The Impact of Mycotoxins and Chronic Illness on Hormones

Margaret Christensen, M.D.

Thank you so much, thanks for having me.

Nafysa Parpia, N.D.

Thanks for being here, Very happy to have you here. So today, we’re gonna be talking about mycotoxin illness and hormones. Dr. Christensen, what kind of hormonal imbalance can you see with mycotoxins?

Margaret Christensen, M.D.

Really pretty much any system. In doctor talk, we called it the HPA axis, the hypothalamic-pituitary-adrenal axis. Although anybody who’s really been doing functional medicine and whole systems medicine for a long time know it’s the hypothalamic, pituitary, adrenal, gonadal, gut, you know, everything is connected. So we can see hormonal dysfunctions across the broad range. So certainly in terms of women’s hormones, everything from infertility issues to things like endometriosis, uterine fibroids, early menopause, heavy bleeding challenges, that can all be there. In the realm of metabolic dysfunction, that would be diabetes and insulin resistance. That’s a huge nother piece. Of course, we know this is incredibly stressful. 

These mycotoxins and just the whole thing that surrounds mold is just so much stress to the whole body so our adrenal glands become involved and our cortisol and adrenaline. And then because oftentimes, we are breathing these things in through the nose, we’re getting a lot of brain and neuroinflammation. And then all the neuro-transmitters become affected. And as you and I both know, we know that so many different hormones in the body are metabolized in the gut. And so when the gut is also compromised because of mycotoxins and biotoxin illness in general, again, you can pretty much see any system affected. 

Men as well. So with men, we see a lot more of the cardiovascular disease and also things like erectile dysfunction. But certainly, we can see abnormalities in testosterone levels as also very common. And then, I didn’t even mention thyroid. So the thyroid gland is in there as well. And we certainly can see problems with triggering things like Hashimoto’s thyroiditis. And antithyroglobulins can go pretty high also in toxic mold illness. So pretty much whether you’re talking about sex hormones, whether you’re talking about thyroid hormones, whether you’re talking about adrenal hormones, whether you’re talking about metabolic hormones like insulin and cortisol, any area can be affected.

Nafysa Parpia, N.D.

Great. So I heard you mention the sinuses. I think that’s a big overlooked issue even amongst functional medicine doctors and naturopathic doctors. And it’s one of the first places that I treat. Sometimes I might even treat there before the gut. Usually I’m treating the gut first, but sometimes people’s sinuses are just screaming so loud. So in most of my patients with mycotoxin illness, I’m seeing a lot of brain fog, a lot of energy depletion. And once we clean up the sinuses, they really turn a corner. And I’d love to hear you talk about that. I’d love to hear you talk about the olfactory nerve and how that impacts the rest of the nervous system, the vagus nerve.

Margaret Christensen, M.D.

You know, that is such a huge piece of the equation and when we are breathing in poor air quality, just poor air quality in general, too. So this can be somebody who lives near a freeway or in a polluted city or, you know, just even using a lot of, for example, fake fragrances and things like Febreze and PlugIns in the house, you know, separate from toxic mold exposure. But with toxic mold exposure in particular, it’s incredibly irritating to the sinuses and creates a lot of sinus inflammation and also to our smelling nerve. That’s the olfactory nerve. So that’s the oldest sense that we have. And you can find it in any… You know, the most primitive of one-celled organisms, they have this chemotactic or smelling sense of their environment. So it’s a very old sense. And when we’re breathing in into that olfactory nerve, it’s a very short nerve, but it goes right from the back of our sinuses right into the brain and in particular into the area of the brain that’s called the limbic system. And it’s passing along the way the pituitary gland. But the limbic system is composed of three major parts. 

Again, this is simplified, but we’re talking about the hypothalamus. That’s the master regulatory center of the brain. So all hormones are regulated through the hypothalamus along with gut function and GI, and all the kind of the automatic body systems are all feeding into the hypothalamus which is then directing the pituitary gland, you know, hey telling the body: Is it safe or not to reproduce? Is it time to eat? And do we have sex? I mean, do we sleep now? All of those things. So I didn’t mention melatonin too. That’s another hormone that’s involved there. So hypothalamus. And then the amygdala is the part of the limbic system that’s always scanning the environment for uh-oh, uh-oh, uh-oh. Is a tiger gonna jump out and bite me? And the amygdala is what is communicating directly with the adrenal glands to say, run-fight-or-flee, you know, fight-flight-or-freeze. And then the hippocampus is the memory center in the brain. 

