00:00 – Dr. Pamela Cipriano: Chronic mold or – or any other type of disease process, it’s in a chronic phase. I always have them change their diet. Diet
00:08 – is going to be the most important thing that you can do to get better.
00:23 – Melissa: Dr. Pamela Cipriano is a doctorally prepared nurse practitioner, and the first nurse practitioner in the state of Connecticut to open a
00:30 – solo practice. She is a board certified acute care nurse practitioner, and practices internal and
00:35 – functional medicine. She specializes in chronic Lyme disease and other vector borne diseases, chronic urinary tract infections, chronic bladder
00:42 – pain, mold toxicity and Candida overgrowth. Today, we’re going to focus on mold, fungi and chronic
00:48 – bladder symptoms, and we’ve collected a lot of questions from our audience. Before jumping in, I just want to say thank you for sharing your
00:54 – expertise with us. Dr. Pamela Cipriano: Thank you so much for having me. Melissa: Can you tell us a bit about your
00:59 – professional background and how you came to specialize in these areas of health? Dr. Pamela Cipriano: Sure. So I was an ICU nurse
01:06 – for years before I went back to school to become a nurse practitioner, and because it was intensive care, I went back to school for acute care. So
01:13 – after graduation, I worked in the Department of Surgery, the Department of Medicine as a hospitalist. I worked as an intensivist in the
01:19 – intensive care unit and in the ER. And just realized that there were so many areas where if
01:28 – the patients had a really qualified primary care provider, they really wouldn’t have ended up in the hospital or the intensive care unit. And so I
01:35 – ended up leaving the hospital and joined a practice with an elderly physician whose partner had just recently retired, and I took over that
01:43 – side of the practice and realized there was a lot of need for preventative medicine, and so I had
01:51 – found that the vast majority of my patients had pre-diabetes, or they were already diabetic, and
01:58 – put them all on an anti inflammatory diet, which was low in glycemic index, and went back for my
02:03 – doctorate degree. It was a retrospective analysis that showed that all of the things that I had
02:09 – proposed and my patients followed actually was statistically significant. So just with diet and
02:14 – lifestyle changes, they were able to reverse the progression from pre-diabetes to diabetes, and outside the research patients with diabetes
02:21 – reverse the diabetes with just diet and exercise. So, it was a good thing for me to see something like that. I ended up opening up my own practice.
02:30 – And at the same time, my son, who had gotten
02:35 – bitten by a tick when he was six years old and developed a bull’s eye rash, had no symptoms
02:42 – whatsoever, but, you know, the pediatrician did put him on some antibiotics. If I have to guess, it was probably about 10 days worth. About 13
02:49 – years later, we went scuba diving. He’d been diving since he was 12, and my younger one was
02:54 – diving since he was 10, so this wasn’t something new for them. We were in the Bahamas and about 100 feet down, and my 19 year old, developed a lot of
03:02 – abdominal pain, so we went back to the hotel. I did a quick exam on him, and he had the tiniest,
03:07 – tiniest hernia that I could feel, where the pain was. Brought him to his doctor, who felt the same
03:14 – way, but sent him to surgery, because he was really in quite a bit of pain. And when they did the surgery, they found his abdominal wall – his
03:20 – abdominal wall looked like Swiss cheese. That’s how they described it. Melissa: Wow. Dr. Pamela Cipriano: So he was 19 years old, very
03:27 – active, nowhere near overweight. In fact, he was almost like an almost under, more underweight than
03:32 – overweight. And nobody knew why that was occurring. And there’s always a trigger when it
03:39 – comes to Lyme, or any other tick borne disease where your immune system is robust enough to keep
03:45 – everything in check. But if you have any type of a trigger, whether it’s surgery, a car accident, a
03:52 – death in the family, an illness, it drops your immune system and now you have this infection that
03:59 – takes over your body. And that’s what happened with him. Right after the surgery, he started with all these very vague symptoms that were
04:07 – progressively worsening, and we had no idea what it was. And he went to see so many different
04:12 – doctors. This poor kid had to learn how to self catheterize himself, because the pain in the
04:18 – bladder was so severe and the inflammation was so severe that he could no longer urinate. And now we
04:25 – have the doctors telling him it’s all in his head. And meanwhile, I am researching and researching and researching everywhere I can find to see what
04:33 – is going on with my child. And he was 29 now, so
04:39 – 10 years later, he was 29 – a month before he turned 30, and I found a research article in the
04:45 – Journal of Urology, and the author had a – written
04:52 – a case study on a gentleman very similar to my
04:57 – son, symptoms were identical. So I contacted the researcher, and he referred me to ILADS, the
05:03 – International Lyme and Associated Disease Society, and that’s how I got involved with Lyme disease. And so I went away for training with Dr Richard
05:10 – Horowitz, who’s a Lyme expert. I joined ILADS, and never expected to be a Lyme literate provider. It
05:18 – just kind of happened, because you go through so much training, and the learning curve was pretty
05:23 – steep. There were so many different diseases you really had to understand, like one tick in this area can carry anywhere between 14 and 19
