ManyExperts Discuss Mycotoxins Without Examining the Sinuses

By Cesar Collado

Chronic Sinusitis Sinus Infection

A friend and colleague who is an expert in building science (indoor air quality and mold remediation) asked for my thoughts on an issue following a “Healthy Building Summit.” There was some debate amongst building science specialists on the link between mycotoxin inhalation and mold illness. Some experts, on the building side, strongly supported the notion that mycotoxin poisoning is primarily as a result of digesting mycotoxins in food, and that inhaling mold spores isn’t as significant a health issue.

This observation from “experts” in the field surprised me from a medical perspective as there is so much literature about mycotoxin poisoning, especially in the post-Katrina “massive hurricane” era.  What doesn’t surprise me is that many people in the HVAC and Indoor Air Quality space spend little time discussing the patient’s symptoms and health.  In fact, in my experience, very little discussion is spent on the mycology of the mold and whether mycotoxins may be present.  This is a significant “blind spot” between a physician’s diagnosis, the patient’s symptoms, and the home professionals working on remediating the home from mold!  In addition, any discussion regarding mycotoxins inhaled through the nose and breaching the blood/brain barrier must, in my opinion, involve an Ear Nose and Throat Specialists.  ENTs are the only specialists to investigate the sinuses and tissues so close to the brain in addition to external imaging.

Fungal Sinusitis

Chronic Sinusitis Sinus Infection

Fungal Ball Removed from Sinuses

Fungal sinusitis is a condition where mold finds a home in the moist, warm environment of the sinuses causing infectious sinusitis.  When this occurs, mold triggers the inflammatory response where swelling and mucous production ignites.  When this happens, mold reproduces inside the sinus cavities, feeding on mucous, to create what is called a “fungal ball.”  These must be removed via medical or surgical procedures by an ENT.

Chronic Sinusitis Sinus Infection

Mold hyphae can grow over a foot, penetrate, grow, and damage tissue in addition to causing an inflammatory response

Antibiotics have no effect on fungi and can often create an bacteria-free environment where the fungi can thrive.  Fungi also grow hyphae, “root like” extensions that penetrate tissue.  When the fungal ball is removed without the continued use of antifungal medicines, the fungi will likely grow back. This is analogous to pulling a weed without removing the roots.

Proof of the connection between chronic sinusitis and fungus came in 1999 when the prestigious Mayo Clinic conducted a study on 210 patients with the condition. 96% of these patients had fungi present in their nasal mucous.1.

Fungal Mycotoxins

Mycotoxins are secondary metabolites produced by certain fungi.  These chemicals have a high molecular weight and are “sticky.”  They only become airborne when they are attached to particulates like dust or are aerosolized.  Otherwise, they settle wherever they land. Extreme inhalation of mycotoxins would be required to cause illness UNLESS the patient is mold sensitive.  Approximately 16% of the population have the HLA-DBR gene mutations that makes them mold sensitive.  In addition, common fungi that produce mycotoxins such as aspergillus, stachybotrys, and penicillium have been found in high concentrations inside water-damaged homes. Chronic Sinusitis Sinus Infection Thus, if a mold sensitive person happens to live in a home that is water-damaged, mycotoxin illness is a real possibility. Unfortunately, many of these people suffer for years and go undiagnosed, because mycotoxin biofilm can adhere to the sinus walls, create myriad health symptoms and illnesses, but are impossible to visually identify or remove without the proper procedures.2

Direct inhalation of mold spores may not necessarily be the only source of the mycotoxins. In cases of fungal sinusitis where visible fungus is identified in the sinus tissue and mucous, the very source of the mycotoxins can very well be produced from the mold growing within a patient’s sinuses. In other words, the internal mold source proliferates the illness.

While there is no FDA approved test for mycotoxins, there are CAP and CLIA certified labs that test for mycotoxins in dust samples taken from the indoor environment or in the urine of patients.  While these tests have limitations, they offer the best evidence that mycotoxins are present and contributing to illness.  Otherwise, the patient may face a tragic and lengthy experience by not being diagnosed, diagnosed with a disease of unknown cause, misdiagnosed, or treated with unnecessary medicine.

Chronic Sinusitis Sinus InfectionThe symptoms of many mycotoxins are known; but, it can be confusing for even physicians as several chronic illnesses share common symptoms. This makes diagnosing mycotoxin poisoning nearly impossible for physicians who do not adequately investigate a patient’s environment during medical history gathering.
It remains a challenge to distinguish mold illness from other chronic illnesses for environmental illness specialists. The exceptions to this are neurological symptoms such as brain fog, memory issues, headache, etc. that mycotoxins can directly cause.  (Learn More about that HERE.)


