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Dr. Darshan Shah
Before we get started with this episode, I'd like to invite all of you to the first ever next Health Longevity Summit happening in Nashville, Tennessee at the Conrad Hotel on Saturday, September 12, 2026. This is an all day summit where you're going to be hearing from some of the best speakers in longevity medicine, including Dr. Vonda Wright, Dr. Luisa Nicola, many of the podcast guests that you've heard here on the Extend podcast. And of course I'm going to be there curating the entire day. We also have incredible vendors coming so that you can try the latest technologies in health, wellness and longevity. Go to next health.com summit and buy your ticket today. We only have 400 spots and they're going quickly. That's next health.com summit. I look forward to seeing you all there. Welcome to extend with me, Dr. Darshan Shah, a podcast dedicated to cutting edge science, research, tools and protocols designed to help you extend your health span. Having become one of the youngest doctors in the country at the age of 21 and trained and board certified at the Mayo Clinic, I've accumulated three decades of practice as a board certified surgeon and longevity expert. Over that time, I've discovered that a mere 20% of health knowledge yields 80% of the results. When it comes to your health span. We are living in a new era where we are creating a new healthcare system no longer focused on disease management, but achieving optimal health and vitality. Join me as I interview world renowned experts offering you a step by step guide to proactively avoid disease and most importantly, extend your health span. Hey everyone, before we dive into today's episode, I want to talk about something that you hear me talk a lot about your biomarkers. And I want to tell you how I'm approaching this situation right now with all of the patients that are calling me from listening to this podcast. So what happens is every day patients are writing to me saying they feel exhausted, they can't lose weight, they're having brain fog and they see their doctor and the doctor tells them all their blood work is normal. But the problem is this doctor usually is only checking about 10 to 15 biomarkers that only tell you if you have a disease developing. Meanwhile, your body has 160 different systems that are running and all of these have blood tests that we can test on how effective they're working for you every single day. So if someone is not close to one of my clinics, one of my next health clinics, then I tell them go to their local lab, laboratory and get on Function Health, Function Health gives you access to 160 different biomarkers, the same kind of comprehensive testing that we do at all of our next health clinics. And if you tried to get this on your own through your regular doctor, it can cost you thousands of dollars. Hormones, inflammation, toxins, nutrient levels, they're all tracked over time in this one platform called Function Health. They could even help you get an MRI scan or a CT scan if you want one. So what I love most about this company is that they don't have a crazy incentive to do this. Function doesn't push supplements. They don't have pharmaceuticals they're trying to get you to take. You're just getting the data and you're getting insights from the data, and you can bring this data to a clinic like ours, and we then have the information that we need to tell you how to improve your health. Membership is now only $365 a year. Literally, it's just a dollar a day. And right now, if you're one of my listeners, you can get a $25 credit towards you just go to the link in the bio or go to functionhealth.com DrShaw and use the code DrShaw25 for a $25 credit towards your membership.
Doctor Scott McMahon, thank you so much for joining me today to talk about all things mold.
Dr. Scott McMahon
Thank you for having me, Dr. Shah.
Dr. Darshan Shah
Yeah, this is going to be so exciting. It's such an important topic and we have so many patients that come in with mold symptoms with positive tests for mold at our clinics, Next Health. And all over the country, it doesn't seem, you know, even though I know there's some geographic bounds to this, it just seems like everyone has some exposure to mold everywhere. So I'm happy to do. I'm so happy to have you on so we can provide my listeners and your platforms. Also, a deep dive into mold and a Masterclass, hopefully in 45 minutes. Yeah. So just a little bit about your background. I know you've been in the field for a while. You're a physician. Maybe you can just give us a quick history of where you come from.
Dr. Scott McMahon
So I'm originally from the Central Valley of California. I went to medical school at Creighton University in Omaha, Nebraska. I did my residency at Duke University Medical center, and I've been in Roswell, New Mexico, ever since. I started out as a pediatrician. I did that for 18 years before I discovered the world of mold. For 10 years. Then I ran a pediatric clinic and a mold clinic. They were two separate clinics in the same building. And Then about six years ago, I retired from the pediatric practice, although I still work in the hospital some. And then I just focused my energies more on mold in general. I closed that practice in January of 2025 and became the medical director of Moldco in late 2024.
Dr. Darshan Shah
Yes, we love Moldco. We send a lot of people over to you guys. So this, this is great to be talking to you. What, was there a story or something that got you interested from pediatric to mold? How did you make that jump?
Dr. Scott McMahon
Well, there, there are a couple of stories. Perhaps the most germane is that there was a local businessman whose daughter had gotten ill, and he alleged it was from the local high school at, through a friend. He, he got ahold of me, wanted me to evaluate some of the other people at that school, saying that there were as many people at the school who were sick as I wanted to see. I said, like, can I see 30 of them? And he said, yeah, no problem, I can arrange that.
Dr. Darshan Shah
Wow.
