Week of January 29, 2024

Week of January 29, 2024

1/ CSM: food intolerance, rapidity of benefit


QUESTION: How long after starting CSM does it typically take before it affects food intolerance?


ANSWER: Cholestyramine use is simply the first step in a pathway that has been honed over the years. Food intolerance remains an enigma in the sense that people who have such intolerance know it and it can be quite profound to the point that people can only eat five

or fewer foods. When we try to define the source of food intolerance we know that antibody testing and some alternative methods have limited applicability to groups of people. It’s possible that there may be an anecdotal correlation but there is nothing that

can be stated with a broad brush.


If you have a chronic inflammatory response syndrome in which food intolerance is present, and this is not unusual, the approach to treatment is not to ask how long will it take but what abnormalities are yet to be corrected. With the information provided I can not give you a conclusive answer.


Consider reviewing our lists of Shoemaker Protocol™ Practitioners or Partners to find a practitioner who can best support you.



2/ Dehumidifier smells


QUESTION: I live in the Pacific Northwest and have installed a dehumidifier in an effort to reduce the elevated relative humidity in our home. Shortly after using a dehumidifier we noted a musty smell that persisted despite use of hydrogen peroxide and vinegar to clean coils, filter and water collection pan.


ANSWER: I agree that ongoing use of a dehumidifier with problems like this is of more harm than benefit. It is quite possible that the drainage pan will need to be vented to a drain and not let stand for prolong periods of time. I would also look at the likelihood of ongoing water intrusion as opposed to the ambient humidity as the source of your problem.


3/ Disability


QUESTION: My illness has progressed to the point I am unable to work. What diagnosis do I use in application for disability?


ANSWER: If you are speaking about Social Security disability, the diagnosis that you use are ones that are supported by the testing that you had done. The most common is to show reduction of V02 max and elevated pulmonary artery pressure.


If you are applying for long term disability you will need to include a functional assessment form and have documentation of why you are unable to do particular activities. Having specific elements of our laboratory protocol as part of your diagnostic submission will provide assistance but by themselves are not enough to guarantee

disability will be granted.


There is an excellent section on disability on the SM site.


4/ landlord dispute


QUESTION: I have been newly diagnosed “mold,” by the Cleveland Clinic. I am involved in a dispute with my landlord who refuses to authorize ERMI testing, relying instead on spore trap air testing. Moreover, they want to see my blood work to see that I have “mold.” What are my legal rights?


ANSWER: There is no restriction on your ability to perform ERMI testing or HERTSMI-2 to bolster your legal argument. The case definition based on the 2008 US GAO Report requires some documentation that you truly do have the potential for exposure to the interior environment of a water-damaged building. For this I would recommend HERTSMI-2 using Mycometrics in New Jersey as your best choice. Please note I have no conflict of interest to disclose with any mycology laboratory.


I am stunned that your landlord is requesting that you divulge personal health information to him. Sounds to me as if he has already been speaking to a predatory mold defense attorney. There is never any requirement to disclose any personal health information to

any 3rd party short of a court order. Were you in litigation you would have to release a copy of your medical records.


I am concerned that while the Cleveland Clinic remains one of the bastions of academic American Medicine, they are inexperienced in the diagnosis of CIRS-WDB and in fact, have been less than proactive over the last 15 years regarding patients with chronic

fatiguing illnesses. I am hoping that they will have the documentation that you indeed meet the 2008 case definition for this illness. I am happy to review your records for you to confirm that your diagnosis is made in the proper fashion. Your medical records will not be disclosed to any 3rd party by me, especially information-hungry defense attorneys.


5/ Duration of therapy


QUESTION: I am a physician from Finland who is sensitized to molds growing in a water-damaged laboratory. How long does it take to become symptom free after therapy has started? Secondly, after re-exposure to prove causation, how soon can the person return to symptomless conditions?


ANSWER: The answers to both these questions are simply dependent on two elements: 1) what is wrong; 2) how bad is it. A diagnostic re-exposure trial would not be performed until a

patient had reached maximum medical benefit. So, the answer to your second question for re-exposure is a bit more straight forward.


There are a wide variety of variables and each patient’s timing will be different, but because you will be initiating treatment within three days of exposure, reclaiming the status of health at the end of the initial therapy usually only requires a few days.


But for the first element of your questions, essentially each of the step by step sequential interventions takes approximately a month. If you do not have a positive nasal culture for MARCoNS, for example, you can skip that step of treatment. If you do, however, have a

positive culture that requires an additional month together with toxin-binding treatment.


If you have gliadin antibody positivity that must be treated; similarly, for androgens, ADH/osmolality abnormalities and TGF beta-1, among others.


The Shoemaker Protocol™ Practitioner essays will provide more information for you regarding the strategic pathway of the 12-step Protocol. Following the steps plus the labs and testing at each step will inform your timing at each step as needed. It is possible you will not need each step, especially in your case.  


6/ Electromagnetic frequency


QUESTION: Do EMF’s have any role in amplification in mold problems? I read an article that said that they do.


ANSWER: Part of the problems that I have in trying to assess EMF is absence of any diagnostic laboratory studies. Even here in rural Eastern Shore of Maryland, we can see a cell tower in the distance. We drive by voltage wires every day on nearby Route 13. Yet despite

those exposures that make other people ill, the vast majority of patients I see do not react adversely to EMF.


7/ CSM, brain detoxification


QUESTION: If cholestyramine stays in the gut, how does it remove toxins from other tissues? My brain seems to be affected so I am interested in how to remove mycotoxins from my brain.


ANSWER: The cholestyramine module may be of interest to you. In the module, there is the PowerPoint; there is the text provided; together with protocols and the video itself.


Removing the toxic effects of CIRS is only one part of the 12-step Protocol process. NeuroQuant clearly shows us that the main source of brain abnormalities is inflammatory and not a direct toxic effect.

Following the steps of the Protocol in the order prescribed will support the inflammatory effects often found in the brain, as well as the other multi-symptom/system effects.


For better understanding, mycotoxins comprise only a small amount of the total inflammatory burden patients have with exposure to interior environments of water-damaged buildings. Focusing on mycotoxins is like looking at one foot of the elephant and ignoring the rest of the beast.


There are references to mycotoxin effects on a variety of tissues but in the human, we must consider other elements such as bacteria toxins, actinomycetes toxins and the huge host of inflammagens.


Fortunately, the mycotoxin research panel used at ProgeneDx shows differential gene activation caused by inhaled mycotoxins but will not show activation from simple ingestion of mycotoxins.


X/ Evaluating VIP benefits.


QUESTION: Is there a lab that does blood test for VIP efficiency?


ANSWER: Please follow the standard CIRS labs together with use of NeuroQuant indicated. The best test for looking at VIP is the mRNA of VIP receptor-2. This test is formed as part of a genomic assay and is available on a research basis now.


You may also be interested in the VIP module available on the site.