Integrative medicine, Mold, Mycotoxins

The Link Between Mold Toxicity and Occult Infections: Functional Medicine Leads the Way

By Jill Carnahan, MD

As clinicians in the field of integrative and functional medicine, we often encounter patients that are frustrated and exhausted from navigating the conventional healthcare system. It has left them with more questions than answers and a slew of unresolved symptoms. Our practices are seeing a growing number of patients with complex and layered conditions, further complicated by an enormous influx of environmental toxins and triggers.

As clinicians at the forefront of “root-cause” medicine, it’s our duty to remain forever students. Educating ourselves on the most up-to-date research and protocols is our best bet in giving our patients a fighting chance. From a clinical standpoint, pinpointing and treating occult infections is inherently complex and challenging. But as our knowledge grows, the way we approach treatment is changing when it comes to conditions such as:

• Lyme disease

• Tick-borne illnesses

• Atypical bacterial infections

• Mycoplasma pneumonia

• Chlamydia pneumonia

• Epstein Barr virus

• Human Herpesvirus

• Parasitic infections

While occult infections and their underlying cause are undoubtedly complex and often multi-faceted, one factor that is garnering more attention is environmental triggers – specifically mold.

Exposure to mold and its metabolites, known as mycotoxins, are of particular concern not only due to their adverse health outcomes but also because they significantly exacerbate and complicate occult infections.

We’re finding that mold exposure and mold-related illnesses significantly impact health and disease states. And more importantly, we’re making strides in learning how to successfully treat patients struggling with these invisible illnesses.

What Does a Patient with Mold Toxicity Look Like?

Patients suffering from toxic mold exposure can have a wide range of clinical presentations. With that being said, some symptoms are more common than others. For example:^1,2

• Fatigue and weakness

• Headaches

• Light sensitivity

• Poor memory or difficulty with word-finding

• Difficulty concentrating

• Morning stiffness and joint pain

• Unusual skin sensations, tingling, or numbness

• Shortness of breath

• Sinus congestion or a chronic cough

• Appetite swings

• Difficulty with body temperature regulation

• Increased thirst

• Increased urinary frequency

• Red eyes or blurred vision

• Abdominal pain or bloating

• Digestive issues– diarrhea, constipation, gas, heartburn

• Metallic taste in the mouth

• Static shocks

• Vertigo

• Sugar cravings

• Frequent infections

In addition, diagnosing mold-related illnesses is made even trickier because patients also display:³

• A generally well appearance

• Sought out multiple practitioners with little results

• On multiple medications or intolerance to medications

• Normal routine lab work

So, it takes a thorough history and physical by a practitioner who knows what to look for to make this diagnosis.

Mycotoxins Effects on Body Systems

Mycotoxins’ impact on the body can vary greatly from person to person. Exactly how mold exposure affects each individual is influenced by a number of factors, including:

• Type of mycotoxin exposure

• Magnitude of exposure

• Method of exposure

• Genetics – in particular, MTHFR and HLA DR

• Age

• Nutritional status

• Immune function

• Presence of other underlying infections

The following body systems are most dramatically impacted by mycotoxin exposure and explains why we see certain clinical presentations: the brain, digestive system, and immune system.

The Brain. Many mycotoxins are known neurotoxins, causing damage to the brain through neuronal damage, chronic activation of inflammatory and apoptotic pathways, hypoactivation of the frontal cortex, and oxidative DNA damage, which disrupts and damages neurons and brain activity.⁴ Because of the powerful impact on the brain, many mold-exposed patients also present with anxiety, depression, PTSD-like reactions, or may even appear similar to a mild brain injury patient.

The Digestive Tract. Mycotoxins are particularly damaging to gut health. The way they impact the gut is threefold. In general, mycotoxins change the structure and morphology of the intestinal epithelium, damaging tight junction proteins and causing increased permeability.^5,6,7 They alter both the abundance and diversity of intestinal microflora. Mycotoxins also significantly reduce mucus production in the intestinal tract. Because gut health and immune system functions are so intricately linked, the damaging effects to the digestive tract negatively impact the immune system.

The Immune System. Depending on the type of mycotoxin and the health status of a patient, mycotoxins can have both an immunostimulatory and immunosuppressive effect. In both cases, either effects cause increased susceptibility to infection, activation of any chronic underlying infections or parasites, and decreased efficacy of vaccines or medications.

The long-term immune system overactivation and low-level inflammation is particularly troublesome when it comes to occult infections – as they cause exacerbation of occult infection symptoms.

Mold Toxicity and Increased Sensitivity to EMFs

Another potential clinical manifestation worth mentioning is mold patients’ increased sensitivity to EMFs. EMFs—the electromagnetic fields emitted by wireless technology—exact mechanism of injury is still up for debate within the scientific community. But it’s strongly suspected that EMF’s damaging effects are primarily due to an increase in free radical concentrations in the body that leads to oxidative stress and genetic damage.

