Mold Illness and Chronic Inflammatory Response Syndrome (CIRS)

What is mycotoxin illness or CIRS?

Mycotoxin illness results in chronic inflammatory response syndrome, aka CIRS. Mold is not the only culprit, although it is often involved. The cause of chronic inflammation is biotoxin illness, which may result from any pathogen with a biofilm.

Biofilm is the sticky byproduct that many pathogens form to adhere to tissues in the body and hide. Many studies now show that mold joins another biofilm “frenemies.”  These pathogens work together to overtake the hormonal and immune systems.

In other words,  CIRS can be caused by mold or it may be triggered by a multitude of pathogens capable of forming biofilms in the body.  They hide and fool your body’s own defenses. Dr. Shoemaker, who developed guidelines and protocols for dealing with mycotoxin illness, formulated this theory.

Pathogens and compounds that contribute to biofilm illness include:

• Yeast/fungi -unicellular
• Bacteria (possibly including Borrelia, Babesia, and other organisms transmitted by tick bites)
• Actinomycetes (gram-positive bacteria from the order Actinomycetales)
• Mycobacteria
• Mold to include but not all-inclusive of aspergillus, fusarium, and penicillium
• Mold spores-behave like fungus or yeast, but are multicellular
• Endotoxins (aka lipopolysaccharides, or LPS; cell wall components of gram-negative bacteria)
• Inflammagens (irritants that cause inflammation and edema)
• Beta-glucans (a diverse group of polysaccharides)
• Hemolysins (exotoxins produced by bacteria capable of destroying cells)
• Microbial volatile organic compounds (mVOCs; organic compounds released by microorganisms when there is an adequate food supply for such “secondary metabolite production”)

Typically, biofilm illness results from exposure to a water-damaged building or leak. This is the first place to look when you feel poorly or worse when first exposed to a potential source of mold. And it’s not always in plain sight either. Many of the triggers listed above are found in areas with water damage or leaks.

Removing the exposure and treatment is crucial for toxic CIRS patients

It would seem to make sense. Remove the exposure to mold, and the patient heals. This is not always the case. Nearly 25% of the population has a certain type of immune gene called a haplotype that makes them more susceptible to immune damage and chronic inflammation.

This has to do with our genes. At the same time, it has much to do with our environmental exposures, heavy metals, and overall toxic burden, which interferes with a body’s natural ability to detox through the correct pathways. This genotype requires significant exposure, a compromised immune system, or a trigger when sets off the immune system. This may be an infection, an emotional response, or a perceived stressor that activates the biofilm illness.

When yeast, mold, or another pathogen with a biofilm comes into play, you may have an extremely difficult time healing from such a high toxic burden. Your skin, liver, kidneys, respiratory system, and bile are exceptional detoxifiers. Still, we can overburden them with the toxic world in which we live.

If you have any of the following symptoms, find a functional medical doctor, naturopath, or osteopath who is literate in treating mold, biotoxin illness, and its counterparts.

Most importantly, you need to remove yourself from the exposure, even if that means selling your home. This is the hardest part of the treatment.

Symptoms of mycotoxin or biotoxin/CIRS illness include:

• Chronic fatigue
• Brain fog/memory problems
• Insomnia/waking multiple times at night
• Difficulty holding urine since the antidiuretic hormone is inhibited
• Static shocks or bites at night
• Tinnitus
• Paresthesias/numbness/tingling in extremities due to mini-episodes of the inflammatory cascade being set off in the body
• Headaches, sinusitis, upper respiratory problems
• Post-exertional malaise
• Visual changes, blurry vision, difficulty focusing
• Joint pains, muscular soreness, cracking and feeling locked up
• Severe personality changes-frustration, anger, procrastination
• Insatiable sugar cravings
• Abdominal bloating or pains; difficulty with digestion
• Shortness of breath
• Worsening of symptoms when the person is placed back in the building with mold (i.e. home or work)

Biotoxin illness can wreak havoc on your body. And, it may stay hidden. Many patients experience lowered immunoglobulins, or soldier cells, due to these hidden infections. Eventually, the body becomes chronically fatigued from fighting a hidden infection without success. Both chronic stress and lowered immunity lead to further infections. Your hormones and libido experience problems. Eventually, this leads to autoimmune conditions and a body with much more pain and much less vitality. Serum biomarkers are consistent with the neuroimmune, vascular, and endocrine abnormalities that characterize CIRS.

