Welcome to The SIBO Doctor Podcast with Dr Nirala Jacobi, a US trained naturopathic physician and medical director of The SIBO Doctor and online education resource for practitioners. This podcast is intended for SIBO- treating practitioners and aims to help educate how we may best serve our SIBO patients. Medical experts join us to discuss functional digestive disorders, clinical practice and research as it relates to SIBO and associated conditions.   You can also join in the conversation on the SIBO doctor practitioner forum Facebook group.

If you're a patient, please note this information is not intended to diagnose or treat medical conditions. Please ask your doctor before initiating any new treatments.

We welcome you to head over to the SIBO Lifestyle Facebook group where we post frequent tips and videos to help you on the road to gut health recovery.

 

Nirala Jacobi:                    Welcome to another episode of The SIBO Doctor Podcast and today I have Dr. Jill Crista with me who is a naturopathic doctor and bestselling author of the book, Break The Mold. She's a mold expert and nationally recognized health educator on neuro inflammatory conditions such as mold and mycotoxin, [inaudible 00:01:36]. Her passion is improving health through education and bridging gaps between medical research and clinical practice. She writes books and offers online courses, and we'll be talking about that today because I stumbled across Dr. Crista just on Instagram. Yeah, I saw these little videos that kept popping up of her giving mold advice of how to reduce mold exposure. And for those listening to my podcast, you'll know that I've already had an episode on mold, but I just find this topic so very important to SIBO and SIFO suffers that I thought that I'd actually have a naturopathic doctor join this, who's has a wealth of knowledge is a survivor herself. A very warm welcome, Jill.

Jill Crista:                            Thank you so much. It's a real pleasure.

Nirala Jacobi:                    Great. Tell us a little bit about how you got into this field.

Jill Crista:                            For my mold experience, it started with Lyme patients. Lyme disease patients tend to be complex patients, especially if they are now coming to a naturopathic doctor saying, "Okay, the drugs didn't work for me, or the antibiotics aren't working, or maybe I don't know what's wrong with me." And they get a diagnosis of Lyme through me. And most of the time as naturopathic doctors, our toolbox is so huge, we have so many tools that we can use. I had pretty good luck treating Lyme patients, but I had this little group of people that were just stuck. They weren't in the way that I noticed the other 85% of my Lyme patients were responding and in one of the patient's homes they found black mold. And I had some experience with mold knowing that mold was a bad deal, basically through naturopathic training, we had environmental medicine training, some training with Dr. Walter Crinnion.

Jill Crista:                            And I had an idea that that was a serious thing, but I didn't really completely understand the full scope and the range that mold was creating harm in that person's body. As I dug into the research and I started to really learn about mycotoxins and their effect on animals, I thought, oh my goodness, this is what's been going on with this guy. Lyme was just something that tagged along, but it's actually mold illness. And I wonder if this is what's going on with these other people that aren't progressing along. And sure enough, most of them had a mold exposure either current or in their past. And by treating it they got better. And that was the big eye opener for me, it was, oh wow, I was missing mold in so many of my patients. And I didn't realize that's what I was missing because it's so difficult to identify.

Jill Crista:                            And then I wrote the book because I had a personal experience where I moved into a relatively new house and it was a well-made house, well-built, nice materials, this three-story, just a beautiful ... You'd look at it and say, oh, it's such a nice house, they kept it clean, whatever. But as we closed up the house for winter, where I live, it's a four seasons. And as we closed it up the air, more and more became the indoor air versus the outdoor air, and we got sicker and sicker and sicker. And it took a couple months for the flood to reveal itself.

Jill Crista:                            Once it did, oh, I knew exactly what to do because my kids and I were more all three sick. Our dog was even sick and I thought, oh my gosh, I have to get this out. I was so fortunate to have the training that I had and the experience that I had that I knew exactly what the next steps were to be and how to individualize it for my kids versus myself versus our dog. I don't cover pet medicine in the book, and that's why I decided to write the book because I thought, wow, I have these tools and everybody should know this because using naturopathic medicine, those tools are accessible to everybody. It's not drug medicine. You don't have to prescribe something for yourself. You can get going on it right away.

