On March 25-27, 2022, Mosaic EDGE (formerly GPL Academy) hosted the Mold and Toxins: Integrative Strategies & Protocols live-streamed online. This three-day event focused on the epidemics of toxin exposure, including both toxic chemicals in our environment and mycotoxins from mold. These toxins can cause symptoms of many acute and chronic health disorders. Those who attended the summit learned how to use effective diagnostic and treatment protocols for their patients with toxin exposure and get them on the road to recovery.

The following Q+A is a grouping of responses from the workshop presentations. Click each presentation title to expand the answers from each speaker.

The material contained within this article is not intended to replace the services and/or medical advice of a licensed healthcare practitioner, nor is it meant to encourage diagnosis and treatment of disease. It is for educational purposes only. Any application of suggestions set forth in the following portions of this article is at the reader’s discretion and sole risk. Implementation or experimentation with any supplements, herbs, dietary changes, medications, and/or lifestyle changes, etc., is done so at your sole risk and responsibility.

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Q: Rhizopus is used for tempeh, but Aspergillus is used to make miso and soy sauce. Just curious if furan-2,5-dicarboxylic acid might also be in those foods & thus be high in the OAT test?
A: Good question, but I do not know specifically.

Q: When we first use the OAT is there someone at the lab that will help us with understanding/interpreting it?
A: Yes. Mosaic Diagnostics has lab advisors available.

Q: If arabinose is “elevated 80% of the time” and the reference range is +/- 2 standard deviations, why isn’t the reference range higher? Or is it that of the types of patient’s functional medicine clinicians see, 80% have high arabinose?
A: The 80% is my impression. Something I have seen over the years in my practice. It is an approximate percentage.

Q: I often do OAT and NutrEval by Genova. When I compare nutritional markers, OAT rarely finds abnormalities in nutrients, but NutrEval very often finds abnormalities in nutrients status. Please offer an explanation.
A: I would recommend speaking to one of the biochemists at the Mosaic Diagnostics about this observation. They might be able to provide more insights from a laboratory standpoint.

Q: I hear mixed things about fungal link to oxalates. Why is there such a wide discrepancy in opinions on this?
A: There is a wide discrepancy about a lot of things in medicine, science, and nutrition. From my experience and research (and I know Dr. Shaw’s too from Mosaic Diagnostics) there is a strong correlation.

Q: Will the nutrients that are low (CoQ10, B2, b12, etc.) get better when you treat the mold/candida/etc.?
A: Sometimes.

Q: Should we give them those nutrients while fixing the underlying issue?
A: I like to in most circumstances.

Q: Or will they not absorb those nutrients because of the overgrowth?
A: They should still get absorbed.

Q: Is DOPA altered with Parkinson?
A: It can be.

Q: How come my sample test I got before showed Arabinose normal level is < 29 instead of <50?data-preserve-html-node=”true” data-preserve-html-node=”true”
A: The reference ranges changed based on age and sex. The sample I showed was just a sample from my practice.

Q: Do you know what may cause burning mouth syndrome in a patient? She has mild white coat of tongue; do you think this is candida or nutrient deficiency?
A: Very likely Candida. Research mineral deficiency linked to this condition too.

Q: If a client’s marker is between the first and second deviation but not necessarily “high”, do you still treat if client has symptoms? (Examples would be in the case of 4-cresol or arabinose being in between the first and second deviation.)
A: Yes. This is reasonable to do if you suspect there is a developing problem.

Q: Oxalates appear to be a sensitive, but very nonspecific test. What is the purpose then of testing it?
A: Some people are extremely sensitive to oxalates. Like any marker, it is always important to correlated to a patient condition.

Q: Emphasis is on elevated levels of different markers. What about negligible to low levels of different markers? Speaker addressed negligible levels of amino acids as being normal, what about other biomarkers. When should we be concerned?
A: For most things, low values have no known clinical significance. This changes though when looking at neurotransmitters. The amino acid metabolites are not the same things are directly assessing amino acids. When neurotransmitter metabolites are low that can be significant, as well as certainly nutrients such as Ascorbic Acid and Vitamin B6.

Q: What is the significance of very low metabolites in mitochondrial markers?
A: No known clinical significance according to Mosaic Diagnostics.

Q: Can you see mild elevations in fatty acid oxidation markers in people who are carriers for some of the inborn errors of metabolism in fatty acid metabolism?
A: This may be possible from my understanding.

Q: Is aspartame high from eating a meal the night before testing? Or is it only high if someone regularly eats aspartame?
A: It could be high ikf ingested the night before.

Q: If #28 marker is just slightly low, Aconitic – what does this indicate?
A: No known significance according to the lab.

Q: There are cases of asymptomatic positive stool test for C diff toxin. Do we need to treat it?
A: I would, at least with some probiotics.


Q: Is burning mouth syndrome candida?
A: Yes. It could be. Do some research on nutritional imbalances that could cause this too.

Q: Do edible mushrooms increase fungal levels in the body?
A: Not that I know of.

Q: Is Biocidin useful for Lyme dx?
A: There are many practitioners who have used Biocidin for Lyme. The company at BioBotanical Research would have more information on this.

Q: Do you use the biofilm busters for a time before starting the antimicrobial?
A: Typically, not with a new patient who is new to integration and functional medicine. I often rely on the botanicals first and then graduate to biofilm busters as needed.

Q: Any recommendations for fungal sinus infections?
A: Compounded nasal Amphotericin B or Itraconazole. Biocidin LSF can be used intranasally too. Contact BioBotanical Research as if they have additional information.

Q: What was the article that was recommended re invasive candida?
A: Candida Pathogenicity Mechanism – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3654610/

Q: Can an elevated arabinose indicate conditions other than candida? Or is it specific?
A: It can be elevated from diet. So, it is critical people follow the instructions on the test collection form.

Q: You mentioned the connection between candida infection and the potential for leaky gut. I’m curious, are there any markers in the OAT test that may indicate that leaky gut could be an issue?
A: There is not a specific leaky gut marker. The Arabinose is about as close as a marker comes on the OAT for this condition.

Q: Could you deduce that a persistently high homocysteine on blood testing should prompt OAT testing looking for metals/chemicals?
A: I do the OAT for everyone that comes into my practice. However, regarding homocysteine/metals, etc. there are other tests to look for too such as environmental chemical exposure.

Q: You mentioned that organic acid markers for mold can be negative, but mycotoxin results can be high for past mold exposure. Why is this?
A: The mycotoxins are different chemicals from the organic acids. Therefore, the MycoTOX profile needs to be looked at as a separate test.

Q: Is there any evidence of Lyme in the OAT test?
A: Not specifically.

Q: Again, please explain the difference between the OAT mold markers and mycotoxin test. Which one is indicative of current mold exposure verses past exposure?
A: If an OAT mold marker is high that is active exposure (most likely) or at least lingering mold colonization (active) in the body from previous exposure. However, the organic acids linked to mold exposure as completely different chemicals from mycotoxins. It is possible to have a mycotoxin stored in the body for months even though someone is no longer being exposed to mold spores. It would also be possible to have mold colonization in the gut if the mold just continues to replicate itself without being treated. The bottom line is do not rely on the OAT to diagnose mycotoxin exposure.

Q: Can candida cause an elevated serum myeloperoxidase level?
A: Most likely if the level is serious enough and there is highly active neutrophil activity. I have not done this type of testing though.

Q: So, are you saying we should use manuka honey to break up biofilms? Or how was manuka honey relevant to candida?
A: I was only using those slides as a point of discussion about botanicals in general having anti-biofilm properties.

Q: Regarding Nystatin, can you please comment on Nystatin resistance and Botanicals for Aspergillus?
A: Nystatin will have some affect on Aspergillus, but Amphotericin B orally seems to work better. But there is literature out there indicating the liposomal Nystatin is a treatment option for Aspergillosis.

Q: If using Nystatin to treat candida will that help a suspected candida/fungal caused rhinitis?
A: Not likely, unless it was compounded into a nasal spray. At least this has been my experience with Nystatin orally is that it seems to have little effect on yeast outside the GI tract.

Q: If you have a patient that has candida issue and you have addressed the root cause as to why will the candida correct itself since root cause gone? or will the patient still have to be treated for candida?
A: Working on root cause is always the best overall approach to take. But they still may need to treatment to bring the levels down and make it easier for the microbiome to regain control.


Q: Since Biocidin has echinacea in it, does not exclude patients with auto immune disorders from taking it?
A: I have never seen Biocidin at the dosages recommended by the company exacerbate an autoimmune problem.

Q: Can you touch on Clostridia spp on the OAT vs a stool test when the results do not match up?
A: The OAT markers are more specific to various clostridia bacteria. Stool testing for Clostridia difficile is specific for toxins A and B. These are often not present even in people dealing with bowel problems, but this test should be done if a serious C. diff. infection is suspected. However, the OAT overall is more sensitive to of clostridia bacteria infections.

Q: What about spore-based probiotics to deal with clostridia?
A: This can be helpful. I personally use a lot of Core-Biotic from Researched Nutritionals and Proflora 4R from BioBotanical Research.

Q: At which point is a stool test also indicated?
A: This can be done at any point, particularly if you want to assess digestive function overall or identify other pathogens. Consider a stool analysis to be complementary to the OAT and an often-necessary test on its own.

Q: Can the posting method be used with Biocidin and other herbals as well?
A: Yes. Pulsing could be done with other botanical supplements too, not just Biocidin.

Q: Why are some people so prone to having recurrent clostridia infection?
A: This likely has to do with many factors such as overall microbiome status, the presence of toxins such as chemicals and mold, and poor immune function.

Q: When you used Biocidin for 6 weeks, when was the binder used in relation to the dosing of Biocidin, and how many times was Biocidin used on daily basis? I dose Biocidin three times daily.
A: A binder can be used in between dosing of the botanical at least twice daily. Best to take away from other supplements by at least 90 minutes to 2 hours.

Q: When you believe a person has clostridial challenges, but the markers are normal, what would you use to begin excretion of clostridial?
A: You could use the same things discussed with regards to active clostridia such as the spore probiotics, e.g., CoreBiotic, as well as botanicals.


Q: Rather than discourage a diet of healthy foods, wouldn’t it be more ideal to focus on the reason for elevated oxalates like dysbiosis/leaky gut?
A: I never discourage a healthy diet, but for some people they do need to reduce high oxalate foods (even some of the healthy ones) for a while to get their levels down, and at the same time as addressing underlying gut problems and dysbiosis. There are plenty of healthy foods that are not high oxalate.

Q: Could high oxalates also lead to interstitial cystitis?
A: Yes, from my understanding high oxalates can be linked to this condition.

Q: Sally Norton talks about yeast as protective against dietary oxalates. Have you heard this?
A: I have, but I do not know the specifics.

Q: I’m curious if you consider Blastocystis hominis to be a problem always. Microbiome research is coming out now that it is associated with better metabolic health and discourage its eradication.
A: B. hominis is a problem for some people. However, I have seen it show up in random stool testing where the primary reason for the test was not anything specific to parasite analysis. https://pubmed.ncbi.nlm.nih.gov/33432175

Q: Patient with good response to a low oxalate diet but shows no oxalates or yeast on OAT. She still has body pain which increases noticeably when she eats more oxalates. Is it possible that she does not release oxalates well?
A: Yes. There can be stored oxalate that either are not be released or dissociated into soluble forms in body fluid.

Q: Should a person take vitamin K 1/2 with calcium/magnesium prior to oxalate meal?
A: Vitamin K has a complementary effect on calcium regulation by assisting in its storage into various body tissues.

Q: Can oxalate level be confirmed on 24-hour urine collection?
A: Yes.

