Mold & Mycotoxins: Binders vs Antifungals

Welcome to the Gordon Medical Forum, patients with mold exposure are often treated with binding agents, yet many remain chronically ill despite months of aggressive protocols. What if the real problem isn't circulating mycotoxins, or rather ongoing gut inflammation and bacterial endotoxins that keep patients trapped in a cycle of illness? In this episode, Dr. Eric Gordon and Dr. Petchman Cateri explore a paradigm shift from binders to antifungals. And while healing the gut microbiome, maybe the key to recovery that the mold community has been missing. Thank you for joining us, and here's Dr. Eric Gordon and Dr. Petchman Cateri. Welcome everyone. Today I'm having a conversation with Dr. Petchman Cateri, and I think you will all be surprised to realize how it fits many of the stories that we're discovering that perhaps our toxic environment is a very big problem for those of you who unfortunately have chronic illness. And though we spend a lot of time, and I truly believe we should get rid of the lime and get rid of the mold, there's more to the story and much more to the story. And that's what we're going to talk about today is how Petchman actually what I think is important is I'm going to have Petchman give us a little history of how he arrived here, because most of the mold mycotasin community are firmly in love with binders. And for some people, they really work well, but doesn't seem like we maybe need them for everyone all the time. And we're going to get into that. So Petchman, tell us the story of how you were in love with binders and then had some other thoughts. Yeah, I definitely had a love affair with binders early on. And you know, I followed the lead of the community and giving credit where it's due, my friend and mentor, Neil Nathan, you know, is the one that opened my eyes and really brought me into this world and helped me start seeing things. And you know, following his lead, I was very gun hoe about binders, and I was treating many, many kids over many years and using combinations of binders and clay and charcoal and cholesterol and ink and chlorella and so forth. And there was one elephant in the room staring me in the face, which was a handful of kids got better. And you know, some of them would get much better. And a lot of them were not. And they were just stuck. And the other thing that was really weird to me is, you know, despite using all of these binders and sometimes using them pretty aggressively, I would keep checking their urine, mold toxin levels. And the levels just kind of stayed the same. Sometimes they went up. Sometimes they went down. Sometimes it didn't. And you know, after a year or two or three, and it was more like three, I started looking at this and saying, God, this just doesn't make sense. Like it doesn't make sense. This is not making sense. There's something just missing from this picture. And then there were some of my patients that are like, dude, Dr. K, we've been doing these damn binders for like six months. My kid is no better off. Like they still got the attention problems. They started autism. They still have, you know, eczema and whatever else. And it really just brought me to a place where either I had to start ignoring what these families and patients were telling me or I had to go to the drawing bowl and say, well, what the hell am I missing? Right. And then I started, you know, looking at everything else that was kind of part of this picture. And with that, I mean, you know, there was Dr. Andrew Campbell that just kept telling me like, page, been forget about these binders use the antifungals. You know, I'm like, okay, why the hell is this guy talking about antifungals? Why is he so big on antifungals? Because if it's the toxins, then why the heck would these antifungals fix the toxins, right? And then there's the Dr. Schumacher camp that's more about the immune system and, you know, these, you know, hormones that modulate the immune system. And you fix the hormones to fix the immune system than that changes. And it's like, wait a second. Why the hell would the immune system influence the toxins if it's all about the toxins? And then you add to that, you know, all of these other conversations of glyphosate and heavy metals and so forth. And then it's like, well, how do those fit into this picture of chronic moltoxicity if we're talking about these moltoxins being the primary driver? And, you know, as I started standing back and, you know, just really taking time to reflect on what the heck is this thing that we call chronic moltoxicity? You know, ideas started coming together for me. And then listening to other people and kind of seeing their perspectives, I started really saying, well, God, maybe there's more to this picture. And this notion of chronic moltoxicity is a problem that has to do essentially with chronic circulation or recertulation of the moltoxins is probably not entirely correct. And then as soon as I came to that understanding and realization, everything else started clicking into place. And all of a sudden it's like, oh, that's why Dr. Campbell says this. And he's treated thousands of patients with antifungals. And that's why the Dr. Schumacher camp also makes sense. And this is also where all of the other toxins come into the picture. Yeah. The toxin is such a strong word. And I think it caught all of our attention. And the fact that yes, we could measure mycotoxins in the urine, though we never really knew what that meant. But we could measure them. And that's always an exciting step in the kind of medicine we do. We actually have evidence that