April 24, 2017
By Connie Strasheim
Editor’s Note: I am very happy to see that issues related to mold toxicity have finally started to receive some attention in the Lyme community and that at least a few Lyme Literate MD’s have stated to bring up mold issues to their patients. Connie Strasheim profiles four doctors who have been especially proactive in her new book, New Paradigms in Lyme Disease Treatment, and excerpts from the interviews are included in this article. A version of this article previously was published on ProHealth. Thanks very much to those at ProHealth for helping to draw attention to the topic of environmental mold toxicity! -Lisa Petrison, Ph.D.
I was diagnosed with Lyme disease in 2005 and but hadn’t really considered treatment for mold at that time, even though it occurred to me that I might not just be battling infections.
I had grown up in a home that had been damaged by water leaks, then spent a couple of years in a very humid, wet climate (Costa Rica).
Then I was exposed to even more mold after the house where I was living in 2015 was poorly remediated.
It was that last exposure that sent me spiraling into an array of M.S.-like symptoms.
In early 2016, I became dizzy, uncoordinated, fatigued, brain fogged, depressed, and unable to walk straight. These symptoms lasted for many months.
I am still doing treatment for mold toxicity, but I have improved significantly after moving out of the moldy house last November and embarking upon a solid mold treatment program.
My treatment program includes bentonite clay to bind the mycotoxins; Nystatin, Sporanox (Itraconazole) and colloidal silver to treat mold in the gut; several nasal sprays including colloidal silver, ketoconazole and EDTA/gentamicin/mupirocin to treat mold in the sinuses and the biofilm there; and a good probiotic.
Fortunately, the Lyme infections haven’t reappeared to cause me problems during this time, which I’m thankful for, and I’m now well on my way back to being functional again.
Yet my experience with mold has taught me that it’s something that any of us who are battling a chronic health condition would be wise to consider as a potential cause of our symptoms.
One thing that I have observed in talking to doctors about this topic is that there is not yet agreement about the best way to treat mold toxicity. Mold or mycotoxin illness is still a relatively newly recognized problem within medicine, and it seems that there is no one-size-fits-all treatment that works for everyone or that has become the established standard of care for patients with mold illness.
Nonetheless, I have observed that some of the best doctors have treatment approaches that have certain elements in common.
For instance, many agree that it’s important to not only treat the live mold in the body, but also bind the toxins that it produces. Treating mold in both the sinuses and gut is especially important since mold likes dark, warm, moist environments.
Thankfully, many more integrative and functional medicine doctors are learning to appreciate, recognize and treat mold toxicity, especially in patients who have also been diagnosed with other conditions such as Lyme disease, chronic fatigue syndrome and fibromyalgia—among others.
And I am thankful for doctors like those profiled in my book, who have openly shared in their interviews with me about how to effectively diagnose and treat mold toxicity, based on their experience with thousands of patients.
I believe that as more and more of us become aware of this major contributing factor to chronic illness, we will see greater strides in our recovery.
The rest of this article consists of some excerpts from my book New Paradigms in Lyme Treatment, in which four Lyme-literate physicians share insights and/or their approach to mold toxicity in patients that also have Lyme or other chronic diseases.
(Editor’s note: The following information is copyrighted and may not be reproduced without the permission of Connie Strasheim.)
Dr. Wayne Anderson, N.D.
First is Dr. Wayne Anderson, a naturopath who has been treating Lyme for over 25 years has observed certain symptom patterns in his patients that have mold toxicity.
In the book New Paradigms in Lyme Disease Treatment, Dr. Anderson states:
“Mold illness is a common co-condition in people with Lyme disease, but the medical community has generally underappreciated its effects upon the brain and immune system. Mold affects the body in the same way as the bacterial infections that I have so far described, in that its toxins stick to the surface of the cells and are absorbed into the cells, where they cause inflammation and cellular dysfunction.
“The organs and systems that are most affected by mold are the self-regulating systems of the brain and nervous system, as well as the endocrine, gastrointestinal and immune systems. Lyme and mold affect the immune system in the same way, and when one of these conditions is present in the body, the body becomes more susceptible to the other. In addition, 23 percent of all people have a genetic susceptibility to mold illness that can be determined by doing certain lab tests (more on this later).
