Why Mold Illness May Start in the Gut (And What To Do) | Dr. Pejman Katiraei
In a Nutshell
Mold toxins from water-damaged buildings damage the gut by entering the bloodstream and bypassing intestinal barriers, which disrupts the microbiome, allows Candida to become pathogenic, and creates leaky gut. This leads to a secondary wave of bacterial toxins that cause systemic inflammation, neurological symptoms, and persistent illness long after leaving the exposure. Treatment requires first identifying and remediating the environmental source, then calming immune activation (mast cells, inflammation) before using antifungals like itraconazole to restore gut integrity.
These notes were generated by AI and may contain inaccuracies.
One study found that 37% of patients who suffer from unexplained digestive symptoms have fungal growth in the intestines, making it almost as common as bacterial overgrowth in the small intestine (SIBO) in this group. People who undergo frequent tests and treatments for SIBO, whether with herbs or antibiotics, may see some improvement then relapse. This incomplete response can be an indication that fungal overgrowth is present.
Environmental exposure to fungi can have an exploitation rear port via inhalation, then transition via bloodstream and taking this rear track to colonize the intestines by bypassing the natural immune barrier of the intestines. When this happens, it can contribute to chronic inflammation, intestinal leakage, microbiome disorders, which may lead to repeated SIBO infection, and transformation of Candida fungus to a more harmful and destructive form. This might help explain why some people continue to suffer from frequent bloating, food sensitivities, fatigue, brain fog, anxiety, or other unexplained digestive and systemic inflammatory symptoms, despite repeated treatment for their intestines.
Dr. Pejman Katiraei is a certified pediatrician and certified integrative medicine physician with training from UCLA, Western, and Loma Linda universities. He specializes in treating children who suffer a lot, some of whom have congenital problems. The same problem also occurs in adults.
This is a very serious matter of importance that is not sufficiently appreciated in the field of functional medicine, and certainly in traditional medicine. When Dr. Katiraei started working in this field about 12 years ago, he thought he understood mold exposure, saying he knew what mold was and what these toxins were. Through one of his cases and learning from Dr. Neil Nathan, his eyes were opened to the truth.
Dr. Katiraei claims he has not encountered any other environmental exposure that approaches even from what mold can do in terms of damage to human physiology as a whole. The percentage of exposure is 30% at minimum, and up to 50% of residents in the United States, and unfortunately the situation is not better elsewhere around the world in Europe and other countries.
Mold toxins disrupt the microbiome, disrupt the digestive system, lead to systemic inflammation, confuse mitochondria completely in some cases, and relate to how the electron transport chain works. They cause nervous system inflammation, lead to death of nerve cells, so brain cells begin dysfunction. The list of problems that could happen is long.
Fungi are a broad category that includes molds, which are more complex multicellular organisms, while Candida is simpler but can be equally harmful. When doctors say mold cannot cause disease, they are absolutely right that mold spores rarely cause disease beyond some allergies and congestion. However, when there is excessive moisture where humidity reaches 90%, without air conditioning, or when the air conditioner is exposed to contamination, or a leak or flood occurs, this excessive humidity leads to complex microbial growth including a large range of mold, in addition to positive and negative bacteria.
Mold releases a range of toxins called fungal poisons, which disrupt mitochondrial function, disrupt the blood-brain barrier, stimulate infections, cause all kinds of strange things, and lead to intestinal disorders. Negative Gram bacteria that grow in these environments release internal bacterial toxins, and many lipopolysaccharide. Positive Gram bacteria release strange compounds such as phenomycin, which is a poison used in research laboratories around the world to stimulate mitochondrial disease injury. There are also volatile gases released by microbes, molecules that can stimulate inflammation, and fungal compounds such as beta-glucans.
The total reaches more than a thousand materials when combined that are literally released into the environment and breathed in, where each performs one or more harmful effects. Traditional sciences fall into the mistake of saying one mold alone cannot cause harm, which is true, but when inhaling more than a thousand molecules, gases, poisons, and compounds at the same time, the extent of the resulting damage is extremely concerning.
