Mold Exposure and the Autoimmune-Inflammation Spectrum

Written by: the Editors of goop


Updated on: February 27, 2020


Reviewed by: Will Cole, IFMCP, DNM, DC

Mold Exposure and the Autoimmune-Inflammation Spectrum

For those with a chronic autoimmune or inflammatory disease, figuring out what’s driving your symptoms can be a job. The check engine light is on—but why?

In his practice, functional medicine practitioner Will Cole, IFMCP, DC, sees people who fall somewhere on what he calls the autoimmune-inflammation spectrum. His clients come to him to determine what’s going on in their bodies, what factors are driving their chronic health problems, and what they can do to snuff out those causes. And one factor his clients are curious about is mold exposure.

According to Cole, mold exposure is one factor in the autoimmune-inflammation space that is potentially overlooked. “Mold can trigger, exacerbate, or perpetuate the inflammatory storm,” Cole says. “And it can hide right in your own home, school, workplace, or car.” Of course, mold isn’t the culprit for every patient’s condition, but there are some questions Cole says everyone should be asking themselves: Do I see mold? Can I detect a musty, mildewy smell? Does my home ever get wet? Does spending time in a different location for a few days cause a noticeable decrease in my symptoms?

If you’re checking off those boxes, it’s possible that mold is present in your spaces and could be making an impact on your health. Cole shared with us his take on mold and disease—as well as how he works with his patients to resolve a mold problem.

A Q&A with Will Cole, IFMCP, DC

What is the first thing to know about mold and health?

There are upward of around 300,000 species of fungi. Some fungi are beneficial, like edible mushrooms or the beneficial yeast in our digestive system that makes up our mycobiome—not to be confused with the microbiome, which is the collective term for the populations of bacteria, fungi, protozoa, and viruses inside our body.

“Mold” is a general term for the many types of unwanted fungi. Mold and mold spores are just about everywhere outside and inside, wherever there is moisture allowing them to grow and spread. Certain varieties of mold are problematic for reasons beyond just leaving stains on damp carpets or walls: They are linked to health problems. Toxic mold exposure has been identified as a potential trigger for inflammatory reactivity issues—different practitioners have different ways of describing this condition, but some people in the chronic illness space use the term “chronic inflammatory response syndrome,” or CIRS. There isn’t a large body of evidence on CIRS, but it can be helpful in describing the collection of symptoms some people experience in response to mold and other triggers.

I find that mold is not necessarily the cause of people’s symptoms but an aggravator. If you’re having health problems in the first place, and then you’re experiencing mold exposure at work or school, it can be an additional stressor on an already stressed-out system. Often, I see people resolve their main issue and then their bodies are able to handle that stress from mold exposure. Other times, mold really is the root of the issue, and we have to weed through some lab tests and treatments until we figure that out. It’s all individual.

What are the difficulties in diagnosing mold toxicity?

There are many potential symptoms, and it can be difficult to accurately link them to mold. Not only is mold a great imitator of different health issues but it can also trigger or perpetuate the symptoms of other health problems, including asthma, allergies, and coinfections. It may also contribute to chronic fatigue and autoimmune conditions.

Also, mold is a little trickster because you can’t always see it in your home. It can be hiding behind walls, in vents, or under floors, hiding in the background while the mold spores do their dirty work of polluting the air you breathe on a daily basis.

What tests do you run to see if someone has it?

    Blood work: I suggest three blood tests. The results may help us determine whether mold exposure is a factor in someone’s illness.

  1. C3a and C4a: C3a and C4a are blood immune markers. I have my clients run this test to determine the presence a specific type of toxin that causes histamines to release from mast cells. Sometimes, I discover a lowered C3a level when someone is suffering from mold toxicity, although in my practice I find C4a is a more dependable biomarker for mold overload. I can use the number we get from that test to help determine the severity of mold toxicity.

  2. MSH: Melanocyte-stimulating hormone may possess antifungal and antimicrobial properties. Low levels of MSH have been linked with mold toxicity symptoms in small, preliminary studies.

  3. VIP: Vasoactive intestinal polypeptide is a hormone that regulates inflammation in the hypothalamus of the brain. According to some early research, people with mold toxicity tend to have lower VIP levels.

  4. Mycotoxin labs: Mycotoxins are toxic compounds released by different mold species. There are labs that can measure mycotoxins in the urine as well as antibody production against mycotoxins in the blood. These tests run through Cyrex Laboratories or the Great Plains Laboratory, both of which specialize in the factors of chronic and autoimmune illnesses. Mycotoxin labs tend to be more expensive—$400 to $600—and are often not covered by insurance.

