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166: Mold + Histamine Connection w/ Dr. Jill Crista

When we think of histamine issues, most of us think of the usual symptoms (e.g. runny nose, congestion, itchy eyes). But did you know that high histamine can also cause behavioral issues and skin rashes, particularly in children?

Or, listen on your favorite app: iTunes (Apple Podcasts) | Spotify | Stitcher | TuneIn | Subscribe on Android

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 talk about mold, mycotoxins, and the connection between mold and histamine issues.

Have you discovered your histamine issues are related to mold illness? Tell me about it in the comments!

In this episode:

  • Why is mold such a problem?
  • What are mycotoxins?
  • Difference between mold and mushrooms
  • What is MPA and how does it relate to the gut?
  • How is mold related to histamine issues?
  • Why might nettles help?

Quotes

“These toxins called mycotoxins are designed for that mold to defend its territory. So the very design of these toxins is to kill other living things, mainly microbial, but they do affect human health as well and the pets in that space.” [3:18]

“MPA is mycophenolic acid, it's made by a few different species of indoor, toxic mold, aspergillus and penicillium.” [7:32]

Links

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?

Practitioner Training Course

Follow Dr. Crista on FacebookInstagram

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

Healthy Skin Show ep. 134: Dealing with Mold & Opening Detox Pathways w/ Toréa Rodriguez, FDN-P

166: Mold + Histamine Connection w/ Dr. Jill Crista FULL TRANSCRIPT

Jennifer: Thank you so much, Dr. Jill for being back with us. Actually, let me start that over, this is the first time you were here. Thank you so much, Dr. Jill for being here with us, I'm actually really excited because Dr. Holland had suggested you as a guest and I've been following your work for some time because mold is not my specialty, I started to feel like that's like a higher scope of practice, and a lot of times you should work with a doctor on. I feel really grateful to have you here to share everything you know.

Dr. Crista: Thank you. Thanks for having me. I feel really lucky to have the platform to spread this word about mold.

Jennifer: Yeah. I mean, it's funny because like I remember even 10 years ago, you didn't really hear that much about mold. The topic has grown in popularity. It's almost maybe a little sexy now in the wellness world.

Dr. Crista: Sexy mold. Well, if that's the case, I take some personal pride in that because I feel like I've been working really hard to get the message out there. There are a couple of docs that we're really putting ourselves out there and trying to spread the word about mold illness because it is one of those most hidden illnesses. I really do hope it trends. I hope it does become sexy because then it can start to hit the radar because I think now it's completely missing. It's missing the radar.

Jennifer: So why don't you tell us a little bit about why mold is such a problem? Because a lot of times people think they don't see mold, so they don't have mold, but that's not necessarily the case.

Dr. Crista: That is not necessarily the case and just because you can't smell mold, doesn't mean it's not there too. The mold toxins, called mycotoxins, these guys don't have a scent. They're a chemical and they don't trigger anything in our scent system. So you can have mold trapped behind building materials and the spores and fragments are trapped there but if it's getting all of the water that it needs, and sometimes it just needs humidity. If you've had a water event, that may have been the spurring event, but then having just high humidity in your house could be the thing that continues to feed it. So, you can have all these things happening in your house behind the building material, not see anything. It can be under flooring, can be in your attic, could be in your crawlspace and-

Jennifer: I want to add to that.

Dr. Crista: And you don't get that smell.

Jennifer: It can be in your front load washer.

Dr. Crista: Yes, it can be in your refrigerator filter. If anybody's interested, I have a video blog about that. I try to make my video blogs, I have a whole bunch of them out there, that are like a minute or less because if you have mold, one of the main symptoms is brain fog. So yeah, I have a video blog about that. So yeah, there can be mold that you don't catch by smelling it. If you look at the CDC's definition of mold illness, it is things that have to do with interaction with spores. So it's going to be sinusitis, allergies, hay fever, asthma, if it's really severe, but that's where they stop with the definition and I'm on a mission to really expand that definition to the toxins and the chemicals that mold secretes. So, these toxins called mycotoxins are designed for that mold to defend its territory.

