Mold Toxicity: A Telemedicine Consultation

Most people who are ultimately diagnosed with chronic inflammation triggered by black mold have heard somewhere “mold can make you sick.” However, only a few make the connection between their years of ill health and the water damage in their basement or attic, behind their kitchen sink, in their car, or around the upstairs neighbor’s overflowing bathtub.

Here’s what’s going on
Mold is everywhere: in the air, in your food, on the surfaces of everything around you. You have two routes of susceptibility.

By far the more common is being allergic to mold. Your primary care doctor knows all about this. The symptoms are typical of a seasonal inhalant allergy, such as to ragweed, but they’re with you all year ‘round. Mold allergy symptoms include runny nose, sneezing, cough, and eye irritation. Treatments include antihistamines, nasal sprays, allergy shots, and trying to remove as much mold from your surroundings as possible.

The second route of susceptibility is chronic inflammatory response syndrome (CIRS), in which toxins produced by certain mold species get into your body and remain there. CIRS is new to many doctors. Your detoxifying systems can’t clear these toxins from your body (more about this later). Instead, the toxins trigger widespread inflammation. If your exposure to mold continues, your toxin levels rise and the inflammatory symptoms worsen.

The reason you can’t clear the toxins is based in genetics. Only about 25% of people are susceptible to CIRS. So, in a typical household there might be just one chronically ill person (perhaps it’s you). Everyone else is fine and your kids may wonder, “Why is mommy always sick?”

Some of you may remember a few years ago a condition called sick building syndrome.  Sure enough, it was 25% of the occupants of a water-damaged building complaining of constant illness during work hours. The other 75% were just fine and it took years to figure out what was going on.

CIRS symptoms
Take a look at this list of incredibly diverse symptoms associated with mold toxicity (CIRS):
–Fatigue and weakness.
–Headache, light sensitivity.
–Poor memory, difficulty finding words.
–Problems concentrating.
–Morning stiffness, joint pain.
–Unusual skin sensations, tingling and numbness.
–Shortness of breath, sinus congestion, or chronic cough.
–Appetite swings.
–Problems regulating body temperature.
–Increased urinary frequency or increased thirst.
–Red eyes, blurred vision, sweats, mood swings, sharp pains.
–Abdominal pain, diarrhea, bloating.
–Eyes tearing, disorientation, metallic taste in mouth.
–Static shocks.
–Vertigo, feeling lightheaded.

If you’ve been experiencing any of these for a long period of time (months, years) and yet you’ve heard only the conventional medicine mantra “We can’t find anything wrong with you/ your tests are normal,” you may be having issues with mold toxicity.

A key question to ask yourself
One question you need to ask about the possibility of this diagnosis: do your symptoms change depending on your location? Although you may not improve 100% by moving to a mold-free house or leaving for a week’s vacation (because your body is still holding onto some toxins), generally you’ll feel better once your exposure is reduced.

The Functional Medicine approach to toxic mold issues we use at WholeHealth Chicago may be unfamiliar to your primary care physician. As I said earlier, all doctors are well aware of mold allergy and may have even heard of sick building syndrome.

But the concept of mold toxins in the body triggering chronic inflammation is relatively new, first catching the public interest  with Dr. Ritchie Shoemaker’s Mold Warriors and Surviving Mold.

Diagnosing CIRS via telemedicine
It’s important to note that nothing we do during these consultations is meant to take the place of your primary care physician. In fact, we strongly encourage you to share our findings with her.

A WholeHealth Chicago Telemedicine visit will go something like this:

After you call our Patient Services team (773-296-6700) and schedule with any of our Functional Medicine practitioners, you’ll receive patient registration forms and a health history questionnaire.

In addition to the forms, we ask that you send us three pieces of information to review before your actual telemedicine appointment:
–A history of your problem (when it started, what makes it worse, and what you’ve done so far to treat it, especially any specialists you’ve seen and any treatment you’ve received). These will be used as discussion points.
–Copies of any recent lab tests.
–A list of foods you commonly eat.

With this information and after discussion, your practitioner will likely suggest lab tests. Two tests are especially valuable:
—Urinary measurement of mold toxins. You’ll receive a kit to collect a urine sample, which you’ll mail to the lab, paying them directly.
—A blood test called C4a. This test measures the amount of inflammation in your body triggered by mold. You can get this test at any Quest Lab or from most hospitals (we’ll give you a prescription and the lab will mail us your results). If you have had (or suspect) issues with candida, mention this to your practitioner as there’s a test to see if your immune system has been fighting it. Candida albicans is a cousin to the black mold species and chronic candida symptoms can mimic CIRS.

Most Quest Lab tests are covered by health insurance. If you don’t have health insurance, ask them to quote you the cash price for the tests. This is often substantially lower than the amount they bill insurance companies.

While we’re waiting for your test results (this usually takes four weeks), you’ll begin a nutritional detoxification program that includes supplements to activate the detoxifying systems in your liver and reduce the oxidative stress brought on by the toxic mold.

Check where you live for mold
If you’re fairly certain mold is an issue in your home, get it tested. We’ll instruct you on how to do this yourself or you can hire a mold remediation company.

By the way, if your home tests negative, remember to check your car. If you have no mold at home or in your car but you have high levels in your body, it’s likely your detoxifying system is trying to clear mold you may have acquired years ago and you’re re-absorbing it over and over.

Follow-up appointments
Your second appointment is two to three weeks after the first, mainly to answer questions and to monitor your response to detoxification.

In your third appointment (again, two to three weeks later), you and your practitioner will review your test results and begin actual therapy. The mainstay of mold toxin treatment is the use of binding agents, which literally bind the mold and remove it from your body.

You’ll also schedule a fourth appointment to review your progress. We may suggest repeating the urine test to see if your mold toxin numbers are going down.

If you’re doing well, fine. If you’re not responding as hoped, we’ll test you for a chronic sinus infection known to slow the toxin removal progress. It often develops in mold sufferers and is called MARCONS (multiple antibiotic resistant staph aureus coagulase negative). Treatment is with an antibiotic nasal spray.

Finally, when your mold numbers are coming down and your home, car, and body have been detoxed, we’ll try to locate a functional practitioner somewhere in your area who has at least heard about mold toxicity, even if she may not have seen many cases.

These telemedicine consultations are based on the treatment and outcomes of hundreds of patients seen by the practitioners at WholeHealth Chicago over its 25 year history. If you explore our Health Tips, you’ll find several articles on both mold and candida that may be helpful.

Be well,
David Edelberg, MD