The Center for Occupational & Environmental Medicine (COEM) has successfully treated patients from all over the world since 1978. Our office consists of three MD’s and a full support staff dedicated to helping patients gain optimal health. Our physicians have seen many cases of mold exposure and its toxic effects. We are experienced in the accurate diagnosis and treatment of mold injuries.


COEM specializes in Environmental, Functional, and Integrative Medicine – which are all board-certified and evidence-based fields of medicine. Our center is one of the few resources for the practice of Environmental Medicine in the entire Southeast. Our physicians treat patients using a combination of conventional allopathic medicine with holistic medicine treatments using some of the best, scientifically validated therapies available. We take the time to develop and monitor individualized treatment plans designed to heal the whole body, not just relieve symptoms.


We look for biomarkers of exposure through blood and allergy testing to determine sensitivity and the type of mold you have been exposed to. Indicators of mold poisoning include, but are not limited to, a low white blood cell count, poor lung function, and neurological damage associated with exposure to biotoxins. Knowing the type of mold and its affects can help the doctor pinpoint the treatment.


The initial appointment is an entire day, starting with a lengthy consultation reviewing your life and health history. We evaluate several factors throughout your history including, allergies, toxins, infections, stress, genetics, lifestyle, and nutrition. At the end of your appointment, the doctor will go over treatment recommendations. To learn more about our new patient appointments, please contact our New Patient Coordinator, Gabrielle at 843-572-1600 or complete the form found on our ‘Schedule Appointment’ page.  

Dr. Bettina Herbert discusses Mold Toxicity on ABC 4’s Lowcountry Live.


Exposure to toxic mold can cause numerous health problems. After pollen, mold is the leading cause of outdoor airborne allergies. Mold produces several harmful substances like allergens, irritants, and the most harmful of all, mycotoxins – a potentially toxic substance. Mold and the toxins they secrete (i.e. mycotoxins) are increasingly being recognized as a source of illness and wide a range of symptoms, ranging from mild to severe, including:


  • Muscle and joint aches and pains (including cramping)
  • Coughing & Wheezing
  • Nosebleeds
  • Sinus pain
  • Headaches
  • Fatigue
  • Dizziness
  • Sleep disorders
  • Night Sweats
  • Sensitivity to light
  • Difficulties losing weight
  • Skin rashes
  • Diarrhea
  • Nausea
  • Abdominal Pain
  • Immune suppression
  • Kidney and lung disease
  • Anxiety & Depression
  • Difficulty focusing or finishing a task
  • Disorganization
  • Feeling disconnected, confused, or losing parts of your personality
  • Nerve Pain
  • Numbness & tingling


Dr Allan Lieberman, in his paper Explosion of Mold Cases in Homes, Workplaces and Occupational Medicine Practice, examined 48 patients who were heavily exposed to mold and stated that the following problems are caused by mold:


  • Muscle and joint pain (71%)
  • Fatigue and weakness (70%)
  • Neurocognitive dysfunction (67%)
  • Sinusitis (65%)
  • Headache (65%)
  • Gastrointestinal problems (58%)
  • Shortness of breath (54%)
  • Anxiety/depression/irritability (54%)
  • Chest tightness (42%)
  • Insomnia (40%)
  • Dizziness (38%)
  • Numbness/tingling (35%)
  • Laryngitis (35%)
  • Tremors (25%)
  • Heart palpitations (21%)


Nearly 50% of buildings are water damaged and can be a host to many other dangers like bacteria and inflammatory toxins (know as biotoxins).


These organisms can metabolize materials and chemicals that are used in the construction of buildings and change them into new chemicals called inflammogens.


When someone who is genetically susceptible becomes exposed to these toxins, Chronic Inflammatory Response Syndrome (CIRS) can occur. This is the body’s uncontrollable inflammatory response to a toxin it can’t get rid of, causing a flood of inflammatory and hormonal changes.


This condition most frequently happens in the 24% of the population who have the genetic susceptibility (HLA DR/DQ genotype) who can’t detoxify mold well (source: Jill Carnahan, MD).


The physicians at COEM are experts in treating mold related illnesses, including CIRS. If you suspect CIRS or toxic mold exposure as the cause of your health problems, call our doctors today at 843-572-1600.

