Updated on March 2, 2017

Step 4: AGA – Diet – Detox

In this article, I’m going to cover the fourth step in Dr. Shoemaker’s protocol – addressing Anti-Gliadin Antibodies (AGA). In addition, given that resolving AGA’s involves changes in diet, I’ve also decided to expand the focus of this article to include other subjects related to gut health. In Alternative Mold Therapies, I already started to look at gut health in terms of diet and probiotics. I’ll continue down the road a bit by looking at the interplay of various inflammatory markers as they relate to gut health and AGA. I’ll then shift my attention to the use of biofilm busters along with anti-fungals for improved gut health. And finally, I’ll finish by looking at improving the three liver detoxification Phases that are responsible for removing toxins of all sorts including Biotoxins. Given that toxins can upset good gastrointestinal (GI) flora, looking at the three Phases of liver detoxification also ties into the general theme of gut health. Let’s get started!

Note: For those interested, this article covering detoxification was followed by two additional detoxification articles GSH Detox Protocol and Blocked Detox.

MMP9 – Leptin Reset – AGA

Let’s begin by looking at three of the many blood draws Dr. Shoemaker took while he was in practice. They are anti-gliaden antibodies (AGA), Leptin, and Cytokines. The measure for cytokines is made indirectly by looking at the level of the Matrix MetalloProteinase-9 (MMP9) enzyme. The correct lab, code, and normal ranges are shown below.

• Antigliadin, IgA, IgG: Quest or LabCorp #8889x (negative: Gliadin AB IGG & IGA < 11 U/mL)
• Leptin: Quest or LabCorp #90367x (normal range: Male: 0.5-13.8 ng/mL; Female: 1.1-27.5 ng/mL)
• MMP9: LabCorp #500124 (normal range: 85-332 ng/mL)

By understanding why Dr. Shoemaker drew these three labs, we can learn a lot about Chronic Inflammatory Response Syndrome (CIRS). From this understanding, various suggestions I make that go beyond Dr. Shoemaker’s protocol will make better sense. Rather than starting with Dr. Shoemaker’s 4th step of treating those people with AGA’s or high TGF-beta 1 with a gluten free diet, I’m going to start by discussing Cytokines and show how they relate to Leptin, AGAs, and a few other inflammatory markers. As these connections are being made, I’ll also interject additions to Dr. Shoemaker’s protocol that I, or others, have found personally helpful.

When I was super sick with CIRS, I read all day for two years. Two of the books I read are Dr. Shoemaker’s Mold Warriors and Surviving Mold. In these books, Dr. Shoemaker describes the cascade of physiological health effects that hollow out healthy, vibrant people until only a shell is left. This story begins with Biotoxins.

In What is Biotoxin Illness, I’ve already described the fact that Biotoxins not only include mold toxins but also toxins produced by Lyme, Blue-Green Algae, Actinobacteria, and so on. In that same article, I discuss that beyond the chemical toxins mold produces (mycotoxins) to lay claim on that piece of decaying matter, there are a whole host of other inflammagens that mold and bacteria emit that make a person with CIRS sick – Beta Glucans, Volatile Organic Compounds (VOC), Lipopolysaccharides (LPS), etc.

I also get into explaining how these Biotoxins latch on the Toll Receptor sites of fat cells and inappropriately trigger them to produce inflammatory Cytokine proteins. Now given that there is no test to measure Cytokines directly, Dr. Shoemaker tested for the Matrix MetalloProteinase-9 (MMP9) protein instead. The reason for this is that Cytokines stimulate white blood cells to produce MMP9. So when MMP9 measures high, we know that Cytokines are high too and this is where we pick up the story.

Having high MMP9 when pathogens are present makes great sense once you understand that the purpose of the MMP9 enzyme is to drill holes through blood vessels. These holes allow special blood cells called phagocytes to penetrate into all parts of the body. Phagocytes gobble up pathogens like foreign particles, bacteria, and dead cells so they need to be able to move freely in order to do their job. This is all very cool. The only trouble is that phagocytes are ineffective against Biotoxins. As such, the inflammation that comes from MMP9 punching all those holes to give phygocytes access produces a lot of inflammation in nerves, lungs, the brain, muscles, and joints without any benefit and no end in site. As long as the Biotoxins remain, this process continues ad infinitum resulting in a cascade of other deleterious health effects.

So high MMP9 matters and you can now see why Step 7 in Dr. Shoemaker’s protocol used the diabetes drug pioglitazone (Actos), along with a no-amylose diet to lower MMP9 and the related Cytokines. The no-amylose diet was important not only because it amplified the impact of Actos on blocking Cytokine production but it also helped to reduce inflammation from Cytokines overall. In general, Actos lowers Leptin, lowers MMP9, raises Vascular Endothelial Growth Factor (VEGF) and improves insulin resistance. Unfortunately, as of June 2011, the FDA has stated that Actos increases the risk for bladder cancer so Actos is no longer available. (Don’t get me started, but the study that showed risk was for folks that took Actos for 2 years compared to the few weeks needed to bring down MMP9. It makes no sense to ban it all together.)

All is not lost. In fact, for those with CIRS that had Leptin levels below 7, Dr. Shoemaker never used Actos anyway as it tends to lower Leptin. The reason for this is that when Leptin gets too low, a very important hormone called Melanocyte-Stimulating Hormones (MSH) drops. I’ve talked about MSH in What is Biotoxin Illness and elsewhere. Suffice it to say that when MSH is low, you’re not going to sleep well, will hurt more, will lose your love for life, will have gut dysbiosis, and so on. Fortunately, taking omega-3 fatty acids at 2.4 g EPA and 1.8g DHA (fish oil) per day works reasonably well as a substitute for Actos. Sweet, I like simple solutions like this.

However, for most with CIRS, low Leptin is not a problem. In fact, Leptin is typically quite high. We have Cytokines to thank for this. As it turns out, Cytokines bind to the receptor sites in a part of the brain known as the hypothalamus that are normally reserved for the Leptin protein. As a result, the person becomes “Leptin Resistant”. When Leptin can’t get access to the hypothalamus, the unfortunate consequence is that MSH falls. When MSH falls, the body responds by making more Leptin in an effort to get the “signal” through. Unfortunately, this turns out to be a futile effort as the receptor sites are occupied by Cytokines.

As a result, most with CIRS have high Leptin and low MSH. When Leptin is high, folks have an increased appetite and their bodies hang onto fat. High Leptin is why many with CIRS can’t lose excess weight. This results in part based upon what was discussed in What is Biotoxin Illness wherein folks with CIRS quickly burn through their glucose stores due to low oxygen. Rather than burning fat, high Leptin prevents this. The end result of all of this is muscle wasting as protein in muscles is the last energy store available.

Leptin Reset

Knowing this, you can see why I was excited when I read the writings of Dr. Jack Kruse because he discusses innovative ways to get around high Leptin and low MSH. I’ll get into Leptin in this article and reserve a discussion on the use of Cold Thermogenisis for raising MSH for some future article. Suffice it to say that if folks with CIRS can either increase Leptin sensitivity or increase MSH, this is very helpful. Granted Dr. Shoemaker found success going after the Cytokine response by supplementing with fish oil. Dr. Kruse’s Leptin Reset Diet offers another approach that may provide additional benefit.

For me, Dr. Kruse’s work was especially interesting because I happen to have low Leptin levels and I’m of average weight. Here was a way to increase Leptin sensitivity. (Even though Actos was still available at the time I was being treated by Dr. Shoemaker, I wasn’t allowed to use it because my Leptin levels were lower.) Although weight lose isn’t the primary focus for those with CIRS, for those for whom weight gain is an issue, increasing Leptin sensitivity has the added benefit of trimming down in a way that won’t result in rebounding. For those that aren’t overweight, your Leptin levels are undoubtedly already lower so weight loss shouldn’t be an issue.

