Chronic Inflammatory Response Syndrome

Do You Have A Mold Health Issue?

This page contains educational material primarily about Chronic Inflammatory Response Syndrome due to a water damaged building (CIRS). This is a biotoxin illness that is caused by the interaction between mold, bacteria and chemicals used in building materials. Other biotoxin illnesses have similar signs and symptoms. They are also treated similarly. Some of them are discussed on this site. Additionally, there is information on this site about Nutrigenomics and Biotransformational pathways as you really can't treat someone with a biotoxin illness without including analysis and treatment of these pathways. This information is for educational purposes only. Nothing in this text is intended to serve as medical advice. All medical decisions should be made only with the guidance of your own personal medical authority. I am doing my best to get this data up quickly and correctly. If you find errors in this data, please let me know.

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Are you unknowingly living, working or going to school in a water damaged building? If so, it could be dramatically affecting your health. Myctotoxins from mold are one of the indoor air pollutants that contribute to a large share of illnesses in the United States as well as other areas of our planet. Many people are unaware that a toxic home or workplace is contributing to their symptoms. Some indoor air pollutants are easily noted such as smoke, or a nasty smelling new carpet. However, a slow water leak from a plumbing issue into your bathroom wall, or a leaky roof, etc. in your home or work can cause a a variety of health issues. The causative culprit is often not noted until it gets way out of hand and even when the mold is noticed, it is often not remediated in an appropriate manner and further-more people often do not connect the mold to their physical symptoms. They go through extensive testing trying to figure out the causative factor in their poor health only to be told they have "Chronic Fatigue" or some other illness without a known cause.

Exposure to water-damaged indoor environments often means an exposure to molds and the mycotoxins they produce, bacteria and the endotoxins they produce as well as volatile organic compounds from both molds and bacterias as well as the building materials themselves. We talk about this illness as a "mold" illness but it really involves mold, bacteria and chemicals from building materials. So, when we talk about mold illness, know that it is really a mix of mold, bacteria and chemical toxins. How the molds interact with the bacteria and the building materials can create a much worse situation than any one of these issues by themselves.

The most common types of mold that are found indoors include Cladosporium, Penicillium, Alternaria, and Aspergillus. Stachybotrys chartarum (sometimes referred to as “toxic black mold”) is a greenish-black mold, which grows on household surfaces that have high cellulose content, such as wood, fiberboard, gypsum board, paper, dust, and lint and is usually an indicator that there has been elevated moisture present or there has been previous water damage. There are a variety of molds known to grown in water-damaged buildings and many are known or thought to cause health issues.

Exposure to mold, mycotoxins, bacteria is well known to trigger inflammation, allergies and asthma, oxidative stress, and immune dysfunction in both human and animal studies. Mold spores, fungal fragments, and mycotoxins can be measured in the indoor environments of moldy buildings and in humans who are exposed to these environments. Most of the time, we are exposed to molds and mycotoxins through the skin contact, through ingestion, and by inhalation. Most common are reports of exposure involving water-damaged homes, schools, office buildings, court houses, hospitals, and hotels. It’s estimated that as many as 25-50% of buildings in the US have had some sort of water damage. Molds have the ability to produce various symptoms, such as skin rashes, respiratory distress, various types of inflammation through-out the body, cognitive issues, neurological symptoms, and immune suppression. The most common symptoms associated with mold exposure are respiratory such as chronic cough, allergic rhinitis and new onset asthma. Mold symptoms can be quite varied but there are specific signs and symptoms commonly seen in people with "mold illness".

How do I find out if my building is water damaged?

You may be able to see visual mold growing. You may be able to smell mold. You may know that the building has had water damage in the past but can not see mold or smell it. Any of these scenarios are reason to be highly suspect of possible toxins due to water-damage and the building should be tested if a person has signs and symptoms that have not been diagnosed as due to other illness or the person is not recovering from treatments for a diagnosed illness they are treating appropriately.