Posted in Mold Treatment


Mold, fungi and mildew are all terms generally used to describe a specific group of organisms that can be found both indoors and outdoors. Molds grow wherever there is enough surface moisture to keep them alive and are found in every type of environment, and in every social and economic condition.

Mold and mold spores require moisture and a food source, such as cellulose or decaying food, to grow. As mold spores swell with water and grow, they elongate, forming balloon-like protuberances (hyphae), which secrete digestive enzymes and mycotoxins. The fungi then digest the food source to support their growth. About 100,000 fungal species have already been identified; in fact, fungi are estimated to comprise an astounding 25% of the world’s biomass. Molds are capable of growing on a variety of different surfaces, like, fabric, paper, and wood. The most common indoor molds are:

  • Stachybotrys – also known as ‘toxic black mold’, produces trichothecenes and other mycotoxins. It feeds off cellulose usually found in dry wall and can become airborne on dust particulates.
  • Alternaria – found in damp places indoors, such as showers or under leaky sinks or ceilings.
  • Aspergillus – found growing on dust, powdery food items, and building materials like dry walls.
  • Penecillium – found typically on water damaged materials and are mostly of green and blue color.
  • Cladosporium – capable of growing in cool areas as well as warm areas.


Water damage is a leading culprit of mold toxicity. Since odorless mold can live in hidden spots and floorboards, it often lurks quietly and indefinitely.

Mold spores are invisible to naked eye, but still are found everywhere. Open windows, doorways and even ventilation systems are getaways through which these spores can enter the home or office. These molds will only land somewhere if the conditions are ideal for their growth i.e. places with excessive moisture and with a supply of suitable nutrients. Wet cellulose materials act as a great support for mold growth – these includes paper products, cardboard, ceiling tiles and wood products. Wallpaper, insulation materials and upholstery are other typical launch pads for mold growth.


Environmental sampling can be performed to check for spores and mycotoxins. Placing agar plated mold dishes in suspected moldy environments can yield counts of colony forming units. One study implies more than four colonies could be a problem, especially for those with recurrent sinusitis.

Calling in a mold inspector to do a thorough evaluation and written report of their findings is important. If litigation is involved it is wise to bring in a CIH, Certified Industrial Hygienist, who is qualified by training to determine the presence and extent of mold over growth.

Posted in Mold Treatment

It has been almost 2 months with our new thermography camera and it has been great! The pictures are so clear and the new turnaround time has been about 5-7 working days. The new style of reports is a great improvement as well. Dr. Kane puts a lot of what he says in a way that everyone can comprehend. He still uses the medical terminology, but he also says things that you and I can understand without using a medical dictionary. Another improvement in the reports is the hormonal grade that is given. What this does is it gives you an idea about the amount of Estrogen that he detects in your breast. It’s a breast appraisal of the amount of Estrogen and the effects that it is having on your breast. This rating alone should not be your sole basis to tell if you are or are not Estrogen dominate, the more accurate way to tell is to do the hormone panel.

All scans are rated from a TH-1 to a TH-5. TH-1 being the best and TH-5 being the worse. We have done clinical studies that show the effects of certain supplements on the breast and how they can reverse the unhealthy changes in your breast. Dr. Lieberman and our nutritionist sat down and put them in a special formula called the Women’s Breast Health Formula. This formula is made up of many different supplements and vitamins. It has been proven to reverse changes in the breast in as little as 6 months. Some women, depending on the severity and her body have taken a year or even a little longer. However, it works and its better than the alternative.

The Women’s Breast Health Formula is just one of the many treatment options that we can offer you. So for all of our current and former thermography patients, come in and see the new camera for yourself. I know you will like it as much as I do. And for all the ladies out there who have never had a thermography, come in and check it out. Please be confident in knowing that this first step you take by getting a thermogram is one of the best steps you can take for your health.

Posted in Blog, Women's Health

As many of our readers have seen, the Center upgraded the thermography equipment in April of this year.  The new equipment allows for an even more sensitive reading of the scans.�

Because the Center received such an overwhelming response from the special offer for the last several weeks, we have decided to offer another special for anyone who missed out.  From now until September 6th any NEW or REPEAT thermograms will be priced at $165.  This is a wonderful discount from the normal price of $275.

A few reminders:

1-      Remember that you do not have to be a current patient of Dr. Lieberman or the Center to receive a thermography.

