(Editor’s Note: This article was originally inspired by an IC patient who called our office in 2020 and shared that her symptoms were apparently caused by hidden black mold in her home. When the mold was eventually eradicated, her symptoms dramatically improved. In October 2023, we had yet another patient call our office who was diagnosed with an aspergillum infection in her urine, possibly caused by exposure to mold in her home. Fungal infections have been found in patients with bladder pain.)
Black mold has gotten a lot of attention in media. Pretty much anyone you ask would agree that exposure to black mold is harmful for your body. However, black mold is far from the only concern when it comes to mold and water damaged buildings. Mold and its friends can do more than cause allergy symptoms like a cough and runny nose. Some IC patients also suspect that it is causing their bladder symptoms.
What is mold toxicity?
Mold is a fact of life. It grows indoors and outdoors. It can travel into our homes from our clothes, our pets, through open doorways or windows and via heating and cooling systems. When it hops a ride into our homes and lands on moisture it becomes an even bigger problem, according to the Centers for Disease Control and Prevention. Mold thrives in areas where there has been a leak. Dark areas are also ideal breeding grounds. Wet cellulose materials, such as paper, cardboard, ceiling tiles and wood, are especially conducive to mold growth.1
The troublesome issue with certain types of mold is that they release mycotoxins. According to the Health Living and Longevity Medical Center in Palm Beach Gardens, Fla., some produce mycotoxins to keep other mold from growing on their territory.2 Those mycotoxins are then released into the air (or can be ingested through food or absorbed through touch). Once they enter our bodies, they can wreak havoc.
Some people are not impacted by mold exposure while others sneeze or cough. It is long term exposure to mold that has the most devastating consequences, especially for those in poor health.
Dr. Daniel Nuzum is a doctor of traditional medicine, a doctor of oriental medicine, a naturopath and an osteopath. He sees mold toxicity patients at his private practice, Spirit Way Medicine, in Idaho. Nuzum said if someone already has a compromised system from a chronic illness, then he or she will have more trouble fighting off mold toxicity. “When we have multiple factors weighing on our immune system, our immune system just can’t keep up,” Nuzum said.
While you’d think that you would know if you were exposed to mold, Dr. Todd Maderis, a Naturopathic Physician in California who specializes in environmentally caused ill- nesses, said that most of his patients didn’t know they were exposed to mold until they got their test results.3 “The mold exposure that causes illness can be current or in the past,” Maderis wrote. “In past exposures, people can continue to have elevated mycotoxins…long after leaving a moldy environment.”
Mold toxicity causes a variety of symptoms, including some IC-like symptoms such as abdominal pain and increased urination. Other symptoms go along with co-morbid conditions common among IC patients like joint pain, fatigue, headache, diarrhea, anxiety and skin sensitivity.
Dr. Todd Watts, a chiropractor and functional wellness practitioner who owns the Total Body Wellness Clinic in Idaho, said one of the first questions he asks patients is how they are sleeping to help determine whether exposure to mold might be the underlying cause of their issues. Red flags to him include insomnia, anxiety, feeling overwhelmed, the inability to think clearly, sharp pain, body pain and food sensitivities.
“Some people can have overall severe chronic fatigue,” Watts said. Nuzum said if he has a patient with chemical sensitivities, he suspects they have been exposed to mold. “I’ve never found somebody that has multiple chemical sensitivities that wasn’t toxic,” Nuzum said.
Another symptom Nuzum usually finds among mold patients is massive anxiety. He speculates that the body recognizes mold as a foreign invader, like an infection, and reacts to the body being under attack. “When you’re under attack, it’s normal to have anxiety,” he said.
Where is mold usually found?
The first place to look is where you spend a lot of time: your home. Nuzum said having your home inspected for mold is a good idea; the mold can often be remediated so that you don’t have to move. Finding the source of exposure is important. “If you’re drowning in a pool, we can’t help you until we get you out of the pool,” he said.
Dr. Ritchie Shoemaker is a well-known expert on mold sickness who developed a protocol for treating mold toxicity 20 years ago that is still being used today. Shoemaker said water damaged buildings are one of the biggest contributors to mold and lots of molds aren’t visible. Studies have shown that 60% of buildings in the United States have or have had water damage.