Another way to screen for mold is by using the visual contrast test at http://www.survivingmold.com.

Over 90% of patients who have a mold or biotoxin illness test positive with a visual contrast test. (fail the test).

The first VCS test is available at Dr. Shoemaker’s website, Surviving Mold. Dr Shoemaker is a pioneer in the field of biotoxin illness and continues to support this community with research. This is a Functional Visual Acuity Test (FACT) that uses a scoring algorithm developed by Drs. Shoemaker to determine the likelihood that a patient is being adversely affected by biotoxin exposure. The second VCS test is available at VCSTest.com. The raw (unconverted) scores and the contrast sensitivity curve are provided for free, and a $10 donation is requested (but not required) for the upgraded results with detailed analysis and interpretation and a PDF that can be downloaded and shared.

If you test positive, another testing is necessary for a confirmation that you have biotoxin illness.

Getting a Diagnosis with Biotoxin Illness or Mold

Dr. Shoemake has a panel of blood tests for diagnosis. I do not use all of these tests; however, they can be very useful. These include:

• The visual contrast test at www.survivingmold.com
• HLA DR susceptible haplotypes (genes)
• Elevated complement (c4a)
• Elevated MMP-9
• Reduced MSH
• Elevated TGF-beta
• Reduced Antidiuretic hormone (ADH) and inability to hold urine
• Reduced VEGF and VIP which indicate decreased blood tissue flow
• Decreased levels of IgG and IgA immunoglobulins or soldier cells, which deem it difficult to mount an immune response within the mucous membranes.
• Positive multiple antibiotic-resistant coagulase-negative staph (MRCoNS) (a marker of low MSH)-MRCoNS can be identified by nasopharyngeal culture. Biofilms produced by MRCoNS, mold, some bacteria, and/or yeast form a barrier to immune defenses and therapies. The MRCoNS nasal swab is more controversial. Researchers suspect that bacterial biofilms may account for many cases of chronic sinus congestion and inflammation.

I personally prefer http://www.greatplainslaboratory.com Mycotox urine test or the new Vibrant mold panel, which also has a successful track record of catching mold combined with an astute, detailed history from the patient.

Will I Need to Move from My Home?

Most likely, you will need to move. Testing a home for mold is difficult. A preferred method to test your home is the ERMI test.

ERMI stands for Environmental Relative Moldiness Index. It utilizes quantitative polymerase chain reaction (MSQPCR) technology to identify mold in dust that has settled in buildings. It is much more accurate as it uses DNA.

If an ERMI test comes back positive, my advice is to move out of the house, which is often the most difficult thing to convince the patient to do for their health. Mold can hide behind walls or crawl spaces so it is very challenging to fully eradicate.

Dr. Shoemaker further refined the relevance of ERMI testing to CIRS patients by creating the HERTSMI-2 scoring system. This is a weighted score that takes the relative levels and danger of particular mold species into account.

The advantage of the ERMI is that it can identify the exact species of various molds present, and it will identify spores that are not airborne. However, it is crucial to understand that not all labs that perform the ERMI test are using the correct methodology. Check out the EMMA test by Real-Time labs which put the ERMI in an easy to understand the context.

In order to ensure reliable and accurate results, labs that perform ERMI testing must follow the EPA patent and laboratory procedure guidelines exactly. Otherwise, whatever results in the test returns will not be confirmed

If I have mold or biotoxin illness, How Do I Heal?

First, remove the offending agent. You may opt to get tested for co-infections like Lyme Disease as you prepare for the potential of healing detox reactions. This is better known as Herxheimer reactions, and they occur as toxic byproducts, and biofilms are dislodged from tissues. This can cause a huge inflammatory reaction in the body which feels terrible for the patient. Herxheimer reactions usually include a generalized worsening of the symptoms-headaches, fatigue, nausea, or even fever that lasts temporarily.

