The Great Plains Laboratory has been educating practitioners for over 15 years on how to help patients heal through cutting-edge testing, research and protocols. In our recent 3-Day Master Practitioner Workshop, speakers shared detailed information on how the MycoTOX Profile, IgG Food MAP and Glyphosate Test can work for you. As well as gave additional information about markers in the OAT and GPL-TOX.
The following Q+A is a response to remaining questions speakers were unable to answer during their presentations.
The material contained within this article is not intended to replace the services and/or medical advice of a licensed healthcare practitioner, nor is it meant to encourage diagnosis and treatment of disease. It is for educational purposes only. Any application of suggestions set forth in the following portions of this article is at the reader's discretion and sole risk. Implementation or experimentation with any supplements, herbs, dietary changes, medications, and/or lifestyle changes, etc., is done so at your sole risk and responsibility.
Andrew Rostenberg,
DC, DIBAK
Bacterial Phenol Overload - A Hidden Cause of Gut-Brain Dysfunction
Andrew Rostenberg, D.C., DIBAK, is a chiropractor, kinesiologist, functional medicine expert, methylation researcher, author, and director of Red Mountain Natural Medicine in Boise, ID.
Q: So if patient with likely phenol overload from SIBO, but also has mycotoxin and oxalic acid issue, what to treat first - the gut?
A: The gut is Phase 0 detoxification – literally detoxification starts in the gut before it even begins in the body. If we are trying to cleanse the metabolic tissues of a toxic patient, but the gut is completely out of order and dysfunctional, then we will not see the best results. Always treat SIBO and other chronic, hidden gut infections first as that opens up the pathways for improved detoxification as the treatment process goes on. You might treat SIBO for 3- or 4-months max, then shift to helping with mycotoxins, mold, heavy metals, xenoestrogens, etc…just depends on what your patient needs.
Q: What if a patient with this high dopamine presentation does WORSE on taurine and TUDCA bile salts?
A: Some people just do not tolerate taurine well. It is a very small minority of people, but they do exist. Studies have shown a relationship to people with psoriasis and an intolerance to taurine. So even though certain supplements are very neutral and well tolerated, you will always find one or two people who are just sensitive in ways that are different from everyone else.
Q: What if someone is missing their Ileocecal valve, (cancer cut out), PLUS no gall bladder? Plus, daily PCN due to no spleen and immune deficiency? What is this person at risk for and how do they fix SIBO?
A: In our experience herbs and natural anti-microbials are well tolerated even by complex patients such as this. Someone without their ICV could perform bowel massages to help regulate peristalsis in the correct direction. They will likely need long-term herbal support to kill excess bacteria and yeast that inevitably get into the small intestine. They will need support for their upper GI tract like betaine HCl, pancreatic enzymes, and bile support (choline, methionine, taurine, ox bile, etc.). They can only fix SIBO by helping to correct the environment in the small intestine, and that will require consistent attention.
Q: So then what can that patient do? Also they have PPI due to GESR and ever increasing brain fog (used to think just due to chemo but suddenly has worsened significantly in the last year, since the pandemic).
A: PPI therapy is a guarantee of nutritional deficiency. That is what we see in practice as the number one problem in our patients – poor nutrient status be it Vit. C, or Vit. D, or any other of the 50 nutrients we need. The goal is to get patients off these PPI medications using any and all available natural medicine tools. Anything that improves the stomach function of our patients will improve their health, and any drug that interferes with normal stomach physiology is a big problem for the long-term health of our patients.
Q: Is this why certain service dogs can smell BS, blood sugar drops? Cancer etc.? phenols vocs, mind blowing…
A: Most likely yes.
Q: What causes flushing when taking high quality B complexes-- SIBO?
A: Any strange or paradoxical reaction to supplements should be investigated as a hidden gut problem until proven otherwise.
Q: So mycotoxins increase aldehydes and also clog up pathway towards COMT and glyphosate can inhibit aromatic aminos, so could things "balance" out, but still be toxic?
A: It’s possible that there are many mechanisms at play and that people can be “balanced out” but still heavily toxic. Best idea is to test and treat these hidden problems and get the balanced without the toxic side effects.
