Medications for Mold Illness: What Works and What Doesn't

Mold illness, a type of Chronic Inflammatory Response Syndrome (CIRS), is a complex condition triggered by exposure to mold and mold-produced toxins called mycotoxins. These toxins can be found in water-damaged buildings, where mold thrives in damp environments.

CIRS causes a persistent inflammatory response that affects multiple body systems, causing symptoms like chronic fatigue, brain fog, respiratory problems, joint pain, and skin irritation. 

Medications can support the proper management of mold illness. They can help reduce inflammation and alleviate symptoms, and some medicines also aid in detoxifying the body by binding and removing mycotoxins. This article will review the most effective medications for treating mold illness, including treatments that help detoxify the body and reduce inflammation. 

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How Mold Illness Affects the Body

Mold illness or CIRS can affect various systems in the body, resulting in a broad spectrum of symptoms that can make diagnosis challenging. These symptoms often develop over time, especially with prolonged exposure to mold or environments that harbor mold spores.

Understanding the Effects of Mold Exposure

People can be exposed to mold and mycotoxins (toxic substances produced by molds, especially in warm, humid, or wet settings) by eating contaminated food. They can also come into contact with them through the skin or by breathing them in.

When someone is exposed to mold, especially in a water-damaged building, the body may inhale or come into contact with mold spores and mycotoxins. The immune system recognizes these substances as threats to sensitive individuals and triggers an inflammatory response. 

This inflammation leads to a wide range of symptoms across multiple body systems, including:

• Fatigue: Persistent, often extreme tiredness that doesn’t improve with rest

• Respiratory Issues: Coughing, wheezing, shortness of breath, and sinus congestion

• Cognitive Problems: Brain fog, memory issues, and difficulty concentrating

• Joint Pain and Headaches: Pain, discomfort, and reduced quality of life due to chronic inflammation

These symptoms may persist as long as the mold exposure continues or until the body can effectively eliminate the toxins. Unfortunately, many individuals with mold illness have trouble detoxifying on their own, which is why symptoms can worsen over time.

Why Medication May Be Necessary

The body’s natural detoxification systems, including the liver, large intestine, and kidneys, are designed to remove toxins from the body. However, in cases of mold illness, these systems can become overwhelmed by the constant exposure to mycotoxins. Some individuals, particularly those with genetic predispositions, may have difficulty clearing these toxins, allowing them to accumulate and fuel ongoing inflammation.

Medications are often necessary because they can:

• Support Detoxification: certain medications, like binders, help trap and remove mycotoxins from the body by preventing them from reabsorbing in the digestive system and re-entering circulation.

• Reduce Inflammation: anti-inflammatory medications can help alleviate the immune system’s overreaction, relieving symptoms like joint pain, headaches, and respiratory issues.

The body may struggle to recover from mold exposure without proper medical intervention. By using medications to assist with detoxification and inflammation control, patients have a better chance of reducing symptoms and preventing long-term damage.

Effective Medications for Treating Mold Illness

Some medications may provide more benefit for patients with mold illness than others. 

Cholestyramine (CSM)

How It Works: Cholestyramine is a pharmaceutical bile acid sequestrant commonly used to treat high cholesterol by binding to excess fats in the digestive system, preventing their absorption. It also binds to mycotoxins in the digestive tract, preventing reabsorption and helping the body eliminate them through the stool. By binding these toxins, CSM helps the body reduce its toxic load.

Benefits: Cholestyramine has been shown to effectively bind mycotoxins such as fumonisins and zearalenone both in vitro and in vivo. 

Potential Side Effects: Some people may experience gastrointestinal discomfort, including constipation, bloating, and nausea. Increasing water intake and dietary fiber may help reduce constipation, and symptoms like bloating and dyspepsia can be reduced if cholestyramine is completely suspended in liquid several hours before ingestion.

Activated Charcoal

How It Works: Activated charcoal acts as a binding agent, absorbing mycotoxins and other harmful substances in the digestive system. Like cholestyramine, it prevents these toxins from being reabsorbed and helps remove them from the body. However, activated charcoal is a nonspecific binder, which may also bind essential nutrients, limiting its use in some scenarios.

Benefits: Activated charcoal is often used as an alternative to cholestyramine, particularly for individuals who cannot tolerate CSM. It is an over-the-counter option for detoxifying the body and can help alleviate symptoms like fatigue and brain fog when used in appropriate doses.