In brief, the Leptin Reset Diet consists of eating a lot of protein and fat within the first 30 minutes of rising in the morning along with reducing carbohydrates (carbs). Dinner is eaten 4 hours before bedtime preferably as the sun is going down and snacking is not allowed afterward. This causes “Leptin Sensitivity” to increase. What this means is that the hypothalamus is retrained to focus on “non Leptin” circadian signals related to timing and diet while ignoring the defunct signals from the blocked Leptin receptor sites – neat bio-hack.

You essentially bypass the broken machinery. It turns out you can retrain the hypothalamus to work properly without the Leptin signal. In addition, another part of the brain called the Pituitary that is also typically tied to Leptin signals begins to act correctly even without a proper Leptin signal. The Pituitary begins to once again stimulate the release of lots of Growth Hormone (GH) while you sleep. When GH levels are correct, our bodies can repair themselves well, abdominal fat is replaced with lean muscle mass, and sex hormone levels improve. In the end, a large part of the Leptin Reset Diet is all about getting GH up to proper levels.

Personally, I followed the Leptin Reset Diet for several months and continue to this day to restrict carbs while eating a protein and fat rich breakfast. I followed the diet because I knew from Dr. Shoemaker that those with CIRS are Leptin Resistant even though I wasn’t overweight – extra weight is one of the signs for Leptin Resistance. For those not overweight, the thyroid hormone Reverse T3 (RT3) will be elevated and cortisol will be higher later in the day; mine were. From Dr. Kruse, I knew the Leptin Reset Diet could help with feeling hungry all the time, repairing circadian rhythms (better sleep), and improving energy levels. How much it has helped, I can’t say. I never followed lab work and may not have been as regular as I needed to be in terms of meal timing. Nonetheless, I do believe in the work of Dr. Kruse and strongly encourage those with CIRS to give it a try.

So we can realize a lot of benefit with the Leptin Reset Diet. Unfortunately, the problem of blocked Leptin receptors remains for as long as Biotoxins are stimulating fat cells to produce Cytokines that then block Leptin receptor sites. Given that those with CIRS never fully recover the ability to clear Biotoxins, blocked Leptin receptors remains an outstanding issue. As such, we’re still stuck with lower MSH until one can develop enough courage to try Cold Thermogenisis (CT) or folks with CIRS have success with the last step of Dr. Shoemaker’s protocol (VIP therapy). Low MSH means gut health will be hard to maintain. Since the theme of this article is gut health, it all fits together. Dr. Kruse’s Leptin Reset Diet is a nice addition to the more general discussion on diet I presented in Alternative Mold Therapies.

Related to reducing carbohydrates, I personally have found that cutting out too many carbs hurts my sleep. In phone consultations with Dave Asprey, Dave commented that he believes Dr. Jack Kruse restricts carbs too much for those with CIRS. Dr. Kruse essentially believes that the body can make all the carbohydrates it needs from protein via the metabolic pathway known as gluconeogenesis. When Dave restricted carbs to 50 grams a day, he had very dry eyes most likely because people who are chronically ill have damaged metabolic pathways and as such, they need the glucose in carbs.

Dave believes it’s better to “pig out” on carbs about once every ten days in the evening eating roughly 250 grams – honey, Mochi (be careful as many brands have wheat), white rice, sweet potatoes, etc. He says you’ll sleep really well and get very hot as you sleep and your body burns off the carbs. By eating carbs occasionally, you preserve your body’s ability to make the mucus that lines the gut, you’ll be able to make tears, and you’ll sleep well. Personally, I eat about 100 grams of carbs daily and save most of them for dinner to help with sleep.

Anti-Gliaden Antibody (AGA)

So it’s been a bit of a winding road, but this is unavoidable to a degree as every part of the body is related to the whole. Let’s finish this section by actually looking at what Dr. Shoemaker did in Step 4 of his protocol to address folks that tested “positive” for Anti-Gliaden Antibody (AGA). It’s pretty simple. If you have AGAs, you need to go on a gluten-free diet for at least three months. After three months are up, gluten is allowed and AGA testing is repeated. If you’re AGA free, gluten is allowed – although personally I think there is enough evidence to suggest gluten should be dropped regardless of AGAs. Note: Very infrequently, those with CIRS will have celiac disease in which antibodies to gliadin (AGA) co-exist with antibodies to Tissue TransGlutaminase (TTG-IgA). These people may never eat gluten again. Make sure to test for TTG-IgA.

By the way, I want to make brief mention of the fact that a gluten-free diet is also prescribed when TGF-beta1 is relatively high. I’ll talk about TGF-beta1 in a later article, but I wanted to make mention of this because of the gluten-free diet aspect and also because having AGAs is just one of the many auto-immunities that may develop with CIRS. As it turns out, auto-immunity in CIRS is a product of high TGF-beta1. Besides AGA, other auto-immunities that may develop include Anti-Myelin Antibodies that destroy the protective sheath around nerve cells, Anti-Cardiolipin Antibodies (ACLA) which impact circulation, Antinuclear Antibodies (ANA) that often result in a misdiagnosis of Lupus, Anti-Neutrophil Cytoplasmic Antibodies (ANCA) that influences ulcerative colitis, along with Anti-Actin Antibodies (AAA).

Biofilm Busters & Anti-Fungals for Gut Health

We know from Dr. Shoemaker that low MSH results in malabsorption or “leaky gut”. However, Dr. Shoemaker does not address gut health except for the use of a gluten-free diet for those with AGAs and high TGF-beta1, as well as, a no-amylose diet for Lymies – see the Binders article. Nonetheless, based upon my personal experience and in talking with experts like Dave Asprey, I believe there are additional steps that may be taken by those with CIRS to improve their health by addressing Gastrointestinal Tract (GI) dysbiosis – an imbalance of bacterial, fungal, and yeast colonies in the gut.

One doesn’t have to look very hard before finding various discussions on the importance and methods for improving gut health. These may include topics such as Candida (an overgrowth of yeast/fungi primarily in the gut), Small Intestinal Bacterial Overgrowth (SIBO – an overgrowth of bad bacteria in the small intestine), Leaky Gut Syndrome, and even Fecal Matter Transplants. With the discussion of diet and probiotics in Alternative Mold Therapies along with the discussion of Dr. Kruse’s Leptin Reset Diet, I’ve covered a good deal of what I’ve found to be useful. I’ll leave it up to you to read Dr. Kruse’s The Leaky Gut Prescription as a way of improving on your understanding and focus instead of treating fungal overgrowth in the gut.

One of the basic premises behind Doug Kaufman’s and Dave Asprey’s diets is that fungal overgrowths are quite common and wreak all kinds of havoc. One of the reasons for this is the use of antibiotics as antibiotics are actually mycotoxins from mold. As such, it shouldn’t be surprising that antibiotic use increases the risk of fungal infections – the mycotoxins not only knock out the bad bacteria that are making you sick but also the good bacteria in the gut that then can lead to a yeast overgrowth (Candida) or some other fungal infection.

According to Doug Kaufmann, other fungi beside Candida can take hold in the intestines and body parts of both immune compromised and healthy individuals. In The Fungus Link Volume 1, Doug makes connections between various mold toxoins (mycotoxins) and disease. Aflatoxins cause tumors, Ochratoxins cause kidney disorders, Patulin causes cancer, and Zearalenone causes estrogenic disorders. In the American Journal of Respiratory Critical Care Medicine, it states that the fungi Blastomyces Dermatitidis, Histoplasma Capsulatum, and Coccidioides Immitis “cause more pulmonary infections than bacteria“. In the Funagalbionic Book Series, the former head of the World Health Organization (WHO), Dr. Costantini, writes extensively about the links between fungi, cancer, and atherosclerosis. Essentially, Dr. Costantini lays out well-supported cases that many cancers and atherosclerosis are really systemic fungal infections and that diet is critical to good health. So while it makes sense that many focus on Candida yeast (a type of fungi), there are many other fungal players that can be problematic and may be much more prevalent than assumed.

