Article

Mold Detox Treatment: Expert Binder Protocol Guide 2025

November 5, 2025

Introduction

Mold detox treatment uses prescription binders—cholestyramine or colesevelam (Welchol)—to capture mold-related biotoxins in the gut and stop them from recirculating. Paired with environmental cleanup and clinician-directed, Shoemaker-aligned care, it can reduce inflammation and symptoms over time.

In plain terms, binders are bile-acid sequestrants that act like sponges: they lock onto toxins in the intestines so your body can remove them instead of recycling them.

In this guide, you'll learn:

What prescription binders are and how they work
When CSM vs. Welchol is typically used and why tolerability matters
How to manage common side effects without derailing progress
What progress usually looks like over the first 12 weeks
Which tests can help your clinician track recovery

Whether you're exploring options after a suspected exposure or already have a CIRS diagnosis, you'll find a clear, step-by-step path forward here.

Take our free eligibility quiz to see if clinician-directed care is a fit.

Medical Disclaimer: This guide is educational only. Treatment decisions should be made with a qualified clinician who can review your history, environment, and lab results.

What is Mold Detox Treatment?

Mold detox treatment is a medical protocol using prescription bile acid sequestrants to remove biotoxins from the body following mold exposure. While cholestyramine (CSM) has been the traditional choice, many MoldCo providers now prefer Welchol for its better patient tolerance. These FDA-approved medications bind to mold toxins in the intestines and prevent their reabsorption, breaking the cycle of chronic inflammation that keeps you sick.

The research is clear: When properly prescribed and monitored by a CIRS-specialized provider, 91% of patients achieve significant improvement when combined with proper environmental remediation and the complete Shoemaker Protocol.

Understanding Mold Detox
Prescription Binders
Treatment Protocols
Managing Side Effects
Supporting Detox Pathways
Diet During Treatment
Timeline and Expectations
Monitoring Progress

Understanding Mold Detox

How Biotoxins Affect Your Body

Here's the frustrating truth: Your body is designed to eliminate toxins. But mold toxins? They play by different rules.

These sneaky mycotoxins create a persistent cycle of inflammation in genetically susceptible individuals (that's about 25% of us, according to Dr. Shoemaker's research). Unlike typical toxins your body can process and eliminate, biotoxins get trapped in enterohepatic recirculation—a continuous loop where they are reabsorbed from the gut and sent back to the liver. This creates a chronic inflammatory state that standard detoxification methods cannot address, which is why prescription binders are essential for breaking this cycle.

The Toxic Cycle Explained:

Liver Processing → Your liver attempts to process biotoxins and dumps them into bile
Intestinal Reabsorption → Without intervention, biotoxins are reabsorbed in the small intestine
Continuous Circulation → Toxins return to the liver, creating an endless cycle
Chronic Inflammation → This recycling triggers ongoing inflammatory responses

This is why you can't just "detox" mold illness away with juice cleanses or supplements!

Why Prescription Binders Are Essential

Think of prescription binders as molecular sponges with a very specific job: breaking the toxic cycle that keeps you sick.

Prescription bile acid sequestrants break this cycle by binding to biotoxins in the intestines, preventing reabsorption. Richmond Functional Medicine explains that the structure of CSM is such that it binds negatively charged ionophores resulting in their excretion in the bile.

Here's why MoldCo exclusively recommends prescription binders (and not the charcoal your well-meaning friend suggested):

The Shoemaker Protocol requires prescription binders for one simple reason: they are the only tool with the right molecular structure for the job.

Cholestyramine (CSM): As a powerful anion-binding resin, it has the strongest affinity for biotoxins, though its potency can lead to more side effects.
Welchol (Colesevelam): MoldCo providers often prefer Welchol because it comes in tablet form and is significantly better tolerated.
Natural Binders (Charcoal, Clay, etc.): These simply don't have the correct molecular charge to latch onto biotoxins and pull them out of enterohepatic circulation.

Bottom line: We stick to what's proven to work.

Prescription Binders

Cholestyramine (CSM): Traditional Approach

Cholestyramine is a bile acid sequestrant that acts like a molecular sponge, capturing biotoxins in your digestive tract. Originally developed for cholesterol management, CSM has become the cornerstone of mold illness treatment.