And that part is what’s remembering sights, sounds, smells, tastes, trauma to tell the amygdala, uh-oh, run-fight-or-freeze, and to tell the hypothalamus yes or no, turn this on or turn that off. So those three components of the limbic system are running completely automatically in the reptile brain. And they’re running all the time. And when you have the olfactory nerve getting inflamed and toxins traveling along that nerve right back into the limbic system, it sets it on fire. And on top of that, if you’ve had any kind of head, neck or spine injury, or any head trauma at all, again, that creates neuroinflammation. 

And then if you have gut issues, we know that the vagus nerve, which is connecting the gut, the heart, lungs also, and into the brain, again, right there into that limbic system area, you can get inflammation coming up from that way. So when you have chronic inflammation in your sinuses, whether it’s chronic infections or just chronic drainage and allergies, that olfactory nerve can really stay irritated and stimulated all the time impacting all hormonal systems in the body. And you and I were talking about mast cells a little earlier. And it’s also a big trigger in the mast cell area.

Nafysa Parpia, N.D.

Yeah, it’s such a huge topic. It’s truly overlooked. So I’m just so happy to hear you talk so much about this. I know you talked about this on your own summit as well. So thank you for really exposing this piece. It’s a huge one.

Margaret Christensen, M.D.

It’s so important. I’m sure this is what you’re doing assigning. You may have somebody else talking on this summit. But you know, again, the importance of doing sinus rinsing. And then we use different types of botanicals and prescription antifungals to treat this area. It can be huge. It can make a huge difference.

Nafysa Parpia, N.D.

Yeah, I often have people use nebulized Argentan silver. I found if they do it five times a day for two weeks, it really helps create an entryway to come in with amphotericin or whatever else is needed. And I also use nasal probiotics. Have them do that at the end of the day and rub a little bit of coconut oil on the inside of the nostrils to keep it moist in there. So it’s an environment to help with killing off the infection.

Margaret Christensen, M.D.

Those are all good things. Yeah, you can use kimchi in your nose too.

Nafysa Parpia, N.D.

Yeah, exactly.

Margaret Christensen, M.D.

Use some probiotics too.

Nafysa Parpia, N.D.

Yeah; in fact, the probiotic I use is from kimchi. Yeah, yeah. I think it’s called naso-biotics. Yeah. So tell us about how mycotoxins impact all hormones. If you could start with the female sex hormones first, that would be exciting.

Margaret Christensen, M.D.

I think that, again, there is different mechanisms that how mycotoxins are impacting. So there’s both direct and indirect. So direct mechanisms would be that the mycotoxins themselves can imitate or mimic what a hormone looks like and can impact or turn on the receptor for thyroid, for testosterone, for estrogen. So we’ve seen that. And there’s a particular mycotoxin called zearalenone. People say it in different ways, but it starts with a Z, that has very profound estrogenic components. But we also know that some of the trichothecenes also can impact directly thyroid receptors and testosterone receptors. So you can have that direct effect on the receptor itself acting like a pseudo hormone. 

So that’s one way hormones are impacted. And the second way are things that we already talked about, is, again, you’re creating this inflammation in the area of the brain in the limbic system and the hypothalamus impacting the pituitary gland that is directly responsible for signaling hormone production. And so, mycotoxins can impact hormones that way. And that’s a little bit more indirect. And then you have, again, mycotoxins impacting the metabolism of all the different hormones, for example, in the gut, because mycotoxins have such an impact on the lining of the gut itself, on the enterocytes, or the cells that line the intestines, as well as on the microbiome of the gut which we know is very, very involved in appropriately metabolizing hormones. So just there in those things alone. And then you have things like in the liver. 

