How Biotoxins and Mold Affect Health and Some Actions Steps to Take (Including Essential Oils)
The Systematic Effects of Biotoxins
I was going to do an easy blog today. I’m in the process of editing a 40+ page journal article (on essential oils and pain) and I was thinking my writing tab may be “tapped out.” I was wrong.
I’ve mentioned previously that my blog topics are sometimes “guided” by various “hints” that “randomly” appear in my inbox or through my research projects. (“Coincidentally,” this connection between my inspirations and brain efforts can be found within a review of rosemary essential oil, which is known for cognitive support). For this article, my muse came in a pesky, quiet voice stemming from several conversations I’ve had with clients and loved ones.
I’ve discussed mold previously, specifically in relationship to how its exposure potentiates and mediates symptoms related to autoimmunity and Lyme disease. (You can read the details of this connection here.) Since then, I have received additional education on the effects of mold exposure and how it can result in what Richie Shoemaker (the “guru” of biotoxic exposures) terms “Chronic Inflammatory Response Syndrome” (CIRS).
His Surviving Mold Website defines CIRS as follows:
“An acute and chronic, systemic inflammatory response syndrome acquired following exposure to the interior environment of a water-damaged building with resident toxigenic organisms, including, but not limited to fungi, bacteria, actinomycetes and mycobacteria as well as inflammagens such as endotoxins, beta glucans, hemolysins, proteinases, mannans and possibly spirocyclic drimanes; as well as volatile organic compounds.”
In layman’s terms, CIRS is a crazy amount of symptoms that occur from biotoxins through various exposure routes. These include water damaged buildings, ticks, cyanobacteria (“blue-green algae”), dinoflagellates, pfiesteria (linked to harmful algal bloom), and poisonous spiders.
(Note: CIRS should not be confused with SIRS, Systemic Inflammatory Response Syndrome. SIRS is a term characterized by changes in body temperature, heart rate, respiration, and white blood cell count. It is usually caused by an infectious agent that disseminates through the body, such as sepsis).
Symptoms can become chronic in those with a genetic susceptibility that does not allow for their immune system to mount a proper response. (This genetic marker, HLA DR DQ, is present in about 24% of the general population). As a result of an inability to tag the invading biotoxins and get rid of them, these individuals have the perfect set up for them to float freely around in their circulation. In an attempt to “do something”, they create an inappropriate antibody response. These antibodies end up attacking cellular structures and can cause issues with digesting gluten. Chronic inflammation ensues and activation of various signaling pathways, including the complement system, in an infective attempt to clear out these biotoxins.
For those who like “geek-speak”, an article on CIRS by Kelly Milani, ND, states that this genetic haloptype leads to “decreased antigen presentation, which results in the reduced clearing of toxins from these biological sources. The resulting increased level of biotoxins causes the simultaneous and progressive activation of inflammatory pathways including TH1, TH2, TH17, complement immunity, and coagulation cascades.”
These wide-range of systemic effects include: gastrointestinal (such as abdominal pain, appetite changes, and IBS-like symptoms), genitourinary (urinary frequency), muscular-skeletal (joint and muscle aches and pains), hormonal shifts (hot flashes, PMS-like symptoms), respiratory issues (cough, shortness of breath, sinus issues), and neurological responses.
Focusing in On Mold and It’s Biotoxin-Producing Posse
Mold is one type of organism that produces some the most common biotoxins found in a Water-Damaged Building (WDB). Its potential roommates include other fungi, various bacteria, actinomycetes (a group of gram positive bacteria), and mycobacteria (a type of bacteria with cells walls resistant to digestion). These inhabitants produce toxic compounds creating a health-damaging stew of metabolic byproducts..
Many people may be aware of the respiratory effects of mold. According to the CDC (Center for Disease Control and Prevention):
In 2004 the Institute of Medicine (IOM) found there was sufficient evidence to link indoor exposure to mold with upper respiratory tract symptoms, cough, and wheeze in otherwise healthy people; with asthma symptoms in people with asthma; and with hypersensitivity pneumonitis in individuals susceptible to that immune-mediated condition. The IOM also found limited or suggestive evidence linking indoor mold exposure and respiratory illness in otherwise healthy children. In 2009, the World Health Organization issued additional guidance, the WHO Guidelines for Indoor Air Quality: Dampness and Mould [PDF – 2.52 MB]. Other recent studies have suggested a potential link of early mold exposure to development of asthma in some children, particularly among children who may be genetically susceptible to asthma development, and that selected interventions that improve housing conditions can reduce morbidity from asthma and respiratory allergies, but more research is needed in this regard.
