How I’m Getting Mold Out of MY Home

What You Didn’t Know About Mold Removal, Testing, and Your Health with Michael Schrantz

When it comes to mold exposure, toxicity and health, what’s really problematic, and what’s not? I learned a lot while going through my own health struggle with brain fog and trouble sleeping related to mold in the home I was living in, and Indoor Environmental Professional (IEP) Michael Schrantz has been one of the most valuable sources of balanced information throughout that journey. On today’s podcast episode, Michael Schrantz is back to share his expert advice and insights on mold testing, mold removal, and health.

In This Episode

Intro … 00:00:45
Austin Mold Update … 00:07:43
Utilizing a Mold Professional … 00:20:53
Building a Case for Mold With a Clinician … 00:32:54
The Role of Laboratories in Interpreting Results … 00:43:30
Remediation Process Example … 00:45:50
Typical Mold Exposure Cases … 01:02:12
Limbic System Reactions … 01:06:38
Discouraging Mold Growth … 01:13:18
Episode Wrap-Up … 01:20:15

How I’m Getting Mold Out of MY Home - Podcast307b MichaelSchrantz

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Hey everyone. Today I spoke again with Mike Schrantz, who is an indoor environmental pollution specialist. When he had come on the podcast before we discussed mold. This time, the follow-up conversation actually turned into what I should do about the mold that was found in my condo in Austin. This has been a pretty eye-opening experience, and I’ve learned a lot in terms of how to use “the system,” meaning we have HVAC professionals, we have remediation specialists, we have IEPs who do their analysis. So I’ve learned a lot. I’ve also learned more about what some of these symptoms feel like, and I think this is an instructive process for our audience to be a fly on the wall to listen to both on the one hand, how clear the path can be to some extent when you have the right professional on your team leading the charge, and how hazy it can be when you don’t.

So it was a very insightful conversation with Mike today. I am not out of the woods. I am midstream with this process, but I’m happy to share what I’m learning and definitely want to acknowledge that when someone does have documented mold in their home, even someone who as myself, I think I’m in pretty darn good health otherwise, and I’m not a very reactive person, I don’t have any seasonal allergies nor food allergies, but mold does seem to be something that for me causes a reaction. So I’ve learned a lot about myself, my body, how to think through this problem, and thankfully, again how to use the system, and most namely having the right person to lead the process so as to use the resources of the environmental medicine system the correct way. So Mike has been a real godsend in that regard.

So I hope you will give this podcast a listen. If you suspect there might be something in your environment that’s suboptimal, and if you’re living anywhere wherein you need to use heating or air conditioning, which for me, living in California for so many years, wasn’t really an issue, but living in Austin now it is. There’s a steep learning curve here, but I suspect that there’s a sizeable number of people who are living in this type of climate who may not be feeling as optimally as they could if they would address this. When I have the reactivity that I have to mold, which is this harder time focusing, a bit of fatigue, and definitely insomnia if it’s so hot where I have to use the units at night, the symptoms aren’t hugely overt.

I mean, the insomnia is pretty overt, but that’s more of a selective period when it’s so hot, even at night, that you must use the AC. But when it’s intermittent use during the day, it’s enough for me to notice it, but again, I would suspect that if you’re not someone who’s really in tune with their body and/or who’s through the brunt of their healing journey so as to have a steady baseline wherein you can easily see if you get thrown off your peak performance, then this may be alluding some. So I want to be careful not to create this kind of boogeyman that is responsible for every time you don’t feel awesome, but all of these things are just giving me more of an appreciation for this environmental aspect of our health. And one way to know if you’re at risk would be if you live somewhere where, for months of the year, you’re really dependent upon either heat or air conditioning.

If so, then this is something to really think about. More so if you’re using air conditioning, because oftentimes with heat comes humidity. Not always, but oftentimes. So in any case, this is a midstream update with my mold journey, which really hasn’t been too bad, but I’ve definitely learned a lot. Just one point here, it hasn’t been too bad for me because I have actually escaped to California while this problem is being repaired. I think it’d be much more difficult if I was actually living in Austin, because I suspect, and this is something that was affirmed by a local IEP, that the type of findings that were discovered in my residence, you’ll see in about half of the homes in Austin, or I’m assuming, in Florida, or many of these humid, mid-South climates, especially along the Gulf coast.

So if I had no option to get out of that climate, I think this would be a much heavier lift and harder process. So I also want to just give some empathy and acknowledgement for those who are going through this and don’t have such an easy out. Now that being said, perhaps it’d be easier to find a place than I’m giving credit to, but I’ve lived in two places and I’ve had the reaction I have to mold in two places, and had overt verified mold in the one, and suspect I would have gotten it in the other, if I had an IEP professional to point me in the right direction for people to do the analysis to begin with. So even more reason why, whether it’s your gut health, your thyroid health, symptoms that you don’t know where they’re coming from, or your environment, working with a knowledgeable professional, even though it may cost a little bit more and take a little bit longer, let’s say, if you have to wait a month to be seen, it’s usually the fastest way to get to your goal of resolving the issue and feeling better. So with that, we’ll go to the podcast now with Mike Schrantz on my mold experience.

➕ Full Podcast Transcript

Intro:

Welcome to Dr. Ruscio radio providing practical and science-based solutions to feeling your best. To stay up to date on the latest topics, as well as all of our prior episodes, make sure to subscribe in your podcast player. For weekly updates, visit DrRuscio.com. That’s D R R U S C I O dot com. The following discussion is for educational purposes only and is not intended to diagnose or treat any disease. Please do not apply any of this information without first speaking with your doctor. Now let’s head to the show.

DrMichaelRuscio:

Hey everyone. Today I spoke again with Mike Schrantz, who is an indoor environmental pollution specialist. When he had come on the podcast before we discussed mold. This time, the follow-up conversation actually turned into what I should do about the mold that was found in my condo in Austin. This has been a pretty eye-opening experience, and I’ve learned a lot in terms of how to use “the system,” meaning we have HVAC professionals, we have remediation specialists, we have IEPs who do their analysis. So I’ve learned a lot. I’ve also learned more about what some of these symptoms feel like, and I think this is an instructive process for our audience to be a fly on the wall to listen to both on the one hand, how clear the path can be to some extent when you have the right professional on your team leading the charge, and how hazy it can be when you don’t.

DrMR:

So it was a very insightful conversation with Mike today. I am not out of the woods. I am midstream with this process, but I’m happy to share what I’m learning and definitely want to acknowledge that when someone does have documented mold in their home, even someone who as myself, I think I’m in pretty darn good health otherwise, and I’m not a very reactive person, I don’t have any seasonal allergies nor food allergies, but mold does seem to be something that for me causes a reaction. So I’ve learned a lot about myself, my body, how to think through this problem, and thankfully, again how to use the system, and most namely having the right person to lead the process so as to use the resources of the environmental medicine system the correct way. So Mike has been a real godsend in that regard.

DrMR:

So I hope you will give this podcast a listen. If you suspect there might be something in your environment that’s suboptimal, and if you’re living anywhere wherein you need to use heating or air conditioning, which for me, living in California for so many years, wasn’t really an issue, but living in Austin now it is. There’s a steep learning curve here, but I suspect that there’s a sizeable number of people who are living in this type of climate who may not be feeling as optimally as they could if they would address this. When I have the reactivity that I have to mold, which is this harder time focusing, a bit of fatigue, and definitely insomnia if it’s so hot where I have to use the units at night, the symptoms aren’t hugely overt.

DrMR:

I mean, the insomnia is pretty overt, but that’s more of a selective period when it’s so hot, even at night, that you must use the AC. But when it’s intermittent use during the day, it’s enough for me to notice it, but again, I would suspect that if you’re not someone who’s really in tune with their body and/or who’s through the brunt of their healing journey so as to have a steady baseline wherein you can easily see if you get thrown off your peak performance, then this may be alluding some. So I want to be careful not to create this kind of boogeyman that is responsible for every time you don’t feel awesome, but all of these things are just giving me more of an appreciation for this environmental aspect of our health. And one way to know if you’re at risk would be if you live somewhere where, for months of the year, you’re really dependent upon either heat or air conditioning.

DrMR:

If so, then this is something to really think about. More so if you’re using air conditioning, because oftentimes with heat comes humidity. Not always, but oftentimes. So in any case, this is a midstream update with my mold journey, which really hasn’t been too bad, but I’ve definitely learned a lot. Just one point here, it hasn’t been too bad for me because I have actually escaped to California while this problem is being repaired. I think it’d be much more difficult if I was actually living in Austin, because I suspect, and this is something that was affirmed by a local IEP, that the type of findings that were discovered in my residence, you’ll see in about half of the homes in Austin, or I’m assuming, in Florida, or many of these humid, mid-South climates, especially along the Gulf coast.

