Mold Allergies: Dive Into Immunotherapy Benefits

Ann Shippy, MD

Welcome to the Mold, Mycotoxin, and Chronic Illness Summit. I’m your host, Dr. Ann Shippy, and today we get to speak with Darin Ingels. He’s a licensed naturopathic doctor, author, international speaker, and leading authority on Lyme disease and immunotherapy, as well as mycotoxin illness. Today, we’re going to get to focus on the immunotherapy aspect of helping people recover from chronic illnesses. Thanks so much for joining us today.

Darin Ingels, ND

Oh, my absolute pleasure. Thank you.

Ann Shippy, MD

Yes, you’ve got such a wealth of knowledge. I think that this is an important piece to cover at the summit, and nobody else has talked about it. How do we help the immune system? What’s another way to help the immune system get back on track? I know that you’ve got quite an expertise in immunotherapy. I would love for you to just start by explaining what that is.

Darin Ingels, ND

Immunotherapy is a very broad category, and it applies to a lot of different aspects of medicine. You’ll hear about immunotherapy for cancer treatment. You hear about immunotherapy for people who have true immune deficiencies. But in this case, we’re talking about immune therapy to modulate your immune system against anything that might be provoking a reaction. Particularly when we talk about allergies or hypersensitivity, mast cell activation can be caused by any number of different triggers. I think the beauty of immunotherapy is that, as a whole, we have a tool that we can use to not only stop the type of reaction that you’re having, but I hate to use the C word, but maybe even cure the problem. We never used that word in medicine. It’s like nobody ever wants to talk about actually fixing a problem. But I think that’s the beauty of immunotherapy, is we’ve got a way to manipulate your immune system positively. If you think about allergies as a whole, they’re overreactions of your immune system, not recognizing what’s part of you and what’s not part of you. We get this element of immune confusion. That’s what an autoimmune disease is. If there’s a way that we can retrain the immune system to not be so overreactive, start to differentiate what’s part of you from what’s not part of you. We have these incredibly powerful tools at our fingertips that are going to get people over that hump. The topic that’s covered in your summit here is mold and mycotoxins, both mold spores and mycotoxins. Those chemicals can be immune triggers. I’ve been using immunotherapy for almost 25 years in my practice, and I find it an invaluable tool in helping people get better permanently.

Ann Shippy, MD

I love that. Can you elaborate a little bit more on why this is important with mold and mycotoxin illnesses? We’ve put a lot of focus on the toxicity side of things and less on the allergy side of things, but I think it’s helpful to address both at the same time.

Darin Ingels, ND

Absolutely. I think a lot of focus gets put on the mycotoxins part just because of what they do to the body. These chemicals are so harmful that they can directly damage your brain, your neurons, and your respiratory tract. But mold allergies are far more common. You can have both problems and clinically, the symptoms of mycotoxins and mold allergies can overlap. As patients and as doctors, we would have a hard time distinguishing if someone’s having an allergic reaction to a mold spore or if they are having a chemical effect from the mycotoxins. My experience is such that a lot of people who’ve been in water-damaged buildings have had exposure to mycotoxins. More often than not, they get sensitized to mold spores. Every time they go out on a humid day in Austin when the humidity is high, the mold spores are very high. People feel those symptoms. They feel the head pressure, they feel the brain fog, and they feel the congestion. They feel that tightness in their chests, and they go. “Wait a second. I know that my home has problems. I should feel better when I’m outside, or I should feel better when I go to a different environment,” and they don’t necessarily feel better.

Why is that? Any time there are mold spores in the air, that can be an immune trigger to set the immune system off. I want to emphasize that mold allergies are incredibly common. What complicates this a bit further is that if you go to the doctor and you get tested for mold allergy, when we think about allergy as a whole, we typically think about these reactions that are mediated by immunoglobulin E, or IgE, and that IgE molecule is ultimately what binds to mast cells. The mast cells pop their balloon and release all their granules, including histamine and about 200 other chemicals. That’s what triggers a lot of the symptoms. But in the case of mold, a lot of mold allergies don’t involve IgE at all. If you go to the allergist, you get skin prick testing, or if you do a blood test called a RAST test, you might find that there are no IgE antibodies. The doctor says, “Well, you’re not allergic to mold spores.” You go. “Yes, okay. But every time I go into a damp basement, every time it rains, and every time I’m in hot, humid weather, I feel the effects of it.” That’s sort of a clinical indication that you’re probably allergic to mold spores. Sometimes we have to do different types of testing to help identify if somebody has an allergy to mold. Maybe it’s IgG; maybe it’s T-cell-mediated. But when we find that people do have that reaction and we start implementing immunotherapy again, I find a lot of my patients do well with it.

