As natural health practitioners most of us are aware of the term bio individuality, which makes for an interesting and varied approach when it comes to clients with complex health issues.
Environmental pollutants, in particular mould toxicity can be an important aspect to consider in these cases. As always, it’s best to take the ‘test, don’t guess’ approach, however, there are a lot of nuances to mycotoxin testing and as practitioners we need to be able to interpret the tests properly in order to fully support clients on their health journey.
But before we go deeper into the topic of mycotoxin testing, let’s define what mycotoxins are and have a look at some of the symptoms of mould toxicity.
Mycotoxins are fungal metabolites produced by pathogenic species such as Aspergillus, Penicillium, Fusarium. They can be inhaled, ingested, as well as absorbed through the skin. They can be stored in the body for years after the exposure thanks to their lipophilic nature.
They can affect the function of numerous systems within the body, including:
• The nervous system – restlessness, anxiety, depression, migraines, dizziness/vertigo, tinnitus, incoordination, dysautonomia, insomnia, neuropathies, dementia, tremor
• The digestive system – food allergies/sensitivities, cyclical vomiting, diarrhoea, constipation, ulcer, hematochezia (blood in stool)
• The respiratory system – sinusitis, hay fever, nasal polyps, wheezing, cough, asthma, chest pain, burning lungs, hemoptysis (spitting blood)
• The immune system – allergies, frequent colds, non-healing infections, delayed healing, cancer, skin issues – itching, burning, photosensitivity
• The endocrine system – menstrual irregularities, male and female infertility
Multiple other symptoms, such as persistent fatigue, could be added to this list, and it may be helpful to use a questionnaire, such as the one designed by Dr J. Crista, the author of ‘Break the Mould’ to assess your clients. As the symptoms are nonspecific, it can be hard to determine whether or not mould exposure is an important factor but if the client has a history of living in a mouldy building, the chances are that mycotoxins are at play.
While taking a case history, ask your clients about any visible mould in their property, mouldy smell, window condensation, general dampness in their home, and air circulation. Apart from water damaged buildings, dietary sources, such as grains, seeds, coffee beans, raisins, and plant based milks can contribute to the overall burden, especially when consumed over a long period of time.
Not everyone exposed to mould will develop mould related illness. Our susceptibility varies depending on a number of factors, with the level and the duration of exposure being the most significant variable. Age and genetics also play a role, but ultimately, it’s the overall physiological state of health that determines our resilience to mycotoxins. Low levels of exposure can produce significant symptoms in compromised individuals while those with vigorous health can cope with higher exposures without developing any symptoms.
Increased levels of mycotoxins have been found in individuals with:
• Gut related conditions, such as dysbiosis, intestinal hyper permeability, and dysmotility
• Thyroid conditions, such as Hashimoto’s disease
• Multiple sclerosis
• Chronic fatigue syndrome
• Cardiovascular disease
This does not mean that mould is the causative factor for these conditions but it’s certainly worth considering mycotoxins with the more challenging clients.
Urinary mycotoxin testing is recommended to identify mould toxicity; however, a negative result does mean your client is mycotoxin free! It might. It might also mean that the specific mycotoxin that’s affecting your client’s health is not being test for. But most importantly, it might indicate that your client’s ability to eliminate mycotoxins is severely compromised.
The test is dependent on efficient liver biotransformation pathways so a negative result may indicate the need for detox support. Dr. Neal Nathan recommends a 7-day glutathione supplementation at 500mg twice a day and/or sauna or hot baths prior to testing to induce detox and avoid false negatives. This is a useful strategy, but the dosage might be too high for sensitive clients and Alex Manos recommends 500mg once a day or NAC to avoid over-stimulation.
Re-testing is recommended after 3 months. It’s key to clarify with your clients that as their capacity to detox increases with your support, so might the levels of mycotoxins on their test. Increased levels might also suggest more or new environmental exposures.
Some of the strategies you might want to consider as part of your protocol addressing mould include:
• Glutathione supplementation – the internal synthesis is compromised in individuals with mould toxicity and supplementing can help sustain good detoxification.
• Supporting regular bowel movements – crucial for efficient elimination of all toxins. Be mindful of using mycotoxin binders in constipated individuals.
• Supporting good stomach acid levels – adequate stomach acid is needed to destroy mycotoxins.
• Supporting sinuses – these are a common site of mycotoxin colonisation and sinus support is recommended for a period of 6 months.
• Using anti-fungals, probiotics and biofilm disruptors.
• Phosphatidylcholine – to supports bile flow. Good biliary health and gall bladder function is needed to support detox.
• Using antioxidants, such as selenium, vitamins A, C, E, zinc, lycopene, EGCG.
• Supporting the lymphatic system – eg. via sweating to encourage detox.
• Referring to Dr Carnahan’s and Dr Crista’s dietary avoidance list to control the levels of of dietary mycotoxins.
Alex Manos rightly points out that ‘you can’t get well in the environment you got sick in’ but what if your client can’t move out of their mouldy property. First, there are specialist services that can help eliminate house mould. Secondly, getting a good quality air filter and a dehumidifier can make a big difference. Additionally, getting a nebuliser with tea tree oil, improving ventilation, and introducing some air purifying plants can further improve your client’s living conditions.
For more details and further resources head to the ANP Education Hub (in Member’s Area) and watch the webinar on Mould Related Illness with Alex Manos, which served as the basis for this blog post.