What You Should Know About Mold Illness (CIRS)
In the past few years, there’s been a growing awareness of mold illness, otherwise known as Chronic Inflammatory Response Syndrome (CIRS). In this article we review the differences between molds, mold spores, and mycotoxins, and we explain why some individuals are more susceptible to CIRS/mold illness than others. We also review symptoms of CIRS and discuss why CIRS is often misdiagnosed.
What are molds?
Molds are fungi that are present in both indoor and outdoor environments. While we don’t know how many species of mold exist, there are estimates that range from tens of thousands to over three hundred thousand. Molds need moisture to survive, and they reproduce by making mold spores.
What are mold spores?
Mold spores are microscopic cells that float through both indoor and outdoor air constantly. They are very hardy and can survive in dry and harsh environments- places that mold may not be able to survive. When these hardy spores land on a surface and encounter moisture, mold growth can occur and begin to digest the surface. Mold can survive on just about any surface as long as it has both moisture and oxygen. While we cannot completely rid our environment of mold spores, moisture control is the best strategy to avoid mold growth (1).
What are mycotoxins?
Mycotoxins are the toxic chemicals present on mold spores and fragments of mold and fungus. These mycotoxins are released into the air and very easily travel through the air. Mycotoxins enter the body through inhalation, through the skin, or even through digestion of mold-contaminated foods (2). Mycotoxins can have a detrimental effect on humans, primarily through their production of pro-inflammatory cytokines (3). Cytokines are small proteins that are important for cell signaling that aid cell-to-cell communication in immune responses. They also stimulate cell movement toward sites of inflammation, infection, and trauma. Because of the toxic nature of mycotoxins, they prompt the production of pro-inflammatory cytokines creating a cyclical inflammatory response.
What is mold illness or CIRS?
As noted, CIRS is Chronic Inflammatory Response Syndrome, also known as mold illness. This is an illness that often occurs after significant exposure to a water-damaged building. Significant exposure may mean different things to different people. For some, a short exposure can do a lot of damage. Additionally, small exposures over time can build up in the body and do damage as well. For these affected individuals, a repeat exposure may give them a heightened response.
Buildings can become water-damaged through things like construction defects, inadequate caulking, and uncorrected water leaks. When this happens, growth of fungi, bacteria, mycobacteria, and actinomycetes can occur. The WHO estimates that 10-50% of buildings have a moisture issue and that 15-40% of homes have mold issues. (4).
OSHA explains that common sources of mold can include:
“…plumbing, roof, and window leaks; flooding; condensation on cold surfaces (e.g., pipe sweating); poorly maintained drain pans; and wet foundations due to landscaping or gutters that direct water into or under the building. Water vapor from unvented or poorly vented kitchens, showers, combustion appliances, or steam pipes can also create conditions that promote mold growth.” (1)
To prevent mold growth, damp or wet surfaces should be cleaned and dried within 24 to 48 hours.
Why do some people become more ill than others?
With exposure to water-damaged buildings, some people are better able to clear the toxins out than others. The body flags the mold as an unfriendly antigen and creates antibodies to rid the body of it in subsequent exposures. However, about 25% of the population has the HLA-DR gene and is genetically susceptible to mold. (5) For these people, the foreign substances, or antigens, have defenses that are ineffective at clearing the mold. This causes widespread inflammation throughout the body. This constant fight and inflammatory response can then lead to chronic illness.
While many people become ill from exposure to water-damaged buildings and mold, most of these people’s symptoms cease once they are removed from the exposure. For the 25% with the HLA-DR gene, the toxins remain in the body and trigger a chronic, systemic inflammatory response. These are the CIRS, or mold illness, patients. These patients often have a number of unexplained symptoms that greatly affect their quality of life, and we often see them at our doors after they’ve sought answers from multiple physicians and healthcare practitioners.
What are the symptoms of CIRS?
It’s important to remember that mold illness is indeed an illness and not an allergy.
There is a long list of symptoms that may arise with this illness. More obvious symptoms of mold exposure include things like respiratory issues, sneezing, nasal drainage, and skin issues. Long-term exposure to water-damaged buildings and mold are associated with more severe symptoms, such as memory and concentration issues. For a more complete list of CIRS symptoms, see the chart below.
Why is CIRS often misdiagnosed?
Many times, patients present with so many bizarre symptoms that practitioners (or even family members) believe it’s all “in their head.” Other times, practitioners misdiagnose mold illness. In a 2013 study of 112 patients with chronic fatigue syndrome, 104 (93%) tested positive for at least one mycotoxin. When compared to healthy control subjects, researchers found that the mycotoxin levels were significantly elevated in the patients with chronic fatigue syndrome (6). When looking for a root cause in complex patient cases, it’s very important to consider mold.
Like the patients with chronic fatigue syndrome, patients are often given various diagnoses that are either incorrect, or if they are correct, they often improve once they are treated for mold. These diagnoses include:
Fibromyalgia
Chronic Fatigue Syndrome
Multiple Sclerosis
Depression
Stress
Allergy
Post Traumatic Stress Disorder
Somatization
Irritable Bowel Syndrome
Attention Deficit Disorder (7)
Recently, there has been some more concrete evidence for neurological difficulties associated with mold illness. In a 2014 study, 17 patients who presented with CIRS showed structural brain abnormalities when compared to a medical control group. These abnormalities included atrophy of the caudate nucleus and enlargement of the pallidum. They also included enlargement of the left amygdala and right forebrain (8).
There is also research to support the inflammatory cytokine response that mold and mycotoxins induce (9). These inflammatory cytokines are also present in neurological conditions, such as major depression (10), which is more reason to test for mold as one of the root causes of neurological issues.
In our next article, we will review how molds trigger inflammatory pathways and wreak havoc on the body. If you believe you have been exposed to mold and/or are dealing with life-altering, unexplained symptoms, such as those listed above, please contact us. We can help.
Article Updated on 2/16/24
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