Amy Nett: Okay. For heavy metals testing, this is a little bit somewhat nuanced. We have been using Quicksilver blood metals panel and Mercury Tri-Test, but if you listen to Chris’s fairly recent talk in the ADAPT community, the talk that he did with them, David Quig, or I should really say his interview with Dr. David Quig, who works at Doctor’s Data and has been into sort of specializing in the arena of heavy metals, Dr. David Quig really advocates for provoked heavy metals testing, so within the past few months, both Chris and I have really shifted into using provoked heavy metals testing. Specifically we’re using a combination of DMSA, say, which is prescription, glycine, which is just an amino acid that you can get from Designs for Health or several other brands … We use a combination of Glycine Powder, prescription DMSA, and if possible, we might even have the patient do about a month of liposomal glutathione prior to testing to start mobilizing some of the metals. We’ve most recently switched to provoked heavy metals testing using Doctor’s Data test.
If I have patients and I’m really concerned about heavy metal toxicity or if they have a lot of anxiety, I might actually still start with the Quicksilver blood metals panel because if somebody has a really high heavy metal burden, I’m going to worry about a strong detox reaction with the DMSA and glycine, so I’m going to proceed with a little bit more caution. As with any medication, I’m going to have a discussion about risks, benefits, and alternatives. I always give patients the option of doing a non-provoked heavy metals test, but I tell them that if it comes back completely normal, I don’t know that we will have answered the question definitively, and so we may still go on to do a provoked heavy metals test. I tell them, though, the downside of a provoked heavy metals test is that if you do have a high burden of heavy metals and then we give you DMSA and glycine, you might not feel well. It’s going to feel like fatigue, malaise, etc. Sometimes just knowing that that reaction might happen is okay and lessens it, but for some of my patients who have anxiety, it’s still just that detox reaction is too uncomfortable and can really exacerbate a panic episode. Those are the patients that are going to be more cautious with.
The one other test to think about is the Quicksilver Mercury Tri-Test. If I have a patient who has a history of having had probably somewhere on the order of four to six mercury amalgams or more, then I’m also going to run the Mercury Tri-Test because that’s the only test that’s going to specie it out in organic mercury.
For mold testing, certainly you can mold test environments with an ERMI or HERTSMI test. That’s E-R-M-I, Environmental Relative Moldiness Index. You can do the ERMI testing, but for patients, we’re basically looking at the markers for chronic inflammatory response syndrome. You can look at those on Ritchie Shoemaker’s website for chronic inflammatory response syndrome. There are a few places where you can read about those markers, but basically, sometimes I’m looking at the HLA type to determine whether or not patients have a genetic predisposition. Again, this is a much bigger topic and it’s really nuanced. Both Chris and I have mixed feelings about chronic inflammatory response syndrome in terms of exactly which steps we’re taking on the Shoemaker protocol, but markers we consider using HLA type, melanocyte stimulating hormone, MMP9, TGF-beta 1, C4A, which is complement protein, C4A, vascular endothelial growth factor, anti-diuretic hormone and osmolality, ACTH and morning cortisol, anticardiolipin antibodies. I think we just hit all the key markers. Remember, these needed to be ordered from specific labs. Again, you can get some of the details, but, like, C4A, you want from National Jewish. TGF-beta 1 is Quest, I believe. You just have to make sure you’re getting them through the correct labs, so that’s if you’re looking for chronic inflammatory response syndrome, and I think that’s what you mean by mold testing. It’s not going to be covered on the organic acids test.