214: What's Bile Got To Do With Clearing Mold w/ Dr. Jill Crista

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When you think of methods to detox from mold, bile may not be the first thing that comes to mind. But, as my guest today will explain, bile can actually play a huge role in how (and if) mycotoxins are leaving your body.

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My guest today is Dr. Jill Crista, a naturopathic doctor, best-selling author, and internationally recognized educator on mold illness.

She helps people recover their health after exposure to toxic mold.

Dr. Crista is the author of Break The Mold: 5 Tools To Conquer Mold and Take Back Your Health.

She also provides online training for medical practitioners to help them become Mold-Literate, to efficiently and effectively identify and treat their mold-sick patients.

Join us as we discuss why you should think about bile when trying to clear mold.

Has mold affected your health? Tell me about it in the comments!

In this episode:

  • What is bile + why is it so important for tackling mold illness?
  • What is insoluble fiber (and how can it help)?
  • Concerns about medications used to treat mold illness
  • Whole foods that can bind to bile (to help you clear mycotoxins)
  • Thoughts on the use of clay + charcoal as binders


“Bile is made in the liver and then some of it is secreted into the intestine. Any excess is put in the gallbladder, and that's where it's stored until you have a really fatty meal, and then it's supposed to be secreted in response to eating fat or oils.” [2:20]

“…people who are missing a gallbladder can tend to have bile dump diarrhea. They can tend to have more problems assimilating fats. They're going to have more skin expression because the skin really expresses when you're not metabolizing fat very well.” [11:54]


Healthy Skin Show ep. 166: Mold + Histamine Connection w/ Dr. Jill Crista

Find Dr. Crista online

Dr. Crista's book, Break The Mold: 5 Tools To Conquer Mold and Take Back Your Health 

Quiz: Is Mold Affecting Your Health?

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Nettle Lemonade recipe

Dr. Jill Crista's Find A Doc page

Mold Canary Membership – an über private membership forum where those who have been affected by mold and want to work with me (but can't because my practice is full) still have access to me via my Live Q&As, How Tos, Featured lab of the month, Recipes, Notable research, and more.

Mold Training Course For Medical Practitioners with Dr. Jill Crista

STUDY: Foods that can bind to bile

215: What's Bile Got To Do With Clearing Mold w/ Dr. Jill Crista FULL TRANSCRIPT

Jennifer: Welcome back to the show, Dr. Jill. I am so excited to have you back. And actually, our previous interview was one of the most insightful interviews that I've had with people, and especially on a topic like mold that I'm not… This is not where my background is. I'm not well-trained on it. And the way that you approach it is just so… not simple. I don't want simple to be mistaken for like, there's not a lot of steps, but you've taken things down to a level that feels so manageable and so commonsense, which I really appreciate, and I think many in my audience do as well.

Jennifer: So I'm excited to talk today. We're going to be talking about bile sequestrants and how that impacts mold, because I don't work with mold in my practice, but I do try to spot mold cases and shuttle people to the right practitioners, especially the right doctor, to get the help that they need. So thank you so much for joining us again today.

Dr. Crista: Thank you for having me. This is such a treat. I love having conversation with you. We've just chatted a little bit before we came on. It's fun, it's super fun.

Jennifer: I know, I know. So since we're talking about bile today, I wonder if some folks here do not know what bile is. I know that my psoriasis people may, because bile is talked about somewhat with psoriatic clients, but for those… Let's just assume that everyone's not really too sure what bile is, where it's made. Can we just do a little 101-

Dr. Crista: Yes, thank you.

Jennifer: … on bile, for us to get started?

Dr. Crista: Yeah, and thanks for letting me talk about bile. I am a bile-ophile, so that's one of my things. I like to label myself because I feel like it's one of the most underappreciated fluids in our whole body. And where it comes in, it's meant for… or a lot of people think of it as part of digestion. So basically, the smell and the taste of food induces salivation, which induces stomach acid secretion. Once that hits the stomach, the next step is bile and insulin and then digestive enzymes. So it's part of that level, kind of if we think of the middle burner, so the small intestine. That's where all of this is happening. So bile is made in the liver and then some of it is secreted into the intestine. Any excess is put in the gallbladder, and that's where it's stored until you have a really fatty meal, and then it's supposed to be secreted in response to eating fat or oils. If you don't have a gallbladder, you can still get better from mold because it's the liver that makes bile.

