Exposure to toxic indoor molds and mycotoxins, byproducts of mold, can harm the immune system and hinder recovery from Lyme disease.
In my professional and personal experience, mold toxicity and Lyme disease often go hand-in-hand, yet mold-induced illness often flies under the radar for years before it is detected.
In this episode of the Life Beyond Lyme podcast, I discuss the crucial connection between mold toxicity and Lyme disease and why addressing mold toxicity is vital for your Lyme disease recovery.
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Episode Notes
- Research showing that Americans spend about 90% of their time indoors
- Study showing that water damage is a problem in up to 50% of buildings in North America (Keep in mind that this is likely a significant underestimation of the true prevalence of water damage in buildings.)
- The International Society for Environmentally Acquired Illness
- We Inspect
- EMMA test
- The Definitive Guide to the Low-Mold Diet
Episode Transcript
This is Lindsay Christensen, functional nutritionist and expert on using nutrition and lifestyle to support healing from Lyme disease and complex chronic illnesses. This is the Life Beyond Lyme podcast, where I’ll help you navigate the confusing world of chronic illness recovery so you can reclaim your health and live your life to the fullest. Each week, I’ll dive into a new topic related to chronic illness recovery. We’ll talk about health challenges such as Lyme disease, mold illness, and mast cell activation disorder, and how nutrition and lifestyle changes can help you heal. My goal with this podcast is to provide you with evidence-based and actionable information that will empower you in your healing journey. I hope you enjoy the podcast!
Hello, and welcome to Episode Five of the Life Beyond Lyme podcast! So far, in the first few episodes of this podcast, I’ve specifically focused on the topic of Lyme disease. However, since mold exposure and subsequent mold illness are big factors for many people with Lyme disease (they were certainly in my health journey!) I figured now would be a good time to do an episode about mold. So in this episode, I’m going to discuss the connection between mold toxicity and Lyme disease, how to determine whether mold is impacting your health, and what to do if you are dealing with both Lyme disease and mold illness.
Before we get started, please recall that all of the content shared in this podcast is for informational purposes only, and is not intended to replace medical care. While I am a nutritionist, I am not your nutritionist. So, you should always check with your healthcare provider before trying any of the health strategies that I discussed in this podcast. All right, so let’s dive in!
You may be wondering, why would exposure to mold be bad for your health in the first place? Some of you may know the answer to this question already. But, I figured I’d start by just providing a very brief overview about why it even matters if we have mold in our indoor environments, or if we have in the past.
Humans really evolved alongside mold, primarily in our outdoor environments. What is newer are the levels of mold and the types of mold and mold byproducts that we can be exposed to in our indoor spaces. These two groups of mold, broadly speaking, outdoor ones and indoor ones, can have very different impacts on our health. Without getting into all of the nitty-gritty details, in general, the mold that occurs in our indoor environments as a result of water damage can really negatively impact our health much more so than modest amounts of mold exposure that might occur outside. Research shows that Americans spend a shocking 90% of their time indoors. However, for people with chronic Lyme disease, the amount of time they’re spending indoors may be even greater due to fatigue and mobility constraints. Unfortunately, indoor environments aren’t always a safe haven for people with Lyme disease, especially indoor environments that have sustained some water damage and mold growth short.
[I’d like to] just briefly describe in a little bit more detail why our modern-day indoor environments so susceptible to mold growth and why is this such a problem. So, the building materials that we use in our modern-day homes, including wood, drywall, and particle board, are all materials that are very hospitable to mold growth. So if there’s any sort of water leakage and I’m not just talking water from the outdoors, like you know, rain coming through a hole in the roof, but just think about all of the appliances that we have that incorporate water, whether it’s your dishwasher, the sink in your kitchen, and every bathroom, toilets, showers, you know, we have so many different ways in which we use water in our homes, and any sort of dysfunction in those appliances that use water or any sort of weaknesses in the structure of our homes that could allow water from the outdoors to get in, creating this perfect environment and the potential perfect storm for mold to start growing and release toxic byproducts that can impact our health.