Q: How does mold affect dopamine?
A: Mold inhibits the ability of the body to breakdown catecholamines, so the higher the mold the more slowly dopamine and other catecholamines will be processed which can lead to dangerously high levels of half-way-broken-down dopamine. Mold produces toxic VOC chemicals (essentially indoor pollution) that must be metabolized through Phase 2 pathways in the liver and kidney. If mold levels are high, there is less bandwidth available for dopamine to get processed correctly. We tend to see people with mold exposure as individuals who cannot adequately metabolize their catecholamines due to the interference from the mold poisons the liver is trying to break down.
Q: Could you provide references for the nutrients to decrease/increase Dopamine?
A: References can be found by searching the PubMed library…sorry nothing convenient to share or hand out on this one.
Q: Patient with intermittent PVCs for several years after mold exposure intermittent anxiety completely resolved with B6 50mg daily. What’s the mechanism?
A: Could be multiple things, but B6 with lower SIBO and it is a cofactor for ALT enzyme in the Liver so it will upregulate detox reliably as well.
Q: Same protocols for SIFO as SIBO…. ? What do you think SIFO is?
A: SIBO protocol is more strict than a protocol required to treat SIFO, so if you treat SIBO you will also help reduce the fungal burden in parallel with the bacterial overgrowth.
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James Neuenschwander, MD
Identifying and Treating Complex Patients with Mold Toxin Induced Illness
A graduate of the University of Michigan with both a Bachelor of Science degree in Molecular and Cellular Biology as well as a MD degree. He is dually board certified in both Emergency and Integrative Medicine and has been the owner of the Bio Energy Medical Center since its opening in 1988.
Q: Prefer IV Voriconazole or oral, and what doses?
A: Oral: 200mg twice daily.
Q: Are there special considerations for treating a patient with diverticulitis (on a third round of antibiotics) with Hx of chronic fatigue, ebv, and mold. I’m not her physician, she’s my sister.
A: I can’t give treatment recommendations for someone that is not my patient.
Q: What do you think about testing as a preventative - even if you don’t have symptoms - it may be brewing and present as a problem later on?
A: Testing for mold toxins is not that helpful if you are not symptomatic—most people don’t have problems.
Q: Have you found any treatment particularly useful to eradicate MARCONS, possible explanations for non-resolution of MARCONS and how do you treat low MSH?
A: Usually from persistent exposure. Need to regular Neti pot or saline rinses in addition to the antiseptic nasal sprays. Can use PT141 to try to increase MSH, but MARCONS will continue to break it down.
Q: On one panel, all mycotoxins were 0 except for OCHRATOXIN, which was high. Could this be from her excess coffee drinking alone?
A: It depends on the degree of elevation. Food sources will typically elevate levels slightly.
Q: I've heard other practitioners say that S.boulardi produces oxalates, so not good for those who already have mold/fungal issues and too much oxalates. Do you have any thoughts on this?
A: Not in my experience. The balance of the microbiome by S. boulardii usually reduces oxalates. There are some people that don’t tolerate any yeast.
Q: Do you check for adrenal fatigue and how do you treat it if present?
A: That is a two hour lecture.
Q: Do you consider EMFs in your patients?
A: Yes, but extremely difficult to treat.
Q: How do you give Itraconazole dose and interval ? With binders?
A: I use voriconazole.
Q: How do you fix VAGAL dysfunction in your practice? fix underlying mold, but how do you stimulate MMC after the eradication of toxicity?
A: I typically use DNRS. LINK
Q: What is the electron transport chain test called?
A: MitoSwab
Q: Any specific lab for AVH alpha MSH?
A: Not really—you need to know your ranges.
Q: Any recs for alternative to tenting for termites?
A: Not an exterminator.
Q: Vocabulary check POP (persistent organic pollutants)?
A: Yes.
Q: Can you say more about the origins and mechanisms involved in generating high osmolality / low sodium?
A: Don’t know the specific mechanism, but has to do with both renal and brain signaling dysfunction.
Q: What is the conference you were referring to in August in Arizona and are you presenting?