Dr. Crista: So what is bile? Bile is there to help us metabolize our fats to help keep all of the fat-soluble nutrients that we need, like vitamin D, vitamin A, vitamin K, vitamin E, all of our essential fatty acids, so the good fish oils, CoQ10, which is kind of like a fatty B-vitamin, it's a way to think about it. So when we eat those oils, instead of having it just be lubrication and have everything exit too quick, the bile is there to break up those oils, and grab it, and help our colon bacteria and some of our small intestine bacteria chew on that and make vitamins out of it for us. And then, the bile gets down to the lower part of the colon and we recycle about 93% of it.

Dr. Crista: So about that much goes back up through something called the lacteals, so that's the lymph system of our colon, delivers it back to the liver, and the liver plunks out the fat-soluble vitamins that we need and puts that into circulation, sends it off to wherever it's needed, and then makes the bile kind of empty so that it can be ready to take the next trip to the colon, to do its job. That works really, really well when we're trying to preserve our fat-soluble nutrients. Bile is why you don't need to take vitamin D in the summertime. And supposedly, you're not supposed to need to take it in the wintertime for the original human design is that we would be able to store that vitamin D in our gallbladder, in our tissues, in our everywhere because of bile and the work that it does.

Dr. Crista: It doesn't work really well when we have fat-soluble toxins, oil-soluble toxins, like mycotoxins, mold toxins. What happens then is the bile is getting those mycotoxins packaged up, so I'll talk through the pathway of the mycotoxin. So we breathe it in by breathing in moldy air. It comes into our respiratory passages, our sinuses, our lungs. Mycotoxins seep right into our bloodstream because they're fat-soluble. They don't need to have a carrier protein or a key to enter the cell door. They just kind of ooze in. And that goes into our bloodstream, which means that when you're breathing mycotoxins, they can go everywhere in your system.

Dr. Crista: When it passes through the kidneys, the kidneys say, “Ooh, that's a toxin. Let's pee it out.” When it gets to the liver, the liver says, “That's a toxin. It's fat-soluble, so we're going to bind it up in bile,” or, “package it up in bile,” I shouldn't use the word bind, “and we're going to send that out to the colon to be pooped out because that's not good for us.” Problem is, then that bile gets recirculated and it goes back up to the liver who gets to see it again, and again, and again and again. So it's like this-

Jennifer: So it's basically like you can't… the mycotoxin trash, so to speak, you can't get it out of your system.

Dr. Crista: Right, only 7% then, gets pooped out. And so, that's why we use binders in mold, although I don't use binders as aggressively as other doctors because I have found, and we see this from research that isn't related to mold at all, that insoluble fiber is a very effective binder of bile. So if the target in the colon is bile that has these mycotoxins all packaged up, then really, what we're trying to do is bind the bile to get pooped out. And we see it from cholesterol studies that insoluble fiber is one of the first things even conventional medicine doctors will say to start taking to reduce your cholesterol, and there's a reason for that. It's because it's carrying that out of the body and now you don't have to recycle and recycle and… I call it detoxification insanity. You're doing the same thing over again, expecting different results.

Jennifer: Okay, so many questions here. Let's jump onto the most immediate question, I think, which would be for somebody listening to this and they're like, “Wait, what would be an example of an insoluble fiber,” since-

Dr. Crista: Yes, so that's-

Jennifer: … they're just terms.

