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Mold Remediation: Keeping Your Living Spaces Free From Mycotoxins And Molds With Mike Schrantz


Is your house damp? Have you had problems with leaks or a pipe bursting? If you have, you’d better call an Indoor Environmental Professional to remedy a potential mold problem. Toxic mold can invade your house and cause significant health problems if left unchecked. Expert Mike Schrantz from Environmental Analytics joins Dr. Jack Wolfson and Dr. Lauren Lattanza on today’s show to talk about how you can protect your home and heart from mold. Learn how mold spores develop, what mycotoxins are, and so much more. You don’t have to be afraid of molds. Just learn how to address and prevent overgrowth, and you’ll be fine.

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Mold Remediation: Keeping Your Living Spaces Free From Mycotoxins And Molds With Mike Schrantz

We’re going to be talking about a lot of things in this episode. It’s very exciting but always keep in mind that everything we’re talking about, how it pertains to heart health, atrial fibrillation, congestive heart failure, coronary artery disease, heart attack, strokes and everything heart-related, there’s a purpose to all of these episodes and it always goes back to the heart. As we help the heart, we help everything else in the body as well. You know that. I want to introduce Dr. Lauren Lattanza. She is our Naturopathic Medical Doctor here at Natural Heart Doctor. Dr. Lauren, how are you?

HHS 3 | Mold Remediation
Mold Remediation: We can’t control the viable spores or cells that float around. They’re a normal part of the ecosystem. However, we can control moisture, which is key.

I’m doing well. I’m happy to be here. Thank you for the introduction.

It’s great to have you on. Our special guest is Michael Schrantz. He is an absolute worldwide expert that so many people go to when it comes to indoor air quality and living in a healthy home or a healthy office. Sometimes people have referred to him as Dr. House. Dr. Lattanza and I are Natural Heart Doctors and then now we’ve got Dr. House if you remember that TV show. This is the house, Dr. Michael Schrantz. He is with Environmental Analytics. You can check out his website. It’s EnvironmentalAnalytics.net. It’s an environmental consulting firm. It has been in business all the way back since 2007 and obviously sees a lot of people locally in the Southwest. He is based out of Tucson, Arizona. He does a lot of consulting work. In the end, Michael we will give you an opportunity to tell people how to get in touch with you as well. Michael, welcome to the show.

Dr. Wolfson and Dr. Lattanza, thank you so much. This is a great opportunity. I’m looking forward to it.

We’ll jump right into it. I’ll let Dr. Lattanza fire away with some of her questions because I know she has been very anxious to ask you all these things. Where we see this episode going is essentially once someone either thinks they’ve been exposed to mold or they’ve got mold mycotoxins that are in their urine. It shows that mold mycotoxins, these things that are released from the mold, are coming into the body and being excreted out of their urine, what do we do from where’s this mold exposure coming from? Dr. Lauren, what do you think?

You and I have the job of finding the root cause. We ask the questions, identify if our patients are potentially having mold exposure. We see the light bulb go off in patients’ heads frequently and, “We did have some water damage X amount of years back and we didn’t have it fully taken care of. Under my sink, I see this, that and the other. What are the next steps once we identify that through the urine testing?” Michael, what do you find the percentage of homes suffer from water damage?

You see these numbers getting pushed around all the time. Whether we want to reference things out of the World Health Organization reports or other things, a safe number to probably say is 50/50, 50% of the homes. It’s biased coming from my end because people that don’t necessarily have problems aren’t going out of their way to talk to me. It’s normally people that have issues. I’ll tell you from common sense, the nature of how homes are designed, and how difficult and challenging the weather can be, it probably stands a reason that a vast majority of homes have had at least some experience at one time with either some minor leak or toilet overflow. How easy can that happen? A plumbing leak, a roof leak and certainly there are more dramatic issues like floods and that thing. It’s a significant issue. Whether the number is 50% or 90%, that’s enough to get our attention.

Where would you see most of that damage occurring do you find?

It’s tricky to say a great question because as an IEP, an Indoor Environmental Professional, for those of you who might not be familiar. When we go out into the environment, we do try to look at low-hanging fruit issues. It’s similar to your intake of how you look at it with a patient first, “Tell us the history. Tell us what you know.” It’s a village. It takes a team effort to understand things. A lot of times, they’ll say, “We had a leak five years ago.” Maybe we never knew that because they painted over the evidence, but the low-hanging fruit issues a lot of times if they have a crawl space. I never seem to have a lot of good luck with crawl spaces because they don’t have to have staining water for someone to think that there might be a microbial issue going on there and then maybe communicating into the living spaces above or in more humid climates.

I think of Miami, Florida as an easy, cheap example here where we are just having high levels of moisture in the air and not regulating that house. This is the common story of the client that calls you guys up and says, “It’s weird. I have mold growing on some of my furniture and books. It’s not related to a plumbing leak or a window leak.” It depends on the climate we’re talking about. Arizona might look a little bit different than say, for example, Miami, Florida. It all needs to be screened at the end of the day because that’s how things are typically missed is when we say, “We don’t have to worry about the attic and the crawl space.”

You’ve become like that inspector of a water-damaged building. Clearly, for people who live in humid climates as you mentioned, the Southeast is very typical. I would have to think that the water damage from those houses does approach close to 100% unless it’s brand new. Even if it’s totally brand new, the mold takes a very short time to take hold whenever there is water exposure. Even though it’s in the Southwest, Arizona, California desert, Utah and Colorado where we live where these are typically dry climates, I tell people, “If you have running water, you can have mold.” You bring up a good point. Maybe we can address how does somebody remediate what you said if they live in a more humid climate. What do you do about generalized humidity?

Before you do anything, always get a professional involved at the beginning.

Moisture control is the one thing we have control over when we think about fungal growth, bacterial growth and loosely microbial growth. We can’t control the viable spores or cells that are floating around. They’re a normal part of our ecosystem. Ironically, we wouldn’t be here without them. They serve an actual good purpose here. That’s not what we’re talking about. The nutrients are plentiful as well. They’re everywhere. They’re abundant. There are people reading who said, “I’ve seen mold grow on glass.” It’s not eating the glass. It’s eating the nutrients that are on the glass. The one thing we can do though, when we can do it, is to control the moisture.

To answer the question, in the more humid climates, moisture control is key. You’ve heard things like whole-house dehumidifiers and portable dehumidifiers. There’s a misconception for those who use air conditioning systems. My background originates in air conditioning here in Arizona. A lot of people think that their evaporator coil, the part that gives you the cooling for those of you who have it, is a dehumidifier. That would be incorrect. It does help manage and maintain some moisture levels in the house, but by and large, its primary purpose is not that. That means that the occupant living in that hot humid climate is going to be looking at portable dehumidification or whole-house dehumidification, which leads to the follow-up question often asked, “What’s a good level, a range?”