there's something there. Yeah. I think that really caught everybody's attention. And I love the way you've, you know, you've woven the three fields together because the bottom line as, you know, you're getting to is it's all inflammation. Yeah. So talk a little bit about the inflammation and maybe tie in for the audience because it's always hard when I'm listening to people talk to me and I've spoken to them before. And I know the punchlines, you know, I want to make sure that everybody gets the story, right? What here is how inflammation is triggering most of our symptoms and how our exposure to mold mycotoxins wet buildings can just play into that very seamlessly without having to have it be the mycotoxin that is necessarily causing all your symptoms. Yeah. Yeah. So, you know, I think first, I want to highlight what you just touched on, which is with dampness or moisture events, what we're dealing with is way more than just the molds or more toxins, right? So you've got microbial volatile compounds, microbial particulates, you've got bacterial endotoxins that we're all inhaling. And even the bacterial endotoxins from the environment, they've done these studies in these sewer treatment workers and when they check their blood levels, their bacterial endotoxins in the blood were highly elevated. So the first thing that we we zoom out and say, well, is it just a mold or is it the soup of stuff that's making us sick? And we all know that it's actually the soup of stuff. So then we say, well, what does this soup of toxic stuff do to us? And to your point, one of the things that this soup of stuff can do is trigger gnarly amounts of inflammation in the nervous system, which is where, you know, autism and ADHD and pans and pandas and all of these other things come from, which is all kind of neuroinflammation plus toxicity. They also trigger a lot of systemic inflammation, which is where MCAS and, you know, other things show up into the picture. The thing that I came to realize, and this was after really carefully watching a lot of my patients over time. And this is, I think, one of the things we don't talk enough about is how much the soup of toxicity affects the gastrointestinal track. So the gastrointestinal track turns out to be the primary mechanism that helps us detoxify these toxins. And, you know, this is where we say, well, yeah, we use the binders to detoxify and we use, you know, co-lean to get the, you know, bile to drain so we can bind it. But we don't ask, well, what was the thing that set this all off? Because yes, there's inflammation and inflammation is bad and that MCAS is bad and all of that. But what is it about these individuals who get really sick, right? What is it about them that makes them so vulnerable, not just that they get sick, but then they stay sick for years and decades later. And I've seen, you know, in my population, individuals who were exposed five years later, seven years later, we're still toxic, we're still really sick. And that's where the gut comes in. A healthy microbiome and a healthy gastrointestinal track are what we need to detoxify, period, hard stop, and the story. So when the gut is healthy, when the microbiome is healthy, the bacteria essentially detoxify these toxins and convert them into these less dangerous compounds. And then when the gut is whole, they just go right outside of us, which is what normal healthy people are able to do. And where the Dr. Schumacher piece comes in is if you think about like what the hell are these HLA haplotypes, right, why would immune susceptibility somehow create susceptibility to toxicity until you look at the data, which suggests that these HLA haplotypes that people test for and say, oh yeah, you're part of the, you know, 20% that are vulnerable for more toxicity. Well, those haplotypes actually create susceptibility within the gut. Those haplotypes create microbiome susceptibilities, they create gastrointestinal susceptibility. So literally the gastrointestinal track, yes, the systemic immune response too, but the gastrointestinal track is what becomes the kink and the armor, if you want to say. And when there is sufficient toxic load and the gastrointestinal track goes out of whack, the microbiome goes out of balance, the fungus in the gut goes out of balance, and you get chronic inflammation and chronic leaky gut if you want to say within the gut. That combination then becomes this perpetual feed forward cycle of toxicity and inflammation that essentially has no end. And why the binders help people feel better is because if you've got this massively he got with all of these toxins that are constantly recirculating and you keep putting binders in there to reduce what's absorbing and recirculating, the picture starts making sense. Does that make sense? Oh, absolutely, absolutely. I mean, this is, you know, we all know that we have to lower the inflammation in the gut. I mean, it's just going to set off your cytokines, it's going to set off your liver. It's behind, I mean, most of why are people feel so bad most of the time, but I think what's so interesting is you're bringing up how big of a fact that the mycotoxins and some of the fungus themselves can disturb the lining of the gut and lead to the inflammation. I think that's the key point. And so as always in medicine, we tend to get stuck on the trigger and forget that really by the time people are chronically ill, we're dealing with the downstream effects, you know, rather than just the trigger. That's what you're bringing out. So clearly, and I love the fact that, yeah, you know, binders will work because they do find some