So, our modern-day homes make us uniquely susceptible to experience mold growth in an enclosed space, and this is something that’s pretty evolutionarily new for us. In contrast, the molds that we are exposed to outside tend to be seasonal [and exposure occurs] in small amounts. And the indoor molds may be different species of molds that what we’re exposed to outside. I’m certainly no expert on mold growth itself or different mold species, but I’m just trying to explain a bit about why our modern environment makes us uniquely susceptible to mold growth and, and why it’s a problem when it’s indoors.
So, moving on. Why is exposure to mold and mycotoxins, the toxic byproducts that mold can release into the environment, so harmful for people with Lyme disease? Well, let’s, let’s do a brief overview of why. So for one, research shows that exposure to indoor mold and mycotoxins can suppress the immune system, and a suppressed immune system makes you more susceptible to chronic infections like chronic Lyme disease. Secondly, exposure to mold spores (these are basically the reproductive parts of mold that allow it to reproduce in the environment) mold fragments (these are parts of molds that can break off and end up in dust) and mycotoxins (which are toxic metabolic byproducts of mold) – all of these substances can increase inflammation inside our bodies, compounding chronic inflammation that we may already be experiencing from Lyme disease. So, if we have inflammation from Lyme disease plus inflammation from mold, this could exacerbate our chronic Lyme symptoms and even cause new even worse symptoms potentially on top of that. Briefly, some signs that your body may be experiencing inflammation from mold exposure would include brain fog, chronic fatigue and joint pain, though there are many, many other problems. We’ll talk more about symptoms in a second, but many other inflammation-derived problems can come from mold exposure.
Alright, So reason number three, why exposure to mold and mycotoxins is harmful for people with Lyme is that mold and mycotoxin exposure can really mess with your gut. We know that about 70 to 80% of the immune system resides in our gut and Lyme disease, Lyme co-infections, and antibiotic treatment can all impair your gut health and function. So, if you already have Lyme disease and your gut health is already compromised, but then you also have this mold exposure piece messing with your gut health, your poor gut may really suffer as a result of that.
And then in addition, if mold is negatively affecting your gut (studies show it can deplete beneficial bacteria and promote leaky gut) you’re basically setting yourself up for impaired immune function and impaired elimination, among other things. So, there’s really a strong bidirectional connection here between mold, Lyme disease, and the gut. So, one of the questions that I always ask my new clients in my initial consultation questionnaire is whether they’ve currently or ever lived or worked in a building with water damage. Some of them answer yes. Many of them answer no. However, I always probe a little bit more in my initial consult conversation with them because water-damaged buildings and mold exposure are more common than we might expect. According to the World Health Organization, a rather shocking 50% of buildings in North America are water damaged and are a potential source of exposure to toxic mold. However, this statistic is very likely a gross underestimation of the true prevalence of water damage in buildings because water damage often goes unnoticed by building occupants for a long period of time. And oftentimes, the resulting mold growth in response to water damage isn’t even visible. It often occurs in hidden spaces such as between walls, so mold exposure can frequently go undetected for a long period of time.
Alright, so we already talked a little bit about how molds really love damp environments, but they also love the very materials that we use to build our homes and other buildings. I already talked a little bit about all the potential sources of water, that are part of that crucial equation for mold growth that we have in our buildings. So, I would just emphasize here that if you’ve had water damage in your home and kind of just cleaned up the mold yourself, or you know, put some fans in there and called it a day, but you’re really struggling with your health, it may be important to look back at this water damage situation that you experienced, do some further testing, which I’ll get into that in in a few minutes. But it may be good for you to dig into that experience a bit more and do some more testing on your environment because it’s possible that there could still be some mold, mold fragments, mycotoxins, or ongoing water damage and mold growth in your home that could be really impacting your health. In short, an unpleasant, musty moldy smell indoors, or a patch of mold on your wall isn’t just an inconvenience or an unsightly problem. This is a very significant danger signal that you need to be accounting for, for your health.