You see it all over the map. When we talk about health, you’ll typically see in the summertime that there’s a range of 40% to 60%. What we like to say is, “Let’s keep it around 35% to 50%.” Let me explain why. We want buffer and some wiggle room because we know that, first of all, not every hygrometer or a device that measures moisture in the air is going to be accurate down to the tenth of a percent and there’s going to be a wiggle room. We also understand that while moisture, typically, if it’s 50% in one room, it might be fairly close to that in another room. It’s not exact. If you have it at that 35% to 50% target range, you’re going to have enough wiggle room to where if it’s a little bit higher at another room, no big deal.

I’m not talking about rain. We had a monsoon storm here in Arizona in Tucson. That’s a short little spike of moisture. I’m not worried about that. I’m talking about you people that are dealing with sustained levels of high moisture for weeks and months. If you have it in that range, it gives you that buffer, but yet it’s also high enough. Remember I said 35% on the other end of the range to avoid some of those more respiratory concerns that probably from your perspective that you’re also considering when you’re thinking about exposure and health.

What we’re talking about here with Michael Schrantz, an indoor environmental professional and expert at Environmental Analytics. You can check out his website at EnvironmentalAnalytics.net. What we’re talking about is people who have symptoms related to water-damaged buildings and those symptoms are any symptoms you may be suffering from. It could be from a water-damaged building and mold mycotoxins, for example.

Whatever disease you’ve been labeled with, heart disease, cancer, dementia, autoimmune, blood pressure, cholesterol, anxiety, stress, depression, brain fog and all these different things, we want you to consider that it could be from a water-damaged building, poor indoor air quality and these mold mycotoxins. We test so many people’s urine and we’re finding these mycotoxins that are in there. Now it’s up to people like Michael Schrantz to find out where these are coming from. Dr. Lauren, what do you think? Now you test someone’s mycotoxins and they’re high in their urine, what do you want them to do with that with Michael?

It’s identified and then, “What do I do now?” We have to identify where it’s coming from. We’re living in the Southwest. It’s a dry climate. People think that we’re safe here. It’s bone-dry outside probably 350 days of the year. We think we’re safe. How do we find somebody like you? Maybe they’re not in Arizona. How would somebody find an indoor air environmental professional to get out to their home?

A two-part answer here, the first part is a couple of resources out there. There are different organizations that have lists of professionals. Think of it as a get your foot in the door type of thing, a minimum amount. One such organization is called the American Council for Accredited Certification. I know it’s a mouthful. Here’s the good news. Their website is a lot easier, ACAC.org. If you go onto their website, you see there’s a tab that says Find Certificants. You follow the narrative in putting your ZIP code. It will pull up a list of potential professionals for you to find. There’s one way.

The other way is there’s another organization called the International Society for Environmentally Acquired Illness. Another long name, but here’s the good news. Their website is easier, ISEAI.org. They have a Get Help tab and there are professionals. That one is a little bit more vetted for people who have a better understanding of IEPs, chronic illness and low-dose environmental exposure concerns where your traditional inspector might miss it. That’s the quick two go-tos that I can offer here without going much deeper.

HHS 3 | Mold Remediation
Mold Remediation: To keep molds from growing, you have to repeatedly wipe dry your surfaces. Contrary to what many people think, a mold spore is very small and can’t be easily spotted.

A lot of times, what people run into is, “I had an inspector come out. They did a couple of spore trap samples. They didn’t find anything and said my house was fine, but my doctor is saying there is an exposure issue.” Does it sound familiar to you guys? There needs to be a lot of education. I only plug IEP Radio, which is a podcast of mine because there are a lot of episodes in there that the audience can go to and learn for free to get a better idea of what you should expect from that IEP when they go out to your house.

At the end of the day, whether you want to hear this or not, here’s some real truth. You’re going to have to be your own ambassador. You’re not going to be able to teleport me out to your house the day of the visit of that IEP to vet that individual. I want to give you that free information. Check it out, IEPRadio.com. It’s a great resource for you to further vet that professional you’re looking for to come out to your home or office and try and find out where that contamination may be.

Thank you for sharing those resources.

What I tell Michael is that I tell my patients, “You paid a lot of money to get your urine tested for these mold mycotoxins. When that inspector walks in that door, you show them the results. The results may say chaetomium globosum or stachybotrys chartarum.” It says what the mold mycotoxin is. You show that to the inspector and say, “I need you to find this. It’s in my body.” As you said, Michael, if they’re just doing a couple of different air samples. Dr. Lauren, you can ask Michael as far as air sample testing and the pros and cons of that.

What are your thoughts on the ERMI or Swiffer testing?

It’s a huge, hotly debated topic out there. There are pros and cons to every sampling. There’s not one perfect sample solution. Unfortunately, if someone said, “I want to select E, all of the above, and do them all.” You start thinking, “I may have to pull out a second mortgage to be able to afford this type of sampling.” This is a very common feeling. I remember Jack mentioning stress and anxiety. There are those emotions that pop up.

In my personal background, experience and perhaps you could say my biases, I’ve collected thousands of what is known as an ERMI sample. These dust samples that are using qPCR analysis to look for not just big-fat mold spores but also the fragments. There are arguably way more fragments in the environment. I’m published with the EPA. I have a study that we did comparing that to spore trap sampling. There are always pros and cons. This conversation could go eight levels deep. I’ll let you guide me Lauren on this one.

There’s the DIY option to do dust samples and Petri dish sampling. At the end of the day, you just have to ask the question, “What value can I get out of this if I’m a homeowner and I read that I can go on a couple of websites and order this ERMI kit?” You know that they can range in costs, typically between $250 and $300 face value for those samples. “What am I going to gain from that? Am I going to get a general picture?” There are arguably times, Lauren, where maybe you’re dealing with the patient and their disgruntled spouse with their arms folded in the background and they’re not even willing to get the IEP out there. I find ironically that could be a good opportunity for one of those DIY-type kits to raise awareness.

The truth of the matter is, if you being the occupant if you’re reading this. If you have the opportunity to get a qualified IEP involved in the beginning upfront, please do it. I understand that might sound biased. Don’t call me up. Use me as your reference if that’s what it takes for you to believe me. That’s fine. The takeaway is you need to get somebody who can quarterback this because Lauren asked a great question, but the answer is it depends.