toxins, and especially some of the chemicals, the nasty stuff that the bugs make, you know, as you're, as you're quote unquote, dysbiosis really gets unbalanced, very disc. And you know, I love that point that you bring up because when you really look at what, you know, colostyramine, for instance, colostyramine, which is this cholesterol medication, if you look at the literature, colostyramine is highly capable of binding these bacterial lendotoxins. And these bacterial lendotoxins are basically these little compounds that the trillions of bacteria in our gut produce. And when they go out of balance, they produce a very toxic version of these little molecules and compounds that actually with the leaky gut are able to go into our circulation and cause rather horrendous amounts of inflammation and toxicity. And I think to your point, you know, what is chronic mold toxicity? Like what is the toxin that makes us sick, you know, for some people years after they have moved out of the mold? And I would argue that it's not the mold toxins that are now making us sick, because at least according to some of the literature that I've seen in mammals, these Michael toxins, these mold toxins can degrade within, you know, a few hours, a few days, not a few years, a few hours to days. So if that's the case, then is there another toxin that has now come into the picture that is capable of constantly being produced and recirculating, which is yes. And that is actually the toxins that we are producing that is getting released and going into our gut, going into our circulation and those endotoxins are what are making us sick. Right. So we have just a step back for once I just just want to remind people of the arc of the story, if you will. Remember, we were running after maybe not Michael toxins, but fungus overload in the body. I said since the 70s with Dr. Crook and Dr. Young, I forget, but anyway for a long time. And then in the turn of this in 2000, 2001, to Dr. Schumacher really started to bring forth the concept of Michael toxins or fungal toxicity and using the binders when he serendipitously found how effective colostyramine was having on somebody's, you know, neurologic symptoms. And at that time, he was training blue green algae toxicity, but who knew? But he realized he put it together. And that's the thing about Richie, a Dr. Schumacher, is that we've had our disagreements over the years, but he is truly a great thinker because he went with that. And then, you know, I wasn't sure if it was just being rebellious, not liking the whole Michael toxin world, but he really realized that it wasn't just the fungus, but it was the whole, all the bacteria that came with the wet building issues. And so it wasn't just toxins, but we've still, you know, we still get stuck. And this is what I love about what you're bringing forth to all of us. Impeachment is just how important to rethink and step back. Okay, we have these stories. And we're doctors. And doctors tend to follow story paths, even, even those of us who like to think we always are thinking independently, but we do tend to get groupthink. And I really like the way you're bringing up. So we're now at the point of the, okay, so your gut's inflamed. And it's releasing these endotoxins. So take it from there. Sure. First, thank you for creating space to have this discussion. And I think one of the things as physicians is it's very easy to just follow where everyone else is going in disregard what our patients are trying to tell us. And I mean, I've got to tell you the reason why I ended up here more than anything where my patients, these families coming to me and say, hey, dude, this stuff isn't working. Like my kid is still sick. We're still sick. What's going on? So I hope that everyone that's listening will honor their patients. And if you're a patient, if whatever you're being told to do, if it's not making dramatic differences, honor yourself and say, hey, something is amiss. Something is not right about this picture. What the heck is it? And that's why I'm so grateful to be having this discussion. So going back to the bacterial endotoxins, if you look and ask, what are these things capable of doing? The literature that comes forth is, I mean, disturbing to say the least. In the world of neurodegenerative disease, that is where I found the biggest body of information. So Alzheimer's, dementia, Parkinson's, you know, all of the neurodegenerative disease models are, they're aggressively looking at how these bacterial endotoxins are impacting the nervous system. And the reason why is of all of the toxins that are out there, by some, you know, argument, these bacterial endotoxins are probably the most dangerous thing for the nervous system. They are the most toxic, pro-inflammatory agent out there. And then when you add to that, what can these bacterial endotoxins do to our immune system? So if we zoom out and first look at how does our immune system perceive these bacterial endotoxins? In the way that immune system perceives it is like, hell no, should you be coming into the body? Because that's essentially a sign that the gastrointestinal tract has been breached. And as far as the immune system is concerned, this is like World War 3, because once that happens, I mean septic shock is one outcome. And for audience members that aren't familiar with that term, if you heavens forbid get to a place where you get so sick and you have such a severe bacterial infection and your gut falls apart, you essentially get this flood of these bacterial endotoxins like a tidal wave that actually causes you to literally shut down every immune, every