Next, let’s discuss some of the similarities and differences between chronic Lyme disease symptoms and mold illness symptoms. There’s a lot of overlap here, but there are also a few differences. So, I’ll start by highlighting some of the symptoms that are similar between these two conditions, and then I’ll talk about some differences. Symptoms that can occur both in chronic Lyme and mold exposure include brain fog, depression or anxiety, mood swings, food sensitivities, chemical sensitivities, undesired weight loss or weight gain, chronic fatigue, hair loss, hormonal imbalances, neuropathy, which just in case you don’t know what that means, I’m referring to that pins and needles tingling in your extremities, like in your feet or your hands or other parts of your body. And then also headaches and insomnia can occur in both of these conditions. Some symptoms that are a bit more specific to mold-induced illness would include respiratory issues such as coughing or actual diagnosed issues with your lungs, chronic sinusitis like chronic sinus infections, or feeling like your nose is always stuffy or like you have gunk in your throat, skin reactions, such as eczema, hives, other skin irritations, watery or itchy eyes, and then frequent urination as well can occur during mold exposure. And, briefly, this [frequent urination] is due to some changes in specific hormones in the body that regulate fluid balance.
All right, so if you’re already dealing with Lyme disease, and you either know or suspect that mold illness is also part of your health picture, it is often best to start by focusing on mold illness. Different practitioners have different opinions on this. But in general, my experience has been that addressing the mold piece first sets you up for a smoother treatment process for Lyme and co-infections. And here’s why: When you address mold illness first you can reverse some of that mold-induced immune system suppression and mold-induced gut issues that can make it harder to recover from Lyme, you can also get the inflammation down, therefore reducing your likelihood of experiencing an inflammatory Herxheimer type of reaction during line treatment. And then if you get your gut working better, this is going to be a huge boon to you because getting your gut as healthy as possible before Lyme treatment sets you up for a better response to treatment and hopefully fewer of the downsides like Candida overgrowth or constipation that can accompany antimicrobial treatments. There are many reasons why addressing mold illness first makes sense, though, it’s always important to talk about this with your provider and make sure that the order in which you’re approaching these conditions is right for you.
All right, so you either know or suspect that mold toxicity is an issue for you. Now you may be wondering where the heck to start with testing. It is crucial to test both your environment and your body. I am no expert on environmental testing for mold, but I’ve been through the wringer myself and many of my clients have too, so I do at least have some resources and directions that I can point you toward as far as mold environmental testing goes. So, I’m going to start by talking about that and then we’ll talk about mold testing your body. If you know that your home has experienced water damage or mold growth, I highly recommend, if it fits within your budget, that you work with an indoor environmental professional, and this is the abbreviated “IEP.” An IEP can thoroughly assess your home. A couple of resources for finding an IEP: One that I really like is the International Society for Environmentally Acquired Illness. That’s abbreviated ISEAI. And on this health organization’s website, you can find a database of indoor environmental professionals who are qualified to do screening of your home or testing of your home for mold. So that is one resource. And then another company that I’ve been referring clients to is called We Inspect, and this company is super well-informed about the health implications of mold toxicity. And as of the date of this recording, they have IEPs in every state in the U.S. So if you need to get somebody to assess your home [using these resources] you can get an actual person into your home. I’ll put links to both in the show notes for this podcast. So, if it’s not within your budget to start right away with an IEP, there is a test that you can do yourself called the EMMA test that’s spelled “EMMA.” And this is an acronym for Environmental Mold and Mycotoxin Assessment. This is a test from produced by Real Time Labs, and I have no affiliation with the lab. But the EMMA test provides more data than another mold test that you may have heard of called the ERMI test. The EMMA test tests for both mycotoxins and mold species unlike the ERMI test. And it’s also not as expensive as specialist-administered home tests like you would get or do through an IEP. So the results of the EMMA test can provide you with a good place to start and they can give you direction as to whether or not it’s worth paying someone to come to inspect your home. So if you can’t dive in right away with an IEP, the EMMA test is often a good place to start. If it turns out that your home has a significant mold issue, there’s a lot of decision-making that’s going to need to happen there as far as whether you’re going to remediate or whether you’re going to move and how you’re going to remediate. I’m not going to dig into all of that. But what I will say is that you do need to get out of the environment that is moldy in order to get well. I don’t usually recommend doing any hard-hitting mold detox treatments or other mold-related treatments while you’re still in the environment that contains mold because that environment is continually stressing your body and exposing you to the compounds that are making you sick. So, you really need to get out of that environment in order to heal. So that’s a tricky topic. There’s no perfect answer. But I feel it is crucial to emphasize that you can’t get well in the environment that made you sick in the first place.
