Molds are very common in indoor and outdoor environments. Mold spores can enter indoor spaces through open doorways, windows, vents, and heating and air conditioning systems. They will grow in moist environments, including paper, cardboard, ceiling tiles, wood, dust, paint, wallpaper, insulation, drywall, carpet, fabric, and upholstery. Mold is ubiquitous and hard to avoid, with research indicating that up to 50% of indoor spaces host significant mold growth. (1, 2)
Mold toxicity and mycotoxin-related illness are often overlooked and difficult to diagnose; however, these concepts as causes for chronic disease are familiar within the integrative and functional medical communities. This article will explain what toxic mold is, summarize the concept of mold toxicity and how it can present clinically, and outline a functional medicine protocol for testing and treating patients with suspected and confirmed mycotoxin illness.
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What Is Toxic Mold?
Molds are fungi that prosper in warm, damp, and humid conditions. Tens of thousands of mold species exist that spread and reproduce by making spores capable of surviving harsh environmental conditions. The most common indoor molds are of the Cladosporium, Penicillium, Alternaria, and Aspergillus genera. (2)
Toxic molds produce toxic compounds called mycotoxins that can cause a variety of severe adverse health effects to humans by disrupting cellular structures and interfering with vital cellular processes. Several hundred different mycotoxins have been identified, but the most commonly observed as a health concern to humans include aflatoxins, ochratoxin A, patulin, fumonisin, zearalenone, and nivalenol/deoxynivalenol. (3, 4)
There is a misconception that black mold is the primary culprit of mold-related illness because toxic molds can be many different colors, including brown, green, blue, yellow, and white. Some of the most common toxic molds in homes include Alternaria, Aspergillus, Chaetomium, Cladosporium, Fusarium, Penicillium, Stachybotrys, and Trichoderma. (1, 4)
Symptoms of Mold Toxicity
Accumulation of mycotoxins in the body can cause many chronic health issues and troubling symptoms. Mold exposure is more likely to induce symptoms if you have a preexisting respiratory condition, environmental allergies, or are immunocompromised. (1)
Mold toxicity can affect nearly every system in the body and can present as a wide variety of symptoms, including (5):
- Difficult concentration, brain fog, poor memory, ADD/ADHD
- Mood swings, depression, anxiety
- Chronic fatigue
- Trouble sleeping
- Digestive symptoms:
- Migraines and headaches
- Eczema, psoriasis, skin rashes
- Coughing, wheezing, shortness of breath
- Runny nose, sinus congestion, watery eyes, sore throat
- Fibromyalgia, muscle weakness, joint pain
- Digestive symptoms and food sensitivities
What Causes Mold Toxicity?
Mold toxicity occurs when a person's detoxification pathways, encompassing the liver, gastrointestinal tract, kidneys, skin, and lymphatics, cannot eliminate mycotoxins from the body (7). While everyone is exposed to mold spores and mycotoxins, not everyone will develop mold illness after exposure. Those at higher risk for mold toxicity include those with a family history of allergies or asthma, a preexisting respiratory disease, workplace exposure, living in high-humidity climates with poor ventilation, and a genetic predisposition to ineffective biotoxin detoxification. (5)
Functional Medicine Labs to Test for Root Cause of Mold Toxicity
Functional medicine tests are available to identify the type and severity of mycotoxin exposure and assess the function of the body's detox organs required in toxin elimination. These results provide a baseline to track treatment progress and guide treatment decisions regarding the necessary agents for an effective detox protocol.
Mycotoxins
Urine mycotoxin testing is the best assessment for recent and chronic mycotoxin exposure. Mosaic Diagnostics, and RealTime Labs offer mycotoxin panels to screen for toxic mold exposure.
Detoxification Pathways
The body has innate mechanisms for naturally detoxifying and eliminating environmental toxins from the body. The liver is most notorious for this function, putting toxins through two phases of detoxification to convert them into water-soluble forms to eliminate them from the body via the gastrointestinal tract, kidneys, skin, and lymphatics. A mold detox protocol is going to be less effective, and can actually exacerbate mold toxicity symptoms, if one of these detox systems is not functioning optimally. A thorough patient review of systems, comprehensive stool test, and genetic panel can screen for sluggish detox pathways and organ dysfunction. (6)
Functional Medicine Treatment Protocol for Mold Toxicity
Treating mold toxicity involves removing mycotoxin exposure, preventing the regrowth of toxic mold, and supporting the elimination of mycotoxins from the body. Mold removal will be discussed in further detail below, but this is an essential aspect of the treatment protocol because continued exposure significantly reduces the ability to eliminate mycotoxins from the body.
To think of this simply, it's like emptying a bathtub. Two components must be addressed: the faucet (i.e., mold exposure) and the drain (i.e., detox/elimination pathways). Without turning off the faucet, it will be very difficult to empty the tub. Once the faucet has been turned off, opening and unclogging the drain will allow you to drain the tub completely.