Again, mycotoxins can really impact many different detoxification pathways both in the liver and kidneys. And so, those also can then influence hormone production. And then you have the whole problem of mycotoxins turning on the immune system, or creating auto-immunity and attacking things like the thyroid. You can also see it with the ovaries and, again, in antibodies against ovaries and testes. And then with leaky gut itself, that also creates it. And then all the stress hormones that are made, just trying to deal with this whole thing in the body is in fight-or-flight all the time. So you can see, again, the very broad range of hormones. And so, and did you want me to specifically kind of delve into a little bit of the women’s hormones?

Nafysa Parpia, N.D.

That’ll be great, yeah. Especially you as an OB-GYN, I’d love to hear your thoughts on this, ’cause now you’re pushing it from two different angles.

Margaret Christensen, M.D.

Yeah, so absolutely, yeah. You know, sleep disturbances is another huge impact too. And that also makes a huge difference in terms of all metabolism of hormones. And then, you know, when you’re chronically sleep deprived and you’re anxious all the time and, you know, impacting the neurotransmitters, that can affect everything from PMS to, again, fertility. So let’s just talk about some of the common things that I’ll see. From leaky gut, we get endometriosis. That’s one of the mechanisms that we see with endometriosis besides what we call retrograde menstruation. But I really think that a lot of endometriosis has to do with the fact that when you have increased intestinal permeability, you are actually weeping cytokines across the lumen of the intestines. And they’re kind of dripping down into the bottom of the pelvis on the peritoneal tissue. 

So we have this sort of Saran Wrap that is called peritoneum that lines all of our pelvis, and it covers all of our intestines. And in that, our cells that can become very irritated by these different toxins and they can contribute to endometriosis inflammation. So we start, again, gut healing helps with that. Because of the estrogenic effects of some of these mycotoxins, we can see very large fibroids. I have seen some huge fibroids among women who have been in moldy situations. Now there’s often genetic predispositions to that. But because there’s so much inflammation created, that inflammation is turning on a hormone that turns our testosterone into estrogen, both for men and women. So you see men with, you know, man boobs. But women too, again, you’re stimulating both weight gain, fibroid growth, et cetera. 

Infertility and miscarriages are another thing. I mean, this is very well known in the animal literature. We know that exposure to mycotoxins in grains is one of the things that creates miscarriages among, you know, cows and pigs and sheep that are eating those things. So it’s been well known in that particular arena. So anybody who’s had recurrent miscarriages and then this history of chronic sinus infections and all that, I mean, they need to get worked up for mycotoxin exposures. So those are common things I see in some of the younger women. And then, of course, you can certainly exacerbate PMS, PCOS as well, because you can get disruption in insulin metabolism and that contributes to polycystic ovarian syndrome. And then the PMS with all the irritability, the breast tenderness, the anxiety, depression, mood swings, et cetera, that’s all those neurotransmitters in the brain and in the gut being affected. 

So those are, you know, a whole wide range of things that can happen. You know, in my case, early menopause it triggered. I was in my, you know, early 40s with my initial exposures. And so that is, you know, another thing that we can see. And in both men and women, we can see a lot of hot flashes and night sweats. Again, I know that you see that with Lyme as well. But when you’re having a lot of night sweats and you’re premenopausal and/or you’re a man, I’m wondering: Okay, where’s the mold exposure coming from and/or do you have one of the co-infections with it? So those are the common things that I see from a gynecologic and fertility, and very heavy bleeding also. You can see super heavy bleeding.

Nafysa Parpia, N.D.

Thank you for this. One thing that I don’t think I’ve heard anybody speak about except for you, Dr. Christensen, is about leaky gut leaking down into the pelvis. That makes so much sense. Nobody talks about that.

Margaret Christensen, M.D.

Yeah, and there’s some interesting data when I’ve given lectures for IFM in their Applied Functional Medicine Clinical Practice Course on the women’s hormones piece and also in the Advanced Practice Module. You know, we talked about some of the data looking at, again, this transudation. I kind of explain it to people, you know, when you scrape your knee and you’re just kind of scraping the skin and it kind of bubbles up and you get this kind of clear stuff, that’s kind of the same idea is that you’re getting these clear transudates across through the intestinal tract and which is draped all over our uterus and ovaries and it goes down into our pelvis. And again, you can create so much inflammation there. And also, that also impacts the gut.