Sinuses are Different

It is the sinus tissues that store the greatest concentration of mycotoxins in the body due to

Chronic Sinusitis Sinus Infection

Innervation of the Nasal Cavity

inhalation and can be the primary residence of the mold producing the mycotoxins.  The sinuses also provide a pathway to the central nervous system along the rich olfactory and trigeminal nerve systems in the nasal sensory pathway that bypasses the blood–brain barrier. The brain is generally shielded

Chronic Sinusitis Sinus Infection

Sphenoid sinus proximity to brain

from contaminants or drugs through the action of the blood–brain barrier. It is for this reason that mycotoxins may not be detected in a urine test where the toxins must be released and metabolized to be excreted in urine. Many patients are actually so toxic and their detox pathways are so blocked that their bodies are not excreting any mycotoxins on their own.

Dr. Dennis, an Ear Nose and Throat surgeon, has performed thousands of sinus surgeries, many of which involve the removal of “fungal balls” and the use of an antifungal to

Chronic Sinusitis Sinus Infection

clear the sinuses of microscopic VOCs.  More conclusive, Dr. Dennis often removes a sample of the diseased tissue, placing it in a mold test plate for incubation.  After a couple of days, a brown “halo” appears besides the tissue sample.
These samples have been sent to a mycotoxin lab where they were verified to be mycotoxins.  In these cases, the diagnosis did not occur until after the treatment.  While after the fact, the evidence is conclusive. Examples of these observations were published by Dr. Dennis and the late Jack Thrasher, the renowned expert immunotoxicology expert, in 2017. The study is entitled “Surgical and Medical Management of Sinus Mucosal and Systemic Mycotoxicosis.” 2. (A lay persons description of the article can be reviewed HERE.)

Treating the Whole Body

Patients suffering from chronic fungal sinusitis are often placed on an anti-fungal diet to starve the fungi and nutritional supplements to help the body detoxify and remove the toxins via the normal metabolization and excretion methods of the body.  Dr. Dennis prescribes anti-fungal nose drops to be taken when a sinus sufferer senses an infection coming.  Patient’s tell me that these drops often stop the symptoms prior to sinusitis becoming unmanageable. The active ingredient is amphotericin B, a potent antifungal that can be toxic to organs; however, since it is administered topically in the sinuses and not systemically by IV, it does not carry the same toxicity profile.  The fact that these nose drops work for patients provides circumstantial evidence that mold mycotoxins may be the cause.

Sinus Care for Fungal Sinusitis

Chronic Sinusitis Sinus Infection

Click for interactive infographic

While a physician may prescribe medicine to alleviate symptoms, proper sinus hygiene is the most effective means to limit the severity of the sinusitis and allow the body’s remarkable ability to heal do its work. Daily rinsing of the sinuses with CitriDrops Dietary Supplement in a nasal rinse system will remove the very spores and debris that is making you sick. (Learn more about the Breathe Easy Kit Here.)

Sinus Defense contains transfer factor that will identify, tag, and remember foreign antigens in the system so that the body’s natural T cells can kill them immediately.  This process is much faster than the body’s antibody response which can take months to work.  BetaMax is beta-glucan which increases the body’s production of macrophages, the “garbage eaters” that remove debris.  CellTropin provides support to the pituitary gland which controls 8 hormonal systems in the body.  The pituitary is proximal to the sinuses where tissue damage and inflammatory mediators make this hormonal gland vulnerable. Hormonal dysfunction can lead to adrenal fatigue and stress hormone reactions.


Home Hygiene:

Removing mold from surfaces with EC3 Mold Solution Spray or fogging everything with the EC3 SANI+TIZER fogger and EC3 Mold Solution Concentrate will drastically reduce the fungal air count in your home.  EC3 Air Purification Candles have been shown to remove mold and mycotoxins from your immediate air where you relax and sleep.

Chronic Sinusitis Sinus Infection

Click to learn more about all Micro Balance Health Products

Ignoring the obvious threat of mold inhalation as a cause of mycotoxin poisoning is nearsighted and simplistic. I hope that building science and environmental medicine will begin a conversation where both parties can learn more from each other and improve indoor environments to be less vulnerable to mold growth. Until then, actively reducing fungal exposure is critical to healing.  Without addressing the environment, the immune system is continually assaulted by the inhalation of mold spores.

  1. Ponikau JU, Sherris DA, Kern EB, et al. The diagnosis and incidence of allergic fungal sinusitis. Mayo Clin Proc. 1999; 74: 877-884
  2. Brewer, JH, Thrasher JD, et. al. Chronic Illness Associated with Mold and Mycotoxins: Is Naso-Sinus Fungal Biofilm the Culprit?Toxins (Basel). 2014 Jan; 6(1): 66-80.
  3. Dennis D., Thrasher, J, “Surgical and Medical Management of Sinus Mucosal and Systemic Mycotoxicosis.” Journal of Otolarynology and Reconstructive Surgery, April 24, 2017