While often difficult to pinpoint due to the abundance of technology and EMFs in our modern world, many patients struggling with mold exposure or underlying occult infections notice a hypersensitivity to EMFs and report a drastic increase and worsening of symptoms when in areas with increased EMF exposure.

Major Sources of Mold Exposure

Exposure to mycotoxins can occur through physical or dermal contact where they’re absorbed through the skin; inhalation when in a home or building with mold growth; and oral ingestion through contaminated food.

Some level of mold and mycotoxin exposure is unavoidable. Mold spores are found naturally in the air, so we’re breathing them constantly. But in our modern world, patients may be exposed to mold at a much higher concentration that becomes toxic. The most prevalent sources of mold exposure that are clinically significant include environmental exposure and mycotoxins in food.

Environmental Exposure to Mold. Most people spend the vast majority of their day indoors—in buildings that may be a breeding ground for mold. With warmth, moisture, and plenty of viable surfaces to grow on, the indoor environment can be the perfect place for mold to thrive. In fact, an estimated 50 percent of all buildings contain mold growth.⁸

Mycotoxins in Our Food. The most common route of mycotoxin exposure is through contaminated food with an estimated 25 percent of all crops containing mold or fungal growth.⁹ Depending on growing and harvesting methods, storage techniques, and/or processing and transportation practices, that number can rise even higher.

Most foods can potentially be contaminated with mycotoxins, but certain food products are more commonly contaminated, such as:

• Wheat derived products

• Cocoa/chocolate

• Coffee

• Fruit juices

• Milk and dairy products

• Vegetable oils

• Ethanol and beer

So, you can see how the average American is exposed to harmful mycotoxins.

Primary Mycotoxins to Be Concerned About

Mycotoxins are produced by a variety of fungal species, have a diverse chemical structure, and cause a broad range of biological effects on the human body. With over 500 species of hazardous molds identified, we’re still learning exactly how dangerous mycotoxins are.

So far, a handful of particularly toxic mycotoxins have been identified and studied, they include the following:¹⁰

• Aflatoxins: Aflatoxins are potent liver toxins and have been linked to cancer, immune suppression, and other “slow” pathological conditions.

• Citrinin: Citrinin is a dangerous nephrotoxin that can cause irreversible damage to the kidneys. It can also act synergistically with other mycotoxins to interrupt RNA synthesis – inhibiting cells’ ability to reproduce.

• Ergot alkaloids: Ergot alkaloids are particularly interesting because their derivatives are used in medications like ergotamine used in the treatment of migraines and bromocriptine used in the treatment of Parkinson’s disease. But when exposed at toxic levels, these mycotoxins cause two forms of ergotism. Gangrenous ergotism impacts blood supply to the arms and legs and convulsive ergotism damages the central nervous system.

• Fumonisins: Fumonisins impact the body’s ability to metabolize sphingolipids, induce neuronal degeneration, induce cellular death, and in high levels can cause death. They have also been linked to infertility.

• Ochratoxin: Ochratoxins inhibit enzymatic reactions and cause widespread oxidative stress. Ochratoxins are known to be neurotoxic, teratogenic, immunotoxic, and genotoxic.

• Zearalenone: Zearalenones, a type of phytoestrogen, leads to significant hormonal imbalance and negatively affects the reproductive system in both men and women.

Keep in mind, these are just the mycotoxins we know about. This area of study is one to follow in the coming years, as we learn how even more classifications of mycotoxins affect our patients.

Treating Patients with Suspected Mold Related Illness

Chronic and complex illnesses such as occult infections and mold-related illnesses are inherently challenging to diagnose and treat. Fortunately, when it comes to conditions that are caused or exacerbated by exposure to mold and mycotoxins, there are simple steps that can drastically minimize exposure.

When encountering patients with suspected mold-related illness, it’s best to take a three-pronged approach of testing, limiting exposure, and detoxing.

Test for Mold Exposure. While there’s no one definitive test, as clinicians, it’s our job to put the pieces of the puzzle together. There are a number of tests that clinicians can use to get a clearer clinical picture and narrow in on a diagnosis of mold exposure. A diagnosis of mold exposure usually requires a combination of diagnostic techniques, including the following:

• A comprehensive medical history.

• A detailed assessment of the patient’s environment, ideally of both present and past. This can also include IEP inspection and Mycometrics ERMI for environmental home testing.