When it comes to the Candida, this yeast normally exists through out the body including the mouth, GI tract, and even on the skin of both healthy and sick individuals. As mentioned, Candida and other fungi may grow to excess not only from antibiotic use (antibiotics are mycotoxins) but also bad diet, intimacy with an infected partner, steroidal hormones (cortisone and prednisone), birth control pills, and compromised health to name a few. It’s the toxins and other imbalances that result from this overgrowth that creates trouble. In addition, Candida can escape the gut and get into the blood stream thereby becoming systemic. Given that MSH is low in those with CIRS and low MSH leads to a leaky gut, those with CIRS shouldn’t be surprised to find that treating with anti-fungals may be quite helpful. (see What Is Candida Yeast Infection by Jini Patel Thompson)

When it comes to CIRS, it appears that the problem goes deeper than just Candida. In fact, Dr. Shoemaker has commented that treating for CIRS helped a lot of folks that were unsuccessful in getter better treating Candida alone. On the other hand, an anti-fungal diet and either natural remedies or prescription drugs have been life-saving for others. My personal belief is that those with CIRS need to address Biotoxin removal and their inflammatory effects along with possible fungal infections and bacteria overgrowth (SIBO). Those without a genetic susceptibility to CIRS can most likely get better with treating Candida alone.

In any event, I find it interesting to note the symptom overlap between Candida overgrowth and CIRS. I can see why some doctors assert that CIRS is really just a bad case of Candida. These doctors will often go so far as to rotate patients through an array of anti-fungals and biofilm busters over a long period of time – see Dr. Woeller Antifungal Parade

Candida Overgrowth Symptoms

• Brain & Neurological – mood swings, headaches, migraines, dizziness, slurred speech, depression, anxious or paranoid without a reason, behavioral issues, poor concentration, poor memory, lack of focus, ADD, ADHD
• Digestive Issues – gas, bloating, constipation, diarrhea, indigestion, nausea, gastritis, colitis, GastroEsophageal Reflux Disease (GERD), Crohns (yeast), Irritable Bowel Syndrome (IBS)
• Immunity – hashimoto’s, rheumatoid arthritis (mycotoxins), ulcerative colitis, lupus, psoriasis, scleroderma, MS, hay fever, mucous congestion, postnasal drip, sinusitis (try anti-fungal NutriBiotic Grapefruit Spray), asthma, bronchitis, chest pain, constantly clear throat or cough, meningitis, allergic reactions to chemicals and foods with an increasing number of triggers over time (skin testing for food allergies is inaccurate), atherosclerosis (sugar depresses the immune system and cane sugar is often moldy)
• Reproduction & Urinary – vaginal and urinary infections, menstruation problems, impotence, infertile, prostatitis, rectal itch
• Skin & Nails – eczema, hives, rashes, athlete’s foot, jock itch, skin rash, acne, hives, ringworm, nail fungus, psoriasis (yeast)
• Miscellaneous – crave carbohydrates and sugar, chronic fatigue that may be worse after eating, increased pain, hormone imbalance, bad breath, white coated tongue, red-dry-cracked corners of mouth, high cholesterol (defense mechanism as cholesterol binds mycotoxins)

Anti-Fungal Remedies

• Wild Oregano Oil (antimicrobial – bacteria, fungi, virus)
• Organic Carrot Juice – damages the walls of Candida yeast – 8-10 ounces of fresh-squeezed juice twice daily
• Tee Tree Oil (skin fungal infections – worked great on my moldy toes :wassat: )
• Olive Leaf Extract (antimicrobial – bacteria, fungi, virus)
• Caprylic Acid (anti-fungal)
• Pau d’acro (anti-fungal)
• Formula SF722 (anti-fungal)
• Grape Seed Extract (anti-fungal)
• Onion and garlic with meals (anti-fungal)
• Apple Cider Vinegar (anti-fungal)
• Natren Healthy Trinity (excellent probiotics – buy direct to ensure product remains refrigerated)
• L-Glutamine – This is one of the most abundant amino acids in the body and is often recommended to help heal the gut. Dave Asprey recommended taking 10-20 grams after a mold hit to help clear the head and heal the gut. I could only tolerate small amounts without getting excess gas and bloating. I did realize some small benefit from G.I. Revive.

Personally, I did not find any benefit from natural anti-fungals like Olive Leaf Extract, Garlic, and others for gut dybiosis with the exceptions of Wild Oregano Oil and fresh carrot juice. I find Wild Oregano Oil to be moderately strong based upon herxing and carrot juice to be of mild benefit – better for maintenance. My sense is that by the time a person becomes chronically ill, there is enough gut dysbiosis and systemic fungal colonization that herbals aren’t going to be enough. In terms of probiotics, Doug Kaufmann and Dave Asprey both speak highly of Natren brand probiotics. Although I believe other strains can be helpful, this is the one brand that has been both beneficial and I haven’t had a bad reaction to.

Doug Kaufman – Prescription Anti-Fungal Dosage

In How Much Diflucan, Doug Kaufmann offers the following general guidelines.

• Dose based upon weight
• Diflucan (fluconazole) – only systemic anti-fungal capable of crossing the blood-brain barrier, the largest dose is 200mg twice daily, has a half life is 48-72 hours so you may reduce the dosage to every 2nd or 3rd day over time, do not use if breast feeding, some Candida is resistant
• Sporanox (itraconazole) – systemic anti-fungal, take with an acidic drink to boost blood levels, typical dose is 100mg twice daily
• Nystatin – stays in the GI tract with adult dosage of 1,000,000-1,500,000 UI taken 2-4 times daily
• Those with systemic infections may need to treat for a couple of months or longer
• Monitor liver enzymes as Diflucan and Sporanox are Azole drugs and consequently may be hepatotoxic
• Do not combine systemic anti-fungals with cholesterol and diabetic drugs – ask your doctor

Personally, I’ve tried over and over again with prescription anti-fungals. When I was really sick, I couldn’t even tolerate low doses of Nystatin – a mild, non-systemic anti-fungal. The symptoms were just too awful – intense anxiety, constant dread, poor sleep, and a scrambled brain. Over time and with improved diet, I’ve been able to work up to treating with 200mg doses of Diflucan for a couple of months. Given that I still tend to go to “the dark side” when I eat too many carbs, or try to treat with anti-fungals too aggressively, I know I still have work to do here. I think my next go-around will involve the biofilm buster Klaire Labs InterFase Plus and perhaps Nystatin to start with along with Natren Healthy Trinity probiotics. By the way, an alternative to Diflucan (fluconazole) that I’ve heard is quite effective is Sporanox (Itraconazole).

Note: Don’t be surprised if you find yourself eating more and more carbs and sugars. It’ll seem like they aren’t effecting you nearly as much anymore This is because the anti-fungals are working. Absolutely resist the temptation. Don’t unknowingly sabotage your efforts!

Anti-Fungal Diets

• Breaking the Vicious Cycle – Elaine Gottschall
• The Fungus Link Series – Doug Kaufmann
• The Bulletproof Diet – Dave Asprey

Important: If you do not seriously change your diet, you might as well forget about taking anti-fungals. It’s like trying to put out a fire while continuously pouring gasoline on it. Given that those with CIRS have low MSH leading to leaky gut, it’s almost certain that those with CIRS will have many food allergies. Food allergy testing is recommended.

Diagnosis

Given that there are over 20 different species of Candida along with an even larger number of fungi that can take up residence in excess in the human body and cause disease, I personally don’t think testing is of much use. What fungi are you going to test for – all of them? I did get tested for Candida and it came back showing a very mild overgrowth. However, given the strong reactions to even mild anti-fungals in the beginning along with very real benefit over time (calmer, more energy, diminished fight-or-flight reactions), clearly anti-fungals have been a significant part in recovering my health. I think Doug Kaufmann’s recommendation to follow the Phase I Diet along with taking anti-fungals for a month to see if there is significant relief in symptoms makes sense. For those that are quite sick, I would suggest starting out very slow and expect symptoms to flair initially. The bottom line is that there is a lot of evidence that suggests lasting and significant benefit may be realized by treating for systemic fungi with very little risk.