So, next up, if you either know or suspect you have mold illness, testing your body is crucial. There’s a fair amount of controversy over how best to test your body for mold-induced illness. Many practitioners who specialize in mold-induced illness recommend urinary mycotoxin testing. And while I think there is a time and a place for urinary mycotoxin testing, I have also found it to be misleading a fair number of times. And by misleading, I mean, it produced what seemed very likely to be false negatives for clients who were experiencing an overwhelming number of symptoms that pointed towards mold-induced illness or even those who had known mold exposure in their home and this test came back showing low urinary mycotoxin levels. So, some reasons why this test may not be a perfect indicator of mold exposure: Well, one is that different people may have different capacities for eliminating mycotoxins in their urine so presumably, somebody could be exposed to mycotoxins in their environment but if their body is not able to detoxify and eliminate them effectively in the urine, they may come back with low urinary levels of mycotoxins on this test, leading to the false conclusion that mold is no longer an issue. This was the case for me. The second thing I’ll highlight here is that the urinary mycotoxin test does not tell you how your immune system is reacting to mold. And it also doesn’t provide any information about whether you may be experiencing mold colonization in your body either in your gut or in your sinuses. So, there are some limitations to this test.
Another testing option for mold illness is mycotoxin antibody testing, and this is an antibody panel performed on a sample of your blood that shows how your immune system is reacting to mycotoxins either that you’ve been exposed to in the past or the present. MyMycoLab is one example of a lab that offers mycotoxin antibody testing. And while I have no affiliation with this lab monetarily, I do run their tests with many clients in my practice, and I have found this test to be useful for determining whether a client is experiencing an ongoing inflammatory reaction triggered by mycotoxins or potential mold colonization, or even mast cell activation related to mycotoxins so I do find this test useful. A third testing option is the organic acids test or boat test “OAT.” This test is not specific just to mold, but it does include a few markers that indirectly provide information about whether there may be some mold organisms in the body presently. In my experience this is not a standalone test for identifying mold illness, but it is most useful when done in conjunction with either urinary mycotoxin or mycotoxin antibody testing.
And then finally, we have chronic inflammatory response syndrome (CIRS) inflammatory markers. That’s abbreviated “CIRS” for short. And this is a panel of markers that can be measured in the blood that directly evaluate the body’s inflammatory response to mold toxin-induced illness. So these markers can be helpful, but they are not specific to mold-induced illness. And they can be increased by other biotoxic or inflammatory conditions like Lyme disease and co-infections. These markers, in my opinion, have limited value. I know there are providers out there who will staunchly disagree with me. But I just personally and professionally with my clients have found these markers to be useful for tracking progress with treatment, like treatments that reduce inflammation, but not so useful for figuring out what the root problem is.
Alright, so clearly, there’s a lot to consider when it comes to testing your home and your body for mold and mycotoxins. For this reason, I highly recommend working with a practitioner who can help you determine whether mold is contributing to your health issues and put together the puzzle pieces for you, you know, from these various testing modalities in combination with your history or present mold exposure, and your symptoms. This is usually not something that is good to DIY; it’s really helpful to have that professional guidance.
Alright, so let’s move on to discussing mold illness treatment and what the heck to do if you suspect mold is part of your clinical picture and may be occurring in conjunction with Lyme disease. So first and foremost, I will emphasize that there is no single way to treat mold illness that works for everybody. If a doctor or other health care provider claims that there is just one way to do it, I would be very suspicious of that. For this reason, I’m not a fan of providers who subscribe to just one approach. I actually have this one approach in mind, but I’m not going to name it. But there’s a popular approach out there for mold illness treatment that’s very much a “my way or the highway” approach. And while it no doubt works for some people, it also doesn’t work for many people. And really, I feel that mold illness treatment should be personalized to the individual.
