Discover How Mold Toxins Influence A Child’s Brain

Ann Shippy, MD

Welcome to another episode of the Mold, Mycotoxin, and Chronic Illness Summit. I am your host, Dr. Ann Shippy, and today we get to talk to Pejman Katiraei, and the hardest part of the interview is saying his name. Because the rest of this is going to be amazing. He is a board-certified pediatrician. He has done two fellowships in integrative medicine. He is so passionate about helping children who are having very severe behavioral challenges get better and fully heal. He has worked with hundreds of kids who have healed. He is very excited to share some of the things that will help bring hope to difficult situations. Thank you so much for joining us.

Pejman Katiraei, DO

It is my pleasure. Thank you for having me and holding this space to allow people out there to hear information to help and know that healing is possible.

Ann Shippy, MD

Yes, that is what it is all about. I have this saying: You can only be doing as well as your least well child. It is just hard to be in a world where your children are suffering. I think that something that resonates with all of us is helping the children. I would love it if you shared a little bit more about your journey and how you came to this place where you have this passion for helping children and where you got to know so much about mold toxicity.

Pejman Katiraei, DO

Yes, absolutely. I think this is the best way to start, my childhood. As an eight-year-old or ten-year-old. I had pretty significant anxiety. Sometimes I do not want to leave my room. My adolescence and teenage years had some pretty impressive levels of depression and not wanting to be here experienced. Part of why I initially got into holistic medicine when I came out of residency was because I just wanted to better understand what was going on.

 Because in conventional medicine, after I finished my residency, there were so many gaps that I could see earlier on. It just does not make sense. We just say, Well, things happen. Anxiety happens; autoimmunity happens; this happens; it does happen. I wanted to find some other answers, and I wanted to find some answers to help myself. The journey that I have had since then has been one to understand myself and that I serve. Because it turns out that my physiology is very similar to a lot of the kids that I take care of. I am a highly sensitive person, and it turns out that a lot of the kids that I take care of end up having PANS and PANDAS, and weirdly, neurological and behavioral issues have similar physiologies. It is just, I think, part of the fragility of a certain physiological makeup that makes us vulnerable to certain things—mold, and toxins.

Ann Shippy, MD

Hey, we are the canaries in the coal mine, and it is so helpful that we get to learn about our physiology, not only to have a better understanding of what people are experiencing but also to try to figure out the nooks and crannies and the complications that got them there.

Pejman Katiraei, DO

Yes. It was just, I think, for the experience I had every time I saw a child struggle. It is just that there is a part of my heart that gets torn a little bit because I can sense their pain. I can experience what they are experiencing. I can sense they are overwhelmed. It has made this journey that much more personal for me to get into the root causes of why things happen. Ultimately, how I got into mold was that I learned a bunch of things and tried a bunch of things. At one point, I was injecting B12 injections into myself, taking gobs of folate, doing gut things—just about everything you can imagine. I have tried it on myself and through my patients, and some things worked. But I also had some children who were just not getting better. 

I remember there was one dear boy, brilliant child, loveliest kid, loveliest family, and he was just falling apart. Extreme anxiety and aggression are typical PANS presentations. I was out of tricks. I had no idea what to do. The mom was like, “Hey, what about mold?”, I just shrugged my shoulders and said, “Yes, sure.” I have no idea what the heck is going on. I have added nothing to this conversation. Why not? That is how I came to know Dr. Neil Nathan, who has become a dear mentor and friend, and Neil helped open up my eyes to mold. That was close to four years ago. Early on, when I came to understand mold, my first thought was, Well, I do not want to deal with this. I have already done enough training. I do not want to become a mold person. Let me find someone else. I started looking, and I started looking to see how many good pediatricians were out there that were dealing with this. I started finding, “God, there are not too many of us.”

Ann Shippy, MD

There are none.

Pejman Katiraei, DO

I could only find a handful in the country.

Ann Shippy, MD

Imagine how many children are getting missed because of that. It is, indeed, such an epidemic. To have so few of you out there, it is great that you are doing this talk today to share because I think there are so many pediatricians, too, who want to help the children that they are caring for. Just the parents asking the question, could it be mold, and having an open-minded physician rather than somebody who is closed-minded say, Hey, yes, let us think about that, let us go investigate it further, is huge.

Pejman Katiraei, DO

Well, thank you. I have got to say, I’ve been guilty of being that closed-minded provider. When I look back, I am like, “My God, how many cases of mold did I miss?” I think through these conversations and through the beautiful work that you are doing we can bring awareness and change things, and I know that is why you do all of this work, it makes the world a better place.

Ann Shippy, MD

It does. Okay. You open your eyes. You’re okay; I’ve been missing this. What happened next?

Pejman Katiraei, DO

I am becoming terrified.

Ann Shippy, MD

Yes, it is a lot to learn very quickly. Mm.