Dr. Scott McMahon
And he arranged for me to meet with Dr. Richie Shoemaker. We had a conversation. I looked at his website. At that time, it wasn't surviving mold, it was the chronic neurobiotoxins. And I was just blown away by that. And I started thinking about patients that I'd had over the years that I couldn't figure out what was wrong with them. I started calling them up and doing the evaluation that Dr. Shoemaker was doing, and I found that pretty much all of them had mold based illness. And I evaluated 15 people from that high school, did lab testing, did a physical exam, did history, and came away from that saying, wow, this, this is real. And, and then I, I, I met with Dr. Shoemaker a couple times in Maryland, where he's from, watched him how he saw patients, how he collected data, and they realized that this is really the future and started. I, I opened my own clinic at that point, just kind of on my own time. Cause I already had a full time job. So I saw people on weekends and evenings until that full time job contract was finished. And, and then I jumped into it more aggressively.
Dr. Darshan Shah
Yeah. Oh, that's such a crazy story. So what kind of symptoms were these young, healthy kids in this high school kind of experiencing? That made that mom reach out to you?
Dr. Scott McMahon
I mean, that's, that's exactly right. These young, healthy kids, they averaged like 22 different symptoms in seven different systems of their body. And as a pediatrician, I knew that kids don't get multisystem illness. I mean, there's a few, you can get a few with diabetes or occasionally cancer or something, God forbid. But multi system illness is not a common theme in pediatrics. These kids had chronic fatigue, they had muscle aches and pains, they had stomach issues, they had a history that they would feel lousy all week at school, they'd go home over the weekend, they would get better. And then Monday morning they come back and by third period they felt sick again. They were having chronic headaches, inattention problems, memory issues, rashes, they were having sleep issues, you name it, any system. And I can tell you the symptoms they were having. Really unusual for kids. But then the cherry on the top was when I did Dr. Shoemaker's 10 lab tests that are used for diagnosis. You know, you would normally expect on a, on a cohort of children that were healthy, maybe 5% would be abnormal, 2 1/2% on high, 2 1/2% low. Just based on the statistics, these kids had 58% abnormal labs. And I looked at that, and then I talked with Dr. Shoemaker, he said, yeah, it's the same with the cohorts that I have. It's 58, 60%. And again, I realized there's something going on here. And then I treated them. I learned how to treat and I treated them. And the ones that took treatment got vastly better. And the ones that didn't get treated didn't get any better. But a lot of them came and saw me two, three years later when they still were feeling crummy.
Dr. Darshan Shah
Oh my gosh. Was that school ever tested for mold in its H VAC systems or anything like that?
Dr. Scott McMahon
It was tested for mold. And I reviewed the mold testing summary. It was about 150 pages long. And I didn't understand that much at the time, but they had found stachybotrys and whatnot. And the school was saying, oh, this is normal. And the indoor environmental professional is saying, no, this is not. And that's what the lawsuit was about that I got involved in with this family is they were suing the school district to force them to do more invasive testing. And the school was resistant to do that. And so long and short of it was that that was my entry point and hopefully I've learned a thing or two since then. Wow.
Dr. Darshan Shah
Yeah, that's. It's such a crazy thing to see all these poor kids suffering and just kind of being ignored. And they are kind of forced to go to that environment every single day, five days a week.
It's.
It's sad. So let's talk a little bit just about mold in general, because I really want to do a deep dive into some of these diagnostics and the treatments. But before, I think it's really good for people to have a really good understanding of what is mold illness, because there's a few ways molds can cause symptoms in your body. There's actually the mold spores, there's different parts of your respiratory tract that can go into, and there's also mold toxins. So can you break all that down for us?
Dr. Scott McMahon
Sure, yeah, sure. There, there are a number of different syndromes that people can get with mold exposure. For instance, some people have allergies to mold and they'll get runny nose and coughing and sneezing and maybe some headaches. And it's pretty predictable and it goes away pretty quickly. And it gets better with antihistamines. There's also hypersensitivity pneumonitis, which is inflammation specifically in the lungs as a result of mold exposure. Or there are other toxic things that can cause that too. Acute bronchopulmonary aspergillosis is another kind of really an allergic reaction in the lungs. But that's not really what we're talking about. What we're talking about is a multi system illness that affects pretty much any part of your body from chronic mold exposure. And this is not an allergy and it's not an infection. It is an immune system abnormality. Most all of these people have a hit to their immune system in that they genetically aren't making antibody against these antigens that are coming in. Antigens are the foreign bad guys for your audience. Antigens are the foreign bad guys that you breathe in that your body can actually detect as being not yourself, being something that's foreign and something that has to be gotten rid of. So your body recognizes those and starts an immune response. And you have a couple different parts of your immune system. One is the innate immune system. It detects the bad guys and starts this kind of blunt force war against them using multiple different systems. And the primary chemicals are called cytokines, whole bunch of different cytokines, and they all do different things. And then you've got the adaptive immune system where you make antibody. And this is like surgical intervention that works really fast and really efficiently without much of a problem. But because of this genetic predisposition, most people can't mount that second part, that adaptive immune part. And so it's just the innate immune system. And if you only got exposed once or twice or every once in a while, it wouldn't be a problem. But if you live or Work or go to school in a water damaged building. Every time you're breathing in those particles, you're triggering that innate immune system. So it just goes on and on and on. And one thing that I remember from medical school is if you had say a virus that caused a cold, the symptoms from that cold don't so much come from the virus itself directly, it comes from those cytokines. And that's what's happening is you keep breathing in more and more antigen, you keep creating more and more cytokines and, and eventually they break the immune system and you start just having symptoms all the time. Now how do you break the immune system? Well, you've got a couple chemicals that bring the immune system back down to normal. So again, if the, if the innate immune system is supposed to detect bad guys and fight them off, at some point you've beaten the bad guys and you need to come back down to normal because you're creating inflammation all that time. But if the chemicals that send the signal to bring everything back to normal, if you can't make enough of those, then you can't turn the system off, even if you get out of the exposure. And that's what we see in chronic inflammatory response syndrome, mold related illness. Mold toxicity goes by a lot of different names is you can't turn the system off even if you get out of the bad building.
