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Mycotoxin Illness is not something I learned about in medical school. In fact, even in my early years of practicing Integrative and Functional Medicine, I was reluctant to explore the concept of Mycotoxin Illness with my patients. Similar to conditions like Lyme disease (which I also now treat frequently), Mycotoxin Illness seemed “taboo” and dismissed by traditional Western Medicine. Yet as is often the case when you have a medical practice like mine, you tend to see patients with multiple symptoms who have consulted with multiple providers and have not been given an explanation, diagnosis or clear treatment plan. I was not looking to treat Mycotoxins…they came and found me! WHAT ARE MYCOTOXINS? Mold is a fungus that can grow in any wet environment. Mycotoxins are very small toxins that are released from mold into the air. Mycotoxins are considered as a type of Biotoxin - and can cause injury to and dysfunction of multiple organs and systems, including the:
Mycotoxins are tricky! They are difficult to detect in your blood. They are very small and can move into and out of your cells with ease. Mycotoxins are secreted by the liver into bile and can be reabsorbed back into the body unless “tagged: by your immune system for removal. GENETICS PLAY A BIG ROLE IN MYCOTOXIN ILLNESS In genetically susceptible individuals, the immune system is unable to “tag” mycotoxins for removal, and they are resorbed back into the body. This may lead to chronic stimulation of the immune system, and in some, to the development of Chronic Inflammatory Response Syndrome (CIRS) that causes injury and dysfunction throughout the body. Certain gene variants can make you more likely to develop Mycotoxin Illness. These gene variants are associated with poor clearance of mycotoxins and increased inflammation and tissue damage. This is why four people can be living in a water-damaged home, yet only one is significantly ill! Only those with certain gene variants are likely to be affected. WHO IS AT RISK FOR MYCOTOXIN ILLNESS? For those who are genetically susceptible, any mycotoxin exposure is a potential risk. Suspicion is raised for those who live or work in a building that has a history of flood or known water damage, leaks or a damp basement. Buildings with flat roofs are more at risk. Signs of water intrusion may include a musty odor, condensation on windows, discoloration of vents or ceiling tiles and/or a need to constantly run dehumidifiers. SYMPTOMS OF MYCOTOXIN ILLNESS Symptoms of Mycotoxin Illness may vary from person to person. Individuals will also vary in how severe symptoms are in relation to the degree of mold to which they are exposed. A key feature in Mycotoxin Illness if the onset of symptoms after a move or job change. I use the following bullet-points when evaluating the possibility of Mycotoxin illness in my patients. For adults, symptoms in 8/13 bullet-points raises high suspicion.
TESTING FOR MYCOTOXINS I test for mycotoxins in patient’s urine, most often using Great Plains Laboratory Urine Mycotoxin kit. Cyrex Labs offers mycotoxin blood antibody testing that can be very helpful, however the cost of these tests for some is prohibitive (over $500) and they are often not covered by insurance. TREATING MYCOTOXIN ILLNESS Treating Mycotoxin Illness begins with a first, most important step - the patient needs to be removed from the mycotoxin exposure. This is generally the most difficult part of the process. If the exposure if through a work place there may be fear of job loss. One’s home is typically one of their most important life investments, and the decision to sell or leave is often difficult. In addition, mold remediation/clean up can be expensive and does not always solve the problem 100%. I have had this conversation with many patients over the years and it is never an easy one, however I have seen dramatic improvement and resolution of symptoms once those affected are removed from their source of exposure. Other steps involved in treating Mycotoxin Illness include:
To promote the clearing of Mycotoxins from the body I recommend: Intestinal Binders Intestinal binders of various forms are taken by mouth to bind Mycotoxins in the gut, preventing reabsorption back into the body. Examples of intestinal binders include activated charcoal, chlorella, zeolite and bentonite clays, and prescription WelChol (most often prescribed to lower cholesterol). Glutathione Glutathione is an antioxidant “powerhouse” which aids the detoxification of Mycotoxins from the body. Glutathione levels are often reduced in those suffering from Mycotoxin Illness and Glutathione supplementation plays a key role in the treatment process. Sweat, Hydration and Regular Bowel Movements Sweat, urine and stool are the three primary paths Myctoxins take to leave the body. Many of my patients incorporate regular sauna use (staring with very short sessions and working up slowly) into their treatment plans. Adequate hydration is important not only to encourage the “flushing” of toxins through urine, but also to prevent tissue damage throughout the body. Intestinal binders can be constipating, so I often add extra magnesium to promote regular daily bowel movements. For those who have developed CIRS, testing and treatment protocols are often more complex. While response to treatment varies per individual, I have been amazed by the rapid and significant improvement in symptoms witnessed in those diagnosed and treated for Mycotoxin Illness. Much of the information in this blog was learned from Dr. Jill Carnahan through educational training with the Institute for Functional Medicine. Dr. Jill is a nationally-recognized mold illness expert and I encourage you to check out her website for more information.
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Integrative Medicine, Carin Nielsen, MD413 Waukazoo Ave.Petoskey, MI 49770