Nirala Jacobi:                    That's fantastic. Yeah, that's right up our alley because we talk a lot about naturopathic treatments, hydrotherapy and self-help treatments on this podcast, but also the SIBO's success plan that I've launched for patients. But really looking at the connection between SIBO and mold, this was really one of those things that also, like you mentioned, was like a light bulb for me. For you it was with Lyme patients and for me it's with SIBO patients that those people that are continuing to have digestive symptoms, even when their lab, and then they may have had SIBO, then they cleared it. I'm a big proponent of retesting after treatment so that you know that that patient actually is clear because it's those chronic patients will undergo continued SIBO treatment from practitioners that think while their symptoms aren't improving, it has to still be SIBO.

Jill Crista:                            [inaudible 00:06:31].

Nirala Jacobi:                    That's the reason why I say, okay, retest. But those other patients that retest, it's negative, SIBO's gone but their symptoms have not abated at all. That's when I started to dig a lot deeper and mold sort of treatment as is outlined by really the pioneer in this, Dr. Ritchie Shoemaker, was always, it's just a bit like, oh my God, this is just nothing, no disrespect, but I felt like there has to be a more natural way of doing this. I'm just so grateful to come across your program and we'll talk about your program a little later on. Can you talk a bit about just some of the digestive symptoms that people with mold illness ... Well first of all, we know that there are a lot of digestive symptoms, but before we go there, actually what I wanted to ask you is because a lot of people assume, well, I live in the desert or I live in Australia. Basically we've had nothing but droughts here, unfortunately. Am I still sort of at risk that my house is mold toxic? Can you talk a little bit about that?

Jill Crista:                            Sure. Homes and work spaces, churches, volunteer spaces, the gym, any built space. We're humans, we'd like a certain temperature, we'd like a certain humidity. And so we've built our built structures to foster that experience and that environment. It really has nothing to do with where you live because it has to do with where you live in. We tend to keep things at a humidity that is a little higher for our respiratory passages to feel comfortable. And we tend to live in spaces now in the more efficient that we've gotten with building structures, we now trap that humidity and we like things always at about 70 degrees. And then there are certain toxic species that love that too. It really has very little to do with where you are in the world, but the structure that you're living in.

Nirala Jacobi:                    Your house doesn't necessarily have to be flooded. For example, you could even just-

Jill Crista:                            Exactly.

Nirala Jacobi:                    Have a minor mold toxicity from, one of your little video clips I learned that about the ice maker in your refrigerator.

Jill Crista:                            Yes. Isn't that that one? That one I couldn't believe, that one creeped me out. Yeah. We're using antifungals in paint, which is creating these super species of the indoor molds. We're using cheaper and cheaper materials. We basically masquerade and predigest our materials, which is exactly junk food for mold. And then you fed it and then you have [crosstalk 00:09:21].

Nirala Jacobi:                    Like a particle board.

Jill Crista:                            Yeah, particleboard and furnishing that's made with particle board.

Nirala Jacobi:                    Dry wall.

Jill Crista:                            Dry wall. All of these things that are basically the best way to feed it. And then you add in our propensity to over decorate, overstuff a house. Now you've got clutter that collects dust, which is again its favorite food and then you add a little water, now you've fed and watered mold. And when I say water, I'm not talking water, water, I'm talking moisture. All it takes is a humidity over 50% and mold can grow if it's in an environment that fosters it. And we don't usually feel good at 50% humans feel a little better at 60% for most of us, for our respiratory passages. You can see where somebody who has a little sinusitis because they live in a moldy environment are now cranking up the humidifier in their bedroom because they have sinusitis and then that turns into this vicious cycle of them feeding and watering mold.

Nirala Jacobi:                    Yeah. Like you mentioned not just building materials but also possibly CPAP machines and water toys for the children and the bathtub and there are all these different hidden compartments where mold can hide and especially with, I didn't even think of that, like a CPAP, you put that on every night. This is for people with sleep apnea. And do you find that people have specific symptoms when they are exposed to that type of mold versus a real water damaged building? Is there any difference in the micro toxic exposure?