• Diagnostic and laboratory screening tests, including

• Cluster symptom analysis

  • Visual contrast sensitivity test

  • CIRS (TGF-beta, MMP-9, MSH, ADH/Osm, VEGF)

  • Biotoxin mold illness panel

  • HLA-DR mold genetic testing

  • Great Plains MycTox testing

  • RTL Mycotoxin and EMMA testing

  • Vibrant Mycotoxin testing

  • Mymycolab.com

  • Immunolytics

  • EnviroBiomics

  • Mycometrics ERMI

Because many patients will not be aware of how they’ve been exposed, it’s important to educate them of this while you take a detailed history.

Minimize Exposure to Mycotoxins. The most promising aspect of treating patients with mold-related illness is the ability to remove patients from constant levels of toxic exposure through implementing steps such as cleaning up the home environment, following a low-mold diet, and purifying the air.

Often the first step in treating mold patients is to identify any underlying source of mold growth in the home. By eliminating factors that create a welcoming environment for mold and completing a comprehensive mold clean up, exposure levels can be drastically reduced.

A low-mold diet works in a few ways. It eliminates foods that are known to be frequently contaminated with mold, limits sugary foods that fuel mold growth, helps restore any nutrient deficiencies caused by mold exposure, and minimizes pro-inflammatory foods that can cause chronic inflammation.

A low mold diet eliminates processed food and sugars; mold and yeast containing foods (like cheese, dried fruits, or alcohol); and gluten and grains.

Purifying the air is the third step. Indoor air is notoriously polluted – with pollution levels sometimes being up to 10 times more polluted than outdoor air. The simple addition of a high-quality air purifier drastically improves air quality by capturing and neutralizing mold spores before they’re inhaled. To be most effective, air filters should filter at least 0.3 microns in size.

Enhance Detoxification. Removing exposure is the first step in helping patients to identify and recover from mold exposure. But as a clinician, one of our primary focuses is helping patients heal and detox. After extensive research and treating countless patients that have occult infections caused or exacerbated by mold exposure, I’ve developed a very specific mold detox protocol.

A critical part of a mold detox protocol is supplementation to aid the body in eliminating mold and to begin healing underlying damages. The specific supplementation protocol included in my Mold Detox Box is outlined below.

Liposomal Glutathione Complex. A potent antioxidant and liver support blend of

• Reduced glutathione: as the body’s main endogenous antioxidant glutathione is a master detoxifier.¹¹

• A complete suite of B-complex vitamins: to provide support for cellular and hepatic function.

• Nanoparticle milk thistle to stabilize and protect the liver during a time of high activity.¹²

• NAD+: A formulation of Nicotinamide Mononucleotide (NMN) and Trimethylglycine (TMG) to support recovery, energy production, and maximum detoxification through boosting cellular ATP generation and mitochondrial health.

• Essential minerals and trace elements to support electrolyte balance and remineralization during detoxification.

• A blend of bitter herbs, R-Lipoic Acid, DIM, milk thistle, quercetin, and luteolin: these compounds work synergistically to support the liver and gallbladder. They support all phases of detox with special attention to bile flow, while encouraging a healthy inflammatory response.

• Detox binders: these powerful agents are designed to safely ‘catch’ toxins in the GI tract for safe elimination from the body. When taking binders, it can also be helpful to include acacia gum, a prebiotic fiber, and aloe vera to soothe the gastric mucosa and reduce the risk of constipation.

How to Most Effectively Use Detox Binders to Detox from Mold Toxicity

Detox binders are a particularly crucial component of a mold detox protocol. Most patients with occult infections and mold-related illnesses have compromised detoxification pathways and need assistance to effectively process and excrete toxins. Binders are beneficial in helping clear out toxin buildup and inducing biofilm removal in the gut (the protective barrier used by pathogens that set up shop in the body).

Without binders, patients may experience enterohepatic recirculation. This creates a vicious cycle of processing by the liver, reabsorption by the intestines, and then recirculation by the liver. When it comes to detoxing from mold, some of the most effective binders include

• Upgraded coconut charcoal

• Zeolite clay

• Monomethylsilanetriol silica

• Humic and fulvic acid

• Fruit pectin

• Activated bamboo charcoal

I recommend mold patients follow a detox protocol that includes taking binders on a daily basis for a minimum of six to 12 months. In addition to binders, adopting other detoxifying techniques can also be useful in eliminating mycotoxins. Other strategies might include

• Infrared saunas

• IV detoxification therapy

• Dry brushing

• Epsom salt baths

• Mineral or alkaline waters

It is important to guide our patients to what combination of detox strategies are best for them.