Sunny, Dry, Mountain Air

Since I’ve “let my hair down” having stepped well off Dr. Shoemaker’s path in this article, I might as well finish this discussion on biofilm busters and anti-fungals with an idea I’ve been kicking around for some time. It has to do with being super sensitive to mold. I can remember fretting about absolutely everything. Knowing that the problem was microscopic mold toxins just made the whole situation worse. Everything seemed toxic to me and everything freaked me out.

Having recovered a significant portion of my health along with doing various testing, I’m wondering if maybe a lot of the reactions I was having were actually internal – driven by a fungal overgrowth within my body. For example, lately I’ve been testing to discern if the mattress that was in our moldy house is OK. The mattress was in a zippered cover the entire time. The cover has been wiped down with QUAT. I’ve slept on the mattress, on the floor with just clean blankets, on a cot with clean blankets, and so on. And yet, I’m still not sure.

What I’ve found is that swings in symptoms make it very hard to wade through the “noise” and come up with hard facts. For example, one time I added a food to my diet that I reacted to and when I slept on the mattress I woke up in the middle of the night “wringing my hands” convinced that I needed to rip the entire side of the house apart to find the mold that must be inside the walls! Later, after cleaning up my diet and taking an anti-fungal nasal spray, I slept on the same mattress with only a very mild reaction in the form of increased jitteriness. It’s the same mattress and pillow. It’s the same clothes soap. It’s the same weather conditions and filtered air. The only significant factor seems to be coming from within me.

I’ve already discussed in Mold Induced Anxiety how I believe even small exposures can trigger very real PTSD reactions. Going beyond this, perhaps the fungi living in my body are reacting to the slight amount of toxins I’m breathing in. For example, maybe Candida in my gut senses the metabolites of Aspergillus that I inhale when I’m in the woods, or that is on the rice I eat, and in defense sends out toxins.

If this sounds far fetched, consider the article, Part 2: Treatments for Chronic Gastrointestinal Disease and Gut Dysbiosis. In the article, the authors write that in vitro studies show that probiotics “suppress the growth of microbial pathogens by (1) directly producing antimicrobial factors, (2) stimulating the host’s cells to produce their own antimicrobial factors, defensins, and cathelicidins, and (3) lowering the intestinal pH via release of short chain fatty acids from epithelial cells”. If simple bacteria in probiotics are capable of mounting such an elaborate defense, it wouldn’t surprise me one bit if more complex fungi are capable of as much or more.

Getting back to the mattress, I do find it very interesting that within the short timeframe of a few weeks I can experience such a wide array of symptoms testing the same mattress. My sense is that this is because a lot of the mold symptoms are actually coming from internal fungal colonies (candida) or bacterial overgrowth (SIBO). In response to toxins from within, my mind incorrectly tries to rationalize what’s going on by looking outward to the external environment.

If this is ever proven, it would be a neat trick that internal pathogens play on its host. We end up chasing our tails looking for external drivers when the main source of the problem is within. After all, being anxious or paranoid without a reason is one of the many symptoms of Candida. Now I’m not saying that mold avoidance isn’t absolutely critical. It’s just that I’ve seen for myself how treating with anti-fungals has dramatically decrease my reactivity to mold. In related fashion, I find it interesting to note how when I was really sick, I avoided contact with people and would always pick the dark, out-of-the-way corners when at restaurants and the like. I acted just like mold – preferring to be left alone in dark, poorly ventilated places.

If you have issues with mold, my advice would be at a minimum to go out in the sun, live in a dry climate (being at altitude has its benefits), interact with friends, exercise, and drink good water. You know, do everything that mold hates. There have been folks that have cleared Candida simply by following these simple guidelines. In fact, this makes me wonder if perhaps part of the reason those with CIRS get better when they move to the desert is a result of knocking out the mold within as much as it has to do with inhaling fewer Biotoxins.

Liver Detoxification

I want to finish this article by looking at liver detoxification. It’s only been recently that I feel like I’m getting a handle on detoxification. I mean I’d read various articles including those that link Glyphosate (Round-Up) and the suppression of Cytochrome CYP450 enzymatic proteins and remember Lance Brubaker talking about these same proteins in relation to defunct Phase I liver detoxification years ago when we purchased an HBOT. Later on, I studied Chris Shade’s heavy metal detox program that works by increasing Phase II and Phase III liver detoxification pathways. Over time, this got me wondering if maybe the fact that Biotoxins aren’t cleared by the liver and gut in those with CIRS is a result of problems with one of the three “Phases” of liver detoxification. Given the importance of clearing toxins in general when it comes to good health, even if the I was wrong and the liver detoxification system was never supposed to clear Biotoxins well, supporting this system would certainly be helpful over the long term.

Getting into some specifics, according to Dr. Shoemaker, the reason folks with CIRS get sick is because they are unable to create antibodies. Now I know I’ve just made a seemingly odd detour by first talking about liver detoxification and then jumping over to antibodies but hang in there. It’s going to be fun.

In his book, Mold Warriors, Dr. Shoemaker goes into some detail about how a person’s HLA DR genotype describes the particular shape of proteins that make up a person’s HLA molecules. It is these HLA molecules that get tacked onto pathogens (internal byproducts and foreign invaders) by dendrite white blood cells so other white blood cells called lymphocyte T and lymphocyte B can actually create antibodies.

In other words, HLA molecules, as well as, processing by white blood cells are important in the creation of antibodies. Antibodies are important because once your body learns to recognize and make antibodies for a particular pathogen, the immune system will be able to mount a response against the “bad guys” very quickly in the future. Upon future exposures, the pathogens will be tagged right away by antibodies so they can be removed from the body before any real damage can be done. Your body learns how to mop up invaders quickly.

So this is where it starts to get interesting because Dr. Shoemaker has said there is very little evidence to actually support this broken antibody theory. That’s right. To date, this is just Dr. Shoemaker’s best guess on why people get CIRS.

Granted, we know that folks with particular HLA DR genes are much more likely to get CIRS. We also know that people that do get CIRS will suffer from a wide range of health issues as a result of the never-ending inflammation caused by another part of immune system (innate immune system) that gets stuck on high alert. Furthermore, we know that if you give those that suffer from CIRS binders so they can clear the Biotoxins that are keeping the innate immune system ramped up, they start to get better. But that’s it.

No one has ever found the smoking gun showing that healthy people who happen to have susceptible HLA genes are making antibodies to Biotoxins while those with CIRS can no longer make these same antibodies. Dr. Shoemaker has said that part of the problem getting this proof has to do with the sheer number of Biotoxins that are created by mold and bacteria combined with the fact that most of them can’t be measured in the human body. As such, the evidence to support the broken antibody theory is very thin. Dr. Shoemaker seems confident that with time that proof will be forthcoming. In the mean time, I’d like to suggest an alternative explanation as to why folks with CIRS get sick. To do this, we need to understand a bit about the three Phases of liver detoxification.

So I’m not going to dive too deeply into liver detoxification. For those that want more information, there are lots of good articles on the subject that describe the various chemical reactions that occur in the liver along with foods to avoid and the various supplements a person can take to aid in detoxification. You could start by reading the follow-up articles I wrote, GSH Detox Protocol and Blocked Detox. For the purposes of this article, I’m only going to cover some of the more interesting supplements as they relate to the subject of tying together liver detoxification with CIRS.

Liver Phases 1 And 2 Detoxification Pathways
Phase I and II Detox Pathways
The Liver & Detoxification
The Detoxification System

Phase I

Before we go one step further, I want to point out that it’s important to get your reactivity under control in order to bring down inflammation before ramping up liver detoxification. Removing foods, chemicals, biotoxin exposures, and other stressors, can help a lot to dampen down the immune response. It’s important to do this first. We don’t want to start moving toxins when the body is already on high alert. It could make matters worse.