Dr. Darshan Shah
And so if this is this chronic inflammatory syndrome, if someone has it, is it more specific to mold or does this also occur with other types of viral or bacterial infections as well? Is this genetic defect translatable to any type of immune system activation?
Dr. Scott McMahon
That's an excellent question. And the answer is yes. Probably about 85% of the patients that I've seen were triggered by mold. So it's by far and away the most common trigger. But when people are talking about post treatment Lyme disease syndrome or chronic Lyme, my thought is that most of these patients actually had their Lyme disease and that triggered the same kind of immune response.
Dr. Darshan Shah
Right.
Dr. Scott McMahon
And I say that because when we, when we look at the symptoms, the overlap is a hundred percent between the two illnesses. The abnormal lab tests and cytokines are a hundred percent between the two illnesses too. And the treatments that we use are the same. You can also get this from exposure to cyanobacteria, which, like blue green algaes on usually freshwater lakes, but it can be saltwater. You can also get it from ciguatera and, and fiesteria, food poisoning. So these are little plankton dinoflagellates that Live in the ocean and fish eat them. And if the fish eat enough of them, and then you eat that fish, you get a hit of that, of those toxins, and it can trigger the same thing inside you. And then we wonder if maybe Covid maybe is another trigger for this.
Dr. Darshan Shah
Yeah. So this chronic, chronic inflammatory response syndrome, it sounds like there's probably biomarkers or blood tests and other tests that you can do to see if you're having this or not. And so I know Shoemaker has a list of 10 different labs to test for this. Can you kind of run through those? And then the other big question I have for this, is it important to test these labs when you're actually feeling symptomatic or should you be doing these labs when? Anytime, just to see kind of what is the status of your cirs?
Dr. Scott McMahon
Yeah, you should do the labs every day. I'm kidding. I'm kidding. So there are 10 different tests. One of them is called HLA. It's short for human leukocyte antigen. And it looks at a part of your genetics that actually codes for what antibodies you're able to make and whether the antibodies that you make are quality antibodies or crummy antibodies. So that's one test. There are two tests that look at your ability to modulate your innate immune system. These are alpha msh, or alpha melanocyte stimulating hormone, and vip, or vasoactive intestinal polypeptide. And again, these are the chemicals whose job is to bring the innate immune system back down to normal after you fought the battle. There are three different cytokines that we look at. One is called TGF beta 1 or the human transforming growth factor, the beta 1 type. Another is called MMP9 or matrix metalloproteinase number 9. And then the last one is C4A, which is a split product from the complement system, which I'm sure you remember from medical school.
Dr. Darshan Shah
You're digging deep there.
Dr. Scott McMahon
Yes, exactly. There's a nose swab that we do where we take like a 6 inch swab and go all the way to the back of your nose and look for a particular kind of germ called multiply antibiotic resistant coagulase negative staph. You probably remember that coagulase negative staph is normal flora and whatnot, but it's not supposed to be resistant to multiple classes of antibiotics. So this one is different and it creates a biofilm. And not only that, but the germs create a chemical called hemolysin. And that hemolysin can Destroy, just cleave MSH right in half. And that's the vast majority of the pathophysiology of this illness comes from not having adequate amounts of msh. And then there are two. I'm sorry, there's a couple of autoantibodies that we look at. Anti gliadin antibody and anticardiolipin antibody. These are oftentimes formed. And then finally, we look at a couple of endocrine tests, we look at your ACTH level in the context of a concomitantly drawn cortisol level, and we look at your antidiuretic hormone level in context of concomitantly drawn serum osmolality, measuring how dehydrated or waterlogged you are. Wow.
Dr. Darshan Shah
Okay, so this group of tests, Dr. Shoemaker, doing deep research into mold, found that if about 50% of these were positive or showing signs of CIRS, then you likely have the C I R S diagnosis, is that correct?
Dr. Scott McMahon
Well, actually, that, that was my work. I published that in 2017, that for adults who had five or more of these abnormals, that. That was highly sensitive. I'm sorry, highly specific for CIRS, and for children who had 4 or 10, that. That was also very highly specific for CIRC.
Dr. Darshan Shah
Wow.
