Mold & Mycotoxins: Binders vs Antifungals

Dr. Pejman Katiraei was following standard protocol—treating patients with combinations of binders, such as cholestyramine, charcoal, and clay, to remove mycotoxins from mold exposure. But after years of practice, he noticed a troubling pattern: only a handful of patients were getting significantly better, while many remained stuck with persistent symptoms. 

Even more puzzling, despite aggressive binder use, urine mycotoxin levels often stayed unchanged or even increased. This clinical reality forced him to step back and question whether the widely accepted model of chronic mycotoxin recirculation was actually correct, prompting him to explore an entirely different treatment approach.

In this episode, pediatric physician Dr. Pejman Katiraei and chronic illness expert Dr. Eric Gordon discuss why antifungals may be more effective than binders for treating mold-related illness. Dr. Katiraei shares his clinical journey from relying heavily on binding protocols to focusing on gut inflammation and fungal overgrowth as the real drivers of persistent symptoms. 

Together, they explore how bacterial endotoxins from an inflamed gut may be causing more damage than circulating mycotoxins, why the microbiome plays a critical role in detoxification, and how antifungal medications can break the cycle of chronic inflammation that keeps patients sick long after leaving moldy environments.

Episode Highlights:

• Dr. K's journey from binders to antifungals after seeing patients remain stuck despite aggressive binding protocols
• Mycotoxins degrade in hours to days - the real problem is ongoing gut inflammation, not long-term toxin recirculation.
• Fungal overgrowth perpetuates leaky gut and bacterial endotoxin release
• Bacterial endotoxins may be more neurotoxic than mycotoxins themselves
• Antifungals like itraconazole have powerful anti-inflammatory effects beyond killing fungus
• Peptides that help stabilize gut integrity and improve antifungal tolerance
• Some patients can heal even with ongoing low-level mold exposure through gut strengthening

Listen in to learn more : 

(00:01) - Chronic Illness and Gut Inflammation

(15:21) - The Dangers of Bacterial Endotoxins

(19:16) - Understanding Inflammation and Healing Options

(24:42) - Antifungals and Gut Healing

(40:04) - Healing the Gut

(47:35) - Learning and Sharing for Healing

About Dr. Pejman Katiraei

Dr. Pejman Katiraei (Dr. K) is a board-certified pediatrician who completed his undergraduate studies at UCLA and then obtained his osteopathic medical degree at Western University. He completed a pediatric residency at Loma Linda University, where he remained as teaching faculty for over four years. He has also completed two fellowships in integrative medicine and has over a decade of clinical experience helping children with severe learning and behavioral challenges. Dr. K is now in private practice in Santa Monica, where he focuses on helping children with mold-related illness, autism, and other mental health challenges.

Learn more about Dr. K

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** This information is not to be taken as medical advice. Always consult your practitioner before making any changes to your treatment.