12/7/21: “Mold, Mycotoxins, and More Part II”

Second in the series of webinars offered, unofficially, to the GPL forum by ISEAI Vice President Mark Su, MD, and special guest, former ISEAI Secretary Peg DiTulio, DPN, APRN.
Topics include: Our overarching intention will be to answer the common clinical dilemma, “Why doesn’t this patient’s history and lab results add up?”, or “How do I make sense of these labs?”.  We will work in a few cases within the presented content.
a) Clarifying Confusions:
     -Revisiting definitions: CIRS vs. mycotoxins vs. “mold”… and a new definition?
     -Potential Pitfalls: mycotoxin lab differences
     -Where is the “mold” coming from?
b) Contemporary Considerations (“More”)
     -What value does the GENIE test have in the landscape of patient evaluations?
     -Revisiting foods as a mold source
     -A new (pathogenic) kid on the block?
c) Big picture perspectives
     -Passe: Silo medicine
     -Multi-Dimensional Medicine and the QYERS Map
     -Critical thinking

2/18/21: “Mold, Mycotoxins, and More Part I”

A webinar offered, unofficially, to the GPL forum, in response to questions that arose within the email forum. This is intended as a presentation describing how Mark Su, MD has been discussing this complex topic with his patients or colleagues. He has no intent whatsoever to criticize or negatively portray any entity mentioned within this talk, in case there is any misinterpretation or misperception. Viewpoints are presented in the attempt of trying to analytically rationalize decision making in this world of translational medicine, where data is limited, yet adopting practices without sufficient explanation, rationale, and/or transparency of context and biases can be fraught with potential for espousing of misinformation that may set patients and the medical practitioner community back for months to years to come.

Slides PDF 2/18/21

3/1/21 Update/Addendum: As a result of evolving GENIE patient test results, Drs. Shoemaker and Ryan have recently presented that other bacterial sources within a water-damaged or sick building are more commonly a cause, and/or larger contributor, to patients’ CIRS symptoms/conditions, than previously known. These entities particularly include actinomycetes, as well as other endotoxin-producing gram negative bacteria. Pending the development of other effective and available diagnostic tools for humans (beyond GENIE, which is interpreted in context of/combo with NeuroQuant imaging, patient history, as well as environmental testing), the suspicion for these entities arises when CIRS patients fail to sufficiently improve, perhaps with persistently elevated CIRS biomarkers, despite taking the appropriate steps for treatment. These entities can be tested for with environmental diagnostic tools, incl. the dust swipe test, most commonly via Envirobiomics, whether at the outset of environmental testing, or subsequently after receiving an initial HERTSMI-2/ERMI result (Envirobiomics maintains the sample, so one can call them after receiving the ERMI/HERTSMI-2 result, and asking them to add on the actinomycetes +/- endotoxin testing, with the correlating add-on charge). Treatment is currently geared toward treating CIRS as before, along with the environment – but the environmental treatment of these bacterial entities is different than that with mold.

My personal opinion is that this further supports the need for some updated terminology. A term such as I proposed for CIRS due to mold/mycotoxin causes could effectively communicate a subcategory of CIRS (eg CIMS), whereas future/TBD terms could effectively communicate other subcategories of CIRS (correlating with actinomycetes, or other gram negative bacteria), given the differences in environmental treatment, and perhaps to be learned over time, in humans as well (?). I also believe it supports the benefit of defining a sick building – the more we learn about the health of a building, as an independent entity of humans, but meaningfully impacting on humans in the human-indoor environment relationship dynamic, the more we seem to be moving toward acknowledging our indoor environments as yet another “microbiome” influence on our bodies – specifically, our immune systems. Defining sick buildings provides us a space to characterize them better, independent of terms that refer to such buildings only in the context or relationship of the illness they cause in humans (eg, Sick Building Syndrome, or Building Related Illness, or even CIRS, etc – these are terms referring to human conditions, not environmental conditions independently of humans).

Clinically, for now, it is worth noting that “fresh off the press”, we are becoming further educated by Drs. Shoemaker’s and Ryan’s work that indeed, CIRS/mold illness/mycotoxin illness/?CIMS is an ever evolving arena.  In that context, this presentation from late February does indeed focus in on the mold/mycotoxin component of CIRS, whereas CIRS as an inherently broader term, by definition, is inclusive of other non-mold/mycotoxin causes of human chronic inflammation as a result of poor indoor environmental conditions.  There is obviously much more to explore and learn, in these regards.