Dr. Crista: … good old-fashioned, mm-hmm (affirmative). I know. It doesn't have sex appeal, so it's not getting promoted, and that is good old psyllium husk. You can go to the health food store and get clean psyllium husk fiber that's been ground down. You can add it to your water and just drink it. You can eat flax seeds. They should also be ground before you eat them because a lot of people don't have enough of the colon bacteria to break that hole down, so just little coffee grinder that's dedicated to your flax seeds, keep them in the fridge, grind up two tablespoons, three tablespoons, and sprinkle that over your food throughout the day. That's the easiest way to do it.

Dr. Crista: Chia seeds are also high in insoluble fiber, and brans of all kinds, so rice bran, oat bran. People who have mold sickness tend to have fungal overgrowth, so I'm careful not to say oatmeal unless they can tolerate it because sometimes, having the carbohydrate part of that grain can be problematic for some people and cause bloating, and discomfort, and more skin breakouts and that kind of thing. But just the bran doesn't have the carbohydrate in it. It has the insoluble fiber. And we've done such a good job in our society to create no insoluble fiber because it's chewy, it's hard to digest, it takes longer to eat, and so we've taken all the holes and the bran off of things so that people don't have to work. But unfortunately, that bran is our colon bacteria's favorite food.

Jennifer: Mm-hmm (affirmative). And that is-

Dr. Crista: And that's how they make-

Jennifer: That-

Dr. Crista: It's important.

Jennifer: … is important. I know. We just said that at the same time. We're like, “That's important. It's so important.” I wanted to ask you, I had found this paper that said that there were other foods that could be helpful in binding to bile, things like okra, beets, asparagus, eggplant, turnips, green beans, carrots, and cauliflower. So for somebody who comes across this and says, “Oh, well, I eat those foods all the time,” maybe not okra all the time, but they eat those other foods all the time, do you think that those foods are sufficient? Any thoughts on that?

Dr. Crista: Well, I would love for food first to be the way that we go. And I think it really depends on the person and how much of a mycotoxin load and other chemical load that they're dealing with, so other fat-soluble nutrient types or fat-soluble toxins that they might be dealing with, like BPA. That's the plasticizers. A lot of xenoestrogens are also detoxified through the bile pathway, so they have a lot of those things going on. In my experience, once we add the mold toxin, it tips you over the toxin load to where food alone doesn't do it. But also, we have to pay attention to how those studies… What did they do to the food before they found that that was effective? And in the case of okra, they dry it and they super-fine grind it, and unless you get it super-fine ground, it's not as effective.

Jennifer: Oh, wow. So-

Dr. Crista: And so, you can actually get okra powder that's super-fine ground from Frontier Co-op in Iowa. And it's the cheapest way to go. So you can add okra to your general food of this dried and super-fine ground, same thing with the beets. So I think it's really, we have to understand, what did they do to the food, or what… it's not just the eating of the food. There's a concentrating of the fiber part of the food and a reduction of the hydration of the food that then makes it out there, thirsty, looking for stuff to bind to, if that makes any sense.

Jennifer: Yes, that's a really interesting point that you bring up. Also, just for anyone listening to this who's, you know for sure you've got a mycotoxin issue, I think it's important to underscore that you can't just say, “Well, I already eat this way. I already eat these things. I'm doing enough. I might not need more support.” I think that's an important distinction to make because it's different when you tip over to that point where your system is overrun with mycotoxins that… It's a-

Dr. Crista: You need a little extra help.

Jennifer: … different ballgame.

Dr. Crista: Yeah.

Jennifer: Yeah.

Dr. Crista: Yeah, and there are foods that are more effective as a whole food, like steamed kale. In studies where we look at people with their gallbladder removed, so it's cholecystectomies, when we look at those studies, those are great studies because they're not looking at mold, they're looking at bile. And so, if we understand the path of mycotoxin, again, you breathe it in, goes to the blood, goes to the liver, gets in bile, goes to the intestine. Now, we're binding bile.