“People who have been exposed to mold will be affected by the mold in a couple of different ways. Some lucky people, whenever they are exposed to a moldy environment, will have an immediate immune reaction; they will feel dizzy and spacey and quickly learn that they need to get out of the moldy environment. A second group of people will be less aware that they have been exposed to mold, and the spores that they inhale will stick to the mucus membranes in their sinuses, lungs and gut, and colonize there. If this latter group has a genetic susceptibility to mold, they will have a greater chance of getting symptoms from mold exposure.
“Mold and biotoxin expert Ritchie Shoemaker, MD, has established a set of criteria that doctors can use to determine their patients’ susceptibility to mold illness. One of these involves evaluating a certain HLA DRB gene pattern, the testing for which is done by Lab Corp.
“Mold toxicity is important for people with Lyme and their doctors to understand because it can cause serious illness and compromise recovery from Lyme.
“A healthy immune system and body that are not genetically susceptible to mold are designed to ‘zap’ the mold upon its entry into the body so that it cannot colonize there, but in certain immune-compromised people, it is able to colonize. Once this happens, it’s very hard to dislodge. Once it’s in the body, it produces toxins, called mycotoxins, which inflame the body.
“Over time, the mold takes over increasingly greater areas of mucous membrane in the body and always ends up finding its way to the bowel. The bowel is dark, moist and nutrient-rich, making it a hospitable place for mold to grow. And the more compromised and damaged the good bacterial community (microbiome) on the endothelial lining of the bowel is from Lyme and other factors, the easier it will be for the mold to expand its territory there.
“Anytime the mucus membranes of the body are inflamed, whether in the nose and sinuses, gut, lung, bladder lining, skin or the vagina, mold colonization should be suspected. The person who is unlucky enough to have high mold toxin levels will have symptoms that can be difficult to differentiate from those of Lyme disease. Like Lyme toxins, mold toxins stick to the cell membranes and then ooze into the cells, where they accumulate and add to the body’s cellular compost heap.
“Mold organisms cannot live just anywhere in the body though; they are confined to the mucous membrane surfaces, and it is their waste products, or the mycotoxins, that enter the bloodstream and cause systemic symptoms. Consequently, the symptoms of mold toxicity are not as dynamic and variable as those caused by the adaptive Lyme microbes. Instead, they are more dull and flat. So if patients have see-saw symptoms—meaning, they get better for a while, then get worse, or have two or three good days, followed by three weeks of feeling terrible—then their symptoms are less likely to be mold-related.
“In people who are predominantly battling mold toxicity, every day is the same; they struggle to get through the day and have low energy and a mild amount of brain fog. This pattern is fairly consistent. Mold also affects the brain and nervous system, so people with mold illness will have specific neurological symptoms. Neuropathies (damage or problems with the nerves) are common. Symptoms may include numbness or tingling in the hands and feet. Mold toxicity also causes a lot of depression, so when people have a Herxheimer reaction from mold detox (removing cellular mold with toxin binders and other therapies), depression may intensify along with other mold symptoms.
“Mold symptom patterns can vary and are always worse during wet or humid seasons when mold thrives. Remember, the effects of neurotoxins are additive and cumulative. So, when brain fog or another mold symptom is added to the brain fog caused by Babesia, Bartonella, heavy metals, petrochemicals or Borrelia, the effects of each organism or toxin may compound those of the others. So, people with significant brain fog probably have more than one factor or infection causing that symptom.
“For more information on mold, see: Survivingmold.com, as well as some of the other chapters in this book, which describe mold and mold treatment in greater depth.”
Dr. Dietrich Klinghardt, M.D., Ph.D.
In New Paradigms in Lyme Disease Treatment, integrative doctor Dietrich Klinghardt shares information about how electromagnetic pollution causes mold to grow faster and become more virulent in the body.
His excerpt illustrates how the environment in which we live (beyond just avoiding a mold-infested home) plays a major role in our recovery.
Says Dr. Klinghardt:
“The negative effects that EMF’s have upon the body are cumulative and twofold. First, EMF’s—particularly the microwave radiation from cell phones and cell phone towers—are highly immunosuppressive. Secondly, electromagnetic pollution drives the growth of microbes within the body, so that, as if anticipating their own death, these microbes replicate much faster and produce more virulent toxins.