Let’s talk about some guidelines for mold illness treatment. I’ve organized these guidelines into the order in which I would recommend approaching them and the order in which I approach them with my clients. So let’s begin. Step one, and I know I touched on this earlier, but step one is to remove yourself from the moldy environment. This may mean removing yourself just temporarily from the moldy environment while it’s going through remediation, or it may mean removing yourself permanently from the moldy environment. If you have the option to do that, like if it’s an apartment that’s exposing you to mold and you know, there’s just no way that remediation is possible (oftentimes landlords just want to do the bare minimum to address the mold issue) your best bet would be to leave and find a new healthy home to live in.
The second step here is to optimize your nutrition. This is probably not surprising to you since I am a functional nutritionist. But your diet plays such a profound role in affecting inflammation levels in your body, your immune system, your gut health, and your ability to detoxify. All of these systems and functions need to be online to get your body recovered from mold exposure. So, optimizing your nutrition is key. I have a whole article that I wrote on the dietary approach to mold exposure, so I’ll link to that in the show notes. But just briefly, a couple things you want to emphasize here are, we want to avoid foods that either contain mold or mycotoxins because that is just going to further increase our body burden of mold and mycotoxins and you don’t really need that if you’ve already been exposed to that in our environment. So, we want to avoid those foods. And then we also want to avoid foods that can support mold growth inside our bodies, especially our guts if we had been colonized by mold. So just briefly here, foods that can contain mold or mycotoxins would include many fermented and cured foods. There are some others but I won’t list them now. And then also foods that can support mold growth would predominantly be simple carbohydrates. So think, added sugars like cane sugar, brown rice syrup, those types of things, as well as flour based foods, bread, pasta, cereal, crackers, etc.
Alright, so after optimizing the nutrition side of things, you can do this simultaneously as well, I suppose, you’re going to want to support your gut health. Your gut can be really profoundly impacted by mold. There are studies showing that mold and mycotoxin exposure can deplete beneficial bacteria and allow the growth of harmful bacteria and promote leaky gut. Mold exposure really can do a number on the gut. But then at the same time, we also need our gut to be intact and healthy enough so that we can eliminate mold and mycotoxins via our stool. So, supporting your gut health is key. This is going to be really personalized, depending on the individual, you know, the gut health that you began with before during mold exposure, and GI symptoms you’re experiencing. This is where it can be really helpful to work with a provider who can help you through this process.
Then number four, we want to focus on reducing mold induced inflammation. The dietary piece, improving gut health, not to mention removing yourself from the environment can all help reduce mold-induced inflammation. However, many people will also benefit from incorporating some nutraceutical types of supplements and nutrients that can quench inflammation. Some examples would include quercetin, fish oil, magnesium, and phosphatidylserine.
Alright, so once you are out of the moldy environment, your nutrition and gut health are being optimized and hopefully your gut is at least feeling a bit better, this is when we can start to support detoxification of mycotoxins. We need to support a few different phases of detoxification; this is not just one single overarching process; there’s actually a few stages to it. So, phase one of detoxification is a biochemical process in which toxins, including mycotoxins, are made water-soluble, meaning they can be dissolved in water so that the toxins can be excreted by the kidneys or bile. Phase one detox is usually performed by a group of enzymes called CYP450 enzymes, and these are located not only in your liver but also in our guts and other cells throughout our body. So, you can imagine the little toxins little mycotoxins going through phase one detox. After they’re made water soluble, these toxins then go through phase two of detoxification. And in this phase, the mycotoxins that were processed in phase one are joined to compounds such as glutathione, which you may have heard of before, and glycine, which is an amino acid, and then the toxins are further prepared for elimination. And then in phase three, our body takes these conjugated toxins and flushes them out through our bile and ultimately our poop, but also through our kidneys, and then our urine as well. So we need to support each of these three phases of detox and there are different nutrients and different foods that are unique to each of these phases. And this actually ties back in nicely to the topic of nutrition and optimizing our nutrition for mold illness. Part of my approach to optimizing nutrition for mold detoxification is supporting each of these three phases. I’ll link to an article where I detailed some of the nutrients that we need for each of these phases. But just briefly, in phase one, we need certain B vitamins, we need certain amino acids. And in phase two we need glutathione and glycine. And then in phase three, we need water and fiber and bitter foods. So, those briefly will be some examples. All right, so then next up, and this is part of Phase Three, it’s an extension of phase three, but we want to support our bile flow and use binders to basically help mobilize mycotoxins into our poop and then binders can help mop up the mycotoxins once they are in our intestine. Some examples of natural binders include activated charcoal, bentonite clay, and a type of fiber called glucomannan.