Ann Shippy, MD

I will check the E level just to see if it is upregulated. I don’t prefer the RAST testing, but I do like to measure the IgA, IgM, and IgG2 levels in certain circumstances. Tell me a little bit more about how you approach that, or sometimes the T cells. Are there particular laboratories that you like, or do you just use some of the traditional labs? Or what’s your approach to the testing side of things?

Darin Ingels, ND

Yes. I’m an environmental medicine doctor by training, so we’ll use different types of skin techniques. No one’s called SET, Serial Endpoint Titration, where when you go to a regular allergist, they just put a needle in your skin, and you’ll put a little bit of the antigen in it, and you just see if you get a histamine reaction. In serial endpoint titration, you can start injecting different dilutions; it’s a little intradermal injection in which you do different dilutions, and sometimes you might find one dilution doesn’t provoke a reaction, but a stronger dilution does. It’s a far more accurate method of helping identify that sensitivity because, even between different mold species, there can be different sensitivities. You could be highly allergic to Aspergillus and maybe not so much to Cladosporium. Because there are so many different mold species out there in the world, you have to look at them kind of as individuals. I think we want to kind of lump it all together. When you look at what’s available through blood testing like RAST testing or even what the allergist does with skin prick testing, they might do the top four or five molds that are common, but dozens of mold species can provoke reactions. It may also be that they’re just not looking at the right stuff. Is it that they’re not looking at the right stuff? Is it just a different immune mechanism? I find SET to be a much more reliable method for identifying mold. If you get in touch with environmental medicine, a lot of these doctors know how to use that technique. If you get a hit on blood testing or if you get a hit on a positive skin pre-test, that’s great. that’s information to help identify what you’re reacting to. But again, if you’ve got a negative RAST test or a negative skin prick test, that doesn’t necessarily exclude the possibility of having an immune reaction.

Ann Shippy, MD

What I find—maybe you find this as well—is that sometimes people are just so used to their allergy level, like they just have the chronic during the day and they don’t even realize that they’re having it, or they just have no symptoms at all. But still, that immune system is just so upregulated in an allergy sense. The testing helps detect it.

Darin Ingels, ND

What’s important too is that depending on what kind of immunotherapy you might be considering as part of treatment, you might need to know exactly what specific allergen you have, because that’s going to dictate what’s part of your treatment. Same thing. If you go to the allergist and they do skin testing, they find out, okay, you’re allergic to Aspergillus and Penicillium. When they give you your allergy shot, that’s what they’re going to put in the shot. They’re only going to put in there what they know. You’re allergic to or sensitive to, so if we don’t know what you’re reacting to, it’s hard to customize that formula for you. With one type of immunotherapy, which I’m sure we’ll talk about in a little bit, it’s highly specific to the individual. We only put in exactly what we know you’re reacting to. Then there’s another technique we can talk about that’s not as specific. That kind of doesn’t matter what you’re testing shows; you can still use it anyway. The other good thing is that we have a lot of options when it comes to immunotherapy to find out what works best for you.

Ann Shippy, MD

This is so great. I’m curious, as you’re asking so many questions for you, but one of them is whether you see correlations with other environmental toxins. When you see the immune system rubbed up by some molds, are you testing for other environmental toxins as well?

Darin Ingels, ND

Absolutely. We tend to think of allergies or reactivity in these kinds of segments, maybe for our ease of understanding. But the reality is that your immune system is one big blob. It’s reacting to mold, pollen, dust, cats and dogs, food, chemicals, and everything.

Ann Shippy, MD

You have to multitask so well.