Maybe an ERMI sample is appropriate right here to try and identify chaetomium globosum because the mycotoxin was on the urinalysis results. You’re less likely to pick up evidence of that with a spore trap sample, but there are other times where the IEP might be looking for an active source. qPCR analysis doesn’t give us an idea of viability or read more recent activity. There are a lot of pros and cons. Each test can be used to answer a variety of questions. I’m sorry. I can’t be more specific. It’s a case-by-case type thing.

It takes a village to solve a problem.

You bring up a good point as well. If you were to hire a professional, we’re all about hiring a professional. If I have a roof, I don’t try and fix it myself. I hire people that are professionals at that. Once we diagnosed you with these mold mycotoxins in your urine, then it’s a matter of, “Use your due diligence. Go look around your house for obvious sources of mold and water damage,” but then number two, now you got to get an inspector in there. Michael, is that the default where they would go to ERMI or Swiffer? Most IEPs are even speaking to you personally. What do you think your approach is, especially when you see someone like me who is like, “I’ve got these in my body? I need you to find them?” What’s your approach and how do you find these?

A lot of people certainly let you too, but a lot of people underestimate the value of a good visual inspection. We’re not even there with sampling yet. I don’t need to sample. Part of the challenge with the type of testing that I’m talking about and you’re talking about is that people need to understand that they are surrogates too. There could be a lot of other organisms oftentimes that are not being represented on these samples. We’re using these samples as surrogates to indicate exposure.

Let’s use the example of chaetomium and they have the mycotoxin that they produce. It’s not like the inspectors because they ignore other mold that’s not chaetomium in the house because there are holistic concerns that you naturally have that the document has. A good visual inspection to look for evidence of water staining or water damage is if they understand the building design, the low-hanging fruit. They have an HVAC system in Miami, Florida that brings a lot higher risk of a concern than an HVAC system in Tucson, Arizona. That history, that client intake of, “Tell me where there have been some leaks,” you can do a lot, answer a lot of questions and potentially save that client money.

Whether it’s Petri dish sampling, spore trap sampling, wall cavity samples to try and locate actual sources, ERMI and a variety of newer technologies coming out with bacteria now, I don’t need to necessarily do that to find low-hanging fruit issues. What happens is we sit down with the client. Afterwards, we review what’s obvious and low-hanging. We say, “Here are your options. You can either assume there’s an issue here because there’s a lot of outstanding evidence here. There was a sewage leak. The water went through the wall. That’s automatic remediation. I don’t need a test to prove it.”

If they have other questions, they would naturally sit down with me and say, “Mike, I get it. It looks like there’s a problem underneath my kitchen sink cabinet. What I want to know also is, do I have cross-contamination in my house? It originated from the kitchen, but do I have to clean all my surfaces and contents?” That’s when you start bringing up some sampling oftentimes because it’s not easy. I can’t see the contamination. A lot of times, we will sample. For me, personally, it ends up being ERMI or the qPCR. We don’t reference the score. I want everybody to know that officially. I don’t look at the ERMI score. I’m looking at the individual molds and their quantities and using some other control data to answer that question, “Does my house reflect normal fungal ecology or is it contaminated?” That’s where sampling comes into play. There’s a variety of other reasons that would justify sampling. Maybe the doctor or you just need it as a baseline. Let’s see what you’re dealing with and then you can test on the backend if you have to remediate to verify that you’ve improved your environment.

Holistically, the biggest success for me has not been in sampling. It has been in a very thorough visual assessment. Sampling just as ancillary data to help justify an action such as, “Do I need to clean? What level do I need to take it to?” That brings me back to my earlier point, which is why you should probably get an IEP involved in the frontend versus the backend because we have these nightmare stories of people spending thousands of dollars on DIY kits. You work with an IEP. They look at all that information and go, “Here’s the problem. You didn’t sample this right. You sampled old dust. You sampled an actual mold when you’re not supposed to.” They get frustrated and go, “What should I have done?” We were like, “You should have reached out to the IEP first so they could have been your quarterback.”

We get the professional involved at the beginning to get some visuals or thorough quantifying data of where and how much. What is your approach to remediation? Let’s say it is localized or underneath the sink. Maybe it did end up down the hallway. What does a timeline look like if somebody does have to remediate some walls in their home?

Working backwards, it’s an excellent question and complicated, which is why we put a four-part remediation series on IEP Radio because, being an ambassador, I know what the best practices are. Timeline is a fair question. It depends on what we’re talking about. Just the remediation or any amount of cleaning, you’re usually in the wheelhouse of about a week plus or minus a couple of days depending on a few factors naturally.

The repairs are what we find are taking the long times. We’ll normally tell somebody that a project from start to finish, meaning you’re going to start remediation on day one and your house is going to be repaired on day X is 4 to 6 weeks, assuming there are no other complications. In terms of the methodology, we follow the Keep It Simple. There are so many different things that I’m sure you guys have heard and have been marketed with of how to clean the house and fogging chemicals that we wonder, “Have they been vetted? Can this potentially harm my patient?” Proper containment and proper engineering controls are vital.

Elbow grease, as simple as that sounds, in the end, has been in my experience the greatest success in a lot of my colleagues. What I mean by that is you’re going to have to HEPA vacuum, damp wipe or dry wipe those surfaces. A lot of people think that a mold spore might look like this big-old thing that you can easily pick up off the ground. We’re talking about stuff that is extremely small. Let me nerd out with you. On average, 250 mold spores can fit on the top of a needle pinhead. It’s the kind you sew with side-by-side without falling out.

HHS 3 | Mold Remediation
Mold Remediation: Mycotoxins are a secondary metabolite. In other words, they can be pre-created by mold that is known to produce those mycotoxins.

For every one of those mold spores, depending on what study you read, there are anywhere between 300 and 500 fragments that are even smaller than those spores. It’s a numbers game, but we have found that you don’t need a miracle fog or cleaning agent that is EPA-registered, not EPA-approved. There’s no such thing. That is what’s working to contain the problem, clean the house and then test it on the backend to verify that your patient’s home reflects normal fungal ecology.

Michael, you’re talking about these fragments. Is fragment the same thing as a mycotoxin? If you think about mold growing in a shower, that mold in the shower releases these spores to propagate itself for its survival. Those spores, in addition, they’re releasing these mycotoxins. Are these the fragments you’re referring to or events? It can be fragmented, but there are also other pieces, proteins and materials that are released as well.

Beta-glucans and cell wall material. Mycotoxins are a secondary metabolite. Translation, they can be procreated by mold that is known to produce those mycotoxins. It doesn’t mean they’ll always produce them. They are a chemical so they might be free-floating in an environment or attached to a mold spore or mold fragment to answer your question. Picture a mold fragment as anything. It could be that mold spore busted into a thousand pieces. It could be for the roots of the mold that are fragmented. It’s the structure of the mold. A mold is organic like we are. We all break down. It fragments.