How CSM Works

CSM's positive charge attracts negatively charged biotoxins, forming an unabsorbable complex that exits through bowel movements. This interrupts enterohepatic recirculation and allows your body to finally eliminate stored toxins.

According to Mayo Clinic, "Cholestyramine works by attaching to certain substances in the intestine. Since cholestyramine is not absorbed into the body, these substances also pass out of the body without being absorbed." This mechanism makes it uniquely effective for biotoxin removal.

Dosing Protocol

The Shoemaker Protocol utilizes specific dosing strategies for cholestyramine, but these must be individualized by your healthcare provider. Your provider will determine:

The appropriate starting dose based on your sensitivity
How quickly to increase the dose
Optimal timing relative to meals and other medications
Treatment duration based on your progress
When to transition to maintenance dosing

Important: Never adjust your binder dose without consulting your provider. The protocol requires careful monitoring and individualized adjustments based on your response to treatment.

Types of Cholestyramine

Richmond Functional Medicine identifies three formulations:

Regular CSM (Sandoz brand): Contains sucrose additives
Light CSM (PAR brand): Contains aspartame (may be problematic for chemically sensitive patients)
Pure Resin: No additives, often better tolerated but requires compounding

The pure resin is more expensive but better tolerated due to its lack of additives. The Sandoz brand contains sucrose while the PAR brand contains aspartame, making brand selection important for patients with specific sensitivities.

Critical Medication Timing

Must space from CSM:

Thyroid hormones: 4 hours apart (or chew medication and take CSM 2 hours later)
Narcotics: 2 hours before or after CSM
Thiazide diuretics: 2+ hours apart
Warfarin (Coumadin): 2+ hours apart
Fat-soluble vitamins (A, D, E, K): 4+ hours apart
All other medications: Minimum 1 hour apart

Important: CSM is an anion-binding resin that indiscriminately binds negatively charged molecules in the gut and bile. Any medication taken too close to CSM may be bound and eliminated rather than absorbed.

Important Contraindications

The Shoemaker Protocol clearly states that cholestyramine is contraindicated in:

Ulcerative colitis patients (absolute contraindication)
Crohn's disease patients (use with great caution if at all)
Complete biliary obstruction
Patients with significantly elevated triglycerides

Certain conditions require extra caution and monitoring:

Hypothyroidism: Requires careful timing of thyroid medication
Diabetes: Monitor blood sugar closely as CSM can affect absorption
Bleeding disorders: CSM can affect vitamin K absorption
Pregnancy/nursing: See Special Populations section below

Always inform your prescriber of all medical conditions before starting CSM therapy.

Welchol (Colesevelam): MoldCo's Preferred Choice

[Learn more: Welchol Binder Guide]

Why MoldCo providers often choose Welchol

Through treating thousands of patients, we've found that Welchol's superior tolerability profile leads to better treatment compliance and outcomes.

The practical benefits often outweigh this difference:

Tablet form (no mixing powder)
Significantly fewer side effects
Can be taken with food
Better for working professionals

Cleveland Clinic explains that bile acid sequestrants like cholestyramine and colesevelam are positively charged molecules that bind to negatively-charged bile acids in your intestines. This same mechanism allows them to bind mold biotoxins effectively.

"I tried CSM three times and couldn't function. Welchol changed everything - I could actually work during treatment." - Amanda, Tennessee

When to Choose Welchol

Severe CSM side effects
Chemical sensitivity
Need to continue working/traveling during treatment
Preference for pill form over powder

Welchol Administration

Welchol offers practical advantages over cholestyramine:

Tablet form: More convenient than powder
With meals: Can be taken with food, improving compliance
Better tolerated: Generally causes fewer side effects

Your provider will determine the appropriate dosing schedule based on your individual needs and response to treatment. The ability to take Welchol with meals makes it easier to maintain consistent therapy during daily activities.

Treatment Protocols

Starting Binder Therapy

Successful binder therapy requires careful preparation and gradual implementation. Dr. Shoemaker's research shows that patients who follow structured protocols have significantly better outcomes.