Pejman Katiraei, DO

It was a lot to learn. But the more I dug into it, the more concerned I became. Because when I started looking at the mold, what did the mold toxins do to human physiology? Then, as a pediatrician, I started asking, Well, how does this play into things for the fetus? Because mold toxins pass through the placenta, they concentrate in breast milk. I started asking myself, What does this do to the baby’s microbiome? What does it do to the baby’s immune system that is priming itself in the first year or two of life? What happens to the nervous system when you have, essentially, neuronal pruning and the neurons start forming the appropriate connections that give us a healthy experience of life? As I started looking at it and started looking at, well, my God, mycotoxins are inherently anti-microbial; penicillin comes from mold. Mycotoxins cause neuronal damage. They disrupt neuroplasticity, and they disrupt the mitochondria. The more I dug into it, the more terrified I became in terms of what this was doing to children. We are barely scratching the surface of our understanding of how this is playing out.

Ann Shippy, MD

There are so few studies on humans. It is mostly on animals. What we see with the animals is terrifying. It is a whole area of understanding that needs so much more research. But just to say exactly what you are saying, we know enough of the mechanisms, and we know that children are so much more susceptible than adults are. It makes sense to be looking at this for almost every child, even preventively, do you think? Prenatally, before you get pregnant, make sure your body is clean. You are not going to be passing those mycotoxins on to the baby.

Pejman Katiraei, DO

Hallelujah. Yes. I think as we have, we get to a place of having these discussions. What intrigues me is: how much disease can we prevent? How much disability can we prevent? Considering that at least 10%, if not 40%, of people are living with mold and have no clue, this is not just 100 people; these are big numbers with a big impact. I think we are just totally there; our eyes are close to it now.

Ann Shippy, MD

Until you start seeing these patterns, I would love it for you to go back in case some of the people listening are not familiar with even how we define what autism is, or PANS and PANDAS. Because I think they are, for some people, they never even heard those terms or understood what they were.

Pejman Katiraei, DO

Yes. We have these terms that we give to these conditions, and, for instance, with autism, you look at this huge spectrum. From the poor children who are non-verbal and literally cannot communicate or function to those who do make eye contact, they do communicate, but they have odd sensory experiences. They get anxious, and they lack certain kinds of social abilities. Then, in the world of pans and pandas, this is brain inflammation. We are looking at what intense inflammation in your nervous system does to drive aggression, anxiety, and irritability. These are the poor kids who are completely neurotypical. They talk to you, and they make eye contact, but their anxiety is off the chart, and they cannot leave the house. They have weird sensory things where they cannot handle clothing; they are just completely overwhelmed by the world. 

Most of these poor children have very unusual patterns of aggression and destructiveness, where they lose essentially the ability to manage themselves at an emotional regulation level. Part of what has come up for me is that when you start looking at the mechanisms of what mold and mold toxins do, a lot of very interesting answers start coming up. For instance, whether in the world of autism or the world of these neuroinflammatory conditions PANS, a lot of the sensory issues that these children have happen to be related to histamine imbalances. We typically think of histamine as just, I am congested, and I have got hives. It is just the EMT dermatologic thing that we think of as histamine. But when we take Benadryl, what happens when you take Benadryl, an antihistamine? You knock out, and how, Benadryl?

Ann Shippy, MD

Yes.

Pejman Katiraei, DO

Histamine is a very important regulator of the sympathetic nervous system. It goes beyond that in the sense that histamine also causes massive sensory distortions. It disrupts the vestibular system. All of those quote-unquote ADHD kids who just cannot sit still for the life of them are constantly moving, and their constant need to move is the child constantly activating the vestibular system to try to feel normal.

I have had kids with whom we did huge occupational therapy, just about anything imaginable, and ultimately we found mold. We addressed the histamine issues through some enzymes, and two to three weeks later, the kid is now sitting still for the first time in their life. I had kids who had PANS and PANDAS, autism, or extreme sensory issues. The kids could not go to church, could not go to the beach, and could not handle clothing. There’s one poor little girl who literally could not wear any clothing, not even underwear. She was six, which meant she could not go to school. Fast forward, regulate histamine, balance histamine, and address the trigger for histamine. The little girl is now wearing all her clothing and happily going to school, thriving. A child who is autistic is going to church, going to the beach, enjoying the beach, and having their feet in the water, which they could not handle before. As you start stepping back and letting go of the diagnoses in these labels and just seeing what is driving this child’s experience in this version of reality that they have, why are they anxious? Why do they become angry? Why do they have this intense fear response? Why do they have these sensory issues?

Ann Shippy, MD

I think it helps siblings and parents of these children to understand that it is physiological; it is their nervous system being out of balance, their immune system being out of balance, etc., and their microbiome being out of balance. All these things mean that they are struggling, and they are not misbehaving because they want to; they are not having trouble putting on clothes because they want to. They are about to crawl out of their skin, and they are doing the best that they can, but they are looking for solutions. I love that you are already talking about some of the solutions. You mentioned this little girl. You gave her some enzymes.

Pejman Katiraei, DO

Yes.

Ann Shippy, MD

What type of enzymes did you use?

Pejman Katiraei, DO

These are diamine oxidase enzymes. They are naturally occurring enzymes in our gut. You just bump up the levels to break down the histamine, and that is helpful. But I want to go back to what you brought up because it breaks my heart, and I see this all the time. Not only does the child get blamed for the behaviors, but a lot of times the family gets shamed, or the child, is, “Why are not you parenting this child? Why are not you disciplining them? Why is your child such a mischievous child?” It breaks my heart because of the thing that happens, and I have seen this, I have had eight-year-olds look at me straight in the eye and they are, “Do you think I am just a bad kid?” if you could just imagine.

