COURTNEY SNYDER MD - HOLISTIC PSYCHIATRIST
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Mold Toxicity - Depression, Anxiety, Fatigue, Brain Fog & Inattention

5/16/2019

36 Comments

 
Picture
"Light Showers on Tidy Town" paper, acrylic on 24 x 48" canvas "Inspired by the coastal towns of Ireland."
By Courtney Snyder
​
One of the challenges of writing blog posts that explore root causes of brain related symptoms is that what we are learning is constantly evolving.  There's so much we still and will never know.  Another challenge - everything is interconnected. The best I can do is to write about these root causes separately. While some contributing factors can occur in parallel, one condition is often leading to other downstream conditions that themselves contribute to things like depressed mood, anxiety, mood swings, brain fog/inattention and so forth.  

Mold toxicity is a perfect example.  It can contribute to Pyrrole Disorder due the stress it puts on the body.  It can lead to elevated copper by overwhelming one of the antioxidants in the body that regulates copper.  Because it interferes with the immune system, it can lead to a susceptibility to candida/yeast, Lyme and its co-infections.  It also frequently worsens mast cell activation (see last post).  I consider it a root of the roots.  In my daily work, I find mold toxicity to be very common.  Here’s why - ​
Water Damaged Buildings
It is estimated that 50% of buildings have water damage. Where there is water damage and retained moisture, there is an ideal medium for toxic mold to grow rapidly and produce spores which carry toxins. It isn’t just the infamous black mold, or Stachybotrys that’s a problem. Aspergillus, Penicillium, Fusarium, and Chaetonium also make toxins that can be acquired through inhalation, ingestion or through the skin. Mold in buildings is often not visible. It can be in a crawl space, an attic, behind a wall, or under a sink. It can be within a component of an air conditioning system or even duct work. The spores can disseminate easily. They don’t necessarily stay, for example, in a damp basement. Outside mold typically has checks and balances and also isn’t concentrated in a contained space.  While it can cause problems with mold allergy, it doesn't necessarily contribute to mold toxicity in the way that mold from water damage buildings does.

Mold Toxins
Once acquired, the toxins enter cells and start an inflammatory process and make it harder for the body to detoxify. There’s evidence that mold can colonize the sinuses and possibly the gastrointestinal tract. This would explain why for many people, simply getting out of a moldy environment is not enough to alleviate symptoms. Not only do they continue to have toxicity, they may also be harboring toxin producing mold. If that wasn’t enough, some will also have mold allergy.

Implications
In one water damaged home, not every family member will necessarily be impacted. Seemingly 25% of people are unable to make antibodies to mold toxins. Add to that the 50% of buildings that have water damage, and you have a lot of people who are unknowingly becoming toxic while spending time in affected homes, schools, workplaces, cars, dorms, and nurseries. When you consider the masses of people returning to water-damaged homes after floods, the implications of this evolving understanding is staggering.

In a world with so many other insurmountable challenges, I wish this weren’t true. There are many who argue that it isn’t. For me, this truth, that mold toxicity is a big part of what is making many people sick, is reinforced every day in what I do.

This type of information won’t disseminate like mold spores. Few people will ever identify mold toxicity as the source of their health problems. Fewer will be able to do what is required to heal. I'm hopeful someone out there will benefit from happening upon this information.

The Vulnerable
For the 25% of people who don’t mount a typical immune response to mold toxins, antioxidants and strategies to enhance detoxification don’t necessarily remove these toxins.  It is arguable, however, that even those who don't genetic vulnerability if exposure is enough could become toxic.  Mold toxins basically go from the body, to the liver and gallbladder where they are bound to bile and sent out into the gastrointestinal tract. The bile, however, is recycled (as a means of conservation), and thus take toxins back into the body.

Symptoms of mold toxicity impact many parts of the body. Often there are many symptoms that seem unrelated, which is why many who are unknowingly dealing with this, end up seeing multiple specialists and are left feeling their doctors think it’s “all their head.” The diagnosis of anxiety or panic, depression, obsessive compulsive disorder, ADHD/ADD, pseudoseizures and conversion disorder are fairly common. I empathize with doctors who have been trained to relieve symptoms as opposed to seek deeper root causes. Still, I do think all physicians (myself included) can benefit from realizing and saying repeatedly, “There’s so much we don’t know,” or even “I don’t know why you are having your symptoms.” The lack of humility or inability to admit one doesn’t have the answer, sadly can lead to some doctors to discount symptoms as “psychiatric” or even blame their patients for feigning their symptoms.