However, those with mold illness have symptoms that vary in individuals and are a different to an immunological response to an allergy, infection, or mucous membrane irritation. Due to these biotoxins ability to directly impact nerve cell function, I commonly see neurological symptoms in my clients that are susceptible and report having mold or biotoxin exposure. These symptoms usually wax and wane relating to changes in humidity and weather. They include headaches, dizziness, memory issues, tremor, fatigue, mood imbalances, numbness and tingling, pin-prick pain, cognitive effects, and vision disturbances.
In a paper entitled, “Structural brain abnormalities in patients with inflammatory illness acquired following exposure to water-damaged buildings: a volumetric MRI study using NeuroQuant®”, the authors report that those with CIRS and exposed to water-damaged buildings could experience structural changes in the brain, including atrophy. The abstract states:
Executive cognitive and neurologic abnormalities are commonly seen in patients with a chronic inflammatory response syndrome (CIRS) acquired following exposure to the interior environment of water-damaged buildings (WDB), but a clear delineation of the physiologic or structural basis for these abnormalities has not been defined. Symptoms of affected patients routinely include headache, difficulty with recent memory, concentration, word finding, numbness, tingling, metallic taste and vertigo. Additionally, persistent proteomic abnormalities in inflammatory parameters that can alter permeability of the blood-brain barrier, such as C4a, TGFB1, MMP9 and VEGF, are notably present in cases of CIRS-WDB compared to controls, suggesting a consequent inflammatory injury to the central nervous system. Findings of gliotic areas in MRI scans in over 45% of CIRS-WDB cases compared to 5% of controls, as well as elevated lactate and depressed ratios of glutamate to glutamine, are regularly seen in MR spectroscopy of cases. This study used the volumetric software program NeuroQuant® (NQ) to determine specific brain structure volumes in consecutive patients (N=17) seen in a medical clinic specializing in inflammatory illness. Each of these patients presented for evaluation of an illness thought to be associated with exposure to WDB, and received an MRI that was evaluated by NQ. When compared to those of a medical control group (N=18), statistically significant differences in brain structure proportions were seen for patients in both hemispheres of two of the eleven brain regions analyzed; atrophy of the caudate nucleus and enlargement of the pallidum. In addition, the left amygdala and right forebrain were also enlarged. These volumetric abnormalities, in conjunction with concurrent abnormalities in inflammatory markers, suggest a model for structural brain injury in “mold illness” based on increased permeability of the blood-brain barrier due to chronic, systemic inflammation.
Now That I’ve Scared the Buggers Out of You….What Now!!
So, are we destined to fear mold and live in a plastic bubble. Honestly, some people have to be quite careful. However, for most, there are approaches to mitigate the effects of biotoxin exposure and decrease negative responses.
The first step is proper diagnosis. Here is a link to steps in treatment and proper diagnosis on Dr. Shoemaker’s site.
This is the link to lab tests, which get into the nitty-gritty details of each marker and their role in the immune response for the curiously minded.
These evaluation tests include:
VIP (vasoactive peptide, which can also be used in treatment to rebalance the immune response), MSH (melanocyte- stimulating hormone, which has anti-inflammatory and neurohormonal functions) TGF-B1 (regulator of innate immunity), HLA DR (genetics), Anti-gliadin antibodies (AGA), ACTH/cortisol (stress/hormonal response), C4a (complement system marker, high in biotoxin exposure), C3a (can be used to assist with Lyme exposure), VEGF (growth factor related to oxygenation), MMP-9 (enzyme linked to inflammation of the endothelium), ACA (autoantibodies to self), ADH/osmolality, and leptin (hormone).
Specialty tests include the Visual Contrast Sensitivity (VCS) test (to establish a neurological response of biotoxins) and the NeuroQuant MRI (discussed above).