05:30 – different diseases. And I found that my son’s issue was because the bladder working as a
05:36 – reservoir is where he was holding on to the bacteria. And treatment was very difficult,
05:43 – especially trying to treat your own child, like I had other providers involved as well. But it was –
05:50 – it was difficult trying to get him to stay on the medication, because every time, every three weeks,
05:55 – he would get sicker. And it was when I was – I was with Dr Burrascano, and he had said that every
06:02 – three weeks, the adult spirochetes come out of the biofilm, and so your patients will get sicker
06:07 – every three weeks. And it was just like, wow, my poor son, like he – his – he was so – he was so
06:15 – understanding about what his body was going through that he knew the changes every three weeks. So it was – it was really tough in the
06:21 – beginning. So he’s doing remarkably better now. Anytime anybody does anything like you get so
06:28 – tired of being a patient where you just want to be a person again, and you start just eating regular food with sugar in it, or alcohol. If there’s one
06:35 – little straggler left over, it’ll start the process all over again. So now he started doing the IV vitamin C’s again and things like that,
06:41 – just to try and get rid of some of the inflammation. But I generally keep people on herbs pretty much for the rest of their lives, which are
06:47 – all very healthy for you anyway. There’s nothing that’s going to be detrimental to your health. If anything, it would be – it would boost your immune
06:53 – system. So that’s usually how I treat Lyme and other tick borne diseases Melissa: Well, so I’m glad to hear he’s doing
06:59 – better. Dr. Pamela Cipriano: Yes. Thank you. As far as the bladder goes, I learned a lot about the bladder
07:05 – because of what I went through with him, and I had also went away for training with Ruth Chris, the
07:11 – nurse practitioner who specializes in chronic urinary tract infections. And because of what I
07:18 – was going through my son, I really wanted to get as much expertise as possible, and so she really
07:23 – focused more on the bladder, and that’s really how I got him a lot better, so that opened up a whole
07:30 – different type of patient population for me. So now I have a lot of patients with tick borne
07:36 – diseases, patients with chronic urinary tract infections, interstitial cystitis, things like
07:42 – that. And interestingly, I haven’t had a patient with a chronic urinary tract infection yet that
07:49 – didn’t have the tick borne disease. Somehow they go hand in hand. Yeah.
07:55 – Melissa: I think a lot of people in our community ask questions about this because they also suspect something like that might be going on.
08:01 – Dr. Pamela Cipriano: Yeah. And anytime you’re exposed to mold, if you do have some type of a tick borne disease, it just makes everything so
08:10 – much worse, almost like on steroids. So if you’re, you know, staying in a B&B and it happened to be an older building where there’s mold, patients get
08:19 – very toxic, very quickly, just from being in that environment. And a lot of times, their symptoms will come back so fast, and they’re – they panic
08:27 – because they feel like they were better. But again, you just need one little straggler left over to start the process. So once we get rid of
08:35 – everything, it’s a lot easier to catch up. You know, if anything does get out of out of hand
08:40 – again, it’s a lot easier to kind of reel it in. Melissa: Yeah. Well, that seems like a good time to jump into some of the questions. I thought we
08:46 – could start with some basics. So the first one was, what is the difference between mold and fungi?
08:51 – Dr. Pamela Cipriano: They’re actually both the same. So all mold and all fungi are the same thing. They’re interchangeable. Mold is going to
08:58 – be several different types of mold. But if you think about a mush, like a mushroom, for example,
09:05 – it’s usually it can be toxic. It could be very healthy, especially like something like lion’s
09:10 – mane. That’s a fungi, but it’s also a mold. Melissa: And what is mold toxicity?
09:17 – Dr. Pamela Cipriano: So mold toxicity and everybody is different. No one is clear from any
09:23 – type of mold. There are certain types of mold that are going to affect you differently, and if you have an underlying issue, or if you have a real
09:32 – allergy to mold, you’re going to be affected more than somebody else would. So for me, it was I had
09:38 – thyroid cancer, and didn’t know it at the time, and that was my underlying thing. And we were in a
09:44 – mold – moldy area. We were by the shore, and I –
09:50 – my asthma was never so bad. I could barely breathe, even with the inhalers. If I didn’t have
09:57 – the cancer, I wouldn’t have gone through that. So there’s always an underlying reason why you react so much worse to mold. It’s a very tiny spore. It
10:06 – literally lives almost everywhere. When there’s water involved, you can be sure there’s going to
10:12 – be mold in the area. Mycotoxins are very similar
10:17 – to the mold exposure that you get, but that’s when people do become very, very ill with mold, with a
10:23 – toxicity. Melissa: And can all types of fungi cause that kind of toxicity? Dr. Pamela Cipriano: The vast majority can.
10:30 – There’s very few fungi that are actually not contributory to the illnesses. But I would say to
10:38 – be on the safe side, I would consider all mold to be dangerous, really, just to be on the safe side.
10:44 – Melissa: And what is the impact of mold toxicity on the immune system, and in particular, the bladder?