Darin Ingels, ND

Yes. We have to go through that checklist. A lot of it’s given by your history. What are the kinds of things that we can identify as something like mold? More often than not, we might see a seasonal pattern to it, particularly if you live in parts of the world where there is a lot of humidity. That tends to be when the mold is at its highest. Pollen very much has a season to it. If you live on the East Coast, where there’s no pollen in the wintertime, it’s very easy to blow up every time April and May roll around. We have clues that pollen is part of your trigger.

Ann Shippy, MD

Is it important to test during the highest seasons for things, or is there enough? Or it does not matter.

Darin Ingels, ND

Not necessarily. Yes.  There’s enough memory. Although if you were to track, particularly with pollen in areas where it is seasonal, and I live in California where we pollinate just about year-round, in areas that do have a seasonal variation, if you were to test in the dead of winter versus the peak like tree pollen season, April or May, you would probably see differing levels of IgE, but it would still be there. It’s not like it’s going to go away completely in the off-season and then come roaring back. It’s always helpful if you can get in at the peak of the season, but it certainly isn’t essential, and I think if someone truly is allergic in that way, you’ll still pick it up on your testing.

Ann Shippy, MD

Let’s get into how immunotherapy helps the body and improves symptoms.

Darin Ingels, ND

It’s interesting. Immunotherapy has been used for literally over a hundred years. This is nothing new. It’s used a little bit differently around the world. But the idea behind it is that we are trying to rebuild immune tolerance. Allergy at its core, or hypersensitivity, is essentially a loss of immune tolerance; your immune system’s ability to discriminate between what is and is not part of your world for some reason is damaged. I think what’s fascinating is that I don’t think we understand the mechanism by which people become sensitive to anything. Why are some people allergic to dogs and cats while other people are not? What makes some people allergic to ragweed? What is it that sensitizes us? I don’t think we fully understand it, but what’s interesting is that if you look at animal studies, if you wanted to study how a different allergen bothers someone, the way they sensitize mice and rats is that they’ll scratch their skin, they’ll break the skin, and they’ll introduce the antigens through the skin. That’s what sensitizes them to whatever you want to test. It kind of makes me wonder how much of our sensitization isn’t necessarily coming from what we’re breathing in, but maybe from what we’re touching, and how much of this also goes back to what happens very early in life.

From the time we’re born and what we get exposed to, I’m sure we’re going to find that in time numerous factors contribute to that. Nonetheless, once that process happens and you are sensitized, we’ve got to turn off that mechanism to retrain the immune system to not be so hypersensitive. And we know a lot of these reactions are driven by what’s called Th2 or T helper cell 2. So, T helper cells, for those of you who don’t know, are the conductors of your immune system. T helper cells direct what our bodies should and should not be reacting to. There are different Th types or T-helper types, but we talk a lot about Th1 and Th2. T helper 1 cells are the direct scavengers of your immune system. If they see something that’s foreign, they’ll go right after it and get rid of it. Th2 cells don’t do that. They are the ones that stand here and go, “Hey, the immune system, there’s a problem over here. Somebody needs to do something about it.” A lot of that is helping stimulate B cells, which make antibodies. When we’re thinking about Th1 and Th2 being like a seesaw, we want them to be relatively balanced. But what happens if you start to become more dominant in one of those cells and secrete chemicals that suppress the other side? If you’re TH1 dominant, it’s going to suppress your TH2. If you are Th2-dominant, it’s going to suppress Th1. You can imagine the scenario here, where a lot of allergies and even autoimmunity are Th2-driven. If that part goes up, it’s now suppressing Th1. Well, wait, that’s the direct scavenger of my immune system. Isn’t that going to make my immune system? Potentially, it could. For years and years, we had no way of measuring Th1 and Th2. We do have a lab, OSIRIS-REx Lab, that does directly measure Th1 and Th2 cells. We can now test for that directly and find out if you are having that imbalance. But ultimately, the goal is, no, we’re trying to get that seesaw more balanced again.

Ann Shippy, MD

That is the most abbreviated, concise, and clear explanation that I’ve heard yet. That’s a great job. I think it’s just so clear now what those important parts of the immune system are doing, why it’s so important to balance, and so on.