Common signs in adults include feeling unexplained exhaustion or mental fog. They suffer from allergies, cough a lot, wake up suffering from congestion, or adults get strange sinus infections. Adults often say they thought the reason was being a parent, or mental fog and memory loss due to advancing age, despite being in their late thirties or early forties. They print with a lot of these things, and half the time adults do not realize the extent of their exhaustion, saying this is simply part of life and needing five cups of coffee to start the day.
In children, it appears first as a strange level of emotion. These toxins stimulate inflammation in the nervous system, resembling pouring about 15 cups of caffeine into the nervous system. These children cannot calm down, which is evident as a form of colic in the early stages of their lives, actually a response of early sympathetic nervous system hyperactivity. It can appear in children who suffer from sleep disorders, taking half an hour or an hour to go to sleep, waking up in the middle of the night or at dawn. They feel only through emotion, are moody, fast exaggerated response. Adults are normalizing these things too, saying some children simply suffer from sleep problems, or are somewhat moody, or quick to emotion, or somewhat sensitive.
Sensory distortions that some of these children suffer from include feeling exhaustion if the environment is very noisy, having problems with clothes, becoming selective in their food. All these are aftereffects that can result from this exposure. In addition to allergies and recurrent ear infections, where the child gets sick repeatedly. These are some things that should raise a red flag that this is not normal.
In children, usually within the first month to third or fourth month as an extreme limit, something begins to change. The child begins to become more emotional, their sleep becomes strange, they now start getting ear infections. The child who was not suffering from any diseases is now taking antibiotics. So usually it's somewhere between one month and four months depending on the child and his physiology and also the degree of toxicity found in the environment.
These exposures and toxins can stimulate an allergic reaction, definitely yes. But where this allergic response appears is virtually variable. In some children it appears as chronic runny nose, sinusitis, respiratory problems, or frequent attacks of bronchitis, until they develop asthma, and all these cases appear respiratory or nose, ear, and larynx allergies. In other children, symptoms appear actually on their nervous system.
Dr. Theo Theoharides is an expert on mast cells who has published around three hundred or four hundred research papers. One of the fields of Dr. Theo's focus is how allergic mast cell response appears in the nervous system. He was one of the first to call autism an allergy response of the brain, and published a research paper together about how this allergic reaction interaction should appear exclusively in the nervous system. So the child may not suffer from any true respiratory problems, while one of his siblings may be suffering from that.
There was a child who was fine a year or two ago, was developing naturally, speaking clearly, appeared to be in good health, and suddenly began to show symptoms of autism. One of his siblings or his parents are suffering from nose, ear, and larynx allergies, but that allergic response in the nervous system can appear in a completely different way.
Not all children who are exposed to mold suffer from digestive system problems. Some children begin developing strange intestinal problems. In young infants, severe reflux is considered one form of presentation. Then in these infants, because their intestines began to tremble and create their intestinal barrier, they begin to get infected with food allergies. So these are the children who begin suffering from acid reflux. If the mother is breastfeeding naturally, she is forced to exclude gluten, dairy products, corn, and all kinds of other things. Some of these children end up using anti-allergy or even primary formula.
In older children, a similar presentation appears where the child was doing very badly well, no major problems, and suddenly after 6 months or a year, they develop food allergies, certain types of allergies, and suffer from constipation and diarrhea. This can also be translated to the skin. When you have immune cell activation in the intestines, what do they do with the skin? It begins appearing in the form of a strange skin rash, begins appearing in the form of eczema. The child was not injured with eczema, and now he developed eczema.
One pattern noticed in adults is that one of the signs that fungi are a root cause of a person's digestive symptoms, whether gases, or bloating, or constipation, or loose stools, or regurgitation, is that they have been diagnosed with bacterial overgrowth in the small intestine (SIBO). There have been a number of patients who were treated for SIBO several times with antibiotics and herbs, getting better, but relapsing later. When examining some of these patients, it was realized that this person had an innate problem and was also exposed to mold. When dealing with that by treating fungal infections, they have a chronic bacterial overgrowth problem that disappears.