10:49 – Dr. Pamela Cipriano: So for the immune system, any type of mold, bacteria, virus, fungi, that gets
10:58 – into the system is going to be reactive to the immune system, and if your immune system is – it’s
11:05 – really robust, you can actually have more symptoms than somebody who has an immune system that’s not functioning as well as it should. Unfortunately,
11:13 – the person who has an immune system that’s under acting, the mold has an opportunity to get into
11:18 – lots of different areas in the body, and some of the symptoms are going to be, you know, brain fog,
11:25 – profound fatigue, joint pain, very similar, sounding like Lyme disease right now, very
11:31 – similar. Sometimes it’s going to irritate the bladder. So mold can be anywhere in the body, and
11:37 – it can and it can get into your body by so many different areas. It could be inhaled, it can be
11:44 – absorbed through your skin. It can come in through your eyes, your hair follicles. My son was
11:51 – cleaning out a home with mold, and he told me that he wore the N 95 mask. And I said, okay, did you
11:59 – put the hazmat suit on because it affects everything, and he didn’t, and he knows better,
12:05 – and he started on charcoal. So he’s taking 1200 milligrams of charcoal daily right now as a binder
12:12 – to try and pull the mold out of the system. So right now he’s not symptomatic, and I’m hoping he stays that way.
12:18 – Melissa: Yeah, me too. Had this mold become part of the microbiome or cause infection directly, or is it more about making you more susceptible to
12:25 – infection? Dr. Pamela Cipriano: It’s more you’re – you’re getting you’re more susceptible to infection because it really affects the immune system. So
12:33 – whenever you have mold toxicity, you’re more prone to other disease processes.
12:38 – Melissa: Okay. Dr. Pamela Cipriano: And mold itself can cause a host of problems. Sometimes it’s not as easy as
12:44 – just taking charcoal as a binder, and there’s other binders that we can try, but sometimes we actually have to do chelation therapy to really
12:51 – pull the mold out of the system. Melissa: What is chelation therapy? Dr. Pamela Cipriano: So chelation therapy is done
12:56 – intravenously, the chelation therapy I’m talking about. So chelation therapy would be anything that
13:02 – pulls toxins out of the body. I use calcium EDTA. It’s an FDA approved way of pulling things out of
13:10 – the body. What it does is it’s given intravenously and then followed by a litre of normal saline. And
13:17 – what it does is it gets into every part of the entire body, and the chelation pulls whatever is
13:23 – in your body literally out. And then we – we do urine tests afterwards to see exactly what is in
13:29 – the system, and then we follow it along until those urine tests are normal.
13:34 – Melissa: Speaking of testing, how do you diagnose whether mold toxicity is contributing to someone’s symptoms?
13:41 – Dr. Pamela Cipriano: So, it’s – the symptoms of mold, like I said, are very, very similar to Lyme
13:48 – disease. When I have a patient who comes in, and I’ve had patients who come in from, like, it’s
13:53 – called a sick house syndrome, where they’re either renting a house or they just bought a house, or didn’t realize that there was mold in the house,
14:00 – and they’re constantly sick, just constantly sick. It could be simple as like sinus infections, ear
14:06 – infections and repeated asthma or bronchitis, to skin rashes, skin infections, Candida outbreaks,
14:15 – urinary tract infections. It can cause diarrhea. I mean, it can be a real systemic issue. So it can
14:21 – go anywhere from something really mild to something much more severe. Melissa: In the home, can you always see or smell
14:28 – mold, or can it be invisible? Dr. Pamela Cipriano: It can be invisible. So there’s a lot of people who come here where
14:34 – they’re testing positive for mold, and they’re assuring me that they don’t have mold in their house, and they don’t have mold where they work,
14:42 – so it’s going to be somewhere. The problem is, is like, if you’re not really paying attention to the attics, if you’re not paying attention to the
14:48 – corners of the basements, or especially like behind drywall, where you’re not always going to see the leaks, you always need water to have mold.
14:57 – You can have mold spores that will stay alive. Literally forever. Once you add water to it, it
15:02 – turns into active mold. So the mold spore, again, it kind of depends if it’s, you know, surrounded
15:08 – by dust and it gets airborne. Can definitely end up with mold problems that way, because it gets
15:15 – into the respiratory system and, like I said, penetrate through your skin and your hair follicles. But it’s really when it’s with mixed
15:23 – with waters, when you have the most problems, because then it gets into the ductwork. You know,
15:28 – it is everywhere. There’s no way to prevent contamination with mold when you’re in a situation
15:33 – like that. Melissa: Do you therefore recommend testing in your home environment for molds? Dr. Pamela Cipriano: I do. I do. There’s a few
15:39 – different environmental companies that you can go through, and they send the kit to your house, and
15:46 – they’ll generally, if you’re not really sure if you have mold or not, sometimes, just using the filter out of your furnace and rubbing it with the
15:55 – swab that they give you, and then sending it back to the company, will let you know if there’s mold or not, because sometimes you really can’t find
16:00 – the mold. It’s really difficult. Like I said, especially if it’s behind a wall and it’s not bleeding through.
