Environmental Medicine: Mold, Heavy Metals & the Truth About “Detox”

So, what if you’re doing everything right? You’re eating right. Your nutrition’s on point. You’re sleeping well. You’re hydrating. And you’re training perfectly. You’re working with your provider to achieve the goals that you’ve always wanted to achieve. And yet, there are these things that are beyond your control. Maybe you’re exposed to mold, heavy metals, or environmental toxins. Man, do we have a story to tell you.

Flying out here yesterday, just being in an airport made me realize how many things you run into in the process of traveling every day that may be not so great. By the time we got to the hotel last night, when I first went in to take a shower, immediately I could smell mold the minute I moved the actual shower head, and then the air conditioner was going and I was all of a sudden starting to get stuffed up. So luckily I had the ability to close or open the window, and that made the difference. Turn the air conditioner off. But it made me realize, wow, I’m in a different environment, something I’m not used to, and how am I going to react to that? And then Zach had a room that was smoked in, and their solution to that was to spray a whole bunch of Febreze in that room. So you can imagine what that must have been like sleeping in there. Craig, give us your take on it, since we’re here in your hometown of Salisbury, Maryland, and the weather is definitely hot, humid, and prone to mold, right?

Yeah. And a coastal town, so it’s definitely the type of thing that is on a lot of people’s minds. Mold, metals, environmental toxins — this is a broad topic and it’s on a lot of people’s minds. A lot of patients that are availing themselves of functional health services will often present with sort of vague, non-specific symptoms of, hey, I’ve got some brain fog. I’ve got some fatigue. I’ve got GI issues and bloat. My joints hurt. I’m getting rashes. Eczema is breaking out. I think it’s the mold. I think it’s the mold in my house. Right? And so it’s up to us as providers to really sort through this whole picture for the patient and figure out, well, is there real exposure there? Because this is an area in modern medicine where there’s a little bit of a chasm between what has been shown to be real, true mold-related illness — we used to see plenty of it in the hospital, where severely immunocompromised patients were dealing with fungemia, or flagrant pneumonias that are related to a fungus — and then there’s this whole other aspect where people are absolutely getting exposed to mold in their environment. It’s ubiquitous, right? And they’re feeling as though maybe they’re having a reaction to it. And in certain situations, they absolutely are. More in the primary care zone, we’re looking at things like allergic rhinitis and upper and lower airway respiratory issues. We’re looking at hypersensitivity pneumonitis in sensitive individuals, and eczema, like I mentioned. But it’s a real issue to say, hey, there’s been an exposure here. How can we tie that exposure to a confirmed test in your environment? How is that relating to the symptoms that you’re having? Do those symptoms correspond to the organism that may have been growing in your environment? Mold is ubiquitous. When it’s indoors, it’s related to a moisture issue, right? As you were talking about with the shower, it’s something that needs to be dealt with. It needs to be remediated. Until it gets remediated, any sort of systemic response to that — and a lot of times that’s immune activation and all the downstream effects of that — is going to be perpetuated. So it certainly is the type of thing that needs to be addressed. And that’s really just scratching the surface with the mold stuff. Of course, we’re going to get into the other heavy metals and whatnot today, but I liked what Kristi said last week. We were talking about tolerance, immune system tolerance. How does our body know not to attack our own tissues, and to let certain processes and certain substances move through membranes without looking at them as foreign invaders or pathogens? And then how do we differentiate between the things that are truly noxious particles, chemicals, so on and so forth? So I am curious, Kristi, in your practice, do you ever have patients that are coming to you complaining of exposure to these things? What does that look like? What is your approach when you’re faced with those questions?