Pre-Treatment Preparation

Essential steps before starting binders:

Remove from exposure: This is the first and most crucial step in the Shoemaker Protocol. Our ERMI/HERTSMI-2 testing helps confirm a safe environment
Baseline testing: Complete VCS test and inflammatory markers using MoldCo's comprehensive panels
$99 starter panel vs $150-200 at standard labsResults in 5-7 business daysDirect provider interpretation included
Clear medications: Your MoldCo provider will review all current medications for interactions
Prepare for management: Get personalized strategies for managing potential side effects

As the only telehealth clinic working directly with Dr. Shoemaker, we ensure every protocol reflects the latest research updates.

Managing Intensification Reactions (or, "Feeling Worse Before You Feel Better")

For 20-30% of patients, starting CSM can temporarily feel like taking a step backward. This "intensification reaction" is not a sign of a new illness but a temporary detoxification response. As binders start working, stored biotoxins are mobilized and released, which can briefly amplify symptoms due to a spike in inflammatory cytokines.

It's important to know this is not a Herxheimer reaction (which involves dying organisms). Think of it as your body finally cleaning house—it can get a little messy before it gets better. Your MoldCo provider will help you prepare for and manage this possibility to ensure a smoother start.

High-risk groups for intensification reactions:

• Elderly or frail patients who have been sick for more than a decade
• Patients with post-Lyme syndrome (CIRS-PLS)
• Those with chemical sensitivities
• Patients with untreated MARCoNS

Your MoldCo provider will assess your risk and adjust protocols accordingly.

Prevention protocol:

Your provider may recommend a personalized preparation protocol to minimize intensification reactions. This typically involves dietary modifications and anti-inflammatory strategies tailored to your specific inflammatory markers and health status.

What Austin from Florida discovered: "My MoldCo provider started me on a preparation protocol first. Made all the difference - I avoided the crash that happened with my previous attempts."

If intensification occurs despite prevention:

Your provider has several strategies to help you through this, including dose adjustments, medication switches, or additional supportive therapies. Many patients find that switching to Welchol provides relief while still maintaining treatment progress.

These individuals may experience worsening symptoms and at times develop new symptoms. This does not mean CSM can't be used, but further precautions must be taken. Using alternative agents like charcoal or clay typically results in very slow improvement with recovery taking years instead of months with prescription binders.

Optimal Timing Strategy

Daily Schedule Considerations

Your provider will help you develop a personalized dosing schedule that fits your lifestyle. Key considerations include:

Spacing doses throughout the day for optimal effectiveness
Timing around meals and other medications
Coordinating with work or school schedules
Ensuring adequate spacing from supplements

Key Timing Principles

Your provider will create a personalized timing schedule that considers:

Optimal spacing from meals
Coordination with other medications
Your daily routine and lifestyle
Maintaining consistency for best results

Real patient insight: "Setting phone alarms was a game-changer. My MoldCo provider helped me create a schedule that actually worked with my life." - Jaime, California

Managing Side Effects

Constipation: The #1 Challenge

Let's talk about the elephant in the room: constipation. It's the most common side effect of cholestyramine therapy, and yes, it can be uncomfortable.

Mayo Clinic lists constipation as a "more common" side effect that may require medical management. The Shoemaker Protocol emphasizes maintaining at least one bowel movement daily for effective toxin elimination - because those toxins need to exit somehow!

Struggling with binder side effects? Our comprehensive constipation guide shares patient-proven strategies that actually work.

Evidence-Based Solutions

Immediate interventions:

Your provider will recommend specific strategies based on your individual needs. These may include dietary fiber, hydration recommendations, and other supportive approaches to maintain comfortable daily bowel movements - critical for toxin elimination.

Prevention strategies:

Your provider will determine appropriate dose progression
Follow mixing instructions provided with your prescription
Maintain adequate hydration as directed
Different formulations may be considered based on individual sensitivities

Critical tooth protection: Your provider will advise on proper oral hygiene practices during treatment. CSM is a powder that, when mixed, can stay in contact with teeth and potentially affect enamel. This is not a concern with Welchol, which comes in tablet form. Following recommended protocols is important for preventing dental issues during long-term CSM treatment.

