What You Should Know About Mold Toxins and Kidney Function

by Dr. Susan Tanner, MD

In many of our articles on mold-related illness, we have discussed pathways of detoxification, primarily those of the liver, the bowel, and the skin. It is necessary to also include in this mix the topic of kidney function, not only in regard to their contribution to detoxification but also in how the kidneys themselves may be impacted in several different ways by mold and mycotoxins.

Kidney Roles and Functions

Our kidneys are wonderfully complex. They can be thought of in the simplest of terms as giant spongy filters. Certainly, they do filter our blood, but the complexity of their many other functions must also be considered including their regulation of salts, minerals, and water in the blood, and their production of red blood cells and renin, which impacts blood pressure.

One big challenge for the kidneys, even though they are effective at filtering out many toxins, including mycotoxins, from the blood, is that some toxins are then difficult to excrete into the urine. Over time, these toxins can accumulate in the kidneys, and as their concentration increases, they can damage the parts of the organ responsible for filtration. Without proper filtration occurring, waste products then build up in the bloodstream.

Testing Kidney Function

Traditionally, the functionality of the kidneys and, to some degree, their health is monitored by blood levels of BUN (blood urea nitrogen), serum creatinine, and EGFR (estimated glomerular filtration rate). However, these markers can be somewhat insensitive to slight variation and are rather non-specific. Hydration status, use of certain medications, and even strenuous exercise can impact these numbers, albeit temporarily at times. There are many other markers, unfortunately not readily available at this point, to assess the degree of renal damage by mycotoxins and provide a means of monitoring worsening effects in a non-invasive way. As a practitioner, I hope to see these markers utilized in practical settings sooner rather than later as both diagnostic proof of mycotoxin damage and to gauge response to therapy. Two that are reported to be easy to use are assays for urinary NAG (N-acetyl-beta-D-glucosaminidase) and Kidney Injury Molecule-1 or KIM-1. An excellent article about the use of these assays in diagnosing kidney injury was published in 2021 in the journal, Toxins, by Raduly, Price, Dockrell, Scernoch, and Pocsi. While quite technical, it is readable and drives home the points of cumulative damage to kidneys by mycotoxins.

One thing that is quite certain is that there is an additive effect in having mycotoxin exposures along with other toxins, such as pesticides, heavy metals (especially lead and cadmium), and glyphosate (Round Up). This comes back again to our adage of “reduce the total body load” when addressing toxicity, and the first way to do that is by avoidance! So here we go again to our mantra of clean air, clean water, and clean food. You need to address all three to have the best and most-effective health outcome.

Symptoms of Kidney Issues Caused by Mycotoxins

With all of that being said, how does one know if there is kidney disease caused by mycotoxins? Renal insufficiency is usually identified by the aforementioned blood tests (BUN, creatinine, and eGFR) but may need to be repeated over time to see if they are consistently abnormal or worsening. Additionally, a collection of 24-hour urine for creatinine clearance may be done to give further information.  Symptomatically, there may be nothing relating to urine frequency or amount as key indicators. In fact, urination frequency and volume may remain unchanged, but it is what is IN the urine (or not) which can be the problem. Some symptoms of kidney issues may be blood pressure changes, fluid accumulation in the extremities, and a vague sense of feeling unwell and fatigued.

Now to move on, let’s say you have known mycotoxin exposure, your blood work for kidney function is normal, and yet you have increased urinary frequency, volume, and constant thirst. Let’s say you are also constantly drinking fluids, but never feel quenched or hydrated. Many patients with these symptoms are checked for diabetes, but tests come back with normal blood sugars. What is going on?

This takes us back to the hormonal and inflammatory impacts of mycotoxins, not just the toxicity. An area definitely worth mentioning here is the impact on ADH, an anti-diuretic hormone. It is also called arginine vasopressin. This is a hormone made in the hypothalamus in the brain and stored in the posterior pituitary gland. ADH communicates with the kidneys to tell them how much water to conserve. Osmotic sensors in the hypothalamus respond to the particles in the blood, which include what we refer to in blood work as “electrolytes”, sodium, potassium, chloride, and carbon dioxide. When the particle concentration is not balanced, or blood pressure is too low, these receptors tell your kidneys to store or release water to maintain a healthy level of electrolytes. They also regulate your body’s sense of thirst.

In a series of hormone events, mycotoxins can impact the production/secretion of MSH, melanocyte-stimulating hormone, from the pituitary. This, in turn, impedes or decreases the secretion of ADH from the hypothalamus, which is the reason that some patients with mold-related illness produce copious amounts of urine and are quite thirsty most of the time. Another phenomenon resulting from low ADH can be increased static electrical “shocks” due to the imbalance of the electrolytes in tissues. Patients who have this will typically have very dilute urine, with a low specific gravity. Diagnosing this problem can be done with an ADH blood test but this is usually complemented by looking at the serum electrolytes and the urine concentration, including an osmolality test.

Protecting the Kidneys

With proper treatment and, of course, removal of the source of mycotoxins being the first order of business, the hypothalamus/pituitary connection for proper ADH can be recovered. Some patients recover naturally, while some are treated with a nasal spray formula of ADH hormone to help regulate fluid and electrolyte balance and normalize blood pressure. Treatment is usually at the discretion of the practitioner, because while the frequency of urination is not necessarily hard on the kidneys, it is hard to find a bathroom all the time, and getting up at night to go disrupts sleep!

To summarize, the kidneys are important organs of detoxification and need support to be able to carry on all of their duties.  Avoidance of mycotoxins, chemicals, and heavy metals is first and foremost for healthy kidney function.  Keeping hydrated with purified or spring water and adding electrolytes, if indicated, is always necessary. Evaluating symptoms such as frequent urination, caused by low ADH, may be another avenue to explore if you suspect you have been impacted by mold and mycotoxins. The bottom line is that kidney health and function are crucial to maintaining wellness. You must keep the filters clean and free of too much debris so that they can keep your body functioning as optimally as possible. Do your part with clean air, clean food, and clean water and your kidneys can then do their part in filtering out the inevitable exposures that you may otherwise encounter.

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