Darin Ingels, ND

Ultimately, we want to get that overexpression of Th2 back down. It can happen with any common allergen, like mold spores, but it can be driven by pathogens, too. We know that Lyme disease, Bartonella, viruses, COVID, and all these things can set the stage where they’re overstimulating that part of the immune system. One of the immunotherapy techniques that we use is called LDI, or low-dose immunotherapy, and it’s directed toward the pathogen. We know that strep has been associated with causing rheumatic fever and rheumatic heart disease. It is an autoimmune reaction to strep. Your immune system treats strep like an allergen, not a pathogen. It engages the wrong part of the immune system. We’ve got mechanisms that we can use to turn those reactions off. I just want to kind of paint a picture of that. Now that we can identify what those triggers are, we’ve got a lot of possibilities for using immunotherapy to downregulate that immune response.

Ann Shippy, MD

Beautiful. That’s LDI.

Darin Ingels, ND

Yes.

Ann Shippy, MD

Okay. Can you say a little bit more about that, like what the process is?

Darin Ingels, ND

Yes. Maybe just let me give you an overview of immunotherapy as a whole. I think that might set the stage. In our practice, there are three types of immunotherapy that we use. I won’t talk much about allergy shots. That’s what a conventional allergist would do. If you do the skin prick testing, they find out you’re allergic to dust or ragweed. You come in every week, and they inject you with dust and ragweed. Over time, they keep building concentration as your tolerance gets better. You eventually get to a point where you’re kind of at a maintenance dose, and that’s what you stay on for many years. That’s what a conventional one does, and that’s pretty much it. But the other options we have are ones called sublingual immunotherapy. Sublingual means under your tongue. The concept is very much like allergy shots, and the testing we do can be very similar. We could do skin prick testing, we could do blood testing, and we could do SET testing. Based on that, we will compile whatever allergens we need in a bottle. Instead of injecting it, you just put these drops under your tongue.

The way all immunotherapy works, at least about allergy, is through these cells called dendritic cells. Dendritic cells are part of your immune system, and they are in your skin, which is why allergies like to do the injections. But they’re also very rich in your mouth and under your tongue. Whether you put that allergen under your tongue or inject it into your skin, the mechanism is the same. It’s just another way to confer immunity through those dendritic cells. What we don’t understand is, “Wait a second. This is the thing that bothers me. This is the thing that’s a trigger. Why on earth can I inject or put it on my tongue? It doesn’t make me worse.” If you can figure that out, please let me know. We’ll win the Nobel Prize in medicine together. All we know is that at the right concentration, at a very specific concentration, instead of your immune system overreacting, it starts to get retrained to not react. The power is the dose or concentration. Because everyone’s individual, it gives us a lot of flexibility to play around with that dose, with that concentration, and to find out exactly what you need. Now, when we do serial endpoint titration, we find out exactly what dose someone needs to neutralize their immune system.

We’re looking for that neutralizing dose that’s going to start blocking that immune response. Over time, we keep increasing that dose as we feel like people’s immune systems can tolerate it. Sublingual immunotherapy is something we can do for mold, pollen, animals, chemicals, and other things. The only reason we don’t do sublingual immunotherapy is that we don’t do it for people who have legitimate anaphylactic food reactions. It’s just that there’s very little research out there on that specific case. There is potential to trigger the reaction because we are putting it under the tongue. There are different ways of dealing with that. But pretty much any other type, like food sensitivity, the ones that are nuisances but aren’t dangerous, then sublingual immunotherapy works well.

Ann Shippy, MD

Do it at home rather than running into that.

Darin Ingels, ND

It gives people the flexibility to do it at home. It’s very safe. There are over a thousand studies on sublingual immunotherapy. This has been used for over 100 years. It’s widely used throughout Europe. They’ve done studies looking at the cost of allergy shots and the cost of sublingual immunotherapy. Sublingual immunotherapy is a quarter of the cost of doing allergy shots. Since most of Europe is socialized medicine, they want to save money, but in the United States, allergists get reimbursed for doing allergy shots.

Ann Shippy, MD

You’ll get a kick out of this. In the early nineties, I was a chemical engineer for IBM. I got sick, and when I couldn’t get help from any of the physicians that I went to to figure out what was happening, I did end up finding an allergist. There was like an hour and a half drive from where I went, and I did the sublingual therapy because I was just allergic to pretty much every food. It made a huge difference. Then, of course, I wasn’t going to be able to drive an hour and a half regularly to do any other type of therapy, but he had an incredible practice and was at the forefront of this.