The vast majority of the children cared for suffer from an innate disorder as one of the factors of their ongoing digestive problems. Many people believe that Candida is something we get infected with, something eaten that arrived in the gut and took control. But this is not true on launch. Every human being has Candida in his intestines. Candida is a symbiotic organism, which means it is simply part of our natural gut microbes. Most people don't realize that.
If antibiotics are not the reason, and the person's diet was not truly responsible, how is this really happening? These fungal toxins and vitality toxins and the like provoke a lot of infections in the intestines. They stimulate obesity cell activation in the intestines, this inflammation begins distorting the entire intestinal environment. The simile created is that it resembles having a healthy and beautiful garden lawn. The garden is beautiful, the grass grows, and harmful grass has no chance to control. There are some weeds there, correct? All gardens have weeds, but when you have really healthy grass, the weeds have no chance of taking control.
What happens when the grass is not watered well and the sun's heat intensifies on it, then one of them starts spraying acid that kills the beneficial grass, so weeds take control and suddenly dandelions appear? What was seen in clinical work with these patients, who constitute the majority of the work, is that the microbiome of these children who become very ill is completely deformed. And most likely, it's not limited to the direct impact of these toxins. The source of most antibiotics comes from mycotoxins, derivatives from mold toxins, hence the name Penicillin is named after mold Penicillium. But the indirect effect of these toxins is what makes it interesting or terrifying.
It is in reality has changed the entire intestinal environment, and during that time the microbiome begins to change, what causes this morphological change. There is one or two studies cited in the research exploring what happens when you have obesity cell activation as a single factor only. It turns out that all of these microbes such as Candida sense their environment constantly. It is amazing how intelligent she is. She is watching her environment constantly. She constantly checks what is happening around her. And when these signals are received, she actually begins submitting to this morphological change. It transforms Candida from a benign symbiont organism to an attack organism that begins actually secreting compounds such as Candidalysin and Alpha-Lys, which penetrate the tissues to begin controlling it.
When Candida overgrowth or fungal hyperplasia occurs in the intestines, the critical question is how much damage had to occur to allow these fungi and microbes to take control. In water-damaged buildings containing mold and bacterial toxins, these substances are inhaled primarily and then reach the bloodstream. The intestines possess multiple barriers to protect against toxins: the mucous layer, immune globulins, and the microbiome. Normally, these protections allow consumption of rotten food without significant effects. However, the intestines lack protection against toxins already present in the bloodstream.
When toxins are inhaled, they travel through the bloodstream and enter through a back door into the intestinal system. Research shows that tiny amounts of these toxins can cause deep damage to the intestines, leading to intestinal permeability, leakage, and inflammation because they bypass all protective layers and reach the epithelial tissue directly. Mycotoxins function like antibiotics, disrupting the microbiome and causing bacterial imbalances that allow Candida to transform into its more pathogenic, disease-causing form.
A clean, functional community with good residents who maintain the neighborhood can suddenly deteriorate when water damage appears. The good residents begin dying from excessive heat, hunger, or other stressors. With fewer good people maintaining order, the thugs and bad elements gain control, leading to looting, destruction, and attacks on neighboring areas. This mirrors exactly what occurs when the microbiome becomes disordered.
Fungal and bacterial toxins cause bacterial imbalances that lead to more harmful forms of Candida. Candida implants its threads deep into the intestinal lining, causing leaky gut. This creates an open gateway for digestive contents to enter the bloodstream. The disrupted microbiome produces more internal toxins, while Candida generates additional harmful compounds. The intestinal lining becomes thin, composed of a single cell layer that is broken and disturbed, allowing intestinal contents to leak into the bloodstream.
Mold toxicity does not result directly from the toxins themselves. Rather, mold toxins erode intestinal integrity and immune system capabilities, causing a secondary wave of toxicity from within. This secondary wave constitutes what is called mold toxicity. Some mycotoxins have half-lives of only a few hours, while others persist for days to weeks, with a maximum of one month. If someone leaves a water-damaged building, these toxins should disappear within two to three months at most. However, most people remain sick for many years.