Dr. Crista: So those are the studies I want to look at because they study really hard, what are the best things that bind that up, because people who are missing a gallbladder can tend to have bile dump diarrhea. They can tend to have more problems assimilating fats. They're going to have more skin expression because the skin really expresses when you're not metabolizing fat very well. So those studies show that steamed kale is about 35% as effective as a drug that can be used called cholestyramine, so adding kale to your diet. But I still have my patients add that extra insoluble fiber because that's what's going to help reduce the load. This-

Jennifer: Say, somebody wanted to give the psyllium husk a try. Are they looking at one tablespoon, three times a day, two tablespoons, three tablespoons? How much psyllium husk are you looking at?

Dr. Crista: So the average in the studies was about two tablespoons a day, but here's my big [inaudible 00:12:37] caveat, is no binding if you're already bound up. If you aren't having two easy bowel movements a day, I do not do binding. We work on pre-binders, and pre-binders are the things that stimulate bile production so that what I'm seeing is, a lot of people… The message right now, or the narrative in mold is like, “Oh, yeah, mold sickness, go on a binder.” Let's just take a second and assess, are you pooping two times a day? If you're not, that's our first goal. And the way that most sick people get constipated is that the bile gets sluggish, and bile stimulates peristalsis, which is the squeezing of the tube down to get poop movement.

Dr. Crista: So if you don't have the pre-binders in place, which are things that taste bitter, these are plants and some dietary things, a lot of people are coffee-dependent on their bowel movement. Coffee is a really powerful bitter, but it also has some calcium-depleting action, has some problems, especially with psoriasis. It affects cyclic AMP, which just is this whole detoxification thing that we need to not be inducing. So there are other plants that can do that. And I'm not against coffee, I just think it gets overdone. So a little bit of coffee, like the normal person's cup, would be great, but they're… I love the plants that are doing this because they come with all these other nutrients that are anti-inflammatory, that are antioxidant, that are helping reset the microbiome, and that kind of thing. Yeah.

Jennifer: Well, let's actually talk a little bit. You mentioned about the more potent binders, the step-up when you actually need some help. So I'm going to read this because it's a medication, so cholestyramine.

Dr. Crista: Mm-hmm (affirmative).

Jennifer: Yes, I got it right. So a friend of mine had mold issues. The one mycotoxin test that her doctor ran on her showed some pretty high levels of a not-so-hot thing that must have been lurking in her home. She went on this med and was told, “Well, you'll probably be okay. There's some side effects, but you'll probably be okay,” and she actually felt horrible. So can you talk a little bit about, what is the medication? Is it common to have side effects, or is it not? I assume, because it's a medication, it has to be prescribed by a doctor. And are there any other things, like clay or charcoal or any of these other binders, that might be an option as well?

Dr. Crista: Yeah, so it is quite common to have side effects because the way that Dr. Schumacher teaches doctors to dose it is four times a day at a pretty high dose, and it's very hard to manage food and supplements and things around that. And the narrative there also, is that if someone feels bad, it's because we've mobilized mycotoxins now. The body knows that we're moving things through the liver, and so now, the liver is freed up to detoxify either more mycotoxins or other toxins in the body. And I have found that that is potentially a problem. That's why, if you do too much at one time, that too much detoxification of anything, you have to be supporting all the pathways of that detoxification steps, all the steps. And I see a lot of people that they're just focused on glutathione, which I do use, but if you're not also supporting all of the things that help that toxic metabolite get out of the body, that's a problem.

Dr. Crista: A lot of people have side effects because the cholestyramine is very constipating. The problem with that is that the binding is sort of like two magnets. It can just slip right off. It's not like Velcro, so we shouldn't even use the word binding. We should use something like attracting or something like that because it's like static cling. So if you have someone who's constipated, now that mycotoxin, [inaudible 00:16:32], falls right off of the bile and now can impact the lining of the gut. These mycotoxins are very… They actually cause death to the cells in the colon, really important. So enterocyte-

Jennifer: Wow.

Dr. Crista: Yeah. You can see ulcerative colitis kind of pictures, Crohn's kind of pictures. If somebody is taking something that is making them so constipated, it's now freeing up that mycotoxin to do localized damage. And in animal studies, we see hemorrhages, so colon hemorrhage and bleeding and things like that. So not to scare everybody, but it is quite common to see side effects if somebody is both constipated and toxic. So that's why we start with, again, the pre-binder idea, like, well, let's make sure you're going to the bathroom two times a day.