Yeah, I mean, when someone walks into our clinic convinced that toxins are causing all their symptoms, we don’t dismiss them. I listen. We ask questions. What are their exposures? Where do they live? What’s their occupation? I think that’s one of the bigger things that I deal with as far as toxicities and exposures — it’s more so their occupation, just because where we are, it’s a very dry environment. Not to say that we don’t have mold. Is there water damage? What objective findings do the symptoms fit? And do the symptoms fit the exposure, or are we working with potentially another diagnosis? I think one of the biggest problems today is that fear sells better than the facts. Patients are — just like Lexi said when she was here about the hormones — we are stressed out as a society. We are stressed out, and so they’re already dealing with brain fog and fatigue and pain, autoimmune diseases and inflammation. And social media tells them they have hidden mold illness and heavy metal toxicity based on tests that often aren’t validated for diagnoses. And instead of the answer, patients get more anxiety. And then the detox industry has become incredibly effective at creating a problem first, then selling the solution. And fear is profitable. I mean, face it, fear is definitely profitable. If there’s anything that we learned through COVID, that was definitely one of them, and evidence is often less exciting. So what we’re trying to do is have them work through where we might see the problem. It’s not as exciting, but it’s what actually helps patients get better. And to me, inflammation is often the common denominator, in my opinion. Whether we’re discussing mold, heavy metals, poor sleep, insulin resistance, ultra-processed food, or chronic stress, they often converge on the same pathways: oxidative stress, mitochondrial dysfunction, immune dysregulation, endothelial injury, and then just this chronic low-grade inflammation that we see in so many of our patients. Environmental medicine isn’t about just chasing every toxin. It’s about understanding what’s driving this inflammation biology in this patient. And I’m sure, Dr. Ferree, you have tons of experience being in Georgia, where mold is probably significant and you deal with it quite a bit.

Absolutely. That study just came out last month looking at the hospitals in Atlanta, actually, and the mold exposure, which is pretty significant. So we know that there’s about 20 percent of the population that is susceptible to mold illness. And when I’m talking about mold illness from my perspective, I sort of divide it into two categories. There’s the invasive mold, like mold in your body, and then there’s the mold toxin illness that comes from exposure to the toxins that molds produce. And it’s actually kind of a cool thing. We learned this last year when we had a huge flood in my office. It was terrible. We had this environmental guy come in and do our office, and he said, you know that the mold only produces mold toxin — it’s sort of like the old game of Tank — the mold will produce toxins in an attempt to kill off another mold. So you’re only going to have that mold toxin produced when there are two molds in the same environment, which I thought was kind of cool information. The other thing to know is that that smell that you smell is often the biofilm. It’s not the mold itself very often. Often it’s actinomyces, which is one of the bacteria that is a major component of the sort of slimy, protective covering keeping things from being a problem. So you’ll often have these sort of co-infections of the environment with multiple different species, and it’s actually the actinomyces that smells. One of the ways you can get rid of that is with Fantastik, but unfortunately you have to wipe all kinds of things down with it to get rid of it. And you have to get rid of all of it, not just the mold. But if we’re talking about the person’s body, the person’s body either will have a mold in it, or it will have an illness induced by the mold toxin. So those are two different ways to think about it. There is a genetic susceptibility where exposure to the mold toxin or other things — like ciguatera, like lots of other things, probably COVID — will trigger in that person the inability to turn off the complement system. Complement is one of our immune system things. And so there is a 13-symptom catalog of the most common symptoms associated with mold illness, and there is a scoring pattern to show you how likely that is to be the case based on their symptoms. There are genetic tests that you can do. In our office we often will check a C4a, which is part of the complement system. A lower C4a, in the sort of 3,000 to 4,000 range, is more consistent with Lyme disease. A C4a in the 15, 16, 20,000 range is more consistent with mold toxicity. Again, this is not what you’re talking about, like aspergillus pneumonitis. It’s more like the mold toxicity where we see our patients just be really sick. And so we’ll see that level. It’s not a perfect test, because it also can be high in patients who have PTSD. So that’s the complication in this group of patients. But this is why people can live in the same moldy environment and be sick or not be sick. People could be exposed to COVID and be sick or not be sick. And there are specific genetic variants that are associated with that immune system that gets turned on and has a difficult time turning off. The biggest problem with mold illness is that you have to remove the person. I would say you guys probably agree — in treating mold toxicity in these patients, one of the biggest problems is getting them to actually move out of the environment. I remember this guy; I treated him for many, many years. He had this really thick eczema on his face. He was probably in his 50s. He had lived in an apartment up in New York City because his wife had moved down to Atlanta, and he had been exposed to mold in the air conditioning unit in his apartment, and he got sicker and sicker and sicker, to the point where he was unable to continue to do his job as a computer programmer. He could not cognitively keep up with the load. And so he had to move home. They both were sick. They both moved in with the mother, who ended up getting really severe dementia — like, it went so fast. And he was a luthier — he made guitars, I’m doing the guitar symbol right here — and he was making them in the basement of his house. So here’s a guy who can’t work, he’s living in his mother-in-law’s house with this very severe eczema and cognitive decline because of his mold toxin exposure, and he couldn’t move out. This is a real problem for these people, because what do you do? You’re sick; you can’t even have the cognitive presence of mind to do things. So these are complicated cases, and removal from exposure is the number one treatment. The second thing we do is try to bind up these toxins, and we do that with what we call binders, and there are a lot of different ways to do that. Remember that detoxification is a process, not a pill. While there are things that can add to and help the process, this is what the body naturally does. We talked about a lot of those things last week, but things like sweating, things like Epsom salt baths. Epsom salt baths can be very helpful with mercury toxicity, etc. One of the things we use in our clinic is binders, and there are some kind of weaker binders and then there are some stronger binders, and the stronger binders tend to be pharmaceutical in nature. One of my questions for Leonard was: if I’m using a binder, particularly like a bile acid sequestrant, in these patients, what kind of other medications or supplements do I need to worry about also being bound by those bile acid sequestrants?