part of your immune system, mitochondria, and within 24, 36 hours, someone heavens forbid could pass away. And I've seen that happen in the ICU. So that's the most extreme version of it. What we find is in milder versions, you may not be dying, but these bacterial endotoxins are now floating through your system, causing damage to the nervous system, causing inflammation to the nervous system, which is where a lot of the odd findings that we see with people who have more toxicity come from, right? Anxiety, brain fog, can't think, can't process my god, my brain is just kind of falling apart. And then we see it in the kids with autism and other kind of neurodevelopmental issues. But the other thing that these toxins do is the trigger horrible amounts of inflammation. There's this thing called an NLRP3-inflammation. This NLRP3-inflammation, which can mediate other parts of our immune system, actually can be powerfully triggered by these bacterial endotoxins. The bacterial endotoxins can trigger mass cells, they can trigger, you know, gun inflammation and systemic inflammation. And then from there they can damage the mitochondria, they can cause liver toxicity on and on and on and on. So it really paints this fascinating picture of how this, if you want to say, layer of toxicity when it's put on top of the mull toxic picture, starts making a lot of sense. And then it also makes sense in terms of once you have sufficient gut inflammation and dysbiosis and fungal imbalances. And we can circle back and touch on, you know, that candida kind of fungal piece. All of that can cause indefinite leaky gut, which then causes indefinite endotoxemia, which can then cause someone to stay toxic for decades after they were initially affected by the mold. Yeah, I just want to remind people, the thing that's hardest to remember when you hear doctors describe illnesses or the pathophysiology, what the body is doing, you know, is we speak in words that are very linear and suggestive that A causes B and B is bad. So when A happens, something bad is going to happen to you. And the amazing thing about the body is how much punching it can take. Because every time, you know, when you think about these things, you think, oh my god, I'm endowed. I have, you know, lipopolysaccharide being released into my bloodstream. Well, guess what? You do. And you're doing, okay. And you can have a lot of it on some days and maybe feel worse. But I just find it because like we're dealing with people with Lyme and Bartnell and BBC and everybody's worried, oh my god, it's in my brain. It's the pictures that are worse than the disease. Okay. So I just ask you to like remember that millions, hundreds of millions, probably people have these things and they're not dropping dead. They feel lousy, but there's resilience in the system. And I mean, because the lipopolysaccharides really can trigger your immune system and is doing it every day a little bit. But the beauty you got to remember is that Alzheimer's and Parkinson's are usually having to people who've had that happening for 50 to 80 years. So don't panic. That's my only thing because I think it's just really important to understand how inflammation drives I think everything. But your body is amazing at balancing it, even if you're feeling bad. It's still doing a decent job at preventing a lot of damage for almost all of us, which is kind of a miracle I admit. But and it's hard to get your head around. But that's why your regular blood tests are still not too bad, even if you've been sick for 20 years. I love what you brought up and I want to add one thing to that, which is I hope every audience member out there listening also realizes all of this is treatable. For the most part, all of this is reversible. Like that's the really cool part of this conversation. And I would love to shift this from, oh my god, this is doom and gloom. I'm going to be sick. My kids are going to be sick forever or whatever too. There's so much we can do. And part of why I came here is what I came to realize is by treating the gut, treating the inflammation, treating the gut imbalances, helping to get the gut to seal as quickly as possible. My goodness, the changes that I started seeing, like with a year and a half of binders, I was getting kids better in like a month and a half, two months. Like the outcomes were staggering. So I hope for everyone listening, I want you to reframe this not this is doom and gloom and I'm going to be sick forever. It's we now have answers to figure out how to get everyone feeling so much better and getting everyone hopefully healthier than they've ever been in many, many, many years. Yeah. And I think we should go there. I want to tell you one more little part of your story. Just and it was not your story. It's how the body works is that when that lipopolysaccharide goes out, it starts triggering off, you know, as we said, the immune system and that's for all those chemicals that we've been busy measuring the cytokines and your T and B cells start getting. Well, they kind of lose some of their oomph and your macrophage and neutrophils kind of start leading the charge too much and you stay not feeling well because when your T and B cells start working, often you can quiet things down a little bit, but as long as the what we call the innate immune system is being triggered by your gut, you're going to be tending to have symptoms that flare on you quite a bit. A lot of inflammation and strange burning, all the strange symptoms that people have. Now we're going to get to the juicy part, which is specimen. What's been your way forward in beginning to