Okay. Sorry about that. That's incredible work that you did that you kind of came up with the actual numbers that can give us as doctors an indicator of whether this is occurring or not.
Dr. Scott McMahon
Yeah, well, Dr. Shoemaker pretty much discovered everything else. So I have one plan to say, and that's cool.
Dr. Darshan Shah
Well, we appreciate the work you're doing on this. It's so important. And then as far as timing of the testing goes, how do you think about that?
Dr. Scott McMahon
What do you mean by timing? Like in the morning, the afternoon or.
Dr. Darshan Shah
You know what, I see a lot, I see a lot of patients come in with occasional symptoms of cirs. Right. And so sometimes I wonder, should I be checking these labs when someone is actually feeling sick or feeling at their worst, or many people come in when they're getting a little bit better already and then, you know, I just wonder what is going to increase the sensitivity of these tests.
Dr. Scott McMahon
Absolutely. The first thing to remember is that unless you're a small child, chronic inflammatory response syndrome is always a multi system illness. By the time you're 11 years old, you usually have six different systems of your body involved. So if it's someone who's coming in and they just have headaches or they just are having recurrent stomach issues or they're chronically fatigued, but, but that's it. That probably is not the person that you want to screen. But if you have somebody who's having all of those and maybe muscle aches and pains and exercise intolerance and they're not sleeping well, you know, and they're urinating many, many times a day or getting up three times at night to go to the bathroom, when you start putting all of those things together, those are the people that I would recommend screening.
Dr. Darshan Shah
Makes. Makes that makes a lot of sense. And is there, you know, we have some of these urine tests for multiple different types of mold toxins. Right. How do you feel about some of these tests and are they valuable or not? Maybe talk about that a little bit. I have some follow up questions. Sure.
Dr. Scott McMahon
I don't consider them that valuable. I think that they, they do show that there has been an exposure if they're positive. But you don't know whether the exposure is because you ate peanuts yesterday or had some chocolate this morning or if it's because you're inhaling it in a water damage building. So they don't differentiate that. They also don't show in your body that you're actually reacting to these problems. So whereas the Shoemaker test actually looking at functional things that are going on, elevations of chemicals in the immune system or abnormalities in the endocrine system, these just show that, that there's a toxin exposure. And then the last knock that I have on them is that I don't know that there are reliable control values for reference ranges. So I really don't know how to interpret what's high versus what's low versus what's normal because I don't have any. I personally don't have faith in the reference ranges.
Dr. Darshan Shah
Yeah, I mean the reference range I would also assume really just depends on person to person. And what is your like tissue load of these toxins as well, it's so dependent upon like the actual one urine sample that you did. And so it's hard, I see what you're saying. And it's really, I mean, obviously like, you know, there's a lot of people that say that we're all exposed to mold quite frequently throughout our lives. And it's really when you become symptomatic is when you really start then needing to achieve some sort of treatment. But also I think if you're symptomatic, one of the treatments is to remove the source of the constant exposure. Right. And so I think, I think maybe it's helpful there a little bit if you're trying to remove exposure and Then the toxin levels go away.
Dr. Scott McMahon
Well, the truth is mold is ubiquitous. It is everywhere. It's blowing around outside when you're walking, it's on your skin and whatnot. But, but there's a quantum difference between the mold that's blowing around outside and what's in a water damaged building right outside. You have molds that are, I, I, I look at them as like hibernating bears. You've got these spores that are floating around. They're looking for food and water. When they find food and water, then they kind of come alive and they, like the bears in the springtime do, and then they can multiply and they become metabolically active and they might start making mycotoxins and, and they multiply by a factor of thousands. But they have to have food and water inside a building. The food is everywhere because sheetrock, false ceiling insulation, it's all food and there's mold all around, but there's not very much of it. And it might be separated by significant amount of space. But if you add water, which makes it the water damaged building, if you add water, within one to two days, the molds are waking up, they're becoming metabolically active and they're multiplying by a factor of thousands. And if there is strain that can make toxins, maybe they're making toxins too. So it's, it's, yes, we are exposed, we're all exposed. But there are certain exposures that are significantly worse than others. And inside a water damage building is one of the worst ones that I know of.
Dr. Darshan Shah
Great.
Yeah. And I agree. I think the water damage building, it's, you know, I live in Malibu, where we're by the Ocean, I think 100% of the buildings here have some mold in them. And so because there's constant water damage happening all the time, and it just, you know, it's a big problem in certain parts of the world, obviously in certain parts of the United States, where you really need to be looking for this. I think, you know, there's a lot of videos and pictures online as well that I refer people to. Like, what does mold really look like and how do you clean it? You know, I think a lot of people are scared to look for mold because the remediation costs can be really, really high. Right. And I would love for you to just kind of maybe talk a little bit of how you look, look for mold. And what does a remediation need to look like?
