Jill C. Carnahan, MD, ABFM, ABIHM, IFMCP
13:17 Mold Sensitivity Genes: LabCorp and Quest are Dr. Carnahan’s favored labs for HLA-DR Typing. The results need to be interpreted. Dr. Carnahan is able to do this with a Rosetta stone from Subject expert, Dr. Ritchie Shoemaker. There are two “dreaded” genotypes for mold sensitivity, 11-3-53 and 4-3-52. It's is estimated that 1% of the population has one of these two genes. Celiac HLAs are related to mold HLAs. It is the misprocessing of antigens.
14:49 HLAs, Pac Man of the Immune System: Dr. Carnahan orders Celiac HLA and HLA-DR typing for Celiac, and HLA-DR for mold, Lyme and other biotoxins. Celiac HLA typing, checks DQ2 and DQ8. People with two SNPs for DQ2, two SNPs of DQ8 or one DQ2 and one DQ8, have a high probability of problems with gluten processing. They may never get Celiac disease, but gluten can create inflammation and trigger autoimmunity. Autoimmunity and mold go hand-in-hand because of the inflammatory cascade.
19:50 The Possible Benefit of This Over-Reactive Immune System: Sometimes Dr. Carnahan has patients who say that they have not had a cold or flu for years. They may have some sort of virus, but their immune system is so dysfunctional that they are not symptomatic. Sometimes it is not the threat causing our illness, but our immune system’s response to the threat. People, who don’t have this cytokine reaction, are more prone to have these HLA types. Their immune system is so dysfunctional that it isn’t rallying a proper response.
21:31 Symptoms of Mold Exposure: Symptoms include fatigue, brain fog where you cannot concentrate, focus or complete a task easily, and memory issues in the form of finding words. NeuroQuant, SPECT MRI, or a functional MRI, all show changes in the brain from the mold. Instead of seasonal allergy responses, people with mold sensitivity have super-reactive mast cells and are in a constant histamine response with allergy symptoms. Your skin is a detox organ, so you might have new onset acne, sores, lesions, and/or scalp issues. Joint pain is common because it is an inflammatory response. Tingling, shortness of breath, sinus congestion, and blurry vision is also common.
24:12 Symptom – Prone to Static Shock: Mold affects the pituitary access to the extreme. One of the hormones in the posterior pituitary is antidiuretic hormone, which controls our saltwater balance, so another symptom is constant thirst that is unquenchable, dry skin, dry eyes,. The antidiuretic hormone is affected when MSH, another hormone that regulates the hypothalamic access. In mold illness, this almost always drops. That regulates cortisol, adrenals, thyroid, and antidiuretic hormone. Because antidiuretic hormone is low, you are drinking lots of water and have more salt on the surface of your skin. This makes you prone to static charge.
28:47 School Buildings Commonly Have Mold: Courthouses, schools and older buildings often have mold.
30:46 Biomarkers of Mold: The CRP or ESR inflammatory markers will be normal for those of us with mold reaction. CMP, basic metabolic kidney/liver, will be normal. CBC, most of the time will be normal. Routine labs will be normal. Because labs come back normal, many are deemed to have a psychiatric illness, especially when they experience another symptom of mold exposure, rage, anger and sudden deep dark depression when exposed to mold. Dr. Carnahan does HLA typing along with testing of leptin and adiponectin which will show early signs of insulin dysregulation. Mold reaction brings on insulin resistance. Dysregulation of cortisol blocks insulin from entering your cells. Your pancreas can be affected from the toxins, causing elevated lipase or amylase. You can have poor production of pancreatic enzymes and poor production of insulin. You can even become diabetic even when they have no family history.
32:51 Symptom - Sudden Weight Gain: People can put on 50 pounds from mold exposure even with decreased caloric intake and increased exercise. Because of the insulin resistance from the imbalance of leptin and adiponectin, these people cannot burn fat. They are metabolically so dysfunctional that typical dietary interventions do not work.
33:28 Mold and Blood Profusion: Mold exposure sensitivity decreases blood flow to your tissues. VEGF shows capillary tissue profusion. Early in the illness, this increases, causing new blood vessel growth. Dr. Carnahan, a runner, would have decreased profusion in her legs, causing lactic acid to build and sometimes her lower legs would go numb.
34:25 Mold Exposure Sensitivity and Autoimmunity: VEGF causes TGF Beta to rise. TGF Beta is a master puppeteer in the immune system that regulates autoimmunity, impactingTreg cells, and t17 cells. High TGF Beta suppresses Treg cells, decreases core antigen presentation, and affects MSH which effects cortisol, leptin, ADH and much more.