try to heal this issue? I love it. You know, some of my colleagues are surprised when I say that over the last, now a year and a half, I've pretty much completely stopped using binders altogether. And the reason why is one, as I alluded to earlier, I didn't find them to be as effective as I hope they were. And I always ask myself for whatever I'm asking a person to do, whether it's a parent taking care of the child or sometimes I get looped into helping the parents. But for whatever I'm asking someone to do, what is the payoff? How big of a payoff is it having? And this is where we get into the antifungals. So I have started almost exclusively using the antifungals and holy moly. The results and outcomes that I've had have been exceptional. There are some kiddos with, for instance, autism spectrum with, you know, sleeping problems and digestive issues and irritability and lack of eye contact. And I just put them on silly old nice statin, which is kind of the most puny and incompetent of all the antifungals. And some of these kids within literally like four to six weeks have started calming down. They're sleeping better. They're eating better. They're making more eye contact. And that's just nice statin. And part of this, I think, is important for us to start with, why the heck would we need the antifungals, right? How do they fit into this picture and what the heck do antifungals have to do with toxicity, right? And this is where I think things get kind of interesting because when I tried to understand what the heck was it that was keeping the gut stuck, right? What was all of this chronic gut inflammation about? And why would these people that left the moldy environment? Why were they still having all of this inflammation and dysbiosis, you know, imbalances in the gut indefinitely? And that's where the fungus popped into the picture. Most people discount the role of the fungi's in modulating the gut immune system. You know, they say, oh, you know, the fungus is such a small part. It doesn't really play that big of a role. It's not a big deal. And frankly, if you do a poop test, pretty much all of the stool tests miss fungus because when you talk to some of the company, like chief medical officers, they're like, yeah, well, the fungi are only 0.1% of the total microbiome. So therefore, it's not a big deal. Whereas if you look at what these fungi do to the mass cells, to the dendritic cells, which are kind of the master orchestrators, if you want to say, if some of the immune response in the gut, they are exceptionally good at peaving off this part of the immune system. And when you have a lot of gut inflammation, that essentially creates the perfect environment for Candida. And I would argue Aspergillus and some of the molds to just set up shop. They look, they're like, wow, this is like club med. I love it here. It's so warm. It's so cozy. I've got all my food. Someone is serving me drinks. I think I'm just going to live here forever. Whereas normally, you know, the gut is more like Siberia for Candida, where it's like, God, I don't want to be here, you know, and they kind of hang around for a second and they leave. When the gut is healthy and the microbiome is whole and the gut is not inflamed Candida and the molds don't hang around. They're there, but in small numbers and they leave. When the gut becomes inflamed, when the microbiome goes out of balance, it's literally like club med and you're giving them free drinks and, you know, they've got a pool to hang out in and they're like, wow, this is fabulous. We love it. So then they call their friends and all of a sudden you've got more fungus, which actually triggers more inflammation, which causes the bacteria to leave. So the beneficial bacteria, the symbiotic bacteria, and there are multiple studies that have shown this actually start dropping off. So the fungus actually perpetuate the dysbiosis. They perpetuate the gut inflammation and they essentially cause this snowball effect to continue. And the more inflammation there is, the fewer the beneficial bacteria there are, the more fungus that's there, you got other bad actors that show up, clostridium, et cetera, and you just get this vicious cycle that has no end. When you start using the antifungals, you start knocking down these bad actors. And all of a sudden, you know, instead of a thousand thugs hanging out at club med, now there's like 500 of them, slowly it's like 100. And then when you look at some of the more potent antifungals, the azals in particular, Foucanazole, which is Diflucan, Etrocanazole, et cetera, it turns out that these azals have some really, really, really cool anti-inflammatory effects. They've looked at them in inflammatory bowel disease, they've looked at them in how they modulate the systemic immune response. And essentially, what I have come to learn is that these antifungals not only get rid of the fungus and kind of get rid of some of the bad actors that are causing the inflammation, they start restoring the immune system within the gut and within the body, that then allows the gut to start really healing at a very quick rate, which is part of why I believe, you know, the people that take it appropriately at the right time, not just throw it into the mix. But when you take it at the right time, these borderline miraculous results are possible because essentially you're doing multiple things at the same time, which is I think part of what makes them so cool. Stay with us. We'll be right back. The Gordon Medical Forum is now online. Join us for events, workshops and webinars with medicines most innovative minds, giving you