Q: Can you expand on the lung CT scans, why were those ordered? Was that showing oxalates in the lungs? Was that patient having respiratory issues due to high oxalates. Simply curious about how/why that patient had a CT and didn’t know it would show up.
A: That was a paper looking at Aspergilloma infection and associated calcium oxalate crystallization. My recommendation is to look up the article and read it for more details.


Q: Do keto diets increase LPS then?
A: From my understanding they can be associated with increased LPS.

Q: Is there another method to measure lithium levels other than hair analysis?
A: Blood levels are typically used for people on lithium medication. There may be a lab that does intracellular analysis of lithium.

Q: What would you think when someone responds badly (anxiety type symptoms) to 5 mg lithium orotate?
A: I have seen this too, but not very common. I would start looking at other mineral imbalances.

Q: Have you been seeing elevated quinolinic acid in patients with long covid? Or any other markers that may help explain common long covid symptoms? Thinking about the implications of neuroinflammation in this population.
A: Not yet, but I have not had a lot of long covid patients at this point.

Q: Do you see elevation of neurotransmitter markers in patients on SSRI or dopamine agonists or similar? Also is there a negative side to super dosing glutathione-2000mg plus?
A: Yes, this can happen. There is a negative feedback mechanism on glutathione production. High dose could also increase detoxification affects which a patient may not tolerate.

Q: Can you please clarify what you mean by resveratrol “decreasing microglia”? thanks.
A: It helps to decrease microglia activation. Therefore, Resveratrol can be helpful for brain inflammation and oxidative stress.

Q: L-cysteine can substitute for NAC as a useful precursor to glutathione, since I believe, NAC is converted to L-cysteine anyway? And if NAC is banned soon as a supplement, a substitute may be necessary in some cases.
A: Correct.


Q: Do you see die off reactions / Herx type reactions with Biocidin? Do you ever titrate up on it, or do you just start at full dose?
A: Depends on the sensitivity of the patient. Starting at a lower dose and titrating is certainly appropriate to do. Herx does not always happen, but more so in the sensitive patient. In my experience, it occurs about 30% of the time.

Q: How often are you using toxin/mycotoxin binders using only OAT tests showing positive yeast/clostridia markers?
A: Often. In general, I use binders about 80% of the time, but in some of the kids I treat it is difficult to do.

Q: I use soil based probiotic same as spore-based probiotics. Can you stay on spore-based probiotics for chronic use?
A: I do not like to use them for extended periods of time, but instead use them strategically as highly needed for certain patients. For example, 60 to 90 days for most clostridia problems.

Q: How long after a 14-day round of rifaximin would you recommend retesting (Dx: SIBO)
A: Two weeks

Q: Can you treat clostridia and a presumed yeast overgrowth at the same time? Put a patient on Biocidin and nystatin for example for a couple of months? Would doing a SIBO protocol help with both clostridia and yeast (using botanicals to treat SIBO)?
A: Yes, yes, and yes, most likely.

Q: I am not sure that I understand why you prefer daily dose of Biocidin for 3 mo. instead of daily for 3-6 weeks and then pulse as it seems that combination worked very well for you?
A: Depends on the patient and I have used multiple methods. The pulsing is generally used for recurrent issues. I have had some situations where I was daily dosing, check the MOAT at 6 weeks and the clostridia is still present. Then switch to a pulsing method, rechecked the markers and things had normalized. During my talk my goal was to show various options with the understanding that there is no single way that is going to work for all people.

Q: If succinic is high but your TOX test is not remarkable, mold not an issue and you still suspect a chemical, is there another chemical testing method/direction you have done?
A: This could be from Glyphosate too. I just came across this information in Stephanie Seneff’s book called Toxic Legacy. Can you discuss low Aconitic marker? According to MosaicDX and the lab report it has no known clinical significance. I am looking into more as ongoing research.

Q: Do high thallium levels have any impact of concern?
A: Yes. Thallium has similar toxicities to Mercury. I see high Thallium in about 5 to 10% of hair metal tests that I do.

Q: Can you share some sources / reference for low cholesterol as risk factor for mental health doze?
A: There is so much information on the Mosaic Diagnostics website. Go to their Resource section and look for past webinars and articles on this topic.

Q: At what level of cholesterol (for adults) would you consider low and decide to supplement?
A: Levels below 160 are considered not ideal. Mostly in my practice, when I look to supplement with Sonic Cholesterol, is levels around 120 to 130.

Q: Is presence of enterotoxigenic E coli going to show any abnormalities on OAT?
A: This would likely show up in the Bacterial Markers section.

Q: Do you recommend activated charcoal during the protocol?
A: It is okay but can be constipating. I prefer the GI Detox+ from BioBotanical Research.

Q: In your experience, is a low oxalate diet required for life or is that a temporary change when working through issues?
A: Some people will do it for life, particularly if they have struggled significantly with oxalates before. However, if the oxalate is mostly coming from fungal sources than a lifelong low oxalate diet is not necessary if the fungus is treated. Depends on the patient scenario, but typically it is not need lifelong for some people.

Q: Some patients with glutathione deficiency, are sensitive even to small dose of glutathione replacement. Are there markers that can indicate reaction to glutathione or is that just indicative of high toxicity? What do you recommend for them?
A: There are no markers that would indicate a tendency towards individual reactions. Every person is different with regards to their individual reactions. For many sensitive people, you have to dose things at a very low level. Start low and go slow is always a good method for sensitive patients.

Q: How long do you use the binder like GI Detox?
A: Typically for the duration of treatment of the candida, bacteria, and mycotoxins.



Q: MosaicDX recommends NOT using glutathione prior to testing however, I have seen that without glutathione many tests are negative, and the patients have a lot of s/s of mold toxicity.
A: To my knowledge, there is no published or unpublished study that this is true. Also, it goes against the scientific fact that glutathione reacts with mycotoxins to form large adducts that will be invisible to a mass spectrometer. Show me your before and after data (at least 10 cases) and I will publish it.

Q: Is Gliotoxin also an environmental mycotoxin or is it primarily thought to be due to candida?
A: Gliotoxin is due to both Candida and mold.

Q: I have a current client with high levels of Citrinin, and I’m curious whether this would primarily come from diet or due to a GI infection of an organism like Aspergillus?
A: High levels of mycotoxins in the USA are almost all due to water damaged buildings but the mold from such buildings often may colonize the lungs, sinuses, and GI tract.

Q: How do we tell whether mycotoxins are present in the environment and are showing up on a mycotoxin test or if they are present due to fungi in the gut? Am I correct in thinking that if the OAT shows fungal markers, the gut is to blame?
A: The presence of mold markers in the OAT test can indicate both the presence of mold in a water damaged building and the presence of mold in the GI tract.

Q: What makes the difference between responses between two people exposed to the same mold? can you be exposed and not be affected? is there a way to make yourself resistant to mold illness?
A: There are many genetic factors that influence response to mold infections and mycotoxins including many glutathione and cytochrome P450 factors.

Q: Clarify my Question: ‘urinary mycotoxin testing vs. serum mycotoxin antibodies…’
A: Vodjani reported that there was a significant relationship between mold antibody levels and mycotoxin antibody levels, so mycotoxin antibodies are an indicator of mold allergy, not mycotoxin toxicity. Urine mycotoxins are the best indicator of non-allergic mold toxicity. There are hundreds of articles on urine mycotoxins and their clinical effects by a number of independent researchers but only a handful of articles on mycotoxin antibodies, all written by employees of the companies selling those tests.

Q: How do you get for sinus fungal colonization?
A: Mayo clinic published a study indicating that fungi are the main source of sinus infections which almost always are due to inhalation of mold spores in a water-damaged building.

Q: How did you clear the Zearalenone from your dog? did you use binders?
A: The dog went from near death to completely well after switching to a grain-free dog food in about one day. I did no other treatment. I had spent thousands of dollars on vet visits and lab tests that were zero benefit. Our vet continues to recommend dog food with grains. Contaminated dog food from moldy grains is probably the most common reason for vet visits for your dog. Completely ignore your vet’s bad advice on dog food.

Q: If someone only has one mold show up on their test, is it really that concerning? And do patients really have to give up the foods the molds are found in? Is that a strong source of mold for most people?
A: The most important factor is the amount of mycotoxins found, not the number of mycotoxins. Food is not a major source of mold in the USA. If the mycotoxin is double the upper limit of normal, I think the person has a significant problem.

Q: How long would a patient have to be off Mycophenolic drug in order to be tested?
A: The half-life of mycophenolic acid is 17 hours. In 5 half-lives (85 hours or 3.5 days), 97% would be eliminated. To be safe, it might be better to say 4 days off the drug.

Q: To help diagnose whether mycotoxins are causing or contributing to patient’s illness, how helpful would it be for them to simply live somewhere else for a week or two? (Assuming they could find a mold-safe house)
A: Unfortunately, if the patient is colonized, they would be taking their mold with them to their new home. Testing is better than guesswork.

Q: How did you treat mold in your car?
A: The dealer (Hyundai) had a procedure. I don’t know how it was done, but it seemed to clear up the mold.

Q: Will you be covering anything on what antifungals to use when?
A: Itraconazole (Sporanox Brand Name) is effective against most molds and is reasonably priced. Voriconazole is thought to be more effective against more molds but is pricier. Nystatin and Diflucan are not nearly as effective.

Q: How long do you typically use binders to help mycotoxins? What would be the average time?
A: I would recommend one month. I do not think formal studies have been done.

Q: Do you recommend pulsing binders?
A: I see no benefit in pulsing.

Q: OAT mold metabolites are indicative of growth in GI exclusively?
A: I suspect that the markers are mainly of GI origin since the markers decreased following the use of nystatin which only kill yeast/fungi in the GI tract. The GI tract provides all the nutritional factors required by mold in abundance. I don’t think that would be true of sinuses or lungs.

Q: When someone goes on vacation or gets out of the house (or source of mold if it is at work or a school), will a lot of their symptoms get better? And how quickly?
A: Getting out of the moldy environment is always helpful but the colonized person is taking the GI mold with them wherever they go.

Q: What supplements / medicines should a patient take while mold remediation is being done? (I’m sure best is moving out but if cannot how to treat to avoid more future problems?)
A: If remediation is not done, the person will have to be treated again and again with antifungals and binders.

Q: So just to confirm, if you are positive on urine mycotoxin test, it means ACUTE exposure? How do you determine long-term exposure?
A: Long-term exposure is determined by clinical history of symptoms and knowledge of the mold in the home/office/school. For example, when did the flooding of the house first happen? When did the water pipes first develop a leak?

Q: Do you recommend treating with medicated nasal spray in cases of positive mycotoxins and upper respiratory symptoms?
A: I think that the standard treatment with antifungals and binders will clear up respiratory symptoms as well if systemic antifungals like Sporanox are used.

Q: So positive results on urine MycoTOX panel mean ACUTE exposure?
A: I would say that the presence of mycotoxins indicates current exposure which can be from moldy buildings and/or previous colonization.

Q: I have a male patient who keeps getting acute pancreatitis, for no reason; could this be mold?
A: Yes, there are a number of articles relating pancreatitis to mold and even pancreatic cancer. Aykut, B., Pushalkar, S., Chen, R. et al. The fungal mycobiome promotes pancreatic oncogenesis via activation of MBL. Nature 574, 264–267 (2019). https://doi.org/10.1038/s41586-019-1608-2 Firsova VG, Parshikov VV, Kukosh MV, Mukhin AS. Antibacterial and Antifungal Therapy for Patients with Acute Pancreatitis at High Risk of Pancreatogenic Sepsis (Review). Sovrem Tekhnologii Med. 2020;12(1):126-136. doi: 10.17691/stm2020.12.1.15. PMID: 34513046; PMCID: PMC8353699.

Q: Assuming you are not a dog, how contaminated are cereals, peanuts, coffee, etc with mold in the USA? Are legumes a significant source of mycotoxins?
A: In the United States, most foods are checked for mycotoxins. Any food may have mycotoxins.