Wow, that list would be really long. I don’t even know where to start with that. There are so many things when it comes to certain medications you have to take separately from that. That list would be so long. A lot of the medications we can’t even take next to other medications. So my mind’s just going in a million different directions right now with that question. But you brought up so many good points, where getting rid of the toxin is so important. With me, I know right around before COVID happened, I was in this office and there was this sewage pipe that I didn’t know was disconnected. And it was blowing right into the air, right underneath my desk. Every once in a while we’d have that rotten egg smell, and we didn’t know where it was coming from, and we’d call the landlord, and sometimes it would get fixed, and we had all types of issues. And I remember during that time period I got really sick, and I was always coughing something up that was green all the time, and I’m just like, I’m about to get over this thing, I’m about to get over this thing — and I never really did. And it was happening for so long. And finally — we hired our first person; this was the beginning of nuBioAge, actually — and he was in the office with me. It was Ben, and he got a sinus infection, and I kept on getting these sinus infections, and I was like, oh, wait a second, this guy just got a sinus infection. Do you get those often? Something’s wrong. And so we had people come in to do all types of testing, and they went up in there to see if we had mold, and they found the problem was that one of the pipes was disconnected and blowing right over my office. And I was looking at what may cause that, and I think it was the hydrogen sulfide that would cause all those problems. And I remember, just during that time period, I felt like I was kind of losing my mind, because I was losing a lot of weight. My mind wasn’t sharp. I couldn’t make decisions. I was just always sick, and I was always scared too. I thought something was wrong. I thought I had cancer. I was doing every screening possibly known to man. And around that time is also right when I got COVID, at the beginning of COVID. I always prided myself in trying to be resilient, but I got COVID and I got it really bad. And it was because my immune system was already under attack. And then psychologically, I developed all this anxiety, all this stuff that just wasn’t part of my personality. And I remember I did a lot of the things that you were talking about. First of all, you have to get rid of the exposure part, right? And so I had a nice time, because I said, okay, my office is now the beach. And every morning I would take my laptop and my backpack and I’d go to the ocean and I’d sit there, and I did that for weeks, and it was amazing. I was like, I should do this all the time. But it was that, and then you also said sweating a lot — I went to the sauna, the steam room a lot. And then slowly I just kind of got my health back together and got my exercise capacity back up, because I couldn’t even exercise. I didn’t have the energy to do anything. So it just reminds me, for so many people out there that might be having a lot of these symptoms, or think that psychologically something might be happening, or just don’t even know — it’s like this hidden thing that’s happening, and you might go in a million different directions. You start taking all these peptides and you start doing all these things, and everybody’s got the solution for you, and you don’t realize that you’re not taking yourself away from the exposure, right? Because you can go somewhere, and $5,000 later you have so many treatments, so much lab work. But it reminds me of what you guys are talking about, just experiencing that. Because I had never dealt with it — at that time I was so focused on metabolism and exercise performance, and I really got a soft spot for all these other things that I heard people teaching about when it came to autoimmune disease, immune dysregulation, all these things that I had heard about. I actually got to kind of feel what it felt like. Because around that time period, I would get this arthritic pain in my hand, and I went to the doctor and I thought I was losing my mind. I made an appointment with an oncologist at one point. He’s like, “What are you doing here?” I was like, “I just figured I’d go right straight to the oncologist, because I know something’s wrong.” But I remember all these patients that I had talked to before, and all of a sudden their stories became real to me, because it was that constant fear. It was that constant autoimmunity, where your immune system wasn’t right, and psychologically they were off too. And so you as a provider, or as a friend, are thinking they might have a psychological component to their disease. And thinking about that on and off switch of the autoimmunity, and that pain happening in my hand — it was good for me, career-wise, just to be able to experience what other patients were experiencing. And then it just got me so involved in understanding the immune system and immune modulation and peptides and what you can do for patients like that. I think I never would have gone down that route if I didn’t really feel what it felt like. So yeah, that was my experience with this whole environmental toxin thing — just, wow, what a disaster it can really cause.