Jill Crista:                            That's a good question. I think it has to do with the species of mold. Each species sort of has its thing that it does in the body. I call it the affinity for a certain body, body space or body type or tissue. And there's also the load, the total load concept, if there are multiple things that are usually in a water damaged, like a flood or a bathroom leak or a roof leak, that's going to host more species of mold than just a single mold. Whereas something like a CPAP machine, you're getting both mold and bacteria. It's actually the bacteria that are more so found in a CPAP machine than mold. But if there's bacteria there, then the mold jumps in and when it's that singular thing. When it's a CPAP machine, I typically see a combination of digestive problems and dementia problems, foggy mind, cognitive issues, insomnia.

Jill Crista:                            Whereas a water damage building, you would typically see fatigue as a big component of that because you've got that mixed mycotoxin, endotoxin exposure. And mycotoxins are the, they're the toxins that mold will emit in a competitive environment, they're not made as part of the normal metabolism of mold growing. They make plenty of other chemicals while they're metabolizing under normal circumstances like theosis, aldehydes, alcohols. We're familiar with one of them called alcohol, he drained, that's a mold toxin. But when it gets in a water damage environment, now it's like choice lakefront property and everybody wants to move in. And then they try to gas bomb each other out. And that is the stuff we get hit in the crossfires of their gassy bombing everybody else out. A water damage environment has more aggression, I guess, than a CPAP machine, this sort of just percolating along.

Jill Crista:                            It's a little bit different type of mold that goes there, but it tends to be things like Chaetomium, which are more of the scary species because it goes through the blood brain barrier and you're breathing it right through your sinuses. Now you've got a double whammy exposure and really near the brain. And the key with understanding the mycotoxin thing is that it sets up a competitive environment in the air that you're breathing in your couch that you're sitting on with bare legs and bare arms. We can intake these mycotoxins in our skin. You can intake the mycotoxins through digestion and breathing. And if that's happening, then those mycotoxins are triggering a competitive environment in your own flora, in your body. And there's the connection to the SIBO too.

Jill Crista:                            That competitive thing that gets turned on happens anywhere that we have a microbiome. We have sinuses, you'll see it in the lungs, you'll see it in the gut, you can see it in the bladder, vaginal tissue, all kinds of places, wherever there's a mucous membrane and you have microbes that are there to protect it, they now get a signal through what you're breathing, that they're under threat. And they, once that gets triggered, they start acting competitively with your own flora. And then you just have all out, I call it Mad Max. It's just like the movie Mad Max. They're all sort of trying to take each other out, but need each other at the same time. It's a tough spot to be in. That-

Nirala Jacobi:                    Just to clarify because that I found is such a key understanding to get across. I think that it's not just what you're inhaling, but let's say you start off with like a dysbiotic flora to start with in the sinuses, for example. And when I say dysbiotic, we always have also patients listening to these podcasts, I have to sometimes stop and clarify a little bit. Like you said, we have a microbiome that's really specific to different mucosal surfaces, but if that's already impaired because of whether that SIBO or SIFO, which is the fungal overgrowth, or you have other dysbiosis happening in these compartments, then that makes things even worse because these mycotoxins trigger these dysbiotic bacteria and fungi to secrete their own toxins, is what you're saying.

Jill Crista:                            Yes, exactly. If you did a test of everybody's sinuses, healthy controls compared to mold sick patients, everybody would have certain species of fungus in their sinuses. There's the big debate is that, well it couldn't be this thing called colonization or fungal overgrowth or even fungal infestation or infection because everybody has those things in their sinuses. And the real key and magic piece to keep in mind is that the people that have been exposed to a water damage building their species and their fungal normal flora are now acting like a water damage building and a pathogenic biofilm, which then triggers the bacteria to act that way and secrete endotoxin. And now you've got the whole flora and the more you breathe those in and you swallow those down, that sends messages to the gut flora. Oh, we're under attack everybody, arm up and start, start firing.

Jill Crista:                            The concept of colonization is a little fuzzy still. We don't have a very good science on it yet in humans. But the way that I think of it is that it's not so much the mold has moved into your body, although that can definitely happen. It's that your own flora is now acting pathogenically and that's where it starts. And then you become immune deficient and then you get denuding of the intestinal barrier. Then you get all these other and [inaudible 00:16:56] poisoning because it's a neurotoxin, these mycotoxins are neurotoxins. They impede the myenteric plexus then you can get gastro-paresis issues, you can get motility issues, then you can get fungus to move into the body because now you have a ripe Petri dish right there. You've got stasis and no immune function. I feel like that's a different level that's really airing on fungal infection, fungal overgrowth.

