Mold

*The information on this website is not intended to diagnose, treat, cure or prevent any disease.

WHAT IS MOLD?

Molds are types of fungus that tend to thrive in damp or wet environments. They grow both indoors and outdoors, and if given a foot-hold in a home, can cause permanent damage to structure and cause many health problems for the occupants. Many, many people are sensitive to molds and their toxins, and the health problems they experience can be incredibly diverse. These can be minor, annoying maladies that resemble a cold such as a stuffy nose or sore, scratchy throat or more serious, such as asthma. While respiratory problems from mold are the most well-recognized, there are other health concerns which may have a connection to mold exposure, however more research is required

Examples of serious health problems which may be related to mold include:

The myriad of symptoms can make mold-related diseases difficult to diagnosis, as they can masquerade as other diseases. Although serious health effects can occur, such as the ones listed, more mild, chronic health effects are felt, which often delays diagnosis or treatment. For people who suffer the more severe affects, however, mold sensitivities can become life-threatening.

COMMON SYMPTOMS OF MOLD

The symptoms of mold can be quite variable from person to person. Common symptoms associated with mold exposure include (but are not limited to):

Inflammation
Sore throat
Stuffy/runny nose
Coughing
Wheezing
Joint pain
Ear infections
Itchy/watery eyes
Skin rashes/Eczema
Joint pain
Muscle pain
Mental fogginess
Fatigue

The list of reported symptoms from mold exposure is quite extensive. In addition to those listed above, a comprehensive list of reported mold-related symptoms can be found here. Like those listed above, these symptoms are often vague and not very specific to any particular disease process.

DIAGNOSIS

Diagnosis of mold-related health problems can be tricky due to the non-specific nature of the health issues it can cause. Examination of home and work environments can be helpful by identifying molds. Most health problems are secondary to allergic reactions against mold, rather than an infection, so allergy testing can be very used. A skin prick test can often demonstrate allergies to different environmental triggers. In this test, a small amount of suspected allergens are injected into the skin. People who are allergic will develop a raised, inflamed area at the site of injection (called a wheal or hive). Specific molds and other allergens like pollen can be tested at the same time to identify your exact allergy.

There is also a blood test called a radioallergosorbent (RAST) test which looks for antibodies against common allergens. A high level of antibodies in the blood against a particular allergen is highly suggestive of an existing allergy, as it indicates the body is primed to mount a response against something that it views as foreign/dangerous.

The downside to both the skin prick test and the RAST test is that both can have a high number of “false positive” results, which means you may receive a diagnosis of being allergic to something which you are not. This is especially problematic for allergens which are related to each other somehow.

Other tests which may be useful include a systemic assessment of inflammation. These tests, recommended by Dr. Ritchie Shoemaker, a leading mold expert, include a variety of markers of inflammation present in mold patients such as transforming growth factor beta-1 (TGF-β1), complement 4a (C4a), and matrix metallopeptidase 9 (MMP-9). Additionally, genetic testing for Human Leukocyte Antigen DR (HLA DR) can give you some clue as to your own susceptibility to mold-related illness. Dr. Shoemaker also recommends testing for some hormones which can become deranged during mold-based illnesses, including melanocyte stimulating hormone (MSH), vasoactive intestinal polypeptide (VIP), cortisol, vascular endothelial growth factor (VEGF), leptin, and anti-diuretic hormone (ADH). Each of these hormones plays an important role in homeostasis of the body, and dysregulation of any of them may result in some of the chronic symptoms of mold. Dr. Shoemaker’s tests and their descriptions can be found here.

TREAMENT OPTIONS

Elimination of Mold:

The treatment of mold and fungal-related diseases will depend on the severity of symptoms and/or presence of an infection (as opposed to allergic conditions). The most effective treatment will be eliminating mold and spores from the environment. Strategies to eliminate mold may include:

Improving ventilation
HEPA air filters
Dehumidifiers in damp environments
Sanitizing and cleaning areas where mold is growing (like bathrooms, refrigerators, basements, washing machines or garages)
- In some cases, professional cleaners may be needed to properly deal with water damage to carpets, walls, and ceiling which lead to mold growth.
Eliminate/discard moldy clothes, linens, shower curtains, etc.

For some people, completely eliminating mold in the environment is not possible, especially for those that live in humid/damp climates. Mold often grows on outdoor structures and complete elimination may not be practical or achievable. If environmental modification strategies do not work, ongoing management of allergies may be required.