Ann Shippy, MD

Heartbreaking.

Pejman Katiraei, DO

What would an eight-year-old have to go through daily to start questioning if they are at their core if they are bad? As a society, I think because of this lack of awareness and just exactly what you brought up, we have so little understanding and ultimately so little compassion for what these poor kids and their families are going through. Part of why I am driven to do this work and to have these wonderful conversations and bring more awareness is that these are not just a few kids. We are probably talking about upwards of four or 500,000 kids in this country, if not in the millions.

Ann Shippy, MD

I would say millions, easily. Because there is such a spectrum. A lot of times, we do not pick it up until it is so severe that they cannot go to school or the family is melting down. There are so many kids that they are figuring out how to get by with it; they need help, too.

Pejman Katiraei, DO

Yes, and I think that the part that you touched on is also important. A lot of these kids go beyond emotional regulation. They are the kids who cannot just manage their emotions, which are, as you said, purely physiological. It is a physiological, physical thing that is happening that is causing their nervous system to lose certain key abilities. But what I also see is that many kids are struggling to learn because of their executive functioning, which means their ability to sit down and do work, their working memory, which we have to use to learn math concepts and science concepts, their ability to focus, and just to hide distractibility. These kids have weird alterations in short-term memory where they just cannot retain any information, oftentimes. then you add to that the weird sensory things that they have. That child that is sitting in the classroom, that has intense brain fog, cannot remember anything, can process things, and simultaneously their brain is picking up on the clock and the friend, tapping the pencil on the table, and countless other things.

 When these children experience this, the other thing that I see is these kids coming to a place where they are saying, “I am just too dumb.” I have had multiple kids say, I am stupid.” These are the words that come out of these little kids’ mouths. “I am just too stupid; I am too dumb. I am no good at learning,” As you said. They just give up. They give up because if you struggle every day if you struggle every day to learn, if you struggle every day to manage yourself, why would you want to continue if you think you are just a failure and you see your friends are learning math? These leads are thriving. It becomes easy for them. Then you look at yourself and say, “Clearly, not coming easily for me.” As a society now, what do we do? We say, “Well, some kids just have learning disabilities, and some kids are just less smart than others.”

Ann Shippy, MD

It is so not true. All the things that you are saying now remind me of my son, who is now 21. But when he was in third grade, we were called in by the teacher. Every time she tried to teach something new, he would disrupt the class. He would be so uncomfortable that he would be rolling around on the floor, unable to sit in his chair, and making lots of outbursts. At that point, he would only wear Crocs to school or could not put on socks. Just all the sensory things, eating dinner was hard because his father’s chewing would be too loud. Unfortunately, that was when I figured out we had mold in our house and got moved, got it out of the mold, and within two months, the teacher was so happy with them. Then he went back to his smart leadership ability. But for four months there, he was not able to learn.

Pejman Katiraei, DO

It is tragic.

Ann Shippy, MD

Yes. I am so grateful that my hidden lake declared itself and we figured out what was going on. It was such a long time ago, and before there was as much information out on mold, I was just learning about it. But it is just such a great reminder, especially for children. When they are so resilient, they can heal so quickly. If you get all the pieces of the puzzle to help them heal, I would love to hear more about how you, when you suspect that a child is being exposed to mold, take the first steps to help confirm that.

Pejman Katiraei, DO

Yes. This is where I have started. I have started questioning how we do what we do. I will give you a perfect example. Early on, before I knew any better, I would just do a urine organic test, just to test the biochemistry. To see if there is anything weird in the biochemistry. I would look at the full test as normal and say that this cannot be mold until Neil said, Yes, it is.

Ann Shippy, MD

Sometimes it is totally stone cold, which is normal for the unaware patients who are the most exposed. They are not eliminating anything. Nothing is coming out of the urine, or it is just building up in the body.

Pejman Katiraei, DO

Yes. The same thing goes for the urine mycotoxins we produce. Because God, I thought, had arrived in Mecca, and I found the test, and I have run—I do not know—hundreds of them. I would get these tests that did not look so bad. But at home, the parents were just a mess. Yes, we have had 15 leaks in this house. I am. Well, let us check it out, and lo and behold! A disaster catastrophe of mold exposure is taking place. But, as you said, the mold toxins were not coming out of the urine. That is when I started asking, well, if the urine tests are not fantastic, at $300 or so per test, and if they are misleading. The other organic acid tests are also misleading. What is the alternative? That is where one of my other mentors is. Do you know Dr. Vojdani?

Ann Shippy, MD

Yes, of course.

Pejman Katiraei, DO

Dr. Ari, as some refer to this brilliant man, was one of the first people. Pejman, have you looked at the antibodies and how the immune system interacts with mold toxins and molds? At first, I was like, No. I had no idea that even happened. His son, Elroy, Was one of the first people to say, Hey, I think there is something to this antibody thing. I started checking for antibodies. Many in my community will cringe if they hear this. But one of the things that I found as an effective screening tool is that it is not the only tool, but an effective screening tool in conjunction with other tests. Usually, I will do an antibody test plus a urine test. I found that combination to be dramatically more accurate and sensitive than doing just one. For the antibody tests, I would say 10–20% of the time give a false read. I have had some cases. Where there were horrendous amounts of mold, the antibodies were normal, but the urine showed

Ann Shippy, MD

Yes. If we do have to look at multiple data points, it is helpful to have that as a foundation so that, as we are monitoring our progress, we can know what and whether we are getting things addressed appropriately. It sounds like we are on the same page there. We have some data.