Potential Side Effects: Constipation and dehydration are common side effects, so staying well-hydrated is important. Additionally, long-term use may interfere with nutrient absorption, so it should be used with caution and under the guidance of a healthcare provider.

Nasal Sprays (e.g., BEG Spray)

How They Work: BEG nasal spray contains a combination of two antibiotics (Bactroban, Gentamicin) and the calcium chelator EDTA, which dissolves the protective biofilm coating that mold and bacteria create when colonizing the sinuses. This colonization can exacerbate respiratory symptoms in individuals with mold illness.

BEG nasal spray is used to clear MARCoNS (multiple antibiotic-resistant coagulase-negative staphylococci), an antibiotic-resistant staph infection that tends to colonize the sinuses in people with mold and mycotoxin illness and worsen respiratory symptoms like sinus congestion, postnasal drip, allergy symptoms, sinus headaches, and others.

Benefits: nasal antimicrobial treatments can reduce sinus congestion, post-nasal drip, and other respiratory symptoms by directly addressing microbial overgrowth in the nasal passages. They are especially helpful for individuals with persistent sinus infections related to mold exposure.

Potential Side Effects: minor nasal irritation, dryness, or occasional nosebleeds can occur using nasal sprays, but these side effects are typically mild.

Glutathione

How It Works: Glutathione is a powerful antioxidant that supports the body’s natural detoxification process. It helps neutralize free radicals and reduce oxidative stress caused by mycotoxins while aiding the liver in processing and eliminating toxins.

Benefits: Glutathione can improve overall detoxification, support immune function, and reduce inflammation, making it a valuable tool for individuals with mold illness. It may also enhance cognitive function and energy levels by supporting mitochondrial function and reducing systemic oxidative stress.

Potential Side Effects: Some people may experience mild side effects like nausea, skin rashes, or headaches, especially when starting glutathione supplements. These effects usually diminish over time.

Medications That May Be Less Effective for Mold Illness

Some medications are less likely to address the cause of mold illness: chronic mold exposure. However, they may still be beneficial for certain patients.

Antibiotics

Why They May Not Work: Mold illness is caused by exposure to mold spores and mycotoxins, which are fungal in nature, not bacterial. Antibiotics target bacterial infections, so they generally do not address the root cause of mold illness. 

However, in cases where a secondary bacterial infection (such as a sinus infection) is present alongside mold exposure, antibiotics may be necessary. This is the case with MARCoNS (multiple antibiotic-resistant coagulase-negative staphylococci), in which the colonization of these organisms in the sinuses is treated with a nasal spray containing antibiotics. Antibiotics offer little benefit for treating mold illness outside of these specific cases.

Potential Risks: Overusing antibiotics can weaken the immune system, disrupt gut microbiota (the beneficial bacteria in the digestive system), and lead to antibiotic resistance. This disruption can worsen mold-related symptoms, as a healthy gut is critical for detoxification and immune function. 

Antihistamines

Why They May Not Work: Antihistamines, commonly used to treat allergy symptoms like sneezing, itching, and sinus congestion, can provide temporary relief from symptoms associated with mold exposure. 

However, they do not address the underlying cause of mold illness or help detoxify mycotoxins from the body. While antihistamines can suppress some symptoms, they don’t resolve the inflammation or immune dysregulation that mold exposure causes.

Potential Drawbacks: Antihistamines may mask symptoms, allowing ongoing exposure to mold without addressing the root cause. This can lead to prolonged exposure to mycotoxins, worsening long-term health outcomes. Also, relying on antihistamines can delay proper treatment, allowing mold illness to progress without addressing the real issue.

Anti-Inflammatory Medications

Why They May Not Work: Anti-inflammatory medications reduce the body’s inflammatory response triggered by mold exposure. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can help manage pain and swelling, while corticosteroids like prednisone are reserved for more severe inflammatory responses.

When They Can Help: These medications relieve joint pain, headaches, and other inflammatory symptoms associated with mold illness. They can also improve quality of life by reducing the immune system’s overactivity.

It’s important to understand that anti-inflammatory medications are used to provide relief from inflammatory symptoms like joint pain and headaches in mold illness. Still, they do not treat the underlying mold toxicity. 

Potential Drawbacks: while NSAIDs are generally safe for short-term use, long-term use can lead to gastrointestinal issues like ulcers, as well as liver, cardiovascular, blood, or kidney problems.  Corticosteroids, when used over extended periods, can cause weight gain, weakened immune function, and increased risk of infection.

