Week of April 1, 2024

1/ NeuroQuant:

 

Q: I reside in Maryland and my treating physician is in Florida. Are there places in Maryland that offer NeuroQuant?

 

A: Yes, Washington Radiology and they have 4 locations between Washington, DC, Baltimore, and some locations in Virginia. The test is commonly available in most medical systems’ radiology departments.

 

Keep in mind, the NeuroQuant Analysis available on the Surviving Mold site will specifically read the initial NeuroQuant report for mold and Lyme points, among others.

 

2/ Nasal Treatment:

 

Q: Is the purpose of the additional nasal testing (biofilm, fungal) to possibly modify or add to the nasal spray treatment as needed?

 

A: There is a correlation of increasing biofilm formation with virulence. 

 

3/ Pertussis infection:

 

Q: Could a pertussis infection trigger CIRS and would it show up as Actinobacteria or endotoxin dominant on GENIE?

 

A: Yes, absolutely. Even though the toxin made by pertussis is a very large molecule and would not be an ionophore, it does not show up as an Actinobacteria or endotoxin on Genie. You would be looking for hypometabolism without specific causation for fungi, Actinobacteria or endotoxins. We have tried cholestyramine for confirmed pertussis

infection in adults without benefit. 

 

 

4/ VOCs, 4-3-53 HLA

 

Q: I am currently being treated for my CIRS in part due to my exposures and my HLA of 4-3-53. As my family is looking to relocate we have been looking at rental homes. Exposure to new carpeting and or new paint gives me a headache within 20 minutes. What should I do?

 

A: The concerns for chemical sensitivity in patients with low MSH, low VIP and prior mold illness are real. We have no mechanism to confirm prospectively that your headache is due to inhalation of VOC’s which could be from off-gassing from carpets, paint or

construction materials. All of these elements are notorious for making chemical sensitivity symptoms flare.

 

It is a general rule that those with your HLA history usually live in homes that are Spartan-like, without carpeting or fabric draperies. Usually new upholstered materials are eschewed in favor of non-porous materials. Should you be in the process of developing chemical sensitivity, an entity that I can’t define by physiologic measurements, but I know it when I see it, I would recommend that

you consider sequential treatments of VIP.  In higher doses this compound has direct beneficial affects on the integrated interactions of olfactory neurons in the suprachiasmatic nucleus of the hypothalamus.

 

You may be interested in learning more about VIP in the comprehensive VIP learning module available on the site.

 

5/ The No Amylose Diet

 

Q: Where do I find references to the no-amylose diet in the book Lose the Weight you Hate?

 

A: Most patients prefer to read the electronic version of the book which is available in the Surviving Mold book store where the diet is explained, including when the diet is useful during the Shoemaker Protocol™, as well as the benefits beyond CIRS recovery.

 

Here are the general guidelines: 

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, as well as inflammation.

 

There are 2 situations where diet is altered during the Shoemaker 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.

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 pro-inflammatory.

 

With that in mind, the use of this diet is also particularly helpful for those with insulin resistance that is shown either by elevated levels of insulin, weight at least 40 pounds over desired or Type II diabetes.

 

If you feel better on this diet, I recommend staying on it. I have advocated its use to help in weight loss since 1977. I am always interested to see a new diet come along that simply follows the concepts of no-amylose (South Beach, Paleo; the list is long).

 

The Forbidden Foods on the No-amylose Diet are:

 

• Roots & tubers including white and sweet potatoes, beets, peanuts, carrots, and other vegetables which grow under ground. Onions and garlic are permitted.
• Bananas (the only “forbidden fruit”)
• Wheat and wheat-based products, including bread, pasta cakes, crackers, cookies
• Cereal grains
• Rice
• Oats
• Barley
• Rye
• Foods with added sugar, sucrose, corn syrup, or maltodextrin

 

The key to the no-amylose diet is to avoid foods that are high in the glycemic index. What this means is that because the enzyme, amylase, is present in saliva it will digest the complex plant starch called amylose (as opposed to amylopectin) causing a marked increase in blood sugar in a very short period of time. This enhanced rate of rise in blood sugar is the most important factor stimulating the release of insulin. Insulin in turn is a pro-inflammatory hormone that does so many bad things to patients with inflammatory illnesses. The no-amylose diet helps to regulate and balance insulin levels as well as reduce inflammation.

