I think black mold makes us nervous because we can see it, clinging to the bottom of the shower curtain, lurking in the corners of the recently flooded basement. You almost expect it to throb or make a vaguely humming noise.<\/p>\n\n\n\n
However, far more dangerous as a home hazard is the radioactive gas radon<\/a>, but because it\u2019s invisible and odorless it\u2019s out of sight and out of mind, so we aren\u2019t frozen in fear at the thought of it as we do with the black guck in our bathrooms.<\/p>\n\n\n\n If you read the internet\u2019s top medical alarmists, Drs. Oz and Mercola, you wouldn\u2019t be a bit surprised if they told you ISIS or Al Quaida was behind America\u2019s black mold terror. Dr. M even alleges that toxic mold can be \u201cFAR more damaging than pesticides and heavy metals<\/a>\u201d (caps his, not mine).<\/p>\n\n\n\n But Drs. Oz and Mercola are timid in comparison to the really serious black mold Cassandras, the most prominent of whom is Ritchie Shoemaker, MD<\/a>, a primary care physician who proposes that mold toxins enter our bodies and produce a state of chronic inflammation that in turn may be responsible for many undiagnosed chronic symptoms, including fatigue, muscle aches, and brain fog. Worse yet, he posits, these toxins endlessly circulate inside us instead of getting cleared out, something our bodies have no problem accomplishing when it comes to Sauvignon Blanc or Little Debbies.<\/p>\n\n\n\n Dr Shoemaker suggests that when your doctor tells you she can\u2019t find anything wrong with you and all your tests are normal you should think CIRS (chronic inflammatory response syndrome) and that your doctor is likely overlooking a toxic mold diagnosis.<\/p>\n\n\n\n This places toxic mold syndrome in league with other controversial diagnoses including candida (yeast), chronic Lyme, Epstein-Barr, Human Herpesvirus-6 (HHV-6), Mycoplasma, and the new XMRV virus<\/a>, the latest cause of chronic fatigue syndrome.<\/p>\n\n\n\n So prevalent is the toxic mold problem that Dr. Shoemaker believes as many as one person in four may be affected. To determine if you\u2019re among the 25%, he created an undeniably complex protocol of rarely used diagnostic tests along with a treatment program (or rather \u201ctreatment commitment\u201d) that includes prescription drugs, nutritional supplements, dietary changes, weight reduction, saunas, and regular exercise.<\/p>\n\n\n\n I may sound skeptical, but I\u2019m not disrespectful of his work. His patients report feeling better after years of chronic symptoms and I\u2019ve learned never (ever!) to argue with a patient who has found something that returns her to health.<\/p>\n\n\n\n On the other end of the mold danger spectrum are reasonably respectable but undeniably conservative sources of information like the CDC<\/a> (Centers for Disease Control), Mayo Clinic, and even the usually alarmist Andrew Weil, MD. These sources, like most conventional physicians, acknowledge that mold in your home can cause some annoying symptoms, but that once you get rid of it you\u2019ll probably be just fine.<\/p>\n\n\n\n Nothing shakes your faith in the medical profession like two diametrically opposed points of view: Dr. Shoemaker with his chronic inflammatory response syndrome and the CDC with its not-to-worry approach.<\/p>\n\n\n\n For what it\u2019s worth, I think when it comes to mold you\u2019re dealing with four separate diagnostic possibilities. And by the way, even the word \u201ctoxic\u201d is controversial. Certain species of mold do produce known toxins, but you need truly heavy exposure for it to be a problem. (For the record, Dr. Shoemaker would disagree with that statement.)<\/p>\n\n\n\n 1 You see mold in your home and you think, \u201cYuck. Well, I\u2019ll just get some Tilex Mold & Mildew Remover. You spray it on, the mold melts away, and you feel fine. In fact, you felt fine even before discovering the mold. Tilex is basically household bleach in water, so for a bigger job like a basement you can make it yourself (there are about as many recipes online as there are species of mold). But if you had no symptoms, it simply means you\u2019re not allergic to mold.<\/p>\n\n\n\n 2 This is by far<\/span> the most common way mold manifests itself negatively in our lives, the notorious sick building syndrome you\u2019ve read about or when you see a news story \u201cSchool Closed by Mold.