Chris Kresser: Sure I’m totally open to you having access to the biotoxin survey. Maybe we can make a note of that, Lauren or Jill, if you’re listening. That’s publicly available information that we converted into an MD HQ questionnaire that automatically records the result. So I think we can make that available to you. The problem and then the visual contrast sensitivity test, that’s a screening tool that was developed by a scientist working for the EPA, Environmental Protection Agency, after Hurricane Katrina. And they needed a quick way of determining who had been affected by mold post-Katrina. Of course, because with the flooding and they had tons of moldy houses and people living in those houses. And so the VCS test was a way of determining who was affected by that. We know that mold toxins preferentially affect the optical nerve and they can decrease our ability to detect visual contrast. So if you’re looking at a bull’s-eye, let’s say with concentric circles of black, alternating with white, and it’s black-and-white, everyone can detect that contrast. But as the contrast diminishes in a series of patterns that the patient has displayed, it becomes more lighter and lighter gray versus white. And people with biotoxin illness have an impaired ability to detect visual contrast on that test. And so it’s a really quick way of determining whether someone might be affected and it’s, according to Shoemaker’s data, it’s pretty sensitive and specific. So in his data, 92 percent of people with biotoxin illness had a positive VCS test. Now I’ll tell you that that number is not nearly as high in our patient population and we’re not sure why.
One theory I have is that because we advocate a nutrient-dense diet, our patients are consuming a lot of preformed vitamin A and retinol and that may be boosting their vision and compensating somewhat for the potential defect in visual contrast detection that they would otherwise have. But that’s just speculation. I don’t really know. I would say it’s more like 60 to 70 percent of our patients have with CIRS have a positive VCS. So these are just screening tools. You have to remember even if a patient has a negative VCS and a negative biotoxin illness survey, that doesn’t completely rule out the possibility that they have biotoxin illness.
If they have a positive VCS and a positive biotoxin illness survey, according to Shoemaker’s data, the likelihood that they have biotoxin illness would be over 99 percent. So it’s easier to rule it in that it is to rule it out with these screening tools. And then the biomarkers that you run after data, unfortunately, I don’t think I’m going to be able to do justice to those in this call. That starts to get very complex and I intend to have a module on biotoxin illness in the future. It’ll probably be one of the first advanced modules that I teach, because as you pointed out, Marcy, there are a lot of people who are dealing with this and it’s dramatically under-recognized and underserved out there. So stay tuned for that. And in the meantime you can look at the Shoemaker Survivingmold.com site and there’s a practitioner directory of people who are familiar with biotoxins who have been certified in his method. And it’s not a lot of people for sure, but there are a growing number of them. Seems like I see a new doctor that gets certified every once a month maybe. And they’re not necessarily functional medicine specialists, but they know the Shoemaker protocol. So in some cases you could refer out specifically for the Shoemaker protocol, but have the patient continue working with you on the functional medicine side.