Dr. Crista: So the very design of these toxins is to kill other living things, mainly microbial, but they do affect human health as well and the pets in that space. These toxins can go through building material. So if the mold's trapped behind building material, you may not be having any quote unquote mold symptoms because you're not having sinusitis hay fever, asthma, that kind of thing, but you are going to be getting exposed to the chemicals and that's where we see, for my personal practice probably the majority of my patients are dealing with mycotoxin illness and not so much spore allergy-type symptoms.

Jennifer: A quick question for you and I get this a lot. Is there a difference and what would be the difference between mold and say mushrooms? Especially now, we have this huge upsurge and seeing of popularity, so to speak of medicinal mushrooms.

Dr. Crista: Yeah. They're all in the fungus family, but the mushrooms and mold that can grow indoor are different … what would that be, genus? I don't know, the next level down. So they're all fungus and that's why part of my protocol is to actually take people off fungal things because when you've been exposed to a water-damaged building the messages in those toxins, what that's communicating to the body is that fungus wants to come and take over your body. So if you add more fungus, like Saccharomyces boulardii is often used for a garden variety candida infection, that works great when it's an acute infection, like you had some antibiotics, you had a candida overgrowth and you're just trying to reset a normal flora. But if you're getting exposed every day to these toxins, now the message is that you are not safe and fungus wants to move in. If you add other fungus, I've just learned from practice that people have more reactions from that. Yeah, so they're different.

Jennifer: So, that could be the S. Boulardii it could even be … Oh goodness.

Dr. Crista: [crosstalk 00:00:05:25].

Jennifer: Lion's mane. It could be any of these that people are marketing as … I think that's an important lesson too, that it's sort of the Goldilocks syndrome. We always think more is better, but then we have to take a step back and say, “Well, is it better for me?” Maybe I need to find the right amount and the right amount in this particular moment is none.

Dr. Crista: Right, and it's a very important part that I teach … I have a practitioner course where I train practitioners in how to treat mold illness. It is the last step, what we call micro remediation, in a treatment protocol. When we know the person is out of the mold, they have all the fundamentals in place, we've done repairing their body from the mycotoxin exposure, protecting their selves, we've reset the balance with antifungals. Then the next step, when we know we've won the game, is using medicinal mushrooms to restore the immunity and the immune function because mold mycotoxins are incredibly immune depleting and suppressive.

Jennifer: Wow. That's really cool to be able to use the different … Wow, that's really neat. So cool. I think that's also helpful to give people hope here, if they're struggling with this or they're not sure what to do. So A, there are practitioners certified in your protocols that can help. Do you have a directory on your website just in case somebody is looking?

Dr. Crista: Yes, yes. I have a Find A Doc page so they can find a practitioner in their area and it's listed by region. So you can go to whatever country you're in first, then whatever state or province you're in and then find your city, yeah.

Jennifer: Perfect, perfect. So I have a few questions for you, because I feel like this … so we talk a lot about the connection between skin issues and gut issues. I think a lot of times in the functional integrative world, everybody just goes, “Oh, you got to heal leaky gut.” Well, that's great but there are so … For me, I'm like, “We have to find the triggers that are causing the problem first.”

Dr. Crista: Exactly.

Jennifer: One really eye-opening post that you shared was about this substance called MPA and how it relates to the gut. Could you talk a little bit about what that is?

Dr. Crista: Yes. MPA is mycophenolic acid, it's made by a few different species of indoor, toxic mold, aspergillus and penicillium. When we were talking about the mycotoxins, those are made defensively, so they're going to be made more like a bomb by the mold if it has something else. But basically I think of it as it found waterfront property and wants to defend itself. But when mold is happy and it's not trying to defend itself, it spits out this chemical, it spits out these kind of … I jokingly in the post call mold farts because it's just happily metabolizing and eating and doing what it's put on the planet to do, which is to break down dead material and make it into nutrients. Normally in nature, there are things that come along like insects and other things that come and eat those nutrients and everything stays in a harmonious balance.