Holistically, to the question, we’re not just focusing on mycotoxin removal. We’re trying to remove the whole part of it because the truth of the matter is, while we might use mycotoxins in clinical practice as a surrogate to try and address an issue, a lot of people are dealing with inflammatory responses to other parts of the mold that aren’t a mycotoxin. I tread lightly because I’m not a doctor. You guys can clarify these points if needed. Even if it was, it’s not like we can say, “Leave the mold spore here in the house and remove the mycotoxin.” The techniques that are supported in our industry are complete removal.

All cardiovascular issues, we can make the case again that water-damaged building, mold mycotoxins, mold spores and mold fragments we’re learning, all of these things are again causing cardiovascular disease. You can go to see another physician and they can put you on pharmaceuticals to cover up symptoms or we can address the cause. This is a major cause we feel a 21st century crisis as to what’s going on. Michael, you find the source of where the mold is, for example. Let’s say it’s under the kitchen sink. These mold spores, fragments and mycotoxins have been aerosolized. Theoretically, they could be everywhere in your house.

You mentioned before testing different surfaces for contamination. You could obviously test individual surfaces or say, “My house is contaminated and I got to wipe down. I got a half of that. I got as many surfaces as I can touch to improve on, but also, there are other things. Can you clear a piece of cotton clothing, cotton-based furniture or wool-based furniture?” It dives into so many different issues. I’m sure you’ve got a million stories you could talk about where people have had to get rid of everything. They just walked out their front door with a fresh pair of pajamas waiting for them and start over.

It’s a great point. You mentioned a lot of them, but what I heard from you is the question, “What about those contents?” Contents porous items are another very hot topic. I do have a strong opinion about that one, although it’s not black and white. Here’s what we can tell you. Let’s talk about science, first of all. When you hear people throwing things away and you don’t understand the backstory. A lot of times, when you do get into the stories, you’ll find out it was fear-based. Unfortunately, there is a lot of celebrity or authoritative-type figures that either insinuate that you should do that or flat out state it, but when you ask them for the data, the actual third-party studies, you’ll find that there’s an elephant in the room. It’s quiet and all that.

I interviewed and again, a shameless plug for a free resource on IEP Radio episode nineteen, Dr. Ralph Moon. He did a study back in 2005 where they inoculated different types of fabrics that were synthetic or natural with mold. In fact, stachybotrys chartarum, aspergillus versicolor and the associated mycotoxins that they produced. They did all this testing, scanning electron microscopy and all other sorts of things to get an idea. The question was, “Could we wash these?”

At that time, dry cleaning was felt, “We’ll take your item like your T-shirt or those linens and send it to the dry cleaner.” The study revealed that normal laundry and I’m talking your normal laundry detergent and/or with bleach where appropriate were the most effective at removing a vast majority of the contaminants. That would be the fungal structures, spores, fragments and mycotoxins, but here’s something else that we also learned and probably more important. There’s a big difference between mold growing on an item versus it settling on.

What I’m trying to tell you and suggest is that, for those of you reading, you shouldn’t automatically assume that you have to throw everything away. There are exceptions. I’m going to try and give you a few of these. Normal cleaning of most items has been shown through testing and data to be fairly effective at removal, however because we know it’s not an exact science. Fourteen spores are good, but with fifteen spores on your item, your arm is going to fall off. No one has that. We would normally tell people to clean them, but then store them in plastic-sealed containers like plastic bins with the rubber gaskets on the lid not because we want you to ignore them, but oftentimes, that’s what gets people to freeze and do nothing. They get so overwhelmed with the prospect of what they might have to do with everything that they don’t do any of it.

Your main concern is your home. This is your sanctuary. It’s what it’s supposed to be. This is what your concern is and to address that. Let me put some perspective on this, so short takeaways. If there’s no mold growing on it, it’s not automatic. You have to throw it away. Even if there was mold growing on it, it’s a case-by-case situation. We would never tell you to throw away your photo album or that crochet that your great-grandma made for you. We might not have you sleeping with it, but you don’t have to feel like you have to throw everything away.

To avoid health problems, it’s good to have critical thinking and to listen to what your doctors are saying.

I want to argue this. There are exceptions. I don’t mean to make this a blanket statement for every single item. It’s a case-by-case situation. We’ve seen straight-up situations where it was better to get rid of it. Usually, there was a good reason but consider this. You’ll love this. It’s interesting how we’re prejudiced. Allow me to explain. If a mold species from outside lands on your T-shirt, you’re fine. You’re not going to get upset or burn your shirt. You’re going to launder it like you normally do. You probably end up wearing that same shirt in another week or two like most people.

The second that the same mold specie grows inside the home, there’s this feeling that the community treats it like it’s plutonium. All of a sudden, it’s an issue. We have a problem with it. What I’m trying to provide to the audience is perspective. We have so many people that are fearmongering using fear-based. Sometimes it’s easier for people to press the reset button. I get it and some people are blessed to be able to do that. What it has caused is a culture of fear and thinking that we need to live in glass bubbles on Mars, which is not the world we live in. No one is defending the other piece of it. You realize that the same species that landed on your T-shirt is the same thing that it could have grown in the house outside. The conclusion is a compromise. We know that it can’t be zero on your shirt. Meaning no molds and mycotoxins.

It can’t be zero because there’s no such thing as that, but you don’t have to automatically remove them soon. What’s the solution? The DIY piece is to go through the items and see if there’s any evidence of actual growth on them. You likely would want to address those items. If you can discard them, that’s great. End of story. Now, we don’t have to worry about it. If it’s an item of intrinsic value, take it away, put it in a plastic sealed container and get it out of your living space, but you likely will involve an IEP somewhere in this process so they can help you inventory each item because we don’t want you to shoot yourself in the foot.

If you’re going to go through all this remediation and cleaning and then you remove, for example, Dr. Lauren has got these books behind her and they’re all moldy. We’re not saying, “Take those books out and then bring them back in and cross-contaminate your home.” What we’re saying is it can be overwhelming. It’s not an automatic throw it away. Ask the question, “Do you see growth on it? Does it smell funny or musty? Do you feel weird when you put that item on?” Use those as clues to discard them. Otherwise, consider trying to clean them and following the industry standard to do that.

On our clinical side, we see vague symptoms that can range greatly from headaches to chronic allergies, cardiac issues, atrial fibrillation and high blood pressure. Maybe you don’t often get that clinical piece. What are some of the most common symptom pictures that you do hear from indoor air pollution?

