Newsletter #26 10 Common mistakes in the diagnosis and treatment of mold toxicity
As I continue to consult with patients and physicians from around the world,
I notice common errors in the diagnosis and treatment of mold toxicity and I
thought it might be helpful to summarize them:
1. Make the right diagnosis. Be sure that the patient’s symptoms fit
with the diagnosis of mold toxicity. Check that they have a history of
mold exposure, even if in the remote past. Even if you have run a
urine mycotoxin test and it is negative, remember that mold toxicity
interferes with the body’s ability to detoxify, so an initial test may be
low or negative, but will show elevated levels after you institute
empirical treatment. Keep in mind that Bartonella and Lyme disease
can present with similar symptoms.
2. Make your mold diagnosis as clear and comprehensive as
possible. If you are only using one laboratory, you will often not get a
complete picture of what your patient has and your treatment will be
incomplete as well. Remember that RealTime and Great Plains
laboratories use different technologies and have different strengths
and weaknesses. If you use both, you will have a much better
overview. Other labs have recently entered the market but we have not
found them to be anywhere near as accurate or clinically useful as
Great Plains or RealTime.
3. Consider other compounding medical conditions early in your
plan of treatment. Sensitive patients will usually have developed
limbic dysfunction, vagal nerve dysfunction, and mast cell activation
syndrome. Failure to recognize these may prevent your patient from
making progress until they are addressed. Other conditions, while a bit
less common, should also be looked for, such as cervical trauma
fibromyalgia, jaw dysfunction and porphyria. These may also need to
be included early on in treatment to optimize treatment.
4. Utilize a complete binder program—when the patient is ready. If
you start binders too soon in many patients, before you have
addressed the limbic system, vagus system and mast cell activation,
taking binders may make the patient worse. Along similar lines, if you
add binders all at once, or in doses that are too high, many of your
patients will experience a severe worsening. This is one the most
common mistakes and unfortunately will sometimes result in the
patient giving up on treatment. GO SLOW and follow your patient’s
response carefully. Be sure that you are using binders that will cover
ALL of the mycotoxins found on urine testing. Using one or two will
limit treatment success and the patient will often tread water until
your binder program is comprehensive.
5. DON’T ADD ANTIFUNGAL TREATMENT UNTIL THE
BINDERS ARE OPTIMALLY PRESCRIBED. Again, one of the
most common mistakes that I see are when practitioners add
antifungal treatments, prescriptions or herbal, before the binders are in
place. Killing mold or Candida before binders are in place often
result in a severe die-off reaction which can last for weeks or even
6. Make sure that the patient checks their home, work or car for
mold from the onset of treatment. While patients are often afraid of
the financial implications of having mold in their homes, failure to do
so will prevent improvement. Patients cannot get well if they remain
exposed to mold. Be sure that whoever is doing the evaluation is
doing more than air sampling, which is not adequate to tell a patient if
their home is safe.
7. Listen to your patient. If they notice any worsening from any aspect
of treatment, they are probably overdoing it. Continuing to do so will
make them progressively worse and may require months to undo.
Checking in with patients on a regular basis, including email reports,
is necessary to do this properly. A common mistake is to tell a patient
that they should stick with treatment until their worsening symptoms
ease up is unlikely to be helpful.
8. Be careful about the timing of the treatment of downstream
issues, such as methylation compromise or mitochondrial dysfunction.
If you attempt to treat that early on (while the patient is in the Cell
Danger Response 1 mode) it will either be unsuccessful or make them
worse. They must improve significantly before they can respond with
benefit to treatments for methylation or mitochondrial dysfunction.
9. Be careful with glutathione. While many patients get clear benefit
from using it, many of our sensitive patients will mobilize their toxins
far beyond their ability to process those toxins and get worse. Please
10. Failure to add antifungal treatment when needed. Once binders
are on board, if patients are not improving and their urine mycotoxin
tests are not decreasing, it is likely that they have colonized mold in
their sinus and/or intestinal areas. Most of these patients will not
improve until you add nasal and oral treatments for colonization.