Nafysa Parpia, N.D.

Right, and I’d love to hear about fertility. And so how can fertility be impacted by mycotoxins 

in both men and women? And I imagine that piece of the leaky gut has a lot to do with that as well.

Margaret Christensen, M.D.

Yeah, no, hugely. And again, because it’s a hormonal disruptor and it’s an abortifacient too. I mean, again, that’s what is seen in the animal studies. So you can can end up having multiple miscarriages. Again, men’s sperm counts and their testosterone levels can be markedly impacted. And we certainly see in men, you can get erectile dysfunction as well. And then again, you can have infertility for all the reasons that I just talked about: the PCOS, endometriosis, uterine fibroids, short abnormal cycles, low levels of progesterone, all of those things can be impacted in various ways.

Nafysa Parpia, N.D.

Right, so a lot of the times, these patients will just go to an OB-GYN or their primary care doctor, and they’ll get put on hormones, oftentimes synthetic hormones, but the gut’s not addressed. And the limbic system’s not addressed. Detoxification pathways are not addressed. And then, they get put on these hormones and then there could be a negative effect. Let’s talk about that.

Margaret Christensen, M.D.

Okay. Yeah. Well, yeah. I mean, that’s a big thing. You know, I mean, people get IVF. They get put on birth control pills. And all those things can work, but then you have the problem that if you’re still full of mycotoxins, they can also be passed on. And they’re fat soluble. Anywho, so you know, that’s something we see as well. Again, we can see more problems during pregnancies as well: hypertension, you know, failure to thrive, failure to grow, those kinds of things. That’s for somebody who’s very severely sick. And yeah. I recommend women take phosphatidylcholine during pregnancy anyway, PC. We both talked about using that as a…

Nafysa Parpia, N.D.

Right, and then when people have dysbiosis, then they’re not able to metabolize their hormones.

Margaret Christensen, M.D.

That’s right.

Nafysa Parpia, N.D.

And then there’s more of a mess. So I think clearing dysbiosis first is important.

Margaret Christensen, M.D.

Yeah, so you and I talk. I mean, we do a lot of the same things. So we, again, start with, we got to clean up the sinuses and then we address the gastrointestinal tract. And this is the order I do things. The sinuses and the intestinal tract at about the same time, start working on opening the lymphatic and drainage systems in the body, and then start up-regulating detoxification mechanisms.

Nafysa Parpia, N.D.

Me too, I follow the exact same pathway.

Margaret Christensen, M.D.

And then, you know, unless somebody is like super, super sensitive and having a lot of mast cell issues, then you need to start with those things first.

Nafysa Parpia, N.D.

Exactly.

Margaret Christensen, M.D.

But I don’t do any kill protocols, like, you know, killing off Candida or killing off Lyme or dysbiosis or anything until I’ve gently worked on those other areas first.

Nafysa Parpia, N.D.

Me too. And I find that if I don’t address… With my patient load, ’cause they have a lot of tick-borne illness and their mast cells on a hair-trigger, so if I don’t address mast cell first, they can’t even handle detoxification therapies. And if I don’t address detox before killing, they can’t handle the killing. So following that order is so important. Tell me how you address the limbic system dysfunction to improve hormone imbalance.

Margaret Christensen, M.D.

Well, that’s a great question. So again, what happens with the limbic system that we talked about involving the hypothalamus, the amygdala, and the hippocampus is that it gets turned on and it gets kind of stuck in this fight-or-flight mode all the time. And this is running completely unconsciously. And if you have a history also of growing up in less than optimal circumstances and having what we call adverse childhood events: growing up with abuse or traumas or alcoholism or neglect and/or any point in life experiencing any of those things, as well as just the trauma and PTSD of being sick for a long period of time and often going from doctor to doctor, and, you know, nobody recognizes that this is what’s going on. 