Q: Do frequent rounds of antibiotics increase the risk of mold and mycotoxins to spread in the body?
A: I know of no studies but suspect the normal flora keeps molds in check.

Q: Do you think it is worth doing a MycoTOX test in patients who are in hospice with hepatocellular carcinoma? Is it too late to do anything at that point? I have so many patients with HCCA, one is a husband and wife:( thank you
A: Aflatoxins from mold-contaminated food and moldy buildings are a major cause of hepatocellular carcinoma. I could find no reports of diminishing the cancer once it has developed but it might be worth a try. If certain foods or building are suspect, mycotoxin results could be used to build a lawsuit case for the family of the couple.

Q: Would an isolated elevation of 14 in marker #6 on OAT, with high (98 oxalic) , and high HVA in a cancer patient, be concerning for aflatoxin or ochratoxin tox ? or maybe just a food exposure prior to testing? this is the conclusion of the staff.
A: Mold such as Aspergillus is common in cancer patients treated with chemotherapy. Many hospitals administer antifungals prophylactically with chemotherapy to prevent systemic fungal infections. High HVA may be due to certain tumors like neuroblastomas.

Q: What is a typical antifungal that is used, Diflucan or nystatin?
A: Not nearly as effective as itraconazole for mold. Voriconazole more effective and more expensive.

Q: Regarding the fibromyalgia patient treated for mold, that had reduction in mold furans in OAT, was she given Nystatin or a systemic anti-fungal?
A: I think both.

Q: When using binders for mold are there specific binders recommended for specific mold mycotoxins?
A: I would recommend GI detox for all since it has both clay and charcoal (NBNUS.com).

Q: Can you explain why some of the “oxalate” experts discount the mold connection to oxalate?
A: I suspect they have had minimal experience and access to OAT and Mycotoxin testing and the appropriate research papers.

Q: What are your thoughts on the MosaicDX urinary excretion test vs ones that test antibodies? Wondering if more sedentary patients with depleted glutathione may not show as much mycotoxin exposure.
A: I suspect the opposite is true. When glutathione covalently bonds to mycotoxins, the altered mycotoxins are a much higher mass than cannot be detected by the mass spectrometer.

Q: How long was the Sporanox treatment regimen for the 3-year-old with Autism treated by Dr Baker thanks
A: The child recovered completely after 6 weeks of the antifungal, but the treatment was continued for a much longer time period. The child continued on Sporanox at lower doses for about 3 years.

Q: 3-year-old child that was switched to Sporanox from itraconazole, Were there less herkzheimer reactions on Sporanox?
A: The switch was made because the parent thought the Sporanox was more effective.

Q: I thought Sporonox is the brand name of itraconazole. Yet your slides make it sound like two different drugs (the 3-year-old with autism slide). Am I missing something?
A: Many physicians suspect that generic brands of drugs are of lower quality or less potent than brand names. The parent thought the child’s progress was better on the brand name Sporanox. The Sporanox brand of itraconazole has been developed and marketed by Janssen Pharmaceutica, a subsidiary of Johnson & Johnson. The three-layer structure of these blue capsules is complex because itraconazole is insoluble and is sensitive to pH. The complicated procedure not only requires a specialized machine to create it, but also the method used has manufacturing problems. So there may be real differences in the 2 products.

Q: Have you seen higher incidence of kidney stones in patients with high oxalate?
A: I have encountered several patients who developed kidney stones after starting diets with frequent spinach salads or spinach smoothies. Spinach is the food with the highest oxalate content.

Q: Is there a plan from the MosaicDX Lab to expand the MycoTOX Profile to include other mycotoxins?
A: Yes.

Q: Can you discuss sinus colonization and how to test?
A: If there is sinus colonization, GI colonization will follow shortly as sinus leakage goes into the esophagus and GI tract. X-rays of the sinuses can be helpful to look for oxalate stalactites formed by colonizing molds. Mold cultures of the nose and urine mycotoxins also helpful.

Q: Do you need to do provocation (i.e. glutathione or EDTA) prior to doing the MycoTOX Profile?
A: No.

Q: Do you need mycotoxin testing and OAT to exclude most mold infections or is one test adequate as a screen?
A: The OAT only screens for Aspergillus and Fusarium so both are needed.

Q: Pulmonary aspergillosis (farmer’s lung) treatments?
A: Remove from exposure, then treat with Sporanox. If severe, surgery may be needed.

Q: How does markers such as Melanocyte Stimulating Hormone, antidiuretic hormone or MMP-9 compared to the mycotoxin urine test?
A: None of these markers are specific for mold. These markers may sometimes be useful in patients with confirmed mold diagnosis

Q: If the OAT finds mold like aspergillus, is it assumed that the patient must be ill affected? or can you have mold in the OAT and have no issue or reason to treat?
A: I have recommended treatment in every case that the OAT mold markers were elevated.

Q: Can a mold toxicity situation produce a raised ferritin situation? I have a 50-year-old male with this situation (not hemochromatosis).
A: Many mycotoxins, especially aflatoxins, are harmful to liver. Ferritin is raised in liver toxicity.

Q: What is the best way to treat ochratoxin?
A: Ochratoxin is treated like all mycotoxins. Remediate moldy living spaces, treat with antifungals, then follow with one month of binders (GI detox, NBNUS.COM has both charcoal and clay).

Q: I see moderately high MPO on many labs but too high for heart disease and no apparent Infection? Can elevated MPO by from stealth gut infection be caused by fungus?
A: Mold fungus can indeed cause heart disease. Here is a resource.

Q: Why do mycotoxins often rise after starting treatment?
A: As molds are killed, they will release all mycotoxins that are stored intracellularly which are then absorbed and excreted into the urine.

Q: If patient can’t move or get away permanently from the exposure or remediation hasn’t quite been a success, can you perhaps pulse antifungals or herbal antimicrobials ongoing for long term?
A: You can do this, but you run the risk of drug resistance if you use this approach too long.

Q: If the mold is in hollow spaces like lung or sinuses does the antifungal treat that effectively?
A: Antifungals will treat any area of the body that has a blood supply. Lobectomy is commonly done when the infection of the lung is severe.

Q: If someone has known lung colonization, home tested positive, awaiting results, am I to assume this would be a patient who most likely would require stronger antifungal treatment, ie Sporanox and not as likely to respond to herbal therapies?
A: Yes.

Q: Can you speak to which probiotics specifically can help?
A: Lactobacillus plantarum and rhamnoses have been shown to degrade aflatoxins.

Q: Can carbon c60 be used as a binder?
A: Carbon 60 is a molecule made up of 60 carbon atoms. The layout of the atoms forms a molecule shaped like a soccer ball. Carbon 60 was first used in nanotechnology and electronics. Charcoal is very cheap and effective. Why not use charcoal?

Q: I know MMS is controversial, but I use it a lot with patients, and it is miraculous. Have you any thoughts on MMS and mold?
A: Miracle Mineral Solution is an oral liquid solution also known as “Miracle Mineral Supplement” or “MMS.” The product, when used as directed, produces an industrial bleach that can cause serious harm to health. The product instructs consumers to mix the 28 percent sodium chlorite solution with an acid such as citrus juice. This mixture produces chlorine dioxide, a potent bleach used for stripping textiles and industrial water treatment. High oral doses of this bleach, such as those recommended in the labeling, can cause nausea, vomiting, diarrhea, and symptoms of severe dehydration. Since this substance is a powerful oxidizing agent, it is mutagenic and carcinogenic. I personally communicated with a woman who developed GI cancer after its use. Another parent had her child taken away by government child protective services after using it on her child. It undoubtedly is a potent antimicrobial but there are so many safer things, why take the risk?

Q: How long should someone be off Glutathione prior to testing?
A: Two days.

Q: I have a patient with moderately advanced Parkinson’s with moderate amounts of mold. When I put him on binders, regardless of the time of day, it decreases/binds his medical prescribed dopamine. As his L dopa is prescribed 4x/day. Other suggestions?
A: Use antifungals for a month before any binders. Then retest. If mold is gone, don’t use binders. If binders are used, use them 3 hours after L-DOPA.

Q: How would you explain increase in urinary mycotoxins after glutathione provocation compared to the urinary mycotoxin test done on the same individual without glutathione provocation prior?
A: To my knowledge, there is no published or unpublished study that this is true. Also, it goes against the scientific fact that glutathione reacts with mycotoxins to form large adducts that will be invisible to mass spectrometer.

Q: How do you time treatment of Mold in a patient with SIBO?
A: I would say exactly the same as a non-SIBO patient.

Q: Do molds have any impact on MS?
A: I have found mold involvement in virtually every neurological disease: MS, autism, ADD, Parkinson’s, Alzheimer’s, and ALS.

Q: I have three clients with mold exposure in the same household. Two out of three showed high levels of mycotoxins but the one that was immune compromised barely showed up on the MycoTOX Profile. Any reason why would one not excrete metabolites?
A: The big suspicion is that the person with the lowest mycotoxins spent less time in the moldiest parts of the house. That has been the reason in other cases I am familiar with. I doubt it is due to immune system compromise.


Q: Amyloid plaque is misfolded fibrinogen from excess iron and low Vitamin C per Dr Robert Thompson. Does this fit into your management?
A: That is incorrect—amyloid plaque has many components, but the major proteinaceous component is the beta-amyloid peptide (of varying lengths, mostly 40 and 42 amino acids).

Q: Can you repeat what you said about low Triglycerides and low zinc? How does this link to Alzheimer’s?
A: This is simply an observation: many of the patients with type 3 (toxic) Alzheimer’s have low serum zinc and low triglycerides. Therefore, if you notice this in the setting of other features of type 3, it supports the diagnosis. We do not yet know the mechanism for these phenomena.

Q: How do you recommend testing for glutathione levels? Is whole blood via LabCorp sufficient?
A: Yes.

Q: In treating patients with cognitive decline and mycotoxin issues, do you find any contraindications in using ketosis as a therapeutic option?
A: Great question; we have not found this to be a problem, but please avoid stress to the extent possible, since patients with mycotoxin-associated cognitive decline are often hypersensitive to stress.

Q: Are we still able to become Bredesen certified? If so, how?
A: Yes, ReCODE 2.0 training is available via Apollo Health. https://www.apollohealthco.com/practitioners/

Q: What would a “cognoscopy” entail at age 45?
A: 3 parts: (1) Blood tests (you can get directly via mycognoscopy.com); (2) on-line cognitive assessment (freely available as CQ test; (3) MRI with volumetrics (optional if you are asymptomatic).

Q: Can you comment on long history of benzodiazepines use and AD and antihistamines use and AD?
A: Yes, both of those have been associated with increased risk for cognitive decline. Anticholinergics, benzodiazepines, PPIs, antihistamines, etc. There are numerous epidemiological studies on this.

Q: Do you test extensively first, then apply appropriate measures, or can one apply some measures without testing, and what are the priorities Dr Bredesen recommends?
A: Best to test first, but you can apply some measures, and then test if/when the measures are unsuccessful. The protocol is detailed in the book, The End of Alzheimer’s Program, and also in The First Survivors of Alzheimer’s.

Q: Have you seen high quinolinic acid for most of the Alzheimer’s participants in the study?
A: Good point. We did not measure this in the study.

Q: Which exogenous ketone do you use? brand name?
A: KE1 is a good one, from KetoneAid. Perfect Keto also has a range of products.

Q: Thoughts about Microwaves, e.g. 5-G, Satellites?
A: It’s concerning. We need a better clinical test to determine who is suffering from this exposure.

Q: What is your preferred source for exogenous ketones?
A: Ketone Aid or Perfect Keto, to name a few. I like KE1. However, if LDL-p is normal (800-1200), you can use MCT oil.