“A Swiss mold researcher once conducted some simple experiments to measure the virulence and prevalence of mold and mold toxins (mycotoxins) in high EMF environments. He exposed molds to a Wi-Fi router and found that the production of mycotoxins was dramatically increased by the energetic frequencies. The virulence of the toxins also increased 600-fold. That means that not only did the mold and mycotoxins multiply more rapidly, but they also became much more potent in the presence of EMFs. There’s an increasing body of research that links many chronic illnesses to microwave and radio wave exposure.”
He goes on to say:
“Of course, there are different types of mold and mycotoxins, and the virulence and pathogenicity of mold varies, in part, according to the environment in which it is found. For example, the Swiss researcher found that aflatoxins can exist in the body in an in-between state, in which they are neither very pathogenic nor benign, or they can become absolutely cancer-causing and devastating to the body, especially when exposed to EMFs.”
Dr. Klinghardt uses the ozonated plant oil Gamma O3 as part of his mold treatment protocol. This is an ozonated oil blend that also has multiple anti-parasitic and anti-bacterial properties. A typical dosage is 10 drops, 3 times daily. Gamma O3 can be purchased at: SophiaNutrition.com.
Dr. Neil Nathan, M.D.
Dr. Neil Nathan is another Lyme and mold specialist featured in New Paradigms in Lyme Disease Treatment.
Dr. Nathan has published his own book on mold treatment, called Mold and Mycotoxins.
This book is a good primer for anyone who is just learning about mold and doesn’t have the energy or mental capacity to read a huge book, since it is relatively short.
Dr. Nathan has found that most people with Lyme disease also have mold toxicity, which begs the question—how many people with mold might also have Lyme?
In New Paradigms in Lyme Disease Treatment, Dr. Nathan says:
“Often, mold toxicity causes patients to develop symptoms from Lyme infections and vice versa, and people with weakened immune systems are far more susceptible to sickness from mold. So mold is a huge issue, and doctors are just beginning to understand and explore it, and like Lyme disease, many conventional physicians are not even aware of it.”
Dr. Nathan has also found symptoms of Bartonella, a common Lyme disease co-infection, to be similar to those of mold toxicity, which can complicate diagnosis.
“One major challenge of diagnosing based on symptoms is that symptoms of some infections, especially Bartonella and mold toxicity, are almost identical, and many patients have both of these. Even though Bartonella is an infection and mold is a toxin, they produce a nearly identical cascade of cytokines, or inflammatory markers in the body. This means that they cause identical symptoms so distinguishing between them is tricky.
“That said, there are some symptom clues that I find helpful for determining which infection is primary or currently most active in the body. For instance, if a patient has intense anxiety or depression, to the point of despair, and mood swings are a major issue, then it’s not likely that Borrelia is currently the main layer of infection, or the major infection that the body is currently dealing with. Rather, the symptoms indicate Bartonella infection or mold—or all too often, both infections.
“I treat my patients’ infections one at a time. This is because, first of all, I see the most sensitive of sensitive patients, most of whom are not capable of doing more than one treatment at a time, because they can’t physically handle it. If mold is a major problem and increasingly becoming so, I will treat mold before the Borrelia and other Lyme-related infections because it’s difficult to eliminate the Lyme infections if there are mold toxins present in the body.”
Dr. Nathan advocates Real Time Laboratories’ mycotoxin test as the best test for mold toxicity. This simple test looks for several types of mold toxins, or mycotoxins, in the urine. Dr. Nathan believes that the test is very clinically useful for identifying mold toxicity, but it must be ordered by a healthcare practitioner. For more information, see: RealTimeLab.com.
In New Paradigms in Lyme Disease Treatment, Dr. Nathan also shares, in basic terms, his approach to mold treatment. He states:
“Mold treatment requires a threefold approach. First, I have my patients test their home, workplace and car to make sure that there is no mold in these places. If there is, it will be difficult for them to get well, and they will need to either get that mold removed or move, depending upon the extent of the exposure and damage.
“Secondly, I give them specific toxin binders to pull the mold toxins out of their body. I like the urine mycotoxin test by Real Time Laboratories, Inc. because it will tell me exactly which mycotoxins are present, which then allows me to be more targeted in my treatment approach. This is because certain toxin binders work better for some types of mold toxins than others.