Many people use air samples but these are limited. They represent a brief moment in time and sample a small amount of air. An air sample may be deemed completely safe while a quantitative PCR test may be positive for mold in the same building. 99% of the toxic substances in a water-damaged building are carried by mold fragments too small to be detected by air testing or mold plates. Therefore the best testing is DNA testing by quantitative PCR that can be compared with values already known.

A quantitative PCR called an ERMI from the lab Mycometrics has been a highly valuable tool for many practitioners and patients in evaluating the potential of ongoing mold exposure in the indoor environment. Several labs perform ERMI testing, but I would suggest Mycometrics as Dr. Shoemaker’s work is based on the ERMI performed by Mycometrics. His research allows us to use an ERMI from a current building and compare it with many ERMI's from past buildings.

The ERMI analyzes a collected dust sample for the presence of molds known to be associated with water-damaged buildings. The lab uses a quantitative PCR and compares these values with other common indoor molds to determine the ERMI score. The ERMI score is then evaluated to determine if the living environment may be safe. If one has a mold-susceptible HLA DR type, an ERMI score below 2 is generally desired. A more recent test called HERTSMI-2 is available from Mycometrics that is less extensive and less expensive but may be helpful to determine if a previously contaminated environment is safe for one to reenter after remediation. I would suggest using the ERMI first as I personally think it is more valid, although some would disagree with me. I have seem people's ERMI's return as safe when they were not at all safe.

Mold plates can be helpful but they are still not going to be as inclusive or extensive as the test you get with an ERMI for evaluating indoor environmental presence of mold.

Remember that none of these tests tell you if the person living, working or going to school in the environment is reacting to the molds either. There are some tests that help figure this out. ALCAT offers a blood test that is a mold panel for sensitivities to 20 different molds. RealTime Laboratories has a panel that looks for myoctoxins in the urine. This is limited to a small number of mycotoxins. Genetic haplotype testing is useful for someone who has removed themselves from a moldy environment and can not get well. People who have specific haplotypes, measured by a lab test, will find they have trouble removing mycotoxins from their body and treatment can be quite useful for these folks.

How do you know if your illness is from exposure to mold, mycotoxins or a water damaged building?

People with Mold Susceptibility often notice the following:

• Musty buildings bother them or they are offended by the smell.

• They may have lived in, worked in or went to school in a building that had been flooded, had a leaky roof in the past, or had discolored tiles, ceiling tiles or discolored walls or some other sign or history of water-damage in the past.

• They may have had recurring sinus infections, post-nasal drip, asthma, shortness of breath, recurring respiratory infections or chronic coughing. They may have continuous flu-like symptoms, frequent headaches, skin rashes or other symptoms that come and go with no rhyme or reasons. They may feel fatigued but be told by their practitioner that there is no discernable reason for the fatigue.

Symptoms Associated with Mold Susceptible Illness, also called Chronic Inflammatory Response Syndrome(CIRS), also called Biotoxin Illness

General Signs & Symptoms

Fatigue, Weakness, Flu-like Symptoms, Exhaustion, insomnia, sensitivity to environment, problems regulating body temperature, Multiple diagnosis from various docs

Eye/Ear/Nose/Throat

Blurred or hazy vision, eyes sensitive to light, Eyes tear up, night blindness, ringing in the ears, hearing loss, dizziness, Sinus/nasal congestion, nose bleeds, sensitive to odors, Eyes puffy/dark circles, vocal cord polyps, nasal polyps, laryngitis or raspy voice, burning in throat/sore throat, sensitivity to environment

Musculoskeletal

Joint pain, shooting pains, Ice-pick pains, burning pains, stabbing pains, muscle cramps, Muscle aches, Weak muscles, Fleeting & moving pains, Tics, Spastic muscles, Charlie horses, Hands curl up like a claw, Toes/feet curl up, AM stiffness,

Lungs/Heart

Shortness of breath and tachycardia (fast heart beat) with exercise, chronic cough, congestion, wheezing, asthma, swelling or edema, heart palpitations, heart pounds intermittently

Digestive/Liver/Urinary

Metallic taste in mouth, bile reflux, Nausea, Vomiting, Diarrhea, Constipation, Abdominal pain, Weight loss, Weight gain, Urinate a lot, thirsty

Nervous/Endocrine/Immune

Insomnia, headache, dizziness, disorientation, mental confusion, poor concentration, poor short term memory, Forget what you are doing, Can't remember names or words, Poor word recall, Di orientation, Decreased learning ability, Real thirsty, Low blood pressure, Light headed, Vertigo, Poor temp regulation, Numbness, Tingling, Tremors, Parkinson's like symptoms, Mood swings, Anxiety, Irritable, Body temperature regulation issues, Difficult concentration, Lack of sex drive, swollen and painful lymph nodes. POTs or postural orthostatic tachycardia syndrome is seen in some people.