 

5. Weight Loss and CIRS

 

Q: If a patient with CIRS is losing weight, is that due to enhanced release of toxins from fat cells?

 

A: For people with inflammatory illnesses resulting from exposure to water-damaged buildings, the underlying problem of their physiology is capillary hypoperfusion. Innate immune responses to toxins and inflammagens will become the inflammatory responses of CIRS but it is the capillary hypoperfusion that must be understood. What this means is reduced delivery of oxygen into capillary beds. This reduced oxygen delivery can bemeasured directly using the Heidelberg Retinal Flowmeter or by measuring lactate using MR Spectroscopy. In the presence of capillary hypoperfusion there is a problem with

efficient use of glucose to generate energy for the cell. This problem derives from the need for mitochondria, the powerhouse of the cell, to have oxygen available to create 36 molecules of the energy molecule ATP out of the 38 possible ATP that metabolism of each glucose can produce. Without adequate oxygen, functionally glucose becomes

nearly wasted with its reduction of ATP limited to a 5% (2/38) capability.

 

In these patients with inefficient burning of glucose, stores of glucose in the complex carbohydrate called glycogen are quickly exhausted. If a person is continuing to try to do something, like walk up a flight of stairs, in the absence of glycogen, the cell will reach for alternative energy sources, either fatty acids or amino acids derived from breaking down protein. Direct fatty acid burn is accomplished in the presence of high levels of adiponectin, primarily in muscle beds, or release (by low leptin) of fatty acids to be  burned directly (this is called beta-oxidation) for fuel. Unfortunately, (1) low adiponectin

is often seen in biotoxin patients and (2) many people will develop leptin resistance as their MSH falls. What this set of problems means is that functionally fat storage becomes protected. What that leaves as a fuel source then is lean body mass or protein. This lean

body mass is controlled genetically and if amino acids, especially alanine and glutamine, are quickly converted to glucose, the body does so at a loss of the basic building blocks of lean body mass.

Patients then with capillary hypoperfusion can maintain fat stores, just as they are losing protein and not look like they are losing weight, but they are. Similarly, some patients with reduced fat stores before illness onset will look protein-and calorie-malnourished. The problem of weight loss here is not due to release of additional toxins from fat cells, it is the ongoing inflammatory response.

 

6/ Worms and mold

 

Q: I am currently being treated for CIRS and have looking into helminthic treatment. I have read reports showing improvement of autoimmune and inflammatory conditions? What are your thoughts on this and its use in treating CIRS?

 

A: I am aware that there have been approaches to treatment for CFS in the past using eggs of hookworms to be swallowed with the idea that deliberate act would restore an antiinflammatory pattern (Th-2) to inflammation compared to a pro-inflammatory pattern (Th-1) that is usually seen. I have not seen data published showing benefit though I have seen presentations that looked solid.

 

There is a researcher, Dr. Larry Klapow, who feels that he has identified nematodes in nasal washings of patients with Chronic Fatigue Syndrome. He works with Neil Nathan, MD who supports the intellectual basis of Dr. Klapow’s research. I have seen anecdotal

reports confirming presence of unusual organisms, identified as nematodes, in Dr. Klapow’s work but have not seen independent verification. He does have some very interesting looking photomicrographs to share! Should you be interested in pursing his

protocols for treatment, and I am wholly unaware of any data on this aspect of helminthic colonization, I would suggest you contact Dr. Klapow or Dr. Nathan.

 

If there is a role for worms in CFS I wouldn’t be surprised as just about any organism known to man has been implicated at one time or another the pathogenesis of this illness. Based on my experience however, these protocols have not been shown to have

application in mold patients.

 

7. Zeolite

 

Q: Does Zeolite (clinoptilolite) have a role removing mold toxins?

 

A: To my knowledge the multiple forms of Zeolite show a remarkable ability to adsorb a variety of particles with a positive charge. Zeolite also holds onto water. Unfortunately, the use of Zeolite has never been shown to have any benefit in treatment of biologically

produced toxins. I suspect that this lack of benefit of Zeolite is due to the fact that the ionophore toxins that I worry about so much all have negative charges in small anion rings. I would suggest you take a look at the cholestyramine teaching module for additional information regarding structure and function relationships and why the positive

charge of the quaternary ammonium of cholestyramine works so well to bind ionophores.