2-      There are very strict instructions that patients must adhere to prior to receiving a scan.  They range from items such as no prolonged sun exposure (no sunburn) to the chest or breasts for 5 days prior to the procedure (including no tanning beds) to no bathing within 1 hour of the exam.  Note: A complete list of instructions is provided to those who schedule.

3-      Thermography involves no radiation or pain and is totally non-invasive, requiring no contact with the body.

4-      Abnormalities caught early enough can often be reversed through simple nutritional therapies.

5-      For anyone who is considering repeating a thermogram with this new equipment, they should know that the method of evaluation is the same.  The only change is the degree of sensitivity and that is for the better.

There is no reason why any woman should not take proper precaution in preventing Breast cancer.  Your health and your life are very dear.

Posted in Blog, Women's Health

I have noticed that many of the patients who come in for their first thermography scan are not sure what to expect or what is going to happen. I want to give some clarity on the whole process that you have to go through.

There are things that you can and cannot do prior to getting your scan. First, you can have no prolonged sun exposure for 24 hours prior to the scan. This is for a good reason. If your skin is hot or warm from being out in the sun, it can cause inaccurate results on your scan. Also, you cannot shave under your arms 4 hours prior to your appointment time. This is pressure and it can cause changes in your breast. When you get here, I will walk you back to our thermography room. I will ask you to disrobe from the waist up. You will have to sit in a chair, in a room that is 69 degrees Fahrenheit, for 15 minutes with your arms up so that the area between your arms and your body may cool. I know this sounds like torture, but it’s really not that bad. You will be cold, but it’s only for a brief period of time. After the 15 minutes, I will come back into the room and get you in place while I adjust the thermography camera. I will get a total of 5 pictures at first. I will then have you put your hands in ice cold water for 60 seconds. Again, I know that sounds like torture but it’s over before you know it! At the end of the 60 seconds, I will take 3 more pictures of you. The purpose of this is to look at the vascular patterns in your breast; to see if they constrict like they should when provoked. After the last 3 pictures, we are done.

The longest part of the whole process is having to cool to the room temperature. The actual screening only takes 5 minutes! All of my patients tell me that the process is never as bad as they anticipated. Many patients have expressed how much happier they are with this process than with mammography. No pain, just cold. If you have any further questions about what to expect, just give us a call and I will be more than glad to answer any questions you may have.

Posted in Blog, Women's Health

Breast thermography is the choice for any woman, regardless of age or breast size, who desires a painless and radiation-free procedure to screen for breast cancer. The American Cancer Society says women are at risk for breast cancer if they:

• Began menstruating before age 12 • Have not borne children • Bore their first child after age 30 • Stopped menstruating after age 50 • Have personal history or family history of breast cancer • Have personal history of radiation exposure to the chest • Are currently taking or have recently taken hormone replacement therapy for longer than 5 years • Are obese We recommend that women having one or more risk factors have an annual breast thermogram and younger, premenopausal women have a baseline breast health thermogram. You can come have a scan done no matter what age you are. It’s perfectly healthy with no side effects. So don’t be scared and don’t worry. Just remember the most is important part is taking the first step.

Posted in Blog, Women's Health

If you have a rating on your scan of TH4 or TH5, this means your chances of developing or maybe having breast cancer are higher than they should be. I know it sounds scary but the one thing I ask of all my patients is NOT to panic.

With our new camera, the sensitivity is so much higher now than it used to be. Please always keep in mind; a scan can detect changes in your breast 10 years before a mammogram can. For the majority of cases, we can help reverse those poor ratings. We do offer multiple treatment plans. We can send you for an ultrasound or a MRI if that is how you wish to proceed after your results come back. We can also start treating with supplements that have been proven time and time again to turn things around. In some women those changes can happen in 6-8 weeks, as others may take a year to see changes. But we have the studies to show it works.

So next time you come in for a scan, if your results come back high, just remember don’t panic. We can get you turned around and on your way back to good health.

Posted in Blog, Women's Health

“Normal (non-cancerous) tissue has a blood supply that is under the control of the autonomic nervous system. The ANS can either increase or decrease blood flow to cells. Abnormal tissue, on the other hand, ensures its own survival by secreting chemicals that override these ANS regulations, thereby ensuring its own steady blood supply. Cancer can be thought of as being “off the power grid” of the body.

