Week of October 31, 2022
Q: We have mold in our basement crawl space. Should we use a product containing hydrogen peroxide and peroxyacetic acid?
A: Cleaning all reservoirs of small particulates really is important. Treatment of basement and crawl spaces demand removal of fragments of microbes as these fragments account for 99.8% of illness. Simply spraying some liquid does nothing to remove fragments.
Strict attention to precise detail is required to clean. Things such as spray cleaning alone or fogging has no role to help rehabilitate homes. Think about it. Say you have some magical spray or fog that “kills” all bacteria, fungi and actinomycetes with a single application (there is no such product for sale). What will that action do to the extant fragments of fungi or bacteria? Nothing. Where does the problem with WDB come from? Fragments by about 500 to 1. What possible logic would support trying to kill what isn’t alive and then not cleaning compulsively? We are looking at the need to clean for safety of those who have HLA genetic susceptibility. Trying to kill chemicals that are not alive is not logical.
There are specific remediation processes required. See the small microbial particles remediation guidelines on the Surviving Mold site or contact a remediation company that works specifically with CIRS.
You may also find the following remediation report with environmental expert Greg Weatherman useful. It provides images and citations to help determine the safety, culprits and causes of possible water damage in a home including basement areas. It is good starting place for the remediation process.
As far as spray cleaning goes, it is useful for non-porous items and surface maintenance cleaning, but far better than peroxide or Isopropyl alcohol are quaternary ammonium compounds. I like Fantastik the best.
Q: Does a no-amylose diet need to be followed when taking Welchol?
A: No. The only time I use a no-amylose diet is when I am using either interventions with Actos (almost never anymore) or Omega 3 to either 1) lower leptin; 2) lower PAI-1; or 3) lower MMP-9. Once those tasks are completed there is no need to continue the no-amylose diet.
Having said that, many patients feel a lot better on the no-amylose diet, as without high glycemic index foods, and thereby bringing extra insulin into their bloodstream, patients avoid the slings and arrows of insulin, a hormone well known as pro-inflammatory.
Q: What do you consider sufficient remediation for tricothecenes? I have a patient with severe depression, migraines, fibromyalgia (narcotic rx) and panic attacks who lives in a home remediated for “black mold” last year. No one ever informed her that black mold could cause physical illness (this is a true story). I am of course working her up for biotoxin illness. However, since nothing was done for the furniture or clothing during the remediation I am assuming that tricothecenes can still be present. What do you think?
A: I don’t assay for mycotoxins as there is no way to say that any one kind of inflammagen can cause the CIRS-WDB. I shoot for ERMI < 2. Trichothecenes, or any mycotoxins, must not be considered to be the sole or primary focus of Rx. Don’t forget all the other “baddies” in the air. The entire “chemical stew” found inside WDB is much more diverse.
I use a “HERTSMI-2′′ value of < 10 as “likely safe,” understanding that we can not measure everything. This is a new HERTSMI-2 roster on the site that is a derivative of ERMI. It is far more accurate than ERMI alone.
Plus, please take a quick look at the appendices in Surviving Mold that review how to clean, clean, clean after remediation.