Darin Ingels, ND

Yes, I said it’s such great therapy. They’ve done studies in children; they’ve done studies in adults. This applies to any age group, and there are very few contraindications to doing sublingual immunotherapy. But again, I like the ability of people to administer it at home just for convenience and safety. There are very rare cases of people having anaphylactic reactions to sublinguals. I’ve only read of three cases, and they were all related to pollen specifically. It’s incredibly rare. It’s just a great tool to have. The other type of immunotherapy that I think is neat is called LDA Low Dose Allergy Therapy, and LDA was developed in the 1960s by a doctor out of the UK. He was an EMT surgeon, Dr. Len McEwen, and he discovered by accident, and I won’t go into the whole story, that if you dilute out these antigens a lot, way more than what conventional allergies do, and you mix it with an enzyme called β-Glucuronidase, and this enzyme’s naturally found in your white blood cells,

That combination seems to help modulate your immune system, whatever you mix with that enzyme. He started treating people for food allergies and environmental allergies. With LDA, the way it’s traditionally taught is that you do it as an intradermal injection. It just goes between the layers of the skin. But what’s neat is that you only get a dose every seven weeks. Unlike allergy shots that start weekly or even sublingually, that’s daily. This you only get every seven weeks. What we’ve kind of learned over time is that, again, for the mechanism already described, you can put it under the tongue as well. The downside to the shot is that it stings. I’ve had it done. It’s like getting stung by 100 bees. It’s not very comfortable. It only lasts about 30 seconds.

Ann Shippy, MD

Is it because of the β-glucuronidase?

Darin Ingels, ND

I don’t know if it’s the enzyme, the extract, or a little bit of both. You only put a tiny amount in. But that little, tiny amount doesn’t feel very good. This is the way it’s been done for 60 years. It’s very effective. But in our practice, we’ve kind of migrated. A lot of our patients are just doing it under the tongue. I read a lot of kids in my practice. They would never tolerate the injection; the sting would hurt too much, and they would never come back and see me. Clinically, we find that the tongue works well again for a lot of people. The fact, again, that you only need it every seven weeks for people who are so used to taking so many supplements and pills daily is pretty nice because it’s almost every two months.

Ann Shippy, MD

You say that even with the sublingual, they only need it every seven weeks.

Darin Ingels, ND

With LDA? Yes, with LDA, it’s every seven weeks. The big difference is that the goal is the same. We’re just trying to build immunity to these different allergens. With LDA, there are technically four mixes; there are two different food mixes. It’s the same number of foods, but they’re in slightly different concentrations. There’s an inhalant mix that has mold and pollen, cat and dust, dog and feather, and pretty much anything you breathe in. Then there’s also a chemical mix. It’s got formaldehyde in petroleum in a lot of the common things that trigger people. You and I work with so many people who are not only mold sensitive but chemically sensitive, and again, you go to the allergist and say, I’m chemically sensitive. They’re going to look at you like you have three heads and go, okay, so here’s a way, again, that we can treat people for those chemical sensitivities to those different triggers. We start people with a lower dose of the food mix, the inhalants, and the chemicals again every seven weeks. After they’ve had a few doses, we can move them up and give them the stronger food mix.

Ann Shippy, MD

Is there also a mold mix?

Darin Ingels, ND

The mold mixes are in the inhalant mix.

Ann Shippy, MD

Okay.

Darin Ingels, ND

The idea behind LDA is that with LDA, there’s no testing involved, or it doesn’t have to be involved. The idea behind it is that the food mix has about 70 different foods in it. The inhalant mix is about the same, and the chemical mix is only about four or five different chemicals. If there’s something in that mix that you’re allergic to or sensitive to, we’re covering the bases. If you’re not allergic or sensitive to it, who cares? We’re not going to harm you by giving you something in that mix that you’re not reacting to.

Ann Shippy, MD

That’s such a low dose.