Q: Have you seen burning mouth syndrome, sore tongue/teeth be associated with mold illness?
A: No. Most of the patients we see with cognitive decline associated with mold do not have peripheral CIRS manifestations, although some do.

Q: Do you recommend intranasal antifungal spray, how do you treat?
A: We typically follow the recommendations from Dr. Neil Nathan, detailed in his book, Toxic: Heal Your Body.

Q: Do you think Coenzyme Q10 can help to reduce cognitive impairment?
A: It’s part of the approach to improve mitochondrial function, so it has a role, especially in those with reduced mitochondrial function.

Q: Is there a place for Hyperbaric Oxygen in MCI/Alzheimer’s?
A: Yes, especially for those with vascular or traumatic contributions.

Q: How does this tie in with the work of Prof Exley and his findings of aluminum in the brain?
A: Yes, aluminum can be one of many contributors, and amyloid is a metal-binding peptide.

Q: Do you use Cyrex labs Lymphocyte Map to evaluate immune system phenotypes?
A: We have used Cyrex testing (Arrays such as 2, 3, 4, 5, 11, 12, etc.) but not the lymphocyte map—have you found it useful?

Q: What are CNS vital signs?
A: CNS Vital Signs is an on-line cognitive assessment: https://www.cnsvs.com/

Q: What role would intermittent fasting play in therapeutics?
A: Yes, it can be very helpful—helps both to create insulin sensitivity (and metabolic flexibility) and ketosis. There are several other advantages, as well.

Q: Do you think that the treatment protocol works for most other neurological conditions as well such as MS, neuropathy, autism, Restless legs, etc.
A: The protocol is designed for the pathophysiology or pre-AD and AD. It is modified for the different pathophysiologies of these other conditions, and of course it is also personalized so that each person’s optimal protocol will be slightly different.

Q: How can we find clinics and practitioners that are willing to follow your approach in treating Alzheimer’s patients?
A: Yes, we’ve trained over 2000 physicians in 10 countries and all over the US. You can check on drbredesen.com or contact Apollo Health staff for a practitioner in your area.

Q: Can you please repeat the name of the person who is utilizing this approach to MCI in San Diego?
A: Several: Dr. Heather Sandison, Dr. Wes Youngberg, and others.

Q: What is the name of the assisted living facility in San Diego that you mentioned is treating Alzheimer’s pts with your protocol?
A: Marama (in Vista, just outside San Diego): https://www.maramaexperience.com/

Q: What is the definition of organic toxic buildup? Does he mean metabolic waste that isn’t flushing through the drainage pathways?
A: Organic toxins such as toluene, benzene, formaldehyde, and glyphosate can contribute to cognitive decline, in part by reducing glutathione and in part through their effects on mitochondria and other cellular components.

Q: Can you give a link for the ARK Project?
A: No link to this yet; we are still treating the first group—patients with age-related macular degeneration.

Q: 2.0 Bredesen Protocol Health Coach here! Are any practitioners utilizing health coaches with the Bredesen Protocol?
A: Great point. Have you talked with Christine Coward or Valerie Driscoll from Apollo? They may be helpful. Also, most of the practitioners do work with coaches (Drs. Ann Hathaway, Kat Toups, Deborah Gordon, Kristine Burke, Craig Tanio, and many others).

Q: When is he talking about “organic toxins” do you guys think he is referring to metabolic waste buildup?
A: Toluene, benzene, acrolein (see the MosaicDX organic toxins test), formaldehyde, glyphosate, and many other organics. These are also important in Parkinson’s (e.g., TCE, PCE, paraquat, rotenone, etc.).

Q: How can we find a provider using the Bredesen CODE in our area? Thanks.
A: Drbredesen.com or apollohealthco.com

Q: How do you convince someone to start addressing contributors to dementia if you notice MCI, but that person doesn’t acknowledge any deficits?
Great point. This is relatively common. Getting all of the family members to have a “cognoscopy” is one way to get people evaluated (therefore the person with MCI does not feel singled out). Good for everyone who is 45 or over to be evaluated and begin active prevention. However, there are some people who simply do not want to admit decline, and it is very hard to treat someone who simply does not want to get better.

Q: Can you provide information about how to learn more about your physician training program?
A: Sure — please check https://www.apollohealthco.com/practitioners/


Q: So boosting NO if someone has clots would be bad because it would decrease eNOS and cause further clotting?
A: eNOS (endothelial nitric oxide supports healthy circulation and lowers the risk of clots while iNOS (inducible nitric oxide) creates very large amounts of NO to kill pathogens and inhibits eNOS, thus increasing the chance of clots. For a deep dive into eNOS and iNOS, watch my iNOS interview with Dr Jill Carnahan on her YouTube channel.

Q: How are you measuring thromboxane a2?
A: It’s a urine test from a company called Chronic Inflammation. (www.chronicinflammationtest.com) I’m encouraging Mosaic Diagnostics to try to get back PLA2 and add thromboxane. I believe these two measures, along with checking Omega 3, 6 and AA are very helpful tools.

Q: Do you have an opinion on how the mRNA/lipid nanoparticles may have role in this (vegf maybe) and how those with the vaccines can help supplement to decrease their risks of these long-term effects? Your opinion so far?
A: This is totally speculative and hypothetical, but it would seem reasonable to think any vaccine will stimulate NOX to create immunity. If this stimulates mast cells, histamine and iNOS, this has the potential to activate platelets and VEGF.
To potentially reduce the platelet activation, finding which step in the process may be most active and trying to lower it may be helpful.
I recently did an interview with Dr Jill Carnahan on her YouTube Channel on platelet activation. You may find this useful.

Q: In patients with limited means, is a hsCRP and sed rate enough to rule out systematic inflammation?
A: Its useful, but I have clinically observed individuals with systemic inflammation with normal hsCRP and sed rate, but it can be useful.

Q: What is the easiest way to determine maybe through testing to suspect if a patient has uncoupled eNOS and should not take arginine/citrulline?
A: I am not aware of any specific testing, but clinical observations would be Raynauds or chronic cold hands and feet, high blood pressure (low eNOS) and genetic testing with down regulation of eNOS and gain of function in eNOS or potential mutations in BH4 production.

Q: Can CDP Choline raise TMAO?
A: I’ve seen this happen, so I always combine CDP Choline with Grape Seed Extract.

Q: Do you know about the “omega check” serum test via LabCorp and Quest. If so, do you recommend target levels for protection?
A: Yes, excellent way to see levels. Omega 3 – 8 to 12%. Omega 6 to 3 Ratio 3.1 to 5.1. AA to EPA 2.5-11.1.

Q: If you have SNPs on both FADS 1 & 2, is increased omega 3 supplementation useless; is it better to do Omega 3,6,9?
A: What we are finding to be most useful is oils like Calamari that are higher in DHA, Algae based DHA or if needed, some of the newer supplements that are Protectins and Resolvins. Omega 6 uses FADS first, and can further weaken Omega 3’s turning into Protectins and Resolvins.

Q: Can you expand on why someone with mutations in FAD enzymes can’t tolerate intermittent fasting?
A: This has been a clinical observation and we are hypothesizing that since they are not effectively using fats, they need carbs on a frequent basis.

Q: What genetic/epigenetic tests are you using to find the sap’s you discussed?
A: We use Functional Genomic Analysis (www.functionalgenomicanalysis.com).

Q: What if you calm the TNFa down with these supplements but the reason that its high isn’t removed? Does it cause more damage?
A: Excellent question, as TNF-a is needed to fight off pathogens, so theoretically it could be lowered too much. This is an emerging field, with much to be learned. What we are doing, is trying to lower it when there is a gain of function of TNF-a or excess Iron stimulating. LDN lowers TNF-a so it’s done regularly.

Q: Are you measuring VEGf? What is your opinion of an optimal level?
A: Just started by doing the Covid Long Haul test and considered high when > 12.3

Q: How much resveratrol do you recommend for pathway 1?
A: 250 mg

Q: Can you clarify a few symptoms patients would have with pathway 1, 2, 3?
A: 1 – Possible excess mast cells and histamine, potential inflammation from RANTES. 2 – #2 Hypertension from higher thromboxane, pain and inflammation and activated platelets and ANTES. 3 – Mast cells, histamine.

Q: Thoughts on NAD+ IV for iNOS/eNOS balance and general endothelial function?
A: Here’s a speculative hypothesis. NAD+ creates NADPH that recycles glutathione. If inadequate glutathione, which is needed to clear Peroxynitrite, the Peroxynitrite may lower BH4 which increases NOS uncoupling.

Q: Have you seen low AA on testing? What are your thoughts about this lab finding?
A: Yes, but I am not aware of why or the potential impact.

Q: For people trying to self-regulate blood pressure with diet, would daily consumption of beets be sufficient to over activate the iNOS pathway? Top 3 tips to balance overactive iNOS pathway? What about SOD supplementation to balance the superoxide?
A: 1 – Beets have nitrates that turn into Nitrites that may create nitric oxide that improves the eNOS for healthy blood pressure. 2 – Balance Homocysteine and Iron, reduce histamine. 3 – Avoid Glyphosate as much as possible. 4 – Avoid and clear mycotoxins. <>br>I use SOD quite a bit, but balance with Catalase, or the SOD can make too much hydrogen peroxide. Catalase clears the hydrogen peroxide.

Q: Preferred means of measuring NOX enzyme activity?
A: I am not aware of any lab testing testing that would measure NOX specifically, however the Functional Genomic Analysis software looks at them. Clinical observations may be excess mast cells and histamine. Also, Homocysteine stimulates NOS, so high Homocysteine may be a useful indicator.

Q: How do we get the software he’s talking about to use as practitioners?
A: You can get a free trial at www.functionalgenomicanalysis.com


Q: RE-bone marrow, I have not heard much about using this as a food (lightly roasted for example, from grass fed organic cows) to support patient’s own bone marrow function. I read these ages ago, used in childhood leukemia especially. Any thoughts?
A: The issue with bone marrow is that it tends to be high in heavy metals (like lead) even if the animal is raised organically. You would need to use a product that is tested for this. Bone marrow was probably the first animal product humans ate—we were scavengers originally and the only thing left after the lions and the hyenas were done with the animal, was the bone marrow. It is a great source of multiple nutrients if you can find something that is not toxic.

Q: You recommended to continue a long-term detox regimen due to daily exposures. Beyond sauna are there any continued long-term supplementation you suggest?
A: I recommend regular liver detox support (NAC, glutathione, milk thistle, etc.).

Q: Regarding sauna – What about those who react to a sauna or even a hot shower. Do they need to take other steps before they can do a sauna?
A: That reaction is usually from autonomic dysfunction. If it is a detox reaction, then start with binders or Epsom salt baths first.

Q: How do you determine thyroid receptor disruption? Clinically, and check organophosphates?
A: Most toxins will disrupt thyroid function, so that is a given. There is no test I know of to test thyroid receptor function—a patient would have a low basal body temperature with normal thyroid numbers and no other explanation.

Q: Can toxins be the cause of burning mouth syndrome? Painful throbbing teeth? Thanks so much.
A: Burning mouth is an autonomic dysfunction along with some type of neuropathy. You have to figure out why. Toxins are always on the list for this.

Q: Can toxins affect free testosterone levels, as well?
A: They will affect production of testosterone. The amount of free testosterone is so miniscule, I am not sure if they will affect this directly outside of affecting total testosterone. I do not know if toxins impact albumin or sex hormone binding globulin (I have not read anything on this)—these are the two proteins that bind testosterone.

Q: I have a patient with elevated MTBE #1 on GPL tox – drinks only bottled water, lives in rural suburb near pond. Any recommendations on looking for source? Any other ideas on detox other than liposomal glutathione and NAC? Thanks.
A: MTBE is ubiquitous. Have they checked the bottled water? None of that is regulated — I can fill a bottle from the tap and sell it with any label I want. If there is not obvious source, work on the liver.

