If you’ve encountered mold from a water-damaged building or contaminated foods, you’ve likely encountered mycotoxins—toxic byproducts of mold. They’re common environmental toxins, and they have adverse effects on many body systems, including the gastrointestinal tract.
While you’ve probably heard about other symptoms that can follow mold exposure, Dr. J and Evan discuss that mycotoxins can also cause severe problems for your gut. They also talk about how mycotoxins impact gut health and the microbiota and what you can do to help restore your gut health once you are exposed to mold.
Dr. Justin Marchegiani
In this episode, we cover:
0:00 – Introduction
1:57 – Mycotoxins
10:16 – Functional Medicine Approach
13:54 – Dopamine Mechanis
15:20 – Mold Inhalation Effects
Dr. Justin Marchegiani: And we are live, It’s Dr. J here in the house with Evan Brand. Today's topic is gonna be wonderful for the podcast. We’re gonna be talking about the mold-gut connection and how your digestive issues may be exacerbated by mold toxins, so great topic here Evan, personally been affected by himself and we see lots of patients all the time with these issues so let’s dive in. Evan, how are we doing today man?
Evan Brand: Yeah man, doing really well, and a lot of people have been to naturopaths, they’ve been the functional medicine people they’ve been a conventional doctor, they’ve been treated for SIBO and SIFO, whether it’s Rifaximin or natural SIBO protocols, maybe they’ve done SIBO diets or some of these rotational food diets and that sort of things, maybe they’ve tried berberine, oregano, garlic, and maybe they’ve made some progress, but then they’re still stick, they’re still suck, I’m gonna mix up my words, they’re stuck and sick so that’s a bad combination of essays and this is likely due to a mold toxin problem because I’ve seen it too many times and I suffered on my own and even the labs now tell us they give us a cookie-cutter report but that cookie-cutter report nonetheless is still valuable because even the lab has painted the connection between mycotoxins which are essentially mold farts that you breathe in, in a water damage building and the connection to certain bacterial overgrowth, specifically Clostridia but also Candida and the mechanism of why this is so damaging especially to young children is because we know that Clostridia bacteria screw up the organic acid levels called HPHPA and this affects levels of neurotransmitters, so when you get these children, they have behavioral issues, they may be diagnosed with something like PANS, which is a Pediatric Acute Neuropsychiatric Syndrome. These kids usually have sensory problems, food sensitivity, skin issues, histamine problems, allergies, maybe they’re biting children, maybe they’re angry or irritable, this can all be traced back due to this toxicity.
Dr. Justine Marchegiani: 100%. So that’s quite interesting, now you talked about mycotoxins essentially being mold fart, so essentially the mold off-gasses, right? And, your different kinds of mold, right? It could be Penicillium, it could be Aspergillus, right? It could be the black mold, Stachybotrys, these types of things and then they produce various mycotoxins and when we do different tests, like plate testing on homes, supposedly each mold or so can produce about 300 different mycotoxins, whether it’s Ochratoxins, or aluminum is that correct?
Evan Brand: Yeah, which is crazy because we can only test for a very, very small amount on the urine so really, we’re trying to just look for some evidence of this bonfire, we’re looking for the ashes, Oh my god, there must have been a fire here, this big mold exposure, we’re only looking at the tip of the iceberg so yeah, you’re right. Our testing is good but it’s still very primitive compared to the amounts of mycotoxins that are being produced.
Dr. Justine Marchegiani: Yeah. And the type of organic acid testing that we’re doing is on the great plains. We’ll look at some of the organic acid compounds that correlate with, like Aspergillus or different mold toxins. Is that correct? What are those big mycotox? What are the big organic acids again?
Evan Brand: So, it’s all on paper.
Dr. Justine Marchegiani: Membranes
Evan Brand: Yeah. So, you’ll see oxoglutaric. You’ll see citric acid can be high in a fungal overgrowth too so it’s all page 1. Oxaglutaric, you got hydroxybenzoic which is related to bacteria. I could pull up an O but in general it’s just page one. It’s typically numbers 1 through 18. If you see any big red flags on that either a combination of a bacterial overgrowth specifically a clustering problem and or Candida or fungal colonization and the lab indicates that so tartaric acid would also be on there, carboxy citric acid is also on there. So, in parenthesis, you’ll see under these organic acids now which is great because this has improved over the years that you and I’ve been running these labs. It now says Aspergillus so on number 6, which is tartaric acid under number six, it’ll now say Aspergillus. And you’ll know if that’s elevated, you’re colonized for Aspergillus which means that you’ve now been exposed to a couple situations could have happened either you had a large enough amount of mold, you were exposed to mold, long enough or your immune system was weak enough where now you become a mold factory. So, you can be a mold reservoir, more specifically a mycotoxin reservoir where you just have this exposure at the moldy hotel in Mexico and then you come back home and you’re sick or if you were weak enough, now you’re growing mold. Even if you move to the desert to avoid mold, you stay sick because you’ve got that colonization so with
Dr. Justine Marchegiani: Ionization, that’s happening.
