What is Mold Biotoxin Illness/CIRS?

Mold Biotoxin Illness, or otherwise known as Chronic Inflammatory Response Syndrome (CIRS), is a multifaceted condition that is related to the contamination of indoor air, food, water, or possibly, from insect bites. CIRS was originally defined by Dr. Ritchie Shoemaker, a former family physician in Maryland, who discovered an association between an unknown illness that some patients were experiencing and a toxin produced by a fish-killing organism called Pfiesteria. Since his discovery in the 1990’s, Dr. Shoemaker has linked a similar kind of illness to toxins from a wide variety of microorganisms and chemicals.

When a person comes in contact with biotoxins, such as mold, fungi, volatile organic compounds (VOCs), particulates, inflammagens, and other gram-negative bacteria, it can cause an inflammatory response characterized by an array of symptoms. Most people will experience some level of illness when exposed to a sufficient level of biotoxins, however, many people recover once they’re removed from a contaminated environment.

Chronic illness only occurs in those who are genetically susceptible to improper toxin clearance (about 25% of the population). This minority of people typically have human leukocyte antigen (HLA) genes that prevent their bodies from being able to “tag” the biotoxin as bad and remove it. Instead, the biotoxin(s) can live in the body indefinitely and circulate, creating chronic inflammatory immune responses, thus, leading to chronic illness. For those who aren’t genetically susceptible, it can cause acute illness while the biotoxins are being processed in the liver and released. However, following exposure, their detoxification system is able to eliminate the biotoxins via the normal mechanisms and symptoms usually subside.

Unfortunately, many people are unaware that their home or workplace may be conducive to mold growth. Mold growth can occur behind walls, under sinks, behind furniture, in the attic, and virtually anywhere there has been water damage or moisture. Today, it’s estimated that indoor pollutants, including mold, are at a concentration of 2 to 5 times higher than that of the pollutants found outdoors and may be contributing to more than 50% of patients’ illnesses [1]. Below are some common signs and symptoms of mold and biotoxin toxicity:

Symptoms of CIRS/Mold Biotoxin Illness

  • Fatigue
  • Weakness
  • Diarrhea
  • Abdominal Pain
  • Disorientation
  • Static Shocks, Electric Shocks
  • Frequent urination
  • Trouble regulating body temperature
  • Skin sensitivity
  • Pins and needles feeling on skin
  • Body aches
  • Headaches 
  • Trouble concentrating
  • Dizziness
  • Joint pain and stiffness
  • Muscle cramps
  • Impaired memory
  • Can’t find the right words
  • Congestion
  • Shortness of Breath
  • Metallic taste
  • Watery eyes
  • Blurred vision
  • Red eyes
  • Mood swings
  • Anxiety 
  • Vertigo
  • Lightheadedness
  • Sensitivity to light

Where You Can Come in Contact with Mold and Biotoxins

Water Damaged Buildings (WDB)

Water damaged buildings are the most common areas of contact with biotoxins. Dr. Shoemaker estimates that 75% of cases are caused by repeated exposure to WDBs. Water gives mold and bacteria an environment they can thrive in, creating a toxic mix of chemicals, fungi, mycotoxins (dangerous toxins produced by mold), inflammagens, and more. A study recently found that sixty-six percent of water-damaged building materials surveyed had at least one mycotoxin present [2]. Since not one single biotoxin source can be determined as the cause of illness, but rather the stew of compounds from the building, the WDB is considered the culprit.

Microorganisms

It’s also important to keep in mind that bacteria, such as Borrelia, Babesia, and other organisms transmitted by tick bites, and even microbial volatile organic compounds (mVOCs; organic compounds released by microorganisms), can contribute to CIRS. In fact, there’s often an intricate interplay between those affected by CIRS also have some form of tick-transmitted illness or vice-versa, which needs to be taken into account when devising a comprehensive treatment plan. 