Dr. Crista: You bring it into an indoor environment and this mold is able to just metabolize and off gas basically, and its products of metabolism. Unfortunately, that MPA also can go through building material. It can also greatly affect human health. So much so and so reliably so, it's actually been made into a pharmaceutical drug to prevent organ rejection and for people with autoimmune disease gone crazy. It's called CellCept.

Jennifer: Wow, wow.

Dr. Crista: So yeah, you could be basically giving yourself a pharmaceutical immune suppressive just by breathing your indoor toxic air.

Jennifer: Wow.

Dr. Crista: Isn't that wild?

Jennifer: That is really wild.

Dr. Crista: We know that this one in particular, it just wrecks the gut, this mycophenolic acid. We know that it's really readily absorbed. So it goes in very quickly and it will cause destruction of the enterocytes, which is the cell lining, the gut.

Jennifer: So this is why it's like no bone broth is going to fix that.

Dr. Crista: Yeah, exactly. No air filter is going to keep up with it either. I mean, that's the other question I get a lot is, “Well, do we have to remediate or can we just run some really good air filters?” I can tell you that an inch square of mold that you can see is over a million spores, a million spores-

Jennifer: Gosh.

Dr. Crista: … and that's just a single layer. So they often grow in 3D of course, so that's balloons full of toxic gasses that are made over a 24 hour period. No air filter's going to keep up with that.

Jennifer: No, no and the other issue too, is that a lot of times … I have worked with a lot of people that have histamine issues. So mold can be connected to histamine issues. Obviously, if you are … Let's say you're in this environment where you have this MPA and this is increasing the permeability of your gut, making it leakier. Now, all of a sudden you have all these … Oh goodness, you've got all these flare ups of hives and when you sweat, you're just becoming incredibly itchy and everything's driving you nuts. Some people even live in humid environments, which I'm sure doesn't help matters any.

Dr. Crista: Doesn't help, right.

Jennifer: So how is it that mold is related to histamine type reactions?

Dr. Crista: So first is the mold spore. The spores are allergenic. So they're going to up regulate how many mast cells you have floating around in your body, they're going to uprate … and when I say mast cell, that is the cell that secretes or makes histamine. So now you have just more cells that can make histamine, but there's also the mycotoxins and those chemicals that we're talking about, those are fat soluble, and we can absorb them more readily through the skin than any other way of getting them in, including breathing and eating.

Dr. Crista: So our skin is, as you know, incredibly absorptive surface and also a layer of fat. So, that's where these things can accumulate on the skin. For different people, that's going to express in different ways. For people who already aren't being exposed to the spores and they're having that allergic tendency in the up regulation of total number of mast cells that can make histamine, they're going to have more of the inflammatory histamine type reactions.

Dr. Crista: For people that their reaction is more increased aging. It's sort of like your Ayurvedic dosha, which way are you going to go? Are you going to be an excess inflammatory person? Or are you going to be a aged, wrinkled, age spot person? Or are you going to be somebody who starts to get scarring types of eczema or scarring types of psoriasis? So, there's all these different expressions with the same cause, and that's why it's so hard to figure out mold.

Dr. Crista: So with the histamine thing, we also are seeing that mold mycotoxins do this particular thing with a gene that can change how much a mast cell can spit out histamine. You basically are just becoming like a histamine factory and it will change where in the body these mast cells go. So mast cells don't decide what they're going to do until they get to the tissue that they're supposed to get in. I heard your interview with Dr. Heather's Zwickey and she had referenced she has these two hives on her hand and that … The why or where we don't know, it could be because you had an old injury somewhere, that that's going to send more of those cells but there is a direct correlation between a mold and mycotoxin exposure and people with increase histamine reactions.

Dr. Crista: We actually see that people that were going along fine in their life and suddenly develop a pollen allergy, or a food allergy, or a grass allergy, or a dog allergy and they've had dogs all their life. That usually is something has happened to their body. So it could be something more gut destroying, like glyphosate or pesticides. It could be an acute exposure, but we often see a new onset allergy of any of those kinds I just mentioned, having to do with exposure to a water-damaged building either through their work or their home.

