Emily Rowe, MD, AP, IFMCP

00:00 – Introduction

• Dr. Barrett introduces the episode focusing on binders and mold toxicity treatment
• Features a presentation by Dr. Emily Rowe on the proper use of binders
• Emphasizes importance of understanding binder administration for those dealing with heavy metals, toxins, and especially mold toxicity

00:58 – Pod of Inquiry Opening

• Standard podcast introduction and welcome

01:29 – Dr. Rowe Begins Presentation

• Introduction to the topic: “Binder Basics”
• Purpose: Educational video for brain-fogged patients to understand treatment
• Video format chosen because reading can be difficult when experiencing brain fog

02:30 – What Are Binders?

• Definition: Medications and natural supplements that bind toxins for elimination
• Also called “sequestering agents”
• Cholestyramine: First binder mentioned
  • Originally used for elevated cholesterol
  • Also used for Crohn’s disease
  • Highly effective for ochratoxin A
  • Most difficult binder to tolerate for many people
• Multiple binder options available for individual needs

03:45 – Why Binders Are Crucial

• Core principle: Binders are the foundation of mold toxin treatment
• Essential for successful mold toxicity treatment

04:15 – How Binders Work: Enterohepatic Circulation

• Mechanism explained:
  • Connection between liver and intestine
  • Substances enter intestines → absorbed by portal vein → processed in liver
  • Liver metabolizes toxins → converted to bile
  • Bile released from gallbladder into intestines
  • Only 5% gets excreted, 95% gets recycled back to liver

05:30 – The Toxic Merry-Go-Round Problem

• Original purpose: Recycling bile salts (efficient for the body)
• Problem with toxin overload: Toxins continuously recycle
• Breaks down liver’s detoxification ability
• Creates a perpetual cycle of toxin recirculation

06:15 – Hormones and Enterohepatic Circulation

• All hormones subject to enterohepatic circulation
• Effects in women: Estrogen dominance, PMS, hormonal imbalances
• Effects in men: Prostate issues
• Why: Hormones are fat-soluble (like mold toxins)
• Gallbladder processes fat-soluble substances
• Body prioritizes mold detoxification → hormones become imbalanced

07:00 – Microplastics and Xenoestrogens

• Plastics (xenoestrogens = fake estrogens) also accumulate
• Everything gets out of control when system is overwhelmed

07:30 – The Overflowing Sink Analogy

• Toxin accumulation compared to overflowing sink
• First step: Turn off the faucet = Get out of mold-toxic environment
• Critical importance of stopping toxic exposure
• Dr. Rowe’s role: Treat mold toxin in body (not mold remediation)
• Can help find good mold remediator

08:45 – Identifying the Obstruction

• Diagnostic step: Check urinary mold toxicity test
• Shows which specific toxins have accumulated
• Different toxins require different binders
• Essential for knowing what to treat

09:30 – Starting Treatment with Binders

• Unclog the sink = Remove toxins from body
• Allow toxins to drain and leave

10:00 – Treating Mold Colonization

• After 1+ month stable on binders: Treat mold colonization
• Locations: Nasal pharynx and GI tract
• Use antifungals (pharmaceutical or herbal)
• Continue binders throughout colonization treatment

10:42 – Review: Mold Toxin Treatment Basics

1. Get out of moldy environment
2. Do urinary mold toxin test
3. Binders are the foundation of treatment
4. After stable on binders: Eradicate colonization (nose, sinuses, GI tract)
5. Treat until mold toxin test shows no toxins
6. Minimum treatment time: 2 years typically required

11:00 – How Binders Work (Technical)

• Bind directly to toxins
• Stop enterohepatic circulation
• Enable toxin elimination through bowel movements

11:53 – Binder Basics: Getting Started

• Start one binder at a time
• Go slow – this is okay
• Typical recommendation: One binder for 3-5 days, then add next
• Sensitive individuals: May need 1 week to 1 month per binder
• Low-dose option: Start with grain-of-rice amount in hot water
• Slowly build up dosage

12:30 – For Extremely Sensitive Individuals

• Generate feeling of safety
• Tell yourself “it is safe to release toxins”
• Helpful techniques:
  • Hypnosis
  • Vagal toning
  • Limbic system retraining
• Communicate to body it’s okay to release toxins

13:00 – Sponsor Break: Stem Regen

• Dr. Barrett discusses stem cell mobilizer supplement
• Benefits of stimulating stem cell release
• Discount code: SB pod (15% off)
• Website: stemregen.co/drstephen

14:09 – Tolerating Binders (Continued)

• If feeling too terrible: Okay to reduce dose or try different binder
• Small amounts still work – just takes longer to build up
• Timeline: After ~3 months on binders, can tolerate more toxin release
• Symptoms start dropping away
• Treatment takes time, but patients feel significantly better

15:00 – Individual Treatment Needs

• Not everyone needs every binder
• Even with multiple toxins present, may not need 7 binders daily
• Treatment individualized