Dr. Scott McMahon
Yeah. So when I talk to people about looking for mold, particularly for instance, in their own place, or if they're looking at renting or buying another place, I have them. Look around and just use your eyes and use your nose. You're looking for signs of water damage, like paint that's peeling or paint that's bulging or baseboards that are warping. You're looking for visible mold. You're looking under the sinks and taking a sniff to make sure that you're not smelling anything. You look in closets and look up at the ceiling to make sure there's no water coming in from above that nobody has seen. And a number of things like that. I mentioned paint peeling, so eyes and nose. The second thing that I would do is a dust test. Like, hurts me too, or an ermi. And that's a DNA test that will give you historical picture of whether molds have been growing in that space or not. And so I think that combination is very good at ruling in or ruling out the likelihood of mold. If you do have it, the next step is unless it's really small, the next step is to get an indoor environmental professional, a mold tester, to come in and identify the source. Because you're always going to have a water source. There has to be a water source. And it could be a pipe that's leaking in a cavity, but it could also be that the humidity is too high. If you live in Malibu, you're right on the ocean there. It could be if the humidity inside Your place is 65% or 70% because your air conditioner is too small or too large or it's not working well, that will promote mold growth also, just from the water that's in the air. So you have to find the source, you have to fix the source, and then comes the remediation. And remediation can be tragically expensive. And unfortunately, it can also be done by people that really don't understand what they're doing, and they can actually make it worse. For instance, if they start ripping out walls and they don't put up plastic for containment so that what they're ripping up doesn't now spread through your entire house, what was contained behind a wall, they can make it worse. And you still pay 15, $20,000, and then you have to do it again because you still can't tolerate the building. So it's really important to take your time and find people that really are expert at what they're doing, who understand that mold can cause illness and who follow not only the IICRC standards, but even higher standards than that. For people that have mold based illnesses because if they're not following higher standards, it's likely you're going to have to have it done again. But there are people and, and I can, if, if you want, I can give your, your listeners a, a website that actually lists vetted mold testers and mold remediators who, I can't guarantee that they'll do it right the first time, but they're much more likely to do it right because they're, they're knowledgeable and they've been vetted by people who are experts in this field.
Dr. Darshan Shah
Yeah.
What's that website? I'd love to reference that in the show notes too.
Dr. Scott McMahon
Yeah, it's medvendor.org thank you for that.
Dr. Darshan Shah
And then some of the tests that you mentioned, I know Moldco does provide some home testing as well, right?
Dr. Scott McMahon
That's correct.
Dr. Darshan Shah
And, and so people can go on the Moldco website, just buy a home test, pretty inexpensive, just to do an initial test to see if what they suspect is maybe mold somewhere in the home, they could detect it.
Dr. Scott McMahon
Exactly. And collecting one of these DNA tests is actually very simple, very easy. Molco provides instructions on how to do it. There's a video on how to do it. So nobody has to do it wrong. You send it back in within a week or two, you get your results with explanation from Molco of what this actually means as well as other resources available. And if you want to also look into care, Molco also has a free risk assessment that people can take to see if care makes sense for them.
Dr. Darshan Shah
So like when you go online on moldco. Com, you can fill out a questionnaire and see if you have all the symptoms of mold exposure, C I R S. And then you guys kind of hop in and say, if there are enough symptoms then we can potentially put into place a treatment program.
Dr. Scott McMahon
Exactly.
Dr. Darshan Shah
And so like we talked about earlier, treatment involves removing the sores. So part of it is testing the home and the second part is then a physical treatment program that, that people need to undergo to clear the cirs from their body. Is that, is that kind of what you're saying?
Dr. Scott McMahon
That is. And Multco has a three step protocol. The first step is to take a binder. We usually use Colacevolam, it's one of the stronger binders. It's a prescription binder. I've been using it for at this point over 16 years. It's very effective, low degree of side effects compared to some of the other medicines.
Dr. Darshan Shah
And this is a pill you make,
Dr. Scott McMahon
this is a pill you take instead of the Nasty powder four times a day. And it is, it's very well tolerated by most of our patients and it's very effective. We usually use it for two to three, sometimes three to four months to detox the body and clear out as much of that foreign junk that was in there that could be causing problems. From there, we understand that you can have those multiple antibiotic resistant coagulase negative staph in your nose. And if you do and it's not treated, that can significantly decrease the efficacy of our treatment protocol. So we usually treat with edta, Ethyl diamine, tetraacetic acid. I think I got it. We use that to clear out the mark ons and the biofilm that can be in the back of the nose. And then when we're done with that, we use another nasal preparation for vip, or vasoactive intestinal polypeptide. If you remember when I was describing how the immune system is broken and how those chemicals that are supposed to bring everything back down to normal VIP and msh, how they're broken in most of our patients, you know, I think it's over 93, 94% of our patients have a low level of MSH when I first meet them as an example. And it's similar. It's a little bit better, but similar for vip. But these are the chemicals that bring the balance back. And so we have an intranasal version of vip, and we have several different dosing mechanisms that we can use to try and bring people back pretty close to 100% of where they were before they started getting ill with mold.
Dr. Darshan Shah
Got it.
And so this is like a nasal spray. Both EDTA and the VIP are nasal sprays. So basically it's a. There's a pill and then stage two and three. Is the nasal sprays correct?