Darin Ingels, ND

Yes. I like this therapy again. The fact that it’s been around for 60+ years means it’s had a long clinical use. Unfortunately, there’s no real research on this. There’s no money to be made by doing large-scale studies. But now that we’ve got hundreds, if not thousands, of doctors around the world who have used therapy for 60 years, it is very safe and very well tolerated. I like this for people who maybe can’t do sublingual immunotherapy, for whatever reason. I like this for kids just because it’s safe and convenient. It’s not something you have to do every day. This is just the conversation we have with our patients about what fits your world best. What do we think is going to be the best option? The nice thing, too, is that we’re not married to anything. If we start down one path and we don’t feel like we’re getting the kind of results we want, we have these other options to try.

Ann Shippy, MD

How long does it take for people to start to notice a difference after starting the treatment?

Darin Ingels, ND

That’s a great question, and everyone’s different. In my experience with sublingual immunotherapy as a whole, most people start to feel the difference somewhere between four and eight weeks after starting treatment. We start to see something change. With LDA, it can be a little different. Sometimes it’s not until the third or fourth dose that people feel the difference. It could be six months, eight months, or longer. That’s kind of the big distinguishing thing that I tell people about between LDA and sublingual immunotherapy time. Sublingual immunotherapy, for most people, does work a lot faster. It’s just that there’s a little bit more involved because you need to go through the process of testing. This is something you need to do daily for most people where LDA is like, “Well, we don’t need to test you. It’s just based on your history, and you only need us every seven weeks.”

Ann Shippy, MD

What about the cost between the two options?

Darin Ingels, ND

There’s a little bit more upfront cost with sublingual because you need testing. We have to find out what you react to. With SET, unfortunately, insurance doesn’t pay for that, so that’s an out-of-pocket expense. But once we’ve done the testing, we’ve established what you’re sensitive to. We don’t have to go back and keep redoing all that testing. That’s a one-time upfront expense. The cost of sublingual immunotherapy versus LDA depends on how many things you’re allergic to. With sublingual immunotherapy, we can mix certain things in the same bottle, but other things we can’t. All of these extracts have enzymes in them, and if you mix the wrong things, they kind of degrade themselves in the bottle and weaken themselves. If you’re allergic to ten pollens, I can put all the pollens together in one bottle. If you’re allergic to eight molds, I can put all eight molds together. But we don’t mix mold and pollen. I don’t mix pollen and dust. I don’t mix dust with food. If you’ve got a lot of sensitivities, you can have four, five, six, or seven bottles. That’s going to be a lot more expensive than just doing LDA. But if you only have a couple of things, you’ve only got two or three bottles. The cost may be kind of a wash.

Ann Shippy, MD

That’s super helpful. I know you’re doing a lot with your patients, and it’s a very integrative, functional approach. How does the immunotherapy fit in with the other things that you do to help your patients heal?

Darin Ingels, ND

It’s just a tool in the toolbox. We’re looking at the whole person. We’re still looking at the mycotoxin part, and we’re doing all the things to try and help mobilize mycotoxin out of tissue. We’re doing some element of detox to help mobilize all the other toxins. We’re doing the sauna, we’re doing the glutathione, and we’re doing the diet and gut health. We have to do all the things that we know impact our immune system, and diet and gut are just as critically important since up to 80% of your immune function stems from the gut. If you’ve got an unhealthy gut, you’re going to have a lot of trouble with your immune system. We’ve got so much research going on, and I’m sure you probably talked to other people at the summit about how these changes in the microbiome are predicting how people are going to respond to different types of illnesses. I have an autoimmune disease, and I have seen all the research coming out that there’s a very specific change in the gut microbiome and very specific strains are out of balance. As much as we can help get the gut under control, I think that’s going to help, again, lower that immune load and reduce that risk of having any kind of autoimmune reaction. If we want to lower that Th2, we need to make sure that our guts are working well. I know we’re just talking about immunotherapy.

Ann Shippy, MD

But we’re so in line here, and it’s great how it all fits together. If they get soft, the whole immune system’s going to be off. It’s an important piece of the puzzle.

Darin Ingels, ND

Yes, absolutely.

Ann Shippy, MD

Yes. I know on the personal front that a lot of your learning comes from helping hundreds or thousands of patients, but that a lot of your learning comes from what it takes to heal your own body. I’d love it if we could just spend a little bit of time sharing about you because I think it’ll give people hope about how sure you can get but then still heal. If you want to, I know you’ve had at least two major crises. The first is Lyme. We want to share a little bit about that. The key thing is that it took you time to recover from that, which would be great.