Maderis’ article said mold pathogens begin growing within 48 hours of dampness or water exposure. He mentioned that flat roofs, buildings built into a hillside and basements are particularly susceptible. Buildings that aren’t maintained well, which unfortunately usually includes schools, apartments and government buildings, are also more likely to have mold growth.3
Nuzum, who grew up in the Midwest, said both of his parents are naturopaths. He remembers his dad treating foundations of his patients’ homes in order to help them get better. His dad would seal around the foundation, put up a water barrier, place stones strategically to siphon water away from the foundation, clean and seal basement walls, add more lights in basements and raise the temperature by 2-degrees. All of those things helped keep mold from growing, which in turn helped improve the health of his father’s patients.
While buildings are the starting point in looking for mold exposure, they aren’t the only source of mold exposure. Watts said he had a female patient who scored high on mold toxicity, but her environment was fine. He suspected her breast implants were the culprit, so the patient decided to have them removed. Sure enough, the implants had black specs floating around in them. “She was getting exposed to mold from the breast implants,” Watts said, noting that within a few weeks she started feeling better because she removed the mold she was being exposed to.
In talking about looking for mold, it is important to note that black mold has gotten the most press and attention, but it is not the main culprit in most cases of mold toxicity. Shoemaker said mold is only 7% of what makes people sick in water damaged buildings. Bacteria that go along with it, like actinomycetes and its endotoxins, make up 75% of what is causing people to get sick. Mold is a common denominator, but other fungi and bacteria are often the most harmful to patients.
How does mold exposure affect the body?
The science behind why the symptoms occur is important in understanding mold sickness. Shoemaker said at the core, it comes down to genes. “Out of the Human Genome Project, we learned that genes can be turned on and off,” he said. Understanding how the genes work is revolutionizing all sorts of medical treatments and treatment for mold exposure is one of them. Shoemaker said the mitochondria, which are the miniscule parts of our cells that produce energy cells for the body to function, get switched off because certain genes get deactivated after someone is exposed to an environmental toxin or bacteria. When that happens, the mitochondria slow down the metabolic rate in the body causing a condition called molecular hypometabolism. And that leads to a deficiency of ribosomal RNA, which are involved in making proteins.
Along with that, TRPV2 small nerve fibers stop working correctly. When that happens, they release anti-inflammatory factors, which causes pain throughout the body. In part for that reason, Shoemaker said most of the patients he sees dealing with the effects of mold exposure have Chronic Inflammatory Response Syndrome (CIRS). Shoemaker said that many conditions, including fibromyalgia, chronic fatigue syndrome and perhaps even IC, could be caused by the same issue. “We are looking at an era of misdiagnosis of molecular abnormalities,” he said.
According to Shoemaker, 80% of mold or CIRS patients have an abnormal level of Antidiuretic Hormone (ADH), which is the hormone that helps the kidneys manage the amount of water in the body. As a result, CIRS patients don’t tend to have an adequate amount of water circulating through their bodies, which causes increased urination and thirst.
Watts said patients dealing with mold exposure have lower levels of oxygen in their blood which impacts the body’s ability to remove toxins. “[These patients] tend to have lower oxygen levels within their body and have more cellular inflammation,” he said. “Mold suffocates oxygen in the body…[and] has an effect on the NRF2 pathway.”
The NRF2 pathway just happens to be the one that helps in detoxification. As the toxins circulate throughout the body, then the body gets inflamed. Nuzum said chronic inflammation can lead to additional problems. “If you’re in that constant state of inflammation, it’s going to be a matter of time before an auto-immune disease starts to develop,” he said.
How is mold toxicity diagnosed?
Diagnosing mold toxicity or CIRS isn’t a quick and easy process. Just like diagnosing IC, other conditions and diseases need to be ruled out as a cause for symptoms. Nuzum, Shoemaker and Watts all agreed that they start with getting a full health history of the patient. Watts said he runs a full blood panel on new patients to see what is going on, including looking at liver and thyroid function. “I look at different symptoms, but if they have mold toxicity…I run a urine test,” he said, noting that if he suspects mold toxicity and other treatments aren’t working them running a urine test for mold toxicity is the next step.