Pharmaceutical Options:

Anti-histamines: These are often the first-line treatment against allergens, including molds, pollens, and animal dander. There are many over-the-counter options such as diphenhydramine (Benedryl), cetirizine (Zyrtec), loratadine (Claritin), and fexofenadine (Allegra). Diphenhydramine is one of the oldest anti-histamines available, and while cheap and extremely effective for many allergy sufferers, it often causes drowsiness and requires multiple doses per day. Later generation anti-histamines are less likely to cause drowsiness and are once a day, but are often comparatively more expensive. For those whom over-the-counter options are do not work, there are also a number of prescription options available as oral pills, eye drops, and nasal sprays.
Nasal Corticosteroids: These are another commonly used treatment option for a variety of allergies, including molds allergies. Like the anti-histamines, several over-the-counter options are available such as fluticasone (Flonase), triamcinolone (Nasocort), and budesonide (Rhinocort). These can be very helpful for decreasing inflammation in the nasal passages and sinuses, reducing sneezing, coughing, and other respiratory issues due to mold allergies. They are typically used once a day and do not tend to have the drowsy effects that some of the anti-histamines have. Prescription options are also available for those who do not find relief from over-the-counter products.
Decongestants: Decongestant medications like pseudoephedrine (Sudafed) or phenylephrine (Sudafed PE) can provide symptomatic relief from runny/stuffy noses. These medications are stimulants and result work by decreasing the amount of secretions the body produces. These medications should not be used by those with high blood pressure or heart conditions unless directed by a doctor. They can also cause feelings of anxiety, jitterniness, agitation, or excitation, especially if you consume caffeine while using them.
Inhaled Drugs: There are many different inhaled drugs which may be used for people with signs of asthma or severe bronchiolar disease. These can be extremely helpful in preventing sudden attacks or providing relief. Types of inhaled drugs include:
- Mast Cell Stabilizers: Mast cells are a type of immune cell (white blood cell) which releases histamine and other inflammatory compounds in response to allergens. If a mast cell encounters an allergen, the membrane destabilizes, releasing the “payload” which then results in a cascade of inflammation, increased blood flow, and leakiness of the blood vessels resulting in swelling and secretions. Mast cell stabilizing drugs make the membrane less excitable, and therefore less likely to release histamine. These drugs come as inhalers and are often prescribed for patients with asthma. They must be taken several times a day and are more effective when used consistently. Examples include cromolyn sodium and nedocromil (Tilade).
- Beta-agonists: This is a class of drugs meant to stimulate beta receptors in the lungs. By stimulating these receptors, airways dilate, making it easier to breathe. This medication is generally combined or prescribed with a steroid (see below).
- Corticosteroids: Like nasal steroids, inhaled steroids can prevent swelling, but with this method the target is the lower airways and the lungs. Inhalers produce very fine droplets which are able to descend into the very small air passages deep into the lungs.
Oral Corticosteroids: For severe allergy suffers, oral steroids can be very effective at reducing the symptoms of allergies. Although very effect, they also have many unpleasant side effects which can make them difficult to stay on for many people. Side effects include weight gain, high lood pressure, acne, insomnia, mood changes, and growth of new body hair, just to name a few.
Bronchodilators: Some stimulant medications such as theophylline may be helpful in opening airways. These medications can also cause agitation, increased heart rate, and increased blood pressure, however, so those with underlying cardiovascular conditions should use these drugs cautiously.
Leukotriene modifiers: These drugs can help prevent both short and long-term effects of allergic reactions. Leukotrienes are inflammatory compounds in the body which are released in response to allergic reactions. These drugs block the pathways by which leukotrienes exert their effects, thereby preventing airway swelling/constriction and nasal congestion. These are usually used combination with other therapies and generally only used after other therapies (such as nasal corticosteroids) have proven ineffective.
Epinephrine (Epi-Pens): Epinephrine is a rescue drug used during an acute allergic reaction (anaphylactic shock). If you have severe allergies, an epi-pen can be a life-saving device and used only as needed. Epinephrine is a stimulant, but it can counter the effects of histamine release by preventing swelling of the airways.
Allergy shots: Allergy shots are a way to train the immune system to pay less attention to an allergen. The idea is that small doses of an allergen are injected on a routine basis, making the body less sensitive over time. For many people, allergy shots are very effective at managing symptoms.