OK, with that precaution out of the way, let’s begin with the understanding that the basic function of the liver and kidneys is to filter blood. They’re responsible for removing a wide range of toxins from the body. In terms of the three Phases of liver detoxification, these include metabolic end products, micro organisms, pollutants, insecticides, pesticides, food additives, drugs, alcohol, hormones, some vitamins, steroids, and so on. Furthermore, the toxins the liver removes are sequestered in bile that then is dumped into the small intestines whenever you eat. If all goes as it should, liver toxins leave the body in stool. The toxins the kidneys filter through from the blood goes out in urine.

In addition, we know the kidneys and liver also remove at least some of the known Biotoxins. In terms of the kidneys, we know this because labs like RealTime make a living testing for mold toxins (mycotoxins) in urine. Furthermore, there are lots of studies that show a correlation between urine and feces mycotoxin levels in livestock and ill health effects. When it comes to the liver, the main reason Dr. Shoemaker’s protocol works is because Cholestyramine (CSM) and Welchol bind to Biotoxins in bile as a way of ensuring these toxins get transported out in stool. So with this information, you can see why I began wondering to myself if perhaps the liver and kidneys were always meant to be the primary means for clearing Biotoxins.

So we know that the failed antibody explanation is just a theory and this is where the “plot thickens”. Based upon my reading, Dr. Shoemaker seems to be arguing that the liver and kidneys were never intended to be the main means of removing Biotoxins. He makes this argument by pointing out the fact that the bile is recirculated in a process known as enterohepatic circulation that serves to reuse bile and bilirubin. He then goes on to say that the fact that the Biotoxins are so small and of a particular shape, in combination with this recycling process, allows them to escape the intestines before they are eliminated and get back into the blood stream. As a result, the majority of Biotoxins recycle endlessly until a binder like CSM or Welchol is taken. These binders grab onto the Biotoxins and thereby make them large enough to prevent their slipping out of the digestive system.

That explanation seems all well and good, but who’s to say that the reason folks with CIRS get sick, is not because they can’t create antibodies but instead is because their liver detoxification isn’t working well? To date, the answer is no one. For example, maybe in healthy guts, bacteria gobble up Biotoxins like candy when they enter the GI tract. Alternatively, maybe Dr. Shoemaker is right and the antibody creation process for clearing Biotoxins fails in people with CIRS but perhaps that is only one part of the entire means by which the body clears these toxins. Maybe antibodies, the kidneys, and the liver always worked together in healthy individuals to clear Biotoxins. Maybe it is a drop in the liver and kidneys ability to clear these toxins the “tips the scales” such that the body becomes increasingly loaded up with toxins. On the other hand, maybe folks with susceptible genes were never able to create antibodies but the liver and kidneys were able able to keep up with the Biotoxins until something else got broken.

Well, that’s just a lot of speculation but the main point is that liver and kidney detoxification may be much more involved with inducing and getting better from CIRS than is currently suggested. In defense of this point, allow me to tie together a few positions. In so doing, I think you’ll be able to see where these alternative explanations about what’s broken in people with CIRS are coming from and realize why I think liver detoxification is so important.

We’ll begin with a little-known book called Porphyria by Steven Rochlitz. This book is an interesting read because of its focus on Phase I detoxification. Mr. Rochlitz is a Board Certified Otolaryngologist (ear-nose-throat) and Environmental Medicine Specialist. In this book, the author hypothesizes that the underlying cause to CIRS, Fibromyalgia, Alzheimer’s, Thyroid Disease, MCS, EMF Sensitivities, and many others may in fact be due to impaired Phase I liver detoxification. In particular, that the body loses much of the ability to manufacture a particular class of Heme enzymatic proteins called CytoChrome CYP450.

In brief, Phase I of liver detoxification is all about converting toxins into smaller and sometimes more reactive molecules. This increased reactivity is needed in order to bind and neutralized the toxic molecules by a process called “conjugation” in Phase II. Other toxins are converted directly into water-soluble forms in Phase I that the kidneys can filter out and are excreted in urine. Out of the various chemical reactions in Phase I (oxidation, reduction, and hydrolysis), oxidation using CYP450 enzymes is the most common. In other words, if Mr. Rochlitz is right and up to 20% of the population suffers from an impaired ability to make sufficient CYP enzymes (along with the over abundance of porhyrin molecules that result from failed CYP creation), then it’s not surprising that the whole host of afore mentioned illnesses may result with all of them having a failure to make enough CYP450 enzymes at their core.

As an aside, recently my wife and I were out sunning on our deck in order to increase vitamin D levels naturally. To my chagrin, I took a major mold hit – see Decks, Gazebos, Porches, Stoops & Mold! Ugh. What I found very intriguing related to this discussion is that both my wife and I sweated profusely the evening after being exposed. I mean, I’d read that some were saying FIR saunas were good for clearing Biotoxins, but this experience along with my understanding of Phase I seemed to solidify this position. In Phase I, some toxins get converted into water-soluble forms that are then excreted in urine or sweat. We both sweated like crazy. Furthermore, perhaps the reason ADH and Osmolality in those with CIRS gets imbalanced is an attempt by the body to clear an excess of water-soluble toxins. If that’s the case, then it’s very important to make sure those with CIRS are no longer being exposed to biotoxins before they try to squelch the imbalance between ADH and Osmolality in order to reduce frequent urination. Well, it’s interesting conjecture but I think I better stick to the point at hand.

A Review of the Mechanism of Injury and Treatment Approaches for Illness Resulting from Exposure to Water-Damaged Buildings, Mold, and Mycotoxins

Mr. Rochlitz suggests that this blockage in CYP enzyme production is likely the result of heavy metals and other toxic chemical exposures. Given this, you can see why I found it interesting to read in Glyphosate’s Suppression of Cytochrome P450 Enzymes and Amino Acid Biosynthesis by the Gut Microbiome how the authors showed residues of Glyphosate (RoundUp) inhibited CytoChrome P450 (CYP) enzymes in mammals. The authors write, “We have found clear evidence that Glyphosate disrupts gut bacteria and suppresses the CYP enzyme class. The connection to sulfate transport is more indirect, but justifiable from basic principles of biophysics.” Wow, CYP enzymes, gut health, and sulfate transport are all related to liver detoxification!

There you have it. It seems quite likely that as a result of the chemicals we use on our crops, along with the heavy metals and various other xenophobic (external) toxins we’re exposed to, that Phase I detoxification gets partially shut down and this then leads to a buildup of toxins in the body and poorer health. If you react to perfumes, paints, environmental chemicals or can’t handle caffeine, there is a good chance you have seriously impaired Phase I pathways. To the degree that we can reduce our toxin burden that tends to overtax Phase I (caffeine, alcohol, nicotine, sulpha and barbiturate drugs, steroids, carbon tetrachloride, exhaust and paint fumes, dioxin, pesticides, and grapefruit juice) along with taking supportive supplements like Vitamins B3, B6, B12, A, C, D3, and E combined with folinic acid and milk thistle, then we’re better off. Note: Eight ounces of grapefruit juice slows Phase I by reducing CYP450 enzymes 30% while speeding up Phase II detoxification at the same time.

So what’s the bottom line when it comes to Phase I liver detoxification and CIRS? For all we know liver detoxification plays a key role in CIRS. Even if this turns out to not be the case, improving detoxing can only help. For me, this means taking a high quality multivitamin along with specific B and D supplementation, and supporting liver detoxification with milk thistle. It means varying the foods I eat along with limiting carbohydrates. Most importantly, I take roughly 10 grams of vitamin C daily to help mop up all the oxidative stress from the free-radicals that are created as a result of toxin conversion in Phase I. Coincidentally, Vitamin C also helps increase Glutathione (GSH) used in Phase II.