Bacterial toxins last only 3 to 5 minutes. The body's primary mechanism for eliminating toxins is the intestines and microbiome. Studies demonstrate that healthy intestinal microbiomes are crucial for detoxifying by breaking down toxins and preventing their absorption. When intestinal barriers disappear, the intestines leak materials that cause overwhelming toxicity. With over a trillion bacteria in the intestines, an unhealthy microbiome significantly increases toxin production.
Three main camps exist in treating mold illness: Richie Shoemaker's camp, Andrew Campbell's camp, and Neil Nathan's camp. Each has a different perspective on the root cause. Shoemaker's approach focuses on biotoxins remaining in the body. However, given the short half-lives of mycotoxins, symptoms persist because of secondary effects on the digestive system. Billions of bacteria produce internal toxins that reach the bloodstream and brain, causing symptoms.
Binding materials such as charcoal, clay, chlorella, and humic acid help because they bind bacterial toxins in the intestines. While they can bind environmental toxins, they are also effective at preventing bacterial toxins from leaking by binding them and facilitating their elimination through the stool.
People with symptoms from water-damaged buildings show extreme sensitivity. They react to laundry detergent departments, experience headaches or fatigue, and develop food allergies. Multiple triggers make them feel unwell. Children exhibit immunological hypersensitivity where almost everything stimulates reactions—they are sensitive to binders, herbs, and probiotics. This reflects excessive immune system activity throughout the intestine, including mast cells. Mast cell activation represents comprehensive immune activation because mast cells communicate with lymphocytes and dendritic cells, stimulating the entire immune system simultaneously.
Neil Nathan discusses how exposure through the limbic and nervous systems causes secondary sensitivity, similar to post-traumatic stress disorder. Individuals react nervously with multiplier effects due to nervous system hypersensitivity. Limbic system retraining and nervous system calming become important secondary factors, particularly with teenagers and adults. Young children do not require this intervention because they remain physiologically pure.
Children diagnosed with autism, PANS syndrome, anxiety disorders, or other conditions share similar underlying pathological mechanisms: inflammation. When inflammation occurs in the nervous system, perception of safety becomes distorted, altering fear responses and what the brain perceives as threats. An insect on the wall transforms from harmless to a tiger about to kill. This manifests as extreme fear, separation anxiety, or panic in some children, while in others, fear transforms into aggression.
All sensory pathways become distorted due to inflammation through multiple factors. Histamine and glutamate levels rise dramatically. Elevated histamine and glutamate cause sleep and appetite disturbances. Food selectivity in children reflects inflammation. Sound perception changes, making surrounding environments extremely noisy. What would be tolerable restaurant noise becomes a torture chamber. Sensory distortions cause children to panic in noisy environments, manifesting as selective mutism or anxiety disorders.
Bacterial toxins including lipopolysaccharides are potent stimulators of inflammation. These toxins reach the brain through a leaky blood-brain barrier and leaky gut. The vagus nerve provides a secondary pathway, constantly sensing intestinal conditions and sending massive information to the brain. Both bloodstream and vagus nerve pathways bombard the brain with inflammatory signals, causing immune system dysregulation that manifests as learning difficulties, attention problems, behavioral issues, and decreased IQ.
In adults, inflammation from endotoxins and lipopolysaccharides in the bloodstream reaching the brain and vagus nerve dysfunction appears as insomnia and anxiety without clear cause, depression, anger, brain fog, and fatigue. When in water-damaged buildings, mold spores enter nasal passages, sinuses, and lungs. Fungal spores can colonize sinuses, creating ideal moist, dark environments for growth. Chronic sinus inflammation is associated with higher rates of cognitive impairment. Studies link chronic rhinosinusitis to autonomic dysfunction.
Richie Shoemaker discusses how certain gram-positive bacteria colonize sinuses and produce extremely harmful toxins affecting the nervous system. Research on adult neurodegenerative diseases examines how internal bacterial toxins provoke neuroinflammation, particularly glial cell activation in Parkinson's and Alzheimer's diseases. This immune activation in the nervous system affects brain cells and leads to neurodegenerative diseases. The same mechanisms observed in adult neurodegeneration apply to what is seen in children.