DrMR:

So if I had no option to get out of that climate, I think this would be a much heavier lift and harder process. So I also want to just give some empathy and acknowledgement for those who are going through this and don’t have such an easy out. Now that being said, perhaps it’d be easier to find a place than I’m giving credit to, but I’ve lived in two places and I’ve had the reaction I have to mold in two places, and had overt verified mold in the one, and suspect I would have gotten it in the other, if I had an IEP professional to point me in the right direction for people to do the analysis to begin with. So even more reason why, whether it’s your gut health, your thyroid health, symptoms that you don’t know where they’re coming from, or your environment, working with a knowledgeable professional, even though it may cost a little bit more and take a little bit longer, let’s say, if you have to wait a month to be seen, it’s usually the fastest way to get to your goal of resolving the issue and feeling better. So with that, we’ll go to the podcast now with Mike Schrantz on my mold experience.

DrMR:

Hey everyone, welcome back to Dr. Ruscio radio. We have Mike Schrantz here back for Part Two of mold, and more importantly, why a specialist can be the quarterback leading the charge of remediating, addressing, or even just evaluating if you have a mold problem in your residence. I’m actually going to share what was somewhat surprising to me, how my newer and current residence in Austin was just found to have mold. So it looks like I just can’t escape it here, Mike, but I’m glad I’ve had you in my corner here to lead me through some of this.

MichaelSchrantz:

Well, absolutely, and your house was no exception. Sometimes it can get kind of messy and complicated.

Austin Mold Update

DrMR:

Yeah, especially in certain areas, Austin being one, where it’s both hot and humid for a sizable number of months in a row. You’re pretty darn reliant on your heating and air conditioning unit. One of the things that Tim Taylor, who is the gentleman who came out and actually did the physical analysis, said regarding my new place in Austin is that you’ll see this kind of finding in about 50% of homes. Which to me, I guess on the one hand, it wasn’t surprising, but also a light bulb went on because there’s been a number of people, friends that I’ve met over the years, and when they learned I was moving to Austin, the remark when this topic came up was, “I never had allergies until I moved to Austin, and then after a year or two, boom, I had really bad seasonal allergies.”

DrMR:

And one of the molds that came back on my report, I’m not sure if it was the cladosporium, if I’m saying that correctly, I think that one was identified as maybe a problem for some people, may not be for others, but it can cause allergies if exposed to chronically. And that got me wondering if Austin isn’t bad in terms of more pollen or whatever, it’s just people are so dependent upon only breathing in air from their HVAC unit for at least four months of the year that they’re just developing these allergies as a byproduct of that.

MS:

It can be the case. You have the seasonal allergy argument, and then especially in your case, when you dive into the people that we work with who suffer from some sort of chronic illness where it’s a genetic susceptibility or there’s some underlying issue that’s not resolved with taking some over-the-counter pill to get better. Listen, everybody can have a roof leak, everybody can have a plumbing leak, but in certain climates, such as areas of Texas, just the ambient humidity is elevated, and our buildings are living, breathing organisms. They’re a lot more complicated than we give them credit. It’s only when we get into problems that you start to dive in and figure out what went wrong.

MS:

Say for example, just a couple quick pieces, found some cladosporium-type species on your HVAC coil. Also found some species of aspergillus and/or penicillium, the lab didn’t really break it down further, but it was obvious that there was growth there. And that’s where it gets tricky, to be honest with you, Mike. It’s not like we have a cheat sheet that says, “Well, this is cladosporium, and because of that, you can leave it there.” The general industry has no real way of looking at this, at least from a functional standpoint and saying, “I’ll leave this alone and remediate it.” In general, if you’re having mold growing on coils or in your ductwork, or some other issues, which we might explore, I’ll leave that to you, the general recommendation from the industry is to physically remove it because we really don’t know at the end of the day whether or not you can be affected by it. But by the time you get done talking about it would have been cheaper just to clean it up and remove it.

DrMR:

Right. Let me share some of my experience for you, Mike, but more so for our audience, just because I think the story here is informative. Over the past six to eight months, I’ve really swung from each extreme on this mold stuff being way overhyped. Yes, it’s something that causes illness, but it’s a smaller number of people, and there’s a lot of this over-exaggeration and no SIBO effect occurring because when people aren’t feeling well and they can’t figure out why, mold is just the esoteric boogeyman that’s offered up and this sort of no-SIBO snowball runs away on you. And then I’ve swung to the other end of the spectrum in that there has got to be something to this, and it’s more common than people may think.

DrMR:

Again, for our audience, that’s this wrestling match that’s occurring in my head on pretty much every topic, because I’m curious and searching on the one hand, but I’m also aware that there’s a lot of snake oil in the field. And so I toggle back and forth, back and forth, back and forth. As more and more data trickles in, one of those positions ultimately wins, or at least a nuanced position that seems to be the most accurate. When I moved to Austin, I had done an Instagram post on this essentially saying that, “Boy, as my routines got thrown off, I really feel like my health was derailed.” Well now with some more reflection, I realize I’m almost convinced that there was mold in my friend’s residence that I lived with for my first few months in Austin while I was just getting everything together.

DrMR:

The testing there was a little bit more ambiguous, although I don’t think I had as competent of a person who came out to do the examination. So part of this could have been missed. It wasn’t an IEP-led endeavor back then, because I didn’t know what IEPs were and I didn’t have Mike in my corner to help guide me. But what I can say is that there’s this very distinct and subtle feeling I would get when the air conditioning was on, which is this slight bit of fog and it was harder for me to focus. It was also much harder for me to sleep; those are the two things that I noticed.

DrMR:

I moved in November, and in the condo that I’m in now, November up until just recently, there’s really no need for heat or for air conditioning. So I have the windows open most of the time, I’m never using the HVAC, not a problem. A few weeks ago, I started having to use it, and I’m noticing it smells like my fourth grade teacher is in the room. It’s like this old lady must smell. I honest to God thought that there was some sort of scented air filter, if those are even such a thing. As I started using the AC more and more, I noticed that same, very distinct feeling of having a hard time focusing coming back. The sleep problem didn’t occur because I wasn’t using the AC at night.

DrMR:

So I had someone come out, this time under the recommendation of Mike, and as Mike was alluding to, there was visible mold growth found in a number of locations. And so I finally pieced together that, for me, it may not be that I don’t do well with AC, because I had said on the podcast before, it’s kind of a coin toss if AC will bother me or not. Well, if a coin toss is 50/50, and Tim Taylor commented that you’ll see this kind of mold growth in half the homes in Austin, that would account for my 50/50 experience. So that’s the context up until now. Maybe we can unpack some of the testing to some extent, but is there anything there that you’d like to remark on?

MS:

You’re talking about a very important piece, the lungs of your home. Any house that has forced heating and cooling, ductwork, a system that especially cools the air, I don’t know how deeply we want to get into condensation and dew point and all that, but here’s what I can tell you as we do unpack it. Take a look at that report that you got, and there’s multiple pictures that show visible evidence of growth inside, not just by the evaporator coil, which is the part of the air conditioning system that cools the air down and moisture condenses, and if everything’s working appropriately, it drains out of a drain pan and life is good and as an occupant, you’re not worried about anything. But in a lot of these cases, especially in humid climates where these systems are working overtime, you might think of it that way, there was growth that was identified in that location and in the ductwork. I mean actually in the flex duct. And I think there was a picture of one register box that had internally-lined insulation that had spotty mold on it.

MS:

When you look at that and you see the other evidence that Tim was good enough to identify, great guy by the way, now you go back to your observation of, “I turned on the system and I started feeling these symptoms.” Man, I don’t know anybody that would bet against that it was part of the issue, because here’s the deal. The conversation is not one of, “I identified a mold spore.” The conversation is, “I’ve identified colony forming units throughout my system, almost homogeneous.” If you were to put it in square footage, there’s a significant amount of area that was directly impacted.

MS:

I mean, we all live in boxes; we all live in homes. It’s a confined space. You turn on the system, and this had probably been going on for quite some time, but it could have been current. As this mold is growing and sporulating and breaking down and fragmenting, those pieces could ultimately bypass your filter, make it downstream to ultimately where you were breathing. So really it’s kind of a weird thing how this happened to you of all people, but you are the textbook example of when HVAC systems get a lot of attention, and it’s totally understandable for you to be concerned as the occupant.