Pejman Katiraei, DO

You do?

Ann Shippy, MD

I do. I do some of both as well. If the urine tests are positive, I find they are helpful and great to track the progress and make sure that we are getting the detox pathways open and that we are eliminating the source of the mold. But the antibody tests can be helpful, too, unless there is enough immunosuppression that it does not show up. Yes, it is great to have multiple pieces of data to know. Unfortunately, some things are covered by insurance and some are not. It depends on what the budget is. Sometimes, if the budget is lower, we just have to go with less data, but if it is possible, it is nice to have.

Pejman Katiraei, DO

Yes, a little hack. I found it, and I forgot who this smart person was who turned me into this. But it turns out that Quest Diagnostics was run in IgG on Cladosporium, Aspergillus, and Penicillium. I have run some side-by-side. Private labs plus these—I know, Dr. Vojdani, no, you need to check the mycotoxins. But one of the things that I have been driven towards is: How do I bring the cost of care down? I am lucky enough to work with those families. They spend as much money as you want; test for everything, in which case. We go for the Rolls-Royce version of the test. But there are also some families looking; we barely are making ends meet, and we need to spend for it.

Ann Shippy, MD

Finances to be able to fix the problem and get the family well. I get that.

Pejman Katiraei, DO

Yes. One of the things that I have learned There is still more; that needs to be done to better understand this. Is it actually through QUEST, which you can check for antibodies against the actual molds? It turns out that Cladosporium and Aspergillus in particular tend to irritate the immune system a lot of times when you check those antibody levels; if they are high, they are usually fairly good indicators that someone’s living with mold.

Ann Shippy, MD

Yes, that dial has been turned up for mold. Yes, well, that is a great tip. Thanks for that. Because if those kinds of things change all the time with the availability at some of the labs, good job.

Pejman Katiraei, DO

Thanks.

Ann Shippy, MD

Yes.

Pejman Katiraei, DO

We have to look outside the box, that is. What. I think. But you entered this domain because you had to for your son. All of us, I think we are all in this conversation because we have to think outside the box. We have to find new ways to find answers. I think the more we say, okay, well, that is how we have done things; how could we do them? Is it better? How could we do it for less money? How could we ultimately get this into the hands of more people? That is how we make change. That is how we do it. Help people get healthier in larger numbers.

Ann Shippy, MD

You start by getting some data on immune system toxin levels if you can. Then what is next?

Pejman Katiraei, DO

Then, if you look and do the testing, and you are, that sure looks molds. The next question becomes: Are you living in it now? Is it at home? Is it in the classroom? I have had some cases where the child I was living with had mold. Three years prior. Their systems were still being affected. It is making sure that there is control over the environment for a lot of these kids with the neuro-inflammatory PANS condition. What I found is that a lot of times their aggression, their intense anxiety, and their intense irritability are being triggered through a mass cell-mediated reaction, almost an allergy-mediated reaction to the environment. Before, when I was still figuring out how the heck to do things, I would just bombard these kids with anti-inflammatory drugs: Ketoprofen, Chromolyn, NSupplement, and Quercetin, and just anything and everything I could do to dump into their system and then. I would just scratch my head. Wait a second, why is this not working? Why is it not moving? Then, all of a sudden, it is because. I missed the mold in the environment. I am sure you have experienced this many times. How easy it is to be misled there!

Ann Shippy, MD

Because mold is pretty hidden and hard to find. Then the school is a whole other issue. In Austin, I have patients all over the place, but especially in Austin, the schools are not great. In Santa Monica, are the schools maintained there? Or do you see a lot of mold problems there?

Pejman Katiraei, DO

They are not bad. We have had some cases where it was very clear that there was exposure. Ultimately, I ended up taking care of two families whose kids were in the same classroom as my mom. Yes, it was weird because the homes were tested and found to be in good condition. Then I asked. Mom, what about the school? Then the mom said that last year, so-and-so was also in the class, and she is a patient of yours. Now that I think about it, half the kids were having anxiety disorders and other unusual things, and it is not good. Yes, it could be hidden. That has been, and I think this is one of the highest and steepest learning curves for me, essentially getting to a place where, through the support of many friends who have taught me how to identify environmental exposures, getting to a place where, if a family says, We do not have mold, we have our house tested. My first response is, Let me see the report. Just about. Every single time, I have seen and am sure. This is us; it is, oh, well, there are no ugly molds that they typically test for. Aspergillus and Penicillium: the outside is fine; they have tested the garden, and the garden does not have this. But the kids’ bedroom had 20 times the level of what the garden had. But somehow, that inspector did not think that. That was a big deal.

Ann Shippy, MD

Sometimes the inspectors do not use the best testing. They are using antiquated testing that is not very accurate. Yes, I just always have to say that I am not an expert in inspecting, but at this point, after 12 years of helping people, that is, I have seen some crazy things in the report. It is a lot of times if they do not find it, the report’s a bit misleading, and if we get somebody who knows what they are doing, then they find it.