A: August 2021 is Integrative Medicine for Mental Health in Atlanta - use promo code: 50MPW21 for $50 off! The Arizona Conference is MAPS and will be 9/30-10/2 in Scottsdale.
Q: High ANA but no other elevated typical Autoimmune panel-would mycotoxins and/or environmental toxins be a potential cause?
A: Yes.
Q: Since binders are absorbing toxins why would too much of a binder cause a Herxheimer Reaction
A: Too quick of a detox will create symptoms.
Q: Can mycotoxins be responsible for persistent fever?
A: Any immune activation can cause a persistent fever.
Q: In the chronically ill patient with known history of Lyme, co-infections, mold toxicity, long term antibiotics, does the OAT help you differentiate what issues are still active and priorities? Any pearls?
A: It won’t differentiate between Lyme and co-infections, but will tell you about mold and toxicity.
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Emily Givler, DSC
Oxalates & Mold: A Hidden Source of Inflammation
Emily Givler, DSC is a Functional/Genetic Nutrition Consultant and Dietary Supplements Counselor with the NutriGenetic Research Institute and Tree of Life. She specializes in food sensitivities, utilizing genetically influenced dietary protocols designed to maximize health outcomes while maintaining a healthy relationship with food.
Q: Anything to consider during treatment for clients with NO gallbladder?
A: These individuals are vulnerable to hyperoxaluria without adequate digestion support with something like TUDCA or ox bile. They may benefit from including calcium alongside higher oxalate foods to aid in the excretion of oxalic acid in stool.
Q: Could you recommend a lab for urine sulfate testing?
A: I use over the counter Quantofix sulfite and sulfate test strips. These are a urine dipstick and are good for home testing.
Q: I've heard Dr. Grace Liu say that O.forminges gets too much attention and that other bifido bacteria and lacto bacteria are actually powerful oxalate degraders. What are you thoughts on this?
A: There are other organisms that can degrade oxalate under various conditions, but the research currently shows that O formigenes plays a primary role in degrading oxalic acid under any physiological conditions. Ideally, we should have a robust microbiome that has a large diversity of symbiotic organisms. I agree that we should not overstate the importance of any one organism. I do find the association between disruption of O formigenes by certain classes of antibiotics helpful to know when taking a history.
Q: How can you increase O. formigenes if not in a probiotic?
A: I try spore-based probiotics like MegaSpore. The goal would be to create diversity even if we cannot target that specific species.
Q: Please be specific with the prebiotics that you use that help the body regrow O.Formigenes
A: I have had good success with MegaSporebiotic, but there aren’t any studies that I can point to on it, only anecdotal evidence.
Q: Lichen Sclerosis not on list, do you suspect any link here?
A: I see associations in my own clients, but it isn’t there in the literature yet. LINK
Q: Where do you get the sulfate test strips?
A: Amazon.
Q: So, what comes first treating the mold or the oxalates? Or do you treat both at same time?
A: This must be an individual decision, but you can start reducing oxalate at any point (as long as a slow reduction approach is taken). You may not see full resolution of the oxalate issue until the mold is addressed if that is the primary driver, but it does not need to be gone before you start the oxalate reduction process.
Q: Do you ever use a Ca Mg citrate combo or the like?
A: Yes, that can be a great choice with meals.
Q: Which product or manufacturer for urinary sulfate testing and what was the range?
A: Quantofix Sulfite optimal 0-10; Sulfate range 400 - 800 optimal; <200 is insufficient, >1200 consider sulfate dumping.
Q: If you see high glycolic or glyceric but oxalic in normal range. We think Genetic, but how do you get them to start excreting the oxalate? Sulfate supplementation?
A: Yes, sulfate is likely going to be effective to start mobilizing trapped oxalate, but I would always start slowly in these cases. Epsom salts are generally my starting point. If sulfite is elevated, molybdenum can increase sulfate. Adding B6 can also help reduce oxalic acid production in cases where there is a genetic cause.
Q: Can you use P5P instead of B6 therapy when glyceric or glycolic markers elevated?
A: Yes, that would be my own preference.
Q: Could a patient's worsening of Symptoms if supplemented with B6 or zinc or B1 be because the oxalates where dumped more?
A: Potentially.