The urine mycotoxin test is the only test that looks for and can show mold toxins, according to Maderis’ article. The two most commonly used laboratories are Great Plains Laboratory and Real Time Laboratory. Both labs require a physician’s order. Maderis added that prepping for the mycotoxin urine test by doing things like taking certain medications for a few days ahead of time and sitting in a sauna for 20 minutes then collecting the first urine of the day the next morning is important since the test only shows what mycotoxins the body has released in the one urine sample.3
Shoemaker performs a Visual Contract Sensitivity (VCS) test, which measures neurologic functions. He also has a 37-question checklist of symptoms that he goes through in-depth with new patients. That is followed by a thorough medical examination, work history and family history. For younger patients, he also goes through a developmental history. The whole objective is to determine whether the symptoms are from a single illness or multiple illnesses.4
Another test Shoemaker utilizes is the Genomic Expression: Inflammation Explained or GENIE test. Developed based on the research of Dr. James Ryan, GENIE tests for hypometabolism and contains 175 reporter genes.5 Its results give physicians an idea of underlying causes for their patients and then necessary treatment. It has a very specific protocol for drawing blood, must be physician-prescribed.6
Shoemaker said in a presentation in October of 2019 that mycotoxins are the cause of symptoms in less than 10% of patients. Instead actinomycetes and endotoxins are to blame, and the GENIE test shows these results.6
How is mold toxicity treated?
Shoemaker’s 11-step treatment protocol has been used for 20 years. It starts with removing the patient from exposure to toxins then removing toxins from the body.4 The steps continue from there to also include dealing with MARCoNs, which stands for Multiple Antibiotic Resistant Coagulase Negative Staphylococci. Shoemaker said such infection is usually present in patients who have been affected by mold and its cohorts.
Shoemaker’s treatment protocol is a methodical one that needs to be followed in sequence with close evaluation. It ends with using vasoactive intestinal polypeptide (VIP) therapy. Shoemaker said he first started looking at VIP in 2005 and has found it helpful in his patients.7 VIP is a peptide hormone found in the pancreas, intestine and central nervous system that aids in digestion and impacts the immune and central nervous systems.8 Shoemaker said CIRS patients usually show a VIP deficiency, so having them use VIP as a nasal spray helps. He starts with four doses a day and eventually has patients go down to one.7
“You restore balance, you restore regulation and the illness goes away,” said Shoemaker, noting that he has a high success rate in patients who have followed his protocol. He has trained more than 500 physicians on how to treat these patients as well.
Watts, who is also a part owner and developer of Microbe Formulas supplements, said he tries to look at the whole patient and not treat just one specific issue. “We need to heal at the mitochondrial level and then build the body back up,” Watts said.
Watts works with patients to help them remove the toxins in their body and get their entire systems back on track and functioning as they should be. While he recommends his supplements and even offers a mold specific protocol kit for around $400, he said education is the most important thing.
“Our process isn’t to give someone a vitamin,” he said. “We try and help and empower people who don’t have the ability to go see doctors. We do [also] train doctors on understanding the road map to health.”
Nuzum said he also works with patients to help them detoxify. He starts first with restoring gut health in patients. “The first place that I work and the most effective approach that I’ve found is actually starting with digestive enzymes,” Nuzum said. He uses a liquid fulvic acid he developed to help decrease inflammation and improve gut health. “If we’re going to take a nutritional approach, we can’t help them until we get their digestive tract functional,” Nuzum said.
While none of the doctors could say that mold or exposure to water damaged buildings is the cause of IC, all of them agreed that exposure certainly wouldn’t help IC and could compound the issue. They did all agree that mold is a systemic issue and doesn’t affect just one area of the body. “Mold is something that is definitely a very big problem in today’s world,” said Watts.
References
- National Center for Environmental Health. Basic Facts about Mold and Dampness. Centers for Disease Control and Prevention. Last reviewed Dec. 16, 2019. (https://www.cdc.gov/mold/faqs.htm)
- Healthy Living and Longevity Medical Center. Black Mold & Mycotoxin Testing. (https://hllmc.com/mold-mycotoxin-testing/)
- Maderis T. Symptoms of Mold Exposure. DrToddMaderis.com. (https://drtoddmaderis.com/symptoms-of-mold-exposure)
- McMahon S. Dr. Shoemaker’s 11 Step Treatment Protocol. SurvivingMold.com. Feb. 22, 2013.)
- SurvivingMold.com. GENIE (Genomic Expression: Inflammation Explained)
- Shoemaker R. The Latest Lessons from GENIE. SurvivingMold.com. Oct. 16, 2019.
- Shoemaker R. VIP My New Friend. Surviving Mold Video Series. Feb. 4, 2014. (https://youtu.be/PiBtYMeH95c)
- National Cancer Institute at the National Institutes of Health. NCI Dictionary of Cancer Terms. (https://www.cancer.gov/widgets/termdictionarywidgetenglish)