Personal Experience
My own foray into this topic, came in 2016 when I started to hear about mold toxicity from some of my functional medicine colleagues. While looking for resources, I took the VCS/Visual Contrast Sensitivity APTitude Screening Test at Dr. Ritchie Shoemaker’s website, Surviving Mold. Dr. Shoemaker is the pioneer who has brought this important problem to the world’s attention, starting with his book, “Mold Warriors.” The VCS test is a screener for biotoxicity. Other biotoxins (such as from Lyme), metal toxicity or even a gluten sensitivity can impact this test. Passing it doesn’t mean you don’t have mold toxicity, but failing would raise suspicion.

The fact that I failed the test and had a number of symptoms suggestive of mold toxicity, wasn’t enough to start me down the path of exploring mold toxicity for myself. Like many, I gladly opted for denial. What such a reality would mean for myself, my family and home was more than I wanted to consider. One year later, a colleague suggested I consider mold toxicity for my persistent low grade neurological symptoms. Fast forward 3 years and through my and my daughter’s healing processes and I’m now regularly diagnosing and treating mold toxicity in adults and children. Repeatedly, I’m surprised at just how common this is in those with brain related symptoms.

I've been fortunate to have as a mentor, Neil Nathan, MD - one of the leading experts and pioneers in this area. Because of my early joining, I’m grateful to be considered a Full Founding Member of the International Society of Environmentally Acquired Illnesses or ISEAI.

Despite the growing knowledge about mold toxicity, available testing and treatment, we still know very little. This area of medicine is in its infancy and we are collectively learning more every day. Even among the pioneers, there is debate about the testing, evaluation, treatment and whether mold colonizes in the body. The below information I share is based on my own education, as well as my personal and professional experience.

SYMPTOMS
It is worth noting, many of these symptoms overlap with mast cell activation and autonomic dysfunction. Mold toxicity is a very common driver of mast cell activation. While there seems to be a genetic component to mast cell activation (fitting with RCCX theory), it has been the experience of many of us, that mold toxicity will take it to another level and that when you treat the mold toxicity many of the mast cell symptoms settle down.

  • Highly sensitivity to a wide range of things such as scents, medications, supplements, emotional triggers, weather changes, etc. This is likely because of the mast cell activation, but also because the toxins not unlike a traumatic event, can prime the brain for danger. By this, I mean, the brain knows something is wrong and is sending danger signals, but it doesn’t know what the danger is. I have met many mold toxic patients who are exceeding vigilant, but not necessarily about mold, because that simply wasn’t on their radar. Instead, they have other contamination fears, obsessions about their health, paranoia and so forth.
  • Fatigue
  • Brain fog
    • In children this can look like ADHD or ADD
  • Cognitive decline or dementia
  • Anxiety and depression
  • Mood swings
  • Headaches
  • Symptoms very specific to mold toxicity, though they don’t have to be present.
    • Electric shock sensations
    • Ice pick-like pains
    • Vibrating or pulling sensations running up and down the spine.
    • Numbness and tingling
    • Balance and dizziness without other identifiable neurologic conditions
    • Atypical Parkinson's Disease
    • Atypical ALS
    • Psychogenic seizures or pseudo-seizures​​
  • Tics, spasms and seizure like events
  • Sensitivity to bright light
  • Sensitivity to light touch
  • Suspected or Diagnosed PANS/Pediatric Acute-Onset Neuropsychiatric Syndrome
  • Chronic sinus congestion
  • Gastrointestinal symptoms
  • Coughing, chest pain, shortness of breath
  • Muscle weakness and pain
  • Joint pain and morning stiffness
  • Excessive thirst
  • Frequent urination
  • Appetite swings
  • Rapid weight gain
  • Night sweats
  • Body temperature dysregulation
  • Impotence
  • (Particular mold toxins appear to be carcinogenic)

The diagnosis of fibromyalgia, or chronic fatigue are both common. In 2013, Dr. Joseph Brewer, an infectious disease specialist and also a pioneer, found that 93% of 112 people with Chronic Fatigue Syndrome had elevated levels of mold toxins.