Q: Do you recommend IV chelation? or use of binders?
A: I do IV chelation for heavy metals—this was not covered in my lecture. I use binders—that was part of my lecture.

Q: What reference range do you use for reproductive hormones? As you know, reference ranges vary from test to test. Also, hormone levels vary depending on where patient is in their menstrual cycle, or arguably even time of the day.
A: I would recommend doing a course in hormone replacement for this answer. Ranges completely depend on where a patient is at in life, their menstrual cycle, and where their base line was. It is usually a range of okay along with managing patient’s symptoms.

Q: What do you say to a patient that won’t change the exposure? Do you still treat them? Can treatment compound the problems they have?
A: Unless it is a temporary situation, I won’t treat them. It is like treating a patient with cardiovascular disease or diabetes that won’t change their diet or lifestyle. That is why we have traditional physicians—they would be more than happy to prescribe drugs for the rest of their lives. I don’t waste my time. If someone doesn’t want to get better, you can’t make them. Move on.

Q: If it’s determined that a patient has low glutathione recycling due to SNP and this likely the cause of presence of toxins-can they take glutathione long term without negative consequence?
A: Be careful with SNPs—there are very few that are determinate. Low glutathione has many causes, one of which is recycling. If you are going to use SNPs, you better have the entire glutathione/sulfation/uric acid/methylation/ammonia cycle SNPs laid out to see the entire pattern. Using a precursor (sulforaphane and/or NAC) first will tell you if you need to use glutathione itself. If those two do not increase the level, then I will use glutathione chronically.

Q: Toxicity of microwaves how significant is this? Seems to be coming way too high.
A: EMFs are a topic all by itself. I am not an expert on this, but the literature I am read suggests that it is a problem.

Q: What do you think about silicon rich water to reduce aluminum levels?
A: The problem with products like Fiji water is that come in plastic bottles and are shipped from Fiji. I typically use a supplement for this (like BioSil).

Q: Any specific suggestions to help detox glyphosate?
A: Binders are an effective way to detox glyphosate as are saunas.

Q: Do you think mitochondrial nutrient support is helpful, at the same time as detox?
A: Yes, most of our chronically patients have mito issues. The ultimate solution is to eliminate the cause of the cell danger response.

Q: Are saunas safe for kids? what age?
A: Yes, I reserve the lower age for children that can express their needs (usually around age 3). Things like headaches or dizziness are signs that they are not tolerating. Start low and go slow.

Q: Do you have a supplement recommendation for blood sugar dysregulation due to toxins for someone who eats clean, has mold, and still needs help getting A1C normal again? Is it just a matter of time?
A: Detox the mold first to see where the patient is at before working with other medications or supplements for the sugar.

Q: Can NAC or glutathione be used long term?
A: NAC – yes, Glutathione — usually, but not something that I like to do.

Q: Do you believe after filtering water through zero water you need to replenish with minerals?
A: That would be ideal, but I tend to take and recommend mineral supplements


Q: Dificid is recommended first line therapy for C diff with fewer side effects than Flagyl or Vancomycin. What are your thoughts?
A: do not have much experience with that antibiotic and how it influences the clostridia markers on this test. However, the OAT does not necessarily differentiate between the pathogenic clostridia species. There are a number of pathogenic clostridia species, and by measuring various metabolites produced by these organisms, you can cast a broader view of pathogenic clostridia that would otherwise not be identified on a stool test. With that said, the intervention is dependent on how aggressive you as the practitioner see fit. Interventions vary from high dose (generally between 10-12 billion) spore- based probiotics to botanicals to pharmaceuticals.

Q: Is MosaicDX Labs doing DBH testing? if not which lab provides the testing for copper- polyuria?
A: MosaicDX is not currently measuring DBH. The best way to assess it, at this time, is either through genetic testing or a spinal tap. We do measure copper (along with ceruloplasmin and zinc) via serum Copper Zinc Profile and via urine through the heavy metal urine test.

Q: How do you time your treatment of a patient with mold, SIBO, IMO, Candida, dementia, and oxalate kidney stones? What is your protocol including prescription medications and supplements?
A: This is highly dependent on the patient, and multiple other factors.

Q: Do you recommend to-do DMSA and Glutathione provocation prior to ENVIROtox?
A: DMSA provocation is only necessary for a heavy metal urine test. Glutathione is not recommended for any of the test on the ENVIROtox (Glyphosate, GPL-TOX, and MycoTOX Profile) as the ranges are based on people not provoking.



Q: How do you approach patients with abnormally low GGT who may have difficulty recycling glutathione?
A: Very good question! And one I have been thinking about and have not figured out a good answer. At this time, I recommend topical or liposomal glutathione.

Q: What are some safe brands for cooking pans?
A: I have not independently evaluated specific brands so can’t make an informed recommendation. We use the new ceramic cooking ware. Appears to not leak toxins and is reasonably easy to clean.

Q: How long do you need to eat organic/limit exposure to see a change in blood work or on other toxin screening tests? / How long would you wait until retesting?
A: Remarkably, blood and urine pesticide levels drop dramatically—75-90%–after just 4 days of eating organically. The problem, of course, is that most are fat-soluble, so they accumulate in the fat. Since blood and urine change so quickly, I recommend testing 2 weeks after the patient tells you they have been eating organically.

Q: If I wanted to grow my own organic garden, where do you get seeds? Are the seeds in a typical store organic?
A: Happy to report there are a lot of good sources! I prefer the seeds to be both organic and heirloom. I like most of the food produced by the seeds I get from Uprising Seeds in Bellingham, WA.

Q: What natural sequent do you recommend?
A: All food-sourced fibers. Unfortunately, very little objective research. The little that is available is mostly wheat and rice fibers. Considering that most people react adversely to wheat, I suggest rice. And yes, good idea if you can get the manufacturer to document arsenic free.

Q: How does exercise with sweating compare with sauna for excreting toxins? Do you recommend red sauna or the blankets?
A: I asked the great researcher Steven Genuis, MD this question. His response is that it doesn’t matter. All that matters is the sweating.

Q: Is NAC ok for pregnant women?
A: I believe <1,001 data-preserve-html-node=”true” data-preserve-html-node=”true” mg/d should be safe for everyone. The only reactions I have seen are in a very small percentage of people who have a sulfur metabolism problem. Watch for IBS, acid reflux and/or allergies as an indication of sulfur overload.

Q: I’m working in community that has several paper mills. What toxic burden does that present to the people?
A: Highly dependent upon the source of the materials used. Unfortunately, trees will incorporate toxins they are exposed to. For example, if grown in an area with mercury contamination, the trees will be high in mercury which is released if there is a forest fire. The only way to be sure is to go to the US Geological Service website (www.usgs.gov). they’ve a large number of maps by county of the many toxins in the environment. Also, the Environmental Working Group has a website where a Zip Code can be entered to determine the toxins in the area.

Q: What is the half-life of PBDEs? How can we get them out of the house/off the floor?
A: I have not been able to get a good answer on this. Appears to be months, but I am not sure. The research does show that the more brominated the PBDE the longer the half-life.

Q: Do you have a resource on the half-lives of specific toxins? Thanks
A: I found a great paper that has many of them, but not all. Also includes a lot of drugs. Therapeutic (“normal”), toxic, and comatose-fatal blood-plasma concentrations (mg/L) in man. 150 pages and almost 1,000 references. Very useful.

Q: What is the most reliable test for metals if you cannot do provocation before testing?
A: Depends upon the toxin (lead—blood, cadmium—urine, arsenic—urine, mercury—urine.). But must recognize the “safe” standards are way too high. Urines should all be first morning.

Q: Dr. P, What about a low GGT? Does this mean liver needs more support?
A: They likely need glutathione. Measure their RBC glutathione.

Q: Doesn’t ggt also assess gallbladder function? In the ICU, we used to check ggt when we suspected gallbladder disease, which makes sense that it’s elevated when they are not detoxing well d/t gallbladder disease…
A: Yes, there are several causes of elevated GGT. Need to determine the full context.

Q: Is GGTP the same lab test as GGT?
A: Yes. The same test but labs use both abbreviations.

Q: Can you repeat the name of Doc in Northern CA who follows the GGTP?
A: Alan Goldhamer, DC measures GGTP in his fasting clinic.

Q: Does 8-ohdg also measure damage from mitochondrial dan?
A: Good question! And one I have wondered about. 8-OHdG has been used for both nuclear and mitochondrial DNA damage but I have not been able to quantify the differences. We do know that mitochondrial DNA suffers a lot more damage and does not have the repair mechanisms of nuclear DNA. So, I would not be surprised if the urinary markers are dominated by mitochondrial damage markers.

Q: Do you think the Big Berkey water filter is enough? Or what about distilled water, with adding minerals?
A: I do not at this time have enough data to compare manufacturers. Distilling water and adding minerals is a good strategy.

Q: Do you think fiber in food is enough, or do you recommend fiber powder?
A: Hard to get enough fiber from diet unless eating primarily vegetarian and primarily high fiber foods. Supplemental fiber seems a good idea to me.

Q: A great resource for parents is Lead Safe Mama website https://tamararubin.com/ information on lead in children’s toys, dishes, etc.
A: Great! Thanks for sharing.

Q: How long should a gal wait to get pregnant following removal of amalgams by an environmental dentist?
A: Assuming active efforts to avoid all other mercury sources and active facilitation of excretion, 6 months will get rid of most of the mercury.

Q: Can you comment on what pollutants we should be concerned with near a landfill in US?
A: Not being facetious — all of them.

Q: What key lab tests should a woman who has had 3 miscarriages in the first trimester have done before getting as part of her prenatal and fertility care?
A: Homocysteine, methylmalonic acid, GGTP, 8-OHdG, blood lead, and urinary mercury.

Q: How do you filter outside air? Isn’t that where your furnace and AC gets the air?
A: Depends upon the installation. The furnace typically recirculates the air of the house and has a separate intake to bring in outside air for the burning. Opening a window lets in outside air. If heavily polluted area, then should consider clearing outside air before it enters the house.

Q: Please tell us some of the toxin-absorbing plant names?
A: Moss case, Pot mum, Gerber daisy, Warneckii, and Ficus.

Q: With use of plants do you increase exposure to soil spores?
A: Probably, likely.

Q: What do you do when people are non-sweaters?
A: More fiber and glutathione.

Q: Does sweating from exercise and/or hot tub excrete these toxins as well?
A: Yes. Note that hot tubs and steam baths recirculate toxins unless removed by a filter.

Q: I have patients who barely sweat, they go in sauna and don’t sweat until have been in there for at least an hour…thoughts on this?
A: Trickly. I can’t recommend specific protocols without knowing more about the patient.

Q: Do you have a recommendation for trace mineral supplementation?
A: Eat organically grown foods. No specific supplement recommendations.

Q: Do you recommend drinking alkaline water while in the sauna?
A: Theoretically, yes. But I’ve no research. The sauna drink I make for myself is slightly alkaline.

Q: Are saunas safe for kids? what age and time limit?
A: Yes, and a bigger question than can be answered here.

Q: What are your thoughts/recommendations for those that don’t tolerate sauna (or even hot showers/baths) without feeling ill?
A: Primarily Red face, elevated heart rate and dizziness. Is it possibly related to histamine intolerance? This question has come up a lot. I will give it more thought.

Q: Is there an optimal reference range for GGTP?
A: My best estimate at this time is 15-20.


Q: How toxic is weed/cannabis these days? I got a feeling it’s loaded with metals and chemicals with cadmium leading the way. Does excess weed-smoking keep the copper/Dopamine high?
A: Acetaldehyde, ammonia arsenic, benzene, cadmium, chromium, formaldehyde, hydrogen cyanide, isoprene, lead, mercury, nickel, and quinoline are common in cannabis. Those who exclusively smoked marijuana had higher blood and urine levels of several smoke-related toxic chemicals such as naphthalene, acrylamide, and acrylonitrile metabolites than non-smokers. Metabolites of the last 2 chemicals are tested in the GPL-TOX test.