Pejman Katiraei, DO

Yes. What have been the weirdest places where you have found mold? Just out of curiosity?

Ann Shippy, MD

That is a good question. Sometimes it is just a very slow dishwasher leak in the hose that has gone underneath the flooring. The wood floor had one patient: it had traveled through the kitchen and the mold. Just that little leak drizzling through, and then through the living room into the master bedroom.

Pejman Katiraei, DO

That is nuts.

Ann Shippy, MD

That is nuts. What else? Sometimes there are problems with the shower plumbing going down and the moisture staying trapped underneath the shower. That is hard to find sometimes. A lot of times, it does not smell like the flashings on a chimney are not being done properly. Just enough rain gets in and travels down into the house, but not enough to show through the paint. The same thing happens with the windows. What about you? Where have you seen it?

Pejman Katiraei, DO

The ones where I was just, are you kidding me? I was also convinced that there was nothing until they found that. We had one family that moved into this beautiful multimillion-dollar brand, a year-and-a-half-year-old construction. When the parents thought I was the weird alien, I said, You guys have mold; how is that possible? This is top-of-the-line construction. Fast forward. The one AC unit they had had four or five AC units. The one AC unit that was feeding the kids’ bedroom area somehow was hooked up by the guy, and this was an AC unit that was a year and a half old. The guy did not hook up the drain properly. That AC unit had just collected all of this condensation, and when they opened up the pan, they took a picture. It was just black mold everywhere. It was so terrifying to think about. Oh, my God, if this is possible, what else is possible?

There were cases where, while the home was fine, there was another family. The home was great. The little girl is constantly getting sick—back-to-back colds, anxiety, sensory issues, etc. The home was tested. Everything is perfect. Another provider had looked; you guys are fine, no mold. Then I looked, and there was mold on the subfloor and just this tiny little speck of a spike in her room. This was just air sampling. I asked, Does the subfloor communicate with her room? Then the. Dad goes, Yes, there is an access door in her closet to the subfloor. They just taped it off, duct taped it, and put an air filter in there, and the little girl got better.

Ann Shippy, MD

My gosh, that is great detective work. I am impressed.

Pejman Katiraei, DO

We have got to help these families. That is why we are here, and that is why you care so much. Why do I take the time to look at these reports? Had I missed a detail? That silly little detail is that there is an access door. That access door leaks air and brings moldy air from the subfloor into her room. That little detail—if I had missed it, I would not have been able to help her. It is what you touched on with your experience with your son. If you do not understand how to see the exposure and ultimately control the exposure, you cannot move the needle. You cannot make these kids better.

Ann Shippy, MD

The toxicity keeps poisoning the mitochondria, the cell membranes, the DNA, and the inflammation. The body is just screaming. Inflammation stays up, and it just keeps injuring the brain and the nervous system. It means you have to get to the root of the source. I would love to hear more of the things that you think help the kids heal more quickly. It sounds like finding the source of getting the histamine levels managed. Do you follow a low-histamine diet along with the dose of enzymes? Then what else do you do?

Pejman Katiraei, DO

Yes, so we try to clean up the kids’ diet as much as possible. Now, what I have learned is that a lot of these kids are in such a fragile place; they are just barely there, hanging on by a string. Before, well, you need to get rid of gluten, you need to get rid of dairy, and you need to get rid of this. You need to get rid of that. It would just cause these families to implode because a lot of these kids have weird sensory issues. then, when you also look at what histamine does in terms of controlling the appetite centers.

The appetite center of the brain is significantly impacted by histamine. A lot of these failures to thrive, kids, or you also look at some of the criteria for PANS and PANDAS, one of the things that is also a criterion is a sudden loss in appetite or a sudden change in appetite. In a lot of these kids, what I have found is that histamine ultimately changes the appetite center. These kids do not have much of an appetite, and for the older kids, what they beautifully articulated to me is that food just tastes disgusting. The experience of eating is not pleasurable for these kids because of the way they eat, especially. If we say, Well, you should be eating chicken, fish, and vegetables, and me being on my high horse before, Well, your kid needs to be eating, what I came to realize is, No, I cannot do that to them. Because these kids are barely consuming calories to survive. By saying, Well, gluten has to go, dairy has to go, and this has to go now. Not that we cannot get rid of it, but I was able to help these families move through it. What we do is control the exposure. 

There is a cool supplement. I do not know if you have ever used it with your patients. It is a Mirica. It is PEA with Luteolin, and Neil was the guy who turned me on to it. It turns out that PEA helps reduce microglial activity. because the microglia are oftentimes involved in anxiety, irritability, and aggression. It changes the fear response through the amygdala. PEA has a fantastic product in a compound that changes part of that inflammatory process, which then brings out the child’s anxiety and calms down the intensity of their nervous system. Then there is luteolin, and this cool bioflavonoid also acts as a mast cell stabilizer. It has many other amazing anti-inflammatory properties. I find that in these kids, when you control the exposure enough to the point where their systems are not getting hit all the time, then I brought in these supplements, and the other thing that I found was that, because of what you mentioned with the mitochondria getting hit, a lot of times fatty acid oxidation is distorted through these mycotoxins. I have just found that you put them on some carnitine, you put them on Mirica, and you put them on these DP enzymes. The carnitine helps improve their vitality. They are just not dragging themselves through life every day; you bring down inflammation. Now the kid is starting to become more sensible. By just bringing them to the more sensible, stable, happy-ish, they are happy, but they are a little more happy.