“For instance, if a patient has ochratoxin as a primary toxin, then the medications cholestyramine or Welchol® will be the best binders for this type of toxin. If a patient has aflatoxins or tricothenes, then chlorella, activated charcoal and bentonite clay are the best binders for these. If patients have all of the mycotoxins, then they would want to use all of these binders. Once we know which toxins are primary, we can be more specific about which binders to use.
“Mold toxin binders are typically taken once daily. The key with mycotoxin binder dosing is to find a dose that the patient can tolerate. For instance, mold expert Dr. Shoemaker advocates cholestyramine dosages that are often much higher than what my patients can tolerate. He often typically recommends a single scoop (which is 1¾ teaspoons) four times daily. Most of my patients could not handle that. In fact, I might start patients who are highly sensitive and toxic at just 1/16 teaspoon once daily or every other day.
“My approach using the other binders is similar. So for instance, even though the recommended dosage for chlorella is 15 tablets twice daily, I have almost no patients who can tolerate that much chlorella. So I might give them ¼–½ tablet once daily, or even once every 2–3 days. Keep in mind that my patients are among the sickest and most sensitive, so Lyme doctors who are also treating their patients for mold may be able to give them higher dosages. I have found that if I start my patients out on a too high of a dosage, they will simply get sicker. They will mobilize more toxins than their bodies are able to eliminate, and they will get worse. Doctors and patients can’t just ‘bull’ their way through treatments, as it’s simply counterproductive.
“Third, it’s important to not only bind the mycotoxins that mold produces, but also kill any mold that may have colonized in the body. Mold experts believe that the sinuses and gastrointestinal tract are the main reservoirs, or places, where mold colonizes. Mold has a particular affinity for the gut and sinuses, so it’s especially important to treat any mold there. This was one of the biggest discoveries that mold expert Joseph Brewer, MD, made several years ago. So even if you aren’t living in a moldy environment, if you have been exposed to mold in the past, then you may still be wrestling with mold on an ongoing basis because the mold in your sinuses and gut continue to produce toxins. This is why treating the sinuses and gut area is so important.
“I use antimicrobial nasal sprays to treat mold in the sinuses and other treatments to treat mold in the gut. The nasal spray that I use will typically be based on the patient’s level of sensitivity. If a patient is fairly strong, I might use amphotericin B nasal spray, although only 40 percent of my patients can tolerate this spray. If they are not as robust—but not too sensitive either—I will use ketoconazole spray. If they are really sensitive, I will have a compounding pharmacy create a Nystatin spray.
“People with mold toxicity also typically have an antibiotic-resistant staph infection in their sinuses called MARCoNS (multiple antibiotic resistant coagulase negative stapylococci) that resides deep within the sinus cavity. These bacteria form biofilms that shield it and the mold from treatments.
“To treat MARCoNS and the biofilm, I prescribe my patients BEG spray, which can be obtained at some compounding pharmacies, such as Woodland Hills Pharmacy (see: WoodlandHillsPharmacy.com). BEG spray contains Bactroban (Mupirocin) 0.2%, Ethylenediaminetetraacetic acid (EDTA) 1% and Gentamicin 0.5%). Alternatively, some compounding pharmacies can compound a chelation spray that contains a variety of agents to break up biofilms. In addition to the antifungal nasal sprays and materials that dissolve biofilm, we also use hydrosol (colloidal) silver as a nasal spray.
“To treat mold in the gut, we give our patients colloidal silver, specifically, oral Argentyn 23, along with a supplement that contains EDTA, which helps to dissolve biofilm in the gut. We use two products in particular: InterFase Plus by Klaire Labs or Beyond Balance’s MC-BFM-1 for this. For more information, see Klaire.com and BeyondBalanceInc.com.
“Along with these products, we will use small dosages of Sporonox® (itraconazole) as the primary agent to kill mold in the gut, depending on our patients’ ability to tolerate it. For my most sensitive patients, the dosages are very small, perhaps one 100 mg capsule of Sporonox every two weeks, and if they can handle more, we will slowly work them up to 1 capsule per day. Dr. Brewer gives his patients up to two capsules of Sporonox twice daily, but I have found that the most effective dosage varies tremendously based on patient sensitivity.
