Ruling Out or Fixing Pituitary Damage to Recover from Mold Toxicity
In the late 90’s when I was seeing a lot of sinusitis patients who had experienced toxic mold exposures and who had also had sinus surgery (some had even had multiple sinus surgeries), I noticed that all reported low energy levels and fatigue. At that time, we measured energy levels on a scale of 0 to 10, where 10 represented high-normal energy levels, and zero represented no energy at all or cannot get out of bed. This group of patients consistently reported energy levels at a 2 to a 5. Most also had delayed healing after surgery and just didn’t seem to be making progress. Of course, first we would assess the probability of ongoing mold exposure, but this group were people who had mold-free environments and who were doing all other therapies, so something was still obviously going on. With low energy being the pervading, common symptom, I postulated that human growth hormone (HGH or GH) deficiency might be the cause.
(Note: Since I am an ENT, I knew the pituitary gland that produces HGH is adjacent to the sphenoid sinus and that the fungus could produce mycotoxins inside the body. Thus, physical proximity and what I knew about toxicity spurred this line of thought forward.)
Molds, Mycotoxins, and the Pituitary Gland
The relationship of molds and mycotoxins to damage to the pituitary is poorly understood. Exposure to such mycotoxins as aflatoxins, zearalenones, and trichothecenes has been shown to cause abnormalities in the pituitary glands of laboratory animals. We know from sinus surgical experience that patients with positive urine for mycotoxins have high levels of mycotoxins in their nasal sinus mucosa and many have significant neurological symptoms which are usually improved after endoscopic surgery by removing the mycotoxins from the sinuses and by using a cyclone device which irrigates and suctions at the same time with an antifungal (Voriconazole or Amphotericin-B). This irrigation is also removing the mycotoxins from brain as, once irrigated and suctioned out, they are no longer present to cross the blood-brain barrier. When this surgery is performed, we have seen dramatic improvement in neurologic symptoms such as hearing loss, tinnitus, vision, cognitive dysfunction–memory loss, concentration, reading comprehension, multitasking, tremors, leg and arm weakness, suicidal depression, and anxiety. The improvement is so significant for some patients that they can physically acknowledge the absence of years-long symptoms almost immediately post operatively. (Note: You can view patient testimonials and recovery videos from sinus surgery with cyclone irrigation in Dr. Dennis’s interview for the Toxic Mold Summit HERE.)
Growth Hormone and Energy Levels
Without the pituitary gland producing normal levels of growth hormone (GH), you cannot recover adequate energy levels from a toxic mold exposure. GH deficiency can cause many health problems including but not limited to chronic fatigue, terminal insomnia (when a person falls asleep, but awakens and cannot return to sleep), exercise intolerance, increased risk to atherosclerosis and hypertension, increased insulin resistance, muscle weakness, increased central fat mass, reduced extracellular water with reduced total body sodium, reduced left ventricular function, increased risk of fractures, breathing problems, poor attention and concentration, depression, and neurological problems.
Since natural production of GH decreases as we age, we see many of the symptoms of GH deficiency in elderly and aging patients. There are also cases of early adult onset GH deficiency. These patients have significantly higher rates of infections, cancer, heart disease and trauma, as well as problems with circulatory, endocrine, nervous, digestive, and musculoskeletal systems. This makes sense as the body cannot repair or protect itself as robustly when GH levels are low.
Mold, Pituitary Damage, and Growth Hormone Deficiency
I called two of my endocrinologist colleagues and asked them to work my mold patients up for pituitary damage and dysfunction especially growth hormone deficiency which is measured by the level of IGF-1 or insulin-like growth factor in the blood. The first few of my mold patients that I had tested had “normal” levels of IGF-1 in their blood per their lab results. To me, this just did not seem right considering their symptoms.
I decided to dig deeper to find out how the lab defined this “normal” range. To do this, I first obtained the list of symptoms which were most associated with GH deficiency. Then, I asked the lab how normal GH was most often determined or defined. The lab said that a reference lab takes 1,000 “all comers” with no symptom screening questionnaire prior to testing. These people could have low GH or could have optimal levels. The lab then takes their blood and charts the IGF-1 levels to eliminate those with low GH and draws a bell curve to include a range of “normal”. Looking at the results for the mold patients, they all had “normal” resting levels of IGF-1 (GH level), because the “normal” GH levels were not actually normal. The bell curve scoring had placed people with low GH symptoms into the “normal” group, even though they were VERY low-normal. Low-normal with lab testing is not optimal as many doctors know. Low-normal is often already sick.
To keep digging, I then asked the endocrinologists to just humor me by doing further testing on some of my patients with symptoms of GH deficiency. When the endocrinologist finally agreed, he planned to do both the Glucagon stimulation test (Glucagon test) and the insulin tolerance test (ITT) for GH deficiency. Glucagon is a hormone that causes the release of both cortisol from the adrenal glands and GH from the pituitary. In the ITT test, insulin is used to lower the blood sugar which puts the system in low blood sugar (hypoglycemia) condition which causes the pituitary to secrete GH. It turns out the first 13 patients were, in fact, GH deficient AND thyroid and cortisol deficient too. In other words, there was definite and wide-reaching endocrine disruption in this group.
