Why Me? Understanding Mold Illness and the Hidden Reasons You’re Affected

At Sanctuary Functional Medicine, we have a steady stream of new patients who come to us with mold toxicity problems, some anticipating the diagnosis and others not. Either way, once we are confident in the diagnosis, the “why me and not them?” question arises. It boils down to an interplay of differences in genetics, differences in toxic exposures (exposome), and differences in the types of mold which live in one’s environment.

Genetics

Confirming a diagnosis of mold toxicity begins with a good history, but laboratory testing is required for diagnostic confidence. We look at markers of biotoxin reactivity like Transforming Growth Factor Beta 1, C3a, and C4a among others. We also look at urine mycotoxin levels to confirm exposures and to which molds someone was exposed to. These labs confirm our clinical suspicions that someone is affected by mold toxins, but still do not explain why they are affected.

Beyond these tests, we could look at human leukocyte antigen (HLA) typing, a genetic test that tells how the immune system handles biotoxins, including the mold biotoxin. These HLA markers affect how antigens (biotoxins in this case) are processed. The differences in processing play a large role in influencing the patient’s ability to get rid of mycotoxins. The markers also tell about the expected intensity of a person’s response to these ubiquitous mycotoxins. Due to these HLA differences, biotoxins make some people sick even at levels which do not even affect others.

While we looked at these genetic markers in the past, we no longer test these unless requested. If someone is demonstrating biotoxin reactivity in the other tests and has mycotoxins in their urine, we do not really need to speed a few hundred more dollars to tell them that they are sensitive to mold toxins. That is a foregone conclusion. We can move on and treat them without spending that money on tests which do not change how we treat them. We will need to do other tests down the road on their home and repeat blood work on them later. The money for genetic testing will be better spent on tests which actually impact on how we treat patients.

Besides HLA differences, other genetic factors may magnify or diminish a patient’s sensitivity to mold. The glutathione pathway, given its role in detoxifying some mycotoxins, may play a role. It is likely that many other pathways interact as significant factors in a person’s ability to clear mold toxins. I would not be surprised if genetic variants in Transforming Growth Factor Beta 1, the inflammatory pathways, as well as other detoxification pathways, are eventually found to affect sensitivity to mycotoxins. Some of the information on these pathways is still being studied. Again, there is little need to test these in detail. Our protocol does not need that information in order to help patients recover their health and their lives. Exposome In addition to genetic variations causing differing toxin sensitivities, different combinations of toxins often synergize.

Chronic infections and life stressors can also amplify or modify the intensity of the toxin’s effects on a person. Even with unfavorable mold detoxification genetics, some may not manifest symptoms if amplifying factors remain absent. The exposome, or the collective set of toxins in a person’s environment, may trigger mold illness when organic compounds or heavy metals tip over the immune system. It is basically a “1+1=3” situation. Either toxin alone might not trigger illness, but the two together can pack a devastating punch. Another amplifier of mold illness includes stress. Stress, in many forms, may work in concert with mold toxicity.

Our patients tell life stories of emotional and physical abuse or traumatic events. The physical stress of a head trauma is one such example. We know that head trauma may trigger leaky brain or a chronic inflammatory state in the brain. This may allow mycotoxins or other toxins to reach deeper into the brain, triggering more damage than it could have done alone. Emotionally stressful events, between the surge in cortisol and the firing up of the fight or flight system, can also augment mold’s effects. Adding the direct chemical effects of mold toxins on the limbic system’s fight or flight response together with the emotional stressor sets the stage for chronic neurologic and emotional symptoms.

With the reality of COVID since 2020, this coronavirus and its often-persisting Long Covid syndrome adds another complicating exposome factor. Early in the pandemic we discovered that the virus was triggering strong biotoxin reactions. While any viral infection will temporarily elevate TGF beta 1, we found that our patients who were reporting relapses in their mold toxicity symptoms had higher TGF beta 1 levels for longer periods of time. When reports of Long COVID patterns were published, we realized that the list of symptoms almost perfectly overlapped with mold toxicity and Lyme disease. Basically, post COVID is a biotoxin illness, likely from the spike protein. With these realizations, we also found that most of our mold toxicity therapies were helping the post COVID patients. We just needed to make some adjustments and ramp up therapies for a time. As the pandemic has continued, we are now seeing many first present with Long COVID without their knowing about a pre-existing mold toxicity or Lyme disease. They had been living life relatively well, maybe with minor symptoms, when COVID knocked them off their feet. Then Long COVID keeps them pinned. To help these patients overcome, we look for the pre-existing conditions that predisposed them to Long COVID. In order to help them overcome Long COVID, we also have to address the mold toxicity. Without addressing this underlying mold toxicity, we don’t see as much improvement in their condition and they seem to worsen again every time they get COVID acutely. Only by addressing the whole picture do these patients have a chance at full recovery.

Types of Mold and Mycotoxins

Which species of mold happens to grow in a home or workplace also determines whether a person becomes ill. Many outdoor molds, either by their inherent nature or their environmental milieu, produce minimal impact on human health. Yes, poisonous mushrooms do grow in the forest which intoxicate or poison the foolish adventurer, but our primary concern lies with molds that grow on water damaged buildings and release volatile toxins into the indoor air. The outdoor molds garner more of a reputation for their ability to trigger allergic symptoms. The water damaged building associated molds are more likely to produce toxins which harm both microscopic neighbors and other larger organisms like humans.

Not only do they make toxic chemicals, they also inhabit closed environments - our homes, our offices, and other buildings - where their toxins can accumulate. If outdoors, even these molds may never concentrate enough airborne toxin due to winds and the sheer volume of space. Indoors, especially if ventilation is poor, they can accumulate in high enough concentrations to create a toxic punch for the unsuspecting and genetically vulnerable. The indoor molds produce various classes of mold toxins based on their species. The classes vary immensely in their structure and complexity.

Chemically, some are simple structures while others are quite complex. Some target mitochondria while others target hormonal systems. Some primarily dysregulate the immune system. A few aflatoxins, like those from peanuts, even increase cancer risks.  

TAKE HOME POINTS

Genetic Differences Influence Susceptibility HLA (Human Leukocyte Antigen) Differences Immune system genetics Affect the processing and recognition of antigens Testing is not necessary for successful therapy Other genetic differences Possibly Glutathione Pathway Possibly Transforming Growth Factor Beta 1 Others yet undiscovered Testing is not necessary for successful therapy   Exposome Sum total of toxins and stressors to which one’s body has been exposed Presence of multiple toxins amplifies the effects of each… 1+1=3 Includes psychosocial stressors which affect body’s balance Since 2020, COVID spike protein also acting as biotoxin illness trigger Can cause mold toxicity symptom relapse Can unmask subclinical mold toxicity Symptoms and therapy similar to other Biotoxin illnesses including mold   Types of Mold and Mycotoxins Outdoor molds tend to trigger more allergic responses Their toxins blow away in the wind without accumulating Indoor molds (those growing in water damaged building) produce more toxins These volatile toxins accumulate in the building Humans breathe them in Molds toxins are called mycotoxins They come in many shapes and sizes They each cause different bodily responses.