An All-In-One Protocol for Comprehensive Mold Detoxification

To obtain all of these critical detoxification compounds, I recommend that mold patients follow a gentle yet comprehensive mold detox program, such as Dr. Jill’s Miracle Mold Detox Box. This all-in-one protocol encourages effective detoxification by combining six targeted formulas. The foundation of the protocol is a formulation that supports the movement and detoxification of mycotoxins from the body with bile-moving bitter herbs, milk thistle, R-Lipoic acid, liposomal glutathione, B vitamins and pure phosphatidylcholine. The inclusion of Nicotinamide Mononucleotide (NMN) plays a crucial role in super-charging mitochondrial health and cellular ATP generation supporting energy, recovery, and maximum detoxification potential. Purified deep sea minerals are included to support remineralization and electrolyte balance during detoxification. To address recirculation of toxins, a full spectrum binder completes phase III of detoxification by ‘catching’ toxins that have been excreted into the GI tract for safe elimination from the body. This easy to follow protocol can be a powerful, effective tool to help patients overcome mold exposure.

Protocol details:

Dr. Shade’s Liver Sauce®

is a blend of bitter herbs, R-Lipoic Acid, DIM, milk thistle, quercetin, and luteolin working synergistically to support liver and gallbladder axis, supporting all phases of detox with special attention to bile flow while encouraging a healthy immune response.

Liposomal Glutathione Complex

is an antioxidant and liver support blend of reduced glutathione, milk thistle, and B vitamins providing powerful detoxification assistance.

NAD+ Gold™

is included to provide regenerative formulation of Nicotinamide Mononucleotide (NMN) and TMG to super-charge mitochondrial health and cellular ATP generation supporting energy, recovery, and maximum detoxification potential.

Ultra Binder® Sensitive Formula

is a powder binder formula supporting phase III detoxification, safely ‘catching’ toxins in the GI tract for safe elimination from the body. The formula includes bentonite clay, activated charcoal, zeolite, and chitosan. Acacia gum is added for its soothing, healing effect, and aloe vera soothes the gastric mucosa reducing constipation which can be common when taking binders.

Quinton® Hypertonic and Isotonic

are nutrient-rich raw marine fluid harvested from protected plankton-rich ocean blooms. Over 78 essential minerals and trace elements support remineralization and electrolyte balance during detoxification. Quicksilver Delivery Systems® utilizes modern science to unleash the curative power of nature. With the world’s most advanced phospholipid delivery systems, Quicksilver Scientific supplements can help to nourish your cells with phosphatidylcholine as they deliver their core effective ingredients faster and more efficiently.

Next Steps in Understanding Mold-Related Illness

While we still have much to learn when it comes to mold and its interaction with other underlying infections, we’ve made great strides in our understanding of how to treat these patients. As our industrial society continues to contribute to the overall toxic burden on the body, I have no doubt that mold-related illnesses and other environmentally triggered illnesses will become more prevalent. And our role in addressing mold exposure will only become more critical as our knowledge of how to diagnose and treat these conditions evolves.

There is a dire need for integrative and functional medicine practitioners well-versed in caring for the patients suffering from these complicated illnesses. I, for one, am dedicated to driving forward with research to find answers and continually improve upon diagnosis and treatment guidelines to serve these patients.

References

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2. Milićević DR, Skrinjar M, Baltić T. Real and perceived risks for mycotoxin contamination in foods and feeds: challenges for food safety control. Toxins (Basel). 2010;2(4):572–592.

3. Hope, Janette. Complete evaluation of mold exposed patients and their environments. Lecture presented: AAEM Dallas 2018.

4. Doi K, Uetsuka K. Mechanisms of mycotoxin-induced neurotoxicity through oxidative stress-associated pathways. Int J Mol Sci. 2011;12(8):5213–5237.

5. Katsuyama A, et al. The Mycotoxin Patulin Decreases Expression of Density-Enhanced Phosphatase-1 by Down-Regulating PPARγ in Human Colon Cancer Cells. Tohoku J Experimental Medicine. 2014; 233(4);265-274.

6. Marin D, et al. Comparative effect of ochratoxin A on inflammation and oxidative stress parameters in gut and kidney of piglets. Regulatory Toxicology and Pharmacology. 2017; 89. 224-231.

7. Akbari P, et al. The intestinal barrier as an emerging target in the toxicological assessment of mycotoxins. Arch Toxicol. 2017; 91. 1007–1029.

8. Indoor Air Quality Scientific Findings Resource Bank. Prevalence of building dampness. https://iaqscience.lbl.gov/dampness-prevalence. Accessed March 2020

9. Liew WP, Mohd-Redzwan S. Mycotoxin: Its Impact on Gut Health and Microbiota. Front Cell Infect Microbiol. 2018;8(60).

10. Bennett JW, Klich M. Mycotoxins. Clin Microbiol Rev. 2003;16(3):497–516.

11. Gaucher C, et al. Glutathione: Antioxidant Properties Dedicated to Nanotechnologies. Antioxidants (Basel). 2018;7(5):62.

12. Yang KY, et al. Silymarin-loaded solid nanoparticles provide excellent hepatic protection: physicochemical characterization and in vivo evaluation. Int J Nanomedicine. 2013;8:3333–3343.