Darin Ingels, ND

Yes. I moved to Connecticut after residency, and about two weeks before I opened my practice, I got bit by a tick and got classic Lyme disease. I had the bullseye rash, 105 fever, joint pain, neuropathy, and the whole gamut. I got treated with Doxycycline right away, and four days later I felt great. I am eight months into owning my new business and working seven days a week. Eight, ten, and 12 hours a day. I started to relapse and went back on doxycycline, and it did nothing. I switched to Cipromycin, and it did nothing. Then I started cycling through the litany of oral antibiotics for nine months, and it got a lot worse. I was fortunate to have found a doctor in New York City named Dr. Zhang, and he treated me with Chinese herbs. A lot of it was sort of a wake-up call that everything, of course, I’ve been telling my patients to do, like, you need to get good sleep, you need to eat well. I wasn’t following my advice, so it was the wake-up call with the Chinese herbs. About a month into that, I felt 80–85% better. But it still took another two, almost three years, to get to a point where I feel like I got my health back. I was doing quite well for about a decade. I started getting symptoms again, and I’m like, I was going through a lot of stress at the time and thought I was having a relapse of Lyme disease. To make a very long story short, I was diagnosed with multiple sclerosis.

I’m sure Lyme was at that stage, and again, I can go back and look at my history as a child. I was on antibiotics every month. I was born until I was about five years old because I had so many ear infections and tonsillitis, and instead of having my tubes put in, I had my tonsils taken out. I was never breastfed. I was bottle-fed. I think it was just a lot of things that set my gut microbiome up from an early stage that, I think, translated to problems years later. To kind of cap all this off, in January of this year, we found out we had a terrible mold situation in our office to the point where we had to evacuate within a week. I had two mold inspectors come in and say, This is dangerous; you need to leave. I’m sure sitting in the toxic mold for God knows how long certainly didn’t help our mess at all. We’re out of that environment, and we’re still looking for a new, cleaner office, which I have come to find is a huge problem in California. But yes, through my process of Lyme and then dealing with that mess, it’s when you have your health issues. Of course, you dig deep, and you always learn so much more. I’ve used a lot of immunotherapy on myself. I’ve done sublingual immunotherapy, I’ve done LDA, I’ve done LDI, and I’ve done all these different things as a way to modulate my immune system. I’m not just a doctor; I’m a patient too. I know what it’s like to go through having a chronic illness and trying to find answers. But I want to offer hope that there’s so much available. If you’ve gone down different paths with different practitioners and you’re still struggling, Thomas Edison said it best because I found 10,000 ways not to make a light bulb. All it is is information. You’ve found things that maybe haven’t worked as well for you, but that doesn’t mean that there’s not something out there that won’t. You just have to keep digging, keep fighting, and know this is your life. You have to do everything you can to heal and get well.

Ann Shippy, MD

It was quite a journey. You’re curious: What gave you your clues for finding the mold in your office? How did you know to go look?

Darin Ingels, ND

The fact that we had water pouring through our ceiling was probably the first sign. We had leaks in our office over the years. They always seem to dry out quickly. It never seemed to be much of a problem. We had so much rain in California this winter. It got to the point where it was leaking every single day. We finally got the mold inspector out, and they said we needed to get out immediately. Then we moved everything out. Once we started pulling the walls out, every toxic mold you can imagine was there. We had a family throwout.

Ann Shippy, MD

A slow leak that had.

Darin Ingels, ND

I think there were leaks there that we just didn’t know about for years. I don’t consider myself someone who’s very mold-sensitive. I’m not the canary in the coal mine that can walk into a room and go, “Oh, yes, there’s mold here.” I just don’t. I don’t sense that. I never felt great in the office. But then again, how much of it is because you work long hours and are tired? There are a lot of excuses for why you don’t feel that way. We spend a lot of time in our office. More time than I spend at home, at least at that time. It just wasn’t obvious until we got out that, yes, this is a big problem. That’s my continued journey of dealing with mold illness and detoxifying. I do everything I know how to do to get the mold out of my system. That’s our journey.