DrMR:

Yeah, and one of the things that is also interesting here is that when living in my friend’s residence, he didn’t have any reactivity at all. Perhaps that’s because he’s Austin born and raised. Maybe this was just like people who grow up with certain parasitic organisms in their environment, like in certain third-world countries, and it causes no ill effects to them. Maybe it’s because he was being exposed to this from a young age that his immune system calibrated to it. But for whatever reason, he had no reaction in the old residence; I did. And then here, clearly I was having reactivity, but perhaps the person who lived there before me did not. What’s also interesting is that I don’t have any environmental allergies, such as grasses, pollen, cats, dogs, nor real food allergies. So this is interesting, and maybe for our audience, reassuring that you’re not alone, or I guess you’re not any weirder than I am if you’re noticing some of these things.

MS:

No, and go back to that example of your roommate who was born and raised kind of a thing. Maybe there is something to be said about our immune system and the geographic area that you’re in, and then you go to a third-world country and you have this exposure and it’s different. We’ve heard similar stories about people going, West Coast/East Coast in the States and have seen a difference. It’s like all other things seeming equal, what’s going on? Clearly there’s a difference in certain exposures. To your point that your friend was not having the same symptomatic reactions, that is just another piece of information to remind the audience that everybody is genetically different. Our constitutions might be of such to where we can live to be 80 or 90 years old and never really have any outward effect or symptoms from that, but then it affects somebody else. You’ve shared your story where it’s the opposite. So it’s a very tricky situation.

MS:

You mentioned something in the very beginning about the fact of the matter is that there’s a lot of companies out there that have got the snake oil. They’re leading with fear-based comments. It’s hard to find somebody that you trust who is not just being honest about what are healthy industry-best practices to properly remediate this and clean it, but also being careful about what they’re saying. We hold ourselves in high responsibility, and that matters. Some people are just so black and white with their comments, not realizing that they’re kind of black and white of, “you don’t have an issue,” or, “you have an issue.” Even with those, earlier you shared the story about how you’ve been on both extremes.

MS:

Somewhere, there’s probably a balance. It’s not that we don’t want you to have that “perfect house,” but last time I checked you weren’t offering to write the check for all the work that you’re recommending be done. And so it’s like, how can I work with somebody that can help me prioritize, “Okay, this definitely should be done.” I’m kind of throwing this in here as an example, but, “Yes. We don’t like the fact that you have a crawl space, but that doesn’t mean you have to trip over yourself to spend $15,000, $20,000, or $30,000 to improve the crawl space.” It’s just such a tricky situation out there because even when you’re working with professionals that we trust, it’s not cheap to remediate all this. And people are often shocked to find out that this type of work and cost thousands, maybe even tens of thousands of dollars, when growing up as a kid, Mom just said, “Throw bleach on it, and that will solve everything.” So it’s totally understandable for the emotions to be there. And, in your particular case, so much was found that it’s also understandable to know that there’s a little bit of work that you’re looking at getting done.

Utilizing a Mold Professional

DrMR:

Sure, and regarding that work, I have a friend who hasn’t been feeling well. He lives in Austin, so he came to be seen through the Clinic and we got him set up on the road. As the audience can probably imagine, when I hear something like “problems with sleeping and chronic brain fog,” mold is a potential, but we’re not going to gloss over someone’s gut health. And so there was this layering of recommendations, one of which was to have an IEP quarterback the process of doing the home investigation for mold. I wanted him to come see Mike, but I think Mike was booking out three weeks, and he didn’t want to wait. Against my recommendations, he just went with whoever. They did remediation and then they retested, and the levels were worse, post remediation than they were pre remediation.

DrMR:

Now, maybe that’s something that happens normally, but that in juxtaposition to the fact that the first company I worked with was a vastly different experience than it is now, has taught me that you don’t always get the same level of analysis or remediation, again, at least from my few data points. But to that point, Mike, as someone who’s probably been all over cleaning up some messes and preventing other messes, how important is it that you just don’t find an analysis company that will come out the next day, and how much does the quality tend to vary?

MS:

Yeah, and I’d add to your other list of things of experiences learning from our own mistakes. I mean, none of us are perfect and we’ve all learned. Some of the ways that we’ve learned is how we used to think this was the great way to clean a place or whatever, and we find out later on that people are chemically sensitive to it. So it’s complicated, you know? As it pertains to this idea of quarterbacking, there’s a lot of free information out there, by the way. One of the biggest problems with the mold industry is that it’s not regulated by the government. The state of Texas licensing department requires that you are licensed to be like a mold assessor or a mold remediation company, but that’s just to help get rid of some of the riff raff that might show up to your house that knows nothing about what they’re doing. It doesn’t guarantee that you’re going to have a successful job.

MS:

There’s no regulation that’s like, “This many spores is good, this many spores is bad,” because everybody is different, and mold is a normal part of our ecosystem. I mean, without it, we wouldn’t be here. Trying to avoid mold is to me similar to trying to avoid air. You’re always around normal fungal ecology. And so it gets muddy; it’s this issue of, “Okay, I found this inspector.” To answer that one question, a good inspector on an average home, say 2,000 square feet, you might spend anywhere from say 500 to a 1,000 dollars just on the labor part, the part for them to take the time, do a good visual inspection, and write up a report with some findings. But then of course, there’s the sampling. And the sampling, as even you know in your own clinical practice, can range significantly.

MS:

Are we doing qPCR? Some people here know it as ERMI sampling, and you’re zoning the house into two or three or four different areas. Or are there so many obvious areas that you don’t need to do expensive sampling like that? Maybe you just settle for a few cavity samples. Imagine there being water damage, for example, underneath your kitchen sink cabinet, and you and your spouse are arguing whether or not you should remediate it because it’s going to cost you $3,000 to $4,000. And you’re like, “I wish I knew somebody who could sample underneath that bottom shelf to see if there’s mold there to help justify the remediation.” Well, do a cavity sample.

MS:

So between stuff like that, like cavity sampling, and more forensic type sampling, like qPCR, you could range anywhere from say $600 all the way up to $2,000 to $3,000. And if you’re doing the math, you could easily get $2,000 to $3,000 or $4,000, just using crude math right now, to have a really thorough assessment. And that begs the issue of what if they can’t afford it? What if you just haven’t got that level? What if your conversation with your clinician is not that strong towards the mold exposure? How far do you go? A lot of times what people do when they first reach out to me when they think they might have a mold problem, they’re not sure, they’re on the fence with wanting to spend money to do a thorough assessment, kind of like what you experienced with Tim, for example, we’ll typically refer them to free resources.

MS:

Go to iepradio.com, which is a podcast I do, it’s all free, and watch the four-part remediation series to see what you’re looking at and to see what best practices are. Arm yourself with that information. Some people are like, “Well, that’s great, but we don’t even know that we need remediation. So we don’t want to spend $2,000 to $4,000 without having a better understanding of what we’re walking into.” And myself and a few other people, who we perhaps can talk more about at the end, of references and resources, offer virtual consultations, which I’ve done with you as you’re aware of. Walking the client through the fundamentals, what do we know about the house? What do we know about mold growth and how it works? Where are the susceptible areas in your home in this particular case? And we use that information to identify potential concerns and know where we want to have a local boots on the ground look.

MS:

Now you’ve been armed with information. Now it makes more sense to hire boots on the ground and have them focus on specific areas. Now you feel like you’re better informed and it’s worth it. It’s all about the perceived value of what you’re getting for that money. And then at that point, that’s when it gets tricky. I mean, you thought it already is tricky. It gets tricky because now it depends on what they found. In the case of your situation, you had Tim come out, he found a bunch of areas of interest, and then had this remedial plan sent to you. It’s all good information, but it can be overwhelming. So the quarterbacking piece is if you can have your local professional, your local inspector, be there for you, he or she is able to pick up the phone, answer any emails, that’s ideal. Somebody who’s already been to your house, knows your situation, doesn’t need to get refamiliarized with the history, that’s ideal.

MS:

But in a number of situations, you don’t have that. They’re not available, they’re hard to reach out to, or you’re just wanting a second opinion. In those cases, I would encourage those listening that, before you pull the trigger, like your friend did in that example, is reach out to a professional like myself. You can find others on ISEAI.org. We can talk about that later, if needed. We offer virtual consultations; we’ll look at your data, what you know, what you don’t know. We’ll guide you through the process from start to finish. It doesn’t cost an arm and a leg. On the low end, it might be $250; on the upper end, maybe $500, but that’s from start to finish. That’s from not knowing anything to maybe doing a follow-up talk and figuring out, “Okay, here’s what they’ve remediated. Here’s what the test results look like. What do you think, Mike?” So it’s very affordable, given how expensive this can escalate to very quickly, guide these folks.

DrMR:

Yeah, because it seems that one of the things you definitely do not want to do is go through an unnecessary intervention or testing, either of which can be anywhere from a few hundred dollars to a couple of thousand dollars. So if one of those is mistargeted, then you just burnt all that money. So you’re much better off perhaps having to wait a few weeks to speak with someone, to get that independent counsel to focus you.