Diagnosis:
While there are some inflammatory markers that can be tested, many of us instead now use urine mycotoxin testing, to identify which toxins are present. Knowing which toxins are present impacts which binders are used to remove the toxins.

Treatment:
  • Evaluating one’s current environment is essential. Many people have learned the hard way that they’re unable to heal if they stay in a moldy environment. There are some ways to start to evaluate indoor environments using plates and/or ERMI testing. My preference, however, if at all possible, is to have a certified environmental consultant visually inspect, and do air sampling or swab testing if indicated. They will also have the ability to identify temperature gradients behind walls and under flooring using infrared light, which can point to contained moisture and thus likely mold. A consultant who is independent from a remediation company (and thus does not have a conflict of interest), can give direction to a remediation company of one’s choosing if needed. They can direct how to contain the space as the mold source is removed so that exposure isn’t increased, as well as indicate which areas of the home and contents that have been exposed. Likely they will retest after the remediation is done.
    • ​​The door to my previous office didn’t have a good seal between the door jam and the concrete below. When it rained, water made its way into the sub flooring. Water damage wasn’t evident until the hardwood eventually started to buckle. Prior to this, however, every time someone walked across the threshold, an invisible “poof” of mold spores carrying toxins was released into the air.
  • Binders are chosen based on the mold toxins that show up on the urine test. Examples include bentonite clay, activated charcoal, chlorella, cholestyramine, and colesevelam HCI. The doses are determined one at a time. For some very sensitive people, only tiny amounts are tolerated, though still effective. The duration of binders can go beyond one year. This is not a quick fix. It takes time and patience, but for most people there is clear and steady improvement. “ I’m now able to read again and remember what I read,” I’m exercising again,” or “I can eat a wider range of foods without reacting,” are the types of initial observations that reflect the beginning of the healing process. For some people, the binders help move them toward healing, while for others who seem to have had colonization, such as in the sinuses, antifungal treatment steps may need to be added.
  • Antifungal treatment when necessary in the form of nasal sprays and/or antifungals for the gastrointestinal tract to address candida which is also frequently present.   These antifungals can be prescription medications or natural such as herbal formulations.  Starting antifungal treatment before some is on adequate binders can lead to worsening of symptoms (the mold and/or yeast can die off and release toxin that aren't being moved out with binders).
  • Diet - As with candida/yeast, mold will thrive on a sugar and a high carbohydrate diet. Though there is a great deal of individuality when it comes to food, most people with mold toxicity seem to do best with a whole foods diet of lean protein and vegetables along with an avoidance of sugar and limited carbohydrates. Of those who also have mast cell activation, some will benefit from a low high histamine diet
  • There are there are other potential pieces to the treatment that may need to be addressed before someone who is especially sensitive will be able to tolerate the binders. These include supporting detoxification, stabilizing mast cells, addressing autonomic dysfunction (by accessing the vagus nerve) and using neural retaining to lower the acute danger response (limbic system dysfunction).  These can all be causes or exacerbated by mold toxicity. 

The duration of treatment depends on a number of factors, including age, severity of symptoms, sensitivity, and the presence of other conditions such as Lyme, Bartonella, Candida and even methylation imbalances. For some the treatment can be 1-2 years, though again, the improvement usually starts long before this. Children tend to have quicker responses and may only need 6 months of treatment.

Anyone who makes this journey will tell you, “It’s a process” - one that can start out with a mix of relief and overwhelm. Relief to finally be finding answers and overwhelm about the larger implications for one’s family, home and the items in their home. Over time, however, through education, and hopefully improved mental clarity and energy, a new reality starts to set in.

