Here’s what you need to know about testing and diagnosing mold exposure.
Mold Toxicity Series: Symptoms and Extensive Testing Overview- Part One
By Dr. Angila Jaeggli, ND
Most people are unaware that significant mold exposure and toxicity can cause serious illness, or exacerbate the symptoms from another chronic illness (such as worsening of autoimmunity). The symptoms can seem very non-specific, such as chronic fatigue, foggy brain, cognitive slowing, and generalized aching, to name a few. As functional medicine physicians, we include testing for current and past mold exposure as part of our chronic illness work-up, and often find that people are walking around with high levels of mold toxins in their system.
This is the first part of a 3 part series on how we begin to assess and diagnose mold exposure and toxicity, and once diagnosed, how we begin our extensive healing protocol to detox mold from the system (part 2 & 3).
Let me begin with a patient story of what mold exposure can look like. Carrie (not real name), a 60 year old woman, came to us with brain fog, memory decline, significant chronic fatigue, and aching joints. What was unusual is that 2 years ago, she felt great, and was a super active woman who had energy to spare. The only change that had occurred was that they had moved into a different house 2 years ago. There was some mold in a closet that they thought had been dealt with, but it had not. Two years later, mold spores were in their clothes, furniture, and rugs and it was draining the life out of our patient. What is interesting about mold toxicity, is that due to our individual detoxification and genetic pathways, not everyone reacts the same to exposure. Her husband was a little tired, but hadn’t gone through the cognitive changes like she had. Now that mold has been identified, they have moved out, gotten rid of the mold infested items, started our mold treatment protocol, and she is beginning to feel clear-headed again, and her energy is beginning to rise.
Symptoms that can be associated with mold toxicity are as follows:
- Psychiatric – anxiety, fear, panic attacks, mood swings, irritability, anger, OCD, reduced ability to cope with stress, hallucinations, and suicidal thoughts
- Cognitive – decreased short-term memory, difficulty concentrating, difficulty learning new information, word-finding difficulty, reduced ability to plan and execute, lack of motivation, brain fog, and Alzheimer’s dementia
- Musculoskeletal – muscle aches, sharp shooting pain, joint pain, morning stiffness
- Cardiovascular – palpitations, vasculitis, edema
- Fatigue and chronic fatigue syndrome
- Respiratory – shortness of breath, chronic cough, sinus congestion, nasal drip
- Neurological – headaches, migraines, tremors, vertigo, seizures, burning along the spine, sensitivity to light, sensitivity to touch, numbness and tingling, sense of internal vibration
- Digestive – abdominal pain, diarrhea, appetite swings, nausea
- Eye tearing and itching
- Multiple chemical sensitivity (MCS) and EMF sensitivity
- Mast Cell Activation Syndrome (MCAS)
So, if you are suspicious that you have had or are having mold toxin exposure, the first step is to 1) test your environment, and 2) test yourself.
For assessing your home or work, one of the top ways to begin is with a home (or work) ERMI test.
What Is ERMI? The Environmental Relative Moldiness index (ERMI) was developed by the U.S. Environmental Protection Agency, Office of Research and Development (ORD) as a research tool to investigate mold contamination in homes. The methodology is based on using mold-specific quantitative polymerase chain reaction (MSQPCR) to quantify 36 molds and calculate an index number for comparison with a database of reference homes. Eurofins EMLab P&K was one of the first collaborators to help establish the reference database and continues to offer this service to clients for the identification of mold problems in some buildings.
Many times we recommend hiring a specialist to come in and evaluate your home (or work). In the Seattle area, we send people to a trusted mold inspector: Jason Kester – https://kesterclear.com/.
We recommend finding a person or agency that only does the testing, so that there is no incentive to give you treatments that are not necessary.
Once your environment has been tested, a good next step is to complete a challenged Urine Mycotoxin test. By ‘challenged’ I mean encouraging and moving the toxins from your body to be able to get an accurate assessment of your toxin levels. Ideally we do this through an IV glutathione push, but it can also be done by several sessions of infrared sauna, along with oral glutathione before collecting your urine.
We like Great Plains Laboratory’s Urine Mycotoxin test: https://www.greatplainslaboratory.com/gplmycotox
We are currently measuring 11 different mycotoxins in our test from a wide variety of 13 mold types (genera) including Aspergillus, Penicillium, Fusarium, Myrothecium, Stachybotrys, Bipolaris, Gibberella, Chaetomium, Trichoderma, Trichothecium, Cephalosporium, Verticimonosporium, and Monascus.
Other lab tests can be run through our standard Quest and Labcorp labs, many of which can be sent through insurance (keeping in mind, being subject to your insurance deductible). Here is the list of lab tests that we consider when we feel a patient has been or is being exposed to mold toxins and is experiencing symptoms:
Recommended lab tests for mold exposure, and the value we tend to see with exposure (Low/High):
- C3a – Low, C3a is used as an inflammatory marker. High levels indicate specific immune- or inflammation-related health problems. C3a levels will be high in Lyme disease but remain low in “mold illnesses”.
- C4a- High -C4a has become the inflammatory marker of greatest significance looking at innate immune responses in those with exposure to Water Damaged Buildings (WDB).
- The complement system is a group of proteins that move freely through your bloodstream. The proteins work with your immune system and play a role in the development of inflammation.
- Each complement activates inflammatory responses, with spillover of effect from the innate immune response to acquired immune response and hematologic parameters.
- These short-lived products are re-manufactured rapidly, such that an initial rise of plasma levels is seen within 12 hours of exposure to biotoxins, and sustained elevation is seen until definitive therapy is initiated.