Evan Brand: Yeah. So, you can prove that which is very important because now that would justify the use of herbal antifungals to try to remedy this situation.
Dr. Justine Marchegiani: That makes sense. Let me go pull up one of my old tests. Let me see if I can find it. Hold on.
Evan Brand: Now, the conventional treatment is typically antifungal medications that are gonna knock this out. But, as you and I with our functional practice, we don’t like to use that. So, number 4 would be classified as the fungal, the ferran-2,5-tricarboxylic, you’ve that Ferran carbonyl glycine. Yeah. So, number six. Yeah. So, this is old enough where they didn’t have the molds but on the new ones in parentheses
Dr. Justine Marchegiani: Let me say Aspergillus. It is primarily Aspergillus for all three of these.
Evan Brand: Yeah, and the number nine tricarboxylic is Fusarium.
Dr. Justine Marchegiani: Fusarium. Yep. And then Arabinose and Tartaric are also correlated with yeast overgrowth. This test here for instance, I did a great plane and a Genova test at the same time and this one actually came back much higher on the Arabino side than the great plains. then the Genova tested. So, it’s interesting you know different samples and such. But yeah, this one Arabinose is strongly correlated with Candida but then
Evan Brand: I just ran my own, I’ve got Candida right now too so I’m on a protocol, right? Now, I just run. Yeah. I showed up with Candida and I want people to know because you were a speaker on the event. It was called the Candida summit which I ran like five years ago and you know we had like 30 people talking about it and I could look back but I tell you I don’t think anybody had made the connection here which was the mold Candida connection back then and now what I’m finding is basically you’re just playing whack-a-mole with Candida until the mold’s gone meaning you may rotate through various rounds of antifungals but out the back door, you’ve got to be using the appropriate binders to pull out the mycotoxins so if you’re just beating Candida down and it keeps coming back. It’s probably the mold, not the Candida that you need to be after.
Dr. Justine Marchegiani: Yeah. And, that’s where it’s good to run a test like this. Also, maybe a urinary mycotoxin test or just make sure your environment’s good because I always tell patients if the environment’s not good and you’re having reoccurring issues then you’re just not getting to the root cause. So, the first thing is to isolate the environment. Make sure the environment, your home, your apartment wherever you’re living run a high-quality mold plate test on there. We’ll put links down below where you guys can access the plate testing. Isolate that, right? Make sure there’s no water damage or if there’s been leaks. Make sure it’s been addressed and dealt with. Make sure that’s dialed then the second thing is you can run a test like an organic acid test with your functional medicine provider. See if there’s any colonization. And, it that’s chronic, yo can get to the root on that and then you can always run urinary mold where you’re looking at mycotoxins coming out in the urine that can also be helpful but typically if this is good and there’s nothing at the home then you’re probably in pretty good shape and it’s probably more of an acute kind of dysbiosis thing probably from poor diet, poor digestion other bugs, other infections, etc.
Evan Brand: Yeah. And the cool thing is that you can kill two birds with one stone or even three birds with one stone and what I mean by that is let’s say you run that oh and you showed the elevated Arabinose, you know, there’s a Candida problem but if we see tartaric above that’s high and then down below, we see some of the bacterial overgrowth markers, the blends that you and I formulate and have, we might be able to kill bacterial overgrowth, fungal overgrowth and a Candida problem. All in one fell swoop and that’s incredible and you know your gastroenterologist or even your mold doctor is likely not gonna be able to do that. They may come in specifically with itraconazole or fluconazole or nystatin. But as you know, we’re facing this big problem of antifungal resistance just like we’re finding with antibiotic resistance and so now, you’ve got these very virulent strains which are difficult to kill with conventional medications. You and I have talked about this before but the long story short of it is all the different alkaloids and terpenes and beneficial nutrients in the plants, those don’t have this resistance problem. And if you’re mixing this herb and that herb, it’s not one plus one equals two, it’s one plus one equals ten. You get the synergistic effect.