16:06 – Melissa: How common do you think mold toxicity is, in general? Dr. Pamela Cipriano: Very. It’s so common, it’s
16:11 – where there’s nowhere in the world that there’s not mold. It’s literally everywhere. And so I
16:18 – think a lot of people, when their immune system just isn’t working to capacity is when they really get affected by the mold. Because your immune
16:25 – system is intact, you might still get affected by the mold, but it’s not going to be a profound effect. But if your immune system is not working
16:31 – properly, that’s when you’re going to have most of the problems. Melissa: And is the immune system piece the reason that someone in the same environment might be fine
16:38 – while someone else is not fine when it comes to mold toxicity? Dr. Pamela Cipriano: It is. So it’s the immune system, it’s any allergies that they may have,
16:45 – it’s their past medical history, it’s, it’s a lot of different things. So where did they grow up? Did they grow up in a mold invested home? That’s
16:53 – the, the first key that they’re going to have issues as they get older. A lot of people go to
16:59 – boarding schools. The boarding schools are old schools. You know, I have a patient right now that goes to a boarding school locally, and her family
17:06 – lives in an entirely different state across the country, and she’s having pretty much every
17:12 – symptom, like I said, mold on steroids. You know, the fatigue, the brain fog, the aches and pains,
17:19 – the vomiting, the nausea, the diarrhea, you know, so, and she has tick borne diseases. So we’re
17:27 – trying to work with everything with her, which is, it’s not easy when you’re 16 years old to have to deal with something like this when you’re trying
17:33 – to concentrate in school. Melissa: Yeah, that’s a lot. And a lot of people interested in this topic and how to get diagnosed
17:40 – if they suspect this. And few people ask questions about a visual contrast test and whether that’s something that you ever use and to share your
17:47 – thoughts about it, if you have any. Dr. Pamela Cipriano: So visual contrast – do you mean, like under a microscope type of thing, like
17:53 – a blood draw or urine? Melissa: Visual contrast sensitivity test for vision, and so it measures different things as far
18:00 – as I can tell, tells you that you might have symptoms Dr. Pamela Cipriano: That I’m not familiar with. I
18:06 – know that they do that with Lyme disease to see if the Lyme is actually affecting your vision. I wasn’t aware that they do that with mold. But if
18:13 – it works for Lyme, I can’t imagine it wouldn’t work for mold. What I generally use is they are
18:22 – laboratories that are not covered by insurance, that are going to be the most accurate testing that you’re going to get. And if I have a patient
18:30 – that the mold is really embedded in their epithelial cells or their endothelial cells, what
18:35 – I’ll do is liposomal glutathione. They’ll – they’ll take about 1000 milligrams a day for a
18:42 – week or two, and then take a really warm bath the night before, and then give a urine the next
18:48 – morning, and that’s usually when we’ll get a positive Mold Test. So sometimes I’ll find it in the blood from Labcorp request. I don’t think I’ve
18:57 – ever really found it in the urine through Labcorp request, but I have had a lot of success with the
19:02 – other laboratories, and there’s so many of them that you could use. Melissa: Okay. And that is interesting, because we
19:07 – do hear from a lot of people that they suspect that fungi of some kind might be contributing to the UTI symptoms, but it’s very difficult to do
19:14 – testing that shows that. How common do you think it is that fungi could be contributing to UTI
19:19 – symptoms? Dr. Pamela Cipriano: It’s extremely common. It’s extremely common. So don’t forget, you know, the
19:26 – kidneys are used to filter out any toxins in the body, and then those, all those toxins go into the
19:32 – bladder, and then we urinate them out. So the bladder is really a reservoir for toxins. And if
19:39 – your immune system is not acting appropriately, or if you have an overabundance of mold or other
19:44 – toxins in your body, it’s going to start to eat away at that protective layer in your – in your
19:50 – bladder. And now we have either bacteria or mold fungi that’s actually attaching itself to the
19:56 – bladder wall, and that’s something you’re not going to find in a standard culture that you get
20:02 – at a local laboratory. That’s something you’d have to do DNA testing with. And that’s why I use MicroGenDX, because they do the basic culture that
20:11 – you would get at a local lab, plus they do the DNA analysis to see what’s embedded in the bladder wall. And that test, I have never had a negative,
20:19 – never. When a patient is symptomatic, the first phase one might come back negative. Phase two, I
20:25 – always find something to treat. Melissa: Okay, and we do hear a lot about Candida when it comes to fungi and UTI. But do you think
20:32 – there are other organisms or other fungi that have had research done about them to know if they could
20:37 – be involved in these illnesses? Dr. Pamela Cipriano: There’s so many fungi that
20:43 – can penetrate the body and get into the bladder wall. So it’s not only Candida. There’s so many
20:49 – that can be – that could be affecting the bladder wall. So when we do that phase two with MicroGenDX, it tells you exactly what’s affecting
20:57 – it, what type of fungus is affecting it, and gives you recommendations for treatment.