Absolutely. And the metal aspect is a whole different thing, right? This is a very real exposure, from anywhere — it could be in our food sources, it could be industrial, it could be workplace, the dwelling situation. And it’s another area where I think there’s a lot of hard science, sort of set opposed to some of the mold issues — like I said, there’s a lot of back and forth on that. Certainly, I believe CIRS is a real condition that needs to be treated, and a lot of people do really well when they go through those treatment protocols, like a Shoemaker protocol or something. But metals are a whole different thing. Is this an area where you’re seeing some patients, Kristi?

I guess one that comes to mind — I don’t know if it was metal, but we were getting blamed that we caused kidney disease in a guy that we were giving testosterone to. And his cystatin, I mean, was fine. It wasn’t us. But what it ended up being was he worked at a tire shop. His dad owned a tire shop for years, and now he was the manager of it, and it ended up being just the environmental exposure from the tires. And they were able to get some insurance money from it, because he was really sick. And I think, for me, these patients are hard. And having that humility that you don’t know the answer yet — but we’ll find out together. I always go back to those four major pathways, and just making sure, you know, do I have their immune system right? Looking at the low-grade inflammation that might be affecting them. Sometimes the environmental toxins are the driver, but sometimes they’re only one contributor, and then sometimes they’re not the issue at all. And just having that open mind, and making sure we don’t allow the patients to drive us down a rabbit hole that we don’t need to be driven down. But like Leonard’s case — that was really interesting, just these vague symptoms that were starting to happen with him, with his hand. Who would have thought of putting that together with a potential exposure?

Yeah. Also very interesting, and something patients need to be aware of, is the difference between these tests. You mentioned this earlier today — like a urine mycotoxin test, right? It cannot differentiate between whether the source is a food source, whether there’s occupational exposure, whether there’s exposure happening in the home. And the same is true when looking at these other tests. If we look at a provoked urine test with a chelator, we know that those tests are not medically sound. They’re not valid as far as saying that someone has had this heavy metal exposure in the past, or it’s ongoing, and now we need to treat it, right? None of this should be taken lightly if you’re considering implementation of certain therapies, because those therapies, which are meant to bind metals, can remove things from the body that are actually very necessary, and all of a sudden you could be contributing to somebody who’s got increasing brittleness of their bones, or you’re looking at issues with the cardiac conduction system. So it’s got to be done with a practitioner that really has a sound working knowledge of these things — better yet, probably even working with a toxicologist — in order to really go through a therapy once it’s been confirmed that that environmental toxin is actually contributing to their disease state.

Yeah, there’s a really interesting study that came out that correlated heavy metal exposure with something like 250,000 cardiac-related deaths per year. You know, it’s interesting to listen to you all talk about how you’re working through these problems step by step, looking at labs, trying to understand where this might be for this particular patient, taking the whole patient into consideration, which I think is so important. Because oftentimes, you can just imagine, people are out there suffering and they have no idea what they’re going to do. Kristi, that is a really interesting story about the guy with the tires. I mean, who knew, right? At the end of the day — obviously it makes sense, some sort of off-gassing of tires or so — but what was it that was causing all of that?