Non-Pharmaceutical and Alternative Options

Mold binders
- Cholestyromine (CSM): This is a binding agent which is labeled for lowing cholesterol, but however it may be used “off-label” to remove biotoxins from the body as well.
- Apple pectin: Cheap, derived from apples, and well-tolerated. This can be a good option for those with sensitive GI tracts.
- Activated charcoal: A highly absorbant compound, activated charcoal can be used as part of many “detox” protocols and also may be helpful in removing biotoxins from the body.
Supplements
- Quercetin: This may function similar to the mast cell stabilizing drugs mentioned above, preventing the release of histamine and other inflammatory compounds
- Omega-3 Fish Oils: Omega-3 fatty acids are known to be anti-inflammatory and allergies are just one of the conditions which they may be helpful in managing. Long term supplementation will achieve the best results.
- N-Acetylcystein: This is useful for thinning mucous secretions in the sinuses and airways, making it easier to clear.
- Curcumin: A highly anti-inflammatory compound, curcumin may also have benefits when used in allergic conditions as well.
- Methylsulfonylmethane (MSM): There is evidence to support MSM’s anti-allergic effects, but ongoing use will result in best results. Some people find that MSM give substantial relief from allergy symptoms.
- Vitamin D: Vitamin D deficiency seems to be linked to nearly every health issue, and allergies are no exception. There is ongoing research into whether or not vitamin D deficiencies have resulted in increased environmental allergies in the developed world (where we often work indoors and have less exposure to sunlight).
- Butterbur: This herbal remedy may have effects similar to the leukotriene modifiers listed in the pharmaceutical options. It has been used in clinical trials with very promising results. Those with liver issues should use this with caution, as there may be a link to liver toxicity.
- Stinging Nettle: Another herbal remedy, Stinging Nettle is used for a wide variety of conditions due to its purported anti-inflammatory effects.
- Goldenseal: This plant contains a compound called berberine which seems to have a diverse range of effects, including anti-inflammatory properties.
- Pycnogenol: This is an anti-oxidant compound found in a variety of plants including peanuts, grape seed, witch hazel, and maritime pine trees. It has been show to be helpful in controlling allergies and asthma, especially when started 5 weeks before the onset of allergy seasons.
- Apigenin: This is a compound found in plants such as parsley, chamomile, and celery which seems to have immune-modulating effects. When used in a mouse model of asthma, apigenin led to down-regulation of the inflammatory state of white blood cells, and may help promote a more normal immune response. Research is very preliminary.
- Luteolin-A: This is compound with anti-histamine properties found in perilla plants.
- Broccoli Sprout Extract: This extract is very high in sulforaphane, which seems to be helpful in allergy sufferers with nasal congestion.
- Bromelain: Found in pineapples, bromelain seems to block the inflammatory cascade in a mouse model of asthma. Sometimes combined with quercetin in management of allergies.
Neti Pots: Neti pots can be a very effective means of removing mold spores from the nasal passages. Daily use of a neti pot can result in significant relief for mold allergy sufferers.
Acupuncture: Some people, those who experience wheezing in particular, may find benefit through acupuncture.
Enzyme Potentiated Desensitization: Enzymatically-degraded allergens are applied to the skin in an effort to encourage desensitization
Ozone Therapy: Exposure to ozone in order to increase the amount of oxygen available to the body.
Speleotherapy: Inhalation of mineral-infused air of salt mines in order to reduce inflammation of the lower airways.
Lymphatic massage: Improving the drainage and circulation of blood and lymph.
Chiropractic Care
Saunas/sweating: Removal of toxins through increased sweating

PREVENTION

Prevention of mold-related diseases largely entails preventing mold growth in the first place. Following the same techniques described in the treatment section, one can try to eliminate mold from their home and workplace, thereby reducing the chance of suffering from the effects of mold exposure. Aside from eliminating mold in the home, it is also important to live a healthy life and ensuring that your body is in the best possible condition to respond appropriately to foreign material, including mold.

Some examples include:

Eat a healthy, well-balanced diet rich in vitamins and Omega-3/6 fatty acids
Avoid working in moldy/mildew conditions
Wear a facemask/respirator if you will be exposed to mold and mildew
Maintain your home environment and clean regularly
Quit smoking, which can impair the immune system and predispose to respiratory infections

Boosting your immune system can also go a long way toward preventing mold-associated illnesses. This may include eating a diet rich in immune-boosting foods. But may also include a number of supplements such as:

Echinacea
Elderberry
Colloidal silver
Astralagus root
Ginseng
Myrrh
Probiotics

Additionally, regular exercise may be one of the most powerful immune-boosting strategies available. Try starting an exercise regimen one day a week and then increase gradually to increase the odds of sticking to it.

CAUSES

The causes of mold sensitivity for most people are related to the development of allergies. Allergic reactions are a consequence of our immune system reacting disproportionately to foreign particles. Although we would like our bodies to eliminate viruses, bacteria, and fungi, a response which results in chronic sickness or anaphylactic shock is inappropriate. Allergies seem more common in developed countries compared to the rest of the world. The reason why is not well-understood, but one major idea is the hygiene hypothesis, which speculates that our cultures are so clean from the moment we are born, that our immune systems never received the appropriate “training” to respond appropriately. We also tend not to have things like parasites in the developed world, and these may also play a role. We essentially co-evolved with parasites (like hookworms), and it is possible that our body is designed to function normally when we have a certain parasite load.

Another hypothesis was mentioned above, and that is related to vitamin D deficiency. It is a common vitamin deficiency in the developed world, and we know that vitamin D has effects on nearly every body system. It is possible that the lack of this important vitamin also results in inappropriately-trained immune systems and a propensity for allergic responses.

Exposure to molds may also result in toxic overload, which can cause many of the symptoms associated with illness. This can result from simply inhaling the spores chronically, or from ingestion of the molds themselves in contaminated foods. There is suspicion that toxin overload may even contribute to problems such as chronic fatigue syndrome and fibromyalgia. Toxins also cause chronic inflammation in the body and can eventually lead immune dysregulation, a situation in which the immune systemic starts to run wild and begins to hurt rather than help us.