You named a lot of them. To name a few, headache, weakness, foggy brain, joint pains, cramps, confusion, coughing and excessive thirst, the list goes on. Those are common. The problem we have and to your point about it takes a village, is if you go online and look these things up, it can include anything from just being stressed out from work to having cancer. That’s overwhelming. A lot of times, to add a point, we rely on the clinicians to provide that cluster symptom analysis and say, “This does seem to be differential and specific to mold.” Maybe that’s in combination or concert with urine analysis, cytokine testing or whatever you’re using to track this patient. That helps us because, at the end of the day, the other issue is we have IEPs that are out there that are giving clinical advice that they shouldn’t do.

This is a complicated illness and exposure. We don’t want our patients to think that DIY sampling is going to answer all their questions. It’s the same thing on the clinical side where they rely on your expertise to say, “This is why this is unique and different.” It’s all over the point. I’ve seen people that say, “I got ice pick pain in my hands.” I’ve seen other people who are high-functioning where they don’t have any symptoms. It’s just that their doctor is saying, “You seem to have upregulation or downregulation of these inflammatory markers. We’re trying to figure out why.”

Also, I tell people and they say, “I don’t have a mold issue. I don’t have any problems with mold. I don’t have any symptoms.” I said, “You’ve got high blood pressure. You’ve been labeled with coronary artery disease on a CT scan. You’ve got atrial fibrillation.” Maybe mold micro-toxicity or poor indoor air quality from water-damaged buildings is a factor. You need to mitigate that not because of symptoms, but because you have an obvious clinical disease that may be related to this particular issue. That’s why we need to take the next step.

As we find an IEP expert, Michael, you could tell this better than I. There’s a whole range of these people not only in quality but also maybe even in the understanding of people’s clinical symptoms and how it relates. Some people may be like, “I became an IEP, an Indoor Environmental Professional because I suffered from this personally or maybe my spouse, child or parent did. I understand the full gravity of what the possibilities are as it pertains to health.” Other people maybe that are IEPs don’t get that clinical side, but this is an opportunity to say, “Your physician is in charge of the clinical side. We’re going to the IEP to say, ‘Find the problems in my dwelling.'”

It’s a paradigm change. The shift is what I picked up from those points and it’s true. In the traditional model of inspection, we didn’t dive that deep into it. Not that it was our role to be clinicians and offer medical advice, but there were a lot of assumptions possibly made and we were still learning. We didn’t say things like an inflammatory response. We weren’t even necessarily talking about fragments decades ago. We were looking at more acute issues, absentees at work and why this is happening. Is it because there’s too much toner coming out of the copy machine or is it because there was a mold issue in the bathroom?

The problem is that a lot of us have glossy websites and we say all the right things to make the client feel good, but the real question is, are we calibrated to meet these new challenges of exposure? I’m guessing that it wasn’t, but a few decades ago where you used to have a symptom and dad told you, “Quit your bitching. Just take a Tylenol,” and then we’ve learned that, “No, there were some underlying things in here.” The IEP has the same challenges. We’re trying to figure out, “Maybe this type of sample analysis of spore trap sampling as an example.” I don’t mean to pick on spore trap sampling. I’ve done thousands of them, but they don’t detect the fragments. You could miss it. That doesn’t mean there’s not an exposure problem in the house.

The other issue I’ve seen IEP is flat-out just dismiss things, “There’s mold in the evaporator coil in their air conditioning system. I see that all the time. That’s no big deal.” I was like, “Where did that come from?” It’s this whole thing about that’s the old model. That’s why to your point, the challenge is real and why those couple of resources that I know are going to be available for you people afterwards are starting points for you. Ultimately, you need to educate yourself.

Even the ISEAI, International Society for Environmentally Acquired Illness on the Get Help page, there’s a 1 or 2-page document finding an IEP that was written by myself and a few others to guide people to say, “What am I looking for?” It’s not a special flashlight. People go, “What do you do different, Mike? Why do you know all the stuff? Is it a special tool you have that nobody else has?” No, it’s not. It’s critical thinking. It’s listening to what the doctors are saying and saying, “How can we apply this if we’re missing it? Are we missing it because we don’t have the right tools for the job?” Those resources can help you find the right person.

HHS 3 | Mold Remediation
Mold Remediation: Normal cleaning with laundry detergent or bleach is fairly effective at mold removal. You don’t have to throw away something with mold if you can simply clean it.

We’ve talked about identifying in your current home, but say somebody is moving for whatever reason. Maybe it is that they had to walk right out their front door and have a new set of pajamas waiting for them somewhere else. What tips would you give and suggestions for people looking for a new home, building a home shopping for a home? What might you look for in that process?

There are a lot of similarities. You think about, “Is there any evidence of water staining, water damage or mold growth? Are you looking at all of the plumbing sources underneath kitchen sinks and vanities? If it has an air conditioning system with the cooling part, are you having that visually inspected? Does it have a crawl space? Does the house smell musty? How do you feel if you’re very symptomatic, assuming you can trust your symptoms? That’s a whole other issue. Low-hanging fruit things, how is the landscape? Is it at the bottom of the hill where the water collects all around the house and under the house? Does it appear to have good drainage?”

None of these things, truth be told, are deal-breakers. What’s a deal-breaker is relative to the individual. You can fix a house if you spend enough money. I would say that if you’re dealing with a crawl space, for example, that’s a typically inexpensive fix. You’re anywhere from $8,000 to $30,000 depending on the complexity. That’s a real number, even a kitchen sink cabinet if there’s mold damage in there. Let’s say they have granite countertops. The next thing you know, you’re remediating that and then they break the granite.

Now you have to replace it. You’re spending $10,000 to $15,000 that you didn’t intend to, but that’s relative. One individual look like that and says, “That’s a deal-breaker.” The other one says, “That’s unfortunate, but this house is worth it. I don’t want to do it, but I am because of those complications.” One more shameless plug is why we created episode 9 and episode 25 on IEP Radio. IEP Radio episode 25 talks about things to consider when buying a home and what you will find on that are strategy. That’s what people are wanting. Let’s say working with a realtor. I interviewed my wife, who is a realtor, on that podcast.

We talked about the issue is timing. It’s finding a realtor who can be your advocate to screen in and rule out. If you walk into a house and it smells musty and there are problems everywhere, but you’ve got three other choices that are much better, it might be safe to reasonably rule out that one because it’s complicated. It also gives you a strategy about like, “Should I do a DIY or an ERMI sample?” Some people talk about that, “Should I do my own sample?” The answer is yes. If you have the budget, you can, but user beware, “Does that dust represent that house or the cleaning service that came out to get the house ready for showing and that vacuum cleaner that was used in 50 other moldy homes?” “I didn’t think about that.”

