Biotoxin Illness: What We Need to Know Moving Forward

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Biotoxin Illness: What We Need to Know Moving Forward

By Craig Koniver, MD | Wednesday, May 19, 2010 12:30 PM ET

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Fighting the Threats of Biotoxins such as Mold, Parasites, Heavy Metals,

Pesticides, etc.

Warning: Reading this may change your perspective on why you feel badly

sometimes or all the time. As you know, we are in constant interaction with our

environment and recently we have been discovering different ways that the

environment can contribute to our health. Most of us are aware that we get sick

from different infectious organisms — the common cold, stomach bugs, pneumonia,

etc. All of these are due to an infectious agent getting into our immune system

and temporarily wreaking havoc. For those of us that are healthy, this may mean

feeling sick for a few days to a few weeks. But for those of us who feel tired,

worn out, have brain fog, joint pain and weight gain, would you ever think that

the cause of this was something in the environment? The loudest messages I hear

are those telling people they did not eat right or exercise enough and that is

why they feel so poorly. And while nutrition and exercise certainly play a large

role in how we feel, the real answer as to why many people have these symptoms

may be due to our interactions with biotoxins from the environment.

Here is some background and detailed information about biotoxins — their affects

as well as what we can do about them. Some of this was adapted from Dr.

Shoemaker's protocol, a pioneer in the field of biotoxin illness.

Background: We are constantly under a barrage of threats from certain biotoxins,

including:

Infectious organisms such as lyme, mycoplasma and chlamydia — all stealth

bacterial organisms that hide within our cells.

Mold, yeast, parasites, pfiesteria, aspergillus and other archaic single cell

organisms.

Heavy metals such as mercury, lead, cadmium, arsenic.

Chlorinated pesticides.

Volatile solvents.

PCBs

Phtalates from plastics.

Others we don't know, can't identify, etc.

These biotoxins can cause harm to every facet of our biochemical framework from

our immune system to our nervous system to our mitochondria. While all of us are

at risk for developing symptoms related to exposure to these biotoxins, certain

individuals are at a greater risk of developing symptoms due to their genetic

predisposition. Once exposed, these individuals begin to exhibit symptoms of

profound fatigue, joint and muscle pain, memory loss, exercise intolerance,

weight gain, headaches, depressed mood — symptoms typically assigned to those

with chronic fatigue, fibromyalgia and depression. Many of these individuals

also have gastrointestinal (GI) dysfunction including diarrhea, bloating,

irregular bowel movements and abdominal pain.

The goal in trying to understand this biotoxin burden is to appreciate the

devastating effects that occur to our immune systems, nervous systems, hormonal

systems, mitochondrial systems and detoxification systems. It is impossible to

catalogue every single biotoxin product that affects us and therefore the goal

is not to get caught up in identification (although that does help), but rather

to examine the damage that has been done with the goal of undoing the damage and

restoring a healthy biochemical framework again.

Here is a summary of how these biotoxins cause their devastating affects to our

systems (per Dr. Shoemaker):

Stage 1: Biotoxin Effects:

It all starts when a person is exposed to a biotoxin. In most people, the

biotoxin is " tagged " and identified by the body's immune system and is broken

down and removed from the blood by the liver. However, some individuals do not

have the genetics (HLA-DR genes) to code for the antibodies and in these cases

the biotoxins are not tagged and remain in the body indefinitely, free to

circulate and wreak havoc. Once present in the body, the biotoxins begin to set

off a complex cascade of biochemical events. The biotoxin binds to surface

receptors (toll receptor) in fat cells. This in turn causes a continual

upregulation of cytokines.

Stage 2: Cytokine Effects:

The activated fat cells start to produce more leptin, which leads to weight gain

that is unresponsive to diet or exercise. Remember that the fat cells are also

pumping out cytokines, this overload starts to block or damage the leptin

receptors in the hypothalamus. Elevated cytokines can produce many different

symptoms including: headache, muscle ache, unstable temperature and difficulty

concentrating. High levels of cytokines can also result in increased levels of

immune related markers such as TNF, MMP-9, IL-1B, and PAI-1. MMP-9 delivers

inflammatory elements from the blood into sensitive tissues and can combine with

PAI-1 to increase clot formation and arterial blockage.

Stage 3: Reduced VEGF:

The elevated cytokine levels in the capillaries attract white blood cells,

leading to restricted blood flow and lower oxygen levels in the tissues. Reduced

VEGF leads to fatigue, muscle cramps and shortness of breath.

Stage 4: Immune System Effects:

Patients with certain HLA genotypes (immunity related genes) may develop

inappropriate immune responses which may include antibodies to: myelin basic

protein (often from fungal infections), gliadin (wheat-like allergy) and

cardiolipins (affects blood clotting).