21:02 – Melissa: Okay, and for mold toxicity or fungi, is it necessary to always treat that? Or can the body
21:09 – detox on its own if it’s removed from the environment? Dr. Pamela Cipriano: So, once – so, for anybody to
21:15 – get treated for moles, regardless of where it is, you have to get rid of the mold in the home. Either you move out of the house, or you have the
21:22 – house professionally cleaned out of all the mold that’s in the house. Once we do that, then we can
21:30 – use a lot of binders to try and get rid of all the mold in the body. Anybody I have who has a chronic
21:37 – infection or chronic mold or any other type of disease process that’s in a chronic phase, I
21:45 – always have them change their diet. Diet is going to be the most important thing that you can do to
21:50 – get better. So, sugar is probably the worst thing that we can ever put in our body. It causes a host
21:58 – of health problems, um, including decreasing our ability to fight off infection. So the first thing
22:04 – I tell people to do is to stop eating, stop eating sugar. So I give everybody – everyone, an anti inflammatory diet that I put together.
22:10 – Everything’s broken down into food groups. Everything is low in glycemic index, and everything decreases the inflammation in the body
22:19 – but the inflammatory part of it is what really causes a lot of issues, and it’s because of the foods that we’re eating. So, you know, I tell
22:26 – people no dairy, something like Kefir might be okay. That’s otherwise pronounced as Kefir. That
22:35 – might be okay. It depends on the person and where the Kefir came from. So if it was organic, it’s
22:43 – usually okay. I’m not a fan of anything dairy myself, just because, in the United States, the –
22:52 – the cows that we use for milk production, you know
22:57 – they’re – it’s not an organic – it’s not an organic type of environment. A lot of mucus gets
23:04 – into the milk. It’s overly pasteurized, so we don’t really get the benefit – the benefits of the
23:10 – milk. So I’m not a real fan of it. If anything, it just causes inflammation at this point. You know,
23:15 – growing up with my grandmother, who came from Italy, we used to drink the raw milk right out of
23:20 – the you know, right from the cow. You know, before all this technology took place and didn’t seem to
23:26 – cause the issues that we have now and in the United States, our food sources are not the best.
23:33 – Everything here is more about keeping food on shelves for a longer period of time, making a
23:39 – profit, and not so much about the health of the population. So you have to really be your own –
23:46 – you have to really make sure what you’re choosing to put in your body is the best thing for you. Melissa: And the topic of diet comes up a lot in
23:53 – our community, and sometimes the questions are around how strict you need to be. So if you’re trying to avoid sugar, does that mean you have to
23:59 – avoid fruit as well as processed sugar? Dr. Pamela Cipriano: So the fruits I have listed on the anti inflammatory diet are all berries,
24:06 – small apples, small pears are fine. They’re not
24:12 – very sweet. When you get into grapes, bananas, oranges, all melons, they’re much higher in sugar.
24:20 – So anybody who’s trying to fight an infection, they’re trying to decrease the amount of sugar they’re taking in, even though it’s a natural
24:26 – sugar, I tell them to avoid those fruits. And if you want to have them once in a great while, that’s fine, but generally the berries are going
24:34 – to be better at antioxidants, and the amount of sugar you get is so minimal. The health benefits
24:42 – really outweigh anything else. But, you know, something like watermelon, there’s literally no fiber to it at all, and the vast majority of it,
24:49 – besides the water part, is just sugar, yeah? And then they just contribute to the mold and
24:55 – everything. Melissa: Right. And then the other elements of treatment, you mentioned, charcoal and chelation.
25:01 – Are there risks or side effects with any of these mold toxicity treatments? Dr. Pamela Cipriano: So with chelation, when I do
25:07 – the IV chelation, it can cause, sometimes an allergic reaction, so we pre medicate people with
25:12 – Benadryl and methylprednisolone. The patients I’ve had have been just so sick that the chelation
25:20 – didn’t bother them at all, if anything, you know, actually made them feel a little bit better. But that – that’s one of the side effects. As far as
25:27 – charcoal goes, the only problem with the charcoal is, if it was pulling out a lot of toxins,
25:33 – sometimes people can become symptomatic that way. So if that’s the case, and I decrease the dose of the charcoal, and I have them taking, you know,
25:40 – start off with like one a day, and then increase slowly, the only downside of doing any kind of a
25:47 – binder, whether it’s been anticlay or charcoal or diatomaceous earth, is it has to be taken at least
25:54 – three hours apart from anything else. So you have a six hour period of time that you can’t have any
25:59 – food, any supplements, any medication in your system. You could drink water, but anything else
26:05 – you add to your stomach is going to get pulled out by these binders, and we don’t want that getting pulled out. We wanted to focus on the toxins. We
26:12 – wanted to get pulled out. So that’s the only downside of it. Melissa: Okay. And while you’re doing this type of treatment, could it actually make bladder symptoms
26:19 – worse before they get better? Dr. Pamela Cipriano: Without a doubt. So whenever we’re doing anything, we’re manipulating whether
26:25 – we’re killing something off or trying to pull it out, a lot of times, an inflammation will start,
26:31 – and it’s the inflammation that causes the symptoms to worsen. And so you know, doing everything you
26:36 – can to decrease the inflammation, and again, it’s all diet is going to be the best thing that you can do for yourself. Water is the most important
26:45 – thing. Not only hydrates you, but flushes out a lot of the toxins. And the vast majority of people
26:52 – do not drink enough water. The proper amount of water is half of your body weight and ounces of
26:58 – water. So if you weigh 200 pounds, you should be drinking at least 100 ounces of water every single
27:05 – day. If you’re drinking caffeinated beverages, you should increase that amount of water, because now
27:10 – you’re getting dehydrated. If you’re exercising or
27:16 – sweating or working outside, again, increase that amount of water, and you do get used to drinking
27:21 – that much water. This is my water jug right here. Melissa: Yes. Dr. Pamela Cipriano: It’s 60 ounces. It comes with
27:28 – me literally everywhere, and quite annoying with it, but that way I know that I got at least 60
27:33 – ounces in. I try and get between 60 and 70 ounces of water in every day. I always meet at least 60.