​Moving Forward
I once wondered how I would feel safe in future homes or offices, given how common indoor mold is. Part of my concern likely lessened by removing the toxins which would diminish the danger response. Also, I've found (as have others) that if we pay attention, our bodies will tell us when there's a problem. The environmental consultant, with whom I work closely, knows that if I walk into a home or office and say, "There's mold here," that even if it's not visible, when he runs air samples, there will be elevated spore counts. For me the cues are increased heart rate, very mild nausea and a subtle buzzing sensation in my body.

Indoor mold has taught me many things, but none more powerful than this - if we pay close attention, our bodies will tell us much of what we need to know. We can call it intuition, or we can call it an acute inflammatory response to an environmental exposure. Perhaps they're the same thing. For me it doesn’t matter. At this point, I simply trust it.


Resources
For more information on this topic or to find a physician in your area, see the International Society For Environmentally Acquired Illnesses / ISEAI website, or google “Mold Literate Doctors (or Practitioners)”

If there is one book that clearly, comprehensively and compassionately covers what is being learned about this complicated area, it is -
“Toxic - Heal Your Body from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivity and Chronic Environmental Illness” by Neil Nathan, MD

I would also recommend Jill Carnahan, MD’s Definitive Mold Clean Up Guide
https://iseai.org/your-definitive-mold-clean-up-guide/
36 Comments
Chrissy
7/2/2019 10:57:27 am

Wow - thank you for the helpful information! You’re a gifted writer, doctor, and thinker! Thankful to have found you and proud to call you my doctor.

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Courtney Snyder link
8/8/2019 02:21:27 pm

Thank you, Chrissy. You are very kind to say that. Courtney

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Angela
5/22/2020 03:53:31 pm

Is there a link between mold exposure and the acute onset of panic attacks and/or panic disorder?

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Courtney Snyder link
7/18/2020 04:03:36 am

Yes, there is. I’m sorry for my late response. Somehow I missed your question. Panic is a fairly common symptom of mold toxicity. It is likely related to mast cell activation, which I discuss in my most recent post and mold toxicity in my experience is usually the underlying driver of mast cell activation.

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Shane Semkin
8/3/2020 03:04:16 pm

Dr. Snyder my wife & I read through extensive information you share & I’m certain my symptoms are mold related. I’ve been sick almost 12 years & tried so many protocols to no avail. Can you please steer me in the right direction to pursue healing?! I’m desperate....

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Courtney Snyder link
8/9/2020 07:44:17 am

Hi Shane. There are a number of doctors with experience treating mold toxicity around the country. Some will take the "Shoemaker" approach and some with take the "Brewer and Nathan" approach. My own way of evaluating and treating mold toxicity aligns with the later. On Neil Nathan, MD's website, he has a resource list. Other practitioners can be found on the ISEAI website. Increasingly doctors and practitioners in the functional medicine community are becoming knowledgable about mold toxicity. As with anything, some will have more experience than others.

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John
8/3/2020 05:46:29 pm

What about those who are overmethylators with Mold toxicity? Overmethylators have low histamine, but if Mold means suffering MCAS, and you treat with Quercetin, you're going to lower histamines even more with Quercetin, right?

I have 3 types of mycotoxins (OTA, citrinin, mycophenolic acid) in my system, and I have often wondered if MCAS was also an issue, but my histamines are generally pretty low (though I actually suspect I may be an undermethylator based on my lifetime traits). I've wanted to add quercetin in for a while but worry it will drop my histamines too low.

Also, any thoughts on using Synapsin nasal spray (with RG3 from Ginseng and methylcobalamin) for helping the glial cells remove toxins from the brain? When I read your this post, it sounds like a Synapsin spray could make things even worse by over activating the glial cells.

Thanks, John.

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Courtney Snyder link
8/10/2020 05:08:50 am

Hi, John. Your question about overmethylation is a really interesting and good one. I find it to be very common for people who are undermethylated (by their lifelong symptoms and history) to have whole blood histamine levels that are much lower than they should be and can at times suggest overmethylation. So when someone has mold toxicity, I don't expect to get an accurate reading doing a whole blood histamine. Overmethylation, interestingly, is becoming less common - something Dr. Walsh has been studying. Quercetin can lower histamine - but primarily by mast cell stabilization and mast cells can release a lot of other inflammatory mediators (and even neurotransmitters) and thus could theoretically be also benefit someone who is overmethylated. When someone has mold toxicity - addressing methylation becomes secondary to addressing mold toxicity, because most people can't tolerate methylation interventions until they are farther along in their mold treatment. If I start someone on anything I recommend that they start low and slow and not continue if they are having any new or worsening of symptoms. I don't have experience with Synapsin, but thank you for mentioning it, I'll look in to it.