So oftentimes we see folks who have been, have had a lot of adverse childhood events and/or trauma in their life. And so their limbic system is already, they’re in fight-or-flight already from those things. And then they’ve been sick for so long that they feel like crap. Nobody’s helping them. Everybody’s just telling them they’re crazy. You just need, here’s your antidepressants. And then you’re having all the side effects from those medications as you do from, you know, the fertility stuff. And so again, that’s pretty traumatic. And then if on top of that you’ve also had any kind of head, neck or spine injuries: so any kind of concussions, whiplash, bad falls, even things like as a kid being hit a lot on the head and/or using large firearms, falling out of trees, off of horses, off of slides, off of fences, off of bikes. 

And we do the Dr. Ayman thing, which is you have to ask somebody 10 times whether or not they’ve ever had a head, neck or spine injury. So all those things together create neuroinflammation, any one of those things by itself. But so many of our clients that you and I are seeing, they have all three of those things. They have traumatic brain injury, chronic stress and PTSD symptomatology, and then biotoxin exposure. Any one of the three which can trigger limbic system activation, but you put all three together and that limbic system has been on for years.

Nafysa Parpia, N.D.

Right, right.

Margaret Christensen, M.D.

And you and I both know that we can get rid of the Lyme. We can get rid of the mold. We can treat everything, but people are still symptomatic. And nobody’s ever addressed how do you calm the limbic system. I’ve used a couple of different programs. And again, you know, I’ve learned at the foot of Dr. Neil Nathan and other greats, you know, who’ve come before. I use Annie Hopper’s DNRS program at retrainingthebrain.com. I’ll also refer to Gupta Amygdala Retraining, and per Dr. Neil Nathan’s recommendation using BrainTap, BrainTap advice. 

So those are good ways to do it. I’m also very lucky that we do have a functional neurologic chiropractor here at Carpathia who does a lot of work with also some brain retraining. But we’re really trying to get that limbic system calmed down. I have people quit watching the news. You cannot watch anything that’s negative, that’s intense, that’s gonna get your adrenaline up; only funny things, only laughter, joyful, playful, benign. You can watch gardening shows. And I like watching house remodeling shows. But for some people, that’s very traumatic, especially if you’ve had to do remodeling yourself.

Nafysa Parpia, N.D.

Right, right.

Margaret Christensen, M.D.

Comedies are good. But yeah, you can’t watch anything that’s really stimulating there. And again, really super good self-care, trying to get yourself into bed, really improving sleep quality. Those are all ways to address the limbic system that you can do. You can do tapping as well. I do. We do a lot of that. I use alpha stim units. I have a very old alpha stim unit that I’ve had for, I don’t know, like 20 years now and we recommend to patients. So these are all ways to address… And at the same time you’re doing the limbic system, you also need to do the vagus nerve, so vagus nerve activation: singing, gargling, humming, the Thymus Thump, laughing, smiling. And many of those things are incorporated into the two different limbic system retraining programs that I use. But all that’s really important to activate that vagus nerve, get it calmed down. And then to use the limbic system, you have to ummm, to really chill out.

Nafysa Parpia, N.D.

Yes, we use the exact same techniques actually. Of course we do. We practice so similarly. Yeah. Is there anything else that you’d like to address that we haven’t covered today?

Margaret Christensen, M.D.

On hormones, well, I think you know some of the other things that can be helpful would include using some peptide therapy. So I will use nasal VIP. Not for everybody, but that can really help with bringing back memory.

Nafysa Parpia, N.D.

I also you’d Selank or C-max.

Margaret Christensen, M.D.

Oh, I haven’t tried that one. Okay, that’s a good one.

Nafysa Parpia, N.D.

Those are great.

Margaret Christensen, M.D.

I’ll use RG3 Synapsin also as an anti-inflammatory. It’s a nasal peptide that can be used to help stimulate new neural growth, especially with these complex brain injury folks. And then BPC-157 can also be used intranasally and help with a lot of SIBO and gut symptomatology to kind of get things moving. So those are some of the things that I like to do. I think it’s just also really, really important to work every day on, you know, focusing on hope and joy and whatever you’re grateful for because that can also really help to turn things around. This is a complex topic, as you know, and it can be overwhelming. So just one day at a time, and just focusing on what kind of the next right steps are can be super helpful. I probably would say I use a lot of natural progesterone. Natural progesterone is very calming for the brain and for the nervous system. 