Dr. Katiraei emphasizes the critical importance of identifying ongoing mold exposure before treatment becomes difficult or impossible. The approach begins with a healthy amount of doubt, as people often assume their homes are mold-free simply because they are relatively new or appear clean.
Two examples illustrate this point. First, a family moved into a newly built luxury home worth approximately $10 million that was less than a year and a half old. When the children began experiencing illness and strange symptoms, the parents initially dismissed mold concerns. After the child's condition worsened, they agreed to professional inspection, which revealed that every door and window had been improperly insulated without proper moisture barriers, causing water to leak from exterior walls during rain and creating mold growth throughout multiple areas of the home.
Dr. Katiraei shares his own experience with his family home. When they first moved in, they renovated the entire house except for the children's two bedrooms. An inspector they considered competent checked the home and declared it fine. However, his daughter developed strange eczema, extreme sensitivity, and became psychologically distressed by sounds, while his young son suffered from persistent diarrhea for the first year and a half of his life despite interventions like removing gluten and giving probiotics.
The problem was discovered to be mold under the insulation in the hallway between the children's rooms, caused by an old roof leak that had been fixed. The inspector had not lifted the insulation to inspect underneath, and this buried patch of mold was making the children sick. This demonstrates how easily mold can be missed in traditional inspection processes.
Traditional inspectors from services like Yelp typically take air samples from one or two areas of the home and may use moisture detection devices. If no moisture is detected and air samples show no problems, they declare the home safe. However, this type of testing can easily overlook mold exposure unless there is catastrophic water damage.
Many caregivers receive consultations from patients who have tested their homes and been told there is no mold, leading them to dismiss mold as a possibility and pursue other diagnoses like Lyme disease while the actual mold exposure continues.
Dr. Katiraei provides evidence-based home assessment guidelines for mold detection that can be downloaded, including recommendations and a few tests to confirm findings from visual examination, along with guidance on when to hire professionals. The link for complete guidelines and recommendations is provided in the presentation notes.
Even without a hygrometer or active water leak, mold can still be present. If a child is sick or a family has strange symptoms, simply being told there is no mold does not necessarily mean it's true. Mold exposure can also occur at school, including in study halls, sports classrooms, or behavioral therapy centers.
The Environmental Relative Moldiness Index (ERMI), or what is known as HERTSMI, was created by the Environmental Protection Agency more than 20 years ago. The test involves using a dust collection cloth from all areas of the home, then sending it to a laboratory for DNA testing to detect remains of potentially toxic mold species.
For most people who cannot find the right inspector or do not want to spend $5,000, this $250 test provides a good initial screening method. Recommended companies include EnviroBiomics and RealTime Laboratories. A key requirement is not cleaning or dusting the home for at least 10 days before testing, as cleaning with natural cleansers can actually prevent capture of DNA fragments.
Finding appropriate inspectors can be difficult. The website isai.org provides a guide for inspectors who understand environmental sensitivity and tend to do more accurate work. This list is considered very useful.
The central HVAC unit must be inspected if present, as it can be a key source of microbial or mold growth due to moisture, potentially spreading mold throughout the house. Not all inspectors will check the HVAC unit, so a specialized AC expert may be needed to open and inspect the unit.
Petri dish testing has been found to be unreliable because mold spores must land in the dish for growth to occur. If contamination exists on one wall but the dish is placed far away, incorrect readings result. However, if the ERMI test indicates concern, purchasing 20-30 Petri dishes to distribute throughout the house can help locate contamination when one room shows significant growth while others do not.
HERTSMI-2, which helped Dr. Shoemaker in its development, is a more accurate means of assessing contamination levels because it focuses specifically on toxin-producing mold and water-loving allergenic mold. A HERTSMI score over 15 is considered the threshold for suspecting contamination, with scores in the thirties and forties increasing the intensity of contamination concerns.
Multiple testing options exist including urine mycotoxin testing, blood mycotoxin antibody testing, organic acid testing, and other complete test panels. The clinic has changed approaches multiple times based on patient experience.
