When Mold Puts Food Allergies, Sensitivities, and Intolerances on the Menu

by Dr. Susan Tanner, MD

In the course of treating patients diagnosed with mold-triggered illness, the topic of food allergies and sensitivities often arises.  Many times the individual finds that he or she suddenly cannot eat a particular food that previously was enjoyed with no problems.  Other times, symptoms such as a runny nose, headache, gastrointestinal disturbances, and/or fatigue occur after a meal making it difficult to pin down which exact food or combination of foods may have instigated the problem. What makes things even more confounding is that the symptoms may be delayed for many hours after a meal. Thus, linking a “cause and effect” type of relationship between the body’s negative response and the food or foods is sometimes lost or not obvious for a while.

Defining the Differences Between Food Allergies and Sensitivities

To address the food issues that can arise in patients struggling with mold illness, it is worth a brief review of the main food reaction terms to help the patient both describe and understand what is going on.  First a true “food allergy” is defined by a very specific immune response in the body which causes a marked and immediate reaction when the food is ingested.  This reaction can be life-threatening and requires immediate action.  We see this a lot in children with a peanut allergy, for example, and it is mediated by the immune cells known as IgE.  A bad rash after eating shellfish is another example of IgE food allergy.

Food sensitivities are a bit different, and most are mediated by a cell response known as IgG response.  These are generally milder in presentation (i.e. not life-threatening) but are most definitely quality-of-life-impacting.  Food intolerances are generally more about the body’s inability to process a certain component of the food which typically causes a digestive type of response.  Examples of this are “lactose intolerance” in patients who do not do well with certain dairy products because they are not able to break down the large lactose sugar molecule in dairy products due to a specific lack of the reducing lactose enzyme.  Gluten intolerance is another example. The large gluten molecule contained in wheat and other grains is hard for some people to break down and assimilate; this is different than the true celiac disease in which a genetic condition allows the gluten to become a trigger for autoimmune reactions in the gut and elsewhere in the body. Those with symptoms of food sensitivities may experience them chronically. Symptoms may include digestive issues like diarrhea, constipation, bloating, or headaches, migraines, sinusitis, fatigue, skin issues, arthritis, focus and attention issues, irritability, and more. It is also possible to have food sensitivities without noticing acute symptoms.
The inflammation created by the white blood cell response may be occurring, but as more of an undercurrent of inflammation such that symptoms are not always noticeable or detected. The inflammation can impact the immune system, though, and make the sufferer prone to other illnesses and autoimmune diseases.

What Do Food Reactions Have to do With Mold?

How does all of this relate to mold?  There are several different mechanisms to understand.  First, the mycotoxins from molds, whether ingested or breathed, become part of the burden on the gut (the lining of the small intestine) mucous membrane.  Mycotoxins suppress normal immunity of the gut and can decrease pancreatic enzyme production.  Either or both of these situations can allow the formation of more IgG antibodies in response to certain molecules hitting the gut wall.  The result is that certain foods, particularly those eaten frequently or on a regular basis, become triggers for a number of reactions.

In addition,  the tight junctions in the gut can become compromised due to inflammation from mold or other toxins causing a “leaky gut”. Our intestinal lining is vital to our health and is designed to allow vital nutrients into the bloodstream while keeping harmful things out. The term “leaky gut” refers to when larger than normal molecules from foods are allowed the “leak” out and get into the bloodstream before being fully broken down.  The body’s immune system then identifies those molecules as “invaders” and mounts an attack; symptoms then occur. Obviously, getting out of the mold exposure is the number one solution to calm the chronic inflammatory response and allow the body to heal. After that, the problem often lies in identifying the culprit foods.  There are blood tests that can help identify some of the offending foods, like IgG food sensitivity tests or ALCAT testing. Antibody-based food sensitivity tests measure your production of immunoglobulin G (IgG) antibodies to foods. The ALCAT Test, on the other hand, is a leukocyte activation test that analyzes direct, pro-inflammatory cellular responses of the innate immune system. In other words, the ALCAT measures changes in your white blood cells or a cellular immune response when your body is exposed to food antigens rather than an antibody response. A limitation in these tests is that they often will identify foods that are eaten on a frequent or daily basis as problematic. The frequency with which these particular food molecules are exposed to the immune system causes them to invoke a positive IgG response in the testing.  In other instances, the identified problem foods may be something the patient never eats. Thus, the question then becomes, how can a food be a problem if the person never eats it? Sometimes the issue is that the particular food is part of a botanical family that may have similar makeup and may introduce cross-sensitivity to a food that the body does recognize from frequent ingestion and react to. Examples are rhubarb and buckwheat or banana and kiwi.