Jill Crista:                            And most of the time the people that are coming to see me, they are at that point. But even if they're in the early stages of starting to develop their own pathogenic, [inaudible 00:17:36] like my biome, they still need antifungals to reset the balance and to tell. The nice thing about plants is that it's also anti-microbial, it's antiviral. It sort of resets the balance of, it's like yelling at your kid who's misbehaving, behave.

Nirala Jacobi:                    Gosh, in one of the things in your course that you talk about is just this plethora of symptoms that can be linked back to mycotoxin exposure and spore exposure, mold exposure. It's pretty much anything, pretty much any symptom, especially the strange, rare and peculiar ones it seems can be linked to mold exposure. From what we understand with the toxicity of mycotoxins to what you mentioned was the myenteric plexus, which to the listener basically is part of the neurological wiring of the intestinal tract. It's easy to imagine how when that gets toxic that can also affect motility. And this is why in my four categories of underlying causes of SIBO, mold toxicity is definitely part of it. And this is the reason I have you on here, is because it is not talked about that often as a primary driver. Besides that, what are the typical digestive symptoms that you see or what are the top symptoms that you see in general and then specifically digestive?

Jill Crista:                            Sure. The top symptoms in general fatigue has got to be up there and it can show up in a very fit person as exercise intolerance. And it can show up in a sedentary person as the classic fatigue, but fatigue, that's not specific to any one condition. But I would say that it's pretty much across the board. Something when you see with everybody who's exposed to mold toxins. Also anxiousness, I don't want to use the word anxiety because then that conjures up panic disorder and that kind of thing in our mind. But the anxiousness that shows up with mold is just an inner unsettled, I'm not safe, something's wrong, I don't know what it is. And sometimes they'll actually go and seek something. They'll try to pin it like, oh it must be this or it must be work. And when an outside observer looks at the thing, they've pinned that anxiousness to, they say, wow, really? Because it doesn't match the level of anxiousness to the level of perceived peace in that person's life about whatever it is they've identified as the reason.

Jill Crista:                            And then gut issues. The gut issues are anywhere from, it can start with just gas and bloating. What we might see with like a typical candida overgrowth is somebody can't, if they crave, but they're disordered by sugars and alcohol and carbohydrates and that kind of a thing, it can look like both constipation and diarrhea. That's the hard part because it just makes your tendency to go off the rails more exaggerated. Each of us constitutionally will be more attendant to constipation or diarrhea. It just exaggerates whatever that tendency is. But typically I'll see an alternating constipation and diarrhea with some nausea and very severe cases where they're both inhaling and ingesting mold. We can actually see vomiting to the point of cyclical vomiting syndrome. That's going to be the most severe version of it. There's gradations to all of this. Constipation is quite common and it reminds me of your SIBO types like the SIBO-C where it's more the constipated side initially and then the body just can say, well I can't do this anymore.

Jill Crista:                            And then you can get the diarrhea. New onset food allergies is very common and it's important to understand why that is. Remember in the beginning I said mold spits out all these normal chemicals as part of its exhaust or mold farts basically as part of its metabolism. And those chemicals are, when we inhale them and ingest them and they're exposed on our skin, we take those toxins on and it fills our cup of ability to handle toxins and that can create then a chemical sensitivity and food allergies. Food allergies also because these mycotoxins are known to disrupt the gut barrier the tight junctions and anything that requires the barriers of the gut and the brain to stay [inaudible 00:00:22:20]. It's both mucosal lining that it disrupts, it disrupts bile, which I know we have lots of talk about with bile.