Q: Does your lab offer any tests for toxicities of chronic Lyme disease?
A: No.

Q: Do touch screens on electronics increase risk of exposure to chemicals?
A: Triphenyl phosphate is a significant hazard on computer screens, touched or not.

Q: Which brand of household cleaners would you recommend?
A: Don’t have one.

Q: Any suggestions on best ways to detox patients who are getting significant number of IVs? Or for anyone getting IVs – should they be taking binders for a particular amount of time before/after? any suggested protocols to detox the plastics?
A: Plastic IVs are all potentially hazardous. Request glass containers instead. Sauna is the best treatment.

Q: 1-bromopropane could be used for foam gluing. Is foam mattress and foam pillows for sleep also big source of? Are older foams better or worse?
A: Good question but don’t know.

Q: Dr. Shaw mentioned that glutathione will detox many toxins. If we start a patient in which we suspect a heavy toxic load on glutathione, are we in danger of seeing a large enough dump to see a severe herx reaction?
A: Most glutathione adducts are less toxic than the original toxic chemical not attached to glutathione. There are exceptions so there could be an occasional toxic reaction. Since there are tens of thousands of toxic chemicals there is no comprehensive source of this information.

Q: How does urine neurotransmitters rate to brain levels? Do they correlate?
A: Urine neurotransmitters correlate to brain levels since the same enzymes are present in both central and peripheral nervous systems for dopamine, epinephrine, and norepinephrine.

Q: Dr Shaw which supplements. do you take?
A: CDP choline, lithium, vitamin C, B6, methyl folate, methyl cobalamin, carnitine, biotin, Vitamins A, D, and K.

Q: What brand of air filter system do you use in your home?
A: None right now.

Q: What other techniques other than supplements and air filtration do you do to keep your toxins low?
A: The main thing is organic food and reverse osmosis water.

Q: Any suggested brands of sauna? Red sauna or blanket?
A: The only sauna not recommended are those made of pine which off-gas terpenes when heated.

Q: Will water distillers remove the vinyl chloride from the PVC in nearly everyone’s home and workplace?
A: Reverse osmosis systems are the only systems that remove almost all chemicals.

Q: When you mention acrylic fibers being carcinogenic-does that include clothing-so much is made from acrylic?
A: Yes, if the person is exercising, the chemicals may off-gas and enter the skin.

Q: I am now wondering how many crafters who are big into the yarn arts are at risk, since there are many yarns that contain acrylic. It would be difficult to do yarn arts wearing gloves. Any advice?
A: Acrylics and other synthetic fabrics would be most toxic when wearing them while hot so they might off-gas.

Q: Can people with a sulfur allergy take glutathione?
A: A sulfur allergy would have to be defined. Virtually no one except industrial chemists are exposed to pure elemental sulfur. Two sulfur-containing amino acids found in almost every protein are cysteine and methionine. Virtually every normal person has high amounts of sulfur containing glutathione. I don’t think someone who is severely allergic to these amino acids could be alive. Some people mean they are sensitive to sulfur containing antibiotics. I seriously doubt that anyone is allergic to glutathione since it is present in virtually every cell in the body. If unsure, put a drop on the skin and see what happens.

Q: Is there an exhaustive list of where each of the environmental toxins are found? if so, where? i.e., work exposure with certain chemicals….
A: The Mosaic Diagnostics website is a good place to star. In this brochure, pages 10-15 are fairly good sources.

Q: Did any ALS patients who you highlighted in the lecture improve with removing exposure, sauna and NAC/Glutathione treatments?
A: Haven’t had time for follow-up. Biggest impediment is that family members consider ALS incurable so don’t want to treat.

Q: Many students are now using iPads that you can write on. Do you feel that the coating on the screen is being absorbed into the hands while writing or is the risk more with inhalation from off gassing?
A: Don’t know.

Q: Are latex gloves without powder toxic?
A: The latex allergy is to the gloves themselves not the powder.

Q: Are you of the opinion that glyphosate is one of the main causes of the rise in autoimmunity, due to alterations in protective microbiome? It’s been sprayed on wheat/oats for 25 years and gluten is proven autoimmunity trigger.
A: Yes. Many articles on this. Wu HJ, Wu E. The role of gut microbiota in immune homeostasis and autoimmunity. Gut Microbes. 2012;3(1):4-14. doi:10.4161/gmic.19320

Q: Thoughts on the use of fermented foods such as sauerkraut packaged in plastic?
A: Plastic packaging is a big problem for all foods.

Q: A lot of people get Culligan water delivered to their home in big plastic jugs…. would it be better for them not to do this?
A: I am one of these people and need to ask what type of plastic is being used.

Q: Please can you repeat and expand on how Norepi influences in immunity after vaccination?
A: Clostridia bacteria phenolic metabolites inhibit the conversion of dopamine to nor-epinephrine by dopamine beta-hydroxylase. Since nor-epinephrine is needed to mount an immune response, the vaccinations don’t work if norepinephrine is deficient. Alaniz RC, Thomas SA, Perez-Melgosa M, Mueller K, Farr AG, Palmiter RD, Wilson CB. Dopamine beta-hydroxylase deficiency impairs cellular immunity. Proc Natl Acad Sci U S A. 1999 Mar 2;96(5):2274-8. doi: 10.1073/pnas.96.5.2274. PMID: 10051631; PMCID: PMC26773.

Q: Can you comment on cancer chemo / immuno drugs and chemical type of toxicity? At what point is it appropriate to test?
A: Many chemotherapy drugs are mutagenic. Organic acid testing might be useful to assess negative effects of chemotherapy.

Q: Not classical toxicity, but what evidence do we have of the biology of intense sensitivity to minute quantities of, salicylates, terpenes, non-pigment pill fillers…doesn’t seem like histamine or IgE related? Hard to use herbals in such patients.
A: Many pharmaceuticals use phthalates as a time release agent. Not a good thing to do.

Q: What is the half-life of xylene?
A: Based on the rate of elimination of m-xylene in expired air, the half-life was 0.8 hours for the initial phase, 7.7 hours for the intermediate phase, and 17.7 hours for the slowest elimination phase. Overall, the elimination half-life of m-xylene from subcutaneous adipose tissue has been estimated to be 58 hours in a man.

Q: How long after painting your inner house are toxins reasonably less to live there?
A: I would say when the odor is no longer offensive. Or use “green” brands of paint.

Q: Why do so many supplements come in plastic bottles, eg the GSE of New Beginnings?
A: Glass would be better, but it breaks in shipping.

Q: Are phthalates what are off gassed in new cars and what would you recommend for people who have a new car and therefore continuously exposed besides binders and NAC/glutathione?
A: The chemicals of the new car smell are ethylbenzene, formaldehyde, and toluene.

Q: Are you aware of any water filtrations systems for the home that would filter out vinyl chloride?? Many newer homes are plumbed with plastic now, no longer copper.
A: You would likely need reverse osmosis.

Q: Can you comment on what toxins you see with vaping?
A: A vape website lists the following: Diacetyl: Inhaling diacetyl has been linked to irreversible lung damage in factory workers, according to the National Institute for Occupational Safety and Health (NIOSH). Heavy metals: Exposure to heavy metals may cause flu-like symptoms, lung damage, and even cancer in some cases. Ultrafine particles: If inhaled, ultrafine particles may damage the respiratory and cardiovascular (heart) system and other parts of the body. Volatile organic compounds: These compounds including acetaldehyde, formaldehyde and acetone may put people at risk for many health problems, such as cancer and heart damage.

Q: How were the percentile data derived? From NHANES or from MosaicDX? Do the percentiles relate to a “healthy” population (however that’s defined!) or a general population? If the latter, how was referencing based on a biased population avoided?
A: 3The percentiles were directly taken from NHANES which attempts to provide data on a normal population. They are not gathering data from patients in hospitals or clinics.

Q: What about toxins in tattoos?
A: 3A consumer group warned of the “the presence of carcinogenic, neurotoxic or highly allergenic products” in three-quarters of inks most used by French tattoo artists, French newspaper Le Monde said in a report. Colored inks can contain lead, cadmium, chromium, nickel, and titanium. These metals can trigger allergic reactions and potentially lead to disease.

Q: When GPL-TOX levels are not elevated greater than 75%tile or 95%tile, but many or some markers are less than or equal to the 75%tile does synergy does take place? Does this suggest increased toxic body burden?
A: 3You are right. Multiple exposures below the 95th percentile might be as hazardous as a single chemical above the 95th percentile.

Q: Can you comment on 3M claims they have a replacement for 1-bromopropane and TCE?
A: 3M™ Novec™ Engineered Fluids are non-flammable fluids used in a wide variety of industrial applications, including vapor degreasing, solvent cleaning of industrial parts, and thermal management of electronics. Claims have been made for better safety for this product. Time will tell.

Q: What are the major differences between Glutathione vs. NAC?
A: NAC is a precursor of glutathione and may be absorbed from GI tract more readily than glutathione although liposomal glutathione is well absorbed.

Q: Do these pathogens show up on stool studies that are designed to find them such as those from Genova Diagnostics or Doctors Data? I’ve rarely seen these pathogens on those studies.
A: The OAT test of the Great Plains Laboratory is the best (and only) test for detection of Clostridia bacteria that inhibit dopamine beta hydroxylase. It is better to ignore the Clostridia sections of other labs,

Q: How much of an influence does glyphosate/toxins have on MS and autoimmunity in general?
A: See question 22. Many patients with MS have high toxic chemicals.

Q: What is the half-life of 1-bromopropane? What is the half-life of 3-HPMA (acrolein)? Can we have the half-lives indicated on the GPL-TOX reports? That would help us tremendously!
A: Wistar male rats were exposed to 1-bromopromane (1-BP) vapor for 6 hours a day, 5 days a week, for 3 and 4 weeks (1500 ppm) and 1 day, and 4 and 12 weeks (700 ppm). … 1-BP in blood decreased rapidly to the detection limit within 0.7 hr. On the other hand, bromide ion persisted longer in both blood and urine; the biological half-life of bromide ion was 4.7-15.0 days in blood and 5.0-7.5 days in urine. : Urinary 3-HPMA levels from acrolein were increased after 2-hr consumption of fried food with an elimination half-life of 10 hr. Human data are not available for 1-bromopropane. I will start looking for the other compounds. PMID:12191883 Ishidao T et al; Toxicol Lett 134 (1-3): 237-43 (2002)

Q: Can an OAT test’s results be within normal ranges and the GPL-Tox or MycoTOX Profile have elevated values?
A: Yes.

Q: Do more “clean” tobacco sources, such as American Spirits, offer much improvement to the multiple toxicities associated with tobacco exposure?
A: American spirits do not contain glyphosate but its smoke has all the same harmful chemicals as any other cigarette.

Q: Which type of sauna do you recommend for most effective treatment in removal of toxins?
A: Any except those made from pine.

Q: Have you seen increased toxic load in your patients who have received the Covid vaccine?
A: I haven’t analyzed the data.

Q: What is the scientology sauna protocol?
A: The protocol can be accessed at the following link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6259397/pdf/10.1177_0300060518779314.pdf


Q: Do air pods emit EMF’s? Kids wear them all day long.
A: Yes, they do.

Q: Can Dr Patrick repeat the suggested dose for NAC? Thanks!
A: I mentioned this during the talk so it will be on the recording- adult dose is 1800-2500 mg contraindicated in peptic ulcer.