Growth Hormone Deficiency With Fungal Exposure
This experience spurred me and my colleagues to perform a retrospective study to explore whether or not there is a causal relationship between fungal exposure and chronic sinusitis, fatigue, and anterior hypopituitarism, especially growth hormone deficiency (GHD).
The endocrine literature reported that adult-onset GHD was estimated at 1-2 adults per 10,000. That amounts to 60,000 cases in the US from ALL causes, finding 6,000 new cases per year. Our study found that about 4.6 million people suffer from GHD caused by fungal exposure; compare this to the only 60,000 known cases caused by all other factors combined. We found that more than 1 in 64 or > 1.6% of the US population was suffering from GHD. Further, in patients with chronic rhinosinusitis (CRS), significant fatigue, and a history of fungal exposure, the incidence of GH deficiency was 51% in our study! This means that fungal exposure is likely the single most important cause of human growth hormone deficiency.
For the study, seventy-nine patients, all of whom experienced mold exposure and who presented with a variety of symptom combinations, were studied.
They had undergone a variety of treatments, including normal saline nasal irrigations, antifungal and antibiotic nasal sprays, appropriate use of oral antibiotics and antifungals, use of a facial steamer with CitriDrops Dietary Supplement, use of Complete Thymic Formula for nutritional deficiencies and mineral supplementation, hormone replacement, and a measured reduction of indoor mold levels. Here is a table from the study outlining the full detox protocol for these patients:
Of the 79 patients in our study, only 13 had conditions that were associated with GHD–four had head injuries, two empty sellas (when the buildup of spinal fluid squashes the pituitary gland flat), and seven had pituitary microadenomas tumors. The other 82% had no known condition associated with GHD. Remember, without GH new cells cannot be made and strength, energy, muscle tone, bone mass, skin thickness, brain function, the immune system and all body systems degenerate more rapidly than normal. So, low GH is significant when trying to help a patient heal, especially from mold.
In our study of 79 patients, we also found a practical way to determine if the patient was likely to have GH deficiency from using the basic IGF-1 lab analysis. Most patients whose IGF-1 was above the 75th percentile could be deemed as NOT GH deficient, however those with an IGF-1 below the 50th percentile indicated, for most, that they were GH deficient. So, if you ever need to determine where your test results really fall, look at the range of normal values for GH, then just add the normal range numbers for your age group together, divide by 2, and, if your IGF-1 is lower than this number, you are likely GH deficient and need to get an evaluation by an knowledgeable endocrinologist who understands the IGF-1 “normal” values are not really normal.
It is also important to understand that GH deficiency rarely occurs alone. Of 50 patients tested for insulin tolerance, 80% or (40/50) had GH deficiency. Of the 79 patient that presented with sinusitis, mold exposure, and fatigue, 52% (40/79) were GH deficient. Resting IGF-1 average was 123 ng/mL. The range for of IGF-1 for those who had GH deficiency was 88-249 ng/mL. Unfortunately, the average person with an IGF-1 of 249 would not likely get an insulin tolerance test (ITT) to prove they were GH deficient, but, GH injections proved to be a necessity for recovery for these patients. Additionally, low thyroid and/or cortisol, accompany GH deficiency as well as low sex hormones, and sometimes low antidiuretic hormone (ADH) , which causes very frequent urination. For example, in our study, 81% were hypothyroid, 75% were ACTH deficient and therefore cortisol deficient.
For our study, rhinosinusitis was resolved in 93 percent of the patients who were able to lower their mold counts to between 0 and 4 colonies as measured with Mold Screening Plates. All patients who received GH and cortisol and/or thyroid hormone, which were previously deficient, noticed an improvement in fatigue.
In conclusion, we found that when the fungal antigen is removed from the patient and the environmental air, the immune reaction stops; the sinus mucosa improves or resolves; and the systemic symptoms improve or resolve. For patients experiencing ongoing fatigue after the abovementioned interventions, when the deficient hormones are replaced, the fatigue improves or resolves as well.
(Note: To read a full abstract of the paper, you can click here: Growth Hormone Deficiency in Fungal Exposure.)
What Can You Do?
First, I tell all my patients that mycotoxins and MVOC’s (microbial volatile organic compounds) enter the body usually through the nose and sinuses. Then they can travel up the olfactory nerves into the brain. MVOC’s can do many of the same things the mycotoxins do and cause neurological, immune system, and possible endocrine disruption. The difference is that MVOCs are much smaller and can penetrate through a plastic bag that can hold water, go into sheetrock, and wood, and remain after remediation. So, if you are “severely ill” with neurological symptoms, I recommend getting into a safe place in which you “know” you are improving, and do not take anything with you, so that recovery can start immediately.
Then, when you are in a safe environment, you can start on the nasal protocol and body protocol to begin to regain your health. Part of the body protocol I use with my patients includes the homeopathic CellTropin spray that I designed to help stimulate the pituitary and endocrine system to start functioning properly. It is homeopathic so the product works with the individual appropriately. The spray also contains homeopathic dilutions of Astragalus and Arginine to help with cellular recovery and circulation. For many patients, these interventions are enough to get them moving ahead and on the way to feeling better.
If you have done everything and are still not regaining your energy levels, you can seek the help of a skilled endocrinologist to evaluate your IGF-1 levels per the scale noted above in the study. If you fall in the range of low GH, you will need to work with the endocrinologist to find the correct replacement therapy to help you fully recover.