Dr. Justine Marchegiani: Yeah. You see the same thing with addressing bacteria and other bigger bugs and berberines and Artemisia Wormwoods have synergistic effects. Also, the fact that you get a lot of antioxidants in a lot of these herbs. And so, especially if they’re high-quality, you get a lot of antioxidant support because when you start killing bugs, it’s a lot of oxidative stress that’s happening. And then, when you provide like an antifungal like Diflucan or an Amphotericin or a nystatin or a ketoconazole, obviously, there’s no antioxidants in those drugs and so you’re gonna have a lot of oxidative stress so it’s nice to have a blend different herb in there. One, to prevent the resistance. And then, also, people have yeast issues and a lot of times they have bacterial bugs as well and efflux pumps are a big thing that a lot of bacteria and bugs use to kind of protect themselves. So, I cannot say, like bacteria is like a sinking canoe, right? and essentially, you poke holes in that canoe with a lot of the herbals and think of the efflux pumps as the person in the canoe, baling water, right? So, they try to keep on bailing water, bailing water, so they don’t sink, right? And so, think of the herbals when you inhibit the efflux pumps whether it’s a ginger or different antimicrobials, it’s like taking the buckets away from the bacteria that’s bailing water and allows then to sink that allows them to effectively be destroyed that along with addressing biofilms too.
Evan Brand: Yeah. That’s awesome and the cool part too is you can minimize the die off if you’re doing this right. You know a lot of people when they hear these conversations, they get afraid. They go oh my God, Candida, mold, bacteria, parasites, worms like oh my God, this is a lot of stuff in me. I want it out of me but now I’m afraid. Am I going to feel worse before I feel better and the answer is if you do it properly that should be minimal to a nonexistent problem? I think you and I have refined our protocol so much over the years now that we have these tools and these other therapies in place that are standalone products but we often add those in or if we see that we hit a roadblock or a big bump in the road like a die off, we can change dosing. We can rotate. We can add in other support. We’re always talking about liver and gallbladder and binders and hydration and biofilms. These other pieces, these other variables, these are the make-or-break things for some people.
Dr. Justine Marchegiani: 100%. And when people kind of want to go after the gut, we live in an antibiotic like kill, kill, kill generation so people tend to, when they find out they have an issue, they want to go kill, kill, kill and that can be very stressful in the body so it’s always very important to calm down the inflammation, get the immune system stronger, get the hormones that help with anabolic metabolism which is healing, recovering, anti-inflammatory support that kind of sets the table because the more stressed and inflamed you are, your lymphatic system, your detoxification system, your immune system won’t work as good and plus people forget your detoxification system, right? The cytochrome p450 oxidized pathways, especially the phase two pathways, they’re gonna run off of a lot of sulfur-based amino acids and so if we don’t have great digestion and we’re not eating you know good healthy animal protein or good healthy plant cruciferous vegetables. If we can’t tolerate them, we can’t break them down. May not have a lot of those sulfur building blocks to run those phase two pathways and so that’s why kind of getting the deck set so to speak so we can really hit phase two better just not with support but just getting digestion working better and a good diet working better sets the table and allows us to effectively kill so much better.
Evan Brand: Yeah and I know we’ve talked about a lot in a short amount of time, we’ve gone fast so listen back as needed but I want people to understand the connection because of the title of this episode, I want people to understand the mold-gut connection. So, the connection is the following: the mycotoxins weaken the immune system and allow the opportunistic bacterial overgrowth to thrive along with the Candida. So, if you’re working upstream at the SIBO-SIFO situation but you’ve got an underlying mycotoxin problem, you’ve got to address that if you fully wanna get better. The other mechanism of the mycotoxins is a couple. Number one is they damage the microbiome so we know specifically that mycotoxins do the same thing as, like food allergens, they disrupt the gut barrier and create intestinal permeability. So, that’s another reason you want to pull those out of the circulation by using specific binders based on your labs. And then the other mechanism too is we know mycotoxins affect the brain chemistry and specifically lower dopamine so when you get into pain signaling, you get into motivation and mood and just your overall vitality. If your brain chemistry is affected, we can also measure that but it could be directly attributed to the toxin for example in like rat studies when they inject them with mycotoxins or expose them to mold toxin, the dopamine levels crash. So now, all of a sudden, you’ve got this brain chemistry piece to address too, now people have heightened pain sensitivity, they’re depressed. They may be just more flat with their life. Once again, they go to their psychiatrist. They’re not gonna bring up mold toxicity, they’re putting them on an antidepressant medication. They’re never gonna say, “hey, oh your basement is flooded, that’s why you're depressed and anxious and you have diarrhea”. So, the connection of the gut symptoms too, the diarrhea, any type of bloating, burping, digestive pain especially in children. Children don’t use the same language as adults. So, if your child is complaining about stomach pain that could be one clue that there’s something related. That was my issue for my daughter, Summer. She was complaining of tummy aches so we did run stool on her. She did have H. pylori when she was two. We tested real high. Maybe I gave it to her by sharing water bottles or something but either way, we took care of that and then stomach pain was continuing that was when we had got exposed to mold. Luckily, I got her on binders. Now, she’s in a better place. So, I’ve seen it unfortunately with my own kids and it’s stressful to see your kids suffer but it’s a good lesson. It’s a good learning lesson that your children are not crazy and if your kids are complaining of a chronic issue like this with pain, you know, consider this as a possibility especially if you as the mother are toxic because the toxins go through the placenta and they also go through breastmilk. So, if you have your own digestive skin, whatever problems, mood problems in your kid, has similar issues as you, well, it could be the generational passing of toxins.