Jennifer: That's where it gets complicated here. So if somebody is listening to this and obviously, they may be at the beginning of their journey. You mentioned, I saw on your website, you had this discussion little video, I should say about nettles, which I love nettles because they have great antihistamine properties to them. Or actually, I guess I should say, would nettles be … Nettles, by the way, for anybody who's like, “Nettles, what the heck is that?” That's an herb.

Dr. Crista: A weed.

Jennifer: A weed, yeah. A lot of people think of it as a weed. Why would nettles be a good option for somebody, or would it be for someone in this particular situation?

Dr. Crista: It's fantastic for this because when you do get the leaky gut and increased histamine, you also have absorptive issues with minerals and nettles hits all those points. It's very high in minerals. It's a deep, deep green so you could consider it one of your green vegetables. Spring and fall are the two times where nettles like to pop up, I'll actually use this as a sauteed green, instead of spinach or instead of chard. So it's high in minerals, high in the deep green color, so folic and folinic acid. It has anti-inflammatory and antihistamine effects, which is … there's your … I've had people say … I have a recipe out there on my website about how to make nettles lemonade. It's a DIY and it's wonderful. So you basically make nettles tea really, really, really … You steep it and make it really strong and then mix it half and half with lemonade. So it's like an Arnold Palmer, but you're using nettles instead of iced tea and it tastes wonderful. It's amazing for chilling out mosquito itches, eczema itches. It's just one of those itch calmers because it hits on all those levels. A lot of people with allergies are running low on minerals as well. All of these little trace minerals that help to re-regulate an inflammatory response. So nettles hits all of those, all those parts.

Jennifer: For someone who doesn't have access to fresh nettles, or they're like, “I don't know what that is. I'm not going to go find that.” There's teas, there's capsules. What would that person do? Is a nettle tea enough? Or are you looking for a certain concentration initially?

Dr. Crista: It is different for everybody. I've had people that come to visit my house and we're sitting outside and have a mosquito bite, or I've had people have hive reactions or whatever. They have one glass of this nettles lemonade and things calm down. So, I think that definitely with nettles, it's the more inflamed you are, the bigger the dose you're going to need. They're very safe to use, they're a food. So like I said, I can eat, and I think if someone wants to go see the video, the amount of nettles I have in my hand. I could eat that at one sitting, and often do and they're wonderful, and it's safe. It doesn't cause any problems with me. It's not like kidney damage or anything like that. They're super safe. So I think that you start, it's very naturopathic, start at the lowest amount. So, if you're buying capsules, start at one capsule, that's usually 500 milligrams of nettles. Or you can buy it in bulk from like Frontier Herbs. If you finding it's really working for you, you can get it in bulk, in a dried, cut and sifted way and then you can use that in tea and make your own teabags, or however you want to use it. It's just so easy and you can bathe yourself in it.

Jennifer: First of all, I want to say, I'm going to link in the show notes to that recipes that people can easily find that-

Dr. Crista: Yeah, perfect.

Jennifer: … on your website, but then let's talk about that, you mentioned … So I'm curious about this, plus we'll have to circle back about the calendula you mentioned. So talk to us about the baths.

Dr. Crista: Yeah. So I often will use nettles with calendula and the one thing nettles doesn't have is it's not antifungal. It doesn't have a real strong antifungal activity. It's going to be antifungal by nourishment, but not really. So nettles will help calm itch and histamine and the calendula calms those two, it's anti-inflammatory, but it's also antifungal. So often for children, we're dipping them into bath teas. So we just make these very strong teas and again, if you buy it in bulk, cut and sifted from a Frontier, it makes it very affordable. So you're not going broke, trying to skimp on a bath or whatever, and you just get the bath, you make strong tea and you can dump those into bath water and soak.

Jennifer: Wow.

Dr. Crista: And it does amazing. Or if you have a problem area, you can make that into just a bowl and take a compress and soak that compress and wring it out and then put it over your affected area. I love what you always say, it's more than what you put on your skin. You have to treat your body, that kind of thing but sometimes you also need to treat topically, you know?