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MS:

We’ve seen inspectors that have the nice glossy website. They say the right things over the phone. They go out and do some sampling, and the sampling isn’t necessarily black and white, but what their interpretation is and how they explain it to you makes you feel like there’s a mold monster in your house, and that you can spend $5,000, $10,000, or $20,000 just to clean the house. I don’t think I need to convince the audience of it, but when you start dealing with those numbers, it really starts to add a legitimate stress in your life, and you start questioning everything. You start questioning what’s appropriate. First of all, is that accurate? Second of all, is that dealing with the root issue or am I going to have to re-clean my house again in a year?

MS:

And the other thing it tests or questions is the diagnosis. Why are you doing this in the first place? Why are you having this mold remediation, this assessment done? Well, if you rewind the clock, the reason you had that done was because your clinician said, “I think there’s a susceptibility. I don’t think you’re getting better despite our efforts to get you better. I think the common denominator here is you’re having continued exposure, and we can’t get past that until you have your home investigated.” And so for all of these reasons, knowing it’s complicated, having someone who is well-versed on the clinical side, not playing doctor, but just understanding and appreciating your diagnosis, being able to give you the tools and the information to say, “Well, this is the type of testing you do here and here’s why. Here’s alternatives if you can’t afford it. Here’s fundamentally how you need to remediate it. Here’s options to clean better, but it’s going to cost more, but here’s some DIY.” Giving all of those options and quarterbacking it will save people a headache and a half.

MS:

I think it’s a shame because legitimately there’s people out there who’ve had a couple of bad experiences, and unfortunately, as a species, we have a generation to go on social media and talk about our negative experiences so many times more than any good experience. And so when you go online, social media, you can use your mind on which sites we’re talking about, and you see someone complain about a bad story and that’s all you read about, it really can be intimidating to your patients and to our audience members who go, “Oh my gosh, why would I want to spend a lot of money to have a nightmare occur?” It’s really not that bad when you have qualified people working for you. It’s about honoring your health and honoring your pocketbook and making sure they’re both pointing in the right direction.

DrMR:

It is amazing how, in some cases, the bad reviews are so much faster to go out there than the good reviews, and you have to be careful about that because it can make things look like they’re a lot worse than they are. And this is something that we see in the Clinic all the time with SIBO, as one example. People come in and when they tell me that they’ve been diagnosed with SIBO, they look at me with a look on their face like it’s a terminal cancer, and it’s just, “Oh my gosh, what have you been reading?” Because the amount of fear you’re associating with this is not requisite to reality. One other thing that you said there, Mike, that I want to just echo, it’s possible that even if your clinician says, “I think you may have mold,” that could be a wastebasket, Hail Mary potential diagnosis, because mold and Lyme in my experience are too easily thrown out there by clinicians without really trying to make the argument.

Building a Case for Mold With a Clinician

DrMR:

It’s a challenging balance to strike clinically, because on the one hand we want to do whatever we can to help get our patients well, a hundred percent. But on the other, if we don’t fully acknowledge that just saying, “Well, I think he may have Lyme,” and not realizing that could be thousands of dollars with a doctor and follow-up testing and follow-up visits, it’s important to really try to build a case and rule something in or out as best you can. That is why myself and all the clinicians at the ACFM try to be really targeted and responsible so that we don’t just tell someone, “Well, must be mold,” and then they go, as you’re saying, Mike, they find kind of a charlatan to do the home inspection. They go through all this remediation and then they follow back up eight months later. “How are you feeling?” “About the same, but $20,000 lighter.”

DrMR:

None of these things are fully black and white; there is gray, but at least try to do the best that you can. But what a good IEP could function to do is if your clinician did make that prospective diagnostic suggestion kind of willy-nilly, the IEP could help counterbalance that. The IEP could say, “Well, I know your clinician suggested ‘X, Y, Z,’ but I’m not really seeing it, or the inspection didn’t really yield anything here that substantiates mold.” So it’s another check and balance that may moor you from just running off the rails and pursuing mold.

MS:

Michael, if you don’t mind, I’d love to tag on that too. I think you nailed it on the head here about building a case. While no one here wants to go to the other extreme and use that as an excuse to bury your head in the sand and ignore things, because I can tell you that happens all the time, and I’ve even dealt with that personally in my own life, there is something to be said about building a case more than words like, “I think,” or, “it could be.” Don’t get me wrong, we all have to start somewhere. If we suspect that there’s something wrong, you want to be open-minded. But I think that the takeaway here is it’s not always black and white, and there’s not a perfect solution. But as one of maybe a hundred examples, I’ve seen clinicians tell somebody that they are susceptible to mold because they have them provide a urine sample to one of a few labs that are well-known for mycotoxin analysis that comes back “elevated.”

MS:

When I do a virtual consult with them, and again, it’s not to play doctor, I want to be clear. IEPs should not play doctors; that’s not our role. But in helping honor where they’re coming from, where their health is at, where they’re at now, where they want to go, we do want to know their background. And when we find out, I asked, “Okay, the doctor says you were having a susceptibility, and it’s because of that,” I’ve asked simple things like, “Well, where are you on glutathione?” And they said yes. And it’s like, “Well then did they tell you that some of these numbers would naturally be elevated?” That’s not non-informational. That’s good to know, but does that really then mean that these levels you found in your urine indicate current exposure? Could it be past, could it be flushing out more than what’s normal? Could it be your diet? That’s a classic one. And really it’s that they didn’t build a strong case.

MS:

And so working with clients literally around the globe, I think my list now is close to 5,000 in my career, I can tell you there’s some common themes. If it was my family member who was going with it, before they ever went two or three levels deep into their home, some people refer to that as the rabbit hole, they want to make sure the clinical piece is as solid as they can accept it to be. Maybe it’s limited by the type of disease or the cost to acquire more information, but once you and your clinician are on the same page, that’s when you use that information to figure out what’s a reasonable counter to that. If we think it’s the house, fine. Then let’s do some pragmatic assessment of the home without feeling like you have to rebuild the entire house, because you’ve read something online about somebody who had an isolated mold problem and they had to go live in the desert and wear a loincloth to get better. That doesn’t describe the majority. So kudos for mentioning the building a case part. I can’t tell you how much that is an issue with the folks I work with.

DrMR:

Agreed. In my case, that tends to be how really astute and thoughtful clinicians operate. They’re never too quick to offer up a diagnosis. They’re also open-minded to a diagnosis, but I think they really want to build that case. I think that’s an important hallmark of a good clinician or consultant. They’re open enough that it could be, but they’re not too quick to run away with it. That’s because they need to listen to those dueling voices in their head. One says it is, the other voice says it’s not, and then they argue with data to see who wins the point. That’s how we build the case. The gathering of those data points is the building of the case.

DrMR:

And regarding testing, it’s interesting, Mike. In California, I probably lived a little bit loincloth like. It was very dry, a Mediterranean climate, and you never use your air conditioning, you never use your AC at least where I was, and all the windows are always open. What was interesting there was my urinary mycotoxin levels look pretty similar as to when I was in Austin for a couple months at that apartment. And then even after I had been out of that apartment for a number of months, and even though my current condo has mold, I’m almost positive I wasn’t being exposed. It was only really an issue when the AC was on, and I had an air filter going on each floor, 24/7, plus usually all the windows open and a fan on blowing air in. And also I notice a symptomatic reaction when I’m exposed.

DrMR:

So I wasn’t exposed for the past few months, but my urine levels still look similar. It could be skewed by glutathione. It could be diet. I think diet hasn’t been demonstrated thoroughly enough yet, but it will be demonstrated that use of probiotics and consumption of fermented foods skews the test. At the Center we’re going to attempt to do a 10 cases versus 10 control study on urinary and mycotoxin test to see if we can either prove or invalidate the urine test. But there’s definitely a a big question mark in my mind. What extent have you looked at urine tests, and do you have any other commentary on how valid they are, or how easily they’re skewed falsely positive or false negative?

MS:

Sure. I also just want to start off with the right tone to say, paying tribute to the pioneers that are out there, the laboratories that are starting. Everything at one point was an idea that was scrutinized, and a lot of opposers, and it had to start somewhere. So a lot of these labs, just so we’re clear, are trying to work with professionals, have clinicians on staff trying to do it. That’s my big way of disclaiming or saying it’s not meant to be an attack on labs that offer these wonderful services. It’s just more of an issue of the ability to interpret and the challenges and what we don’t know and letting that client, the end user, know that upfront, versus making it like it’s the all seeing eye. I’ll tell you this about mold and certainly segue it right into the urine analysis, a lot of the research we know about mold comes from the food industry. It’s a multi-trillion dollar industry dealing with grains and silos, and the predominance of mold to grow in these conditions led to a lot of research and trying to figure out how to control them.

