that as long as as long as mold is around functional medicine is is is going to be practiced because it doesn't seem like there's you know there's much hope unless you're taking a root cause systems biology approach given the complexity and all the the layers of of that that that's being described here yeah you know there is as i'm listening to these incredible experts um i'm reflecting back to my last 40 years in the field and i'm reminded of a meeting that i went to and i was invited to uh at the nimh the national troops of of mental health and in environmental medicine at in Bethesda this would have been back in the probably the late 70s i guess and this was a time where the the government had just built a brand new building for the epa the environmental petition agency and people in that building were getting very sick and the construct was that they were having psychological dysfunction that there was something wrong with the you know way that they were being managed or stressed and they were somehow they were having these uh what were considered functional illnesses and back in those days functional somatic symptom was another name for psychosomatic illness so they were having functional somatic symptoms which was being said as a consequence of it's all in your mind disease and then finally a group of individuals maybe a little bit more enlightened and more on the frontier started saying well maybe there's something in this building that's actually associated with this kind of epidemic of people feeling bad maybe it's not just like uh they're having social disorder because of somebody that has said they should not feel well maybe there's something really organic and they started to look at it much more intensely and of course they found that the building was poorly constructed there were all these sites with a ventilation system up the HVAC was not working and there was mold and they had to take the building apart right and that was from from what I know and I may be wrong on this but it's a first example I I saw in the literature where they defined this as sick building syndrome well that was kind of the start of the going from kind of it's all in your mind to where no actually the federal government in the EPA's own building environmental protection agency recognize it maybe there's something to the environment that can produce these symptoms organically so it's it's amazing to see how far we've come but in some ways maybe it's also disappointing we haven't come farther that still we have these leaders that are advancing this concept and there's a lot of people still pushing back because they haven't what had what they consider adequate proof all they have to do is look at the body of literature over the last 40 years to kind of get the story but that's that's kind of where I am in listening to this wonderful kind of description of our two clinical leaders here. Well I'd like to just go a little step further there because I was speaking to a doctor friend the other day who's who works with the American Association or Academy of Environmental Medicine and you know they've had education on these topics recently and you know I've had quite a sort of a blowout with ACCME about you know continuing med medical education on this topic and it does seem that you know some of the areas that this topic you know shunts around is is caustic to you know to those kind of organizations so I mean Jill do you think that there's hope in that regard do you think it's just a case of just continuing to prove the outcomes and eventually you know medicine moves forward one funeral at a time or do you think there's another way that we can sort of accelerate this evolution towards systems biology approaches and understanding the root cause. Which Jill. That's my way of keeping it open. I love it. I would say the results right like kind of like we said before like as we start to see people healed and and I know Jill you writing and I'm writing and I'm doing a documentary these things like I have such a passion just like you do for getting and you've already just like I've shared your book with my patients too so I love that we can play off each other and I have such respect for the work that you've done so it's I think we just continue to get the word out and even though I have a love hate relationship with social media that's a platform where people are listening and so I'm there and I'm talking and I'm talking about this topic because the you know the public that's where the ground you know swell the forces can actually make a change in policy and in the environment. Dr. Chris I understand you've had some success in this area now as well with with getting continuing medical education for for this topic so anything that we can learn from you. Yeah I think just continuing to reiterate the fact that in toxin based illness medical ethics preclude us from doing randomized clinical controlled trials I mean that's really that's the that's the nugget and so we are in a in the business of using animal studies which of which there are plenty and there are human studies but they're retrospective they're oops everybody at the hospital got sick or everybody at the school got sick but as far as what to do to get someone better other than the avoidance then you know presenting the research that shows in occupational studies that 50% of people do get better getting out 50% don't 50% have persistent symptoms that can last 10 20 years after that exposure so something that does need to be done treatment wise and the more that I've been educating I hear medical doctors not you guys but conventional saying well no one really wants to find this because we don't have anything to treat it so my next challenge is to figure out how to prescription pat our way out of mold illness and that's my that's my current challenge just to figure that out. Well yeah I want to share something there that 50-50 ratio thing reminds me of you know sort of the Cleveland Clinic Center for Functional Medicine where you put 100% of people through a 12-week group where they have to do the fundamentals of health and half the people get better don't need the doctor and then half will need to you know to go down a path of getting to the root cause so I think you know I think one of the things that I appreciate it from from from all of you guys here tonight is just thinking about what are the sort of the you know the what we can do to get to get everyone started and certainly even if you go back to the video at the beginning the foundation the bottom of the matrix doing the fundamentals of health being connected to other people stimulated the limbic system through you know through connection and engagement is is a real possibility and we're seeing and I would say from my own experience you know we're seeing that if you organize personalized lifestyle medicine or functional medicine in such a way that it becomes palatable to the systems you know then the uptake of that is is is not as unlikely as it once was and I think things are changing things are changing rapidly I'm not sure if mold is going to lead us into the next era but COVID might and long COVID might and so it's exciting to see you know sort of new areas of interest and things moving in this in this direction well I want to thank all of you for you know for your participation here this evening and I know as I shared here at the beginning we're going to be hanging out in in Chicago this event is sold out but if you want to get in touch with us we're we're hoping to convince Dr. Blan to do some live streaming or something we'll definitely be there with the cameras so we'll get some some of the best bits and get some interviews with some of the the other speakers I think this world of functional immunity is really you know ready for its its time to shine thank you so much to all the sponsors for today for the the functional forum and you know just to highlight a few things I mean it's been a big month for Fullscript they're quite Emerson Ecologics and I know you know they've just there's so much that they can do on Fullscript actually there are protocols where you can at least get a starting point if you don't really know where to go there's some great resources on there on supplement protocols created by some of the leaders in the field on just these types of topics you know vexia diagnostics when I got all my lab tests for getting to the root cause of my condition that was easy to put it all together and I just want to give a shout out to heal community because you know one of the people actually that works for me he took two years out of his life to recover from Lyman Mold with the help of a functional medicine doctor Dr Christine Burke and you know he's he's said a number of times that you know had he been in a community of other people who are at different stages of their development and different stages of their you know chronic disease reversal then you know the whole thing would have happened a lot quicker and I think that you know those patients that come out of the other side of this are ready to be of service right to the to the whole and are ready to help and so if you can find a way to connect those who are just looking for hope at the beginning like you said Dr Kanahan who are just at the beginning who have no hope to have them meet other people who are just like them but further along the path can be one of the most powerful tools in healthcare that we're using to really a very very small percent of it of its potential all right so next next month second of May 2022 the 100th episode we're going to be live from Indianapolis the reason why we're live from Indianapolis is because Indianapolis has such a thriving community and it's just one of the communities that is thriving across the country we would love to hear from you if you want to be part of a community wherever you are in the world we'd love to hear from you and maybe we can pay you up with a local organizer thank you Dr Bland Dr Krista and Dr Kanahan for being part of the show tonight this has been the the Functional Forum this is the 99th episode we've all learned a lot thanks so much for tuning in and we'll see you next time