Answering Questions About Gluten, Mold Detox, Genetic Testing, Fecal Transplants, and More!

By Dr. Susan Tanner, MD

Today seemed like a good day to address a few of the questions sent to me following the publication of some of the recent articles that I have written for Sinusitis Wellness. Each question is a great topic for an entire article in and of itself as our readers are incredibly informed, but, in an effort to reply as quickly as possible and to help more than just the asker, I wanted to feature my answers here as a Q & A article for a wider audience to be able to see. I hope you find this informative–I am of the mindset that if one person has a question, countless others do too!

Do I need to go gluten-free to heal from mold illness?

One of the things that I remind my patients of in treatment is the importance of reducing the “total body load”.  Part of that load is inflammation, which can be caused by a multitude of factors.  We know that gluten is a large molecule found in wheat, barley, some oats, and rye.  With the prevalence of genetically modified grains, the glutens are altered somewhat and have the propensity to be more difficult to assimilate.  In mold- and mycotoxin-injured patients, there are combinations of effects on digestive functioning including a decrease in pancreatic enzyme output to increased immune reactivity in the lining of the small intestine.  Therefore, consuming gluten in these conditions can lead to more inflammation.  Additionally, there is a molecular similarity between gluten and the glucans in the cell walls of molds and candida, which may render gluten more apt to cause an allergic-type response.  While everyone is different, it does appear that going gluten-free, at least until the mycotoxin and mold load are lowered, can contribute to healing.  Most grains have a higher glycemic index anyway, and in an effort to keep that minimized avoidance of gluten-containing foods is also helpful. Over time, some patients are able to add gluten back into their diets, preferably in non-genetically modified forms.

What are your “go-to” mold detox supplements?

While we do try to be very individualized in our treatment of each patient and recognize that genetics may play a role in how we treat, there are a few things that I feel are safe to recommend to almost everyone who needs to reduce mycotoxins in the body.  These recommendations are made based on the assumption that ongoing exposure to mold is being eliminated. It is hard, or impossible, to completely detox from mold if the influx has not been halted!  With that, I would say that the very basics (and this just refers to detox, not to other health support)  would include Glutathione, combinations of herbals for liver detox, such as Myco-Detox, N- Acetyl Cysteine, and mineral compounds containing selenium, zinc, and magnesium.  When taking these, I also recommend the use of a binder to soak up the byproducts released by the liver. Chitosan or a combination binder containing compounds like charcoal/clay helps to do this but remember to take them a few hours away from other supplements.  I think of this as sort of a baseball scenario: You “pitch” the toxins out of the liver then “catch” them with the binder to take them around the bases and home or out of the body. Certainly, this is not all there is to detox, but this is a start that can get the process going.  Many other things help and may depend on the size of the load, the sensitivity of the patient, and the specific genetics involved.

Is genetic testing beneficial if you already know you have mold-triggered illness?

This is an interesting question, and again, may not have a one-size-fits-all answer.  I have had many patients who have done genetic testing which identify a particular pattern or SNP (single nucleotide polymorphism), indicating that the genomic sequence is altered.  However, this alteration does not always present itself symptomatically, so is important to not just treat what we think the alteration to be but only how it may be manifesting.  There are blood tests that can be done to see whether this is the case or not. Some years back there was quite a bit of writing about the “mold genes” with the assumption that people who had these genes were more prone to become ill from mold than those who did not.  I followed along this pathway for some time and found many patients who did not have these mold genes who were quite ill from mold exposure and others who did have them seemingly unaffected.  I do think that there is a basis for genetics and the relationship to mold illness, but I don’t think it can be defined as one gene or one set of genes.  For this reason, I insist on a complete history of every patient, and genetics really only enters the picture if certain biochemistry is not responding in an expected way to treatment.

Furthermore, I would never want a patient who identified as not having one of these mold genes to assume that it is safe for them to have toxic mold exposure! Mold exposure or living in an unsafe indoor environment can ignite many different health problems because mycotoxins are poisons and, with prolonged or acute exposure, cause the body to react as if it is being poisoned. I think we can ALL agree that poison is not safe for ANYONE, regardless of their genetic makeup.

Regarding the recent article on Clostridium difficile infection, have you found that FMT could be used for not only treating this infection but other patients with ongoing gut dysbiosis?

For those of you who do not know, FMT refers to a fecal microbiota transplant.  This involves taking a small amount of stool from a very healthy person with no bacterial or yeast overgrowth, mixing with saline and filtering it, then introducing it via colonoscope into the intestine of the patient who has a GI infection that they cannot clear.  While the most common infection treated in this manner has been c. diff, at Mt Sinai in NY,  this method has also been used in treating patients with irritable bowel syndrome (which we feel may be due to yeast), Crohn’s disease, and ulcerative colitis.  Screening of the donor is, of course, of utmost importance, but truthfully this procedure is quite a low-risk one and relatively inexpensive. As repugnant as many feel that it may be, it actually has been life-saving in some circumstances.  Of course, the simultaneous use of probiotics and immune-supportive products for the gut is a very helpful and necessary adjunct to FMT treatment.

I had elevated mycotoxins on my urine test in the past, then I completely remediated my house. However, my repeat mycotoxin test still shows elevated levels.  Where are they coming from?

I know that it is frustrating to do all that work on your home and still see the presence of mycotoxins!  A few things I would suggest that you do:

1. First, use mold plates to check your clothing and furniture to see if there are residual molds in these items.  If so, then they need to be either discarded or properly cleaned, then retested.

2. If everything in the environment has been checked out and is ok, then the other thing you may need to do is a CT scan of your sinuses.  It is possible that a fungal ball could have formed in your sinuses during the time of your exposure.  Because some of these sinuses don’t drain directly out the nose, you can sequester spores and form a fungal ball.  The mold there continues to produce mycotoxins.  If this is the case then treating with prescription antifungal medication via a nasal nebulizer may be necessary, and if still to no avail, surgical intervention may be necessary to remove this.

I hope you found the answers to some of these recent questions helpful in your journey to healing.  Sometimes answering one question may lead to others, and I hope to expand on each of these topics in future newsletters!

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