Testing Your House for Mold
Click here for the caveats of testing mold in the environment.
Dr. Sarah’s Confession and Approach
For my sickest people, usually those with Lyme and mold exposure, I usually suggest many of the lab tests to chart and follow progress. For example, if possible, it’s important to start out with the genetics if one is very sick and suspects exposure, as this demonstrates a “weak link” that needs to be considered.
For most of my clients exposed to mold who are not genetically susceptible, or lack funds for testing, we support the body’s immune response and all organ systems to allow for optimal clearance of the biotoxins. I personally do not have certification with Dr. Shoemaker, but I may someday but I have had experience with using naturopathic and functional medicine approaches that are based on his research, in those with Lyme and mold exposure. I have seen amazing results with these principles and the use of essential oils for those who aren’t extremely ill. However, if one is severally compromised and very genetically susceptible, they may have to consider home remediation and a visit the “guru’s” students.
A Final Helpful Tip and Why It is Right Under Your Nose
Cladosporium, Penicillium, Alternaria, and Aspergillus are the most common molds found indoors. Stachybotrys chartarum (Stachybotrys atra, “black mold”, “toxic mold”) is another indoor mold that is greenish-black mold that grow on household surfaces that have high cellulose content. These unwelcome guests form their biotoxins, which include the volatile mycotoxins produced from mold spores. These airborne “mold bombs” are the reason why those living with a “moldy basement”, but “never go downstairs”, can still have symptoms from exposure. They are in the air!
Six essential oils of Mentha arvensis, Mentha piperita, Anethum sowa, Cymbopogon winterianus, Nardostachys jatamansi, and Commiphora mukul were selected and tested for their efficacy against Aspergillus flavus, A. fumigatus, A. sulphureus, Mucor fragilis, and Rhizopus stolonifer. These oils were fungistatic or fungicidal to one or the other molds, depending upon the concentrations.
Not only do essential oils modulate our internal environment, they also have the potential to mitigate some mold formation in dwellings, such as stated in this article which explores the use of thyme oil. Furthermore, a 2005 field study was with Dr. Close found diffusing a certain blend of essential oils decreased “black mold.” This blend contains cinnamon, which was reported to be “fungitoxic” to various fungi related to respiratory tract mycoses. The abstract on cinnamon reads:
Cinnamic aldehyde has been identified as the active fungitoxic constituent of cinnamon (Cinnamomum zeylanicum) bark oil. The fungitoxic properties of the vapours of the oil/active constituent against fungi involved in respiratory tract mycoses, i.e., Aspergillus niger, A. fumigatus, A. nidulans A. flavus, Candida albicans, C. tropicalis, C. pseudotropicalis, and Histoplasma capsulatum, were determined in vitro as minimum inhibitory concentration (MIC), minimum lethal concentration (MLC), inoculum density sustained, and exposure duration for fungicidal action at MIC and higher doses, as well as effect of incubation temperatures on fungitoxicity. It is concluded that these inhalable vapours appear to approach the ideal chemotherapy for respiratory tract mycoses.
What I like most about essential oils is they are not just “fighting mold.” They can also support overall wellness and balance out the immune response. For many of my mold sensitive clients, they see a difference right away if they stop diffusing essential oils. Of course, one caveat could be those with overresponsive neurological sensitivity to smell from mold exposure, in that case, functional neurology is indicated. After this, essential oils can be reintroduced.
Although it may seem overwhelming, the big picture is that if we know what we are up against, we can use what works to support our body to deal with it and live healthy, vibrant lives!
Best slideshow on the science of mold illness: http://www.slideshare.net/keithberndtson/mold-toxicity-syndrome-cirs
Surviving Mold Web Site, including these links:
- Shoemaker: http://www.survivingmold.com/shoemaker-protocol/Certified-Physicians-Shoemaker-Protocol
- Biotoxins and CIRS: http://www.survivingmold.com/mold-symptoms/molds-mycotoxins-more
- Symptoms of Mold Exposure: http://www.survivingmold.com/diagnosis
Biotoxin. Definition. The Free Dictionary. http://medical-dictionary.thefreedictionary.com/biotoxin
Washington State Department of Health. Marine Biotoxins. http://www.doh.wa.gov/CommunityandEnvironment/Shellfish/BiotoxinsIllnessPrevention/Biotoxins
Chalasani N, Roman J, Jurado RL. Systemic inflammatory response syndrome caused by chronic salicylate intoxication. South Med J. 1996 May;89(5):479-82.