MS:

So it’s funny if you do a lot of research, you’ll find that there’s always a connection with food. Now that doesn’t have to translate to that’s where your source is. Mold doesn’t just grow on grains and stuff like that. It can obviously grow in water-damaged buildings and it can produce secondary metabolites, that being mycotoxin in this case. And I think what I’ve learned is that the most valuable piece of information I’ve ever seen presented, and that doesn’t say much for the clinicians, it’s more just the IEP here, is trend data. It’s the doctor that is working with the client, the patient. That client might be working in concert with an IEP, and they did a baseline sample in a really moldy home. They found this all out and it was horrible. They had elevated levels of say two or three mycotoxins, and then they track it.

MS:

Then they started with some binders or detox program, and then did remediation. In month three, there was remediation performed. There was an improvement in the results of the mycotoxin. This actually happened with a case in Canada where this lady had taken four samples over about the course of a year. There was a steady improve in the results, which also correlated with a steady improvement with other symptoms she was having. And I’ve seen that a couple of times where it’s not just one static sample, it’s a trend. It’s showing over time how you are doing. Because of all the unknowns, we can agree and debate. We know this much about diet and how that can affect us. I think that you and I personally would be pretty much on the same page with the lack of consensus, but the acknowledgement that these are all these possible sources. And all that would lead to say since we don’t know all that information, can we really hang our hat on one sample, or do we look for trends?

MS:

And so for the audience that’s listening, whether they’re the patient, the clinician, or even the IEP, and again, IEPs don’t play, doctor, is just to say, “Okay, well, what I’m getting is that the clinician thinks there might be an exposure. I would suggest that you agree with the client to say to investigate the house now, and here’s how we can do that.” Or you might say, “You really are on the fence, and you don’t have a lot of money to spend, and you’re going to go back to see your clinician in another month anyway, why don’t you reach out to your clinician and see if you can wait to spend money for an IEP to do boots on the ground and see whether or not that follow-up urine sample looks like it’s trending improvement before you pull the trigger to pull out $1,000 or $2,000 to have somebody go mold hunting in your house?” That’s been my experience.

The Role of Laboratories in Interpreting Results

DrMR:

That’s totally fair. Good point on the labs. I probably have a bit of a skewed bias toward being skeptical. That bias is partially fair because I see day over day in the clinic, how people are just raked through the mud. But I should also bridle that not to conflate that with all labs and all places all the time, because a lot of what I’m seeing is misuse or overuse of labs. Sure, some are not validated, but I think you made an important clarifying point that these labs are…

MS:

I’ll sink my teeth in. I think on the topic of skepticism, it’s everything you mentioned. If there was a pause in any part of my previous explanation that people picked up on, it was because I think that this is an issue of, in a sense, is it the natural evolution of pioneering work, and this is just part of the growing pains, but we don’t market it? Maybe we should do a better job, we being these industries that offer these services. When you see the labs presenting what’s elevated versus not elevated, where are they getting their controls, and what are the parameters? I mean, is it all inclusive? It’s like when you see these prescription medications on TV and then there’s like an hour long list of side effects. You just don’t know if it’s really worth doing it at the end?

MS:

I think that, number one, the limits of these tests should be better explained to the end user who’s paying $400 if it’s out of pocket on average for some of these tests. The other piece to it is the interpretation by the lab versus the clinician. I have seen plenty of clinicians that defer the interpretation completely on the bar graph that these labs are using to indicate what’s normal versus what’s elevated. I wonder at times, and this is me tossing you a softball right now, I’m wondering if there isn’t some responsibility for the clinician to have a little bit better understanding about what are some normal ways that a person might have “normal” or slightly elevated levels of ochratoxin A, which doesn’t mean that they need to sound the alarm bells and that they must have an exposure. Could this just be a normal exposure to their normal environment? In other words, not a moldy building.

Remediation Process Example

DrMR:

Well, that’s why we want to try to do that 10 known-exposed individuals compared to 10 healthy individuals case control study, because that would at least help clarify it. My example has been pretty compelling here, because before any known mold exposure, my test looked pretty similar to how they do now, which makes me think that that diet might be more of an influential factor than we appreciate. But that’s why we’re doing some of the research that we’re doing, so that we can put data to this rather than just speculating. So I’d like to share the procedural aspect here with the audience, and get your free consult on, Mike. So jump in now.

MS:

No, that’s fine. That’s why I’m here.

DrMR:

So Tim came out, Tim Taylor. Not the Tim Taylor from the tool man TV show, a different Tim Taylor. But he did his analysis, send his photos, took some samples. Clear mold. He wrote up a remediation plan. As part of that plan, he said, “I’d also like to have an HVAC specialist come out and do an analysis on your HVAC system.” And that was later done by another Tim, Tim H., and we’re awaiting his report. But as I’ve started to piece together this process, it would be as follows, and correct me if I have anything wrong here. A remediation company will come out. They’ll set up a containment area. They’ll do the physical remediation. They’ll retest. And as long as all the retesting looks good, then they will consider their job done. But before they break down the containment, Tim H. the HVAC specialist, will come in, do his work in the HVAC unit, and then that essentially completes the remediation. Is that a fair overview in terms of how this typically works?

MS:

From the 30,000 foot perspective, and I know you’re doing that for the audience’s sake, yes. There’s an important thing I want to mention, which is timing. What if, and by the way, they found mold in your ductwork, and there’s this elephant in the room question in my camp, which is, if you’re having the remediation company come out and do all the traditional remediation to these other areas, and they don’t include part of that as the removal of the ductwork. Industry standard, if you have actual growth identified on, say, for example, flex duct or lined insulate, duct that’s lined, sort of metal duct with lined insulation, that means the insulation is on the inside of the ductwork, it’s not wrapped on the outside, like a Christmas present. There are exceptions, but in those cases the industry would mostly say to just get rid of it. Replace it, end of story.

MS:

And so it’s a timing issue because if you just get done doing all your traditional remediation, you got done doing all the cleaning, and you’ve even done that third-party testing that you just mentioned a moment ago, and then they remove moldy ductwork, naturally the occupants are going to wonder if they just re-contaminated some of the local areas where they did that work. So all I would say is this. The timing of when, for your case, you do the ductwork really depends on how they set up their containments. In plain English, is there a way for them to remove the moldy ductwork, and then of course, protect the areas where the ductwork is at, like where there’s a ceiling penetration. Plastic that off so there’s no communication between that attic space or whatever.

MS:

And then do all your cleaning, get all the inspection done, and then once everyone gives you the pass and everything is good, that’s when you would install new ductwork and that sort of thing. Again, don’t let the last thing that happened, be the replacement of your moldy ductwork or, I should say, the removal of it, or even the cleaning of your system. Try to have that work done before the final clean to the house is done, or whatever that specific scope of work was, so that any “onesy twosies” that get released during the removal of your contaminated ductwork will likely be picked up during the final rounds of cleaning.

DrMR:

And who is the person that would diagnose the duct. Would that be the IEP or would that be the HVAC specialist? Whose umbrella does that typically fall underneath?

MS:

That’s fair. There’s two different discipline issues going on. So when we’re thinking about the traditional mold piece, ideally it would be an IEP to be able to do just what you had with Tim, for example. Pictures of areas with mold on it. It was within your ductwork, that’s good. But one of his recommendations was also to have the vents and ducts inspected by a licensed HVAC company to make sure that they were properly sealed and also ultimately to get to areas he couldn’t get to. See there’s a little Bit of a liability piece to this. I’ll speak for Tim, although he’s not here. He doesn’t want to be ripping apart connections for the duct system and then maybe cause damage and be responsible for putting it back together. He doesn’t have that type of insurance. Not to go too deep into the concerns here, but I mean, just giving you a reality check.

MS:

So a lot of times it might be a couple of disciplines working together. It’s basically Tim saying, “I identified these areas. This is not good. Let’s have you take an air conditioning company who’s got the licensing and the tools to open this area up, take photos, and document what they’re finding.” Because ultimately if they find a problem it’s likely going to be a similar or the same HVAC company, who’s going to provide any sort of duct cleaning or duct replacement. They’re going to follow industry standards that are available, there’s a couple, to replace that stuff. And so I guess the short answer is sometimes it’s not just one person. It’s more of an issue of phases. Phase One is have Tim go out and see what he could find in that particular case. But he did find something, now Tim’s worried about your entire system, which based off of the pictures I saw was understandable. He wants to have that company come out, get a fuller picture of what’s going on just to make everybody feel warm and fuzzy.

MS:

You said, build your case, right? Tim’s building this case. And then that way, if they come back and they show positives, when he ultimately has a follow-up conversation with you and says, “Based off of what we’re seeing, I think you should replace your entire system,” your jaw drops because you realize you’re going to spend “X” amount of money in duct replacement. You then at least feel like the case was built enough to justify that recommendation.