Ann Shippy, MD

They have started to be able to press the pause button a little, yes, and start to choose how to be beautiful.

Pejman Katiraei, DO

I have had some families where the parents were borderline tearful. Sally ate broccoli for the first time. She took a bite of salmon. It is just so fascinating to see how these kids naturally gravitate toward healthier things. Then, over six months, we slowly dripped the gluten and dairy out of the diet and got rid of junk food. Because they can now eat the food slowly. Transition them to a healthier lifestyle. Foods.  through that, they start getting better. That is the first step I have learned to take to slowly stabilize these kids and then help them get healthier. A place where we can do all the detoxing and so forth.

Ann Shippy, MD

That is beautiful. One of the things with kids, of course, is that a lot of them are not able to swallow pills. You have found all the things in forms that they can take in chews or the quick way of things? But how do you deal with actually getting the supplements into the kids?

Pejman Katiraei, DO

I have taste-tested all of these things myself, and sometimes I will just give them to my kids for the sake of seeing what happens. Fortunately, these products are tasteless. Their texture is a fine powder that dissolves pretty much in any juice or liquid. Carnitine is pretty much tasteless; Mirica is tasteless. The histamine blocker is tasteless. A lot of times, these families will just open up the capsules, dump them in a little bit of whatever the kid likes, and they just drink it. They are relatively inexpensive as well. That is one of them, which is neat.

Ann Shippy, MD

Beautiful. Then, when the child starts noticing, they are getting better than they were at first. It can be challenging to get them to take it, even if they do not have much taste. But once they are, if this is helping them, what else can I do?

Pejman Katiraei, DO

Yes. When they start asking for the supplements themselves. The most amazing part is the eight-year-old saying, Mom, can I have my vitamins now?

Ann Shippy, MD

I love it too. The kids get to the point where they are the ones that are enforcing gluten- and dairy-free because they know they are going to feel better if they do that too. They are at the grandparents, saying, Okay, let us look at the label.

Pejman Katiraei, DO

Yes, it is amazing. It is so amazing to see what these kids do. When they are finally able to function. Yes. Speaking of hope, the part that just makes this so exciting is the unimaginable transformations. I am sure you have seen way more than I have because I’ve only been into it for a few years. But the transformations are borderline mind-boggling. There is a beautiful young lady. She is now 12 or 13. We started three years ago. Mold exposure, high anxiety, weird sensory things—I just could not learn for the life of her. The classic severe ADHD, weird learning disabilities, poor executive functioning, etc. Fast forward three years. Mom cleaned up the environment and took it to the nth degree, went hardcore with the diet to the point where it is egg-free, gluten-free, dairy-free, etc. It is intense. We did some supplements and got all of the mycotoxins out of her system. What is wild is that same girl, is now literally at the top of her entire school. We are not talking about the average run-of-the-mill school. She is at a competitive academic school. She is the top student in the entire school. Two or three grade levels in reading and math ahead of time. Winning two grade levels above. It is just insane. The change that has happened in her brain.

Ann Shippy, MD

To see what the kids are capable of when they have gone from that, am I smart? Can I learn that it is so rewarding and exciting?

Pejman Katiraei, DO

Yes.

Ann Shippy, MD

They had so much heart and compassion, too, because they knew what it was to suffer.

Pejman Katiraei, DO

Yes. It is amazing. I think this is the part that drives me the most—the way these kids change. Their perspective on life is that now they want to learn, and they say, I want to learn. I want to learn more. I have had kids that are, and I just feel happy. I was not happy before. But now I feel happy about it. Not only is this such a beautiful gift to give to families and kids for their experience now, but how does that change their entire experience in the future? I am sure you have thought many times about your son, had you not found the mold. Where would he be?

Ann Shippy, MD

Yes. His self-esteem, how he thinks about it, and stuff. He feels so different, rather than knowing he is smart. He is 21 and doing an internship this summer. He is confident, and he is doing things that contribute a lot to the organization that he is working with. It is just that I cannot even imagine what would have happened to him if he had not, and if we had not had the luck of starting to learn about mold and finding out what was going on. Yes. I thought that if you would share a little bit about what you do with kids and then help them, I loved how you said to get all the mycotoxins out. What’s your strategy for helping? Part of why the kids have gotten to the point that they are is because they definitely have some glitches in their detox pathways, usually or have had a huge exposure. What do you find with helping the kids get the toxins out?

Pejman Katiraei, DO

Great question. I have started straddling the two different perspectives: There is your perspective of colonization is what is driving the toxicity. What is interesting in the mold microbiome, or the fungal microbiome version of the gut is that the studies that are out there available are foreign for you and between all and healthy. Adults say, Well. colonization can happen. It happens, 

Ann Shippy, MD

It happens.