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John
8/18/2020 04:53:42 am

Dr. Snyder, I'm curious on your thoughts about probiotics for those with mold toxicity/mycotoxins. One functional medicine doc told me that probiotics are mostly wasted and to rely on fermented foods like Farmhouse Gut Shot (fermented vegetables) or Kombucha (fermented tea) to help colonize the gut. I had another functional medicine doc tell me that fermented foods are a terrible idea for someone with mold as that could actually make mycotoxins worse or even help the body colonize mold in the gut!

I know gut health is important, especially for fighting off mold, yeast, or candida. Do you suggest taking a probiotic when healing from mold, and if so, are there specific strains one should look for or just rotate out a variety of probiotic strains every couple of months?

Thanks, John.

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Courtney Snyder link
8/18/2020 01:57:11 pm

A lot of people who have mold toxicity have mast cell activation and about 50% of people with mast cell activation seem to have problems with high histamine foods and thus would feel pretty bad on fermented food. While yes, the microbiome is important, I often wait a little and start probiotics after someone is at least on the binders to remove toxins. 2 reasons 1) die off of mold or yeast can be hard to tolerate if binders aren't on board 2) toxicity makes it very difficult for the microbiome to get back on tract, so aggressive probiotics aren't always as impactful as we'd like to think When I use probiotics, I like spore forming.

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Lillian
8/27/2020 05:30:58 am

Hi Courtney, gorgeous painting "Light showers on tidy town". I come from a coastal Irish town and this is such a lovely stylised image of our fair isle. Now a question of great importance to all us Irish folk likely to be suffering pyrrole disorder: is there ANY doctor/specialist in Ireland testing and treating pyroluria?

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Courtney Snyder link
10/7/2020 06:26:06 am

Thank you, Lillian, for your lovely comment. I apologize I am only seeing your comment now. Yes - there are a number of practitioners in Ireland. I met Patrick Magovern, MB DObst LMCC MICGP PGCertNutMed at one of the Walsh trainings and really liked him. Here is a link to the Walsh Research Institute resource page that has a map with the practitioners in Ireland. https://www.walshinstitute.org/clinical-resources.html

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Zachary Tomlinson link
2/11/2021 06:43:52 am

I find it alarming that getting exposed to molds can cause serious respiratory problems or depression. I saw a couple of flyers regarding mold removal around my parent's home, and I wanted to learn more about it. I should probably reach out to an expert that can remove molds for my future home!

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Courtney Snyder link
2/15/2021 06:51:43 am

Hi Zachary. Thanks for the comment. Consultants/experts can be very helpful, especially if you know there is a problem with water damage (for a prospective home, this could be reason to forgo that house). Another route if there is not an obvious problem is to do ERMI testing. Here some info on that:
Article/interview about how to evaluate for mold in your home
https://chriskresser.com/how-to-test-your-home-for-mold-with-mike-schrantz/
To do ERMI testing mentioned in this interview, contact -
Mycometrics
https://www.mycometrics.com/products.html
Courtney

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Sherry Darrah link
3/15/2021 08:45:30 am

I was exposed at work for almost 10 years and worst symptoms are Extremely off-balance/Coordination walking and slurred speech from Gliotoxin, and 2 black molds i am on Bentonite clay and activated charcoal. Will I return to normal balance, walking and speech or is there a chance its permanent?