DrMR:

And to replace the system, is there a ballpark for that cost?

MS:

Do we have one system? Do we have two systems? Is the ductwork hard to replace? Are we just doing the ductwork, but are we cleaning the air conditioning system components versus replacement of the entire furnace? If mold grows on a coil, we don’t typically tell you to replace the coil. That would be silly. Do you know how many coils would be in the landfill right now? Because that’s a non-porous item. But ductwork replacement is not cheap. Even if you had really good access, I mean, you could argue if you had a nice high attic space where people can get into the attic and that’s where all your ductwork is, you’re going to spend anywhere between $3,000 to $5,000 between replacement of ductwork and the labor involved to do that.

MS:

Maybe to some of these people listening that’s not as dramatic as they were thinking, but what if it’s a multi-story house with ductwork that runs in interstitial cavities that would require ripping open dry wall and/or other complicated issues? It could grow significantly. So let’s just say that the minimum is three grand, but it could easily go up from there. And that’s why anybody in that situation would be getting a couple different bids from companies who would say, “Well, here’s our estimate to replace this,” so that you have an idea of what you’re walking into.

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DrMR:

Gotcha. And then in terms of the sequencing, would it still be that the remediation company comes out, they set up their containment, they do their, let’s say dry wall or whatever remediation, they retest. Once that’s clear, then the HVAC person comes out and they do whatever they have to do, God forbid, not including replacing all of the ductwork. He retests, and once that checks out, then the containment is broken down?

MS:

For selfish reasons, if I had it my way, if the air conditioning system is under the radar of suspicion, which in most homes, if you have air conditioning, it will be, I would have had that assessed up front. For the reasons of knowing that if you do have to replace it, there is economies to scale to have it done. Remember we talked earlier about the timing of doing whatever normal remediation, but let’s say that now it’s time to get out the old ductwork. Let’s go ahead and do that before you do a final clean. There’s ways to save money.

MS:

If you knew that you were going to have to deal with the air conditioning system versus if you did it the other way, and you said, “Well, let’s just deal. We had water damage under the kitchen sink. We had water damage on this wall. We remediated those areas. We cleaned the entire house.” I’m being very general stroke right now. I don’t want anybody to imply that we’re always thinking you should clean your entire house. I’m just trying to give an easy example here. But let’s say you did all that, including clean the entire house, and then you had an HVAC company come out after all that and they show you evidence that you have mold throughout their ductwork.

MS:

Well, first of all, you’re going to get frustrated because you’re going to be like, “Wow, yet another problem.” And then you’re going to deal with the cost of replacing that. And now that you’ve replaced it, you’re going to wonder, because you’re human, did they cross-contaminate the living spaces in my home when they were replacing this, removing the ductwork and the whole thing. And by the time you get done doing the sampling and talking with your clinician that just wants to err on the side of caution anyways, you’re going to re-clean your entire house.

MS:

So save money. If you have a forced air conditioning system, if you’re having an inspector come out there, you might as well have them at least take a look at it. And if there’s any indications, a lot of times with IEPs, we definitely have them look at the evaporator coil. With homes I’ve done in the past, if I can’t get access to your evaporator coil, I’ll have the homeowner schedule to have an HVAC companies show up on the same day at the same time and open that up so I can at least peek at it. And that way, if it passes my initial assessment, we’re not complicating things by telling them to look at it fully after the fact. It’s a staged process, but air conditioning is the lungs of the home. And in your particular case, look how many of the issues were identified that were related to your air conditioning system.

DrMR:

Gotcha. So where do you think I go from here? Just selfishly asking, but this obviously could help inform other people. Tim Taylor did the initial analysis. He recommended that Tim H., the HVAC pro come out. We’re waiting on the HVAC pro’s analysis. I’m assuming that goes back to Tim Taylor to update the remediation plan. And then we just execute that. I’m assuming that’s how this works.

MS:

That’s right on point. You’re lucky to have a local boots on the ground in your area like Tim, a great guy to do that for you. So in your particular case, the answer is yes. Have him quarterback it, look at it, make sure everything is in line with this whole concept of timing to save on cost and the logistical piece of it. And then obviously the next step you’re looking at is actually getting the remediation done and doing testing on the back end.

DrMR:

Yeah, and I think that’s exactly what happened to my friend. I think he rushed into remediation and I think he has to have some ductwork replaced. Maybe part of the reason why is because he got an analysis from a professional who I think was only looking at what they do, which is a certain type of remediation. They then did that remediation. There wasn’t an IEP sitting atop of the whole process, and he was just crushed with disappointment when he said that the retesting was actually worse than the baseline.

MS:

Something you said right now just highlighted another point we’ve been making earlier, which is that this is part of the struggle. Hindsight is 20/20. Different industries bring different knowledges, like an HVAC company versus a plumber, versus an IEP, versus a traditional IEP that does maybe a couple spore traps samples in your house, versus somebody like Tim or with my background taking deeper looks. You spend so much money up front to get the job done right. The motto or adage is true that you typically get what you pay for. It’s a hard barrier to break, and we totally understand that. I had four remediation projects on my current home before we ever moved in. Even though I know a few people to help me out with that, it still cost a lot of money, and it was kind of a deflating experience for me, in a house that you’re moving into.

MS:

Here’s my point. When you know that you’re facing a financial hurdle, a decision, maybe it’s because you and your spouse are not on the same page, and your spouse thinks you’re crazy, the other spouse doesn’t think mold is a problem. Does that sound familiar to anybody here listening? Honestly, when you run into that issue, virtual consultations and being able to quarterback with somebody like myself or a few others who do that sort of thing for a living throughout the States and even beyond I think is the great way. I think it’s worth every penny because it’s not just simple discussion. You’re getting the education. You’re seeing what Mike and I loosely did with piecing together the health and how to apply a proper weight of concern. How do we honor health without going overboard, and certainly not have things being dismissed left and right?

MS:

So it truly is a balance. And the reason that it’s always an issue of trying to find balance is because mold is a normal part of our ecosystem. Simply to find it is not meaning you have a problem. And no, I’m not talking about mold growing on the side of your bedroom wall. I’m meaning the lesser things like the companies that come out and say that you need to remediate your shower because you have topical mold growth on your grout lines, which by the way, is very normal if you’re using it as a shower. It doesn’t mean you should have to spend $4,000 or $5,000 to remodel that part of the house. So between the snake oil concerns, the lack of consensus of how to interpret a topical issue versus something that might be hidden behind a wall, and the initial barriers of cost, doing a virtual consult is a huge thing.

MS:

I want you know I didn’t come on today’s call to really focus on that, but it really is a good piece from how you presented it to start with that. See what we can help guide you with. Let’s identify the obvious issues, the low-hanging fruit. Let’s identify the unknowns. Let’s talk about your options to addressing the unknowns, and more importantly, why? Why do we need to address it? Well, why are you assuming? So it’s educating that person. And there’s just not a lot of IEPs that have that model. A lot of the IEPs are still stuck in the traditional paradigm of, “I’m going to charge you $300 to $500. I’m going to come out with an infrared camera and a moisture meter. I might take two or three spore traps samples.” They don’t usually find a problem; they can, but they don’t always find a problem.

MS:

And you can help me out in this piece. They take that information to their doctor and say they didn’t find anything, but yet every marker, every indication, every cluster of symptom is suggesting exposure. And that’s where that chaos and that confusion occurs. Why is an IEP saying there’s not a problem, but the doctor is so hard-pressed to suggest there is? If the doctor has presented a good case, if they built a good case for you, and you find out that your typical mold inspector came out there for 45 minutes, scanned your house, took a couple of samples and didn’t find anything, it’s very possible that that local inspector missed something.

Typical Mold Exposure Cases

DrMR:

Right, fully agreed. Joe Mather and myself, Joe Mather one of the other doctors at the ACFM, we’ve both had mold exposure. In our discussions, there’s pretty acute symptoms. This is given that you’re not in the environment. Let’s say you were at work or you were out to lunch or you were whatever. Then you come into the environment, and then boom, there’s a change in how one feels. That to me seems pretty logical in the sense that if you’re not being exposed, you’re not feeling well, sure, there might be a gestation period like 30 minutes, a couple hours, maybe even a day or two. But then when you get back to the center and you’re re-exposed, there’s this fairly perceivable shift. Now that’s taken from Joe and taken from myself. I’m wondering, in your experience, Mike, does mold exposure typically follow that trajectory? Can it be more innocuous where it’s harder to pin down exposure reaction, getting out of the exposure, or remission of the reaction? Does it typically tend to follow that sort of trajectory?