Q: Will an air filtration machine with a Hepa filter remove aerosolized printer ink?
A: Depends on unit look for the filtration capacity- ultimately you want a unit that filter down to .003 microns

Q: Do we presume, or is there evidence, that all people with positive mycotoxin tests are colonized and/or have biofilms?
A: No evidence UNLESS there is no obvious sign of exposure meaning (home/workplace/school tests negative for mold and mycotoxin yet symptoms persist. My colleague Neal Nathan who knows much more about this than I do does not recommend nasal washings for culture due to false negative findings and recommends treatment in the above case.

Q: What about PEMF use? Can it mitigate EMF effect?
A: I would ask you to think about EMF/EMR like you think about tobacco smoke- would you recommend a vit. C therapy for smoking patients and not also intervene w cessation strategies? PEMF is helpful but mitigation involves remediation (hard-wiring, avoidance of Wi-Fi, keeping phone away from body or off, etc.).

Q: Do you recommend any of the protective EMF wearable devices?
A: Clothing that is penetrated with silver wire is protective, if you mean a device like a magic dot or other applications, no evidence.

Q: Vitamin E- do you recommend taking just tocotrienols or the full spectrum with tocopherols? There are some good literatures about benefits of just tocotrienols for cell membrane health and oxidative stress.
A: Vit. E, like vit. C is a complex of related compounds: gamma, alpha, beta, delta tocopherol and all four tocotrienols are necessary.

Q: Are using traditional headphones or Bluetooth headphones just as damaging as putting your phone to your ear?
A: Don’t know what you mean by traditional headphones, there are air gapped external earbuds that are OK to use but anything that allows a signal to go to your ear/skull/brain is damaging.

Q: You mentioned high prolactin as being from pesticides? How would you manage this in your pt?
A: The actual data on this comes from pesticide applicators who are occupationally exposed- treatment for OP toxicity involves B complex and high levels of antioxidants (C, E, Se, Zn, ALA, GSH, NAC, melatonin especially). OPs have short ½-life in body so further avoidance is crucial. Of course, other psychologic stressors can also raise prolactin so that must be addressed as well.

Q: Can Ozone break down the forever chemicals?
A: No, the fluorine/carbon bonding is the problem not vulnerable to ozonation.

Q: Does putting a device on airplane mode reduce EMFs?
A: Yes, it does there is still some small residual exposure but most of it comes from the phone searching for a signal.

Q: What is your opinion about using alkaline water in machines (such as “Kangen” machines) to remove pesticides from vegetables or using as drinking water? Would this result in removing beneficial bacteria from the gut?
A: I thought the US Consumer Protection Agency made Kangen illegal to import into the US I didn’t think they were still available. Water cannot hold an alkaline charge, it’s the minerals in the water that determine pH. Cheaper to just add mag glycinate to your water, no? Vinegar is highly effective at removing pesticide residue from fresh fruits and vegs, Dr. Pizzorno had an entire slide on that protocol. Cheaper as well.

Q: How about glass IV bottles from McGuff pharmacy?
A: We used to all our IVs in glass bottles in the old days, I do disagree w Dr. Shaw about phthalate contamination from IV bags, I think they have to be heated to contaminate IV w phthalates.

Q: I heard an ND say that toxins are stored in the bones too and not just fat tissues, but I have never heard that before – Is that true?
A: Depends on toxin- lead, cadmium, per fluorinates are stored in bone, the science on that is clear.

Q: I heard from a mold specialist that some ‘mold’ (Penicillium) is only introduced from Pharmaceuticals – Is this true?
A: No, look at my slide from EPA identifying molds commonly found in buildings.

Q: Thank you for bringing up EMFs!!! How about the recent satellite launches since 2020?
A: See this article that was just published a few weeks ago- measuring ground level EMF/EMR from small cell towers- they are source of the radiation not satellites: https://www.spandidos-publications.com/10.3892/wasj.2022.157.

Q: Do Sleep number beds increase your risk of EMF exposure significantly?
A: I had to look this one up (LOL). Obviously if you can program them remotely they are receiving a signal. You would have to use an EMF meter to quantify the v/M or microwatts/cm2. (Safe Living Technologies has a good meter.

Q: Do you think using a keyboard and mouse is safer than touching the IPAD itself?
A: No same exposure, safest is a hardwired external keyboard and mouse a few feet away from computer

Q: Where can we get more training on how to evaluate patients on EMF exposure and possible treatments for them?
A: We have a free lecture on our training website: emeiglobal.com and the emfconference2021 has CME courses as well.

Q: Could we get the name of the EMF study that Dr. Patrick is referring to in her lecture?
A: PMID: 32168876 let me know if this isn’t the one you wanted

Q: What is the best way to protect against EMF? Do you recommend products from Aires Tech or similar companies? NO please go to EMFConference2021 and see CME education courses for doctors as well as my course at emeiglobal.com
A: There is no magic pill for this- sorry. All of the Aires Tech “scientific papers” were peer-reviewed in house, and none were published in actual peer-reviewed journals. Grounding and PEMF helps but does not substitute for remediation.

Q: Regarding covid, anxiety, and EMF, both can stimulate mast cells, NO/ONOO activity, kynurenine, NMDA activity, etc. How relevant do you feel this has been over the past 2 years, even though everything is being blamed on covid?
A: I am very concerned about EMF hypersensitivity which has many of the same symptoms as Covid-19. Please follow Dominique Belpomme MD, a French oncologist who has published clinical data on this in his patient population of electrosensitive/chemically sensitive population.

Q: How do you propose we evaluate someone’s EMF sensitivity?
A: Here is a free YouTube by a physician from the UK- Erica Mallary-Blythe MD, who covers how to diagnose during an office visit: https://youtu.be/_iP-Zv3VLV4.

Q: Should the router be turned off at night?
A: Yes, if not hard-wired it is important to turn off the router at night.

Q: Is there any research showing that cellphones used in the car have stronger negative effects?
A: Cars act as small Faradays cages catching and holding in EMF, especially signal cell phone generates so yes exposure is worse in an automobile.

Q: Can you comment on how to protect from EMF exposure with hearing aids?
A: Turn off Bluetooth that connects hearing aids to your phone.

Q: EMF question- Are wireless headphones a big source? More dangerous due to proximity to brain?
A: Yes, Bluetooth is more exposure than regular headphones, air gapped headphones are best, easily available through online vendors.

Q: Can you comment on urine iodine testing? Endocrine tells me that neither serum or urine iodine testing is accurate. What reference range should we target?
A: Depends on reason you are testing, anything less than 200 mcg in urine is deficiency according to standard medicine.

Q: What are the ways to support the body & or reverse these effects of EMF for our children?
A: 1 – Cell phones should be kept 3 feet away from body (use speakerphone). 2- No devices in bedroom at night. 3 – Turn off router at night. 4 – Deal directly with internet and device addiction in children.

Q: Do you have any Canadian sources for labs that test for PFAS?
A: Sorry, I do not- use the PFAS sites I talked about for resources.

Q: What labs companies that will check my water that also includes MTBE?
A: Watercheck.com call them if it’s not on the website they can look for almost anything.

Q: Can you repeat the name of the researcher who is doing PFAS and Covid?
A: Phillipe Grandjean PhD

Q: If fish are high in PFAS would fish oil supplement be counterproductive in supporting health?
A: As you know good fish oil undergoes a process of distillation to remove POPs (PCBs, organochlorine pesticides) and can remove PFAS please ask your fish oil manufacturer for a Certificate of Analysis for PFAS, very few will be able to provide it.

Q: What are the most common toxins used on golf courses in the USA? Glyphosate and 2,4-D?
A: Golf courses have 2-4 times the pesticide use of agricultural land, herbicides are commonly glyphosate-containing but yes 2,4-D as well.

Q: Could you comment on the use of apheresis use for chemical and other toxins?
A: Therapeutic apheresis for chemical toxicity is only available in Germany right now and one or two places in U.S. I have never had to use it if able to use sauna, colonics, IV nutrients, chelation.

Q: Does plasma donation help with detoxification of any of these toxins?
A: Yes, it does lower blood levels of PFAS, this has been published by Stephen Genuis MD.

Q: I’ve heard that using Data on your phone is less EMF exposure than WIFI. Is this true?
A: Yes, cellular data doesn’t have same exposure as phone searching for a Wi-Fi signal.

Q: Does the blood removed from phlebotomy treatment for pfas get donated? Do you have to let know not to use the blood?
A: You are way ahead of the rest of the medical world, but no one can’t donate blood and then tell the blood bank not to use the blood, they won’t listen to you.

Q: Would you please repeat the company name who is using plant based can lining?
A: EDEN foods.

Q: Can you comment on natural cholestyramine alternatives as a binder for PFAs and other toxicants, such as beets and okra?
A: Sorry for any confusion but CSM is only agent that has been shown to reduce PFAS, foods will not do it Genuis also published this data.

Q: Milk cartons – are they a source of BPA type exposures? Is the fact that milk is cold a reliable protector for humans, or are we getting gradually poisoned by such packaging?
A: BPA in food contact materials: cans (beverage and food), hard plastic water bottles, no BPA in tetrapaks (milk, soymilk, almond milk, etc.).

Q: Melamine is frequently used in children’s dishes. Is melamine also toxic even if not microwaved?
A: No

Q: As an ND, I love castor oil packs for detox. Is that something you still recommend?
A: Sure, castor oil increases lymphatic flow, but then lymph has to clear blood, kidneys and intestines.

Q: What is your optimum cholestyramine dose and frequency of dosing?
A: Standard dose 4 grams qid, not realistic for patients due to need to dose in between meals. 4 grams bid at bedtime and on waking will do the job.

Q: Where can we find more of your past and future webinars online?
A: Emeiglobal.com or National Association of Environmental Medicine (envmedicine.com) we also have some lectures on YouTube.

Q: What is the lab that measures PFAS for free? What is the lab that measures BPA?
A: PFAS for free will be done by public health depts. If local water levels are high otherwise no free testing. Millionmarker lab does BPA, BPS, BPF.

Q: Did you know Theo Colborn? Please let me know.
A: Yes, Roy I was fortunate to spend time w Theo for a few years before her death, we both live in gas and oil fracking areas in CO, and she was very active in addressing exposures from fracked gas and oil wells. I was very fortunate to know her as a colleague and friend, feel free to email me.

Q: What suggestions would you have for those with histamine intolerance or mast cell activation disorder and want to use a sauna? (Generally, heat can cause issues in those disorders)
A: Bowel tolerance vit. C (L-ascorbate like that made by Perque) or using C Cleanse and luteolin Also keep heat down around 100.

Q: Do you think we should take glutathione every day for the long term? Or should this be in bursts?
A: No idea why “bursts” would be a good idea, please explain that. Oxidative stress is constant so- no glutathione = massive oxidative damage = mitochondrial damage = tissue and immune damage.

Q: What is your opinion regarding the work of the Weston A Price Foundation?
A: Theoretically eating ancestral diets is a great idea. Sadly 80 years of persistent pesticides and organic pollutants like PCBs and PFAS have caused mammal fat to be a depot for toxicants. Butter, farmed fish, and beef have high levels of PCBs: cardiotoxic, immunotoxic, thyroid disruptors, reproductive toxicants.


Q: Does freezing foods 24 hours (like grains, nuts, and coffee) kill the mold?
A: The issue is not the mold in the food—it is frequently not there due to processing. The issue is with the mold toxin. Freezing food does not destroy mold toxins. Only cooking to temperatures over 500 degrees will destroy most mold toxins

Q: Have you seen a patient with a VCS that is normal with an OAT or Mycotox that is abnormal?
A: Yes. The presence of a mold toxin does not mean that the person is reacting to it. Most people can have mold toxins in their system and not be sick. The Mycotox would be abnormal with a normal VCS. The OAT is a bit more complicated. Mold markers on the OAT are an indicator of colonization—this is abnormal, and a person is going to have an abnormal VCS—I don’t think I have seen a normal VCS with an abnormal OAT.