Jennifer: Yes, yeah. But you can't just ignore, I think that's my big grievance, at least with just my experience with having eczema and going to a dermatologist, was it just was the outside. Like, “Here's a cream, here's a cream.” I realized that it's both the outside and the inside. If we were to approach it more from that perspective, probably we'd have way fewer people suffering the way that we do now in this day and age, which is frankly really sad and surprising given all of our medical advancements in science and all the research we have and all the wisdom that we have from so many different modalities as well. Yet here we are, with people who have peeling skin, their babies are crying in horrific pain. Everyone's like, “Well, I don't know what to tell you. You're just going to have to learn how to manage this.” I'm like, “That's not an acceptable answer.”

Dr. Crista: No, no, not at all.

Jennifer: So I wanted to ask you about, for those people who are really struggling right now, where maybe say they even go outside and it's just those mast cells become really destabilized so they're in a sweaty environment. They're having this issue and there's a lot of talk about using binders and glutathione and whatnot. Do you have any thoughts that you'd like to share on is that helpful? Is it not? Because you hear one person and then you listen to other people and everybody's got a different opinion on that.

Dr. Crista: Yeah, I do have a lot of thoughts about that, but I think really having people understand where I'm coming from, that I'm coming from my experience trained as a naturopathic doctor with a naturopathic view on things, which is very holistic and with a certain selection bias of the type of people who are going to come see me. I'm not getting the people that want just the cream, I'm getting people that want to get to the root cause. So I'm very lucky that way, and so my view on things is colored by my experience. I think also a nice thing about when there are lots of different ways to do something, that means there's no one perfect way. My way is an approach, but it may not work for everybody. So, do investigate different ways to do this so that you're finding that thing that gets you to the end goal the fastest.

Dr. Crista: For me, binders aren't the end all be all part of a treatment. That's a Shoemaker protocol kind of approach but when you treat more holistically, we're doing … I have five steps I have in my book, five tools. First one is avoidance. Second is fundamentals. Then there's repair, protect and fight. So the idea there is avoidance is the most important step, is you have to get out of that mold exposure. Just doing that, 50% of the time is effective. People's bodies detoxify, they eat the right food, they've got everything dialed in.

Dr. Crista: That is not the case for the other 50% who need to go through the rest of the tools and the fundamentals, that next step, sometimes that's the thing then that cures the person and that has to do with eating the right diet, things you shouldn't eat if you're mold sick, as a therapeutic diet, not a lifelong diet. Then things like getting on a circadian rhythm, getting movement, getting exercise and the nutrients that I find most important for mold sick people, that they're deficient in, is essential fatty acids and all the good fats. It makes sense because if this is a fat soluble toxin and you don't have good fats, you have hardened fats, it's going to lock those toxins in. So I have my little rhyme I got from my teacher, which is the solution to pollution is dilution.

Dr. Crista: So if you're diluting a fat soluble toxin, you need copious clean, correct fats. So making sure you have a diet high in good fats and supplements, if you can't do that, to really dilute out those fats. Then that's where binders come in, because the idea of the fats is that it's moving things through the bile and bile is where we detoxify fat soluble toxins and binders bind the bile. If it's a water-damaged building exposure. Now, if you're eating moldy food, that's a different deal, you might need certain … Dr. Neil Nathan's doing some incredible work right now, like this binder for this mycotoxin and this … But for the general mold sick person from a water-damaged building, making sure you're moving the bile, a lot of people can't do that. Then making sure that you're grabbing as much bile in the gut as possible and you can do that through food. An insoluble fiber of any kind can grab that bile and carry it out and then you have to make new clean bile with all those good fats that you just ate. So the second nutrient would be bioflavonoids, colorful veggies. You can't go wrong with vegetables.

Jennifer: No, you can't. No, you cannot. I love that. I mean, it's great too, that you have this great book that offers people that … I guess they may need help, right?

Dr. Crista: Mm-hmm (affirmative).

Jennifer: At a certain point, you may need more, deeper help, but at least it's an initial first step of saying, “Okay, let me start identifying issues and then dealing with it.” I like the approach. I mean, I think it's great to do food first when you can, sometimes you need more help-

Dr. Crista: Yeah, absolutely.