When to adjust dosing:

No bowel movement for 2+ days
Severe abdominal discomfort
Symptoms interfering with daily life

Other Common Side Effects

Bloating and Gas (40-50% of patients)

Management strategies:

Your provider may suggest dietary modifications, digestive support, or medication adjustments. Many patients find relief by switching to Welchol, which MoldCo providers often prefer for its gentler side effect profile.

Nausea Management

Common side effects include gas, bloating, reflux, heartburn, nausea and constipation.

Effective approaches:

Your provider can recommend various strategies to manage nausea, including medication timing adjustments, mixing suggestions, or supportive therapies. Many patients find that switching to Welchol significantly reduces nausea while maintaining treatment effectiveness.

Fatigue During Detox

Increased fatigue often indicates effective toxin mobilization. This typically improves after 2-3 weeks as toxin burden decreases.

Support strategies:

Your provider will guide you on:

Maintaining electrolyte balance
Optimizing sleep quality
Appropriate activity levels during treatment
Energy support strategies tailored to your needs

Nutrient Depletion Concerns

CSM can bind fat-soluble vitamins (A, D, E, K) and certain minerals.

Nutrient support considerations:

Your provider will guide you on:

Appropriate timing for any supplements
Monitoring key nutrient levels
Individualized support based on your lab results

Remember: MoldCo's comprehensive testing includes vitamin D monitoring, helping your provider track and address any deficiencies.

Supporting Detox Pathways

Hydration: Foundation of Successful Detox

Proper hydration is critical for toxin elimination and managing binder side effects. The Shoemaker Protocol emphasizes monitoring both hydration status and electrolyte balance throughout treatment.

Daily Water Requirements

Your healthcare provider will recommend appropriate hydration levels based on:

Your body weight
Number of daily binder doses
Climate and activity level
Individual health factors

Proper hydration is essential for successful treatment and minimizing side effects.

Electrolyte Balance

Dr. Shoemaker's research shows CIRS patients often have ADH/osmolality dysregulation. Monitor for:

Excessive thirst
Frequent urination
Muscle cramps
Dizziness

Electrolyte support:

Add mineral-rich sea salt to water
Consider electrolyte supplements (without sugar)
Monitor sodium and potassium levels

Liver Support During Treatment

Evidence-Based Support

The liver processes mobilized toxins during treatment. Your healthcare provider may recommend specific liver support strategies based on your individual needs and health status. These are typically integrated into your comprehensive treatment plan and adjusted based on your response to therapy.

Supportive foods:

Cruciferous vegetables (broccoli, cauliflower)
Beets and beet greens
Artichokes
Garlic and onions
Green tea (organic)

Critical to avoid:

Alcohol (impairs detoxification)
High-sugar foods (increase inflammation)
Processed foods (additional toxin burden)
Grapefruit (interferes with liver enzymes)

Gut Health Optimization

Microbiome Protection

Binders can affect gut bacteria, making probiotic support essential:

Probiotic protocol:

Your provider may recommend specific probiotic strains
Timing is critical - take several hours after your last daily binder dose
Duration and type depend on your individual gut health status

Digestive support:

Your provider may recommend digestive support based on your symptoms
Dietary approaches like bone broth can support gut healing
Specific protocols will be tailored to your digestive needs

Prebiotic foods (introduce gradually):

Cooked and cooled potatoes
Green bananas
Jerusalem artichokes
Asparagus

Diet During Treatment

The Low Amylose Diet: Key to Reducing Inflammation

Not sure what to eat during treatment? The low amylose diet is specifically recommended in the Shoemaker Protocol to reduce MMP-9 levels and manage intensification reactions. Research shows this diet can significantly improve treatment outcomes when combined with binders.

Get MoldCo's complete diet guide with meal plans, recipes, and shopping lists designed for mold recovery.

Why Low Amylose Matters

The Richmond Functional Medicine protocol notes that a low-amylose diet is a "powerful tool to lower MMP-9" during treatment. This is because amylose, a type of resistant starch, can feed inflammatory gut bacteria in CIRS patients, and removing it helps reduce that inflammatory load.