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Courtney Snyder, MD link
3/16/2021 07:42:31 am

Hi Sherry. There are many variables and I don't know the severity of your symptoms or other potential contributing factors, but in my experience such symptoms (if primarily related to mold toxins) tend to improve with proper treatment. Treatment can involve many areas beyond binders for mold toxins - such as detoxification support, treatment for colonization in the body (after binders are on board), lowering brain inflammation and preventing recurrences of brain inflammation and neural retraining. Also I am a believer in the physiologic power of our imagination - which has also been shown to help with neural retraining (over time) - meaning regularly imaging ourselves in our healthiest state while still taking appropriate steps toward healing. Warm Regards, Courtney

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Nicole Schwanger
3/16/2021 05:59:36 am

Dr. Snyder. I’m currently working on treating sibo/candida overgrowth with Cleveland clinic FM. I have a lot of mold symptoms and the visual test was positive but my mycotoxin urine test was negative. Would you still be concerned with mold at this point? My worst symptoms are anxiety/panic, now starting depression, poor blood flow in my legs and feet, “benign fasciculitis”, the buzzing/surging feeling in my chest and down my spine, brain fog. Some days I feel ok and others it’s exhausting just to stand out of bed. Thank you for all your research and work.

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Courtney Snyder link
3/16/2021 07:30:02 am

Hi Nicole. You can still have mold toxicity even with a negative test. I have found the RealTime Test to be more sensitive than the Great Plains Lab test for mycotoxins (and especially GPL mycotoxin tests done during a few months around Spring and Summer of 2020). Other biotoxins (such as bartonella) can cause symptoms similar to mold toxicity, though I don't find this to be as common as mold toxicity. The visual contrast test is not specific to mold toxicity - other biotoxins can impact it as well as gluten sensitivity. I hope something here is helpful. Courtney

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Sabrina
8/9/2021 11:43:33 pm

I was literally in tears reading through this. I noticed my symptoms after I moved into an apartment and as my health slowly started declining and I finally started speaking up and trying to figure out what was wrong, everyone was calling me crazy. I was finally diagnosed with fibromyalgia but deep down I knew when everything started and what was the cause. It took a long time to move out of that apartment but the symptoms I’m left with are ruining my life. My chest constantly hurts, I feel electric shocks all through my left arm randomly, joint pain and stiffness, brain fog etc.
I honestly don’t know what to do at this point. I’m hoping I can find some help so that I can start recovering from this somehow. If you read this please reach out because I can’t live my life this way anymore, even if I need to travel for help, I’ll do whatever I need to do so I can put this behind me. Thank you for all the information!

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Courtney B Snyder link
8/10/2021 02:59:02 am

Hi Sabrina. I am glad you found this post, though I'm sorry that you are struggling. Increasingly, there are "mold literate" doctors around the country. Some websites that will have lists with locations include: Dr. Neil Nathan, MD's website, ISEAI(International Society for Environmentally Acquired Illness) and Paradigm Shift. And, you're welcome to contact my office. At this point, most functional medicine doctors are aware if not learning about mold toxicity and how to treat it, so searching for functional medicine doctors in your area and inquiring with their office if they have experience diagnosing and treating mold toxicity. There are now a lot of resources and understanding out there and a lot of reason to be hopeful. I hope this information is helpful. Courtney

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Jessica Winn
8/18/2021 01:30:26 pm

I’m so glad I found this page. I became severely ill in January of this year. I am still on leave from work and it’s August. Never in my life would I have ever believed that Mold could make me as ill as I became. I am so thankful that I am on the road to recovery, but it has been a long and difficult road. The hardest year of my life so far, hands down. It’s such a slap in the face when even my landlord did not believe me. I have been to so many specialists, so many doctors, and I am so thankful that going to a functional medicine doctor finally led me in the right direction. It was the very first time I ever tried functional medicine as well. I would literally be on Prozac still living in a moldy home if it were up to my regular PCP. That honestly blows my mind! I am so affected by this experience that I want to try to find ways to raise awareness to help others. It is just very disheartening to know that not one of my regular traditional medicine doctors ever even thought that Mold could be the problem. That terrifies me. I think about all of the sick people out there and everything they’re going through and how many people are actually probably sick from Mold. I really, really want to do something and I’m open to suggestions on how to raise more awareness about this terrible problem that is making thousands of people sick. Landlords need to be accountable for the conditions they are having people living in. We need more mold laws, no one ever deserves to be this sick from something that is so fixable. Thank you so much for your website and for sharing this information! It is obvious you are definitely doing the right thing by people and their health, and I can’t tell you how much I appreciate that.