exclusive access to groundbreaking conversations, insights and solutions from leading pioneers in chronic illness treatment. Learn more at Gordonmedicalforum.com. Yeah, I think the antifungals for the upper gut are something we have to pay a lot more attention to. There are lots of people who feel that they're really underneath a lot of SIBO is because there's been the hydrogen is being fed by the fungus. And also, you know, in those of us in the line world, I mean, for decades, we've used sometimes, at least in Germany, used to be a big thing, a month of vitrokinazole before they start or die flu can in the old days, before they started antibiotics and often along with them. And again, Bart Nellin is sensitive to some of the azoles. So you're treating a lot. You know, we always think we're being specific, but drugs are nowhere specific as we'd like to think. So you did this one. So you knocked down the inflammation with the vitrokinazole, okay, or other antifungals. And so now, how do you your next steps? So, you know, the next step really depends on the patient. But one of the things I want to highlight is first, how important it is for someone to be ready to take it. And part of what I see with a lot of my colleagues is, I mean, they did everything right. They identified the mold in the patient. They said, okay, you've got fungal markers. Let me put you on an antifungal. But they missed some key pieces such as they're still living in mold, like we're living in huge amounts of mold. And when you have that exposure, like, yeah, you can use this antifungal, which has anti-inflammatory properties. And sometimes people will get better only to relapse as soon as they come off the medication. And then I've also seen some kids get way worse, where all of a sudden these kids are flaring. And I've heard some adults just completely like fall apart when they get put on these medications, because you have a gastrointestinal track that is highly sensitive, highly unstable. And here you come along just knocking off large amounts of the fungal population, which in of itself can cause either a detox effect or trigger abnormal immune responses that shouldn't be happening because that person wasn't ready. So part of what I want to highlight is it shouldn't just be like, oh, well, I lived in mold and I feel like hell, so I'm going to take some itchoconazole and I'm going to find someone to prescribe it for me and I'm going to get better. You have to be meticulous about getting these things dialed in, get the gut in a relatively happy place, you know, get the diet dialed into some extent, make sure there aren't horrible amounts of mold in your environment. And once you do that and things calm down, then the itchoconazole or whatever anti-phongose could become a really wonderful tool to kind of move things along. Yeah, I think great respect for your sensitivities because there are people who will blow up on a tiny little bit of nice that and other people who can take a million units, two million units and just feel better. So do not jump off the cliff without at least thinking about your previous abilities to jump off cliffs. Now, yeah, so that's setting those are getting people ready. I mean, do you usually start with the antifungals or do you ever use any of the other anti-inflammatory approaches to, you know, to begin with? There's pretty much anti-fungal and then add in the other anti-inflammatory. So gut stabilization things. Really great question. I do start with some, you know, basically supplement anti-inflammatory. So I use some things to stabilize the mass cells. I love the DAO enzymes to reduce histamine because if you look at how histamine triggers more intestinal permeability, histamine triggers, more inflammation in the gut. And this is beyond, you know, mass cell kind of systemic findings. The DAO enzymes I find to be super helpful tools to just start reducing how much inflammation is in the gut. One of my supplements that I've come to like no financial affiliation is America. So it has PEA, which I think is really wonderful for also calming down some of the mass cell reactivity in the gut. Sometimes I'll use oral immunoglobulins, which are generally well tolerated, and the oral immunoglobulin start binding the bacterial endotoxins. They start reducing gut inflammation. They start improving leaky gut. And then, you know, that's along with some zinc and vitamin D. That's kind of like my core foundational go-to. Sometimes depending on the individual fish oils could be helpful, but sometimes fish oils can trigger people. So over time, I've actually started doing less and less, because as I started really paying attention to my patients, I found like 40-50% of kids would tolerate fish oils, but another half did it. Right? And with all of these things, as I started really becoming aware of how many things were a problem. And as another example, you know, sometimes I'll get patients that are on like, let's say 8 or 10 different supplements, and then you go through those supplements, you know, all well-intending supplements, but some of those supplements, the herbs themselves could potentially be an immune trigger. The citric acid, which is one of the primary, you know, inactive ingredients that they use as a filler, is a huge trigger for those who are sensitive. So as time has gone by, I have started doing less and achieving more, because I find the fewer things you use with a lot of intentionality, sometimes can go a lot further than just throwing the kitchen sink and saying, well, I'm going to use so far a thing, because that helps with liver detox, and then do glutathione, because