Week Of August 28, 2023
Swimming Pools
1/ QUESTION: A patient from Australia writes, is it possible for mold spores to exist in a chlorinated swimming pool?
ANSWER: If the pool is outdoors it is highly unlikely that the pool itself is contributing to your illness assuming normal levels of chlorine (or algaecide) or whatever biocide is being used. For people who have indoor pools, the extra moisture and humidity can contribute to enhanced growth of microbes. The water itself, however, will not provide habitat that support mold spores.
2/ QUESTION: I feel that swimming is a wonderful exercise to help patients recover from CIRS. Is an indoor pool safe?
ANSWER: The excessive humidity indoors from pools and spas is a giant area of concern for creating a habitat suitable for growth of toxigenic organism. If you have an indoor pool Iwould be monitoring HERTSMI-2 on a regular basis with the cost of monitoring simply being added to whatever kinds of maintenance costs are involved. Don’t forget that swimming is arduous; exceeding the anaerobic threshold in CIRS patients occurs easily in a swimming workout. Better to make sure anaerobic threshold is improved by following the exercises described in Surviving mold and then taking on swimming.
3/ MSH benefits, and tanning/pigmentation
I read that if a person has low MSH they will not tan well. Unfortunately, I am
having the opposite effect. My skin is turning very dark. Is this related to MSH?
Melanocyte stimulating hormone has multiple effects on inflammation, hormone
balances, mood and mucosal defenses. It also has a great deal to do with increasing skin pigment. The potential benefits of MSH include better energy, improved function in private personal interactions, improved sleeps and enhanced skin pigmentation. Low MSH people are not necessarily pale whatever their racial heritage. Low MSH patients do not have enhanced pigmentation in my experience.
I have measured MSH in over 10,000 patients and would look forward to hearing the outcome of your case. Your doctor can sort out the problem. The differential diagnosis of skin pigmentation is not long; you should have some answers very soon.
Diagnosis, mycotoxins
4/ QUESTION: I took your online test which revealed I was positive for mycotoxin poisoning. I had urine testing done; the results were negative for mycotoxins. I have been ill for two years in our 5-year old house. Multiple species of fungi were identified in an area of an ongoing leak. I have had fungal antibody testing that was negative. I have had six Lyme tests together with an evaluation with an infectious disease specialist who said that I did not have an infectious disease. Have you ever seen a case of someone who had mycotoxin poisoning but the tests were negative?
ANSWER: If I could do one thing for you, it would be to remove the idea that inflammatory response syndromes are due solely to poisoning from mycotoxins. What we see inside a water-damaged building is a diverse array of compounds that can create inflammation, and for those with HLA based susceptibility, such inflammation is persistent. In addition to fungi which can produce mycotoxins; and mycotoxins can have genomic effects together with activation of innate immune receptors, there are bacterial toxins; toxins made by actinomycetes; and the real possibility exists that mycobacteria species are also making mycotoxins.
To conclude that the problem is mycotoxins alone is not only incorrect it is
worse than that in that it would make one focus on fungi to the exclusion of other agents that are in my opinion of far greater importance. I see no indication to use antibody testing to diagnose any CIRS illness. As such antibodies, even if they are monoclonal, which is never the case in fungal antibody testing, have nothing to do with innate immune responses and furthermore, do not show when an exposure occurred (assuming the lab is correct, an assumption that is usually not
substantiated). The test does not tell us if one was made ill by such exposure.
There is no difference in the symptoms of patients with illnesses caused by Lyme or water-damaged buildings; this commonality of complex symptoms presentation also extends to illness from other exposures, including dinoflagellates or cyanobacteria. Symptoms alone are not adequate to diagnose these illnesses. As far as treatment goes, please review the 11-step Shoemaker Protocol™ found on this website.
For more in-depth information, you may be interested in reading the Shoemaker Protocol™ Practitioner Essays, or the Paper published in the journal Health in March of 2013.
For example, cholestyramine alone will not remove coagulase negative staphs; will not correct antigliadin antibodies, rarely corrects low VEGF, and it not guaranteed to correct ADH and osmolality. Having said that, treatment with cholestyramine or Welchol is mandatory as an initial step of therapy after you have been removed from exposure.
Diet, nuts and inflammation
5/ QUESTION: I have been made ill by water-damaged buildings and I have an HLA of 4-3-53. This question might seem a bit off the wall at first. I have read a disagreement along the community of nutritionist talking about inflammatory states suggesting that eating nuts creates an inflammatory illness. I like nuts. I read in a recent paper in the New England Journal that eating nuts makes you live longer.