“Mold treatment can be complicated, but the protocol that is outlined here, which was created by Dr. Joseph Brewer in Kansas City, is effective for treating mold toxicity.”
Dr. Raj Patel, M.D.
Finally, Raj Patel, MD shares a similar perspective to that of many other Lyme-literate doctors in that he believes that mold toxicity is a common condition found in people that battle Lyme disease and some other chronic diseases.
In the following excerpt from New Paradigms in Lyme Disease Treatment, he shares his perspective on mold illness and some additional insights on diagnosis and treatment.
“One of the least recognized causes of inflammation and compromised immune function in people with Lyme disease is mold and mycotoxins (mold toxins), along with other inflammatory agents. These accumulate in the body when people are exposed to a moldy environment caused by water damage, either at home or at work. People who have a genetic aberration that prevents them from effectively removing mold toxins are more likely to get sick. If such people are regularly exposed to water-damaged buildings, toxins will build up in their tissues and organs over time and trigger a chronic inflammatory response. This inflammatory response can lead to a compromised immune system and create havoc with the body’s hormonal system.
“Increasingly, I am finding that many people with Lyme disease are also simultaneously sick from mold. In general, I’ve found that if routine antimicrobial treatments for Lyme disease are not sufficient, then it is sometimes because the patient has mold illness. I suspect that at least half of all cases of unresolved Lyme disease are due in part to mold illness.
“Whenever people have both mold illness and Lyme, it can be an uphill battle to treat Lyme, unless the mold toxins are addressed first. I have seen patients who have been on antibiotics for two to five years—or even longer—who are still unwell. Treatment for Lyme microbes shouldn’t take that long. This is because, unbeknownst to their doctors, they are concurrently being exposed to mycotoxins and other dangerous compounds from water-damaged buildings.
“The challenge for doctors and patients is to identify all of the potential factors that are blocking recovery. If, as a doctor, you have addressed all of your patients’ issues upfront (which is often easier said than done), it shouldn’t take more than a few years to effectively treat them for Lyme.
“It is nearly impossible to differentiate symptoms of mold and mycotoxin illness from those of Lyme disease because the biotoxins from each trigger the same inflammatory pathways in the body and can cause similar symptoms. For instance, brain fog, joint pain, fatigue, paresthesias (sensations of burning, tingling and numbness) and intestinal inflammation, among other symptoms, can all be caused by both mold and Lyme disease infections.
“When physicians take a detailed history on their patients, it is critical for them to evaluate them for certain risk factors related to mold exposure. For instance, I might ask my patients if there are any obvious signs of water damage or mold in their home or workplace, and/or if they have been exposed to a water-damaged building in the past.
“In addition, I also order lab tests. One of the most effective tests for evaluating biotoxin illness is the HLA DRB/DQ panel. In his work on mold illness, Ritchie Shoemaker, MD, has discovered that certain variations in the HLA DRB/DQ genes are associated with a genetic inability of the immune system to remove mold toxins. People who have these variations in their genes are therefore more susceptible to mold illness. This test can be ordered through LabCorp as well as through many other laboratories.
“Another blood test that I recommend is called C4a. C4a is an inflammatory marker that is almost always elevated in people with mold illness. Normal C4a values (when the test is done through Quest Laboratories) range from 0 up to about 2,800. In a person with purely Lyme disease-related infections, the C4a may go up to about 10,000. If the numbers are even higher than that, there is a strong possibility that the person has mold illness or chronic viral infections—or both, in addition to Lyme disease. However, a C4a value of less than 10,000 does not preclude or rule out mold and/or viral illness.
“If I suspect that my patients have mold illness, I will then have them test their home for water damage by performing an Environmental Relative Moldy Index (ERMI), a convenient at-home mold test. I commonly use Mycometrics Labs for this purpose. For more information, see: Mycometrics.com.
“The ERMI test is simple to do. You simply take a dust sample from 8–10 household surfaces that don’t normally get ‘disturbed’ by activity and which have been accumulating dust for about 4 weeks. The laboratory then analyzes the samples for 36 strains of fungal DNA that may be potentially harmful to humans.
“If ERMI test results indicate that there could be significant moisture damage in the home, and patients’ test results and symptoms are consistent with mold illness, then this means there is a very strong possibility that their current living environment is making them sick.