it helps with this. You know, and it's not to say those things aren't helpful at all, but we have to kind of one, respect the patient's body, and really be attuned to like, what is this body needing right now? And a lot of times what that body needs right now is just the reset and the gut to allow that gut to heal. And once that happens, then, you know, so far a thing and true meric and glutathione and all of these things could be fabulous. But hopefully you might not need, because I still find the most frustrating thing is that when people come in with 20, 30, 40, even more supplements, and you know, they're all good. It's like, they're not bad, they're good, and they're not toxic, they're well-made, and they don't have any, you know, fungal things. But still, it's too much, and it's really hard to prune it, because, you know, it's all a good idea. So I sometimes have to stop all of it, because when I try to, I go through the list, and at the end of the list, you know, I've taken out of like, you know, eight out of 40, and wait a minute, just stop everything, because we shouldn't, you know, we need them, but we shouldn't need them every day for all of your lives. Anyway, a little aside, sorry about that. No, it's really important, and I'll, you know, admit, like, I was there. If you had caught me seven years ago, when I really started getting into this, I was the guy that was putting, you know, some of these kids on like 14 different supplements, and it's like, well, I'm going to support the liver and support the gut, and, you know, do this probiotic, and that probiotic, and whatever, and I hope everyone listening will walk away with less is always more. You know, sometimes you need a bunch for short term, but if you're six months out, you're still taking 40 things, it's usually we're missing something we should be doing. No, no, no, it's a lot of stuff to take. Anyway, so here we are. So we, and as far as so, you know, are there particular peptides that I have mine, but I want to hear what are your particular peptides for lowering the inflammation in the gut? Yeah, so peptides are things like my, if I had to choose two things on a deserted island to take with me, it'll be probably a traconisol and peptides. Those two have hands down been absolutely the most helpful tools that I have been able to put in my bag of tricks. And, you know, I was trained as an herbalist. I spent five years training as an herbalist, and it's ironic that now, you know, of all of the things that I do, most of it is actually pharmaceuticals, because it just works better. So with the peptides, lorazetide, and then I'm still trying to see which works better, KPV or BPC157. So I'm kind of doing, if you want to say side-by-side comparisons in the children that I serve to see who gets better faster, but, you know, what you touched on in terms of some people fell apart with just even tiny amounts of niestatin. Part of the protocol that I've started doing is I pretty much start all of the kids on niestatin, and that's my way of dipping my toe in the water. And it actually gives so much information, right? Because if someone falls apart with niestatin, that's kind of like big yellow red flag, like do not proceed to the other anti-fungals, because bad things will happen, right? But with those children, when I started putting them on the peptides, and most of them were on lorazetide and KPV, like my goodness, like three weeks later, gut immune system stable, gut integrity better, niestatin no longer a big deal, and then we were charging ahead into the other anti-fungals, and they were doing fantastic. How about yourself? What do you like? Yeah, well, that's kind of my favorite. I find that I used to start with BPC 157, but I don't anymore, because too many people couldn't tolerate it who were really inflamed, you know? I didn't get the results I wanted. I find that, you know, again, if you have real ulceration, you know, real physical, like major level messes, the BPC 157 is wonderful. But when you're trying to just lower the inflammation in the gut, I like the KPV, and then sometimes the TV for frag with the lorazetide, because almost everybody who we see has a level of wheat, gluten, some kind of sensitivity to the wheat, you know, I mean, it's there, or some relative there are. And so I think again, the lorazetide for a few months is just a gift, a gift to let the gut take a breath, learn how to heal, learn how to get a little better, and yeah, and then the immunoglobulins and, you know, and then it tends to be all kinds of little things. I sometimes still throw in if it's an old, oldy but goody that I'm forgetting the name of, it's a fish, a whitefish protein that I used to use. I still, I still throw that in at times, because it helps heal the small intestine, you know, or gluten mean if they can deal with it. But I think the most important thing that I find is just people learning what their bodies can tolerate, you know, because if they still insist that they're going to like eat the things that they know, I mean, I'm not, I don't give people lists, don't do this, we just listen and figure out what your body likes. If you keep eating what it doesn't like and it gets inflamed with it, this is going to be a long-term relationship that's not going to serve you, you know. So I just love, I think the way you laid it out, it's just, you know, remove the trigger as best you can and try to get some healing going. And how much this is like when I think the lime story is, you know, we started off, you know, because with mold, we started off, we had to kill it all. And then we had to bind it