27:40 – I don’t always get to the 70, but I try my best to. Melissa: Yeah, yeah. It does help to have a size
27:45 – water bottle that’s appropriate for what you’re aiming for. One of the problems in this space is that patients often find it really difficult to
27:52 – find a clinician that is literate in how to go about testing and treating fungal overgrowth and
27:57 – mold toxicity. Do you have any advice for how to find a clinician that can help?
28:03 – Dr. Pamela Cipriano: It’s a really difficult question, because, you know, if you’re a mainstream provider, you really don’t know about
28:11 – Lyme disease, you don’t know about mold toxicity, you don’t, you don’t – you just don’t know about it. And until, like the American Medical
28:18 – Association or the CDC starts really discussing
28:24 – these things, it’s just not going to happen. When I first started at ILADS, I think it was 2017 or
28:33 – 2018 was my first conference there. I was just curious, because there were about three or four
28:38 – hundred people there besides myself, and I wanted to know how they got involved with this, because I
28:44 – didn’t know the first thing about Lyme disease, like I knew about as much as everybody else knew. I didn’t know anything about mold toxicity, like
28:51 – nothing like that. And just like with the doctors around me, I just asked how you got involved. And
28:56 – it was always a family member. A family member, it was one person, it was his patient. But it always
29:05 – seems to strike home before you actually are forced to figure out what is going on, and all of
29:11 – a sudden, you’re in a realm that you never even knew existed. When I went back to school for functional medicine, that really helped a lot,
29:19 – because that really teaches you so much about what we’re talking about now. So I guess the answer
29:25 – would be, if you can find a provider who practices functional medicine, they would be the most likely
29:30 – ones that would understand about – at least about mold, not necessarily about Lyme disease, because
29:36 – that’s an entirely different subject, but at least about mold and mold toxicities.
29:42 – Melissa: Okay, yeah, that’s helpful to think about. And let’s talk a little bit about chronic urinary tract infection, because I know that’s
29:48 – another area that you specialize in. What is your approach when you first see a patient who has had chronic lower urinary tract symptoms?
29:55 – Dr. Pamela Cipriano: So again, I do the MicroGen testing, because I want to know what bacterias are we dealing with. And a lot of times, when I get
30:01 – patients, they’ve already done this, they’ve already actually ordered the test on their own, and they’ve done the testing, but then they don’t
30:07 – know what to do with the results. And then they bring the results to their mainstream provider, and they don’t know what to do with it either,
30:12 – because it’s something that they feel uncomfortable with, going by something MicroGenDX is sending them because they, first of all, never
30:19 – heard of it. They never heard of phase two testing, and a lot of times the bacteria or the
30:25 – fungi that is getting – is coming back positive, they’ve never heard of that either. Melissa: Yeah. Dr. Pamela Cipriano: So, it’s, it’s a little bit
30:30 – difficult if you don’t have some experience behind you to help these patients. But generally, when I have a patient like that, they’ve already done the
30:36 – MicroGen testing, and they’ve already seen their providers, sometimes functional medicine providers, where they’ve been on a number of
30:43 – antibiotics and there’s really no improvement at all. And that’s when I go into the discussion
30:49 – about biofilms. So biofilms are very, very strong
30:55 – structure that is very difficult to break down, and it’s a hiding place and a place of refuge,
31:02 – really, for bacteria, mold, fungus, any viruses,
31:08 – things like that, that can survive even if a person is detoxing. If they’re doing the charcoal,
31:14 – they’re taking antibiotics, they’re taking anti fungals, they can still survive in that because those medications cannot penetrate that biofilm.