Pejman Katiraei, DO

It happens.  The thing that I ultimately found was that when I combined antifungal regimens, especially anti-mold regimens, along with the binders, that is when I saw the best outcomes. Now, I do not do this off the bat because most of the kids are so toxic and fragile. That they would just fall apart in a second if I did that. It would be a slow buildup over several months. But initially, I was taught, well, you just bind the mycotoxins, and that fixes everything. I found it that did work and did not go beyond the anti-mold thing, and I can touch on what I found to be helpful. We know that there is a total toxic load. It is not just mycotoxins. The entire conversation that we are having is likely about the reason why are we seeing mold toxicity has become such a big problem. 

Everyone is now carrying a fair share of other toxins, which makes us inherently more vulnerable, and then you have something new in building science where buildings do not breathe mycotoxins concentrate. That double whammy is probably what is driving what we are seeing now. But, as I started working and asking, well, how did these other compounds influence the body? At the top of the list for me is glyphosate. You look at the incredible work of Dr. Seneff, and others say it is weird. Glyphosates are so weirdly similar to what they do to mycotoxins. They are almost like two ugly cousins. They both disrupt the mitochondria; they both disrupt the gut; they both disrupt the microbiome; and they both disrupt neuroplasticity. The laundry list just goes on and on and on. That is where I started looking at this. I should not just be looking at detoxing mycotoxins. because that is silly. We know that everyone has a load, and even if you are gluten-free and organic, you still get exposed to glyphosate.

Ann Shippy, MD

Yes, that is ongoing. All the time, people have been eating organic exclusively for years, and they are still getting glyphosate exposure and trying to figure out where it is coming from. It is such a big problem.

Pejman Katiraei, DO

Yes. That is where I have started looking at using combinations of humic acid, fulvic acid, plus glycine, and then bentonite clay. Along with that, I have become a big fan of cholestyramine. I do not know if you are a big fan of that.

Ann Shippy, MD

I try to avoid it if I can, but I could see how, with kids, that might be an easier answer. I just think it causes so many disruptions for most people, but if I can find a way to get people better without using it, I would prefer it just because I see people reacting to it too often. But I would love to hear about your experience because if you are seeing that it is working, I am happy too. Maybe it is the combination of things that you are doing with this cholestyramine.

Pejman Katiraei, DO

I never go for cholestyramine first, because that is a quick way to make someone sick, and then they overheat.

Ann Shippy, MD

You give up. Okay.

Pejman Katiraei, DO

Yes, I stepped on a few landmines as I lost limbs. I am that. That was just a bad idea. But what I found is that when the exposure is controlled, the immune system is calmed down, and the nervous system is calmed down. You start a trickle of whatever other binder clay chlorella, or whatever you like. At a certain point, the child’s resilience is there. What I found is that cholestyramine is, I do not want to say, magical. But it helps move the needle. Part of what we were theorizing is that it is not just the ochratoxins that cholestyramine binds. We do not know if this ion is essentially also getting bacterial endotoxins or other types of toxins that we do not understand because everyone talks about them as just this mycotoxin binder. It is good for a handful of things. But I am pretty convinced that it is doing something more than just the mycotoxins.

As I said, I experiment with myself. Not that I had any big mold exposure where I was. Let me try it on myself. Let us all see how it tastes and what it does. I took five grams of it twice a day for a little while. What I found was the mental clarity that I was having. There is a weird sense of well-being. My gut is pretty decent. My diet is not awful. But what started coming up for me is that this is something that Neil has talked about. I have seen some papers here and there discussing this. There is probably more to this compound, whether they are bacterial endotoxins in the gut. Other things that the other toxins are not binding to, the cholestyramine may start getting rid of that.

Ann Shippy, MD

It’s making me think that we will have to do a little research on this. Cholestyramine is an old cholesterol medication; in the old days, when I was doing internal medicine, it was a possible cholesterol drug. I wonder if it is a little bit of a lipid exchange; I wonder if it is pulling out some of the damaged lipid membranes. The way you have described your brain filling is better and gives more clarity. I am; maybe it was a little. Yes, refreshing the brain cell membranes, and lipid membranes. Let us see if we can find some data to support my theory.

Pejman Katiraei, DO

It could. That is what makes this fun. It is stressful because there is so much we do not know. But it is also amazing because there is so much we can learn.

Ann Shippy, MD

I am having so much fun doing this summit because I am getting to nerd out with people like you. We have a whole hour or more of your time to just mind-bend. Because we all have our experiences with our patients and the successes and the things, we have to learn new things to help them get better and dig deep. The more we can share and help each other and help the audience to ask the questions, and it is such a gift to get to do this with you.

Pejman Katiraei, DO

Likewise. It is a pleasure. That is how we learn. That is how we grow; if we share information, I would say half of what I have learned has been through my patients. Whether I have suggested something, and they are the ones that come back, This sucked. Or, my God, this change my kids’ lives or they come with their own thing, What do you think of this? I am, well, Sure let us test it out and, and then a month later, My God. She is so much better. I am, Well I guess, I should pay more attention to that.

Ann Shippy, MD

Beautiful. It is the practice of medicine because each patient is so individual and unique, but we get these principles that we can apply and get pretty far.

Pejman Katiraei, DO

Yes. Collectively, if we put our heads together, I can imagine how much we can accomplish.

Ann Shippy, MD

Yes. For sure. Is there anything else that you would like to share about the healing process that you help the children with?

