How to Identify Hidden Mold Toxicity (and What to Do About It)
Written by: the Editors of goop
Published on: June 22, 2017
Updated on: June 22, 2017
Reviewed by: Dr. Ann Shippy
Although we’ve spent a lot of time learning about how to limit our exposure to a wide range of toxins (from heavy metals in food to endocrine disruptors in fragrance), we hadn’t really considered mycotoxins until a number of readers and friends reported that they’d been diagnosed with mold toxicity. Mycotoxins are produced by microfungi, i.e. mold, and can wreak havoc on essentially any system in the body, leading to a confusing malaise of chronic symptoms, from headaches and allergies to autoimmune conditions.
Ann Shippy, M.D., a functional-medicine doctor in Austin, Texas, specializes in treating mold toxicity and other sources of toxin overload. As Shippy explains, mold-related illnesses are often difficult to pinpoint, as few physicians are trained about them. Likewise, she says mold itself can be hard to detect in homes/buildings even when it’s causing problems. Shippy first learned about mold toxicity at an environmental health conference years ago, but also personally underwent her own struggle and recovery from mold toxicity, seriously deepening her understanding of the subject. Here, she explains how to best prevent mold growth in your home in the first place, find and get rid of mold, as well as test for and heal from mold toxicity.
For more, see Shippy’s Mold Toxicity Workbook.
A Q&A with Dr. Ann Shippy
What about mold makes it dangerous to our health?
I don’t want to minimize the danger mold allergy has on the respiratory system: Allergies and asthma can significantly impact quality of life, and can be deadly.
Mold toxicity, specifically, can have big health consequences, because of the kind of toxins molds make as their biological byproducts. These toxins fall into two main categories: mycotoxins or microbial volatile organic compounds (MVOCs). The fungal MVOCs, produced as mixtures of alcohols, aldehydes, acids, ethers, esters, ketones, terpenes, thiols, and their derivatives, are responsible for the characteristic moldy odors sometimes associated with damp indoor spaces. Mold toxins range from mildly toxic to extremely potent (i.e. they can be used for biological warfare).
Mold toxins suppress the immune system, damage and kill cells, cause cancer and birth defects, impair mitochondrial function and the nervous system. Thus far, there is a vast amount of research on the effects in animals, but limited research on humans. This is changing now that we are able to measure some of the mycotoxins.
What are the common—and hidden—sources of mold that are most problematic?
Mold toxicity is not usually a problem outdoors. The problem occurs when the mold is present indoors and the toxins accumulate in our air and belongings. Mold growth on our food can also provide harmful doses of mycotoxins. (Mold on food is a topic for another interview, but an example of potential concern is coffee, and Bulletproof is the main brand I know of that actually monitors the levels of mycotoxins.)
It is estimated that over 50 percent of buildings in the US have some water damage, which encourages mold growth. One of the most common sources of mold occur in buildings that have leaked, and the organic materials (like carpet and drywall) haven’t dried completely (within 24-48 hours) or been removed. People don’t realize that there can be hidden mold. For example, if you’ve had a toilet overflow or roof leak and didn’t get dehumidifiers running immediately, it’s highly likely there’s hidden mold. I recommend removing baseboards, cutting out wet drywall, removing wet carpet or hardwood floors, to minimize the risk for mold any time you have a leak.
Another issue is that water sources are often hidden. I’ve often seen windows that have been installed with incorrect flashing so that water comes in when it rains, gets the drywall wet enough to grow mold, but not enough to see through the paint. This can also happen with any exit to the outside, such as vents, chimneys, doors. (My first exposure to mold that made me sick was caused by a flashing defect on a chimney. Rain water was running down between the walls and activating the mold, but it wasn’t getting wet enough that we could see it through the paint.)
Other places to look are: water lines to appliances, plumbing, AC drains, shower pans, HVAC systems and ducting, behind wallpaper, areas where you have condensation, carpeting, crawl spaces, basements. Hidden mold can be very difficult to find without doing invasive testing.
In high enough humidity—when the humidity is over 60 percent—mold can grow on many surfaces: shoes, sofas, carpeting, etc. Have a goal of keeping your indoor humidity less than 50 percent (even when you are gone on vacation this summer!).
How do we test for mold in our environment/home/office, and get rid of it?
We still need to develop more comprehensive testing technology for the presence of mold toxins in buildings (as well as in the human body). There are limitations with all environmental mold testing options. The mold plates available at hardware stores don’t usually catch the most toxic mold spores. These molds don’t send out very many spores, or they are heavy and don’t make it very far, so they don’t land on the plates.
The spore traps that most mold inspectors set up with a pump are a little better. Most inspectors, though, can tell you stories of the test coming back completely normal even when there were huge amounts of mold in the building.
The Environmental Relative Moldiness Index (ERMI) test, which uses DNA technology to detect the types of mold present in dust, is more sensitive but also has limitations in the algorithms that are used to predict how much toxic mold is present. It often underestimates how significant the health impacts are. In my practice, I currently use a DNA scan called HC-45 that detects 45 different molds and ELISA testing for 15 mycotoxins in dust samples. If any of them are elevated, I recommend investigating further.