Dr. Crista: Simple amino acids, like taurine, which we need taurine and glycine to make bile acids, taurine itself, if you're on a high-fat diet, like a good fats diet, that blocks mycotoxins from impacting those cells, and it helps pull bile… or pull mycotoxins out and bile out. We have to be thinking about this from a broader standpoint. One of the side effects as well is that cholestyramine also binds… It binds bile so effectively, we can see a deficiency in the nutrients that we need to make bile, so taurine, which impacts our retina, impacts our vision, a lot of people with mold sickness have vision issues, glycine, which impacts our neurotransmitters, that's like our chill-out neuro-transmitter of our brain, and also all of the fat-soluble nutrients. So all the ADEK, essential fats, all the things that are critical for healthy, glowing skin, can be taken out if you're put on this drug because it's so effective at grabbing bile, you deplete those nutrients.

Jennifer: Yeah, and it was traditionally used as a cholesterol medication.

Dr. Crista: Yeah, yep. If somebody has a familial cholesterolemia situation and adding insoluble fiber, like they're taking a quarter cup two times a day of insoluble fiber and you're not getting anywhere, that's when we go to the medication. Some people say cholestyramine made them feel awesome, that they felt so much better, but it does peter out, and I have concern about how frequently it's used at that high of a dose and for such long durations. For high cholesterol familial types, we use a much less dose, and it's this slow creep. You're just trying to keep ahead of it, and I've found that plants work really well for that.

Jennifer: Mm-hmm (affirmative). We've got activated charcoal, we've got the bentonite clay. I've seen even zeolite-

Dr. Crista: Which is a clay, basically.

Jennifer: Okay. What are your thoughts on those, because I see all these different products, and people will ask me about different types of binders. Are those included in this, or do they have the capacity to bind or attract bile, or even bind with mycotoxins, or they're not really all that effective?

Dr. Crista: They do bind to the actual mycotoxins. So in some cases where you are eating mycotoxins, and we know this from animal studies, not really from human studies, where they know darn well they're going to be feeding the animal moldy feed, instead of cleaning up the food, they're adding charcoal, clay, zeolite to the food to try to bind up that mycotoxin in the food either before it's eaten by the animal or while they're eating the food. So we do see that they're pretty effective at that, I would say on the scale of probably the kale, to that level, probably 25% to 30% of what a cholestyramine would do.

Dr. Crista: But they do also come with their own complications. Charcoal, if used long-term, can deplete nutrients, clay as well. Some clays are also toxic with lead. So when I do need to use extra binding, and some classic times would be when I'm about to start them on the anti-fungal part, because we will see some die off, then I like to use a product that's a carbonized bamboo product, and this is called… If anyone's looking, it's Takesumi Supreme. It's also purported, although even though I have Japanese speakers in my family, we couldn't find the research, but they purport that it also absorbs EMF's because it's so alkaline, it's so thirsty. But I will use something like that.

Dr. Crista: And I've found, when it's time to go beyond the insoluble fiber piece, which by the way, if people have SIBO, SIBO-friendly ones are sunflower, pumpkin seed, and sesame seed, so you can even do it if you're on the bi-phasic diet. So if we have to go beyond that two, three tablespoons a day of the insoluble fibers, then I use a combination product that might have a couple of things, because I'm trying to get at the bile, but also anything that might also be out there, like endotoxin. People who feel really good on charcoal have a huge endotoxin load, in my experience. People who feel really good on zeolite have a heavy metal toxic load as well. So those are when I'm looking at the whole picture of somebody and I'm trying to pick and choose, but I only do them in a pulsed fashion and when we know there's going to be a predictable flare, so adding antifungals is a great time to have a flare.