Antifungals (for Internal Use)

When They Might Work: Antifungal medications may be effective in cases where there is confirmed fungal colonization in the body, such as in the sinuses or gastrointestinal tract. This can occur in some individuals with mold illness, where mold or yeast has colonized specific body areas. Antifungals can be an important part of treatment to eliminate colonization in these cases.

Risks of Overuse: internal antifungals are not always necessary for treating mold illness, and their overuse can lead to complications such as liver toxicity and the development of fungal resistance.  Long-term or unnecessary use of antifungals can damage the liver, reducing its ability to detoxify the body from mycotoxins. Therefore, antifungals should only be used when fungal colonization is confirmed, and a healthcare provider should carefully monitor their use to avoid adverse effects.

Supportive Treatments for Mold Illness

Supportive treatments include promoting cellular health and a balanced inflammatory response.

Nutritional Supplements

• Omega-3 fatty acids: Omega-3’s reduce inflammation in the body, helping to alleviate joint pain and cognitive symptoms caused by mold exposure.

• Vitamin C: Vitamin C boosts the immune system to help the body fight off infections; its antioxidant function supports detoxification and protects cellular health.

• Magnesium: Magnesium supports muscle function and relaxation, which can be helpful for patients dealing with fatigue and stress from mold illness.

Probiotics

• Lactobacillus species: These help restore gut health, improve digestion, and support immune function, benefiting patients with mold-related gut issues.

• Bifidobacterium species: Bifidobacterium enhances detoxification by improving the gut’s ability to process and eliminate toxins, aiding in recovery from mold exposure. They also enhance gut lining recovery and immune function.

IV Therapy

• Intravenous vitamin C: Provides an antioxidant boost to the immune system, helping patients reduce inflammation markers.

• Intravenous glutathione: Supports liver health, which may promote detoxification pathways. Proper detoxification is necessary for the removal of mycotoxins and reducing systemic inflammation in patients with severe mold illness.

• IV nutrient therapies: Essential vitamins, minerals, and nutrients support cellular and mitochondrial health, providing critical nutrients to aid in energy production and improve cellular function during the detoxification process. They can also benefit patients with impaired nutrient absorption due to mycotoxin-induced gastrointestinal damage.

When to Seek Medical Guidance for Mold Illness

People living with chronic, widespread symptoms that have not responded as expected to conventional treatments may consider seeking medical guidance.

Recognizing Symptoms That Require Medical Attention

Seek medical help if you experience:

• Chronic fatigue that doesn’t improve with rest, sleep, or time.

• Respiratory issues like coughing, wheezing, or sinus congestion, especially in damp environments.

• Cognitive problems such as brain fog, memory issues, or confusion.

• Joint pain or headaches that persist.

• Skin irritation like rashes or itching.

These symptoms may signal a need for a professional evaluation to address mold exposure.

Consulting with a Specialist

Consult a healthcare provider experienced in mold illness and biotoxin-related diseases, such as those in environmental or functional medicine. Specialists can provide accurate diagnoses and appropriate treatment for complex mold-related conditions.

Creating a Personalized Treatment Plan

A tailored treatment plan based on your symptoms, lab results, and health status is essential for effective recovery. This personalized approach may include detox protocols, medications, and lifestyle changes to target your specific needs.

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Key Takeaways

• Effective medications for mold illness include cholestyramine, which binds mycotoxins; glutathione, which supports detoxification; and anti-inflammatory medications, which may help reduce symptoms like joint pain and headaches.

• While some medications, like antibiotics or antihistamines, may not address the root cause, combining detoxification agents and anti-inflammatories can significantly improve symptoms and health outcomes.

• Mold illness requires medical supervision, and a personalized treatment plan tailored to individual symptoms and lab results is essential for successful recovery.

Additional Resources

Surviving Mold - A comprehensive resource by Dr. Shoemaker on mold illness, including diagnosis, treatment protocols, and patient stories.

The International Society for Environmentally Acquired Illness (ISEAI) - Offers educational resources for patients and practitioners on mold-related illnesses.

The ISEAI also offers a list of practitioners, resources, and support for those suffering from environmentally acquired illnesses, including mold toxicity.

‍Environmental Protection Agency (EPA) - Information on mold prevention, health impacts, and guidance on how to deal with mold contamination.