I mean, it was a metal part, and then it was also the fumes from all the rubber that comes in.

I think it was just really interesting for me, where I have a very sort of set life, right? I’ve gotten to a certain stage in my career where I’m getting up, I’m training in the morning, I’m priming, I’m doing all the things. I’ve got a really solid schedule. And traveling out here, just everything that I was going to be exposed to — hey, I never ate before I left in the morning. I always ate at the airport. I didn’t eat lunch on the plane, something that I packed — I actually ate whatever they gave me on the airplane. And yesterday it was the complete opposite: ate at home, and stayed really hydrated. Leonard, you would be proud of me. That was my best hydration day in an airplane ever.

It’s hard to stay hydrated when you’re traveling.

Yeah, and what was amazing about it was, I had a lot of water, and yet I got to the hotel, and when we got there — I don’t want to name the brand, but there was a certain brand of water, and something is in that water that makes you thirsty. Because I drank — okay, now I need some water — so I got two bottles of this water that’s in the lobby of the hotel, drank them, and about 30 minutes later, I finally have fallen asleep, then I wake up and I’m parched. So I don’t know. It’s just so interesting to think about all of these things that are beyond our control that we run into throughout the day, just in everyday life. Getting into the Uber, and one of the Ubers just had this really intense tree on the mirror, and I was like, “Oh, dude, please.” I’m worried that Zach’s going to get a migraine in the process of this, because of the scents — and we talked about that a few episodes back, the phthalates and all of that stuff. It’s just crazy to think how much we’re exposed to that is beyond our control. And again, you could do everything right, but you could run into these situations. And what I love about you guys is that you really are working it in a way where you’re problem-solving through a series of things until eventually you come to the conclusion. But it must be difficult. I want to go back and ask you a question, Dr. Ferree. Since you’re the nervous system girl, as you say — it must be difficult at times, I imagine, for all of you, to manage those patients where they’re freaking out, right? How do you actually manage them through this process of discovery?

Yeah, Kristi mentioned that before, too. I feel so blessed, because of the way I’ve set up my practice, I have the opportunity to spend an hour, an hour and a half with every patient. So the history taking is extensive. Sometimes I’ll see a patient for a year and I’ll go, “I’m going to walk out of the room and pretend like I don’t know you, and I’m going to start asking you all the same questions again,” because it’s almost like I need to re-hear the information. Because the first time I heard it, my brain went, “Ooh, let’s go this way,” and now I might hear it a second time and be like, “Oh, I totally forgot you also had that thing.” And so I’m honored that I get to practice medicine this way because of that. If you’re trying to do this with somebody that’s got seven minutes, it’s just not going to be helpful. And this guy I mentioned before — I saw him before I converted my practice over to the membership model that I do now, and so I had seven minutes. He was sick all the time, and I was like, “Here’s your steroid. See you later.” I mean, that’s not going to help him. It probably made it worse. And it almost never happens in a vacuum. This is what Kristi was referring to earlier: their illness almost never happens in a vacuum. There’s almost always — I’m trying to grow a business, like Leonard was talking about, like nuBioAge is just getting off the ground, we’re just hiring our first employee — and as a founder, you know you’re working really hard when you’re first getting things off the ground. That doesn’t mean that was the problem, but we also have to address that. We can’t just stick with, oh, you have mold, see you later. We have to look at the entire patient situation and look at them top to bottom. What is their skin situation? Are we putting things on their skin that keep them from being able to get rid of toxins through their skin, which is one of our better detox routes? Looking at what their diet is. Are they eating a lot of cooked fats that are oxidized because of the cooking process? And so now those oxidized fats are getting incorporated into their mitochondria, into their immune system cell walls. So is that part of what’s happening? Is that part of the reason? It’s not the whole thing, but it certainly has to be part of the thought process and the treatment process. You can’t just treat the mold toxicity and expect that this patient’s going to get better, because it isn’t ever just the one thing. It’s always in the organism, and then how does that organism fit in the environment where they are as a whole? What is that organism’s relationship to their spouse, or their children, or their parents, or their school, or whatever? So it’s treating from top down, kind of all around. Craig, a few minutes ago, said something about brittle bones. One of the things I think about with lead poisoning: menopause might start to reveal the toxicity that you had from decades earlier, because lead in particular is stored in bones and teeth. So now we go through — oh, I just got chills — we go through menopause, and our bones begin to break down, if we’re not seeing one of us, of course. Our bones begin to break down, and that lead is released into the system. So now there may not be an environmental exposure — although there probably is, because of the world we live in — but the other possibility is the bone breakdown that’s happening. So use some of those tests that look for bone turnover markers, especially in those patients, and think about whether that is a source of toxicity, particularly in your menopausal women.