There are a lot of things to consider and because it’s complicated, look for those low-hanging fruits that we talked about in episodes 9 and 25. At the end of the day, you may find that this house is the house of your dreams or let’s be realistic. It’s a seller’s market for many people and you don’t have a lot of options. You have to look at it differently and say, “I’m willing to deal with this. I don’t want to but don’t assume because you have mold in vanity in your bathroom that you have to walk, but be aware and conscious that you probably should address it.”

I would also say that there is this general inspection that happens after you signed a contract to purchase a home. That general inspection will come in and say, “I took a look at the HVAC system to make sure it’s functioning. I took a look at the lighting and the appliances.” Michael, you would agree there is this opportunity for a separate indoor environmental professional to come in and look at some of these other things. For example, I know you had some knowledge on radon, whether it’s radon exposure or looking for obvious sources of mold. If you’re going to invest all this money in a house, make sure you have all the facts before you close on it. It’s extremely important to know about the indoor air quality before you get on that inspection period.

We talked about it on episode 25, but I’m glad you brought it up. One of the strategies is that on day one of the inspection if you can plan it as the general home inspector and they’re going to look for low-hanging fruit. I wouldn’t trust them ironically to look for mold problems, but you never know. They might find, “This house doesn’t have a roof,” and you’re going to walk just because there are other deal-breakers. You screen it.

A lot of times, though, when we’re working with people who have a chronic illness or a low-dose environmental exposure concern, we talk about, “You have to spend more money.” Get an IEP out there on the same day or if you can do it on day two. That way, if you need to cancel because you found something on day one with the general inspector. If you have an air conditioning system, don’t just have them inspect the system for functionality, which you need to do as well, but have them photograph the evaporator coil. Treat it like a glamour shoot. At the end of the day, what the reality of it is, is that when I look at the evaporator coil, I’m going to be looking at it differently than an HVAC technician.

The photos are helpful because then you can either take it back to the IEP you’re working with or maybe you’re working virtually. There are a few of us IEPs that offer virtual services. We can look at it and go, “That’s an issue. You can see growth along with the ductwork and that’s going to insinuate. You’re going to need to replace that ductwork.” Now you need to get an estimate of what that’s going to cost because you’re trying to figure out if you want to buy this home or not. It’s absolutely well said. If you’re in that category of illness or exposure, if I were you, I would make the IEP inspection piece mandatory just like you would want a normal home inspection.

Spending a couple of thousand dollars if that’s what it amounts to upfront to potentially save you $50,000, $100,000 or $200,000 down the road, not to mention the contamination of your belongings, it can get ugly very quickly. Invest in the IEP upfront. There is no doubt.

I love that you talked about using strategy, time and team. Everything at your disposal, using it wisely with a strategy going into all of that. What are some common misconceptions that you see in this field that you would like to address or maybe some blanket things that you would like our readers to know about indoor air quality? Maybe they’re not familiar as you and I. It’s new to them.

Thank you for this opportunity. There’s a couple of things to contrast each other. There’s no doubt for the record that we have concerns about environmental exposures. The challenge with a chronic illness is that they’re not normally an acute exposure like 20 to 30 square feet of mold growth growing on a wall. You walk into the house. It hits you in the face. You pass out. These are more like your leg breaking. These are acute things. It’s frustrating. Sometimes people are like, “Is that really what’s going on?” There’s a ton of evidence about water-damaged buildings. We even have governmental organizations and other things the EPA recognized. There’s a consensus that it’s a concern.

I say that upfront because the other thing too is, in my personal experience, what I’ve seen come out of the woodwork is the other extreme. I want to provide some perspectives here. That is the term one, normal fungal ecology. People, our goal is not mold-free, yet some of you have heard that term and some of us use that term to mean different things. What your goal should be ultimately in your house is that normal fungal ecology would be normal background levels of the molds that are outside of your house. We live in a world surrounded by this. Without it, we wouldn’t be here. That’s your goal. That may or may not be enough of a concentration to make a difference for you. You may be super sensitive, but for a vast majority of people who need to detox or get treatment, if you can get the house to reflect normal fungal ecology, that is your target.

When you hear stories about people throwing things away, the reason they do that is based on fear.

I want you to know that here because, believe it or not, there are a lot of people that think if you find a mold spore in your house, that’s a problem. It clearly shows that they don’t have an understanding. Probably no thanks to a lot of the bad information they can find online. The other thing too is we need to have better definitions of the term exposure and things like contamination. I personally hate the word contamination because it reminds me of radiation or plutonium, but we use it because we want to describe exposure to something that we would want you to be exposed to. Hence the term contamination.

Remember that normal fungal ecology, it’s not like it’s a tight ship. It’s a moving target. The concentration of the types of molds that are in the air settling out are changing. Not drastically, but they’re not static. They’re not just hovering and not moving. It’s not that simple. Maybe that offers some relief to people on the other perspective of the same. We’re not looking for an exact level and that I can tolerate ranges. I don’t have to have zero mold-free. The other term is exposure. We don’t live in a cleanroom or in a bubble on Mars. I say that for this reason. We have immune systems and our bodies depend on exposures to keep us strong in background levels.

I have even found that some people think when they use the term exposure that they have to have nothing in their house. We are constantly exposed to various concentrations of dirt, dust, pollens, plants, fibers, mold and bacteria that are normal background. You could argue that’s exposure. We just need to do a better job as IEPs and professionals to speak wisely to our audience and say, “We’re looking for normal fungal ecology. You will have an exposure that’s normal exposure, but it’s when it becomes elevated or atypical that people like Lauren and Jack become concerned. They start seeing evidence of that either in the cluster symptom analysis that they’re looking at with you or maybe perhaps it’s a urinalysis or whatever biomarker they’re using to follow you. That’s when it becomes a concern.” I want to touch on that because it’s a touchy subject for a lot of people.

To continue with that theme as well, I would like to have people remember the common sense of what are the best foods, the importance of sleep, the importance of sunshine and the common sense things that the medical doctors are typically lost. Common sense would tell us that we have been exposed and been around bacteria, viruses, mold and parasites. We have evolved in all of that. As you said, we should embrace all of those things as it helps prime our immune system and make us as healthy as we can be.

The problem would lie in is that, years ago, we had open buildings and open housing structures that we’re allowed to breathe, that a lot of outdoor air was coming in to exchange with the indoor air and vice versa. Now, under the guise of eco-friendly, keeping energy costs down and the green movement, we live in so many of these hermetically-sealed buildings with materials that could easily foster growth from water damage. Recognizing that this kind of 21st-century environment could be leading to any symptom you have or any sign, disease or medical condition you may be suffering from.

