Mold Related Illness
Mold exposure can occur in the home, workplace or school resulting in serious health effects such as asthma, sinusitis, rashes, severe fatigue, headaches, chronic congestion, gastrointestinal symptoms, itchy unusual rashes and “brain fog” among others. The symptoms could be due to allergy to mold and/or reactions to mycotoxins. Mycotoxins are known to be neurotoxic, inflammatory and immunotoxic, which can either upregulate or downregulate immune system function.
The first and foremost requirement for mold exposed patients is to remove them from moldy damp environments and other sources of mold such as their furniture This can pose a very difficult problem especially when it involves a patient’s home. Patients often require long-term antifungal medication, detoxification, and intense nutritional support sometimes intravenous. They often require desensitization to mold and other inhalants.
Decontamination of a mold contaminated environment can be quite challenging it should not be undertaken lightly, especially if someone is already having symptoms caused by mold. Bleach should not be used to clean surfaces, but rather HEPA vacuum and Borax. Usually it is best to call in a professional firm experienced in mold remediation. Frequently belongings such as furniture, books, and mattresses cannot be sufficiently “demolded” and have to be abandoned or risk contaminating another environment.
The goal of remediation or moving to a new location is to have the home as mold free as possible. Probably the most cost effective and reliable method of testing would be the Environmental Relative Moldiness Index (ERMI). ERMI testing was developed by the EPA and uses PCR DNA technology, which is used to measure dust samples. Submitting dust samples from the home is simple, straightforward and reliable. Ideally the score should be less than 2 before assuming that the environment is safe enough to return. Various laboratories are able to carry these tests out. 2 of them are: Real-Time Laboratories-855-692-6767. Mycometrics-732-355-9018.
Mold exposed patients often become colonized with fungus. This colonization involves the skin and mucosal surfaces such as the nose, sinuses, throat, esophagus intestinal tract and bronchial system. Invariably these patients become allergic to mold and often develop allergies to substances they were never previously allergic to such as dust mites, pollens and foods. Treatments include binding agents to sequeste mycotoxins, antifungal drugs, detoxification and desensitization.
Typically urinary mycotoxin testing is ordered to assess the degree of exposure and what types of fungus the patient has been exposed to...
A typical treatment would generally include:
- Mycotoxins binding agents which attach to mycotoxins for removal through the intestinal tract such as cholestyramine, bentonite, charcoal
- Antifungal medication-nasal or nebulized amphotericin, itraconazole, fluconazole. Oral antifungals such as amphotericin, itraconazole, ketoconazole, nystatin are usually recommended. Both amphotericin and nystatin are very poorly absorbed and therefore safely used. Itraconazole, ketoconazole and fluconazole are well absorbed and systemic and been reported to cause liver dysfunction. I have rarely if ever seen any evidence of liver damage using these medications.
- Immunotherapy-most patients who have been overly exposed to mold become allergic to mold, dust mites and often other allergens. Now they have become hypersensitive to normal levels of mold that never previously bothered them. Allergy testing and desensitization to mold/mycotoxins is generally recommended. Sublingual desensitization is preferred since the mucosal membranes have been colonized and/or sensitized.
- Detoxification using External Enhanced Counterpulsation (EECP) with oxygen- improves microcirculation, stimulates lymphatic circulation, hepatic, renal and cellular detoxification. This is particularly important since many of these mycotoxin exposed patients developed a toxic vasculitis and this treatment can restore normal vascular function.
- Counseling- from a specially trained medical marriage and family therapist familiar with environmentally induced medical conditions. The effects of the resulting health problems, disrupted home environment, loss of home and belongings can have a devastating effect on patients and their families mentally, socially and spiritually. Counseling can support and nurture patients as they go through this difficult time in their lives.