Yeah, it’s cool to look at the different tests too. The patient should be equipped with some working knowledge of the different tests that are going to be utilized to differentiate between the different types of metal exposures, or metal that the patient may be harboring in the body, because it really does matter. For example, when we’re looking at lead, we’re looking at venous whole blood. If we’re looking at mercury, it’s actually going to be dependent upon the type of mercury. If it’s a methylmercury — that’s from seafood, shellfish, that sort of thing — then you’re looking at whole blood, again, venous whole blood, for that. But if it’s an elemental or inorganic mercury, this is where the urine test really shines. So being able to work with a provider who’s going to help walk you through that process is important. And then, once something is found to be contributing to somebody’s pathologic state, what’s going to be the treatment for that? A lot of times, when it comes to certain substances that we’ve all been talking about, it’s eliminating the exposure, removing yourself from that environment. If you look at something like cadmium, which is going to be something that cigarette smokers are inhaling into their lungs on a regular basis — well, maybe put down the cigarettes, and you might start feeling a lot better. So interesting stuff for sure.

Well, I have a quick question. One of the things that we all advocate for here is hydration. Everybody talks about sauna. Everybody talks about doing all the things that you can do to minimize or be ready. I like what Kristi said — I don’t know how many episodes ago it was, but she said, “I’m trying to get my patients to be able to be resistant to” — or what did you say, Kristi? How did you phrase that exactly?

Well, resilient. They’re at a point where they’re just resilient, where they can handle those insults. They’re healthy enough — their mitochondria is healthy, their immune system is healthy — that when they are exposed to it, they’re able to kind of push it off, or maybe deal with it short term, but it doesn’t create this chronic inflammation in them.

Yeah, that was the big thing for me, is that I felt like I was so resilient, and I felt like I completely lost that. And what was interesting is that I had data on the Pnoe, the metabolic breath analysis that we talk about. It was during COVID, where we were looking at the impact of COVID on exercise capacity, and there was a study showing what COVID did to mitochondrial function in patients. And looking at my data before all this happened — my fat max, or the way that my mitochondria was functioning, how efficient it was — I look at my fat max and where my zone 2 was, and I think it was like 25 beats lower. I was in zone 2, or fat max, around 110, and now after 90 beats per minute I was already out of it, which was telling me that my mitochondria just wasn’t functioning. There was this really cool study that compared mitochondrial myopathies — what happens in mitochondrial myopathies, all the organ systems that it impacts — and then it was talking about long COVID or post-COVID situations, and they were almost identical. And I remember thinking to myself, luckily enough, I think I was still okay. I probably would have gotten in trouble if I did this with somebody else, but I was able to personalize exercise, take peptides — mitochondrial peptides — take some of the supplements that we knew were impacting mitochondrial function, and kind of exercise my way out of it. But I know that that’s not the case for a lot of patients, where it would just cause more oxidative stress. And that’s what I did for a while. But I remember just really wanting to get that resilience back, because I felt so fragile. I felt like anything could take me out right now. And I talk to Dr. Robin Rose about this all the time, because she gets really sick patients, where her goal is always, I need to get them to well, and then once I’m there, then it’s time to build that resilience — and what are all the things that we can build towards resilience? And this goes into the conversation about medicine kind of evolving and changing, to where patients that are seemingly healthy still want to see a physician — hopefully they’re not going somewhere else to do it — to build that resilience, and say, hey, I’m seemingly healthy, my regular doctor’s telling me I’m healthy, but what can I do to build muscle, to build stronger mitochondria, so that in case something happens later on down the road, I can deal with it? I’m glad I was in a good situation — and I wasn’t in a good situation, because I had this vent pouring poison down onto me, but I got COVID during that time period, and luckily I was able to kind of get through it. But that would have been one of those weird cases where it could have taken me out, and it would have made sense. And that’s what happened to a lot of people during that time period, where you thought someone was seemingly healthy, and you didn’t understand why COVID was so dangerous for them. So yeah, that resilience part is part of the longevity, and how we measure that. And that’s kind of the cool part about where medicine’s going: the ability for physicians to build resilience in their patients.

