Why should I be concerned about mold and mycotoxins?
By Dr. Debby Hamilton, MD, MPH
By Dr. Debby Hamilton, MD, MPH
Mold is a type of fungus that features filaments known as hyphae. These hyphae produce mold spores which are called mycotoxins. Different species of molds produce various kinds of mycotoxins. Even a single species of mold, such as Aspergillus, can produce multiple types of mycotoxins, such as ochratoxins and aflatoxins. The primary producers of mycotoxins are the mold species Aspergillus, Penicillium, and Fusarium. Overall, more than 300 varieties of mycotoxins have been identified.
Molds are a health concern primarily because of the mycotoxins they produce, which cause many adverse health issues. The initial impact is often within the gut microbiome, where mycotoxins are known to decrease beneficial bacteria and increase gut pathogens. Because the intestinal microbiome plays a significant role in immune function, this dysbiosis is a first step to developing immune imbalance and inflammation. Mold illness caused by mycotoxins can present many different symptoms. It can mimic neurologic disorders such as chronic pain, movement disorders, mood disturbance, and even dementia. Dr. Shoemaker was one of the first practitioners to treat mycotoxin illness and describe it as a syndrome with a severe inflammatory response, calling it Chronic Inflammatory Response Syndrome (CIRS).
CIRS is a multi-system chronic disorder with many symptoms that range from fatigue, gastrointestinal symptoms to neurologic and cognitive issues. Additionally, CIRS can present unusual symptoms, such as static shocks, pain, including icepick headaches, weakness, and visual changes. CIRS often develops after exposure to a water-damaged building and includes exposure to mold plus other toxic bacteria.
Typically, practitioners use urine mycotoxin testing. Many reputable companies offer tests to measure common mycotoxins such as ochratoxins and aflatoxins. Modern blood testing is also being used to identify mold illness. It is important to note that when a patient undergoes treatment for mycotoxins, test results may initially indicate an increase of mycotoxins as the body begins the process of eliminating them. Because this is a relatively new field, advances in diagnostics are continuous.
A person with CIRS often has specific laboratory markers that indicate inflammation, immune system dysregulation, and hormone dysregulation. Dr. Shoemaker developed this list of markers to help diagnose and follow the treatment of patients with mold and water damaged building related illnesses.
Removing mold from the home or office space is critical for a person to recover from mold illness. The mold must be removed from the building, or the person with mold illness will continue to be exposed, causing ongoing symptoms.
There are professional organizations that will inspect the home for mold and put down testing plates. Do-it-yourself mold testing kits are also available.
The process of natural elimination of mycotoxins is through the digestive tract. The body releases bile salts that bind to the mycotoxins to carry them out of the body in a process known as enterohepatic circulation. Unfortunately, there can be challenges with this process. The body works to conserve bile salts by reabsorbing them back to the liver instead of excreting them through the digestive process. When the bile salts that are bound to the mycotoxins are reabsorbed, the mycotoxins are also reabsorbed and are thus able to cause illness. To ensure the process of enterohepatic circulation does not allow absorption of mycotoxins, many practitioners will utilize binders (also called adsorbents). These substances, when ingested, bind to the mycotoxins in the intestines, separating them from the bile salts so that they can be eliminated from the body.
Many of the binders that are most effective for the elimination of mycotoxins are derived from soil. Humic acid and fulvic acid (which are derived from humus in the soil) have been found to be useful for binding aflatoxins produced by Aspergillus. Different clays, such as zeolite clay, have also been used for binding mycotoxins. There are many varieties of zeolite. The clinoptilolite form has been shown to have a high ion exchange capacity, which enables it to bind more mycotoxins at once.*
Practitioners have used charcoal as a binder to treat toxin exposure for a long time, and it is considered very safe and effective. Charcoal has been found to be successful in binding with a variety of mycotoxins, such as Ochratoxins, Aflatoxins, Trichothecenes, and Zearalenone.
Some polysaccharides, such as microchitosan, have also been effective for both mycotoxin and fungal removal.*
In general, it is a good practice to utilize a combination of binders for the removal of mycotoxins because each individual binder has diverse affinities for specific mycotoxins. Because many of these binders are derived from soil and other natural sources, there is a risk of heavy metal contamination. Therefore, it is critical only to utilize purified and tested binders to avoid potential toxin exposure.*
While mycotoxin binders are the mainstay of mycotoxin removal, other supplements can also be helpful. Because molds are fungal or yeast organisms, antifungals can be effective. Often, colonization of the body by mold occurs in the gastrointestinal tract or the nasal sinuses. Therefore, targeted antifungals for both of these areas can be beneficial. The immune system is also essential in the fight against mold illnesses, so it is crucial to support the immune system with targeted immune support for mycotoxin removal.*
Our collective awareness of mold exposure from water-damaged buildings has increased dramatically. We now know that a percentage of people exposed to mold will have significant immune and inflammatory reactions from mycotoxins released by molds. These mycotoxins can lead to a cascade of health issues, impacting potentially every system in the body. Fortunately, we now have tests to check for mycotoxins within the body and potent binder combinations to address mold illness and remove mycotoxins.*
For practitioners interested in industry resources for mycotoxin illness, please visit The International Society for Environmentally Acquired Illness. ISEAI is a 501(c)(3) nonprofit professional medical society that aims to raise awareness of the environmental causes of inflammatory illnesses and to support the recovery of individuals affected by these illnesses through the integration of clinical practice, education, and research.
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