Chris Kresser: Yeah, CIRS is really complex, and it’s hard to give kind of basic recommendations. But if you are in a moldy environment and you know you’re sensitive to mold, I wouldn’t recommend a supplement in that case. I would probably recommend a medication called cholestyramine, which is a binder that binds to the mold toxins and reduces toxin carriage and toxic burden.
Now of course, ideally, as you well know, the best option is to get out of a moldy environment. And since you mentioned a boat, I can use my favorite analogy to talk about this. If you’re in a boat that has a hole in it and it’s sinking, you can bail water and that will slow the sinking process down, but ultimately you have to plug the hole. You don’t want to be just bailing water forever. And even if you are bailing water and there’s still a hole you’re probably at some point not going to be able to keep up. So in this analogy, living in a moldy environment is the hole in the boat and cholestyramine is the bailing of water. So cholestyramine can help on a temporary basis, but you’re not going to be able to fully advance and recover until you get yourself out of the moldy environment. So I would consider cholestyramine. Welchol is another alternative. It has one-fifth of the binding sites of cholestyramine, so it’s not as fast or powerful, but it has fewer side effects. The main side effect of cholestyramine being constipation because it binds to bile acids, and that’s how it works and removes toxins from the body. But it can cause constipation; it’s pretty notorious for that. And for some people it’s minor. For other people, it’s really significant and they can’t tolerate it at all.
So Welchol is another alternative. In terms of natural binders, there are things like charcoal and bentonite clay and silica. We use those for metal detox. There’s less, there’s not really any evidence that they are beneficial for mold. Although some clinics use them for that purpose, mold toxins. We have had some patients, however that seem to respond to those. So you know, they may be worth a try if you don’t have access to cholestyramine or Welchol.