Yeah. The host matters as much as the dose.

Can you elaborate on that? The host matters as much as the dose. I mean, that’s a really profound statement.

It’s what we’ve talked about many times: what is the person like? What is their health overall? What is their mitochondrial health? What is their exercise capacity? What is their fat max? What is their VO2? All those things. How are they in the world? And of course, for me, what’s their nervous system like? What’s their stress level like? What are we doing to manage that? Two people can be exposed to the same dose of mercury, lead, mold, etc., and have two different responses based on what their resilience is — that’s borrowing Kristi’s word.

Wow. Fascinating. You know, I think one of the things that’s really cool is we always get to this point in time where we break things down for that end user — the patient that’s seeking, that’s trying to find the right provider to work with. And luckily, you guys are really just phenomenal at helping people to understand: where do you start? So if you think that you might be living in a house that has mold in it, obviously the first thing is to try to figure out how to get out of that. But if you can’t, what do you do? If you’re going to be traveling all the time, what are the things that you can do to build that resistance up? I guess it’s a lot of the things that we talk about — hydration, nutrition, sleep, and exercise would be the core of that. But beyond that, does anyone want to take a stab at what’s the next level? Actually, I’m going to punt to you, Sue. There are peptides for all these things and whatnot. Have you found, in your patient that you were talking about before, or any other people, some real needle movers for these guys?

I think we have to start — I always tell patients this — with the overflow. It’s like the bathtub, right? If you run into your bathroom because you see water coming through the ceiling, and instead of turning the water off, you just bring a bunch of towels, you’re not going to get very far. You’re going to end up falling through the floor, through the ceiling, into the next floor below. So turning off the exposure, I think, is the number one thing. And then figuring out how to use the detox pathways that you have. Making sure you have adequate — simple as B vitamins — that your liver is functioning optimally, because it has the nutrients that it needs to make the enzymes to help the digestive process occur. Making sure that your microbiome is optimized, so that you have the right bugs, that the intestinal epithelial cells are functioning optimally, so you’re resorbing fluid, so you’re not in this enterohepatic recirculation based on things like beta-glucosidases, that sort of thing. That your immune system is optimal, that you’re not continuing to be exposed to illnesses. I can’t tell you — in the fall that we’re coming up on in the next couple weeks, everyone’s just headed back to school, and I know all my folks are going to start coming in with their little kid illnesses, and so we’re prepping them: here are all the things we need to do to make sure that you are optimized for the next couple of months, so when you are exposed, your risk — or your illness — will be lower. I bet you know that firsthand, Leonard.

Yeah. No, I think you made the point earlier, and I don’t want people to just go past that. The most important thing is making sure your environment is right. Sometimes these mold tests and environmental tests for your home can be a little bit expensive, but boy, is it worth it. Because you could have the best physician in the world, and you won’t be able to move the needle if you don’t take care of your environment. So hopefully somebody that’s listening to that, that’s been suspicious but didn’t really want to pay for it — it’s definitely worth it.

Yeah. I had a drug rep that had it in her car filter — and it was the car that was given to her by the company, right? So she had to get the company’s approval to get the testing done. She lost like 40 pounds after we got her removed from the exposure. That was amazing.

She lost 40 pounds after?