The energy crisis you referred to was in the late ’60s, early ’70s. “Let’s build these houses and buildings tighter. Let’s save on our utility bills.” Everybody raised their hand and were like, “That’s exciting.” It was an inverse relationship holistically with indoor air quality. We started seeing new phrases emerge, sick-building syndrome, building-related illness and trying to figure out what is going on because it wasn’t acute. It was subtle. It came in through the back door. In these tighter buildings, we realized that maybe we had exposures before, but there were some wiggle room and flex in the fact that they were leakier in the outdoor environment. It was diluting the concentrations enough to where they weren’t presenting themselves symptomatically in the people.

It’s absolutely important. We think about the home and exposure. Half of it to your point, is certainly finding the sources and removing it like cancer. The other part is creating a healthier home. We start having to incorporate new techniques that the older homes weren’t doing. Natural ventilation was opening up a back door or front door and letting a little draft in. I still recommend it. It’s a great idea when weather permits, but now we’re using terms like mechanical ventilation, bringing in the fresh air and using better filters that we have in our homes now to compensate for how we’ve changed that built environment of now.

Michael, you told us about some fantastic places to get more information. You talked about IEP Radio. No shame was plugged there because this is all great information that our readers need to find. Give us a refresher one more time. Where can people find out more about you and how they can work with you?

I always start by telling IEPRadio.com because it’s a free resource. It’s totally educational. A lot of people, when they see these things, they’re like, “You’re really big. Show me the data.” I have a references page that lists where I’m pulling a lot of this information from because a lot of us are lost. If you’re looking for something more personal, if you’re looking for me to consult with you, that’s great. I appreciate the opportunity. You can go to EnvironmentalAnalytics.net. You can learn more about me. My CV is up there to get a little bit better idea of my background. There’s a contact form you can fill out. We’ll do what we can to help.

You mentioned those shorter URLs as well, ACAC.org and ISEAI.org. You chose a long name, EnvironmentalAnalytics.net. We have NaturalHeartDoctor.com. We’ve got some longer URLs. Dr. Lauren, I’ll let you close it down. We appreciate you being on the show, Michael.

Thank you.

Thank you so much for your time and all of the valuable information. Before we let you go, I wanted to touch on, bring it back to cardiovascular wellness and ask you specifically, how do you live a heart-healthy life?

I’ve had some personal changes in my own life. At the end of 2020, I was looking at how overweight I was. I hide it well. Eating healthy is huge. I have found that little thing called portion control and eating more organic foods. I’m shopping at the Sprouts and the Whole Foods and things as much as I can. It was a major game player in my gut biome and being able to feel better. You might imagine that I also have a home with upgraded filtration and mechanical ventilation. Practice what you preach. I’m hopeful that doing that has made an improvement to myself and my family.

The other thing too, quite honestly, is stress management. We are so distracted with the demands of technologies, phones or computers that we’ve taken for granted with that downtime. We used to make fun of people that lived in slow life. Now, I envy them. I would argue that stress management has been huge in my own life. I got to tell you. It’s a night and day difference between diet and stress management. It was like I woke up in a new skin and body. That’s what I’ve been doing mainly.

You got to bring it back to basics, good food, clean air and stress management. We appreciate your time. Thank you so much.

Jack and Lauren, thank you.

About Mike Schrantz

Michael Schrantz, CIEC, CMI, BPI-BA/EP is the founder and operator of Environmental Analytics. His company offers comprehensive indoor environmental quality consulting that covers a wide range of environmental assessments for the residential, commercial and medical sectors. Michael has over 24 years of active indoor environmental quality and building science experience.

He has been involved in over 5000 related projects expanding around the globe and specializes in working with individuals suffering from chronic illness and low-dose environmental exposure concerns. He is a Council-Certified Indoor Environmental Consultant, an accredited certification through the American Council for Accredited Certification (ACAC), and carries multiple certifications in various environmental fields. Michael is one of the IEP panel of professionals with Surviving Mold, and a Founding Board Member with the International Society for Environmentally-Acquired Illness (ISEAI) serving as Treasurer. He is a published author involving qPCR sampling, and volunteers hundreds of hours every year to industry-related organizations and groups.

He is the host of IEP Radio, a free educational resource for patients, clinicians, and IEPs covering a wide spectrum of topics including microbial remediation, sampling and many interviews with some of the leaders in functional and diagnostic medicine. You can learn more about Michael by visiting his website http://environmentalanalytics.net

About Dr. Keith Smigiel NP, DC

Dr. Keith Smigiel

Dr. Keith Smigiel is a regenerative medicine physician and pain management specialist. He takes an integrative approach to medicine, focusing on customized solutions tailored to individual needs. Using advanced, non-surgical treatments, Dr. Smigiel stimulates your body’s ability to naturally heal itself.

Dr. Smigiel helps people suffering from conditions such as chronic pain and erectile dysfunction, to hair loss and weight gain. Combining treatments such as PRP Therapy, Ozone, Neural Prolotherapy, and IV Infusions with functional rehabilitation, he helps you look and feel better.

He heals the body, instead of just treating the symptoms!

With his professional qualifications as a certified family nurse practitioner, a doctor of chiropractic, and a fellow of the International Academy of Medical Acupuncture, Dr. Smigiel offers patients comprehensive care from a broad perspective of conventional and alternative medicine. He also has extensive experience in functional rehabilitation and chronic pain management.

Dr. Smigiel is married to Angela and has two children, Sophia and Larz. When he’s not busy helping patients, he enjoys hiking, mountain biking, motocross, and boating.

About Dr. James Kneller, M.D., Ph.D., FHRS

Dr. James Kneller, M.D., Ph.D., FHRS

Dr. James Kneller is one of the nation’s leading heart rhythm specialists. Dr. Kneller is certified by the American Board of Internal Medicine (ABIM) in Clinical Cardiac Electrophysiology, Cardiovascular Disease, and Internal Medicine.

As a Fellow of the Heart Rhythm Society (FHRS) and Certified Cardiac Device Specialist (CCDS), Kneller provides comprehensive patient care, combining best medical practice with invasive procedures using state-of-the-art technologies to treat heart rhythm disorders.

Beyond guideline-directed therapies, Kneller is passionate about optimized personal health. With a deep interest in complimentary alternative medicine (CAM), he strives to reduce the need for pharmaceuticals, invasive procedures, and exposure to harmful radiation. With Natural Heart Doctor, he strives to help each and every client to Live Well, Eat Well, and Think Well to attain their 100-year heart!