Now, I will say that the topic of binders is a controversial one. And back to that comment I made earlier about, you know, there’s a group of practitioners out there who very much take this “my way or the highway” approach to mold detox, and they will say that you can only use pharmaceutical binders, namely, Welchol or cholestyramine for mold detox. However, in my practice, I have not found this to be the case. While there are no doubt people who do well with pharmaceutical binders, there are many others who do not. And these people instead use natural binders like charcoal or clay and have been able to recover their health. You do not need to use pharmaceutical binders [if they are not a fit for you]. Talk with your provider about it. And if you can’t tolerate those [pharmaceutical] binders, don’t despair, there are natural ones that you can use that can be really effective and get you back on track with your health.
And then we also want to support bile flow. And one of the main ways we can do that is by consuming foods that activate bitter taste receptors, not only on our tongues, but also in our intestines. We actually have taste receptors in our intestine that can sense when we consume bitter foods, and in response to that our bodies create bile. This is why bitter herbs have been used for so long in traditional herbalism to support the liver and bile because tasting them and consuming them activates bile flow. Some examples of bitter foods that you can eat to support your bile flow would include bitter greens, such as dandelion leaves, arugula, and I’ve radicchio. Other bitter vegetables, like artichoke, can also be used. You can use lemon – there’s a compound in lemon called D-limonene that stimulates bile. And then green tea and even coffee [can be used]. These are both foods with bitter compounds that can stimulate bile flow.
And then finally, some people will need to use antifungals in their protocol if they’re experiencing mold colonization caused by mold exposure. Mold colonization can occur in the gut. It may also occur in the sinuses. So, whether it’s a pharmaceutical option like Sporanox or a natural option, I often use herbs and nutraceuticals like a fatty acid called undecylenic acid that can have antifungal properties in the gut. Those types of treatments can help address the mold colonization piece because in that case, you’re not just needing to eliminate mycotoxins but you’re also needing to kill off mold that has potentially decided to take hold inside your body and you need to get rid of that in order to support your recovery process.
Alright, so I know that was a very rapid-fire overview about how to address mold-induced illness that may be co-occurring with your line treatment. But hopefully that overview was helpful and has given you some guidance and perspective on the steps you may need to take if you know or suspect that mold exposure is impacting you and may be impacting your line recovery. I’ll finish up with the comment that if you are dealing with Lyme disease and you either know or suspect that mold exposure is impacting you, it is crucial that you address it. Don’t push it off until you’re done with your Lyme treatment. And in fact, as they mentioned earlier, you may even want to address it first. It’s important to talk with your provider about that, but we really don’t want to leave mold exposure unaddressed because it can hinder your Lyme recovery process and it can make it more difficult to tolerate Lyme treatment. That was certainly the case for me. And then if mold exposure is left untreated, it can also drive other health issues like leaky gut, which can, in turn, drive all sorts of inflammation and problems throughout your body. You don’t want to leave mold-induced illness unaddressed.
If you need help recovering from mold illness and Lyme disease. I’d love to work with you in my practice! I offer a complimentary discovery call to individuals who are interested in becoming clients. I’ll provide the link to the discovery call in the show notes for this episode. Thanks again for joining me here on the Life Beyond Lyme podcast. I hope you found this episode informative and helpful in your Lyme and mold illness recovery. If you’re enjoying the podcast, I would be so appreciative if you’d leave a review on Apple podcasts. Your positive review will help me bring more listeners to my podcast so I can reach and help more people. Thanks again for listening and I’ll talk with you again soon!