Week of July 31, 2023
1/ Foreign and Airline travel
QUESTION: I have used VIP with success for my 4-3-53 haplotype. I often travel out of the country and wondered what is the best way to help with mold exposure.
ANSWER: The problem of exposure to indoor environments that are contaminated includes air travel, especially international flights that fly at altitudes that fly over 35,000 feet.
Specifically, the air turnover inside these big planes is supposed to be one turnover for every 45 minutes. At 40,000 feet, the ice-cold air needs to be heated before it is distributed thereby adding additional costs to the air turnover. As if that problem of stale air is not enough, the air is recirculated through filters that are often not changed quickly
and end up being heavily contaminated according to flight attendants who have contacted this site in the past. I have no photos or data to back up this hearsay evidence of contaminated filtration systems.
Use of VIP for acute exposures is in its infancy but as opposed to older therapies that relied on problematic agents such as erythropoietin, while effective but risky, VIP is much safer in high doses provided VIP can be kept refrigerated.
Given the existence of at last half of our buildings in the U.S. being moldy, the problem is worse in other countries. Look at some of the construction techniques you see in U.K. and you will understand my concern. Interestingly, very old buildings, such as dank castles in Scotland or dungeons in Ireland rarely have toxigenic organisms found in those areas.
If you are able to keep VIP chilled that is the best way to be protected while traveling overseas in addition to full dose Welchol or cholestyramine. The dose for acute exposure is much higher than four doses a day; people with 4-3-53 especially will need to be
looking at 16-20 doses a day.
Alternatively, finding a compounder to make VIP for you overseas is worth the time that it would take to arrange this needed event. Fortunately, Australia has a compounding pharmacy available that can make VIP that works. I don’t know about U.K and the
continent.
If you are frequently in UK, Europe, or Canada, you may be interested in working with Shoemaker Protocol™ practitioners who serve these areas. View our International Practitioner List
You may also be interested in Dr. Shoemaker’s comprehensive CSM and VIP learning modules.
2/ HERTSMI-2 testing
QUESTION: One of our children is having body rash issues that came on after we moved into our house 6 months ago. She has been treated with an antifungal but it is not clearing quickly. Our functional medicine doctor suggests that we look into mold and do a
HERTMSI-2 test. How do I do this?
ANSWER: HERTMSI-2 testing is either performed on dust that you have obtained by vacuuming an area 3x6 for 5 minutes using a special cassette obtained through Mycometrics. There is a
protocol in the instructions from that excellent lab that will tell you exactly what to do.
The recent paper that Dr. David Lark and I showed that use of Swiffer cloth testing was equivalent to doing vacuum sampling for dust provided a single Swiffer cloth is wiped in one direction at least over 10 horizontal surfaces that are not routinely vacuumed at home. You will not skew the HERTSMI-2 result from a Swiffer cloth if you have more than 10 surfaces but if you do less than 10 surfaces there could be a problem. Also, avoid areas of visible microbial growth when you do the sampling as we don’t want to overload
the cloth with visible organisms.
You may be interested in the free HERTSMI-2 Scorecard available on the site.
3/ Mycotoxin testing
QUESTION: My doctor has recommended a urine test for mycotoxins as a useful step. Please comment.
ANSWER: Any urine mycotoxin test must be one in which there is strict dietary control to avoid possible falsely elevated readings. In addition, the mycotoxin test antibody must be shown to be monoclonal in published peer-reviewed literature to avoid confounders with a variety of epitopes. Finally, urine must be frozen to transport.
4/ Food intolerance from mycotoxins
QUESTION: I can’t tolerate any vegetables, fruits, nuts, seeds, legumes dairy or grain. I can’t tolerate fish oil among others. All I can eat are chicken and beef and possibly coffee and almonds.
ANSWER: I do not agree that your case is reflective of intolerance simply due to fungal contamination or mycotoxin contamination of stored food. I would start by assessing the potentials of your case to be due to low levels of MSH providing inadequate regulation of inflammation in the gut.
Community Note: You may be interested in Shoemaker Protocol™ Partner and nutritionist, Judy Cho, and her clinic, book, and offerings based around “The Carnivore Diet.” LEARN MORE HERE
[Link to Judy Cho’s info page]
5/ Mycotoxins in food
QUESTION: What brands of chocolate, seeds and nuts have fewer mycotoxins than others? Are there any lists for my review?
ANSWER: To my knowledge, no stored foods can be assured to be safe from fungal growth. If the activity of water (AW) is over 0.85 there will be mycotoxin production from fungi growing on stored food. Food venders go to great lengths to prevent such contamination.
Rarely is this level reached in commercial storage. The good news is that extensive studies have shown that in normal patients, or control
patients if you will, eating standard diets in the U.S. and Europe do not have confirmed illness from ingestion, despite presence of mycotoxins from those foods being invariably found in urine using careful methods. The assumption that the problem is mycotoxins
remains unproven as that there are other elements that fungi and bacteria produce that can make people ill.
As well, the Shoemaker Protocol™ has been effective in tens of thousands of patients without altering the diet because of these factors. There are 2 situations where diet is altered during the Protocol: 1/ eliminating gluten in those with anti-gliadin antibodies in order to help inflammation improve. 2/ The low-amylose diet is used in step 7 in conjunction with correcting MMP-9 as needed.
The Low-Amylose diet was developed by Dr. Shoemaker to help people with CIRS who have high levels of MMP-9. Cutting back on amylose, a carbohydrate found mainly in starchy foods that mainly grow underground, works to lower MMP-9 levels.