15:30 – Common Binders Listed

• Cholestyramine
• Welchol (cholesterol medication)
• Charcoal
• Optifiber
• Glucomannan
• Bentonite clay
• Zeolite clay
• Chlorella
• Saccharomyces boulardii

16:30 – Saccharomyces Boulardii (Special Binder)

• Unique properties: Can take any time of day
• Not required to separate from food/supplements
• Healthy yeast that prevents bad yeast overgrowth
• Binds to gliotoxin
• Gliotoxin effects: Brain inflammation, anxiety, mental restlessness, focus issues, ADHD-type symptoms
• Dosage: 2 pills once daily (1 pill if sensitive)
• Additional benefits:
  • Balances vaginal flora
  • Helps with recurrent yeast infections
  • Very helpful for bacterial vaginosis

18:00 – Timing for Other Binders (Critical Section)

• Important: Binders bind both bad toxins AND good nutrients/medications
• Must separate from thyroid hormone and other medications
• Recommended timing:
  • Take binder
  • Wait 30-60 minutes
  • Eat something with fat (stimulates gallbladder to release bile)
  • At least 1 hour away from vitamins, herbs, supplements, medications (before AND after)

19:00 – Ideal Binder Timing

• Best time: Before dinner (3-5 PM)
• Think of it as “binder happy hour” instead of alcohol happy hour
• Avoid: Taking binders right before sleep
• Reason: Liver peaks 1-3 AM; binder timing should align with chronobiology
• If necessary: Taking at night before bed is better than not taking at all
• Puts extra stress on liver but still beneficial

20:00 – Practical Advice: Just Take Them

• Most important rule: TAKE THE BINDERS
• They don’t work if you don’t take them
• If struggling with perfect timing: Take with dinner
• Will bind some food (may help lose ~5 pounds)
• Take while prepping dinner or ordering GrubHub
• Still works even if not perfect

20:45 – Emphasized: TAKE THE BINDERS

• This is how mold toxin treatment works
• You must bind toxins to eliminate them

21:00 – Hydration and Bowel Movements

• Must hydrate when taking binders
• Binders coagulate/bind substances
• Need fluid to keep everything moving
• Do NOT get constipated while on binders
• Binders can cause constipation

21:30 – Preventing Constipation

• Regular incorporation of:
  • Psyllium
  • Pure lean fiber
  • Flaxseed
  • Chia pudding (very helpful)
  • MiraLAX if needed
  • Herbal Chinese supplements
  • Laxative teas (like Senna)
• Daily goal: “Jump up and say ‘I pooped today!'”

22:00 – Eradicating Mold Colonization

• Timeline: After 1-2 months stable on binders
• Target areas: Nose, sinuses, GI tract
• Treatment options:
  • Colloidal silver
  • Strawberry (for nose/sinus)
  • EDTA (breaks up biofilms)
  • Antifungal sprays
  • Oregano oil
  • Various herbs
  • Chinese herbal formula: Intestinal Pulsatilla Formula
  • Pharmaceuticals: Nystatin, Itraconazole
  • Heavy-duty option: Voriconazole

22:45 – Why Treat Colonization

• If not eradicated, mold lives inside body
• Perpetually releases toxins
• Essential for complete treatment

23:12 – Monitoring Progress: Urinary Mycotoxin Testing

• Check every 3-6 months during treatment
• Preparation for test:
  1. Stop binders 3-5 days before collection
  2. Stop methylene blue (interferes with test)
  3. Take daily glutathione for 1 week (pills, injections, or IV)
  4. Big sweat day before collection
  5. Early dinner night before
  6. Collect first morning urine

23:50 – Treatment Duration and Expectations

• Treat until: Urinary mycotoxins no longer present
• Minimum treatment: Often 2 years to fully eradicate
• Not a quick fix
• Cannot rush detoxification system
• Trying to detox too fast makes you worse/sicker
• Good news: People often feel significantly better 3-6 months into treatment

24:10 – Additional Resources

• Scott “The Better Health Guy” podcast Episode 122
• Deep dive on different mold toxins and binders
• Highly researched, information-packed content
• Multiple perspectives offered

24:33 – Dr. Neil Nathan Mention

• Mentor to Dr. Rowe
• Extremely effective mold toxin treatment approach

24:40 – Contact Information

• Can reach out with binder questions
• Call, text, or email
• Follow up with Chris or Dr. Rowe

Key Takeaways

Core Treatment Principles:

1. Binders are the foundation of mold toxicity treatment
2. Minimum 2-year treatment typically required
3. Get out of moldy environment first
4. Test to identify specific toxins before treatment
5. Treat colonization after stable on binders

Critical Timing Rules:

• Take binders 1 hour away from other medications/supplements
• Best time: 3-5 PM before dinner
• Follow with fatty food after 30-60 minutes
• Avoid right before bed when possible

Most Important Rule:

TAKE THE BINDERS – even imperfectly timed binders are better than no binders

Expected Timeline:

• 3 months: Better tolerance of binders
• 3-6 months: Significant symptom improvement
• 2+ years: Full toxin eradication

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