Dr. Scott McMahon
Yes.
Dr. Darshan Shah
And combined with also eliminating the source, and then there's probably other things people can do as well to help kind of detoxify themselves. Can you kind of give us maybe a laundry list of other advice that you have for people?
Dr. Scott McMahon
Sure. There are a number of different things that I've seen patients use, and they have variable efficacy with each other. But one of the, one of the more powerful techniques that I've seen is using hyperbaric oxygen therapy or hbo. Hbot. I've. I've sent people who are having chronic headaches or sleep issues or hypoxia to get hbot, and they've had some really amazing results. It helps also if you've had cognitive issues, processing issues, which are very, very common. In mold based illness. And so I've seen some really excellent improvements with that. In my own experience, I've seen it when people stop taking dives, you know, if they take 60 dives, they'll have improvement all the way through. And it's not always durable. Sometimes when they stop taking the dive, they lose some of those benefits. But I'm talking to somebody in, in Israel right now who's actually, they are doing a, an experiment, you know, to be published, and they're using a different protocol than most of my patients have used. And they are finding that they're having, again, it's not published yet, but they're finding that they're actually having some very exceptional improvements without losing the benefit when they stop the dives.
Dr. Darshan Shah
Hmm.
Okay. And when they're, when they're doing these dives, I assume like they're using a specific, like a 2 atmosphere hyperbaric oxygen chamber. And they're probably in there. And I know there's different protocols, like the number of minutes, a number of times that you do air brakes. So it's really important to go to a place that does hyperbarics that understands how to treat mold with a very specific protocol. And I think I'm familiar that Israel group too. It's going to be exciting to see what they've landed on as the best protocol.
Dr. Scott McMahon
Exactly. So I'm very excited for that.
Dr. Darshan Shah
Yeah, me too. Yeah.
Dr. Scott McMahon
So another thing I've seen a lot of people using is infrared saunas, IR saunas. And you know, the technology is such that you can, for a relatively inexpensive price, buy your own IR sauna. They have portable ones that you wear like a suit or maybe you look like somebody out of Minecraft, but. And then, you know, you can have, you can have one built into your house and whatnot. Not all my patients improve with sauna. A few of them get worse. They probably weren't hydrating well enough. But a considerable number, at least 30 to 50% of the people that I've had that use saunas were saying that it really made a significant difference for them. And of course, I assume that they're detoxing out. The things that we're trying to get out with the binders, maybe they're detoxing other chemicals, maybe heavy metals and the like, but they're getting stuff out of their body. Again, not everybody responds, but the people that do are very positive about it.
Dr. Darshan Shah
That's fantastic. Yeah. And both of those therapies are therapies that we have at our next health clinics as well. So we do treat a lot of people with mold and we found those two to be very promising as well, combined with a really good medical therapy and also removal of the source if at all possible. And then lastly, one of the newer therapies that we're looking at is plasmapheresis. And I don't know if you have any experience or heard any people using that.
Dr. Scott McMahon
I don't have any personal experience with that other than my patients. And really just in the last couple years that I was in practice, I had some patients that went overseas to get that or to Mexico and some who've done it in the States now. And I, I think that's a very exciting technology. I'd like to see some published data on it. But I mean, I understand what plasmapheresis does and it just pulls out lots of things, but could also pull out like autoantibodies and proteins that you don't want in there and immune complexes. And there's just a number of things that, that are maybe not beneficial for your body that if they could be pulled out, could help not just with mold based on, but maybe with longevity also.
Dr. Darshan Shah
Yeah, absolutely. And so I think, you know, these are all exciting treatments and people are really suffering from the symptoms of cirs and mold. And it's really just the, unfortunately it seems like there's a lot of treatments out there and not all of them work for everybody. So you have to try different things until you find what works for you. And it's a very individualized kind of program. A lot of the times for people.
Dr. Scott McMahon
I think that's absolutely right. And I, I, I don't think you could say it any better than that. Some people are gonna respond to this and some people are gonna respond to that. So you might as well try a few things and see what works for you.
Dr. Darshan Shah
Yeah, that's why I love what you guys are doing is you're really like working with people. You know, sometimes a treatment could take months. Right. And so it's, it's not like a one shot, here's an antibiotic and you're done with this kind of a thing. It's a, it's a, it's a long process and, but people do feel better. Are you guys having a lot of success with the protocols that you're using?
Dr. Scott McMahon
We're having tremendous success. In my own practice, I saw a little under 90% of adults had 70 to 90% improvement. I think we're actually seeing comparable and maybe slightly better with this first year and three months that we've Been seeing patients and we've just been trying to perfect the protocol, and I think that we're having just tremendous success.
Dr. Darshan Shah
That's amazing. Yeah. And I think it's great that you kind of put it together in just a really well thought out program. And moldco that's super hyper focused just on helping people with mold. And so, you know, typically access to very knowledgeable physicians in mold is very difficult. And then also then finding the testing and the. And the treatment protocols is even more difficult.
Right.
Because these are tests that are not typical tests that doctors are used to running.