Pejman Katiraei, DO

Sure. I would say this is the last piece of what I found to be most helpful, on top of just doing some things to support the detox pathways is just what I have become a huge fan of essential oils. What we suspect and I am sure you know this. There are a lot of these molds. They colonize and ultimately get into biofilms, and they just go in these little huddles and dodge a lot of antimicrobials that are directed at them. When you look at the properties of various essential oils, such as Thyme. These essential oils have not just been shown to be helpful as antifungals and anti-mold agents. But they also have inherent biofilm that disrupts properties. 

One of the things, I have become a big fan of and where I have seen, some of the best cases of outcomes are when I have the binders, they are doing their job, we clean the environment, and we address the diet, but start using essential oils, and sometimes I will use them in combination with different fats. But as these oils slowly trickle into the body over many months, it is not that you just nuke the gut; one day and you are done. But when used over several months, what is amazing is, that you see a change in the microbiome, whether you are using organic acids or other ways to assess it, just through kids who are chronically constipated or with chronic diarrhea. All of a sudden, stools are normal. Also if you track the mycotoxins, the best cases of clearing the mycotoxins are when the essential oils have been used, at least on my kids; binders. While I know, Itraconazole, and some of these are more heavy-duty pharmaceuticals can be used for months without any known issues. I have just found that I do not need to go somewhere that is hardcore, where you just use some essential oils, and you just give it time, and six months later, you get to where you need to be. Without having to call in the bulldozer.

Ann Shippy, MD

Which essential oils are you finding most effective?

Pejman Katiraei, DO

The thyme is my favorite one. There is a product called Wyeth Formula that has researched nutritionals. It is thyme, and I am blanking on the other combination. There are two essential oils in it. It is a little heavy-duty. It is in a capsule, so I cannot give it to little kids. But that is my all-time favorite, and I am starting to experiment with other combinations that have thyme and some of which have oregano, etc. But for the little kids, I used combinations of things on the BioSide and Beyond Balance has some cool antifungal herbs. I will just keep rotating them and just keep slowly etching away from the problem. It is when you look at the water versus rock theory, water does not break down rock immediately. If you could give it enough time it creates a canyon. I looked at it like that. You just drip it in; you just give it time. Next thing you know, the canyon is opened up.

Ann Shippy, MD

Well, I am so grateful that you had the patient who asked you, Why could this be mold? Because I just think you are doing such an amazing job with helping these families and kids and plowing new territory here. I am going to hope that you are going to write the pediatric mold book.

Pejman Katiraei, DO

We will see.

Ann Shippy, MD

Because it is different with kids, you have to understand that what you are learning in these last four years is pure gold, and you have a heart of gold to go with that brilliant mind. We are lucky to have you in this field, to be helping so many families, and to be sharing your wisdom.

Pejman Katiraei, DO

Thank you. We are all in this boat together to help people. Thank you for the work that you do and just the love, care, compassion, and wisdom that you bring into our world.

Ann Shippy, MD

Thank you. I see you, too. That is what it’s all about, is it not?

Pejman Katiraei, DO

Yes.

Ann Shippy, MD

How do people find you? I know that there are going to be a lot of people watching this who want to know your website and your Instagram. The best way to learn more about what you are doing and to keep up with you

Pejman Katiraei, DO

We are on Instagram, so it is. Wholistic Kids with the W, the W-H-O-L-I-S-T-I-C kids. That is our Instagram. The main website that is where we are focusing right now is Wholistic Mind is the term used right now. Also with a W. Wholistic Minds (wholisticminds.com)is a portal that we have been building for the last four years. The premise of this portal is; that there are too many people who are sick, there are too many people struggling to find answers, and there are a lot of great providers who want to help, but they do not have the time or energy to spend five years digging into something to gain that mastery. 

Wholistic minds is there essentially a way to use technology and artificial intelligence to increase the efficiency of providers who are good so they can serve more people. Hopefully at a lower cost standpoint because you can serve two people in one hour versus one person per hour. That hopefully reduces costs and increases its availability. It also fills in the knowledge gaps, I think back to six years ago. If I had a tool that could help me see the things that I did not know how to do or see or at times help us see through our bias. I have had times when I got locked into this mold, and No, it was not mold; it was something else even in its rudimentary form. At least one or two times, the system started flagging other things that had slipped my mind.

One family was living in a commercial agricultural area where glyphosates were being sprayed by the gallons. They were literally across the street from this farm with wafts of glyphosate. We are not talking; Oh, there is a little pesticide residue on your cucumber. It is wafts of glyphosate are just washing into this family’s home. I would have been completely oblivious to it because I was so focused on the mold conversation. Part of our wish and intention Is. by using this system, we can help a lot more great people come into this conversation and ultimately holistic medical domains of health care to then allow a lot more great providers to provide better care more efficiently to serve the millions who needs this kind of care.

Ann Shippy, MD

I am looking forward to learning more about this. It sounds like a great project.

Pejman Katiraei, DO

Thank you.

Ann Shippy, MD

Well, for the health of many people forward. Thank you.

Pejman Katiraei, DO

Thank you.

Ann Shippy, MD

Well, thank you for joining us today, and I look forward to many more conversations with you in the future. It is so great to get to hang out with you.

Pejman Katiraei, DO

Likewise. I love our time together and just getting to chat and help inform people.

Ann Shippy, MD

Thank you so much.