Yes. Because she had put on so much. One of the things that can happen is the mitochondrial inefficiency and the metabolic inflexibility that occurs with the mold toxicity. So they gain a ton of weight, and she gained a ton of weight, and so she lost 40 pounds after we removed her exposure.

Wow. You know, I remember Cynthia bringing this up once: in these patients that might be exposed to these toxins, that lose a lot of weight really fast — because you store so much of these toxins in your adipose tissue — do you ever worry about someone losing that amount of weight that fast? And are you thinking about binding, are you thinking about all these things, as people are losing weight?

That’s a great question, and we do think about that, especially in our obese patients that are taking GLP-1s. You can’t ignore that that’s a possibility, and many of them will come back saying, “Oh, I feel so tired. I feel so miserable for the first several weeks.” We warn them ahead of time — they all have my cell phone — so we warn them ahead of time that that might happen. And I don’t know if it’s going to be you; it may or may not be. You might feel amazing. And that can be partly because of that metabolic flexibility and their inability to handle the conversion over to fat burning from glucose. But it also could be because of toxin exposure.

Yeah. I had never thought about that, and then as soon as she said it — Cynthia always kind of blows my mind with some things that she says — I got to go backwards and think about it. Like, oh, that’s probably what happened with that person, where some people got some pretty rare, weird things that happened as they were losing a lot of weight. Yeah, that was a great episode.

I had a teacher yesterday, and she gets her GLP-1 at a weight management clinic, but yet she’s coming to me for her hormones, and then really for health, right? I mean, that’s what I’m doing it for. But she’s just resistant, and I kept on diving and diving, and now Dr. Ferree made me think about what I missed with her: I need to look at her environment. I know she’s a teacher, so what does her classroom look like, and then her home? Now I know, because it was driving me crazy. I actually thought about her last night: what am I missing, man? I mean, I had her gut better — she’s actually on the Zepbound — so anyways, thank you for that little tidbit.

Yeah, I had the opposite problem. I think I ignored it for so long, because I remember having that InBody there, and I was losing so much weight and I had no appetite, and I’m like, man, I’ve figured this nutrition thing out. I was still trying to exercise. My body fat was the lowest it’s ever been. Everybody’s like, you’re so skinny. I’m like, yeah, I’m doing great. No, I was just poisoning myself.

I feel like we’ve covered it all. Is there anything else that we need to get into this episode to kind of tie it all together?

You know, I think that these things are very real. They can translate into clinically significant disease states. We have to be vigilant about our exposures. But as Kristi and Sue have mentioned throughout the episode, we also have to not have the blinders on to the other stimuli that could be causing pathologic conditions, right? So cast a wide net, as they say, and then rein it in. Just know that these environmental toxins can create real issues for you. You have to differentiate how you’re going to test for these things, and then the treatment protocol needs to be specific to what you have going on, and needs to be done by somebody who’s well qualified to get you through to the other side. So tread carefully, and hopefully, if you’re a patient out there dealing with something like this, you’re best suited to seek out providers such as Dr. Ferree, or Kristi, or myself, or any number of people in the functional integrative space, and we can help you through that dense forest.

So don’t buy a 7-day detox cleanse on Amazon, right?

Yeah, exactly. And even things on the other side of the equation, or the flip side of the coin: certain substances that people use regularly are very effective, right? Curcumin is a natural chelator. People that are taking high doses of curcumin for years and years can end up giving themselves iron deficiency anemia. So just work with somebody who has a working knowledge, and don’t go trying to do everything yourself, because you can get yourself into a pickle. So, from all of us here at Cell To Systems, power to you. Godspeed.

Yeah, you heard it wrapped up right there. So thanks to the team. Thank you guys so much for always bringing so much incredible knowledge. And I think the key takeaway here is: don’t do this alone. Like professional stuntmen — don’t try to jump off that roof by yourself. Seek a professional, and find out exactly how to do it the right way. Hey, we’ll catch you on the next episode, which is going to be — woo — so good. I cannot wait to get into it. And thank you all for watching. Please remember to like, share, and subscribe. And if you know anyone who’s dealing with any of the issues that we talked about today, this is definitely one that you want to share with them. Until then, we’ll see you on the next episode of Cell To Systems.