Phase II

While some toxins are converted into water-soluble forms and exit the body in urine in Phase I, many of the toxins need to be further processed in Phase II. There are a total of six detoxification pathways in Phase II. The primary means of converting toxins in Phase II is by conjugation. In conjugation, the partially processed fat-soluble toxins from Phase I are combined with anti-oxidants to make them less toxic and water-soluble. For example, in Glutathione Conjugation, the toxins are combined with anti-oxidant Glutathione (GSH). In Amino Acid Conjugation, toxins are combined with glycine, taurine, glutamine, arginine, or ornithine anti-oxidants. Once conjoined, the toxins leave the cell (toxins are often stored in fat) and are transported out of the body by Phase III processes and eventually are eliminated in stool or urine.

Phase II Detoxification Pathways

1. Glutathione Conjugation (glutathione conjugate made from cysteine, glutamic acid, and glycine)
2. Amino Acid Conjugation (glycine, taurine, glutamine, arginine, and ornithine conjugates)
3. Sulfation (sulfur compound conjugates)
4. Methylation (methyl group conjugates)
5. Acetylation (acetyl-CoA conjugates)
6. Glucuronidation (glucuronic acid conjugate)

The complexity of each of these six pathways is significant. For example, if you study Chris Shades videos on conjugation with Glutathione (GSH), you’ll see that not only does your body need to be able to make GSH but also a whole host of other Phase II enzymes. For examples, transferase enzymes bind toxins to GSH. Synthetase enzymes synthesize more GSH. Peroxidase enzymes quench GSH radicals. Reductase enzymes repair GSH oxidative capacity. And so on, and so on, and so on. Not only does your body need to be able to complete all these enzymatic steps well, but it needs a range of nutrients to keep these processes churning that includes, vitamins B1, B2, B3, B6, B9, B12, C, E, folate, SAMe, glycine, taurine, choline, methionine, betaine, selenium, N-acetyl-cysteine, MSM, magnesium, molybdenum, zinc. Note: If garlic upsets your stomach or your urine has a strong smell after you eat asparagus, you may have impaired Phase II pathways.

Given this introduction, what I’d like to do next is to talk a bit about three of these pathways – Glutathione, Sulfation, and Methylation conjugation. Even though a person could spend the rest of their lives learning about any one of these detoxification pathways, I’m hoping to apply a little common sense and come away with basic steps that those with CIRS might benefit from. Let’s start with Glutathione (GSH) Conjugation.

Glutathione Conjugation

What really intrigued me about Chris Shade’s detox protocol for heavy metals is that here is a protocol that’s proven to work in firing up Phase II and Phase III liver detoxification. Not only does Chris’s protocol up-regulated liver detoxification for mercury removal (a focus of Chris’s protocol), but anytime you fire up GSH detoxification you’ll also be pulling out lead, arsenic, cadmium, aflatoxins produced by Aspergillus mold, chloroform, DDT, bromobenzene, chlorinated hydrocarbons (herbicides/pesticides), organic nitrates, paracetamol (Tylenol), and radiation (scavenges reactive oxygen species ROS). In addition, by getting the liver involved in heavy metal and other toxin removal, the often overtaxed kidneys get some relief. This is very cool when it comes to heavy metals because chelators like DMPS and DMSA work exclusively through the weary kidneys. (Although, they are hepatotoxic to the liver so one really does need to take care with these chelators.)

So when it comes to CIRS, to the degree that we can reduce our toxic load in general, overall health including gut health improves. Glutathione Conjugation is a major detoxification pathway that Chris Shade figured out how to get it working even better at toxin removal. To the degree that we can implement on his procotol, those with CIRS should be better off. By the way, did you notice that in the list above, Glutathione Conjugation removes the mold mycotoxin called aflatoxin? To top it all off, it’s really nice that Chris’s protocol is straightforward.

Now before diving into firing up GSH detoxification, you’ll want to make sure to do “pre-detoxing” that includes GI cleansing, improved diet free of allergens with plenty of protein and good fats along with perhaps taking coffee or ozone enemas – ozone boosts baseline levels of Glutathione (GSH) and Super Oxide Dismutase (SOD). Furthermore, you’ll want to avoid substances that slow Phase II detoxification including a low protein diet, aspirin, other NSAIDs including ibuprofen, smoking, birth control pills, and yellow food dye. Note: Grapefruit juice and curcumin slow down Phase I and speed up Phase II at the same time.

When it comes to implementing Chris’s protocol, one option is to just go ahead and study up on Chris’s three detox protocols and then purchase QuickSilver products. After starting the protocol, very gradually increase detoxification while taking mineral supplements on “off days” – especially if you’re feeling tired. Off days are essential as detoxification levels will drop to baseline regardless of the amount of supplementation without them. According to Chris, it takes 3-18 months to detoxify heavy metals with the first 6 months being the most active time. The average is about a year.

QuickSilver Detox Protocols

• QuickSilver Level 1 Protocol
• QuickSilver Level 2 Protocol
• QuickSilver Level 3 Protocol

On the other hand, I see no reason why a person couldn’t come up with their own program and save money. Granted the thiol-functionalized silica resins Chris developed for binding mercury in the intestines in Phase III sounds like they’re really potent, but there are other good binders like chlorella for mercury. In addition, while removing heavy metals is always helpful, the focus for folks with CIRS, and consequently the binders used, is necessarily different. From where I stand, its about boosting liver detoxification overall and taking binders to mop up the mess.

Getting into some details, at 50 minutes into this video, Chris Shade discusses how liver detoxification decreases with age and then presents a study that shows a marked drop in important detoxification nutrients as rats age. In the study, Glutathione (GSH) was roughly 20% lower in the older rats while Vitamin C and E along with GSH enzymes were about 35% lower. Amazingly, by giving the older rats the equivalent of 6 grams of the dried fruit of Haritaki for adult humans (a very reasonable amount), the levels in the aging rats returned to those of younger rats. Wow! By the way, Haritaki Terminalia Chebula is an Ayurvedic fruit called the “King of Herbs” in Tibetan medicine and is often shown in the hand of the Medicine Buddha.

In fact, if you look at the ingredient deck on QuickSilver ClearWay CoFactors, Haritaki Terminalia Chebula is the primary ingredient. It also includes bitter dandelion root to stimulate bile flow, B vitamins, and others, but what Chris found is that Polyphenolics, especially Haritaki, really fired up GSH Phase II detoxification. In other words, the key player is the Haritaki. From where I stand, someone like me that is already supplementing minerals and vitamins should be able to add in Haritaki Terminalia Chebula as part of their own detox protocol. Other polyphenolics include epicatechin (grape seed extract, green tea, cocoa, pine bark extract), ellagic acid (pomagrates), and quercetin (fruit skins).

In addition to ClearWay CoFactors, Chris’s protocol also includes super tiny liposomal forms (etheric) of Vitamin C, GSH, and R-Lipoic Acid with EDTA. In my article, Liposomal Vitamin C, I discuss how to make your own liposomal C for a fraction of the cost. Granted Chris’s “etheric” form is so small that it goes directly into the blood while being held under the tongue. However, I see no reason why a person couldn’t squelch oxidative stress by simply increasing the quantity of homemade liposomal C they ingest.

Regarding GSH, although I’d like to be able to buy Quicksilver Scientific Reduced Glutathione, at $46 for a 100 pump bottle and a protocol that uses up to 18 pumps a day, that works out to $8.25 a day for GSH! That’s over $2,000 for a years worth of GSH. I don’t know about you, but for me that’s a lot of money.

As such, I think homemade liposomal GSH using Reduced Glutathione is worth a try. It’s the same process as making liposomal Vitamin C. Also, according to this article, ”…do-it-yourselfers can in many cases actually challenge the levels accomplished by these very high dollar commercial (liposomal) machines…”

In addition, Chris also recommends his etheric liposomal EDTA along with R-Lipoic Acid solution as part of the detox protocol. Since QuickSilver’s IMD Intestinal Cleanse binder doesn’t attach to metals like lead and cadmium, EDTA supplementation is required. Regarding R-Lipoic Acid (R-LA), R-LA is a precursor to GSH and according to Chris Shade is also a more potent chelator than the alpha-lipoic acid (ALA). If you’ve read Andrew Cutler’s heavy metal protocol, ALA is used to mobilize metals especially across the blood-brain barrier.