Foods to Emphasize

Proteins:

Grass-fed meats
Wild-caught fish
Pasture-raised poultry
Eggs (if tolerated)

Vegetables (non-starchy):

Leafy greens
Cruciferous vegetables
Zucchini, cucumber
Bell peppers

Healthy fats:

Olive oil
Coconut oil
Avocados
Nuts and seeds (except peanuts)

Foods to Strictly Limit

High amylose foods:

Wheat and gluten-containing grains
Corn and corn products
White potatoes
Bananas (especially green)
Legumes and beans
Rice (especially cooled)

Sugar and processed foods:

All refined sugars
High-fructose corn syrup
Processed snacks
Sugary beverages

Anti-Inflammatory Nutrition Strategy

Reducing Dietary Triggers

Diet alone cannot cure CIRS but can significantly impact inflammation levels:

Priority nutrients for CIRS recovery:

Anti-inflammatory fats (your provider will guide specific recommendations)
Antioxidant-rich foods and appropriate supplementation
Essential minerals as indicated by testing
B-vitamin support based on individual needs

Avoiding Mold-Contaminated Foods

High-risk foods to avoid:

Aged cheeses
Dried fruits
Nuts (especially peanuts, cashews)
Coffee (unless tested mold-free)
Grains stored in silos
Corn products
Alcoholic beverages

Safe food handling:

Buy fresh, use quickly
Store in airtight containers
Check for visible mold before consuming
When in doubt, throw it out

Sample Daily Menu

Breakfast: Vegetable omelet with avocado
Lunch: Large salad with grilled chicken, olive oil dressing
Snack: Cucumber slices with almond butter
Dinner: Wild salmon, steamed broccoli, cauliflower rice

Your provider will advise on optimal timing of meals relative to your medication schedule.

Exercise During Treatment

Understanding Exercise Intolerance in CIRS

More than 90% of CIRS patients experience exercise intolerance and chronic fatigue due to molecular hypometabolism. The Shoemaker Protocol warns that pushing beyond your anaerobic threshold causes the "push-crash phenomenon" - leaving patients bedridden for 2-3 days while the body undergoes gluconeogenesis and lactate reversal.

The Incremental Exercise Protocol

The key is "NO pushing, then NO crashing." Start incredibly small and build gradually:

Phase 1: Walking

Your provider will help determine an appropriate starting point for exercise. The key principles are:

Begin with very short durations that don't cause post-exertional malaise
Consistency is more important than duration
Gradually progress only as tolerated
Daily gentle movement is the goal

Phase 2: Add Core Exercises

Once walking tolerance is established, your provider may recommend adding gentle core strengthening. This phase combines walking with core exercises, progressing as tolerated.

Phase 3: Add Upper Body

The final phase incorporates light resistance work. Your provider will guide you on appropriate weights and duration based on your recovery progress.

Critical principles:

"Doing less EVERY day is more beneficial than doing more and skipping days"
Never exceed your current tolerance - there's "a clear penalty for overdoing"
Consistency trumps intensity during CIRS treatment
Options include walking, stationary bike, swimming, or level treadmill

Why This Matters

Incremental exercise safely raises your anaerobic threshold while reducing leptin resistance and production. This structured approach helps rebuild exercise tolerance without triggering the inflammatory cascade that comes from overexertion during active CIRS.

Special Populations and Considerations

The following information is for educational purposes only. Special populations require careful medical supervision and individualized treatment plans.

Pediatric Protocols

Children with CIRS require modified treatment approaches. According to the Shoemaker Protocol, pediatric patients can be successfully treated with appropriate adjustments. MoldCo providers often prefer Welchol for pediatric patients due to its better tolerability profile.

Dosing Adjustments

Pediatric dosing requires careful calculation by your child's healthcare provider. The Shoemaker Protocol includes specific pediatric guidelines that must be individualized based on:

Child's weight and age
Severity of symptoms
Individual sensitivity to treatment
Ability to tolerate the medication

Most providers start with very low doses and increase gradually while monitoring the child's response.