Jennifer: See, this is not my wheelhouse, this whole entire conversation, because this isn't what I get into, and so you've educated me tremendously on this topic. It also underscores to me why this is so complicated for someone who's going through mold illness. It's not a straight line. There's not one way, and that's what I'm hearing from you. There's not one way. If you just do this step, and that step, and this, and 10 or 20 steps down the road, you'll be better. It doesn't sound like it's as simple, and that because there is so much… We have different genetic factors. Obviously, people live in different homes, they've got different nutrient issues, different dietary factors, different levels of dysbiosis, even, within their GI tract or their bodies, all sorts of things. It does make it complicated, and it is one reason why… Think I've had… been even contacted on Instagram and say, Oh, do you deal with mold?” And I'm like, “No, you should go see a doctor.”

Dr. Crista: But people can do a ton to improve their picture. I'm all about empowerment. I'm trying to change that narrative, that it is complicated. I think it's lengthy, I think it's individualized, which is what I'd really tried to convey in my book, is like, okay, these are the tools, some of them, there are many, many that we can use for each section, pick and choose the ones that match for you. And if you're using whole foods and plants, and plants make it so easy because they have these multiple mechanisms of action, we're improving a whole lot of things with just one or two plants. I mean, that's what they were put on the planet for. But I do think that some people can get really sick and they need a skilled practitioner because everyone will have mold sickness in a different way, because it's fat-soluble. It can go to lots of different places.

Dr. Crista: So the other bile things that we see if somebody gets depleted with cholestyramine use, or too much gunky bile, bile does all this other stuff for the gut, which then affects how your skin looks and all those things. Itself, being in the colon, it will increase secretory IGA. And we talked about how mycotoxins can damage the lining of the gut. By the presence of it in the colon, it will bring intestinal cells to the surface. I think of it like shark teeth, like if a shark loses a tooth, another one just, [inaudible 00:24:36], comes up. That's what bile is doing for our gut. And it helps improve your vision. I mean, it's amazing. It's an amazing fluid.

Jennifer: So the point here isn't to be anti-bile. We need our bile, but there's that balance point. You don't want to go too far. Going too far and getting rid of too much bile could actually have very negative, unintended consequences, essentially. Well, so first of all, you've got an excellent book we've talked about before. Tell us a little bit about the book and where people can get it.

Dr. Crista: Yeah. It's on my website, on Amazon, Barnes & Noble. If you don't like to support Amazon, you can go to Ingram. That's a indie book place. And if you're in Canada, I don't know if you have Canadian listeners, we now finally have distribution in Canada through Ingram, so that's where you can get it.

Jennifer: Awesome. And tell everybody the name of the book.

Dr. Crista: Break the Mold: 5 Tools to Conquer Mold and Take Back Your Health.

Jennifer: Yeah, it's a great resource for anybody who's curious about this. And then, if you are a practitioner listening, more so on the doctor side of the spectrum, Dr. Crista has a really amazing training program to… and also, a list. So if you're a patient and you're looking for help, you can go and seek out a mold-certified physician who has gone through her training. So either, you can go through her training as a doctor, or if you're a patient, you can look for someone who's gone through it. That way, you know that you're working with someone who has this level of experience and knowledge and understands how to individualize the process for you based on what is presenting, which I think is really important and awesome. And so, I just want to thank you so much for being here again. I know you are so busy, so it's a huge honor to have you back.

Dr. Crista: Oh, so funny-

Jennifer: And-

Dr. Crista: … talking to you.

Jennifer: … hopefully, we'll have another conversation all on mold again, sometime.

Dr. Crista: Yep, sounds good. Thank you so much.

When you think of methods to detox from mold, bile may not be the first thing that comes to mind. But, as my guest today will explain, bile can actually play a huge role in how (and if) mycotoxins are leaving your body.

Jennifer Fugo, MS, CNS

Jennifer Fugo, MS, CNS is an integrative Clinical Nutritionist and the founder of Skinterrupt. She works with women who are fed up with chronic gut and skin rash issues discover the root causes and create a plan to get them back to a fuller, richer life.

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