Dr. Justine Marchegiani: So, let’s go over that mechanism one more time with dopamine. So, obviously dopamine is a neurotransmitter and when we’re chronically stressed, physical, chemical or emotional, dopamine can go downstream and get converted into adrenaline which kind of helps manage the acute stress response. Is it just a fact that the mold is inflammatory and creating a stress response and activating the sympathetic nervous system that the dopamine is being taken and depleted downstream or is there something else? I want to make sure I get that mechanism hammered down.
Evan Brand: I don’t know. Type in rat dopamine, mold or rat dopamine, mycotoxin. See if you can find it. There were several papers on this. I don’t know if they discussed the mechanism in it or not. My assumption would be that it’s multifactorial. I think the big mechanism would be that the mycotoxins affecting the gut barrier then affecting nutrient absorption then there’s likely less amino acid conversion to dopamine. So, I’m thinking, it’s more of a malabsorption problem but also we know that ochratoxin for example damages
Dr. Justine Marchegiani: Like malabsorption, like it’s affecting the absorption of protein in the gut?
Evan Brand: Yeah. I think that’s one mechanism. I think the other mechanism would be direct brain damage. We know that okra toxin for example damages the cerebellum. We know that the Verrucarin and the Stachybotrys mycotoxins affect the brain and the prefrontal cortex which impairs, like your ability to think clearly. So, I think it’s both. I think it’s the gut damage and I think it’s the direct brain damage too. I am going to pull it up here. Can you see it on screen?
Dr. Justine Marchegiani: Yep.
Evan Brand: Let me make it bigger on my side here.
Dr. Justine Marchegiani: Yeah. So many mycotoxins, trichothecenes. We test that in some of the mycotoxin tests. Yeah. Induced neuronal cell apoptosis so some of that could be you’re just causing the cells in the brain and especially in the substantia nigra of the midbrain. That’s where dopamine cells are being produced. Some of it could be apoptosis that means programmed cell death and or inflammation in the olfactory epithelium.
Evan Brand: Interesting.
Dr. Justine Marchegiani: So, it seems to be a neurodegenerative and then look it says it caught ochratoxin A causes acute depletion of dopamine and its metabolites.
Evan Brand: Look at that.
Dr. Justine Marchegiani: So, I wonder if that’s a, it sounds like it’s possibly a stress response, right? Because dopamine can, tends to go downstream to adrenaline. It could be almost like an autoimmune response because you’re having apoptosis. This is neuronal cell death, program cell death. This is part of the reason why apoptosis is important, right? Because if you don’t have good immune function, this is how cancer forms, right? Your immune system helps program cells to die when they need to die. This is apoptosis but if you can’t do that then cells can overgrow hence you have a tumor, right? And so, this is actually happening to unhealthy or the very healthy tissue that you need to be functionally healthy that produces dopamine in the midbrain. So very interesting.
Evan Brand: Yeah. Talking about the hippocampus too, we know that hippocampus, I’ve got two of them. Remember, that’s why a lot of people have brain fog problems and also I would say that short-term to long-term conversion is impaired.
Dr. Justine Marchegiani: Can you see this one here? The mold inhalation one
Evan Brand: I’m just seeing that you’re highlighted on the hippocampus word for now.