Diagnosing CIRS/Mold Biotoxin Illness

Repeated exposure to a WDB, history of a tick bite, consumption of a reef fish, exposure to blue algae, or dinoflagellates are common triggers for a mold biotoxin illness/CIRS diagnosis. Also, if your symptoms cannot be explained by any other illness, it may be mold biotoxin illness. One of the first steps to diagnosis mold biotoxin illness or CIRS is to evaluate your environment for mold, namely your home or areas you spend the most time. Keep in mind that anywhere in your home where moisture is present can lead to mold growth. Moisture and warm environments are the most desirable conditions for mold to grow and reproduce. 

Areas in your home where there is a lot of moisture, such as in a bathroom, laundry room, or kitchen, can be potential areas of mold growth. Common signs of possible mold growth, which may be otherwise invisible, include a musty smell or odor, color or appearance changes to a given surface, moisture issues/humidity, or allergy symptoms. 

It’s important to remember that there is a difference between mold toxicity and mold allergy, which can help determine the most appropriate diagnosis and subsequent treatment for your symptoms. While mold allergies are caused by mold spores that become inhaled and stimulate symptoms similar to those of hay fever, mold toxicity, in comparison, is caused by the volatile toxic vapors that are dispersed by mold which can lead to a chronic inflammatory response [3, 6]. 

In order to be considered for CIRS, symptoms in 6 out of 13 symptom clusters (see below) need to be identified. If 8 out of 13 symptom clusters are identified, there’s a high probability of CIRS.

Biotoxin Illness Symptom Clusters

Photo Credit: Surviving Mold

Once CIRS is suspected, your healthcare provider can order tests to verify. Five out of the necessary 10 tests need to be abnormal in order to be diagnosed with CIRS/Mold Biotoxin Illness [4]. Your Newbridge provider’s can help determine which labs and diagnostic tests are right for you and how to complete them. A few of these labs include: 

Transforming Growth Factor beta-1 (TGF-beta-1)

TGF-beta-1 is a conductor of our immune system, and when in the normal range, it helps maintain a balance between the side of our immune system that responds to intruders, yet not so hyper-reactive that the immune system begins to attack the body. When out of range, it can be a signal to autoimmune processes in the body [5].

Matrix Metalloproteinase-9 (MMP-9)

The release of MMP-9 is triggered by the innate immune system, which contributes to increased permeability of membranes to allow certain molecules to pass through more readily out of blood vessels and into areas such as the joints and brain. This is necessary during acute injury, for example, but long term, elevated MMP-9 can contribute to damaging inflammation in these same tissues.

C4a and C3a

C4a and C3a anaphylatoxins, or in other words, create an allergic response, and therefore, contribute to symptoms of an allergic reaction such as swelling, histamine release, etc. Biotoxins stimulate the innate immune system to produce these substances. Because C3a is produced in response to an infectious agent, it’s necessary to consider other triggers such as Lyme bacteria.

Treatment for CIRS

Eliminate Exposure

Perhaps one of the most important aspects to recovering from mold biotoxin illness is to avoid exposure. If you suspect or identify mold in your home, you’ll want to seek the most appropriate remediation options. You’ll also want to ensure any water pipes or leaks are fixed. If the property has a history of flooding, you need to evaluate the risk of it happening again and maybe even consider relocating. Other sources of moisture to be aware of include any sources of condensation, such as window sills, or any other area that indoor and outdoor temperature differ, which creates condensation. Have your air conditioning, heating, and ventilation unit inspected and cleaned as well, as it could otherwise be circulating fungus spores around the house. Get an expert to look into it and consider getting a HEPA air scrubber to clean the air. It may also be necessary to utilize dehumidifiers in one or more rooms. To prevent mold growth, it’s recommended you can keep the humidity of your property around 50% as mold finds it harder to multiply in drier air [6].