MS:

Yeah, I mean, again, disclaimer, not a doctor, but I’m happy to share the experience of which I have a lot. I’ve got to have a common nominator here, at least a disclaimer. Assuming that limbic system is not in play, I will tell you that, to use a percentage that you used earlier, it seems like it’s kind of 50/50 or maybe 60/40 in terms of people that I’ve seen who are symptomatic. They go into a building that’s water-damaged or otherwise ultimately had a source of mold or bacteria and they react accordingly to different degrees. The symptoms can be, as you know, multiple, but there is a healthy percentage of high-functioning people who don’t notice a difference between indoor and outdoor, but there’s a general just always feeling 70%. They’re always feeling 80%, whether they’re going in and out.

MS:

I guess to tie a couple of pieces here in that observation, when we have a client who does say like, “I walk in the basement, I feel worse. I get out of the basement for 30 minutes, I feel better.” Anywhere from instant reaction to a couple of days has been a theme for those people that are symptomatic. That’s usually what I hear. Almost immediately to a couple of days later. There’s this delayed response, not too sure what that’s all about. I’m sure there’s a clinical explanation. But for those remaining balances, and I’ll bet you’ve got at least one audience member that’s listening right now who might fit that category, that’s where you talk about critical thinking coming into play as an IEP. Looking at it and going, “We still want to honor your health. Just because you’re not feeling symptomatic in the home, that doesn’t mean clearly you don’t have an exposure issue going on.”

MS:

But what I’ve found with those folks is that a lot of times there’s underlying other issues. Maybe they’re dealing with SIBO, for example, or they’re dealing with some other stress or some underlying genetic issue that’s getting in the way to when they address that root issue with their body, all of a sudden now they are more responsive to the environment. For me, the takeaway is that when somebody calls me up and wants to work with me, they’re not really symptomatic in their building where they’re going but the doctor’s saying mold, we just look at it a little bit differently. We just say, “Okay, well let’s honor that.” If your doctor has built a case, and I’m using these terms on purpose because we’ve been talking about it today, and you feel like that’s worthy of concern, then let’s talk about some professional options you have, meaning local boots on the ground. Let’s talk about a couple of DIY options you can do, some self-testing you can do in the house.

MS:

After we’ve had that discussion about the house itself and its history. Tell me about any water leaks you know of. Oh, you have a moldy crawl space, or you have a basement that smells really musty. Sometimes the evidence is right in front of us and the clients don’t even realize it, but in a majority of cases, as I’m sure you can appreciate, the people that are reaching out to me aren’t the ones that have 20 square feet of mold growth in their dining room that is visibly staring at them. It’s the ones that have hidden issues. Maybe it’s in the ductwork, maybe it’s in that basement wall that’s finished and there’s a moisture problem coming through. And so symptoms can be something that you should look at, but just because you don’t have them, number one, doesn’t mean that you’re not having an exposure.

Limbic System Reactions

MS:

The other thing too is consider that maybe there’s a limbic system PTSD type issue going on. If you are symptomatic, well, how are you feeling when you’re walking into that building? If you’re anxious going in there because every time you go in that building you’ve experienced a negative reaction, there’s something to be said about that. What I have seen, last piece here, is with folks that have that issue, even after they’ve done the remediation work, and let’s just assume for this conversation that it’s been effective, because of the trauma they’ve experienced, some of them ultimately just move because they there’s an association with that home that they just can’t get out of their way in order for them to recover.

DrMR:

I think you make many good points. One would be limbic. This is something definitely at the clinic we’re looking for clues of limbic imbalance from their initial paperwork onward. Actually, even with their initial interaction with our staff. We’ve trained our staff on how to look for these things. Not in a bad way, but we’re trying to understand people as best we can, and all of these things are partially diagnostic. Just the way someone discusses their health, even with our staff, could potentially indicate that they’re limbic, or have some limbic imbalances that are in need of support.

DrMR:

Along with that, another reason why it’s so important, in my opinion, to start with a solid foundation of diet, lifestyle, and gut health, because some of this constant congestion, chronic fatigue, or chronic fog may be a derivative of their diet, their lifestyle, and their gut health. And if all those things have then been satisfied, it makes it more likely that there could be a true environmental issue or that whatever degree of environmental issue is present, it’s no longer the host immune system that’s overreactive, because ostensibly as we improve diet, lifestyle, and especially gut health, we’re going to get the immune reactivity as best as it’s going to get. So if there’s still a degree of reactivity, then it’s more likely that the environment needs to be modified.

MS:

One just quick piece for those who are fighting that limbic system. Just to be clear for maybe a few of you, or maybe your significant others that are listening that don’t understand, this is not a psychosomatic, “you’re crazy.” That’s not what we’re talking about. What we’re talking about is a metabolic reaction, something that actually is causing a response in your body because of your illness and because of your experiences. It’s a very powerful and observational thing that needs to be taken into consideration. Like Michael said, in his practice, what they’re doing is screening for that because are you shooting yourself in the foot? People ask me, and I don’t know if I shared this with you last time, but in 2019, people always would ask, “What was the number one thing you saw, Mike, personally, that just made a change? Was it a special air purification device? Was it a special testing method or a remediation technique?” And I would always say it was neither. The biggest thing that I saw improve people’s outcomes, their demeanor, how they’re feeling, that whole thing was any sort of limbic system retraining.

MS:

This idea of DNRS or, there’s a few programs out there. I’ll leave you to explain to the audience if and when you feel it’s appropriate. But the point is that had nothing to do with me. I had no doing in that, but it was such a powerful observation that even on IEP Radio, I actually interviewed a couple of well-known limbic system type programs to kind of get your mind rewired the right way, dealing with that whole flight or fight system, that whole thing. And I was just fascinated by it, which is kind of weird because IEP Radio’s not really focused to be clinical specific, but I was so impressed at what I was seeing with people who took it and talking with me afterward. I mean, we’re talking about getting off the phone with them and there’s tears in our eyes, because it was the one thing that helped them.

MS:

So I just want to take a moment. It took a moment to say all that because I know there might be a couple people listening that maybe they or their spouses may misunderstand this piece. No, this is absolutely a real thing. That in concert with a susceptibility makes it very difficult for some people to truly get better. We’re learning; we’re evolving, and that’s something that should be looked at.

DrMR:

A hundred percent agreed. It’s one of the therapies that’s the most effective of the ones that we recommend at the clinic. Given that you have to look for that person who needs it. It’s not just, “Oh, you’re still bloated? Limbic.” You have to make a case, but I fully agree with you that it can be quite the needle mover. And yes, also agreed, and just let me echo that I look at it oftentimes just like the common musculoskeletal ankle sprain or hip musculature imbalance analogy I often use, in that same light. This is an imbalance that formed from some sort of insult or injury, and it can totally be rehabbed and rebalanced with the right work. In this case, the work would be limbic work. So yeah, fully agreed, and definitely something that can really help people.

RuscioResources:

Hi, everyone. This is Dr. Ruscio. In case you need help, I wanted to quickly make you aware of what resources are available to you. If you go to DrRuscio.com/resources, you will see a few links you can click through for more. Firstly, there is the clinic, which I’m immensely proud of. The fact that we deliver cost-effective simple, but highly-efficacious functional medicine. There’s also my book, Healthy Gut, Healthy You, which has been proven to allow those who have been unable to improve their health, even after seeing numerous doctors, to be able to help them finally feel better. There’s also our store where there’s a number of products like our elemental heal line, our probiotic line, and other gut supportive and health supportive supplements. Health coaching. We now offer health coaching. So if you’ve read the book or listened to a podcast like this one, or are reading about a product and you need some help with how or when to use or how to integrate with diet, we now offer health coaching to help you along your way. And then finally, if you’re a clinician, there is our clinicians newsletter, The Future of Functional Medicine Review, which I’m very proud to say, we’ve now had doctors who’ve read that newsletter find challenging cases in their practices, apply what we teach in the newsletter, and be able to help these patients who are otherwise considered challenging cases. Everything for these resources can be accessed through DrRuscio.com/resources. Alrighty, back to the show.

Discouraging Mold Growth

DrMR:

Maybe one final question. This came up in my conversation with Tim H., the HVAC pro. If this is as helpful as he is suggesting it could be, it really does even more so reinforce my feeling that working with the best people is really the way to go. He made a comment that there’s this, I don’t know if you would call it a filter or a purifier, but it’s this honeycomb UV lights device that produces these hydrogen peroxide ions that discourage growth of mold going forward, and help deactivate or essentially make them heavier so they fall into the floor rather than staying in the ambient air. And he said that he’s seen some pretty impressive anecdotal reports with people using this. Why I find it attractive is, let’s say you can’t get the humidity right forever in your home, then this is one safeguard against things recurring. Have you heard of this? And what thoughts do you have about it?