It’s worth noting that when the QuickSilver protocol was initially launched, it did not include the GSH, R-Lipoic Acid, or EDTA products. If I remember correctly, GSH was still recommended but unavailable from QuickSilver. I believe R-Lipoic Acid and EDTA were added in later on to improve the number and rate of heavy metals removed. Although it’s important to remove heavy metals, this is not necessarily the focus when it comes to CIRS. A person with CIRS should first be concerned with addressing the massive inflammation from CIRS before using chelators like R-Lipoic Acid and EDTA to remove metals like lead or cadmium.

Nevertheless, if you’re looking for alternatives to QuickSilver products, Detoxamin EDTA suppositories are well spoken of. Besides directly supplementing GSH, you may want to consider making your own liposomal GSH Precursors solution using ingredients from Master Herbalist, Troy Hyyppa, at Living Soil Herbal Farmacy. Another option is to consume high quality whey protein as a precursor to boasting glutathione as is recommended by Chris Kresser, Dave Asprey, and Dr. Mercola.

So that’s it. When it comes to ramping up Phase II detoxification along the GSH Conjugation pathway, the key ingredients are Haritaki Terminalia Chebula along with GSH and precursors to GSH. Granted we could add in some R-Lipoic Acid and EDTA but for those with CIRS, the focus should be on increasing detoxification in general and reducing inflammation. You can deal with heavy metals later. After pre-toxing, cautiously increase GSH while adding in Haritaki seems like a reasonably safe approach with significant upside potential. Now let’s spend a minute looking at improving detoxification along the Phase II Sulfation pathway.

Sulfation

Second only to GSH conjugation is detoxification through conjugating toxins with sulfur compounds. Some of the toxins removed are food colorings, toxins from bacteria in the gut, steroid and thyroid hormones, neurotransmitters, acetaminophen and antihypertensive drugs, along with environmental toxins. Sulfation is enhanced by methionine, cysteine, taurine, GSH, MSM, NAC, R-lipoic acid (R-LA), Vitamin B1 and B2, magnesium, and molybdenum.

Accoring to Chris Shade, Polyphenolics like Haritaki worked best for detoxing mercury although the sulfur compounds “sometimes packed more punch”. Sulfur compounds are found in crucifers like broccoli, broccoli seed, Brussels sprouts, pok choi, bok choy, as well as, non-deodorized garlic oil (better for detox upregulation than cloves), oil of mustard (wasabi), onion, and others. Cruciferous vegetable contain indole-3-carbinol that up-regulates both Phase I and Phase II.

You can get Diindolemethane (DIM), a sulfur containing molecule found in cruciferous vegetables, and Indole 3 Carbinol (IC3) supplements. In conversions with Dave Asprey, Dave commented that DIM and IC3 promote beneficial metabolism of estrogen for folks that are estrogen dominant by turning on Sulfation pathways often shut down by mold. At that time, Dave was taking IC3.

In this Dr. Mercola & Dr. Stephanie Seneff Interview, Dr. Seneff discusses the importance of sulfur. To ensure the body has sufficient sulfur, eat foods high in sulfur (meat, seafood, oysters, egg yolks) and get adequate sunlight. You may also consider supplementing MSM or Chondroitin Sulfate – Chondroitin Sulfate also happens to be good at lowering the Histamine response.

In addition to diet, Dr. Seneff recommends soaking in a tub of hot water containing 1/4 cup of Epsom salts twice a week – Epsom salts contains both magnesium and sulfur. Bathing in Epsom salts is similar to bathing in healing sulfur hot springs. Among other things, sulfate is needed to bind to aluminum and transport it out. Aluminum from the environment, flu shots, antiperspirants, cookware, and chemtrails in combination with a cholesterol sulfate deficiency may be the underlying driver behind Autism, Schizophrenia, Alzheimer’s, and others. (Part 5 of 7 at 9:00) If you’re concerned about aluminum, take a look at Miso and Cilantro Soup for Detoxification.

Sulfation detoxification is important. Diet along with sun bathing and Epsom salt baths are easy ways to ensure you have sufficient levels of the sulfur compounds required to conjoin toxins in Phase II. I’m sure you’ve probably heard of these recommendations before but now you have a better understanding of their significance.

Methylation

Methylation is important for a lot more than just liver detoxification. However, when it comes to detoxification, methyl groups are conjugated to toxins such as excess estrogen, adrenaline, histamine, serotonin, dopamine, melatonin, along with homecysteine and various chemicals (amines, phenols). In general, Methylation is enhanced with methionine, B-vitamins (B6, B12, folinic acid, choline), betaine, magnesium, and SAM-e. Most of the methyl groups used to bind toxins come from SAM-e.

It doesn’t take long reading on the Net to realize Methylation is a huge topic. The waters that experts like Dr. Amy Yasko, Dr. April Ward-Hauge and Dr. Ben Lynch swim in are deep. Personally, I had 23andMe DNA testing, a couple consultations with Dr. Tim Jackson, one consultation with Sterling Hill, and worked up about 25 pages of notes before my health improved enough using other means that I decided to just implement Rich Van Konynenburg’s Simplified Approach. If you’re interesting in getting into the details, here is a nice Methylation primer.

In looking over my old methylation notes, I’m reminded just how inter-related and involved methylation is. For example, my notes point out that I have a CBS 699 mutation that can lead to increased sulfur and ammonia levels. Knowing this, even though Dr. Seneff recommends making sure a person gets enough sulfur, in my case, my particular SNPs point to the importance of supplementing molybdenum in order to make sure that eating cruciferous vegetables and eggs along with taking Epsom salt baths won’t result in an excess of toxic sulfite – molybdenum helps convert toxic sulphite to benign sulphate. Likewise, I have several Detox “CYP” enzymes mutations listed on Sterling Hill’s more detailed methylation report that indicate issues with CytoChrome CYP450 enzymes discussed in Phase I above. I guess the more you know the better off you are.

Nevertheless, my latest approach is to keep protocols as simple as possible. As such, the late Rich Van Konynenburg’s, Simplified Approach fits in well. Supplementing with a little Methl and Hydroxy Cobalamin, along with a touch of Folinic Acid and some Phosphatidyl Serine seems to do a nice job getting around many of the common methylation blockages. Alternatively, Kimberly commented that Freddd’s Methylation Protocol has helped moldies.

A Simple Explanation of the Glutathione/Methylation Depletion Theory of ME/CFS by Rich Von Konynenburg
A Guide to Freddd’s Protocol

Simplified Approach For Lifting Methylation Blocks In CFS (March 30, 2011 Revision)
Rich Van Konynenburg. Ph.D.
Methylation Block Supplements (one only from each numbered item)