In adults, mycotoxins cannot be measured directly through urine tests because blood levels are not high enough for easy measurement. Bacterial exotoxins are extremely difficult to test because they may have already disintegrated by the time samples are collected and tested.
Several companies have created urine tests that concentrate and measure mycotoxins. However, severely ill children lose the ability to excrete these toxins in their urine, often resulting in completely normal-looking urine test results despite exposure. Additionally, multiple studies show that when dealing with moldy food, toxins end up in the bloodstream and then urine, potentially causing false positive results from foods like peanut butter sandwiches.
Organic acid testing in urine checks body chemistry for mitochondrial problems and metabolic disorders, and can also search for vital indicators of fungal dysfunction in the intestines. While initially used as an essential tool for determining toxin exposure, it was realized that these tests may appear completely normal in 60-70% of children exposed to toxins because they only verify imbalances from the intestines.
Organic acids testing is still used regularly but never relied upon as the primary assessment tool for determining toxin exposure in children.
Mold spores and toxins tend to irritate the immune system similarly to viruses like COVID, Epstein-Barr, or flu, stimulating strong immune responses that can be detected through testing. The settled approach is the test invented by Dr. Andrew Campbell and Ari Vojdani called the MycoLab mycotoxin antibody test in urine or blood.
While slightly more expensive at around $400, the sensitivity and specificity may be better than anything else available. A warning is that 10-20% of children have immune systems that are not perfectly normal due to immunosuppression from these toxins, potentially resulting in normal test results despite actual exposure. However, this occurs in less than 20% of cases, providing approximately 80% accuracy.
There is no dividing line in test interpretation because variations exist in these tests. The clinical picture determines importance, as all tests are subject to error and not up to required standards in terms of full effectiveness. The individual's story provides crucial context, including timing of symptom onset relative to environmental changes.
An hour and a half is spent with each family reviewing the complete history from the moment of the child's birth, including colic, gastroesophageal reflux, food allergies, eczema, crawling delays, loss of eye contact, recurrent infections, autism, learning difficulties, and sleep problems. Environmental exposures like camping trips with tick bites, vacations, lake swimming, or parasite exposure must also be considered.
The story of what happened and how it began provides significant context for determining whether environmental exposure can explain the entire situation. The intuitive sense that symptoms match mold exposure patterns is considered more important than any single test result.
There are different types of mold testing including antitoxins versus antibodies for mold. Antibodies test for the mold itself.
Alletess is a company that offers mold antibody testing at approximately $200 compared to $400 for other tests. The downside is that in children, the Alletess test is not as reliable. Sometimes the Alletess test shows no reaction while mycotoxin tests indicate exposure. In adults, the immune response tends to be more reliable.
The test measures allergic response through IgG response to mold, which explains the late immune response. The panel also includes IgA, which looks at mucosal immune activation in nasal passages, respiratory ducts, and intestinal systems.
When IgA results appear positive for fungi, this indicates the fungi have begun settling somewhere, most likely representing natural colonization. This finding may indicate need for targeted antifungal antibiotics and mucosal membrane repair in nasal passages or intestines.
If IgA results appear positive, it usually indicates something is wrong. When IgA reaction appears in the test, the immune system is still working, which is somewhat reassuring. Children with IgA positive results still face difficulty because fungi have colonized somewhere, and it takes time to eliminate them.
If stool examination reveals IgA levels are nonexistent in the stool, and blood IgA levels are measured, this is an extremely bad sign because it means the immune system in the intestines or mucosal surfaces is completely dormant. These children end up with the most serious problems.
Children in a deeper state of problems are those whose immune system has been put to sleep. These children usually have the most difficult and complex cases. They typically have a thousand types of food allergies, suffer from chronic stomach pain, have had a million ear infections, are sick all the time, and have failed to thrive.
Stool analysis is not reliable for detecting fungal overgrowth or pathogenic candidiasis in the digestive system. A patient diagnosed with Candida in the esophagus had negative stool analysis, demonstrating the mismatch. Fungal disorders don't happen in the far part of the colon where stool comes from, so the test only gives a glimpse of what's happening at the end of the colon. If fungal disorders are higher up in the intestines or proximal colon, they won't appear in stool analysis.