Dr. Scott McMahon
Yeah, well, you can get all the tests at LabCorp, but you. But you're right. Many physicians aren't aware of them. They don't know how to order them, and they certainly don't know how to interpret them.
Dr. Darshan Shah
Yeah, yeah, exactly. And so I think it's good to have a resource. And that's why we wanted to partner with, with you at moldcode, because we do have a lot of people that suffer from mold. And, you know, it's really good to have a resource like moldco to refer them to for really well thought out, individualized, personalized therapies. And then we can also help a lot because we have locations all over the country where we can. We have hyperbaric chambers, we have the saunas, we have the plasmapheresis, we have IV therapy. We can also be a part of the overall recovery from this. And there's a lot that we can do together.
Dr. Scott McMahon
Absolutely. Yeah, absolutely. And just to put the scale of the problem, you know, one out of four people in the United States has a genetic predisposition. That's over 80 million people.
Dr. Darshan Shah
I did not realize that one out of four.
Dr. Scott McMahon
That's crazy, right?
Dr. Darshan Shah
That's crazy.
Yeah.
Dr. Scott McMahon
2001, the EPA did a study that showed that 50% of homes and 85% of commercial buildings had historical water damage. So we're really talking about exposures everywhere you go. Not every building, but at least half of the buildings that you're going into. And if you have that genetic predisposition, your body just doesn't handle it. The adaptive immune system doesn't come in and help. If it's a chronic exposure, over time it leads you down that path to multi system illness. So we're really talking tens of millions of people with this illness and maybe a thousand or two thousand practitioners in the states that treat this. And they're at varying different knowledge levels. So it really is kind of a crisis. And I'd like to believe that moldco is Helping relieve some of that pressure, you know, so that you don't have to wait six months to get in. So you don't have to pay thousands of dollars to get in and you can get started on a protocol and education to move you in the right direction. Right, right.
Dr. Darshan Shah
It's so great. And you know, I think for the practitioner education piece of this, Dr. McMahon, you wrote a book on mold toxicity. Right. So what's the name of that book? Because I want to read it and learn more.
Dr. Scott McMahon
I did. I wrote a book with Dr. Richie Shoemaker. It's called the Art and Science of CIRS Medicine. C I R S Medicine.
Dr. Darshan Shah
Yeah. I think it's critical for anyone that's seeing a lot of mold patients to reference that and definitely going to buy it from my bookshelf. And then also, you know, I think you've also written some papers which I think are really important because, you know, this is such a controversial topic and to get doctors together to agree on certain things, that's hard anyway, never mind with, with something as kind of like difficult as mold. And so you've written some consensus papers as well?
Dr. Scott McMahon
Absolutely. And I'll tell you that in the, in the worldwide literature, there are actually hundreds of articles that show that humans who are exposed to the indoors of water damaged buildings get sick. And it's not just respiratory issues, it's cognitive issues, neurologic issues, gastrointestinal problems, skin rashes, sleep problems, chronic fatigue. I mean, the literature is there. It may not be in JAMA or something that everybody reads, but the literature is out there and they're sufficient to really make the case. I was, I worked with ming Duli in 2020 and we published a systematic review of all of the literature that had been published around the world. Between 2011 and 2018, there were 273,000 subjects in there. There were 114 studies and 98.2 studies verified what I'm saying that if you, if humans that spend a lot of time in water damaged buildings get single system illness like respiratory asthma, things like that, but they get multi system illness also like mold toxicity, chronic inflammatory response syndrome, et cetera. So it's there, it's in the literature, it's not controversial for people like you and me that have studied it, but for most people that don't know. Well, they don't know.
Dr. Darshan Shah
Yeah.
And I think also, you know, in physicians, the primary care physicians many times see patients and there's a bunch of vague symptoms going on. We can't see anything in our standard laboratory test, it's very easy to chalk it up to, you know, psychological issues or other. Other multiple diagnoses that don't all come together under one umbrella. And so, you know, it can be. You can start treating someone for headaches, you can start treating someone for rhinitis, you can start treating someone for muscle aches. And it's all these different diagnoses, but really coming together, coming and just really looking at the whole patient and seeing, like, is there something multisystemic going on here? It's hard for many physicians to make that leap. So hopefully, you know, I do have a lot of physicians and practitioners listening to this podcast, and hopefully this is something that they can kind of put in the back of their brain somewhere that if you're struggling with someone with a lot of different multisystemic symptoms, to think about mold as a potential diagnosis.
Dr. Scott McMahon
Exactly. And that's where the power of the lab testing comes in.
Dr. Darshan Shah
Right.
Dr. Scott McMahon
Because if. If you don't know, if you're not sure, you do the lab tests, and if they all come back normal. Well, that's not what it is. You've ruled that out. But if. If you did five tests and three or four of them are abnormal, well, maybe that's the direction that you need to go looking.
Dr. Darshan Shah
Exactly, yeah.
Just to complete the subject, I've been seeing a lot of talk now about mold in foods. Different stored grains, coffee. You know, a lot of people drink a lot of coffee. I'm one of those people. And. And how should we think about mold in some of these cases as well in food?