\u201d You or family members have developed some irritating respiratory symptoms: cough, sore throat, sinus drainage, red eyes, maybe even some asthma-like symptoms with wheezing and shortness of breath. It dawns on you that you saw mold in the basement, your apartment has been smelling musty, or a well-meaning neighbor visits and wrinkles her nose like a deranged rabbit, suggesting \u201cYou\u2019ve got a mold problem, honey.\u201d<\/p>\n\n\n\n Your symptoms are all respiratory because you\u2019re inhaling the mold spores and you\u2019re having an allergic reaction, sort of like indoor hay fever, but instead of pollen it\u2019s mold spores. Like hay fever or asthma, you\u2019ll likely get relief with antihistamines or steroid nasal\/lung inhalers, but your best bet is to verify mold as the culprit and get rid of it. You can buy a perfectly good mold home testing kit online or at a Menard\u2019s or Home Depot. If your symptoms worsen in places where mold is heaviest, get the mold professionally removed. You\u2019ll also learn ways to keep it from returning (such as using air cleaners and dehumidifiers).<\/p>\n\n\n\n 3 Possibility #3 is very<\/span> rare, but not at all controversial. Aspergillus<\/em> <\/a>is a common strain of mold that most of us breathe with no bad outcome. However, in certain susceptible individuals, aspergillus<\/em> can literally set up house in the sinuses or lungs, producing constant severe allergy symptoms like cough and shortness of breath. If the situation worsens, the aspergillus<\/em> moves on to the liver or brain into a fearful-looking \u201cfungus ball\u201d (see appetizing x-ray here<\/a>). BTW, it\u2019s curable with surgery and anti-fungal medications.<\/p>\n\n\n\n Usually people who develop aspergillosis <\/a>have other longstanding medical conditions, such as chronic bronchitis or emphysema, or they\u2019re immunocompromised due to conditions like HIV\/AIDS. I\u2019ve seen exactly one case of aspergillosis in my career\u2014a chronically ill, malnourished homeless man brought into a VA emergency room.<\/p>\n\n\n\n 4 Possibility #4 is the CIRS as postulated by Dr. Shoemaker, in which the toxins produced by mold trigger a state of chronic inflammation. The tests he\u2019s selected to diagnose this condition<\/a> are virtually unknown to most physicians and, unless your insurance picks them up, cost about $1,500.<\/p>\n\n\n\n Dr. Shoemaker was reprimanded by his state medical board in 2012 and no longer maintains a private practice. To some, being reprimanded by a conservative panel of physicians for out-of-the-box thinking is not in itself a bad thing. Many doctors practicing unconventional therapies have been reprimanded, only to be recognized as medical pioneers some years later. The problem you would face as a patient if you were interested in the Shoemaker Protocol is that doctors practicing unconventionally prefer not to wave red flags in front of state boards and you may find it difficult to locate a physician to supervise your care, order the tests, and prescribe the drugs.<\/p>\n\n\n\n If you read the proceedings against Dr. Shoemaker<\/a> you\u2019ll see the board was responding to a complaint from an unnamed person who was not a patient. <\/em>My guess is that a local health insurance company filed the complaint because his tests were costing them money. You can read the details of his protocol at www.survivingmold.com<\/a>.<\/p>\n\n\n\n If after reading about CRIS and mold illness you\u2019re interested in pursuing this beyond a home mold test kit<\/a> and a bottle of bleach, I believe you can replace some of Dr. Shoemaker\u2019s tests with a selection that won\u2019t shock your primary care doctor. (If you\u2019re uncertain about your at-home test results, get your home professionally tested. We refer patients to Larry Schwartz at Safestart Environmental<\/a>.)<\/p>\n\n\n\n I recommend these tests\u2026<\/p>\n\n\n\n In summary, most mold is unattractive but harmless. Some people are allergic to it and respond by sneezing and wheezing. Aspergillus<\/em>, despite the scary x-rays, is rare. The verdict is still out on mold-induced CIRS.<\/p>\n\n\n\n Be well, PS Thanks to my friend Keith Berndtson, MD, medical director of Park Ridge MultiMed, for his lecture material and major article on CIRS<\/a>.<\/p>\n\n\n\nControversial diagnoses<\/strong><\/h3>\n\n\n\n
Other end of the spectrum<\/strong><\/h3>\n\n\n\n
Four diagnostic possibilities <\/strong><\/h3>\n\n\n\n
Still curious?<\/strong><\/h3>\n\n\n\n
David Edelberg, MD<\/em><\/p>\n\n\n\n