- TGFB-1 – High, TGF Beta-1 is a protein that has important regulatory effects throughout innate immune pathways. This protein helps control the growth and division (proliferation) of cells, the process by which cells mature to carry out specific functions (differentiation), cell movement (motility), and the self-destruction of cells (apoptosis). Neurologic, autoimmune and many other systemmic problems also are found with high TGF Beta-1.
- VIP – Low, -Vasoactive intestinal polypeptide (VIP) is a neuroregulatory hormone with receptors in the hypothalamus. This hormone/cytokine regulates peripheral cytokine responses, pulmonary artery pressures, and inflammatory responses throughout the body.
- Low VIP levels are present in mold illness patients. This leads to unusual shortness of breath, especially in exercise. To date, every multiple chemical sensitivity patient Shoemaker has seen (over 500) have had low VIP. VIP plays a role similar to MSH in regulating inflammatory responses.
- MSH -Low, Alpha melanocyte stimulating hormone (MSH) has multiple anti-inflammatory and neurohormonal regulatory functions, exerting regulatory control on peripheral cytokine release, as well as on both anterior and posterior pituitary function.
- In mold illness, MSH will be too low in over 95% of patients. This means increased susceptibility to mold illness, ongoing fatigue, pain, hormone abnormalities, mood swings, and much more. MSH is a hormone, called a regulatory neuropeptide, and it controls many other hormones, inflammation pathways, and basic defenses against invading microbes. Without MSH, bad things happen; chronic sleep disorders with non-restful sleep develop, and endorphin production is reduced, so chronic pain follows.
- MMP-9 – High, Biotoxins can cause cytokines to become elevated resulting in the release of MMP-9 from neutrophils and macrophages. This cytokine is a marker to tissues inflammation. Matrix Metalloproteinase-9 allow inflammatory mediatory to migrate through tissues in response to cellular mediators. It breaks down the extracellular matrix and helps to propagate an inflammatory response. Elevated levels are seen in CIRS, but it is also elevated in the lungs of asthmatics.
- ADH/osmolarity -Antidiuretic hormone is crucial in regulating the body’s blood concentration of electrolytes, known as osmolality.
- VEGF – Low, measures the amount of vascular endothelial growth factor (VEGF) in your blood. VEGF is a substance that helps encourage the growth of new blood vessels. Your body makes more VEGF in certain cases. Vascular endothelial growth factor (VEGF) is a substance made by cells that stimulates new blood vessel formation and increases blood flow in the capillary beds. VEGF is a polypeptide. Deficiency of VEGF is quite common and is a serious problem in biotoxin illness patients that must be corrected. If you don’t have blood flow, cells begin to starve and don’t work properly.
- Androgens – Low, Ideally, the dysregulated gonadotropins, ACTH, cortisol and testosterone will be corrected as the biotoxin treatment is implemented in a stepwise process. However, this does not always occur. A low MSH will disrupt the typical fluctuations of LH and FSH and the androgens. With an elevated aromatase activity typical in CIRS, just giving testosterone can result in elevated estrogen levels. Part of the protocol is checking a full hormone panel to allow a full view of the steroidogenic pathway. This includes: free and total testosterone, estradiol, estrone, SHBG, LH, FSH, DHEA, DHEA-S and pregnenolone.
- Gliadin Ab (Celiac/Gluten sensitivity)
- Leptin – High, Leptin turns on how tightly the body holds onto fatty acids. When Leptin is high, one holds onto fatty acids and stores them in fat. This leads to rapid weight gain, and because of the high Leptin, standard approches to weight loss like eating less and exercising more will fail. The inflammatory responses that causes Leptin levels to rise lead to patients who are chronically tired, in chronic pain, and forever overweight.
HLA DR – Your Genes
- Human Leukocyte Antigens (HLAs), are found on the surface of nearly every cell in the human body. They help the immune system tell the difference between body tissue and foreign substances.
- The immune response genes are found on chromosome six. Patients could have two alleles, copies of genes (for each gene, one allele is inherited from a person’s father, and the other is inherited from a person’s mother), out of approximately 10 possible, as part of their genotype. Based on Dr. Shoemaker’s data, in normal populations compared to international registries of gene frequencies of HLA DR, we know the frequency of mold illness-susceptible patients approximates 24% of the normally distributed population. Almost a quarter of the normal population is genetically susceptible to chronic mold illness. Three quarters are not.
| DRB1 | DQ | DRB3 | DRB4 | DRB5 | |
| Multisusceptible | 4 | 3 | 53 | ||
| 11/12 | 3 | 52B | |||
| 14 | 5 | 52B | |||
| Mold Susceptible | 7 | 2/3 | 53 | ||
| 13 | 6 | 52A, B, C | |||
| 17 | 2 | 52A | |||
| 18* | 4 | 52A | |||
| Borrelia, post Lyme Syndrome | 15 | 6 | 51 | ||
| 16 | 5 | 51 | |||
| Dinoflagellates | 4 | 7/8 | 53 | ||
| Multiple Antibiotic Resistant Staph Epidermis (MARCoNS) | 11 | 7 | 52B | ||
| No recognized significance | 8 | 3, 4, 6 | |||
| Low-risk Mold | 7 | 9 | 53 | ||
| 12 | 7 | 52B | |||
| 9 | 9 | 53 | |||
We would love to create a personalized plan for you for your health and wellness journey! Please reach out if you have questions or want to share your story!
In love, health and light,
Dr. Angila Jaeggli, ND
Phone: (425) 835-0359
Sage Integrative Medicine Clinic, PLLC
110 James Street, Suite 103
Edmonds, WA 98020
info@sagmedclinic.com
Instagram: drangilajaeggli
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