Sunday, April 21, 2013
Mycotoxins and Mold
Mycotoxins and mold have been on my mind for a number of years now. They routinely fall into line with a host of variables: gut ecology, hormone regulation, diet, resting and pacing, viruses, bacteria, mycoplasma, Lyme disease, mitochondrial and methylation deficiencies, sleep abnormalities and mercury. It is a vast juggling act. I have written elsewhere about my experience trying to remediate the mold in my daughter's former apartment. I am interested in the idea of mycotoxins as a confounder to recovery in ME/CFS.
Yesterday I watched once again Dr. Ritchie Shoemaker's astonishing 15 minute lecture at the IAMECFS conference in 2009. I remember thinking how important this information was when he presented - but no one seemed to notice, and his profound insights were just buried under a pile of mediocre presentations. This lecture unfortunately is not online. Eric Johnson has the written lecture on his website.
Yesterday I also read a long review article on Water Damaged Buildings, Mold and Mycotoxins. It is by Janette Hope and can be read here. This article clarifies and consolidates known information on mold, mycotoxins, various bacteria and endotoxins, deals with the mechanism of illness, outlines symptoms, neurological and otherwise, and suggests treatments.
Among the treatments are FIR sauna and Cholestryramine. I was particularly interested to read about "Probiotics and Dietary Interventions" - "These treatments have the potential to have significant beneficial effects, as much of the metabolism of toxins occurs via intestinal biotransformation". So here we have a potential cross-over of gut ecology treatment and mycotoxin remediation. Maybe these same ME/CFS patients in Dr. Brewer's study have a functional imbalance in their gut biome. I think it would be worth finding out.
Lisa Petrison has written to Dr. Joseph Brewer regarding his experience with mycotoxins and mold. Dr. Brewer's answer follows:
Although I am an infectious disease specialist, I had no focus whatsoever on "mold issues". Prior to February 2012 (when I first heard about the urine mycotoxin assay at RealTime Laboratories) I didn't even have an interest in mycotoxins or environmental illness. These findings surprised me as much as anyone as the results began to unfold last year.
These patients were all randomly tested. These are long standing patients of mine that were previously diagnosed with CFS/ME (basically"average CFS patients"). We discussed the test and offered it to them at routine follow-up clinic visits. Very few suspected mold illness until I brought it up at their routine visits.
We only found that they "lived/worked in buildings with visible mold" after we asked. Some patients didn't even remember the exposure until we prodded a bit (mainly because the exposure had been so far in the past - such as an apartment they lived in college).
I now see patients every week that are shocked when I bring up mold. They have very impressive exposure histories but no one asked.
If these CFS patients who are on the blogs get tested, I suspect ~90% will be positive. A doctor from the East coast has found almost identical results to mine in their cases (90% positive). Same for a physician on the West coast.
Anyone who sends a specimen to RealTime Lab must pay for the test "up front" but many of the patients ended up getting reimbursed (at least for most of the testing cost) from the insurance. They were not biased since most were hoping to get reimbursed.
I think it is hard for people to get their "arms around this" and want to implicate selection bias but that simply was not the case.
I hope this helps.
Joe Brewer, MD