March 2012: The evolution of my practice

It’s been 2 1/2 years since I last posted an article on this blog.   It’s mostly because I’ve been posting updates on our Facebook page.  However, it’s time to write more than just a few sentences to describe what’s happened over the last 2 1/2 years.

In July 2010, I left my practice of 10 years at Internal Medicine Associates of Rockdale (IMAR)  in Conyers to open Bridges to Health, LLC in Atlanta with Terry Thompson Horn.  Starting a new business is not easy and there were many hiccups and obstacles to overcome, but one by one they were solved.

I left IMAR because I wanted to focus on understanding why people get sick and correct the underlying causes instead of masking symptoms with medications.   My intention was to use the principles of functional medicine which says that every part of the body is interconnected with each other.  If you correct problems with food allergies, digestion, hormones, metabolism, and inflammation, then health should be restored.  Extensively using lab tests not used by conventional doctors, I found that the vast majority of people who were told previously that “their tests were normal”, had multiple abnormalities with food allergies, digestion, hormones, metabolism, and inflammation.

In the middle of 2011, my approach to health care was turned on its head when I started to read the research by Ritchie Shoemaker, MD.  He has been studying chronic fatiguing illnesses for over 10 years.  He discovered that just about everyone who has chronic fatigue, fibromyalgia, multiple symptoms, or unexplainable symptoms had what he called a biotoxin illness.  Biotoxins are poisons released by microbes and they primarily damage nerve function.  Dr. Shoemaker found that 75% of the population had genes that protected them against biotoxins, but 25% did not.  Without protective genes, those exposed to biotoxins would build up  high levels in their bodies and their immune system would go into a “state of panic” and release large amounts of chemicals such as free radicals in an attempt to eliminate the toxins.  This process is called chronic inflammation.  It is like an army who knows they are in danger and fire their weapons blindly at an enemy they can’t see.  This results in collateral damage to the body.

Some of the major effects of this chronic inflammation include lowering of blood flow, oxygen, and nutrients to organs and tissues and disruption of hormones.  For example, lack of blood to the brain will cause fatigue, poor memory, and mood disorders.  Lack of blood to muscles will cause muscle pain.  Lack of blood to the gut can lead to a variety of digestive complaints.  The hypothalamus is a gland in the brain which controls all hormones.  Chronic inflammation from biotoxins usually causes it to malfunction.  One can get an abnormality of just about any hormone in the body.  Many people who come to my practice have diagnosed themselves with a hormone problem.  In most cases, the hormone problem was triggered by a biotoxin.

Shortly after reading about Shoemaker’s research, I started to run tests looking at those genes and for inflammation caused by biotoxins.  To my surprise, I found that nearly all my patients did not have protective genes against biotoxins and nearly all of them showed signs of inflammation from biotoxins.  I shared my experience with other integrative practitioners around the country and to their surprise, they found the same thing I did.  Could it be that the vast majority of people who aren’t helped by conventional medicine and seek integrative care have a biotoxin illness?

What are the symptoms of biotoxin illnesses?  Many of my patients were told by their doctors that “it was in their head”, they were “depressed”, or they are “getting old.”  Some are diagnosed with chronic fatigue syndrome, fibromyalgia, or irritable bowel syndrome.  Universally, they were told that their labs were normal.  However, when I ran labs looking for evidence of a biotoxin illness, I found it nearly universally.    Biotoxins affect people differently so no two people look exactly the same.  The following is a list of the symptoms I and others seen so far that seem to be either caused or worsened by biotoxins.