1. General Vitamin Neurological Health Formula: Start with one-quarter tablet and increase dosage as tolerated to 2 tablets daily. Note: General Vitamin Neurological Health Formula has been replaced with 2 capsules of All in One by Holistic Heal -> 53¢/day. Alternatively, consider taking Nature Made Super B Complex for B1 through B6 vitamins and then add in additional vitamins like A-C-D-E-K, Omega 3 fish oil, along with minerals like magnesium, molybdenum, potassium, selenium, and zinc separately – see my discussion of supplements.
2. Hydroxy B12 Mega Drops: 2 drops under tongue: 2,000mcg -> 23¢/day – some react)
   PERQUE Activated B-12 Guard: 1 lozenge: 2000mcg -> 30¢/day
3. Enzymatic Therapy – B-12 Infusion: one-quarter tablet: 250mcg (1,000mcg/tab ->5¢/day)
   VRP Vitamin B12 Methylcobalamin: one-quarter dropper: 250mcg (120 droppers -> 6¢/day – some react)
   FolaPro L-5-methyltetrahydrofolate: one-quarter capsule: 200mcg (800mcg/cap ->8¢/day)
   MethylMate B 5-Methyltetrahydrofolic: 6 drops: 210mcg under tongue (35mcg/drop -> 23¢/day – some react)
4. Seeking Health Folinic acid: one-quarter of a 800mcg capsule daily (800mcg/cap ->5¢/day)
   Metagenics Fola Pro – L-5-MTHF: one-quarter tablet of a 800mcg tablet daily (800mcg/tablet ->6¢/day)
5. 1,200mg of Lecithin or 500mg of Phosphatidyl Serine Complex
   Swanson Sunflower Lecithin Non-GMO: three-quarter teaspoon ->3¢/day
   Now Foods Sunflower Lecithin Non-GMO ->7¢/day
   Source Naturals Phosphatidyl Serine Matrix -> 33¢/day

Gordon Medical: Update on the Methylation Protocol (August 12, 2012 Version)

1. Supplements can be taken any time of day, with or without food.
2. B12 Perque Activated Lozenges and FolaPro replace liquid drops of B12 Hydroxy Mega Drops and MethylMate B due to occasional allergic reactions.

Now I’m sure that there are methylation experts out there that would cringe upon hearing my recommendation to try Rich’s simplified approach without methylation testing. However, in my experience with CIRS, although methylation is important and helpful, it’s not critical. I can say that when I was really sick, I had trouble taking B vitamins – seemed to make symptoms worse. However, I can’t really say how much of that was from methylation blocks and how much of it was just background noise from being loaded up with Biotoxins and unknowingly taking mold hits. Whatever the case, I would recommend increasing methylation supplements very slowly and to do so apart from other therapies so you can tell if it’s causing issues. Given that detoxing can take quite a while and I don’t see my methylation blocks lifting any time soon, I continue to this day to supplement according to Rich’s simpler method.

Phase III

We’re finally down to the last step. The toxins have been conjugated and are ready to be transported out of the cells, across the ExtraCellular Matrix (ECM), into the blood, through the kidneys, and out into the intestines by a small group of “transport proteins”. For examples, the protein MRP1 transports the toxins out of the cell and into the blood, the OATP protein transports the toxins through the liver, and MRP2 proteins transport the toxins into the intestines. Unfortunately, when the gut is inflamed from heavy metals or low MSH, Phase III transport proteins are inhibited between 60-75%. When this happens, the whole detoxification system slows, free radical damage from Phase I ensues, and this eventually leads to serious detox impairment.

Once again, diet and gut health are very important. In addition, taking binders can help prevent the toxins from being reabsorbed through the intestines. Furthermore, binders also help maintain physical separation between toxins like metals and the endothelial lining of the intestines. This helps prevent inflammation and keeps Phase III transport proteins working well.

Each binder is better at grabbing onto certain toxins over others. In the QuickSilver protocol for removing heavy metals (especialy mecury), IMD Intestinal Cleanse is recommended. However, for CIRS, a more general approach toward binders may be taken. Given that increasing liver detoxification is going to result in an array of toxins showing up in the gut along with the fact that we’re not especially interested in binding mercury, taking more than just Cholestyramine or Welchol seems prudent.

According to Chris Shade, Chorella has anion exchange, cation exchange, and direct metal binding capacities. Zeolite has cation exchange (although it doesn’t bind mercury) and attaches to (sorption) mold toxins. Charcoal has sorption of large molecules like hydrocarbons such as benzenes. (Charcoal and clays should be taken away from foods.) Chitosan has anion exchange ability and supposedly should work like Cholestyramine (although Dr. Shoemaker says it doesn’t work for CIRS). Dave Asprey recommended PectaClear EcoNugenics as a metal binder. The Better Health Guy, Scott Forsgren, likes Takesumi Supreme.

Summary

MMP9 – Leptin Reset – AGA
Inflammation from Cytokines causes the blood marker MMP9 to rise. These Cytokines block Leptin receptor sites in an area of the brain called the Hypothalamus. As a result, Leptin levels rise causing the person to hang onto fat. Due to the impaired Leptin signal to the Hypothalamus, another part of the brain called the Pituitary doesn’t make Growth Hormone (GH) while we sleep. Without sufficient GH, our bodies can’t repair themselves, lean muscle mass becomes abdominal fat, and sex hormone levels drop.

Dr. Jack Kruse’s “Leptin Reset Diet” retrains the Hypothalamus to stop looking at Leptin levels and instead focus on the signal from the diet and light cycles. It is a very cool bio-hack as those with CIRS can begin to realize health improvements before reaching the last step in Dr. Shoemaker’s protocol – using VIP.

With CIRS, comes high TGF-beta1 levels. High TGF-beta1 levels often lead to auto-immunity that includes Anti-Gliaden Antibody (AGA). According to Dr. Shoemaker’s protocol, people with AGAs or high TGF-beta1 must go gluten-free for at least three months and then retest. Those with confirmed Celiac Disease in which antibodies to gliadin (AGA) co-exist with antibodies to Tissue TransGlutaminase (TTG-IgA) may never eat gluten again.

Biofilm Busters & Anti-Fungals for Gut Health
There is plenty of evidence to suggest that fungal colonization in the human body is much more prevalent than conventional medicine leads us to believe. These fungal infections can cause a wide range of debilitating illnesses. Given the sheer number of types of fungi and lacking testing procedures, it may make sense to try using a biofilm buster like Klaire Labs InterFase Plus in combination with Nystatin or Diflucan. Diet is absolutely critical. After successful treatment, maintenance doses of natural anti-fungals are recommended.

Liver Detoxification
Dr. Shoemaker’s argument that the reason people get CIRS is due to an inability to make antibodies to Biotoxins is a very thinly supported theory. That doesn’t mean his protocol doesn’t work, but simply that the driver behind CIRS is unknown. For all we know, the three Phases of liver detoxification along with a healthy gut biome are the real means by which the body clears Biotoxins. Studies are coming out showing links between RoundUp and impaired liver detoxification across all three Phases, as well as, many others linking environmental toxins with gut dysbiosis.

At a minimum, improving liver detoxification will help with overall health by enhancing clearing of toxins that includes chemicals, heavy metals, and Biotoxins. However, it’s important to first elmininate foods, chemicals, biotoxin exposure, and other stressors that are keeping your immune system on high alert. Do not ramp up liver detoxification until you’re well along in your healing process. Start slow and increase detoxification gradually.

In Phase I, the keys to improved detoxification are a rotating diet, avoiding substances that impair Phase I, proper supplementation with vitamins and minerals, along with taking liposomal Vitamin C to help quench free radicals. A high fat and high protein diet with lots of vegetables and reduced carbohydrates is recommended.

In Phase II, much can be done to ramp up detoxification by supplementing with the Ayurvedic herb called Haritaki Terminalia Chebula along with supplementing directly with liposomal Glutathione (GSH) and the precursors to GSH. Epsom salt baths and simplified methylation supplementation help improve other aspects of Phase II detoxification. To prevent fatiguing the detoxification system, it’s essential to take “off days” and supplement with minerals.

Before increasing detoxification, it’s important to “pre-detox”. This includes gastrointestinal (GI) cleansing, an improved diet free of allergens, and perhaps coffee or ozone enemas. Furthermore, you’ll want to avoid substances that slow Phase II detoxification.

In Phase III, many toxins that have been cleared out of cells in the body are transported into bile that is dumped into the small intestines by the liver. Binders are very important not only to ensure the toxins stay in the GI tract and are excreted in stool but also to reduce inflammation to the gut lining. Gut inflammation impairs Phase III detoxification between 60-75%.

Detox Series

1. AGA – Diet – Detox
2. GSH Detox Protocol
3. Blocked Detox