31:22 – And so now we have to start with biofilm busters. And the biofilm busters I generally will use is
31:27 – either going to be like nattokinase, serrapeptase, or lumbrokinase. And again, that goes with my Lyme
31:34 – training. We use a lot of biofilm busters, because with Lyme disease, the bacteria hides in the
31:41 – biofilm. So there is a researcher, her name is Eva Sapi. She’s out of the University of New Haven,
31:48 – and she did all the research on liquid stevia. So she’s a botanist by trade, and she tried different
31:55 – plant extracts to try and break open the biofilm. She actually got silly enough to – it was in a petri dish – she got silly enough to even try,
32:01 – like, Clorox, bleach and gasoline, and like, nothing would break open this biofilm. So then she
32:07 – tried liquid stevia, and she tried it from several different sources, and that’s the one that
32:12 – actually broke open the biofilm, because plants, in general, need to be able to fight off biofilm,
32:17 – or they wouldn’t survive. Melissa: Yeah. That’s very interesting. Are there other tests that you use, aside from MicroGenDX,
32:24 – to help analyze the situation? Dr. Pamela Cipriano: So, yes, so I use Doctor’s
32:29 – Data a lot. Doctor’s Data I use for mold toxicity
32:34 – and for heavy metal toxicity. They’re great for that. It used to be – what’s the name of it? Great
32:41 – – can’t think of it now. Great, something. But
32:47 – they changed. They sold the practice. They sold their laboratory to Mosaic. So I started using
32:52 – Mosaic now, which is pretty much the same laboratory, and they did the same thing. They do a lot of heavy metal toxins and mold toxicities. So
33:01 – the urine is going to be – it’s going to be able to tell you if you have mold or anything. But
33:06 – MicroGenDX is definitely the lab that I would recommend if you really want to find out how to treat it as well.
33:11 – Melissa: Aside from the biofilm disruptors, how do you approach treatment of organisms if you find bacteria?
33:18 – Dr. Pamela Cipriano: For the urinary tracts? Melissa: Mm-hmm. Dr. Pamela Cipriano: So once we break open the biofilm, we’ve already started the antibiotics,
33:23 – because if we don’t do that, now, we have a bunch of bacteria that’s floating around in the body, and that’s something we don’t want to do. So
33:28 – generally, what I’ll do is, I – D-mannose is something that’s fantastic because it’s going to
33:33 – help to decrease inflammation, and it’s also an anti microbial. There’s all – there’s so many different supplements that we can try to try and
33:40 – decrease the inflammation and fight off the antimicrobials. I’m not a fan of antibiotics if I
33:45 – don’t need it, but for somebody who has a chronic urinary tract infection, I always incorporate antibiotics and antifungals as well. And sometimes
33:54 – people are on an antifungal for quite a while, because the bacteria – when you have a disruption
33:59 – in the balance of the body you need to treat everything. And on that same subject, the
34:07 – microbiome in the gut is one of the most important things that you can do to keep that healthy, to try and prevent any overgrowth of bacteria or
34:15 – mold. So the microbiome is really the starting place when you’re trying to get rid of any type of
34:22 – bacteria. So when you’re treating a patient with a chronic urinary tract infection, it’s not only the bladder you’re looking at, you’re like treating
34:28 – the entire body. So what I’ll do is put patients on probiotics if they’re on antibiotics. Even if
34:35 – they’re antibiotics from nature, I always have them take it twice a day. And bifidobacterium has
34:41 – been found to be the bacteria that is most important to have in your microbiome. As infants,
34:48 – we have a robust amount of bifidobacterium. Mothers who are breastfeeding are giving their
34:56 – infants a robust amount of bifidobacterium, but then we start eating. And we start eating, not the
35:02 – healthiest diet. We start eating, you know, the fun stuff, especially when we’re younger, and we start depleting our microbiome of all of the
35:08 – really healthy bacterias. And that’s really how the disease process starts. So the
35:14 – neurotransmitter – neurotransmitters that are used in the brain, your dopamine, serotonin,
35:22 – epinephrine, norepinephrine, actually is made in the stomach. So if you have a poor microbiome
35:30 – here, you’re going to have anxiety, depression, you know, a lot of psychiatric disorders, because
35:36 – you have faulty neurotransmitters being used in the brain. So you have to, like, treat the entire body to get everything healthy. So it’s not, I
35:45 – know, you know, in medicine, we tend to have, we have a urologist and we have a nephrologist and we have a cardiologist and we have a neurologist.
35:52 – It’s one body. You have to treat the entire body. Melissa: Yeah, and I think this is often the
35:57 – problem for patients, and that’s what they express themselves. They’re trying to find someone who look at it more holistically. When you do have a
36:04 – course of treatment in place, how long does it usually take for people to feel like their symptoms have resolved?