Dr. Justine Marchegiani: Let me switch back to the other one here. This is mold inhalation. This is interesting. Let’s go pull this up. All tight. Mold inhalation causes innate immune activation, neural cognitive and emotional dysfunction.
Evan Brand: So, this is pretty new. July 2020 paper here so relative.
Dr. Justine Marchegiani: Yeah. Yeah. So, the ability of mold to cause such symptoms is controversial since no published research has examined the effects of controlled mold exposure on the brain. Patient symptoms following mold exposure are indistinguishable from those caused by innate immune activation by bacterial or viral exposure. Interesting. So, in this study here they added in. See here. Toxic and nontoxic mold stimuli would cause innate immune activation with concomitant neural effects and cognitive and emotional behaviors. We internationally administered intact stachybotrys. This is black mold extracted non-toxic stachybotrys spores and a saline vehicle to mice.
Evan Brand: You don’t want to be that mouse.
Dr. Justine Marchegiani: Wow. No. As predicted, intact spores increase interleukin 1 beta, immune reactivity in the hippocampus both spore types decrease neurogenesis. This is forming new neurons in the brain and causing striking contextual memory deficits in young mice while decreasing pain thresholds. So, this is another word saying, causing more pain in the body. So, if you have mold exposure, joint pain could happen, right? And enhancing auditory acute memory in older mice. Nontoxic anxiety. Yeah. Also increase anxiety like behavior. Levels of hippocampal immune function correlated with decreased neurogenesis that’s creating new neurons in the brain. Contextual memory deficits, right? Obviously, less memory and or enhance auditory cued feared memory. I wonder what that means. Maybe it’s just like, uh, you’re more sensitive to external stimuli.
Evan Brand: I read that. Yeah. I read that as sound sensitivity which is yeah part of the toxin and light sensitivity too so people will often have to wear sunglasses even when it’s not very bright. You and I talked about that in the context of adrenals years ago but that’s also a mold toxin thing.
Dr. Justine Marchegiani: Yep. And an immune activation may explain how both toxic mold and nontoxic mold, skeletal elements cause cognitive and emotional decline. So, it’s really important. We don’t wanna be in an area where there’s a bunch of mold toxins and we can do a whole other podcast on how to mitigate mold toxins as a whole. I mean, of course, get your home tested. That’s the first thing. If you have water damage, make sure it’s mitigated by a professional right away because mold starts to form when sitting water in as little as two days. Got to make sure that’s under control and then if you’re on the fence, get yourself tested, right? We’ll run an organic acid test. Maybe run a urinary mycotoxin test and see what your actual load is but again one of the big telltale cue signs is you know, get your home. If there’s mold there and you start feeling significantly better and you go back, you notice an increase and definitely get your internal mold tested as well via urine.
Evan Brand: Yeah. Well. I know we got to wrap this thing up. We got calls to get to but I hope this is helpful for people. We can always get geekier and dive deeper and go longer but I think you guys get the gesture, the connection of the brain toxicity, the gut damage. There’s a mitochondrial element with the chronic fatigue piece. So, if you are suffering from any chronic issue whether it’s mood like depression, anxiety, energy problems like chronic fatigue, low libido, poor erectile function, cold hands, cold feet, increased light sensitivity, blurry vision could be other things but this is a big smoking gun and all of us are inside way too much. We’re not outside like the Amish are all day. They might have moldy homes but they’re not breathing it in the majority of time. They’re outside in fresh air where the toxins are diluted. So, us with our indoor lifestyle as modern humans, we’re at more risk of this stuff and our buckets are already full due to pesticides and other toxicity in the environment so this is a really, it’s an epidemic problem, maybe the biggest one.
Dr. Justine Marchegiani: And not everyone is as genetically sensitive, right? Some people, they go into a moldy area. They get brain fog, right away. Some people do fine. Either way, it’s definitely a stressor in the stress bucket and if you know it’s there, you definitely wanna pull it out because it’s gonna help give you more resiliency and more adaptability. Great podcast today Evan. Everyone listening on the audio version, we pulled up some studies and some lab tests on the video version. We’ll put the link down below so you can see the video version. We’ll put some links to some of the labs and the products that we talked about today so you guys can take a look at those. Evan, great chatting with you. Head over to evandbrand.com to reach out to Evan via functional medicine nutritional support worldwide as well as justinhealth.com, Dr. J myself at justinhealth.com for me myself. We are here to help and support you guys wherever you are. Have a phenomenal day everyone.
Evan Brand: Take it easy. Bye-bye.
Dr. Justine Marchegiani: Take care. Bye now.
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