About Dr. Lauren Lattanza NMD, FACC

Dr. Lattanza Office Visit with Patient

As a Naturopathic Physician, I am trained to treat the whole person and get to the root cause of disease.

I went to Arizona State University where I graduated with a bachelor’s degree in psychology with a depth in physiology and minor in Spanish. After my undergraduate degree I was working on prerequisite classes towards medical school, which is when I came to learn that my values identified best with the principles of naturopathic medicine. I knew that I wanted to help patients identify the causes of disease and be able to offer treatments which would improve their health rather than simply treating symptoms.

I dedicated the next 4 years to the Southwest College of Naturopathic Medicine in Tempe, Arizona where I attained my Doctorate of Naturopathic Medicine. I served as Class President all 4 years, Board of Trustees – Student Trustee, spoke as the Club President for our branch of Toastmasters, and was voted by my peers and attending physicians to earn the Outstanding Leadership Award for the Class of 2020. Throughout medical school I took it upon myself to work alongside MDs, DOs, chiropractors, and functional medicine practitioners in addition to naturopathic physicians.

As a Spanish speaking student, I was able to volunteer with community clinics around Phoenix and provide free healthcare to low-income families. Due to this combined exposure, I came to find my passion in treating cardiometabolic and digestive disorders that are all too common, yet largely preventable. I took the opportunity to learn the broad spectrum of healthcare so I can ensure that I am able to provide my patients with the best options.

About Dr. Jack Wolfson DO, FACC

Dr. Wolfson Office Visit with Patient

Dr. Jack Wolfson is a board-certified cardiologist, Amazon best-selling author, husband, father, and the nation’s #1 Natural Heart Doctor.

For more than two decades, more than one million people have enjoyed the warmth, compassion, and transformational power of his natural heart health courses and events.

Dr. Wolfson is the founder of Natural Heart Doctor Scottsdale, his heart health practice in Arizona, and Natural Heart Doctor, an online resource center with natural health information. Doctors from across the globe reach out to Dr. Wolfson for training and education in holistic health practices.

He has been named one of America’s Top Functional Medicine Doctors and is a five-time winner of the Natural Choice Awards as a holistic M.D. Dr. Wolfson’s work has been covered by more than 100 media outlets, including NBC, CNN, and the Washington Post. His book “The Paleo Cardiologist: The Natural Way to Heart Health” was an Amazon #1 best-seller.

Dr. Wolfson and his wife Heather have four children and are committed to making the world a better place to live. They provide for those in need (including animals) and support natural health causes through their philanthropic efforts.


Our chiropractor is an expert at adjustments and holistic chiropractic care and works closely in conjunction with the other health care experts at Natural Heart Doctor.

Call (480) 535-6844 for details and scheduling.

IV Therapy

We use specially formulated natural vitamins and minerals that are injected into a vein to prevent or treat dehydration. Ideal for people in Arizona.

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Stimulate your body’s natural healing abilities and promote physical and emotional well-being with acupuncture at Natural Heart Doctor.

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Health Coaching

Our health coaches use evidence based skillful conversation, clinical interventions, and strategies to engage you actively and safely in health behavior changes.

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Cardio Tests

We use the most advanced testing in the world to assess heart health and to identify the root cause of your health issues.

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Office Visits

Schedule an office visit with one of our cardiologists, holistic physicians, chiropractor, or health coaches.

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Frequently Asked Questions

I’d like to receive an online second opinion from Natural Heart Doctor. What do I do next?

You can initiate a second opinion online through our website at any time. To begin, select the team member you’d like to speak with and open an account.

Click here for cardiologist Dr. Jack Wolfson.

Naturopathic Medical Doctor Dr. Lauren Lattanza. Get details.

Naturopathic Medical Doctor Dr. Tonia Rainier. Get details.

Click here for  Natural Heart Doctor Health Coach.

Alternatively, you can email health@naturalheartdoctor.com. A member of our care team will help guide you through the process of starting a second opinion.

What is the cost of a Natural Heart Doctor Online Second Opinion?

The cost for most second opinions varies by team member. This fee includes information collection, a phone or video consultation, a second opinion from a Natural Heart Doctor specialist and guidance throughout the process from your personal Care Team at Natural Heart Doctor.

Cardiologist Dr. Jack Wolfson’s Second Opinion Fee is $1500.

Holistic Physician’s Dr. Lauren Lattanza’s Second Opinion Fee is $250.

Naturopathic Physician Dr. Tonia Rainier’s Second Opinion Fee is $250.

Note: We apply the Online Second Opinion Call fee as a credit to any future consultations with Natural Heart Doctor, should you choose them.

Will my insurance cover the cost of a Natural Heart Doctor Online Second Opinion?

Most likely, no. Most health plans do not cover online second opinions or consultations. You are responsible for the cost of our second opinion. Natural Heart Doctor cannot file a claim with your insurance carrier, nor can we provide a procedure (CPT) code for this service.

What is the timeline to receive an online second opinion?

We do our best to schedule your second opinion as quickly as possible. Typically, it takes 5 to 7 business days after your information has been collected to receive your phone or video online second opinion.

What information do you need in advance of our call?

Our office will send you a short questionnaire to complete and return. We DO NOT need your complete medical records.

How many questions can I ask the expert during our call?

You may ask a maximum of five questions. This is to ensure that the expert has sufficient time to devote to each question. All questions must be finalized before your online meeting.

What should I expect to receive once my second opinion is complete?

You will receive a summary of our discussion along with our second opinion. The second opinion will be in written form. After you have reviewed the second opinion, a Natural Heart Doctor clinician will follow up with you by phone to address general medical questions about the information provided in the second opinion.

What if I have follow-up questions for the expert after I have reviewed my second opinion?

If you have a clarifying question about an expert’s response to one of the questions in your second opinion, and the Natural Heart Doctor clinician is unable to address it, then you may request a follow up session for an additional fee. 

Is my medical and payment information secure?

Natural Heart Doctor is strongly committed to protecting the privacy and security of all our patients. Our website meets all federal requirements for protecting personal health information under the Health Insurance Portability and Accountability Act (HIPAA). All financial transactions are processed by Natural Heart Doctor securely using industry standard payment processing tools.

I would rather visit Natural Heart Doctor for an in-person appointment. What should I do next?

If you would prefer an in-person appointment at Natural Heart Doctor instead of an online second opinion, please call (480) 535-6844 for details and scheduling.

Can I schedule a follow up appointment with the specialist who provided my online second opinion?

Yes, we’re happy to help you on an extended basis. Our clinician can discuss options with you when presenting our second opinion summary.