    VCS: The visual contrast sensitivity test is an online or in-person visual test to see how well you can distinguish contrast between black, white, and grey tones. Since certain molds can have neurotoxic effects, exposure can manifest as a neurological symptom, such as inhibited vision. You can find the VCS test online for free or for a small donation.

    Genetic testing: I usually suggest my clients do testing through 23andMe (which runs about $200) to assess their genetic health risks. Certain genetic variants within the HLA and MTHFR genes may influence our risk of developing mold toxicity symptoms.

How do you root out the source of your mold exposure?

Once you’ve determined through lab work that you have been exposed to mold, the most important thing you can do is work on finding the source of your mold exposure and having it removed. You can have a local mold inspector come to your home and determine if mold is present in your house, and they can suggest local professionals who can complete the remediation process. The online directory from the National Organization of Remediators and Mold Inspectors is my preferred resource to find an inspector.

I’ve never seen a case so bad that remediation was not possible. Some of my clients have found it necessary to get out of the house for a couple weeks while the situation gets cleared up. Depending on the extent of the damage, the cost could be very minimal or, in severe cases, up to a few thousand dollars.

How do you treat mold toxicity?

Even after you have removed the mold from your home and are no longer feeding the exposure, you’ll still want to take whatever steps necessary to resolve your symptoms and get mold biotoxins out of your system completely. These are some of the interventions I recommend to my clients when we’re working on a mold issue:

Adopt a mostly plant-based, anti-inflammatory diet.
Food is first. Any other treatment modalities we use have to come on top of a sustainable, clean diet that supports the body’s anti-inflammatory pathways. I teach my clients how to navigate the Costcos and Aldis and Walmarts of the world so they can do this in a way that’s cost-effective for them.

One way I use food to support people struggling with mold toxicity is through what I refer to as a ketotarian diet—a mostly plant-centric keto diet that I developed. Spending some time in nutritional ketosis is a good idea for someone struggling with mold toxicity because it can be helpful in supporting your body against inflammation. Tailoring keto toward whole, plant-based foods is good for overall nutrition and health.

Try supplementing with glutathione.
Glutathione is one of the body’s most powerful antioxidants. It supports the body’s natural defenses against oxidation and free radical damage. If you’re suffering from mold toxicity, there can be a vicious cycle: If your body is not producing enough glutathione on its own, the overall effect of mycotoxins can build up in the body, affecting your cellular health and therefore affecting your production of glutathione.

Since glutathione is high in sulfur molecules, loading up on sulfur-rich foods, such as broccoli, cauliflower, and Brussels sprouts, may help support your body’s glutathione production. I also love supplementing with NAC (N-acetyl cysteine) to help the body replenish glutathione.

Consider taking zeolite or other binders.
“Zeolite” refers to a group of naturally occurring minerals including clinoptilolite, mordenite, and analcime. Zeolites have an ability to bind to mycotoxins in your system. These supplements can sometimes be expensive, but I don’t keep my clients on them for very long. Usually, we run a second panel of mold toxicity tests after three or four months. If the client is feeling better and their labs are greatly improved, we start cutting things out—since zeolites can be pricey, they’re one of the first things to go.

I am also a fan of activated charcoal as well as the cholesterol-lowering medication cholestyramine. One small study has suggested cholestyramine may be an effective therapeutic agent for patients with mold toxicity symptoms.

Support a healthy level of NAD+ in the body.
NAD+, or nicotinamide adenine dinucleotide, is an important coenzyme found in every living cell. In the body, NAD+ is responsible for repairing damaged DNA and supporting overall cellular health. One of my favorite ways to support NAD+ levels is to supplement with a form of vitamin B3 called nicotinamide riboside—it’s a precursor to NAD+.

Get some sun.
Spending more time in the sun has been shown to raise levels of the hormone MSH. (Low levels of MSH may be correlated with mold toxicity symptoms.) I ask my clients to get somewhere between twenty and sixty minutes of sunlight a day, depending on how far they live from the equator, how much direct sunlight they get in their region, and their skin tone.

Will Cole, IFMCP, DC, is a functional medicine expert and one of the hosts of the goopfellas podcast. Cole specializes in clinically investigating underlying factors of chronic disease and customizing health programs for thyroid issues, autoimmune conditions, hormonal dysfunctions, digestive disorders, and brain problems. He hosts an online group course designed as an introduction to functional medicine, in which he helps clients review their blood work, uncover hidden health triggers, and move forward with customized lifestyle recommendations based on their lab results. Cole’s first book, Ketotarian, outlines why and how to pursue a mostly vegetarian ketogenic diet. His latest book, The Inflammation Spectrum: Find Your Food Triggers and Reset Your System, is now available.

This article is for informational purposes only, even if and regardless of whether it 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. The views expressed in this article are the views of the expert and do not necessarily represent the views of goop.

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