Getting rid of toxic mold can be dangerous if you do it yourself. I highly recommend finding a remediation company that will safely remove the mold for you. (State laws vary so much on requirements for inspectors and remediation companies. Ask lots of questions and get recommendations to help you choose wisely.) The remediation company should set up containment so the toxins don’t get spread everywhere. Using most mold sprays and chemicals can make people even sicker by adding even more toxins, so I highly recommend avoiding them. When very sick from mold, it may take getting rid of belongings that can’t be adequately cleaned including sofas, mattresses, clothing, and other items. Some people end up having to move out of their homes or offices to get better.
Should we all be testing for mold regularly, or only if it seems to be an issue?
Right now it is difficult for most people to test regularly because of the expense and the limitations of the technology. For now, if you have the budget, I highly recommend testing your environment and/or yourself at least annually for early detection and prevention. If you’ve previously been sick from mold, testing more frequently could pick up the presence of mold before it becomes problematic. Some day we may have technology that detects the presence of mold toxins continuously in real time.
How is mold toxicity diagnosed?
Diagnosing mold-related illnesses is still controversial. A major part of the problem is that the testing technology is limited. There has been some progress in recent years, though. When mold exposure was first identified as a health issue, the only test available was for antibodies to mold—which tests if you have an immune system response to an exposure to mold. That test does not identify toxicity. Now we can test for a few of the mycotoxins in urine, some of the common shifts in inflammation, and changes in hormones that commonly show up with blood testing.
If a mycotoxin urine test is positive, we start looking for the source. But if the mycotoxin test is negative, it doesn’t mean there is not toxic mold exposure—because we can’t test for all of the important toxins yet. If you get a negative result but you still suspect mold is an issue, it could still be helpful to look for potential sources of mold in your spaces.
Are certain people more vulnerable to mold toxicity than others?
Genetics, nutritional deficiencies, previous accumulations of environmental toxins, age, high levels of stress—are all factors that can impact how fast you get sick from mold.
People inhabiting a building with mold get sick at different times and with varying symptoms. Each person has different genetic factors that create different symptoms even when everyone is exposed to the same moldy environment. The bottom line is that some people are the “canaries” and get sick first.
People who are immunosuppressed (genetic immunodeficiency, lung disease, transplant patients, newborns, elderly) are more susceptible to toxicity—as well as to fungal infections—when exposed to mold. However, with high enough cumulative exposure to the most potent mycotoxins, everyone gets sick.
Also, consider your work environment: Does it have a high potential for exposure? For example, farmers working with crops and silo’s, construction workers doing remodeling, and heating/air-conditioning technicians all might consider mold as a possible root cause of illness.
Beyond removing the mold source, how do you treat mold toxicity?
One of the most important aspects of successful treatment is immediately moving into a non-toxic environment. Some people have to replace many of their belongings as well. I recommend my patients consume a paleo diet (see Shippy Paleo Essentials) with at least 50 percent of the volume of their food coming from vegetables, organic if possible. Eliminating inflammatory foods like gluten, dairy, grains, and sugar is foundational.
Taking supplementsto help support the immune system, augment the detoxification systems, rebuild the gut, reduce inflammation, and boost the mitochondria is also helpful. (Mitochondria are the “power houses” inside our cells and they often get damaged by environmental toxins, including mycotoxins. Supplements that support your mitochondria can jump-start your healing process.)
Here are some of my favorite supplements:
FOR THE IMMUNE SYSTEM: Liposomal vitamin C (with phosphatidyl choline and carnitine), 1000mg twice a day
FOR DETOXIFICATION: Liposomal glutathione, 250mg a day, gradually increasing to 500mg
FOR THE GUT: robiotics, 100 billion units a day
FOR INFLAMMATION: Omega 3, 1000-2000mg a day
FOR OUR MITOCHONDRIA: CoQ10, 200mg a day
Always important for healing from illness and maintaining health:
How long does it take most patients to detox/rebalance their systems?
Some people get well very quickly (weeks) after removing the source of mold toxins, just by getting into a clean environment and avoiding re-exposure. Others can take over a year to recover fully. In patients that are slower to recover, even after addressing the above support (diet, detox, immune, gut, mitochondria), I recommend additional functional medicine testing such as: methylation pathways, other genetic factors, infections, nutritional deficiencies, mitochondrial function, digestive function, and testing for the presence of other environmental toxins. This helps us to find the additional factors that can be addressed to help the body come back into balance. The key is if you haven’t completely recovered, there is still another piece of the puzzle to figure out. Don’t settle for just a partial recovery!
A former IBM engineer, Ann Shippy, M.D. transitioned to the world of medicine in part in search of better solutions to her own health ailments, which she hadn’t found in traditional medicine. She is board certified in internal medicine and certified in functional medicine. Her practice, which is based in Austin, Texas, takes a functional approach to a wide range of health concerns, including toxicity from mold exposure and heavy metals, autoimmunity, and digestive issues. Shippy has authored two health manuals: Mold Toxicity Workbook and Shippy Paleo Essentials.
The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of goop, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.
Related: Common Household Toxins