•    Fatigue
•    Insomnia
•    Brain fog
•    Poor memory and concentration
•    Confusion / disorientation
•    Word finding problems
•    Headaches
•    Weakness, poor stamina
•    Autoimmune disease
o    Hashimotos
o    Lupus
o    Rheumatoid Arthritis
o    Multiple Sclerosis
o    Polymyalgia Rheumatica
o    Others?
•    Parkinson’s Disease
•    Alzheimers
•    Lou Gehrig’s Disease
•    Fibromyalgia
•    Chronic Fatigue Syndrome
•    Multiple Chemical Sensitivity
•    Light and sound sensitivity
•    Blurry vision
•    Red eyes, tearing
•    Tinnitus
•    Seizures
•    Muscle pain and/or cramps
•    Muscle or facial twitches
•    Tremor
•    Joint pain and/or stiffness / tendonitis
•    Back pain
•    Painful soles esp in the AM
•    Neuropathy: numbness, tingling
•    Neuropathic pain
•    Skin sensitive to light touch
•    Metallic taste
•    Digestive problems
o    Reflux
o    IBS
o    Persistence microbial imbalance
o    Abdominal pain
o    Nausea / vomiting
o    Constipation / diarrhea
o    Food sensitivities
•    Feeling hot and / or cold
•    Hot flashes
•    Fevers
•    Sweats
•    Swollen lymph nodes
•    Frequent infections (sinusitis, bronchitis)
•    Hormones (numerous)
o    High and low adrenals
o    High and low estrogen, progesterone, testosterone
o    High and low thyroid
o    ED, decreased libido
o    Menstrual disorders
•    Mitochondrial damage
o    Problems generating energy
•    Impairs liver detoxification
o    Depleted antioxidants
o    High levels of lead and mercury
o    High levels of other environmental toxins
o    Sensitive to alcohol
•    Mood disorders and swings
o    Depression
o    Anxiety
o    Bipolar disorder
o    Schizophrenia
o    Obsessive compulsive
•    Dizziness / vertigo
•    Restless legs
•    ADD
•    Autism
•    Poor wound healing
•    Air hunger / shortness of breath / cough
•    Chest Pain
•    Palpitations
•    Hair loss
•    Appetite swings and weight problems
•    Frequent urination
•    Thirst / feeling dehydrated
•    Interstitial cystitis
•    Electromagnetic field sensitivity

Insulin resistance.


According to Dr. Shoemaker, the most common biotoxin are those released by indoor mold and bacteria.  When wood or drywall is exposed to a relative humidity of 60% or higher such as from a water leak or being in a humid basement or crawlspace, that’s enough to start feeding the growth of mold and bacteria.   They release a variety of substances which trigger uncontrolled inflammation in genetically susceptible people.  75% of the time, the mold is in a crawlspace or basement and the HVAC system blows the toxins into the main areas of the home.   Because, most people have protective genes, only some people get sick while the rest feel fine.

Dr. Shoemaker has developed a step by step protocol which he says will help over 90% of people recover.   I’ll talk more about those steps in a later post.

For more information:

Dr. Shoemaker has written a book called Surviving Mold.  Parts of it are difficult to read, but it is all about his research on CIRS.

Dr. Shoemaker has a website at

Dr. Mercola has interviewed a mold expert at

The Global Indoor Health Network has a document on mold at

Policyholders of America has a document on mold  at

Dave Ou, MD




Shoemaker R, Rash JM, Simon EW. Sick Building Syndrome in water-damaged buildings: Generalization of the chronic biotoxin-associated illness paradigm to indoor toxigenic fungi; 5/2005; Pg 66-77 in Johanning E. Editor, Bioaerosols, Fungi, Bacteria, Mycotoxins and Human Health.

Shoemaker RC, House DE. A time-series of sick building syndrome; chronic, biotoxin-associated illness from exposure to water-damaged buildings. Neurotoxicology and Teratology 2005; 27(1) 29-46

Empting, LD. Neurologic and neuropsychiatric syndrome features of mold and mycotoxin exposure. Toxicology and Industrial Health. 2009; 25(9-10), 577-581.

Shoemaker RC, Mark L, McMahon SW, Thrasher JD, Grimes C (2010). “Research Committee Report on Diagnosis and Treatment of Chronic Inflammatory Response Syndrome Caused by Exposure to the Interior Environment of Water-Damaged Buildings”

McMahon SW, Hope J, Thrasher JD, Rea WJ, Vinitsky AR, Gray MR (2010). “Common Toxins in Our Homes, Schools, and Workplaces”


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