Kaukonen KM, Bailey M, Pilcher D, Cooper DJ, Bellomo R. Systemic inflammatory response syndrome criteria in defining severe sepsis. N Engl J Med. 2015 Apr 23;372(17):1629-38. doi: 10.1056/NEJMoa1415236. Epub 2015 Mar 17.
Milani K. Chronic Inflammatory Response Syndrome Diagnosis and Treatment. What is Chronic Inflammatory Response Syndrome. 9pgs. Available at: https://www.survivingmold.com/docs/MILANI_CIRS_TREATMENT_STEPS.PDF
Wikepedia. Pfiesteria. https://en.wikipedia.org/wiki/Pfiesteria
Johanning E, Landsbergis P, Gareis M, Yang CS, Olmsted E. Clinical experience and results of a Sentinel Health Investigation related to indoor fungal exposure. Environmental Health Perspectives. 1999;107(Suppl 3):489-494.
CDC. Mold. Basic Facts: Mold in the Environment. http://www.cdc.gov/mold/faqs.htm
CDC. Facts about Stachybotrys chartarum and Other Molds. http://www.cdc.gov/mold/stachy.htm
Ammann, HM. Is Indoor Mold Contamination a Threat to Health? http://www.mold-survivor.com/harrietammann.html
Shoemaker RC, House D, Ryan JC. Structural brain abnormalities in patients with inflammatory illness acquired following exposure to water-damaged buildings: a volumetric MRI study using NeuroQuant® (abstract). Neurotoxicol Teratol. 2014 Sep-Oct;45:18-26. doi: 10.1016/j.ntt.2014.06.004. Epub 2014 Jun 17.
Shoemaker RC, House D, Ryan J. Vasoactive intestinal polypeptide (VIP) corrects chronic inflammatory response syndrome (CIRS) acquired following exposure to water-damaged buildings. Health. 2013; 5(3): 396-401. Available at: http://www.scirp.org/journal/paperinformation.aspx?PaperID=28586
Ryan JC, Gingzhong W, Schoemaker R. Transcriptomic signatures in whole blood of patients who acquire a chronic inflammatory response syndrome (CIRS) following an exposure to the marine toxin ciguatoxin. BMC Medical Genomics.2015;8:15. DOI: 10.1186/s12920-015-0089-x
Kitic D, Pavlovic D, Brankovic S. The role of essential oils and the biological detoxification in the prevention of aflatoxin borne diseases. Curr Top Med Chem. 2013;13(21):2767-90.
Šegvi? Klari?, M., Kosalec, I., Masteli?, J., Piecková, E. and Pepeljnak, S. Antifungal activity of thyme (Thymus vulgaris L.) essential oil and thymol against moulds from damp dwellings. Letters in Applied Microbiology. 2007; 44: 36–42. doi: 10.1111/j.1472-765X.2006.02032.x
New Cinnamon-Based Active Paper Packaging against Rhizopusstolonifer Food Spoilage. http://pubs.acs.org/doi/abs/10.1021/jf800699q
Cinnamon bark oil, a potent fungitoxicant against fungi causing respiratory tract mycoses. Allergy. 1995 Dec;50(12):995-9.
Screening for Antifungal Activity of Some Essential Oils Against Common Spoilage Fungi of Bakery Products. Food Science and Technology International. February 2005; 11(1): 25-32. doi: 10.1177/1082013205050901
Close, J. GET RID OF MOLD NATURALLY using THIEVES ESSENTIAL OIL. http://www.naturesmoldrx.com/
Sarbhoy AK, Varshney JL, Maheshwari ML, Saxena. Efficacy of some essential oils and their constituents on few ubiquitous molds. Zentralbl Bakteriol Naturwiss. 1978;133(7-8):723-5.