Skin

Skin is sensitive, Skin is itchy, Feels like bugs crawling on skin, Feels like bugs stinging or biting but nothing there, Easy bruising, Itchy pimples, skin sores, Bumpy skin, Thickened skin, Skin peeling, Burning sensations, Red Face, Sweats - especially at night, static shocks, Skin reacts to sun, even through clothing sometimes, vitiligo, cherry hemangiomas, dermatographia urticaria(when you can write on the skin- may be related to high C4a).

Extremities

Cold Hands/feet, Discolored hands and feet such as white and red mottling, Parts go to sleep (numbness), tingling, Hands shake, Clawing of fingers or toes

How to Improve Your Health When You are Sick due to Mold Susceptibility

Removing yourself from moldy environments is the first step of treatment and the most important. For those who do not have genetic sensitivity, this may be the only step neccessary along with building remediation.

Remediate the building ( I don't have these pages finished but they will still help, go to this link on mold prevention that has some cleaning tips on construction which will give you a lot of ideas on how to prevent mold and or remediate it.

If you can't remediate it, move.

Bile Acid Sequestrants, Mycotoxin and Endotoxin binders: Using binders to bind toxins directly or to bind the bile which is bound to the mycotoxins is super helpful. Cholestyramine is the most common one used. Some people have had success using charcoal and clay. Although they are helpful, I find cholestyramine to be quicker. Some have found success with rice bran and I have not yet tried this method but the research looks like it may work 50% as well as cholestyramine. Please learn how to use binders correctly or you can end up with constipation and you can bind fat soluble vitamins as well as medications. Things like magnesium, and vitamin C can help with constipation from binders. The same information on timing and precautions for taking cholestyramine can be used for other binders such as charcoal and clay. To see this data, go to How to Take Cholestyramine.

Support the bodies detoxification and biotransformation process to remove toxins from the bodies. Support Phase I, II, III of the Detoxification Process: Stress support of glutathione.

Genome analysis: Getting a genome analysis and examining any mutations that may effect your biotransformational pathways can be incredibly helpful. There are dietary, environmental and supplemental actions taken to assist your health once you know what variants exist.

General Support of Organs of elimination: This includes the gastrointestinal tract, the urinary tract, the lungs, liver, and skin.

Adequate Nourishment: Make sure the body is getting adequate nourishment with a stress on minerals and antioxidants.

Endocrine System : Make sure there is hormonal balance. Check thyroid, sex hormones, adrenal hormones, vit D.

Avoid Foods that tend to have mycotoxins or be sure your source is clean.

Realize that living or working in a moldy environment can lead to immune system dysfunction which can allow microbial, or fungal colonization such as candidal overgrowth in some people. Other people may have MARCONS, while others may have repeated herpes out-breaks. It is important to attend to any viral, microbial, parasitic or fungal infections.

Use immunomodulating, anti-inflammatory herbs and supplements which will lower the inflammation that has been caused by the mycotoxins/bacteria and chemical assault. Some people prefer to use protocols that use drugs and Dr. Ritchie Shoemaker has a very good drug protocol that can be used. He addresses the specific lab markers that are found to be too high or too low in CIRS. The herbs and supplements that are used also address these lab markers as the aberrant lab markers are by and large due to inadequate immune system response and inflammation.

Use an air filter at home and work such as Aireox.

There are additional things to rule out and treatments to undertake that I have or will elucidate in the Mold/Biotoxin treatment section of my website. But this gives you a brief

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Biotoxin/Mold