When the hands are placed in cold water during the breast screening, an ANS reflex occurs in the breast. Generally speaking, this reflux causes the blood vessels in non-cancerous tissue to constrict, but does not result in constriction of blood vessels supplying blood to cancerous tissue. The resulting difference in blood flow can result in cancer showing up as “hot spots” on thermograms.

Scientific signs and criteria established by the American Academy of Thermology are used to interpret thermogram data. Breast Thermology does not diagnose breast cancer; rather it detects physiological changes in breast tissue that have been shown to correlate with the presence of cancer or per- cancerous states. Breast cancer is only diagnosed by pathological microscopic examination of breast tissue.”

(Source: Dr. Ilya Nudelman, M.Sc., D.C., D.Ac.)

Posted in Blog, Women's Health

This blog shares a document provided to us from Dr. Robert Kane, the physician who works with COEM to interpret Thermography scans.  He discusses in this document how to understand and interpret the different rating levels he provides on each report.  It gives a really thorough explaination of each rating that is very easy to understand.

Those of you who have not scheduled a Breast Thermography are encouraged to call us to schedule one as soon as you are available. Thermographies are painless, safe, and very quick. We offer a coupon through the office of $100 off for new and repeat Thermography appointments.

Please enjoy the information below from Dr. Kane.

Understanding Your Thermal Breast Imaging Report

© Robert L. Kane, DC, DABCT, All Rights Reserved

Introduction: Thermal imaging is a tool that is used to help assess risk for breast cancer. Unlike screening examinations or diagnostic examinations, the findings can suggest risk for currently having breast cancer or for developing it in the future. This information can be used to help determine when additional testing or intervention designed to lower risk is necessary. By watching for changes from examination to examination, Thermal Imaging can also help monitor the effects of interventions to see if they are effective. This includes things such as modifying one’s diet or lifestyle, and improving nutrition among others. It does not directly detect or diagnose cancer but can help reach those goals. Thermal imaging does not replace mammography or any other diagnostic or screening examination.

TH 1: Lowest Risk Based upon temperature analysis, this rating suggests the lowest risk that breast cancer is currently present or that it may develop in the future. This rating cannot guarantee that the breasts are cancer free and should not delay any other breast examination recommended by your doctor. When cancer is present, it tends to be growing less quickly (less active) or has not produced enough inflammation or changes to the blood supply so that it is visible on thermography.

TH 2: Low Risk This is also a low risk thermal image. The increase in risk between TH1 and TH2 is minimal. This rating is not a guarantee that breasts are cancer free and should not delay any other breast examination recommended by your doctor. When cancer is present, it tends to be growing less quickly (less active) or has not produced enough inflammation or changes to the blood supply so that it is visible on thermography.

Follow Up Recommendations for TH 1 and TH 2: Follow-up imaging for women over 30 years of age should be performed annually and, for women 20 to 30 years of age, every 3 years. Imaging should be performed along with your annual breast examination.

TH 3: Medium Risk This rating suggests a medium risk that breast cancer is currently present or that it may develop in the future. Follow-up thermal imaging and other breast examinations can help clarify any significance to this rating. When cancer is present it may be more active and growing slightly faster than those found in the lower TH risk categories. This rating can also be caused by conditions such as normal variation in anatomy, some benign tumors, lymphatic activity or congestion and low grade inflammation or infection. It is important to determine the cause of the thermal findings and not prematurely conclude that cancer is present.

Follow Up Recommendations for TH 3: 3-6 month follow-up thermal imaging is recommended depending on your individual situation. Additional imaging such as mammogram or ultrasound should be performed if it has not taken place within the last year. Your doctor will recommend the best test for you. If something is being watched on another examination such as a mammogram, you should consult with your doctor to determine if any additional testing is necessary at this time. Interventions intended to reduce risk should be introduced as a preventative measure. TH 4: High Risk This rating suggests a high risk that breast cancer is currently present or that it may develop in the future. Since this rating can also be caused by inflammation, infection and some fast growing benign tumors, it is important to determine the cause of the thermal findings and not prematurely conclude that cancer is present. Other factors such as lymphatic congestion and/or hormone imbalance can contribute to these findings and need to be considered when evaluating their significance. Most women with TH4 ratings do not have cancer at the time of the thermal imaging examination but do indicate high risk for developing cancer in the future.