36:09 – Dr. Pamela Cipriano: It – that really varies. So it depends on how long you’ve had it for and how severe it is. If it’s in the bladder wall, it’s
36:16 – going to take a lot longer. But generally, I want to say a starting point is a month on start
36:23 – antibiotics, and it’s really based on patient symptoms. The average is probably three months on
36:29 – antibiotics. But like I said before, I always incorporate supplements and herbs, so when I can
36:37 – get them off of the antibiotics, they’re going to stay on something that’s going to help to decrease the overgrowth of either fungus or bacteria,
36:46 – really, for the rest of their lives. And again, these have health benefits, so it’s not like an antibiotic that’s going to be killing off all
36:53 – bacteria in your body and causing an overgrowth of fungus now, because we’re trying to keep everything balanced. These are things that are
37:01 – from nature, so they’re not synthetic, like the medications are, and the body accepts it a lot
37:06 – easier and a lot better. They don’t always work in the acute phase where you have to use the antibiotics, but I had – I had patients that
37:15 – really refuse allopathic antibiotics, and so we will use all supplements and herbs, and they do
37:22 – eventually get better, but it does take a lot longer. Melissa: Okay, what about for patients who might have Hannah’s lesions? Have you seen that they’re
37:29 – also able to resolve their symptoms and their chronic bladder pain? Dr. Pamela Cipriano: So, they can definitely be – so that’s because of the inflammation that that’s
37:37 – formed from, so it’s really an irritation of the bladder, of the bladder wall itself, and that’s
37:43 – what causes a lot of those lesions to be produced. So, you know, cranberry juice is a great thing to
37:51 – try and decrease the bacteria, but something like that, you wouldn’t want to use that because
37:57 – there’s already so much irritation and so much inflammation in the bladder wall that we want to try and do something to suppress it, and that’s a
38:04 – balancing act, because for you to get rid of the bacteria in the bladder, you have to keep that pH
38:10 – of the urine to at least 6.0 or lower. And that’s why I would generally tell people to start
38:17 – something like cranberry juice. But in that case, I would probably tell people to try apple cider vinegar. So apple cider vinegar isn’t going to be
38:24 – as irritating to the bladder wall that like pure cranberry juices, but it still has the
38:30 – antimicrobial effects, and it still helps the bladder – the urine and the bladder to stay at
38:35 – that 6.0 or lower pH. Melissa: And do you have any recommendations for bladder pain in general, how to manage that while
38:42 – you’re recovering? Dr. Pamela Cipriano: That’s – that’s probably the hardest thing that people have to go through, is,
38:48 – is the pain itself, and that’s coming directly from the bladder wall, because that, that mucosal
38:54 – lining is no longer there. And so what we’re trying to do is allow the body to decrease the
39:01 – inflammation and allow that mucosal layer to start forming again. And so once we get rid of the
39:08 – bacteria, and once we get rid of the inflammation, that’s when things are going to start improving
39:13 – for them. So the bladder pain is a direct – it’s directly related to the infection itself. And
39:20 – what’s going on with the bladder wall. That does take a long time, because we can be completely
39:28 – free of any mold, any bacteria, and we could have gotten rid of all of the biofilms, and you can
39:35 – still have that bladder pain. So that’s something that does take some time to go away, and when it’s
39:40 – gone, sometimes people don’t even realize, oh my God, it’s gone, like they’re just so used to having that pain, and then suddenly it’s no longer
39:47 – there. And that’s a wonderful feeling for a provider. Melissa: Yeah. And it is a strange feeling
39:53 – sometimes to recover. I remember when I recovered from chronic UTI, it was the absence of symptoms
39:58 – that seemed so strange to me. I. After having them for so long, and it was hard to describe to people this absence of symptoms that I was now thinking
40:05 – about all the time, because they weren’t there. And it’s – is a different experience that it’s hard to relate to if you haven’t been through it.
40:12 – Dr. Pamela Cipriano: It’s very difficult. My – my – when my son was going through this, it was really hard for me to understand the bladder pain
40:19 – he was experiencing because he had never had a urinary tract infection, because guys generally
40:24 – don’t get them, but women get them all the time, and I ended up with this urinary tract infection. I don’t know if I willed it on myself to try and
40:31 – understand what my son was going through. I honestly don’t know, but I’ve never had a urinary tract infection that took a long time to go away,
40:38 – and this one did, and the bladder pain and the feeling like you have to void, was a horrible
40:46 – experience. And I remember calling him in tears that I finally understood what he was going
40:52 – through. And it was like he was like, he wasn’t happy I was sick, but he was so happy that I finally got it.
40:58 – Melissa: I can relate to that. Dr. Pamela Cipriano: Because if you don’t experience it, you don’t know what people are going through. Melissa: Yeah. Dr. Pamela Cipriano: You really don’t, and I don’t
41:05 – want to wish any anyone sick, but you really do have to experience what your patients are going
41:10 – through to really understand why they are having such symptoms and why they’re so anxious and
41:17 – they’re just trying anything to get relief. Melissa: Yeah, it really does help to better understand the impact on the quality of life and
41:24 – how it does impact every area of their life. And I think if you haven’t been through it, it’s really difficult to have that insight.
41:31 – Dr. Pamela Cipriano: I agree, I really do. Melissa: So if patients are interested in working with you, how can they get in touch?
41:37 – Dr. Pamela Cipriano: So, I work at the practice of health and wellness. I’m in Thomaston, Connecticut. You can go on our website, which is
41:43 – thepracticeofhealthandwellness.com. Our phone number is 860-880-2525, and you can meet us. You
41:51 – can see us on Facebook or on Instagram. And I’ve been doing a number of podcasts, so I hope you see
41:57 – some of the other podcasts that I’ve been doing as well. Melissa: Great. Well, we’ll be sure to add the links to the video description so people can find
42:02 – you more easily. And thank you so much again for sharing your expertise with us. Dr. Pamela Cipriano: Thank you so much for having me. This was a pleasure.
42:08 – Melissa: Thanks so much for watching. I hope you found this expert video helpful. If you’d like to learn more about this and related topics, be sure
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