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Courtney B Snyder link
8/18/2021 05:16:15 pm

Hi Jessica. You articulated so well how many of us feel (about mold and now about EMF). I really appreciate your desire to raise awareness. I would says use whatever your natural abilities are to share your experience - maybe it's writing, or art or activism. Whatever it is, you want it to sustain you and not deplete you. Maybe it's focusing on educating landlords (or which there is very little financial incentive on their part to want to think about this issue) or maybe it's educating doctors. I think telling our stories can be powerful. There's no one way to impact this - it will take everyone bringing their unique abilities to the table. Thank you for such a thoughtful comment. Courtney

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Emma hughes
10/5/2021 06:40:36 pm

There was mold found in many areas in my home and my mom more than anyone, has been dealing with symptoms that I think are due to mold toxicity illness. She is dealing with brain fog, decreased word findings, memory issues, and majority of the symptoms you’ve mentioned above.
This article really gave me some great insight on what might be going on. I’ve been trying to figure out where I can take her to get checked for mold toxicity.
Are you still located in Louisville ky?

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Courtney Snyder link
10/6/2021 06:18:57 am

Hi Emma,
I currently do telehealth and see individuals from KY (I'm licensed in KY, OH,IN and FL - where I am living). If you are interested in learning more about the evaluation and treatment process, you're welcome to call the office, and Marty will share that information with you. The lab test that I use for mycotoxin testing is a the Real Time Lab mycotoxin urine test. You do not need a doctor's order unless you are wanting to bill insurance. Unless someone has Medicare or Tricare, it is not covered. The cost is $399 and typically can be purchased directly from RealTime. If your mother has Medicare, then likely you would want to have a "mold literate" doctor order the test at the time of an evaluation.
There are a few states Realtime can't sell the test directly to patients. If that is the case (which I don't think it is for KY) then DirectLabs also sells the test with I think $50 upcharge. I'm glad you found the blogpost helpful. Best to you and your mother, Courtney

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Meg
11/23/2021 07:26:18 am

One of the best reads yet as I start my journey into treatment mold for my teen son and myself. 10 years of me asking Drs why anesthesia for a long hernia surgery triggered long term anxiety and hives in my son. Now finding he is an undermethylator and we had a large hidden mold exposure over three last two years. Worsening symptoms of misophonia that he has suffered from for the last 15 years. I fear it’s all related. So little studies and treatment for debilitating misophonia.

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Courtney Snyder link
11/28/2021 05:42:38 pm

Thank you very much, Meg, for your comments. It is very common for someone to have undermethylation, mast cell activation and mold toxicity. Addressing mold for most people causes the mast cells to settle down. You may already be familiar with Polyvagal Theory. This information may be helpful as you look for ways to address your son's misophonia. If you're not familiar, I discuss it in my post about the vagus nerve. I'm glad you are finding your answers. Best to you and your son, Courtney

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Joanne
12/22/2021 04:47:32 am

Hello
In the city where I live the mold inspectors do not do ERMI testing. I read about Immunolytics. How does this compare to ERMI? Is one better than the other? Thank you

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Courtney Snyder link
12/23/2021 03:04:22 pm

Hi Joanne,
Some of my colleagues prefer Immunolytics and some of us prefer ERMI. Another test that I am starting to use more of is the EMMA test by RealTime Labs. I can't say that one is better than the other. The immunolytics test can help locate the room where there can be a problem, the ERMI can help determine if there is a problem (when there is no known source of water damage). The EMMA can do this as well and is also good for evaluating the duct system, as you can send in part of your air filter. None of them are perfect. If you know you have a source of water damage, then the testing may not be necessary, but instead involving an inspector who can help guide a remediation company of what needs to be done to remove the source, advise on the remediation and retest after. Ideally the inspectors are using a mix of tools and not just air sampling which is often the case. Great question. I wish I had a clear cut answer. Courtney

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joanne
1/3/2022 08:51:59 am

Thank you for your reply!