“The next step is to perform a series of C4a tests to determine whether the mold illness is due to a current or past exposure of mold from the home or workplace, and to determine whether patients are currently reacting to mold in their home/office environment. The testing process is as follows:
“1) First, I order a baseline C4a test to determine patients’ current level of inflammation.
“2) I then give them a mycotoxin-binding medication called cholestyramine, which is typically prescribed to lower cholesterol in the body but which also binds mycotoxins in the gut. I find that if my patients’ elevated C4a is the result of mold illness, then taking high doses of cholestyramine for three to four weeks will significantly reduce their C4a value. It is important that patients do this under physician supervision.
“3) After the second set of C4a tests are completed, I will ask my patients to stop taking cholestyramine for four to five days. During this time, they must stay at home and avoid being exposed to any other indoor environments. They can go outside, but they can’t go to any other building, whether a restaurant, store, etc.—even for just 5–10 minutes.
“4) After those four to five days, we repeat the C4a test. If my patients’ test numbers rise again and are higher than their second set of test results, then it means that they are having an inflammatory response to their home environment. If their C4a test results stay the same or are lower than their last result, then it means that they are likely not reacting to their current living environment. The source of mycotoxin exposure is either elsewhere or due to a prior mold exposure.
“So by doing a series of C4a tests, doctors can discover whether their patients are currently being exposed to mold and mycotoxins or whether their mold illness is the result of a prior exposure to mold.
“A third test that I sometimes use to confirm biotoxin illness in my patients is an MRI of the head (without contrast) using a global NeuroQuant® analysis. This test utilizes special volumetric software, called NeuroQuant, to measure the size of each regional brain structure. Dr. Ritchie Shoemaker discovered that there’s a very unique ‘fingerprint’ on the brain in patients with mold illness that can be detected on the MRI. Specifically, the MRI will reveal that certain parts of the brain have enlarged while others have atrophied, due to the inflammatory response. Lyme disease, on the other hand, produces a very different ‘fingerprint,’ or brain pattern, on the MRI. The results of this test can help me to determine whether the primary source of inflammation in the patient’s body is due to mold or Lyme disease.
“So these are some of the tools that I’ve found valuable for determining whether the primary cause of my patients’ symptoms are due to Lyme infections or mold, although most often, I find that they are caused by both.”
About Connie Strasheim
Connie Strasheim is the author or co-author of 11 wellness books, including the recently released New Paradigms in Lyme Disease Treatment: 10 Top Doctors Reveal Healing Strategies that Work (October 2016) and Beyond a Glass of Milk and a Hot Bath: Advanced Sleep Solutions for People with Chronic Insomnia (March 2017).
She is also a medical copywriter and an editor at ProHealth.com, as well as Editor of the Alternative Cancer Research Institute (ACRI).
Her passion is to help people with complex chronic illnesses find freedom from disease and soul-spirit sickness using whole body medicine, and she collaborates with some of the world’s best integrative doctors to do this.
In addition to Lyme disease and insomnia, Connie’s books focus on cancer, nutrition, detoxification and spiritual healing.
To learn more about her work, see: www.ConnieStrasheim.org.
From Paradigm Change
Limitations of the RealTime Labs test are discussed in the Paradigm Change blog article “Looking at the Literature About Mycotoxin Urine Tests.”
A wide range of treatments for mold-related illness is discussed in the Facebook group Mold Avoiders, which now has more than 7000 members.
Information relevant to those pursuing mold avoidance is discussed in the book A Beginner’s Guide to Mold Avoidance, written by Lisa Petrison and Erik Johnson. It is available for free in PDF format for those who sign up for occasional emails on mold avoidance topics from me. It is also available as an Amazon Kindle book.
For updates on additional information about recovering from mold-related illness, sign up for occasional newsletters from Paradigm Change. You also will receive a free copy of the book Back from the Edge, which provides information about the extraordinary life of mold avoidance pioneer Erik Johnson.
The Paradigm Change Publishing page of the website provides information about a number of additional books of interest to those pursuing mold avoidance.
Find out about new information about recovering from chronic illness and living a healthful lifestyle by liking the Living Clean in a Dirty World page on Facebook.
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