It is often very depleted in folks who have been under a lot of adrenal stress and who are having heavy periods and bad cramps. And so natural progesterone, either topical or orally, in the second half of the menstrual cycle. If you’re using something topical, you can do 25 milligrams a day; orally, 100 to 200 milligrams a day. That’s a prescription though. And then, you know, perimenopausal, you gotta use it a little differently: three weeks on, one week off. And postmenopausally, just depending on the situation. I may have somebody on it continuously. So I think a natural progesterone is a very useful tool to help in a lot of the hormonal imbalances. It does so many different things.

Nafysa Parpia, N.D.

And then what about when a woman needs estrogen as well? How do you…

Margaret Christensen, M.D.

Oh yeah. So again, so what I’m doing first is really cleaning up everybody’s diets and getting things working. And I have like a 10-day hormone flush protocol that we also do to help get rid of the excess estrogens. And then, doing hormone replacement therapy, I’m using a bio-identical very low dose. I use biased, so it’s mostly estriol and a little bit of estrodiol. People do a lot of different things a lot of different ways. But I use that and have used it very successfully for a long time. I tend to use a lot of things vaginally. I’ll just use a little bit of testosterone vaginally. That can be super helpful. You can use smaller amounts when you’re using things, you know, mucosally. Some people use sublingual troches and all that. I don’t like that because to me that’s still using stuff orally. You’re still swallowing a lot of that. 

My preference is not to use oral estrogens because what you’re doing to up-regulate or increase your liver metabolism and some of the clotting factors, which are already problematic in mold. So I avoid oral estrogens. Oral progesterone can be okay. My preference is transdermal estrogens and testosterone, and preferably vaginally. Also, DHEA can also be used very successfully vaginally and can really help also with preventing bladder infections, preventing vaginal infections, helping with vaginal dryness, painful sex. As you and I both know, many, many, many women get yeast infections ’cause they’ve been on tons of antibiotics ’cause they’ve been sick all the time from the mold. So not only are they getting external mold and mycotoxin exposure, now they have internal fungal overgrowth from yeast and…

Nafysa Parpia, N.D.

Exactly, yeah.

Margaret Christensen, M.D.

So I use antifungals fairly liberally too, both botanicals and prescriptions.

Nafysa Parpia, N.D.

Me too. Well thank you so much.

Margaret Christensen, M.D.

You’re welcome.

Nafysa Parpia, N.D.

Would you like to tell about your gift?

Margaret Christensen, M.D.

Yeah, yeah. I have a program through molddetoxdiet.com, which is for lay individuals to help them walk through this whole process and we can kind of look at our protocols. And we have little free snippets from each of them. There’s eight modules in that. And so, we can offer that as our free gift. If you are a practitioner and are watching this, Dr. Gail Clayton and I created the Advanced Mold Immune Module to really help people understand the whole role of what mycotoxins do to the immune system. And it’s not just about mycotoxins. It actually is learning about Th1, Th2, you know, polarization and the polarization of actually all the T-cells and mast cells. If you’re a lay person, you don’t have to know any of that. But most people have heard of mast cells at this point. So we delve deeply into how to address that. And that’s quite advanced, although we’ve had some lay folks who are, you know, bio-hacks and geeks take that course. So we do have a little snippet of each of the modules on that too. So I’ll make those available to your participants.

Nafysa Parpia, N.D.

Thank you. And can that be found on your website too?

Margaret Christensen, M.D.

That’ll be found at molddetoxdiet.com. Yeah. So my website is carpathiacollaborative.com. But for the practitioners and for the lay people wanting to know exactly kind of what to do immediately, molddetoxdiet.com has those two different ways you can do it.

Nafysa Parpia, N.D.

Great, well thank you, Dr. Christensen.

Margaret Christensen, M.D.

You’re so welcome.

Nafysa Parpia, N.D.

Pleasure to have you.

Margaret Christensen, M.D.

It’s nice to meet you too. Alrighty. Good luck to everybody.

Nafysa Parpia, N.D.

Thank you.