Special pediatric considerations:

Children <6 years may present with single-system illness
By age 11, multisystem illness develops like adults
Some children will have 100% improvement with just removal from the bad environment
Many achieve 100% recovery after just 2 weeks of CSM
Children 5 years or younger often only need CSM therapy
More frequent monitoring (every 2-3 weeks)
Higher risk of nutrient depletion

Monitoring requirements:

Weekly weight checks
Growth chart tracking
Vitamin D levels monthly
Developmental milestone assessment
School performance monitoring

Pregnancy & Nursing Considerations

Safety Profile

Cholestyramine is Category B in pregnancy (no proven risk in humans), but treatment requires careful consideration:

During pregnancy:

Defer treatment if possible until after delivery
If severe symptoms, work with maternal-fetal medicine
Monitor fat-soluble vitamins closely
Ensure adequate weight gain
Consider environmental controls as primary intervention

During nursing:

CSM is not absorbed systemically
Minimal risk to nursing infant
Monitor infant growth patterns
Ensure maternal nutrition
Time doses away from nursing when possible

Alternative approaches during pregnancy/nursing:

Aggressive environmental remediation
Anti-inflammatory diet
Safe supplement support
Stress management techniques
Consider treatment between pregnancies

Timeline and Expectations

Typical Treatment Duration

The question everyone asks: "How long until I feel better?"

According to the Shoemaker Protocol, most adult patients require 2-4 months of consistent binder therapy, with some achieving results in as little as 1 month. Treatment continues until VCS is normalized and the patient has plateaued in symptom improvement.

Good news for parents: Children often respond much faster, with many showing 100% improvement in just 2 weeks of CSM therapy. (Yes, really!)

Research-Based Recovery Milestones

Visual Contrast Sensitivity (VCS) Improvement:

4 weeks → 64% show improvement
6 weeks → 91% show improvement
8+ weeks → Nearly all responders improve

These aren't just numbers - they represent thousands of patients who got their lives back.

Factors affecting duration:

Severity of initial exposure
Genetic susceptibility (HLA-DR status)
Compliance with protocol
Concurrent infections (MARCoNS)
Environmental re-exposure

When to test progress:

VCS testing: Every 4 weeks
Inflammatory markers: 6-8 weeks
Symptom questionnaire: Weekly
Comprehensive retest: 3 months

Phases of Recovery

Phase 1: Initial Detox (Weeks 1-2)

Common experiences:

Possible intensification reaction (20-30% of patients)
Increased fatigue
Digestive changes
Mood fluctuations

Some patients will develop an acceleration reaction when they first start CSM due to the degree of cytokine elevation in their bodies.

Phase 2: Stabilization (Weeks 3-6)

Typical improvements:

Energy begins returning
Brain fog starts lifting
Sleep quality improves
Digestive symptoms stabilize

Key milestone: Passing VCS test indicates effective biotoxin removal

Phase 3: Progressive Recovery (Weeks 7-12)

Continued improvements:

Cognitive function restoration
Joint/muscle pain reduction
Mood stabilization
Immune function improvement

Important: Richmond Functional Medicine notes that patience is key, as it can take anywhere from nine months to two years to go through the entire process.

Phase 4: Maintenance

Long-term protocol:

Reduced binder dosing (once daily or as needed)
Continued environmental vigilance
Regular VCS monitoring
Ongoing dietary support

Re-exposure protocol: If exposed to mold again, your provider will guide you on appropriate steps to take

Defining Recovery: What "Cured" Really Means

Dr. Shoemaker considers a patient cured when:

Symptom count matches controls (2-3 symptoms)
VCS has normalized
T regulatory cells are in normal range
GENIE (gene expression) is normal

A patient could be considered "cured" even while still taking VIP. However, most practitioners add the requirement that patients should be:

Off all CIRS medications
Able to enter any building for any length of time without relapse
Maintaining stable improvement for at least 3 months

This comprehensive definition ensures true recovery rather than temporary symptom suppression.

Monitoring Progress

Symptom Tracking: Your Recovery Roadmap

Systematic tracking is essential for optimizing treatment. The Shoemaker Protocol emphasizes objective measures alongside symptom improvement.