ANSWER: For those who are avoiding sources of amylose, seeds and roots need to be recognized as being potent stimulators of a rapid rise of blood sugar solely following chewing. This rapid rise of blood sugar stimulates a rapid rise of insulin which in turns sets off inflammatory pathways. So foods with amylose are not a good idea for those who have (1) high insulin; (2) insulin resistance; (3) who are using either Actos or omega 3’s to reduce MMP-9, PAI-I or leptin.
Over the years most people have been surprised that I suggest avoiding peanuts as they grow below the ground. Despite the fact that walnuts and cashews, for example, are seeds and theoretically could contain amylose, they have not been potent stimulators of a rapid rise of blood sugar. I do not restrict use of any nuts other than peanuts for those worried about insulin-driven inflammation.
The inflammatory responses of CIRS are innate and are not driven by insulin for those who are not using the no amylose diet.
Dishidrosis
6/ QUESTION: I have cracks in the skin of my fingers and thumbs as well as both heels. I am concerned they are fungal infections because Nystatin helps as well as glutathione
ANSWER: Deep fissures in the skin that are painful, bleed easily and never heal usually are a manifestation of a problem with sweat glands. The clinical term for what you described sounds like dishidrosis. This is not related to exposure to water-damaged buildings or to fungal infections. The deep fissures in the skin certainly could host secondary colonizers including fungi but the problem begins below the rete ridge of the skin.
Treatment of this condition can be difficult primarily because no one is yet to find
where/why the sweat gland problem actually begins. The neck of the sweat gland, which connects the skin to the bulb of the sweat gland itself deep below the skin, becomes obstructed for no unknown reason. Typical steroids help nicely as well as low dose benzoyl peroxide gel. You must avoid having the skin dry out. Curiously, the greatest therapeutic advantage is obtained from old fashioned country preparations like mink oil with silicone and lanolin being spectacular in their benefit. Stop by a hardware store and pick up some Red Wing boot
grease (I am not kidding) to get started to heal this painful, sometimes chronic condition.
Since the problem is excessive drying of areas of skin once the obstructed sweat glands lifts the protective epidermis off the underlying dermis, the mink oil acts as an artificial epidermis. If the skin doesn’t dry out then the fissuring can heal from below.
Education, patient
7/ QUESTION: I have heard that 25% of the population has HLA susceptibility. What duty do we have to the other 75%? I would like to convince them that they should be investigating issues that could affect quality of their life.
ANSWER: There has been a concerted effort made by insurance companies as a whole and likely the US Chamber of Commerce in particular to contribute to dissemination of deliberate misinformation regarding the health effects of water-damaged buildings. We need to add federal agencies in this broad brush of blame as their failure to aggressively focus on treatment of patients injured. Actually, the Feds say their role is not to promulgate therapies; it should be to assist with reasonable information. The origins of this delivered misinformation have to do with money, of course, but it also has to do with lack of physician awareness of the academic basis that underlies CIRS.
One internist from Oregon complained that I was asking him to learn about TGF beta-1 when he had never heard of it. In point of fact there are 75,000 references on PubMed to TGF beta-1. It would have taken him 15 seconds to start to see that there is a huge literature.
Until there is an ongoing threat of medical malpractice litigation focused on physicians that deny illness, there is not going to be any push for physicians to learn. Perhaps that statement sounds too cynical. If the person without illness hears from so-called experts in the media saying that a little bit of mold never hurt anybody (without disclosing their possible conflicts on interests) it
is only human nature for the non-affected person to think that someone who is ill and who has 15 health symptoms and more is some kind of whacko. The history of incorporation of new information into American medicine is checkered at
best. It took dead American Legion members to focus on Legionnaires Disease. It took a spread of HIV from the Haitian and gay population to the general population to focus research interest on this important issue. Tobacco products were redeemed safe for years with the same institutional kind of strategy currently employed by Nay Sayers regarding mold. Many of the same people with academic credentials who testified in favor of Big Tobacco are still cashing checks from Big Mold. The UCSF Legacy Library has a list of which docs and PhDs were paid. Take a look at it some day.
Education is an investment in time and energy with such efforts often greeted by the idea that even if you lead a horse to water you can’t make it drink.
My suggestions is to not get downhearted but continue to learn on your own to publish the truth as only the truth will set us free.
