How Do I Know If It Is Mold That Is Making Me Sick?
Patients and friends often ask me, “How do I know if it is mold that is making me sick?” Most of the time, either their symptoms brought them to read about mold-triggered illness, or they know about my personal story with mold, and they hope that I can provide some answers. Unfortunately, a definitive “yes” or “no” is not always easy when it comes to mold—the presentation of mold-related illness can mimic many different illnesses, and there is no “positive/negative” lab test to be done. Over time spent working with patients and sorting through the many and varied ways in which mold can present, though, I have found that a combination of observations, tests, and evaluations can lead to an accurate diagnosis.
A Detailed Patient History
Everything must start with a detailed patient history. Even if mold is the cause, it may not begin causing symptoms in a noticeable way until the capacity or threshold of the individual patient has been breached. This explains why several people in one household may have vastly different manifestations or severity of symptoms, even though they are ALL living in the same moldy environment. The patient’s history, when recorded exactly and with attention to the right questions, can often be the first and most obvious indicator of mold illness.
As we have mentioned in previous articles, symptoms of mold-triggered illness can affect all of the organ systems of the body. Symptoms can be strictly respiratory, such as chronic sinusitis and bronchitis, or can involve other expressions that are not commonly thought of as being related to mold, especially the fatigue and brain fog and neuromuscular complaints.
Making it even more difficult is the fact that mold in the home or workplace is not always obvious or visible to the naked eye. There are a lot of mold situations where all of the growth is completely hidden behind walls or under tile or in a dark crawlspace. Further, moisture and water intrusion events are not always dramatic and sudden in presentation, so the person never even thinks to suspect their immediate environment as a potential cause of their illness or symptoms.
A Clinical Example of Mold Illness
A middle aged woman presented with a combination of progressive debilitating fatigue, muscle weakness in the legs and arms (she could not lift her legs to climb up stairs), and an odd tingling and numbness in her lower legs and feet. She had trouble walking due to her balance being off so badly that she had to hold to walls so as not to fall. Her sleep was disordered, and she was up to urinate at least 5 times per night. The worst symptom, however, was the brain fog. Thinking through simple problems became quite difficult, and word retrieval was so impaired she was fearing early dementia.
The patient’s regular lab work was unremarkable. There were no glaring abnormalities, and autoimmune disorders were, more or less, ruled out. She, as well as other health practitioners, began to fear that this was a psychosomatic response, as her life was quite stressful. She finally sought out environmental medicine help and the answers began to unfold.
Detailed questions about her home revealed the fact that her home was constructed with a foil wrap covering the insulation as an energy conservation measure back in the mid 1980s. Additionally, there had been slow leakage from an improperly sealed bathroom shower pan into the ceiling space below. Leaking eaves allowed saturation of the entire side of the house that then became infested with termites. (NOTE: Termites go after moist wood, so always note that if there are termites, there may also be mold!) When a mold remediation specialist was called, it was found with moisture probes that moisture inside the walls had caused substantial mold overgrowth. Before testing, there had been no evidence anywhere in her home that mold was present. Once mold plates were put out, significant growth of mold spores indicated multiple problem areas in the home.
Fungal swabs of her nasal passages revealed mold growth similar to the molds present in her house. Additionally, blood tests including Immunoglobulin G (IgG) levels of various molds were highly positive, indicative of chronic exposure. Specific inflammatory markers, especially transforming growth factor beta-1, was highly elevated. (TGF beta1).
With these findings, appropriate mold-focused therapy was initiated. Soon, she returned to her previous state of health. ( A very important note to her progress: Her home was completely remediated for mold and moisture intrusion, and all contents were either fogged and treated for spores, or discarded.)
Other family members in the same household were affected, but differently and less severely. Her individual history revealed that she had previously had severe mono from Epstein Barr and had also recently recovered from West Nile Virus. Did these viral invaders predispose her to react more strongly to the mycotoxins from mold? We believe so.
How Does This Example Inform Diagnosis?
This above example shows that an individual’s history is so very important. Without it, an accurate diagnosis could have been elusive; therefore, informed and targeted treatment could not have occurred. Further, clinical examples help us to understand more about the importance of the presence of a “mold gene” that has been written about by other mold professionals. While it does seem that some people are genetically inclined to become more ill from mold than others, the mentioned “mold genes” are not always what are found to be the causative factor. It seems that there are likely many genetic players at work that can affect how well the body can detoxify certain chemicals including mycotoxins. The detoxification pathways can be affected in many different ways by genetics, some very subtle, but I believe that as the understanding of how our bodies detoxify is better understood, we will be able to be more predictive about who and why some people succumb to mycotoxin illness, while others do not. Nevertheless, breathing clean air is important as part of maintaining general good health, and no genetics can make up for this!
Is it Mold?
Now, circling back to the question, “Is it Mold Making Me Ill? To find your answer, ask yourself a lot of questions. Here is a good place to start:
- Construct a timeline of your health and life. Put everything on it, every illness, every possible environmental exposure (chemicals, pesticides) and see where this all falls relative to your onset of symptoms.
- Evaluate your home and/or your car or place of business. Are there noticeable changes in symptoms depending on location? Has there been a water intrusive event in any of these places? Are there damp or wet crawl spaces or basements? Have termites been an issue?
- If the answer to number 2 is yes, then either have a certified mold inspector come and evaluate, or, at the very least, put out mold plates to screen your environment. You can also do mold/mycotoxin screening kits that give detailed lab diagnostics on your environmental exposures.
- Get a thorough physical evaluation done to rule out causes that are more overt.
- If you complete the previous steps and are circling back to mold as the possible cause, then seek the care and advice of a physician who understands mold and can offer a systematic approach and treatment.
Most importantly, do not lose hope! Mold illness is treatable! I highly recommend the American Academy of Environmental Medicine for finding a trained practitioner. The website lists practitioners by state and city with the training to address environmentally-triggered illness. Remember mold illness is not mold allergy, so allergists in general are not the ones to treat this. Rather one who understands the highly inflammatory and toxic effects that mold can have is who you want to seek for care and advice.