Below is a dietary and supplemental protocol that can be used in clinical practice to help patients reverse symptoms of mycotoxin poisoning. These can be done with sweating and lymphatic drainage techniques to expedite toxin removal from the body. Patients with mold toxicity tend to be sensitive and may experience die-off reactions when initiating a detox protocol. As such, sensitive patients may respond better to treatment plans that first incorporate gentler therapies, such as dry brushing and dietary modifications.
Therapeutic Diet and Nutrition Considerations for Mold Toxicity
People exposed to toxic mold often have impaired digestion and food sensitivities. Improving digestion with a whole-food, low-inflammatory elimination diet improves nutritional status, systemic inflammation, and detoxification abilities. (7)
An anti-inflammatory diet is any nutritional pattern focused on an adequate intake of fruits, vegetables, unsaturated fats, oily fish, whole grains, legumes, tea, herbs, and spices. The Mediterranean diet is a classic example and the most well-studied anti-inflammatory diet; however, the diet should be tailored to the patient's personal needs and food intolerances.
Some foods are more likely to be moldy and act as a source of mycotoxin exposure. These foods should be eliminated from the diet or avoided as much as possible: rice, coffee, nuts (Brazil nuts, walnuts, peanuts, and cashews), dried fruit, alcohol, processed meats, and corn. (3)
Supplements Protocol for Mold Toxicity
The following supplements can provide additional nutritional support for the body's inherent detoxification and elimination pathways. As mentioned above, lower dosing protocols may be required for very sick and sensitive patients.
Activated Charcoal
Activated charcoal acts as a binder in the gut to adsorb mycotoxins packaged in bile, prevent them from being reabsorbed into circulation, and eliminate them through stool. Activated charcoal can cause constipation, leading to the resorption of toxins even with binder usage. Bowel patterns should be monitored regularly by the patient and provider, and measures should be taken before initiation and during binding therapy to keep the bowels moving regularly. (8)
Dose: 500-1000 mg on an empty stomach twice daily. Take one hour before or two hours after food or administration of any other supplements or medications.
Duration: 3 months
Glutathione
Glutathione acts as the body's master antioxidant, playing a major role in phase II of liver detox and removing free radicals generated during detoxification. Mycotoxin exposure can decrease glutathione concentrations in the body, interfering with their elimination and contributing to excess oxidative stress and inflammation. (5)
Dose: 5 mL twice daily
Duration: 3 months
Detoxication Factors™
Detoxication Factors™ by Integrative Therapeutics is a comprehensive nutritional formula of over 30 ingredients that support general nutritional needs and healthy phase I and II liver detoxification pathways. Certain ingredients in this formula, like N-acetylcysteine (NAC) and green tea, can stimulate glutathione biosynthesis and upregulate the detoxification of certain mycotoxins.
Dose: 1-2 capsules twice daily with food
Duration: 3 months
Mold Removal Options to Consider
Mold removal begins with identifying the source in the home and workplace. Mold testing through swab, air, and ERMI testing can help confirm and identify toxic mold exposure. Repairing leaks, fixing ventilation, removing water-damaged items, and eliminating moisture will arrest mold growth.
Mold remediation, which removes harmful mold, is best performed by a professional company. Make sure the contractor you hire has experience remediating mold. Check their references and ensure they follow remediation guidelines of the Environmental Protection Agency (EPA); American Conference of Governmental Industrial Hygienists (ACGIH); Institute of Inspection, Cleaning and Restoration Certification (IICRC); or other guidelines from professional or government organizations.
Resources for mold remediation can be found on the following websites:
- Surviving Mold
- Centers for Disease Control (CDC)
- United States Environmental Protection Agency (EPA)
- U.S. Department of Housing and Urban Development (HUD)
- American Industrial Hygiene Association (AIHA)
Once the toxic mold has been successfully remediated, prevent regrowth by controlling humidity levels; promptly fixing future roof, window, and pipe leaks; thoroughly cleaning and drying after flooding; and adequately ventilating the shower, laundry, and cooking areas. (1)
When to Retest Labs
A toxic mold protocol should be performed for three months at a minimum. Retesting urine mycotoxins after three months of detoxification therapy is warranted to monitor treatment progress and confirm the successful removal of mold exposure.
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Summary
Toxic molds are certain fungi that produce mycotoxins, which detrimentally affect human health even in very low concentrations. Mycotoxin illness can be difficult to diagnose given the wide variety of clinical symptoms it can present with, often overlapping with other health conditions. Understanding that mold toxicity is a common cause of chronic illness, functional medicine providers often consider mycotoxin screening and testing to get to the root of disease. Recovering from mold illness can be a slow process, but with a trained professional helping you through mold remediation and detox, restoration of health and vitality is possible.
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