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Joanne
1/6/2022 11:19:23 am

Hello
Myself and 2 daughters have had ongoing chronic heath issues. I am looking into mold toxicity as a potential cause. I had all three of us do the visual contrast test which we all passed. I am unsure as to whether to do home mold testing or urine testing for us as a first test ? What do you do if your VCS test is negative? Are there other tests that can diagnose CIRS that may not be due to mold? Feeling confused as to where to start.

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Courtney B Snyder link
1/16/2022 07:59:00 am

Hi Joanne. The visual contrast test doesn't rule out mold toxicity. In fact, I stopped using it in my practice a number of years ago because very often people with mold toxicity passed the test. Urine mycotoxin testing is typically the place to start (my preference is RealTime Lab) - you can order it from them directly or if they don't sell to your state - Direct Labs will. There are blood tests that those trained with the Shoemaker approach use to diagnose CIRS. I don't use them, because they don't guide treatment for me (or tell what is causing the CIRS - which mold toxins, bartonella, lyme?) The mycotoxin test does guide treatment - depending on which toxins show up impacts which binders we use. I hope this is helpful. Best to you and your daughters, Courtney

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Joanne
1/16/2022 08:02:36 am

Thank you for the information.

Jennifer Sloan link
8/8/2022 03:29:04 am

I lived in extremely high mold toxicity for many years. I have lots of symptoms but the newest one - and one that concerns me greatly - is can mold cause the pressure in your eyes to increase.

Reply
Darren Lovatt
10/2/2022 05:08:15 pm

Hi, the cirs mold connection to symptoms seems plausible but can also be connected to psychological stresses in my opinion. But possibly exposure to some kind of toxins can then lead to psychosomatic reappearing of symptoms. In 2008, I went on a certain anti depressant and turned me into a zombie, as well as developing ocd with germs. I became so aware of germs. I moved into my own apartment still like a zombie due to anti depressants and having ocd issues. I withdrew off the depressants at the same time as having a bathroom floor holding water. To this day, I'm not sure if my symptoms are cirs or related to withdrawal. I moved in my own new rental house 2 years ago, and get strange symptoms. I possibly have carried these symptoms from my apartment with me, psychosomatic. The only way of not getting these, are when I'm not in my house living alone. If I'm staying at my parents house, I still struggle with ocd but do not get the fatigue, looking pale , dull less etc. POSSIBILITY THAT MOLD ISSUES CAN BE OVERBLOWN AND CONNECTEd TO TRAUMA AT THE SAME TIME (anti depressants withdrawal). LIVING ALONE AND HAVING ANXIETY ALL LIFE CAN ALSO BE CONNECTED IN A TANGLED WEB OF WHY SYMPTOMS ACCUR. MOLD ALONE SHOULNT CAUSE EVERYTHING.

Reply
Courtney B Snyder, MD link
11/22/2022 02:53:36 pm

Thank you, Darren. I really appreciate your comment. I agree, there are usually multiple variables, but in my experience, mold toxicity can lower the threshold for many other variables to create symptoms. The reason I think it's important to provide education on mold is that it is one piece that many people aren't considering and it can be keeping them stuck. It would be unusual to simply address mold and not also someone's stress response (which could already be heightened by trauma), nutrient imbalances, and more. Urine mycotoxin testing does help us know if mold may be a factor. But, even with mold toxins on board, which I would always recommend addressing, the stress response can usually be lowered even before doing so. We see this for those who are so sensitive to treatment that we have them start with DNRS (to lower limbic and immune reactivity). They typically will have significant symptom improvement even before starting on binders. Thank you again for your comments, Courtney

Reply
Bruce Culbreth
11/21/2022 06:53:57 pm

This is one of the most insightful articles I have read about mold problems. I live a couple hours away from any major cities and no doctors around here know about these problems or how to treat. I recently found out I have gallstones, causing major GI issues. Could mold be the cause of the gallstones and if so could mold treatment help this. If not what could help remove the stones so I don't have it removed. I live in north central Florida, do you practice in Florida or have a recommendation for this area. I thank you so much for your information.

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    Courtney Snyder, MD

    I'm a conventionally trained child, adolescent and adult psychiatrist.  My current approach to health is both holistic (pertaining to the whole person) and functional (addressing the root causes of illness). I write this blog to share what I've learned.

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