all. And then I must admit, I still like some of the binders because I think there is a lot of toxins that we're getting out, especially in adults that they're useful for, you know, or pectosol to lower inflammation. But adults, it's easier because they can take more stuff. If you're really limited in what you can give people, yeah, I would agree for a lot of people, they can move it out them. But just quick overview of this because you, when we start talking, it just got so clear to me, is that we're always going back and forth between removing triggers, removing inciting events and supporting the system so it can heal. Okay. And we get lost all the time in thinking that we have to do one or the other. And it's almost always both, it just depends on the timing. You got to keep them out of the mold or you're not going to get them better. But if all you do is avoid the mold and your guts and mess, you're going to be constantly having ongoing inflammation just from normal daily intake of food. He got a quiet, you got to heal the gut. And if the gut's colonized, which it usually is, you got to get rid of the colonization. I just want to emphasize to people. I think the most important thing that we heard today is not that there's no such things as micro toxins, but that micro toxins are triggers for events. And they might not be as long lasting. I think that idea of the long lasting, recirculating micro toxins started with some of the, again, with the fisteria, you know, with these red green algae toxins, which I believe, you know, some of them are more fat soluble. And I think that's the thing is that if some of the more fat soluble things might be hanging around in the fat for a longer period of time. And so maybe a little intermittent binder is good as it goes, but so much of what, what I'm understanding from what you're trying to tell this measurement is that it's ongoing just little bits of exposure that are triggering off your gut, which is creating the persistent incitokine storm or LPLipopolysaccharide and driven inflammation. Is that too simple? No, no, I think that that really nails it. And you know, one of the things that came up for me as you're sharing all of this is, you know, by taking this approach, one, how more efficiently can we help people? And can we actually help people heal even when they're living in mold? And not horrendous amounts of mold, but like part of what I'm really striving for is creating a model that actually can allow at least some people to heal. And I have one little child right now where, you know, a lot of neuroinflammation, a lot of different, you know, signs of toxicity and with the peptides and some antifungals and a handful of supplements, like by some miracle of God and they have mold like everywhere. By some miracle of God, this child is starting to heal. And I think it takes us to, you know, if we can build up the resiliency of the body, and I think this is what's so cool and fun about this conversation. Like, if we give the body what it needs and really support it at its core key area of deficit, right? Kind of build it up at the core foundational level that it needs to then do what it naturally should be able to do on its own. How many people can we help? And I think part of what's so cool about this conversation and the peptides and the antifungals and everything is really what we're doing is going at the core core core level of where this toxicity starts. And by really shifting that, hopefully we can really help a lot of people. And that's why, you know, I'm so excited to be here and to be sharing this because at the end of the day, my wish is as many people and as many kids as possible can benefit and heal through this information. Yeah. And I just want it when you said something that just triggered, I always hate when new ideas come up and I go like, that's not very new, but it seemed new in them, but it's just that is that, you know, what's the difference between the person who is living in the moly environment and is not having many symptoms? Probably a fairly healthy gut. Da. So, you know, instead of throwing up our hands and going, oh, until you move out, we can't do anything. Like you say, maybe we can get the gut to be a little more robust even in the midst of the war. I mean, you don't stop treating people in the hospital just because, you know, bad things are happening outside. That's an excellent point because that's always, and it helps understand why one person in the house or half the household is perfect and only one person is really sick. How much toxicity has been there already? And for our audience, toxicity is something that we're going to be spending more and more time on because we're learning more and more about how we can deal with it, especially as we get older. So, that's a little teaser for the future. But for right now, I want to thank Pechman so much for joining us and teaching and sharing his information and making me think, which is really a lot of the reason I do this because, you know, I want other people to get well and I want to learn. I just really get a kick out of hearing things and from the people who are thinking about them. So, thank you so much. Appreciate your time. Pleasure to be here and thank you for creating this space, you know, for me to share and for people to learn. That's what it's all about. We're here to help as many people as we can. And that's a wrap for today's episode. We hope you enjoyed the conversation as much as we did. We love hearing from our listeners and one of the best ways to show your support is by leaving us a review on your favorite podcast platform.