Track your progress with precision: MoldCo's comprehensive testing panels include all key inflammatory markers at 40-60% below standard lab pricing.

Daily Monitoring Essentials

Track these key indicators:

Energy levels (1-10 scale)
Cognitive function/brain fog
Sleep quality and duration
Digestive symptoms
Pain levels
Mood changes
CSM doses taken and timing

Weekly assessments:

Weight changes
Exercise tolerance
Overall symptom cluster score
Side effect severity

Visual Contrast Sensitivity (VCS) Testing

VCS testing is the most important tool for monitoring biotoxin removal in the Shoemaker Protocol.

VCS monitoring schedule:

Baseline: Before starting treatment
Week 4: First progress check
Week 6: Critical assessment point
Monthly: Until consistently passing
Quarterly: During maintenance

What VCS results mean:

Failing score: Biotoxins still present
Improvement: Treatment working
Passing score: Ready to reduce binder dose
Sudden decline: Possible re-exposure

Lab Marker Improvements

Priority Markers to Retest (6-8 weeks)

Inflammatory markers:

C4a: Should decrease by 50%+
TGF-beta1: Target <2380 pg/ml
MMP-9: Goal <332 ng/ml
MSH: Should increase toward 35-94 pg/ml

Success indicators from research:

91% of patients showed normalization of contrast sensitivity
C4a levels typically drop within 10 days on proper treatment
MSH improvement may take 3-6 months

Adjusting Treatment Based on Results

If markers not improving:

Confirm environmental remediation (retest ERMI)
Check for MARCoNS (nasal culture)
Assess protocol compliance
Consider intensification reaction management
Evaluate for other biotoxin exposures

If improving but slowly:

Optimize binder timing
Add dietary interventions
Increase hydration
Consider switching to pure CSM

Once markers normalize:

Continue full protocol 4 more weeks
Begin gradual dose reduction
Maintain VCS monitoring
Implement maintenance plan

Key Takeaways

Prescription binders are essential: MoldCo providers typically recommend Welchol (colesevelam) for its better tolerability, with 91% of patients showing VCS improvement and 85-90% showing biomarker normalization
Start slowly: Your provider will determine the appropriate starting dose and increase schedule to minimize the 20-30% risk of intensification reactions
Timing is critical: Your provider will create a personalized schedule for optimal medication spacing and effectiveness
Expect 2-4 months: Most adults need 2-4 months of treatment (occasionally 1 month); children often see 100% improvement in just 2 weeks
Monitor objectively: Use VCS testing every 4 weeks to track biotoxin removal - stop when VCS normalizes and symptoms plateau
Support detox pathways: Maintain proper hydration as directed by your provider, protect tooth enamel with recommended oral hygiene, manage constipation proactively
Exercise carefully: Over 90% have exercise intolerance - use incremental protocol starting with 2-5 minutes daily
Stay the course: Intensification reactions can be prevented with appropriate preparation protocols; prescription binders provide much faster recovery than alternatives

Remember: You're not alone in this journey. MoldCo's treatment protocol has helped thousands navigate successful mold detox treatment with expert guidance every step of the way.

Medical Disclaimer

This article is for educational and informational purposes only and is not intended as medical advice. The information provided should not be used for diagnosing or treating health problems or diseases.

Mold illness and CIRS are complex conditions requiring professional medical evaluation and supervision. Treatment with prescription binders must be prescribed and monitored by a qualified healthcare provider familiar with the Shoemaker Protocol.

Individual responses to treatment vary significantly based on genetics, exposure severity, and overall health status. Never start, stop, or modify prescription medications without consulting your healthcare provider.

MoldCo's role: We provide comprehensive testing and connect you with CIRS-specialized providers who determine appropriate treatment. All medical decisions, including medication selection and dosing, are made by your provider based on your individual needs.

If you suspect mold exposure or CIRS, take our eligibility quiz to see if MoldCo's specialized care program is right for you.

Binder Information

Treatment Support

Monitoring Recovery

Testing During Treatment
Understanding Detox Reactions
Recovery Timeline

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