Inflammation Caused by Certain Foods

Then there is the situation in which intolerances develop that don’t necessarily stimulate the immune response but do create an inflammatory response.   I see this quite a bit with gluten.  We may test and not find a particular immune sensitivity to gluten. Then, celiac disease is ruled out but the patient knows that gluten produces an array of physical symptoms.  Again, the large size of this molecule has the ability to inflame or react in the gut and have a spreading phenomenon throughout the body. In those cases, avoidance, even without test confirmation is best.

Another issue is the production of histamines in the gut which occurs in patients with either a genetic setup for this event or damage to the gut lining. When the gut lining is damaged, this reduces the amount of zonulin, a protein that helps maintain the tight junction between the lining cells of the gut.  I become most suspicious of a histamine issue in patients who have a drippy nose or nasal congestion, itchy skin or rash, or headaches after eating, although it certainly may present with other symptoms.  The use of Histamine Relief can help these symptoms, but the first step is to heal the lining of the gut.

Food Issue Interventions

Regardless of which food problem may be presenting itself, the treatment of any and all of these reactive situations comes back to some basics.  Step one is always, always to avoid the trigger! In other words, if that trigger is mold, get out of the mold!  If your body is continually dealing with the toxic burden of bad air, no diet in the world is going to outdo that! Rather than immediately going to IgG testing, I have found that the removal of the most common inflammatory foods, which are usually either those with the largest protein molecules or the most stimulatory to yeast, can go a very long way in helping patients feel better. Hard though an elimination may be, I find that feeling better helps people stick to it.  Common foods to eliminate to stop reactivity include gluten, dairy, soy, egg in some cases, and sugars.  We term this the “detox diet” and again, the vast majority of patients do very well with this while we are helping clean up and support the gut function.  Cleaning up gut function includes the use of broad-spectrum probiotics, such as Miroflora Balance, to help get the good bacteria into action creating a healthier immune lining of the gut.  Along with IgG Gut Protect, an abundance of healthy bacteria aids in healing leaky gut. Then, the addition of Digest Assist supports the breakdown of foods into their smallest molecular components when the pancreas has become overburdened and overworked. As we have discussed in previous articles digestive enzymes become depleted in times of toxicity in the body, so helping the digestive process with mold-free, effective enzymes to help break down and absorb food can work wonders for many people. This triad is the mainstay of treatment as one is addressing the food problem area of mold-related illness.

Additional Help

If still having problems with foods even with adherence to a detox type of diet there are several next steps, usually done under supervision and recommendations by your practitioner.  Some of my patients have had much success using a 4-day rotation diet.  This process means that you do not eat the same food but every 4 days.  It requires pre-planning and shopping and organization but is quite doable once you get into the swing of it.  The great part about a rotation diet is that it too can help you identify a problem food by keeping a food diary of how you feel and function when eating certain foods.  I won’t go into the full explanation of this here, but perhaps a future article will be on this very subject!

A question I often get is “how long do I have to follow this diet?”  There is no simple answer, but I reply “as long as it takes.” Some patients bounce back and are much better and more tolerant of foods in 3 months.  Others, even after a year or two still find that they have problems when they stray too far off their dietary plans.  This is likely dictated by several factors, including genetics, how clean the indoor environment remains, and if there are other, beneath-the-surface types of burdens that must be dealt with such as dental issues, heavy metal toxicity, or persistent viruses.  This is part of the reason that following up with your practitioner is so very important as you navigate the path to wellness.  It is not always a straight line, much as we wish it were so!

As we begin our entry into the holiday season and food becomes an important focus with friends and family, proceed carefully!  There are so many recipes and products now that can help you avoid the more common problem foods.  The additional stress that holidays bring may put an extra burden on your pancreatic function so don’t forget to support it!  Additionally, all of the other things that help support the body and the immune system will become even more important, so don’t leave them by the wayside or your health will truly suffer. Positive interventions include outdoor time, exercise, quiet time, and good hydration.  And, contrary to popular belief, if you have not delved into the path of a healthy diet to aid with your mold recovery, the time before the holidays is a great time to start. Rather than contributing to the anxiety, overwhelm, and excess that characterizes this time of year, structure with your diet gives you the gift of self-care with healthy, non-inflammatory foods that support your gut so that it can serve you so well and keep you grounded and sane.