To prevent this:

• Load up with omega 3 fatty acids like fish oil or krill oil. CBD oil and other anti-inflammatories like curcumin or alpha-lipoic acid may also be useful before starting the treatment. This will lessen healing detox reactions.
• Nattokinase or serrapeptase, which are fibrinolytic enzymes, are useful to help temper the inflammatory cascade and prevent numbness or tingling in the extremities.
• I employ a kill, bind, and sweat method which works beautifully for patients who do not suffer from postural orthostatic hypotension. liquid liposomal Biocidin is used as biofilm disturbers. An hour later, I utilize a binder like Biotoxin Binder by Cellcore Biosciences. I do not endorse cholestyramine, as it has caused detrimental micronutrient deficiencies occasionally in patients. Finally, if you can tolerate it, I ask them to sweat daily after the binder for 30 minutes each day. This method not only gets biotoxin illness but heavy metals and some environmental toxins as well. It is an excellent treatment plan to heal patients with multiple issues.
• A silver nasal spray with a biofilm buster like EDTA is extremely useful as are nasal botanical washes. BEG spray, which includes EDTA and an antibiotic, is often used as my second line of treatment. A nasal spray of Doxycycline and biomolecular oxygen is also really imperative.
• Secondary issues, specific to each individual patient, will also need to be addressed. For example, if a patient has low secretory IgA, which is very common, they will heal much faster by replacing those immunoglobulins. Products like LD colostrum or SBI protect by Orthomolecular Products are very beneficial for low IgA. Mitochondrial damage or high TGF-beta may also need attention. I find that acetyl-L-carnitine, NAD, and nicotinamide useful for mitochondrial damage in some patients. The organic acids test (OAT) by Great Plains lab may also elicit some key findings in how the patient’s detox pathways are spun out of control and help to narrow treatment.
• The gut will likely need to be addressed as well, as it is definitely involved with the immune system. Avoid constipation as this will worsen healing detox reactions since toxins are not being moved out properly. Digestive enzymes, bitters, probiotics, or anti-constipation aids should be employed. Magnesium, colon hydrotherapy or coffee enemas are crucial during heavy detoxing. Diet should be free of processed sugars (fruit sugar is mostly tolerated but dependent on the person), gluten, dairy, or boxed/convenience foods.
• I often employ proactive tasks for the patients such as castor oil packs on the liver or gut, coffee enemas, and IV ozone. Ozone is extremely antipathogenic and has a successful track record against CIRS and biotoxin illness in general.
• Most importantly, DO NOT GIVE UP! Indolent, chronic infections may take months to properly treat holistically and naturally but it can be done! Healing detox reactions should only last 2 weeks to a month at the longest, at which point, the patient breaks through and their body begins to positively react to treatment.

Keep the faith. Find a physician you can trust. You can heal.

REFERENCES:

1. https://www.survivingmold.com/docs/Berndtson_essay_2_CIRS.pdf
2. Chronic Illness Associated with Mold and Mycotoxins: Is Naso-Sinus Fungal Biofilm the Culprit? Joseph H. Brewer, Jack D. Thrasher, Dennis Hooper. Toxins (Basel) 2014 Jan; 6(1): 66–80. Published online 2013 Dec 24. doi: 10.3390/toxins6010066
3. https://chriskresser.com/5-things-you-should-know-about-toxic-mold-illness/
4. Rea W.J., Didriksen N., Simon T.R., Pan Y., Fenyves E.J., Griffiths G. Effects of toxic exposure to mold and mycotoxins in building-related illnesses. Arch. Environ. Health. 2003;58:399–405. [PubMed]
5. Campbell A., Thrasher J.D., Gray M.R., Vojdani A. Mold and mycotoxins: Effects on the neurological and immune systems in humans. Adv. Appl. Microbiol. 2004;55:375–398. doi: 10.1016/S0065-2164(04)55015-3. [PubMed] [CrossRef]