TH 5: Highest Risk This is also a high risk thermal image. As with TH4, this rating can also be caused by inflammation, infection and some fast growing benign tumors so it is important to determine the cause of the thermal findings and not prematurely conclude that cancer is present. Other factors such as lymphatic congestion and/or hormone imbalance can contribute to these findings and need to be considered when evaluating their significance. Most women with TH5 ratings do not have cancer at the time of the thermal imaging examination but do indicate the highest risk for developing cancer in the future.

Follow up Recommendations for TH 4 and TH 5 It is strongly recommended that you consult with your physician and begin additional imaging such as mammography, ultrasound, or any other appropriate test promptly to help clarify the thermal findings. A biopsy may be recommended if this rating occurs in a breast with a lump or other suspicious finding on another examination. Interventions intended to reduce risk are strongly recommended as a preventative measure. Follow-up thermal imaging should be performed at 3-month or at the discretion of the Thermologist based upon the thermal findings and any intervention being performed.

Modifiers A plus or minus sign is used to upgrade or downgrade the severity within a particular TH rating.

Hormonal Grade How Do You Determine the Effects of Estrogen on Your Level of Risk: The

Hormonal Grade: Lifetime exposure to estrogen has been identified as a significant risk factor for the development of cancer. The hormonal grade is a way to look at the effects of estrogen on the breasts. When we measure the level of estrogen and progesterone in the blood, urine or saliva we are looking at the hormonal balance in the whole body. The question remains, what is the effect of these hormone levels on the breasts. Normal fatty tissue in the breasts can actually produce estrogen and will be missed on blood testing and can contribute to risk. Some women have estrogen receptors that are more sensitive or bind estrogen more easily. They may even have low estrogen levels but their breasts are actually being over stimulated by the estrogen they have. By looking at the hormonal grade, we can put all of these factors into perspective. It is important to recognize some additional factors that can affect the hormonal grade that may or may not be the result of estrogen stimulation. Systemic inflammation can produce mottled thermal patterns that can simulate the appearance of estrogen stimulation in the breasts and should therefore be considered in the case of an elevated hormonal grade. Altered thyroid function can create mottling and can directly alter the estrogen progesterone balance. In addition, chronic: pain, stress, hormonal imbalance, allergy, illness, (low-grade) infection, exposure to foods/chemicals for which one is sensitive can also affect nervous and/or immune/lymphatic system function creating mottling. When the hormonal grade is at a 3 or 4, all of these factors should be considered.

Grade 0 – There are no symmetrical blood vessel patterns in the breasts which means the breasts do not appear to be stimulated by estrogen at all. Your breasts appear to be handling the estrogen in your body very well and there is really nothing to be done to restore hormonal balance in the breasts. If you are taking hormone replacement, this rating is great news since it suggests that the estrogen is probably not contributing to any risk you may have for developing cancer. This rating is most common in post menopausal women and is considered to be the healthiest.

Grade 1 – Symmetrical blood vessel patterns are seen in the chest wall and upper most breast surface only. This suggests a small amount estrogen activity but like Grade 0, suggests that the estrogen in your body is not contributing to any risk you may have for developing cancer. This rating is also common in post menopausal women and is considered to be healthy.

How should you follow up for a Hormonal Grade of 0 or 1: No follow up or management is necessary. You are doing just fine!

Grade 2 – Symmetrical blood vessel patterns now extend to the upper-inner and/or upper outer quadrants of the breasts. This suggests a slightly higher activity than Grade 1 suggests and the estrogen in your body is probably not contributing to any risk you might have for developing cancer or that the contribution is small. This grade is commonly seen in premenopausal women and is considered to be healthy.

How should you follow up for a Hormonal Grade 2: This grade does not necessarily require any follow up or management and may be normal especially for pre-menopausal women. For post menopausal women who are not on hormones, they may wish to work with a holistic practitioner to try to lower the estrogen stimulation to the breasts especially if their TH rating is suggesting any elevation in risk.