Jennifer: … and that's okay but when it comes to mold, I think that's where … and I just want to reiterate this again because I think that people need to hear this. There's a lot of people in the health world now that somehow pop up and they're an expert in something. As a clinical nutritionist, I feel like there are certain limitations on a scope of practice for anyone in the nutrition profession and I just think mold is … that's my opinion. I think mold is something, if you're going to work with somebody, you're going to go to a physician and work with them on that.

Dr. Crista: Yeah and that's the ideal thing. What I found and why I wrote my book is that there just weren't mold literate doctors out there. I thought to myself, “Oh, I'm in my little bubble.” In my little world, naturopathic doctors knew this is what I did, but that doesn't help anybody. then when we had mold in my own house and I was like, “Oh, oh, it's mold. We do this and we do this and we do … I had the protocol. That's when I felt very duty bound to write a book. So the book, we were talking about the steps. If you've done avoidance and you've done the fundamentals and you're still not better, that's where the meat of the book is, is how do I protect myself, recuperate from this? You asked about glutathione, that's a kind of a big gun. Some people can't tolerate that, quite a few of the really sick people can't tolerate just going for the glutathione right away.

Dr. Crista: Same thing with antifungals, they're a part of my protocol, but I wait until the very end because I … which might be two weeks from the first time I saw them, it might be eight weeks from the first time I saw them. It's different for everybody depending on what they came in the office with. But I've learned if you start there, I made people a lot sicker. We've seen in studies that if you try to kill mold, it will kick up its production of those mycotoxins to defend itself. You don't want to do that inside.

Jennifer: No, no, no, there's a lot of like, “Oh, you're just detoxing. You're just detoxing.” I'm like, “There's a certain point when that level of stress on someone's system is not helping them.”

Dr. Crista: Right, right. Like I say in my book, if it's too much, it's too much. Yes. it's not resolving in two to three days, whatever that is that you just did. I mean, any exercise program, you're going to be sore for a little bit too. I mean the same kind of thing, but you can push your body to where you're actually causing damage. So yeah, we got to slow it down.

Jennifer: Yes. So, the book is called Break The Mold: 5 Tools To Conquer Mold And Take Back Your Health. That is available, I assume Amazon and most other spots?

Dr. Crista: Yep and soon bookstores.

Jennifer: Awesome.

Dr. Crista: [crosstalk 00:26:45] that worked out.

Jennifer: That is awesome. I want to make sure that everybody can find you as well because you have a lot of great resources and as you said, short videos, so they're really easily consumable. You can find Dr. Jill over at drcrista.com and she's also on Facebook and Instagram. She's got a lot of great information over on Instagram, that's where I have mostly followed her. But her website too, is an amazing resource. I don't want to forget about moldquiz.com. Can you tell everyone what exactly is moldquiz.com?

Dr. Crista: Yeah. So this is a quiz I put out, just because I think a lot of people that, when they hear an interview with me, or they hear a certain symptom, they're like, “I have that.” So someone might be listening right now with eczema and think, “I wonder if mold is the problem?” So the quiz will tell you if there's a probability that it's mold or not based on symptoms, so it's just a short quiz. There's a lot of descriptions, so if you want to learn, that's fine but if you just wanted to get … take the quiz and get your results right away, you can do that too but there's a lot of education there. You get your results and they're targeted results to show if it is mold, what kind of way are you being affected by mold that's individualized to your symptoms?

Jennifer: Perfect. Well, thank you so much. I hope that we can have you back and maybe dig into some more. I love that we made mold sexy today and we talked about mold farts and also-

Dr. Crista: [crosstalk 00:28:18].

Jennifer: … nerdy things, I know, nettles. I mean, we went in areas that I've never gone before, but I love it. I really appreciate your willingness for sharing this kind of stuff so that people out there who are seeking answers and really can't seem to get much help, maybe this is a light bulb moment for them, or it's the motivation they needed to get the ball rolling. But I really appreciate it and I hope I can have you back sometime.

Dr. Crista: Thank you. Thank you, that was fun.

These toxins called mycotoxins are designed for that mold to defend its territory. So the very design of these toxins is to kill other living things, mainly microbial, but they do affect human health as well and the pets in that space.


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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