Stage 5: Low MSH:

Reduced melanocyte stimulating hormone (MSH) production results in yet another

set of problems and symptoms. The production of melatonin is reduced which

results in sleep problems. Endorphin production is suppressed which leads to

chronic and sometimes unusual pain. Lack of MSH can cause malabsorption or

" leaky gut, " which further weakens and deregulates the immune system. White

blood cells eventually lose regulation of cytokine response so that

opportunistic infections may occur or recovery from infections is slower.

Stage 6: Antibiotic Resistant Staph Bacteria:

Reduced MSH also allows resistant staph (MARCONS) to flourish in the mucous

membranes. These bacteria further compound the problem by producing exotoxins A

and B that cleave MSH, further decreasing the MSH levels. At this point, the

downward spiral starts to perpetuate itself.

Stage 7: Pituitary Hormone Effects:

Reduced MSH can decrease pituitary production of antidiuretic hormone (ADH)

which can lead to thirst, frequent urination, neurally-mediated hypotension

(NMH), low blood volume, and electric shocks from static electricity. While sex

hormone production is often down-regulated the pituitary may upregulate the

production of cortisol and ACTH in the early stages of illness, then drop to

abnormally low, or low-normal ranges later.

Using this model of how the damage sets in, we then need to work backwards to

fix this problem.

Helpful baseline levels:

HLA labs: these help to determine who is " genetically " at risk for harsher

symptoms.

MSH: Melanocyte stimulating hormone, a master controller of immune response.

Leptin: fat cell hormone that binds to MSH.

Cortisol: salivary testing throughout the day--stress hormone released by

adrenal gland.

DHEA: another stress hormone that complements cortisol.

Testosterone: ranges vary based upon either blood or saliva testing--androgenic

hormone that seems to change inversely to cortisol.

CRP: non-specific marker of inflammation.

ESR: another non-specific marker of inflammation.

TNF Tumor Necrosis Factor: an inflammatory cytokine that gets turned on by

biotoxins.

MMP-9: another inflammatory cytokine.

PAI-1: Plasminogen activator inhibitor.

Anticardiolipins: When elevated there will be an issue with blood clotting.

VEGF: Vascular endothelial growth factor — responsible for helping regulate

blood vessel integrity.

Erythropoietin: activator of red blood cell stimulation.

Volatile solvents.

PCBs

Chlorinated pesticides.

Phtalates

Heavy metals.

Infectious organisms:

Parasites

Yeast

Bacteria

Viruses

Mold

Food sensitivities.

Gut integrity.

Here is my approach based on lab findings (obviously this changes per patient

individuality):

1. Begin to rebuild immune response--we need to reduce INFLAMMATION

repsonse! Use of the following can be beneficial:

o Larch arabinogalactan: has been shown to decrease NF-kappaB, TNF; works

by " cleaning up " the lymphatic system.

o Carnosine: amino acid that reduces inflammation in the brain.

o DLPA (Phenylalanine): helps to restore Endorphin system damaged by low

MSH.

o Ashwaghanda: calming adaptogen that reduces cortisol burden.

o Lecithin: helps restore cell membrane fluidity damaged by biotoxin damage

to fat cells.

2. Work on hormone imbalances:

o Manage high/low cortisol appropriately.

o Replace DHEA with sub-lingual DHEA if low.

o Replace testosterone if low.

o Replace progesterone if low.

o Replace thyroid hormone with armour thyroid if low.

o Add melatonin at bedtime if sleep difficulties manifest.

o Naturally boost growth hormone with GABA, glycine, arginine, others.

3. Chelate heavy metals identified:

o IV Calcium EDTA for high lead/mercury.

o Rectal suppository Calcium EDTA for any high metal burden.

o Oral DMSA for elevated mercury.

o Zeolite

o Use IV Glutathione to enhance liver detox and promote heavy metal

removal.

4. Start Chemical detox:

o Potato chips weekly. Yes, potato chips have been shown to help with

removal of fat soluble toxins.

o Chlorella daily.

o Rice brain oil (gamma oryzanol).

o High dose fish oil.

5. Begin reassessment

This is a marathon and not a sprint. An obvious goal is reduce exposure to the

biotoxins! Practically speaking, however, this can be very difficult. Mold,

metals and chemicals are particularly important to remove from the environment,

so that involves careful assessment at both home and work.

We may need to continue the Cholestyramine as long as there is ongoing exposure.

Useful reading:

Mold Warriors by Shoemaker, MD

Mastering Leptin by Byron s, CCN

Biotoxin illness and management will become a very important aspect of disease

management in the future. This is complicated and confusing, but if we take this

a step at a time, we can make a lot of progress and finally get to the bottom of

many disease symptoms.

Image courtesy of NOAA Archives.