Q: Do you have a recommendation for a good vagal nerve stimulator?
A: I have not had great success with these. The one I use is the Alphastim—it clips to the ear lobe. It can also be used peripherally for localized pain.

Q: Are those that are most sick usually have the genetic predisposition? Sometimes when test couples when one has cognitive decline, other spouse feels normal but has exposure on testing.
A: Cognitive decline is almost always linked with ApoE4 variants (along with ApoC1 and TOM40 variants). This has to do with the brain’s ability to detox. Illness is always the intersection of genetic predisposition and the environment. Enough toxicity and everyone gets sick (think Hiroshima). Little enough toxicity and no one gets sick. Everything else is on a bell curve.

Q: Could low serum sodium secondary to mycotoxins be due to suppressed aldosterone?
A: Yes. This would typically be tied to low cortisol and ACTH levels (measure aldosterone in the morning along with cortisol). For most of my mold patients, the issue is not the adrenal cortex (aldosterone) but pituitary signaling (low AVH). Almost always, I will have a high osmolality and low AVH. Low aldosterone would specifically lower sodium but shouldn’t raise osmolality.

Q: Do you have a MARCON test that you recommend?
A: I think the lab we use is MicrobiologyDx—we do the swabs in the office.

Q: What are the best binders for Aspergillus, Penicillium, and Citrinin molds?
A: This table is from a 2014 Townsend Letter on Mold and Mycotoxins. I think Neil Nathan was one of the authors.

Q: Is there less toxin exposure when granular forms of herbicides are used on landscapes rather than sprays?
A: Anything that prevents it from getting airborne would help. You still have the issues of contaminating ground water and absorption through the skin if you work the soil afterward or walk barefoot in the area. Not ideal, but better.

Q: Can you review briefly whether mold toxins need to be commonly considered in treating patients living in all climate types, including semi-arid and arid weather regions?
A: It is less likely, but most arid and semi-arid regions are hot, and people have air conditioning. This offers an avenue for mold to enter the house (there is plenty of mold in Las Vegas, but it is nothing like Michigan).

Q: What may be the biological mechanism of substantial multiple food/chemical/odor sensitivities? When the response does NOT look like IgE mediate, but may be within a few minutes to an hour? Thank you.
A: Cell danger response/immune activation leading to autonomic dysfunction. The cell danger response can be set off chronically by infection, a toxin exposure, or emotional stress. Once that is turned on long enough, you get autonomic dysfunction and become hypersensitive to everything. The key is brain plasticity training—DNRS (www.retrainingthebrain or the Gupta Program (www.guptaprogram.com) are the two that I use. Trying to treat with avoidance is too difficult. This tends to work better than desensitization for those types of sensitivities.

Q: Do you see cardiovascular symptoms with mold and mycotoxins, like poor circulation, cold hand and feet, Raynaud syndrome, etc.?
A: Yes—chronic activation of the cell danger response/immune activation will ultimately cause damage to the endothelium and vascular dysfunction. It will also induce autoimmunity in a susceptible individual.

Q: Assuming they could find such a place, would a 2-week test of living somewhere else and feeling better be a reasonable screen for mycotoxicity in patient with suggestive tests who wants more certainty before spending $tens of thousands on remediation?
A: This is true, if you can find that place. I typically send people to live on a beach for two weeks (preferably in the Caribbean). Even though there may be mold, the air circulation with clean (ocean) air takes care of that.

Q: What is a water fast?
A: ? taking nothing but water (no juices or other nutrients). I typically would do this for 3-5 days and only if I think the individual can handle it.

Q: Would you recommend the Mold IgE test for future antibiotic use for chronic individuals?
A: I have never done that. I have no experience

Q: Can you recommend an ozonator for furniture/etc.?
A: There are many. DMRSUP has one for about $100. You need a generator that has a hose that you can use focally on furniture or feed into a box where you have books and the like to be ozonated.

Q: Can UV light kill mold instead of using ozone?
A: UV light will kill mold, but not mold toxins.

Q: Do you advise Glutathione provocation prior Mycotox testing? DMSA prior heavy metal testing?
A: No on the glutathione. For heavy metals, I do a first mornings urine as the unprovoked sample, give 2000mg of DMSA and collect urine for 6 hours for the provoked sample. I then compare the two.

Q: For your workup list, can you please mention how you test for these things? i.e., what lab you like to use.
A: Sorry, this is too general. I use Mosaic Diagnostics for Mycotoxin and OAT testing. Not sure what other labs they are talking about.

Q: How to measure IP flow and NK cells?
A: Any lab can do this. CD3=T cells, CD4=T-helper, CD8=cytotoxic T cells, CD19=B cells, CD16/56=un-activated NK cells, CD57=activated NK cells. Check your local lab for how to order. Cyrex labs also has an much more in depth panel called a lymphocyte MAP.

Q: Does inactivated MSH, as you mentioned with mycotoxins, have anything to do with melanocytes in the skin (i.e., a patient with small patches of vitiligo on shins…. normal thyroid workup)
A: Vitiligo is an autoimmune disorder. A person can be pale if they have chronically low MSH, but it shouldn’t cause vitiligo.

Q: Do you use the nasal culture to test for intranasal fungus, bacteria, and Marcons and how successful do you find the recommended intranasal antibiotics or antifungals?
A: Yes, I use the nasal culture—not the most sensitive for fungus and mold. I use the intranasal sprays—treats most people.

Q: How do you treat the MMP9, C4a, and TGF𝛽?
A: Eliminate the mold exposure, fix the gut and the diet, use binders. These are makers of immune activation—I don’t treat them directly.


Q: Can you please confirm that the patient MUST be eating all the foods in this IgG xMap test for 6 weeks prior to taking the test?
A: I confirm that.

Q: When doing a retest, do you recommend having the person reintroduce prior reactive foods before testing? I’ve seen patients test low because they avoided a food for 6 months, but when the reintroduce it after retest and have it several times, they react.
A: If a person has a very high value for IgG antibodies against a particular food, immune memory cells store that information. That person should probably never eat those foods again on a regular basis. Retesting is probably useful only for new allergies, not for previous allergies.

Q: Is sheep or buffalo milk also closely related to cow with respect to IgG?
A: Yes, there is considerable similarity among the milk of all these species and likely cross-reactivity.

Q: How much of gluten sensitivity is related to use of round up or other pesticides causing a toxic exposure rather than a direct reaction to gluten containing foods? Some people report ability to tolerate gluten products when they travel abroad.
A: The food map test will not react to glyphosate so any positive is a reaction to the protein sequences of the foods. The failure to react abroad is likely due to elimination of the food at home and reduced immunity. The occasional exposure when traveling is not enough to trigger a reaction.

Q: Is the IgG testing sensitive to food that the patient has not eaten in months to years? How long does the IgG last in the system?
A: See question 2.

Q: Are molds often present in chocolate, like they are in coffee beans?
A: Virtually any food can develop mold, but coffee is a more common source because it the beans are washed (called fermentation) after harvest, making mold growth more common during this washing and subsequent drying.

Q: Do you recommend any special preparation for the test- eating broader variety of foods – 1-2 days prior the testing?
A: Eating foods a day or two before the test is unlikely to affect the test. Basically, the person should be told to keep the same eating habits before the test.

Q: Can mold mediated Congestive heart failure, with Mito damage be resolved?
A: I suspect that most mold damage can be reversed.

Q: Does the Food Map test meat glue and cooked forms of foods?
A: The allergic reaction is mainly due to the sequence of amino acids in the proteins which does not change with cooking. All food protein, cooked or raw, pass through strong acid in the stomach, and a range of digestive enzymes in the stomach and small intestine. It is likely that these factors are much more important than cooking. Mosaic Diagnostics test checks for meat glue.

Q: Foods are altered by digestion. How do your food antigens you use correspond to what the body is seeing?
A: See question 9.

Q: Will this test help clarify how to address intense sensitivities (that do NOT present clinically as allergies) to multiple foods?
A: IgG food allergies do not (usually) cause histamine reactions like IgE allergies but are associated with a large variety of clinical symptoms such as migraine headaches, irritable bowel, depression, psychosis, seizures, autism, attention deficit, and many others.

Q: How is this compared to a different from Cyrex labs testing?
A: Mosaic Diagnostics test covers milk allergies, is covered by some insurance, and can be done on dry blood spots. Cyrex no.

Q: If IgA deficient individuals have frequent eye infections, is that also the case for patients with frequent upper respiratory and GI infections?
A: IgA deficiency likely increases susceptibility to respiratory and GI infections and greatly increases risk of autoimmune diseases.

Q: What would be the next step or test for someone who clearly has symptoms to a particular food but the IgG Food Map is negative or low?
A: Try an elimination of that food and see if symptoms clear up.

Q: Is this food allergy test effected by cans food it packaged in (BPA can linings ) and / or plastic containers?
A: The test only measures reactions to proteins in the food, not additives.

Q: Do you think that A2 milk would be better tolerated by these patients with Autism?
A: Yes.

Q: Do you find that patient’s IgG Food Sensitivity panels show elevations of foods they eat often?
A: For the food test to be positive, the person must eat the food often and have an allergic reaction to it. I eat hamburgers almost every other day but do not have an IgG beef allergy.

Q: Does the food sensitivity testing include any dietary guidelines for patients such as hidden sources of the foods and a rotation plan?
A: Mosaic Diagnostics includes a rotation plan with the test. I am not a big fan of rotation diets. I think you should completely eliminate any food that is strongly positive.

Q: Do you have any data on how sensitivities change with a GAPS diet?
A: The GAPS diet will not change food allergies any differently than any other elimination diet.

Q: How long do you recommend someone avoid gluten in an elimination challenge?
A: I think that gluten is such a common element of most diets that most people are not going to adhere to an elimination diet for at least one month. The food allergy test is much more convenient and gives information on all foods, not just gluten.

Q: How do you decide when to rerun the IgG test? how often is it different?
A: See question 2.

Q: Will IgG show in the blood spot if food has been eliminated for an extended period of time (months or years)?
A: No.

Q: What is the clinical usefulness of the IgG C. albicans result as part of the IgG Food MAP?
A: Candida is a common exposure and carbohydrate control is necessary to control Candida which makes it useful when selecting diets.

Q: Do you recommend three days on and three days off or something like that for moderate reaction to food IgG?
A: Each patient will likely have to determine themselves the degree of improvement in an elimination diet and whether the food restriction merits the restriction.

Q: Do you see a reduction in IgG response on repeat IgG food test after decrease in Toxin load in general (removing mycotoxins, metals, etc.)?
A: I have not evaluated such experiments.


The tests discussed throughout each workshop are all used to help identify exposure sources and biochemical imbalances in individuals with chronic health conditions. The Organic Acids Test (OAT) contains multiple markers which may be influenced by environmental and mold toxins. Often, the combination of the OAT, MycoTOX Profile, and GPL-TOX Profile can be used to help identify how a patient might be getting exposed, as well as assist with correlating their symptoms back to these sources. Determining the underlying causes of chronic illnesses for patients is the key to integrative medicine, not just treating the symptoms. The Mosaic Diagnostics continues to find new ways to detect these causes of many illnesses and study the correlations between the results and conditions.

Registration includes:

  1. Ability to purchase MosaicDX tests discussed throughout the program at special workshop-only discounted rates.
  2. 60-day access to the full conference recordings.
  3. Permanent PDF access to each speaker’s slides.
  4. The option to purchase continuing education credits (5 credits per day), whether you attend in-person, watch Live Online, or watch the conference recordings at a later date! See detailed information about credits.
  5. An interactive Workshop Hub website where you can live chat and network with attendees and ask questions to the speakers.
  6. And last, but most certainly not least, qualified practitioners will receive a free OAT.

Register for Upcoming Practitioner Workshops – CME Available!