Dr. Scott McMahon
You know, there. There are some, like, case reports of people that were eating very large amounts of moldy hay, and they got some very bad symptoms, and some people even died from that. But generally speaking, though, the large amount of foods that. That we consume that have some degree of mycotoxin on, like coffee, like chocolate, certain kinds of wine, some cheeses, peanuts, and a number of other things. They're very small amount of toxins. And those toxins go through the mouth that has relatively high pH and then to the stomach that has relatively low pH, and then they get exposed to a number of different degrading enzymes that can destroy them or activate them. And then they go to the liver for that first pass detoxification before they ever go to your body. And I've yet to see any. I would get to see any research that actually is looking at that to see if people are developing symptoms from it. There's actually quite a bit of literature for farm animals, for livestock because they feed cows moldy day. And so, you know, they want to look at that. And they. And they know you can't feed horses moldy hay because they get sick as an example. So a lot of that work has been done in farm animals, but not in humans. So it's really hard to know just how much. But on the other hand, when you inhale something, you inhale a mycotoxin or these respiratory particles, we know that it triggers the immune system. And we also know that the primary root that's bad for you for most toxins is inhalation and often several orders of magnitude higher or more dangerous than it is for ingested toxin. For even the same toxin. I think the biggest concern is inhalation. I'm not as concerned about ingestion. I'm not saying you shouldn't drink your bulletproof coffee. What I'm saying is it's more important to focus your money on making sure your house is remediated properly and eat as healthy as you can afford.
Dr. Darshan Shah
Yeah, yeah. So probably a little bit overblown on the food molds, but. But mainly if you're experiencing symptoms, go looking where you know it's more the inhalation and especially from indoor sources, from water damage abilities, is your likely biggest source of the exposure.
Dr. Scott McMahon
Likely biggest, yes.
Dr. Darshan Shah
Makes sense. Well, this was a masterclass. In a quick 45 minutes, we covered a lot of ground. Did I miss anything?
Dr. Scott McMahon
Dr. McMahon, I wanted to thank you for your partnership with Moldco because you're a forward thinking person. I know you think about longevity, you're looking at optimizing health and we really appreciate the partnership we have with you. I really appreciate having the opportunity to talk to you today.
Dr. Darshan Shah
Same. I. I really appreciate the work that you're doing. You know, people are struggling so much with mold and to have a platform where they can go to and get good information and good treatment by experts, world experts like yourself. I mean, it's. The amount of access people have now is exactly 180 opposite of just a couple of years ago. So really appreciate you and the founders of MOCO coming together and putting this together.
Dr. Scott McMahon
Awesome.
Dr. Darshan Shah
Thank you.
Well, thank you so much, Scott and I look forward to seeing you in the future sometime.
Dr. Scott McMahon
I do too. It's a pleasure to spend time with you today, Dr. Shop.
Dr. Darshan Shah
Thank you. Thank you so much for listening to the podcast today. Please remember to subscribe if you like this episode and give us a good review and share a link with your friends. It really helps us support all of our efforts. I also want to remind you that the information shared on this podcast is for educational purposes only and is not intended to replace professional medical advice, diagnosis or treatment. Please consult with your healthcare provider or physician before making any decisions or taking any action based on what you hear today, especially if you have any underlying health conditions or on any medications. Your doctor knows your personal health situation the best and is always important to seek their guidance.
Release Date: July 7, 2026
Featured Guest: Dr. Scott McMahon, Medical Director of Moldco
Length: ~45 min
In this episode, Dr. Darshan Shah interviews Dr. Scott McMahon—a leading expert on mold-related illness and chronic inflammatory response syndrome (CIRS)—for a comprehensive “masterclass” about the hidden impacts of mold on human health. Drawing from his clinical experience and research collaborations, Dr. McMahon explains why mold exposure is an underdiagnosed but significant cause of multi-system unexplained symptoms, especially for genetically predisposed individuals. The episode offers practical guidance for testing, diagnosis, remediation, and treatment protocols, plus insights for both patients and clinicians.
Timestamps for Deep Dives:
| Timestamp | Segment | |------------|-------------------------------------------------------------| | 04:23 | Dr. McMahon’s journey from pediatrics to mold medicine | | 07:05 | First major school case: multi-system symptoms in youth | | 10:10 | Comprehensive breakdown: what is mold illness/CIRS? | | 13:49 | Mold as a trigger & other triggers (Lyme, algae, etc.) | | 15:30 | Shoemaker protocol labs: what and how to test | | 18:09 | Dr. McMahon’s research: defining diagnostic thresholds | | 20:03 | Evaluation of urine mycotoxin tests | | 24:02 | How to search for and remediate mold in the home | | 28:32 | Moldco’s three-stage treatment protocol | | 31:01 | Adjunct therapies: HBOT, saunas, plasmapheresis | | 36:53 | Scope of the problem: prevalence and practitioner shortage | | 38:24 | Dr. McMahon’s book & research on CIRS | | 41:15 | Importance of whole-person symptom analysis for diagnosis | | 43:51 | Food sources of mold: necessary caution vs. overblown hype |