Hundreds if not thousands of stool tests conducted on children exposed to biotoxins and mold were never positive. The test should never be relied upon to detect any type of congenital disorder or fungal exposure.
Urine tests for mycotoxins are not used at this stage. Specific immunoglobulin IgG antibodies with mold are considered more reliable. The framework is still in early observational stages. Simply getting a positive antibody result doesn't mean much without context.
When paired with exposure history or a known source, the framework can be established for thinking about who suffers from fungal problems, fungal overgrowth, or mold exposure. The exposure history is considered and analyzed.
This framework applies more to adults. Looking for ear, nose, and throat symptoms including sinusitis, tinnitus, earache, runny nose, post-nasal drip, and possibly redness or dry eyes. Systemic symptoms include neurological problems, fatigue, and possibly digestive symptoms.
A unique aspect being tested is performing CT scans of the face and jaws for adult patients to check for actual documented inflammation in nasal passages. If a patient has buzzing in one ear or facial pain, and there's evidence of sinus inflammation, plus positive antibodies and exposure history and neurological symptoms, this creates a very strong case.
Reference ranges used are not completely accurate. If the number is greater than two (forgot the unit), the test is considered positive. The approach doesn't rely solely on the result if it's three to conclude mold infection. Levels in the thirties, forties, or fifties speak of more than 20 or 30 times the normal rate. Combined with other framework aspects, this determines whether the person has a mold or fungal problem.
Results are being collected and data is being gathered to publish on the validity of this framework, as reliance on mycotoxins in urine was not sufficient. Almost everyone tested from hundreds of people had positive results, which is not very helpful. The goal is to get some negative results.
Environmental remediation is essential if mold in the environment is contributing to symptoms. Once the environment is addressed and symptoms stabilize, there is an imbalance of bacteria causing leaky gut, immune activation, and systemic inflammation.
The treatment model has changed somewhat since the Substack article was published approximately a year and a half ago. The approach begins by looking at strengthening the child's immune system, then adding a few other things.
Since biotoxin disease's basic root is inflammation produced by the intestines, the protocol begins with anti-inflammatory agents. Two essential supplements include DAO enzyme (diamine oxidase), which breaks down histamine, and a substance called Mira which is lutein with fats called PA that has calming properties for somatic cells and calming properties for inflammation in the nervous system.
The first approach is to soothe inflammation. Treatment of many children using these treatments as evaluation tools showed that children who live in relatively clean environments with light to moderate intestinal infections begin improving with this mix of essential vitamin D, zinc, and miracin, plus digest. This applies to approximately 30 to 40% of children, provided they still live at high toxin levels and their food system isn't bad.
Another 20 to 30% have much higher inflammation levels and severity. These children use medication instead of dietary supplements because this category often doesn't tolerate Mira for reasons not completely understood. These children become more anxious and emotionally affected, and suffer from digestive problems, while responding better to medications.
Mitochondrial support has been introduced at a very early stage of treatment because mitochondrial errors and energy production problems are widespread among these children, affecting up to 80 to 90% of them. When mitochondrial errors exist, immune system disorders occur. Great articles exist about how this leads to worsening mast cell instability, adrenal gland problems, and other things that increase systemic instability.
While treating to calm immune systems, once that is achieved, mitochondrial support is introduced to enhance their system and improve their vitality. From there, the approach moves forward toward literally rehabilitating the intestines.
Cromolyn and Ketotifen are established drugs for somatic cells that primarily help calm hyperactive or shocked cells. This allows for better tolerance of subsequent treatments. The same approach is used with adults. When mold presence is suspected and excessive reaction appears, immunity modification and somatic cell calming begins, including over-the-counter histamine antibodies, possibly cromolyn or ketotifen, and even medications like terzepatide (adults only, not children), which are GLP drugs proven effective for somatic cells.
Moving directly to eliminating fungi in the body without this preliminary work makes the situation generally worse, which has happened enough times that it is certainly not wanted for anyone.