Ann Shippy, MD

The first thing starts with, where is the mold coming from. Thank goodness it declared itself. You could get on to finding a clean place or figuring out how to make this one clean for you.

Darin Ingels, ND

Hopefully, our next space will be much better.

Ann Shippy, MD

Yes, it will be. It has to be. Are there any key things that you’ve found most helpful with the mycotoxin illness for you?

Darin Ingels, ND

The biggest thing is to get out. You’ve got to get out of that environment. I’m sure we both have the same issues. We’re dealing with people who can’t get out of their environment. It’s just so much harder to treat, and I realize how difficult it is, especially if it’s your home. Where are you going to go? Not everyone has a place to go, and just getting up and relocating herself is no easy task. Even moved our office and tried to find a space that we could go to on a moment’s notice that we felt was cleaner and that’s a challenge. But I just can’t emphasize how important it is to find ways to do the best that you can to get out of that environment. It’s just going to make your process go so much better because we do all of these great things to try and help get them out of tissue and desensitize you. But if you’re living in a toxic soup, it’s just a thousand times harder.

Ann Shippy, MD

We’re lucky because we work for ourselves. We can move on if we have to. But I know a lot of people are locked into how they make their living. Finding it at work is a whole other ballgame. If you own your house, you can at least take action on it. If you’re renting, that’s a whole other challenge to deal with with the landlord. We understand the trials and tribulations of getting into a clean place, but I can’t emphasize it enough. It is just foundational.

Darin Ingels, ND

I’ve seen so many people. I’m sure you have too. It’s like, no, they leave that moldy environment. It’s a shock to find out that they went to another environment that was as bad or worse than the one they just left. We see this in California a lot, and maybe in Texas, too. It’s just the way that construction is done here. It’s just that they don’t build houses for the weather. They just know. I think a lot of contractors just cut corners, and when they’re building, they throw up these track homes very quickly, and it just takes one pipe that didn’t get sealed properly that start dripping over time. I have a patient I’m working with who lives in, I’ll say, a relatively brand-new house. They’re less than three years old. They’ve already spent $100,000 on mold remediation because they had so many leaks and so many problems, and their poor little girl, who at the time I said was like five years old, was busting out in hives every day. This poor little kid kept giving her all this medication without understanding what she was reacting to. Once they finally remediated the house, the hive stopped.

Ann Shippy, MD

All these symptoms are just the nudging to find what’s right and what’s challenging me. Why are things getting upregulated, and what combination of things? That’s a beautiful story. Unfortunately, I’m seeing the same thing with new construction. Sometimes it’s almost worse. Some of the houses were built in the seventies and eighties.

Darin Ingels, ND

Yes, well, when I lived in Connecticut, my house was built in the 1940s, and I was very hesitant about buying an older house. I kept thinking, Boy, this house is old and it’s probably leaked and had issues, and it turns out that house was built. They were solid, and they were built quite well at that time, at least in Connecticut. In the ten years I lived in that house, I never had a leak or a mold issue. I kind of feel like in a lot of these older homes, the construction was better, but yes, you just never know. It’s a hard thing.

Ann Shippy, MD

Not a test.

Darin Ingels, ND

Yes, you just have to test and find out, and just make sure that your living environment’s as healthy as it can be.

Ann Shippy, MD

Beautiful. I love what you’re doing out in the world. You’re helping so many people in your practice and with all your teachings. I like to let people know where they can find out more about you and benefit from some of your programs and things.

Darin Ingels, ND

My office is in Laguna Hills, California, at the moment, and the best way to find me is just on my website. It’s just dariningelsnd.com, and all of our information is there. We’d love for people to have a very active newsletter. We’ve got a lot of great information to share with people, so we’d love for you to join our community.

Ann Shippy, MD

Thank you so much. My heart goes out to you as far as finding a beautiful, clean office that you can welcome your patients into and stay healthy yourself.

Darin Ingels, ND

Thank you. Yes. We look forward to finding it.

Ann Shippy, MD

Thank you so much for joining me today. This is an important piece of the puzzle that I think a lot of people will want to know more about and look into as part of their healing process.

Darin Ingels, ND

Thank you for having me. As part of the summit.