Jill Crista:                            These people become, they have new onset food allergies if they were able to tolerate a food their whole life and then they take a job and they've had water damage at this job and now they can't eat certain foods and I'll see a lot of times it can look like sulfur sensitivity. They can't handle onions, garlic, maybe they can't handle [inaudible 00:22:47] anymore. They're cutting and they're cutting, they're cutting out food because they're having reactions. To me that's a little trigger of like, why now? Because in my experience, the patients that have had a dairy allergy or an egg allergy, they've had something going on with their body all their lives. And that's been the tricky digestion. And once we find that food allergy things clear up in their gut and their sinuses, but if they've really had a pretty hardy digestive tract or have never had sinusitis and it's new or new grass allergy or new something, new onset for someone that was previously healthy, then that triggers my radar.

Nirala Jacobi:                    That's certainly within the spectrum of very common symptoms that we see, especially in people with chronic SIBO. You all this food sensitivity development is really pretty common. All right. Can you just briefly talk about how your approach is a bit different from Dr. Shoemaker's?

Jill Crista:                            Sure. I think because I'm trained as a naturopathic doctor, a key part of my and ours treatment program would involve lifestyle changes. And as we've been trained in environmental medicine, like Dr. Crinnion taught us the first three steps to any toxin exposure is avoidance, avoidance, avoidance. He puts it on the first three because it's so important. That avoidance piece, I think Dr. Shoemaker's all in with that. But then the second is the fundamentals. And that would be things that when you go to see a naturopathic doctor, we would probably do it every single one of our patients. We clean up their diet, work on circadian rhythm, work on exercise, work on sleep, these are things that we would have, hydration, we would already have sort of, it applies to so many conditions and improve so many conditions, that's our fundamental.

Jill Crista:                            And that is not something that I see as part of that protocol just because it's a different approach. And then in my approach, I also add a lot of respect for mycotoxins and the damage they can do in the body. There's a lot in the protocol to protect people from the damaging effects of mycotoxins and certain things have actually been shown to protect the body from the mycotoxins actually absorbing into this cell like DHA, green tea, some of those things. Really respecting mycotoxins and the damage they can do. That's a key part of the protocol. And then antifungals. The nice thing is that, and that's very different from a Shoemaker approach that's just coming from a naturopathic approach where we're trying to reset the balance in the body.

Jill Crista:                            And we don't have to wait for it to be a frank infection to justify using a medication or a pharmaceutical. When we have plants, we can get them on board because they're so effective, but so gentle to the body. That's why it's so easy for me to say, oh, give them an antifungal or I'm going to put my patient on this antifungal because we're not going to get some of the heart changes you would see from a triazole medication, we're not going to get some of those liver changes and kidney damage and that kind of thing. That would be the key parts that are different.

Nirala Jacobi:                    One of the things I'm really curious about, and I'm curious to see if you also find this, is that when people come in with this full bucket syndrome and they're already sort of preloaded and then they're exposed to the mold and they're having a hard time to detoxify. I have people that cannot handle at all these antifungals.

Jill Crista:                            Absolutely. Yeah. And I'm in the same place that, and that's why my program is a stepwise program that you don't put those antifungals in unless you have the body ready, you have the avoidance fall, you have fundamentals. And I use the visual of an orange peeling an orange because I think of the avoidance and fundamentals, they need to be so thoroughly done and really examined that it really is like peeling outer two layers of an orange, the orange layer and the white fluffy layer. You can't get to the meat of that orange unless you've done that full peeling. And I feel like that's the same with treating mold, that if we go in with an antifungal and I've done it, that's why I created this stepwise program as I actually helped a patient with Lyme disease, have seizures after treating her with Lyme and it wasn't getting better. We threw in some antifungals and she ended up having a seizure about since.

Nirala Jacobi:                    Wow.

Jill Crista:                            That's when I learned, okay, I did something wrong there. I need to be better about protecting the nervous system and the brain, be better about the antioxidant status and the nay among trees and that kind of thing before I just go willy-nilly thrown in anti-fungals.

Nirala Jacobi:                    Great. Wonderful.

Speaker 1:                          Thank you for listening to the SIBO Doctor Podcast. We hope you found the information in this episode useful in the treatment of your SIBO patients. Thanks to our sponsors, sibotest.com a breath testing service with easy online ordering and QuinTron, maker of outstanding breath testing equipment. Tune in again for another episode of the SIBO Doctor Podcast. Thanks again for listening!