Remove Biotoxins

If you’ve been diagnosed with mold biotoxin illness or CIRS, it’s imperative to rid your body of the biotoxins produced by water damage. Among the most consistent and regular means of detoxification is through elimination, meaning it’s crucial to avoid constipation and support the body’s natural detoxification processes. This includes protecting and enhancing the gut lining and functional integrity of the gastrointestinal tract. We often recommend binding agents, both naturally derived and pharmaceutical grade, to help bind the toxins in the body, which are then eliminated in stool. Supporting the liver, a major organ of detoxification, is also important, which can be done through targeted supplements, herbs, and foods. 

Nutrition

As with any other chronic illness, optimal diet and nutrition are a cornerstone to healing. Following a diet that is anti-inflammatory, rich in antioxidants, fiber, and vitamins and minerals will support your body’s ability to detoxify from the biotoxins, reduce systemic inflammation, support your immune system, and restore energy. Eliminating inflammatory foods, such as sugar, dairy, gluten, and some grains, will also allow the gut lining to heal, which, in turn, supports immune function. When recovering from mold-related illness, it’s often recommended to avoid foods that may contain traces of mold, such as corn, barley, wheat, peanuts, rye, cottonseed, chiles, spices, dried fruit, cocoa, bread, black pepper, and alcoholic beverages. 

Remember that food provides information for our cells and provides instructions for how our body will function, even at a genetic level. When given the right information and ingredients, our body’s are equipped for restoration and healing. Here at Newbridge, our integrative and functional team of providers will help tailor and individualize a nutrition plan that’s suited to your body’s unique needs, as well as your food preferences.

Supportive Modalities

Herbs and Supplements

In a Functional Medicine approach to CIRS, both pharmaceutical and botanical agents can play a role in treatment to help the body’s ability to recover. Various herbs can be used to support different organ systems, including the detoxification pathways as well as the immune system. Targets supplements may also be recommended to support the body through the different stages of healing. 

Other plant-based botanical supplements can be used to support the immune system and other physiological and biochemical systems to boost your body’s innate ability to heal.

Ozone Therapy

Ozone therapy has been used to treat a wide range of conditions, and in the past few years has gained recognition for its positive role in treating mold biotoxin illness. Ozone therapy floods your body with small amounts of ozone in a controlled way, which has been shown to boost mitochondrial function, decrease inflammation, and facilitate recovery from biotoxins [8, 9].

Far Infrared Sauna

Far infrared saunas help to increase body temperature and can be beneficial in supporting detoxification, a key component to recovering from CIRS.

Low-Dose Immunotherapy

In the 1960s, Dr. Leonard McEwen pioneered what we know to be the first type of immune desensitization called Enzyme Potentiated Desensitization (EPD), which is a form of immunotherapy that can treat different types of allergies. EPD evolved into Low Dose Allergen therapy (LDA) with the work of Dr. W.A Shrader Jr. LDA helps restore immune tolerance to the environment outside and inside the body. LDA can be used to help desentize the body to several common indoor and outdoor allergens, including mold.

CranioBiotic Technique (CBT)

CBT was first developed by Dr. Anthony Smith in Idaho, and is based on principles of neurophysiology. CBT uses Muscle Response Testing (MRT) to obtain feedback from your body concerning “health stressors” that may be causing problems. These stressors can include allergies, pathogenic organisms, toxins, and physiological dysfunctions. Once a stressor has been revealed, your CBT practitioner can then relay this information to your brain. This is accomplished by the gentle stimulation of specific neurovascular “reflex points” on your cranium and upper body. As soon as your brain accurately recognizes the stressor, it can begin to correct it.

Our Mold Biotoxin Illness/CIRS Providers

Stephanie Belseth, APRN, CPNP

Stephanie is a board-certified Pediatric Nurse Practitioner with over 25 years experience in inpatient and outpatient primary care, pulmonology, asthma, early childhood screening, and neuro-developmental disorders.

Tara Calmes, DNP, CNP, ANP-BC, CFMP

TARA CALMES, DNP, CNP, ANP-BC, CFMP, is a board-certified Nurse Practitioner with a doctorate in nursing practice. She has extensive experience in neurological health, biotoxin illness, gut health, chronic illness treatment and more.

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