Grade 3 – The blood vessel patterns now extend to the level of the nipple line as they do during pregnancy under the effects of estrogen. This suggests moderate estrogen activity and may suggest that estrogen stimulation of the breasts may be contributing to risk for developing cancer. The reason I say ‘may’ is because woman who are pregnant, lactating will generally have a Hormonal Grade of 3 or 4 due to natural hormonal changes. Also, women on birth control pills and hormone replacement will also commonly exhibit this Hormonal Grade as a function of the hormones they are taking. This grade simply says the level of stimulation is elevated. The TH rating will let you know the level of risk for developing cancer. Other possible causes for this rating included large breast size, poor estrogen-progesterone balance and poor estrogen metabolism.

Grade 4 – The symmetrical blood vessel patterns now are seen extending below the nipple line. The significance is the same as Grade 3. The level of stimulation is just greater.

How should you follow up for a Hormonal Grade 3 or 4: The first thing to do with a Hormonal Grade 3 or 4 is to check the TH ratings to see the level of risk. We will show you how to put together the two rating systems in the next section. The next step is to investigate what might be causing the elevation. If you are pregnant or lactating there is nothing to do. This is completely normal for you and should not generate any concern. If you are taking hormones or birth control pills, this is likely the cause and reducing the activity may not be possible as long as you continue on these medications. Use the TH rating to determine if there is an elevated level of risk for the breasts. If there is a TH rating of 3 or higher, addressing the estrogen may be a way to lower your risk. If discontinuing treatment is not an option or not desired, watch the TH ratings to see if any increase in risk can be detected and use that with your health care provider to determine if changes to your hormone intake are warranted. If there are no obvious sources of estrogen that could explain the grade it is time to look at environmental and dietary estrogen, estrogen-progesterone balance and estrogen metabolism. Tips on how to do this may be available from the center where you were imaged or a consultation with a holistic health care provider can be considered.

How do I understand the significance of a particular TH rating with a particular hormonal grade? The easiest way to think about this is to remember that the TH rating looks at the effect of all risk factors on the breast tissue while the Hormonal Grade looks at only the effects of estrogen. In other words, you can have a high hormonal grade suggesting lots of estrogen stimulation but a low TH rating. This means that although the estrogen stimulation is high, it is not causing a measurable increase in your level of risk. It is also possible to have a high TH rating and a low Hormonal Grade. This means that the level of risk for the high rated breast is elevated but that estrogen does appear to be a contributing factor.

Posted in Blog, Women's Health

It’s Leap Year! We have 1 more day this year, more time, or do we? What is time? It’s not a clock or a watch or a calendar. Time, I’ve been told is an artificial construct, something man created to give order to his world. Our ancestors observed patterns of change in the sky above them and used these patterns as a basis for creating the concept of time. Time gives predictability to our lives, even if it is an illusion. “When?” and “How long will it take?” are important questions to us, but perhaps we need to worry less about how much time we have and be more concerned about how we use the time we have, the choices we make.

I’ve observed that the perception of time seems to vary with individuals. Young people often think time is moving too slowly, while older people know that it moves much too fast. Some people seem to think their time is more important than the time of others. Observe the driver who weaves in and out of traffic, unnecessarily endangering other drivers because he or she didn’t allow enough time to get to a destination, or the doctor’s office that expects a patient to be on time only to wait and wait and wait for the doctor who spends 10 minutes with them, if they are lucky, or the insurance company that demands that we pay our premiums on time but makes us wait far too long for them to pay a legitimate claim. My grandson operates on his own time schedule. He doesn’t care what day it is or what time it is. If he is absorbed in completing a task he has set for himself, forget about expecting him to do what you want him to do when you want him to do it. He’s very bright and he usually makes good grades in school, but he sometimes has difficulty completing a test in the allotted time because he wants to answer every question correctly and fully according to his standards.

Most people are concerned with saving time, but what if we could buy time? At COEM we make it possible for women to buy time when it comes to breast cancer with our thermography program. Thermography, a completely safe procedure with little discomfort, gives a woman an early warning signal by providing information about changes in breast tissue which may predict the development of cancer 6 to 10 years before the cancer actually develops, and gives her time to do something about those changes. We offer advice about life style and dietary changes and supplements which can reverse those changes and restore normal tissue, preventing cancer. Thermography helps a woman save her life by buying time. Call and set up an appointment and buy yourself some time.

Posted in Blog, Women's Health