MS:

Sure. I’ll start by saying this. In July of 2018, the EPA came out with a 74-page document titled “Residential Air Cleaners: A Technical Summary.” It was their third edition. On page nine, I’m just trying to save everybody some time here, they wrote a section titled “Byproduct Emissions for Some Air Cleaner Technologies.” Don’t worry, I’ll spare you the drama and get you to the meat and potatoes. There are concerns that some devices can create by-products, not just ozone, by the way, for some of you that are somewhat educated on what a by-product could be, because of purification technology, whether or not it’s PCO technology, hydroxyl radicals, and there’s the whole host of other things that you can learn more about on that document.

MS:

Let me give you some considerations and takeaways when doing what you just discussed. I like to keep it simple. Everyone who is listening who suffers from a chronic illness, their life’s equation is not “X+Y=Z.” It’s typically X plus 99 other variables equals them. And so the more we can remove from that, the more control we offer the patient or the client, which obviously is an appreciated thing. When you’re talking about an air conditioning system, there’s no argument that some systems because of their design, where they’re located, we talk about like Texas and stuff like that, they have the tendency to support microbial growth. After all, if you have an air conditioning system, you have a part of that system that gets really cold, removes moisture, and it can be a breeding ground for mold or bacteria and biofilms under the right conditions.

MS:

Some people will add UV lamps with a specific wavelength that has been supposedly documented not to produce ozone that they use to sanitize the coil, just the part of the evaporator coil that actually cools the air. The old, original marketing that everyone was exposed to at one point or another was that people were saying, “Just slam this into your ductwork and we will kill and destroy mold.” Well, for those of you listening, if you’re having an inflammatory response, you’re not really just caring about the viable mold spores and killing it. You don’t want it to be there in the first place, so that doesn’t solve your problem. And this idea of destroying, I think, is relative under what they defined as destruction. Was it just zapping it with a UV white and damaging some of the cell wall, or was it obliterating it into harmless water vapor or whatever the by-product would be? So if you’re struggling with an air conditioning system, where you know you want the cooling and the conditioning of the air, since most of us live in places where we use that, before you slap on like a UV light to sanitize the coil, have it inspected first. Have it looked at. Are you seeing the tendency for microbial build-up to occur, like what Michael experienced in one of his situations?

MS:

If the answer is yes, other than cleaning that system of course, I am open-minded to trying that technology, but user beware that sometimes when you add one thing, you’ve got to ask the question. For example, they have these devices that can produce ionization. They charge the particles, and those particles go out into the environment. The argument was that these particles would coagulate and fall to the ground or stick to the surfaces. In other words, they would get out of your breathing zone. But has anybody listening ever wondered about the long-term effects of breathing in ionized air? We are a species. What’s the normal concentration of ionization in our environment, and are we multiplying that by some order of magnitude and thus there’s a long-term exposure?

MS:

So, 30-second nuggets from all that information. If you think you’re having an issue where microbial growth is occurring in your evaporator coil, that’s the part of the system that cools the air down, and you’re realizing that even with cleaning it has a tendency to do that, go ahead and try and install a UV light that could sanitize that technology over it, the idea being that it will help prevent growth from being there in the first place, and that’s what you’re looking for. Any other technology, we just simply don’t know that much about long term. Treating you like the friend you are Michael, I would be hesitant to say, and I’m not familiar with the specific device you’re talking about, but I do think I know which one it is. I don’t know that there’s any third-party robust studies that would make me feel comfortable enough to say go ahead and use it.

DrMR:

Yeah, and that’s what Tim said. He said, full disclosure, he doesn’t believe that there is any good clinical data yet, but he’s heard some good anecdotal reports. He also said to defer this to your IEP, so here I am doing that.

MS:

And you know what, that right there by the way, good for him. For him being honest and not trying to just sell you something that is marked up and has high margins for them, which unfortunately is some of the snake oil stuff we see. Just being aware and putting your needs first is evident by that explanation, that this guy is trying to be honest with you. And yes, he’s not qualified to tell you. He got us a brochure from the supplier saying this works miracles, and he’s not tasked with the same level of having to be critical like you and I have. And so as far as he knows, he thinks it does work. But why is it that some people that’s slap on some of these devices complain after they start working and some people don’t? What is different about one home to another? Is it the production of byproducts? Is it the limbic system mapping and knowing there’s something there and smelling something and having a reaction to it. I’ve seen it. So let’s slow down and not think that adding more is better. Let’s save those HVAC add-ons for last resorts if you fundamentally have a design challenge such as moisture and mold buildup in your evaporator coil.

Closing Thoughts and Further Information

DrMR:

Yeah, it’s a refreshingly practical perspective, Mike, which I really appreciate. Well, that’s an hour and a half gone by there in no time. And hence why I think, for the audience, if you’re suspicious that there could be something going on in your home, mold or otherwise, get a professional. Because here, I’ve just gotten some of my questions answered and there’s actually a few more that I’ll probably have to follow up offline regarding, and learn from my friend’s experience. I totally understand; he was so sick of feeling tired all the time. I get it. But doing these things the wrong way quickly is definitely not better than doing them the right way more slowly. But Mike, any closing thoughts you want to leave people with and then where would you point them online?

MS:

First of all, sympathy and a little bit of empathy to your friend, knowing that it’s frustrating and that there was a lesson to be learned for all of us. The lesson I learned the most was the reminder that when you’re not the one in it, when you’re not the one in the weeds dealing with exposure and illness and going through the symptoms, it’s hard for other people to relate. We want to let you know that we hear you. We want to let you know that we recognize that it’s not easy. There’s so many people that are suffering, and through it all is trying to find a balanced guide, a captain, if you will.

MS:

Really it is a two-part team. You have an IEP you trust and you have a clinician you trust. If you’re one of those people that are looking for an IEP. By the way IEP is an indoor environmental professional, for those of you who have been wondering half the interview. There’s a couple of sources you can go to. I’ll tell you real quick, the user-friendly version is ISEAI. It’s the letters I S E A I, International Society of Environmentally Acquired Illness, ISEAI.org. If you go there, you’ll see a “Get Help” tab at the top, and if you scroll down, you’ll figure out the rest. You’ll see that there’s a search tool that you can try and find IEPs that have been vetted to some level for them to be on this list. And you’ll be surprised to know that a few of them, myself included, offer virtual consultations.

MS:

So reach out to them. Larry Schwartz is a well-known one in the greater Chicago area. I’m in Arizona. We do consultations around the globe. If you’re looking to reach out to me personally, you can go to environmentalanalytics.net. Just to go to the contact page, fill out the basic information. It should take you 20 seconds, and then myself or my office manager will certainly get back to you. If you’re looking for free information, which we always know is not as critiqued and it’s not necessarily as specific to your unique situation, but there is a wealth of information on iepradio.com pertaining to everything mold remediation, like the containments, even the testing leading up to the clearance testing on the back end. Topics about air samples versus dust sampling. Topics about chronic illness and a general on how to appreciate it.

MS:

Dealing with somebody, are you renting right now? You need some help with some strategy of how to work out a contract that gives you the ability to break a lease without penalty? Looking at purchasing a new home and you want your realtor to help strategize with you? Go on IEP Radio. There is a ton of stuff on there that you can learn. Honestly, I think that half the people I talk to, if they would go there first and they have the time, they wouldn’t even need to speak with me. So for those people that are in tight situations from a financial perspective, don’t feel like you always got to drop $100 here, $200 there to get professional advice. There is a ton of good information, and iepradio.com is where you’d start.

DrMR:

Mike, I have to thank you again, just because the inception of this was on the podcast maybe a year ago now when Amy Kapadia first mentioned IEP. I had never heard of that type of professional, but it immediately resonated because I know that in GI and thyroid, my areas of focus, testing is notoriously misused. And so it made sense that it could be the same thing in other realms. And thus far, I took one step with an environmental testing company, and I think they were doing the best that they could, but I just didn’t have that structure and that objective mind to analyze. And now that I do, I feel much better about what I think otherwise is probably a dauntingly confusing and controversial topic for people to navigate. You’ve been really essential in stewarding me along what’s become a personal path for me of figuring this out. So I really appreciate what you’re doing, both professionally and personally. So thank you so much again for all you’re doing and for taking the time today.

MS:

And same to you, Michael. I really appreciate you being an advocate for transparency and being pragmatic, brother. I really appreciate this opportunity.

DrMR:

A hundred percent. Thank you again, buddy.

Outro:

Thank you for listening to Dr. Ruscio radio today. Check us out on iTunes and leave a review. Visit DrRuscio.com to ask a question for an upcoming podcast, post comments for today’s show, and sign up to receive weekly updates. That’s D R R U S C I O dot com.

 


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