Two most common mitochondrial supports are used. For children who can afford it, many wonderful mixtures are available. The favorite product is from a company called ANRC (Autism Nutrition Research Center), which has ANRC Multivitamin Plus, a truly wonderful combination of B vitamins and all types of antioxidants.
Another great product is from the company called Neuro Needs, which has a compound called Energy Needs that tends to be very effective. For very sick allergic children, treatment sometimes starts with just carnitine and CoQ10 because they cannot tolerate B vitamins in the beginning.
Probiotics are not used because most children seen have very difficult health conditions, and for these children, probiotics are considered risky because it's unknown what their immunological device will withstand and what it cannot tolerate.
Immune globulins, especially purified versions like SBI Protect and Mega IgG, are amazing and definitely used. Sometimes butyrates are tolerated very well and used in the early stage.
Often, once anti-inflammatory drugs start working and handling some nutritional needs, the approach goes directly to antifungal agents, which become just another layer of immune modification and anti-inflammatory treatment.
Itraconazole is an antifungal that also helps modify the immune system. It is a prescription-only medication effective in eliminating fungi such as Candida and mold. The autism community has used this for a long time, and Dr. Andrew Campbell has spoken about this since time immemorial.
Some children, once they get just two doses, begin changing their way of interacting suddenly. They start communicating visually better, become calmer, and more balanced. This change cannot be attributed only to antifungal effects through eliminating fungi because fungi cannot be eliminated this fast, and the entire microbiome cannot be changed in just two doses.
Azole compounds in general are antiparasitic medications used for cancer treatments, and the family to which antifungals and antiparasitics belong actually has amazing immune-modifying properties. Itraconazole is the medication that covers mold more than fluconazole, and it has all types of amazing immune-modifying properties. Through different multiple routes, it actually works as an antagonist to infections inside the nervous system and intestines as well. It has antagonistic effects on fungi that kill Candida and different types of mold that may grow in the body, which promotes antibiotic effects on present inflammation.
Itraconazole has different shapes or structures. The well-known trade name is Sporanox, which if not covered by insurance may cost up to $3000 monthly. There is also the generic alternative itraconazole, which can be obtained at a much cheaper price, perhaps about $60 monthly. There are also vehicle installations where pure itraconazole powder is put into capsules.
The generic alternative works well with patients, and for children, lower doses are prescribed intentionally without reaching the maximum allowable dose, finding it effective. This way, all benefits in the intestines and all immunological device benefits are achieved without exposure to any toxicity.
Itraconazole specifically has some features that may disable mitochondria. The myopathy, heart toxicity, or liver toxicity that may actually be caused is because of its effects on mitochondria. One method of using it involves taking a dose at most one day after another, typically 100 mg daily, because it seems to achieve all good results without causing a lot of toxicity.
Absorption of itraconazole is lower in adults because there are known absorption problems with generic types of itraconazole in particular. A study gave half the group the well-known brand medication and the other half generic medication, and in the generic medication group, only about 27% achieved sufficient levels in the blood, while 73% achieved that with the commercial brand.
Therapeutic drug monitoring is being studied, which essentially examines itraconazole levels in blood after taking the medication for about two weeks. Among the four people tested so far, only one person was within the standard therapeutic range or close to it, and this was the only one who witnessed any kind of improvement. At least with adults tested, monitoring levels in blood is extremely valuable and matched and correlated to some degree with improvement or lack thereof in these individuals.
With the right child at the right time, itraconazole works very well. Some cases showed they did not have an innate problem but had mycoplasma, Lyme disease, or a complete set of other things, and the approach was completely on the wrong path. For the right person at the right time, it works very well.
Children with level three autism, children with excessive anxiety, severe learning difficulties, debilitating abdominal pains, and terrible eczema have turned into completely different humans. Children with autism who were not able to interact or look at someone are now playing with other children. Children who suffered from exhausting anxiety and were unable to leave home have now become social and go out. Children who were failing in school are now among the top students. Eczema that was covering the body from head to foot is now perfectly clear.
The book being written aims to present this understanding and help families everywhere access this information so they can help their children improve.
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