By Jill Carnahan, MD
Exposure to mold and mold components is well known to trigger inflammation, allergies and asthma, oxidative stress, and immune dysfunction in both human and animal studies.
Mold spores, fungal fragments, and mycotoxins can be measured in the indoor environments of moldy buildings and in humans who are exposed to these environments.
Most of the time, we are exposed to molds like Stachybotrys via skin contact, through ingestion, and by inhalation. Sites of exposure typically include water-damaged and poorly ventilated homes, schools, office buildings, court houses, hospitals, and hotels. It is estimated that as many as 25% of buildings in the US have had some sort of water damage.
Molds have the ability to trigger a wide range of symptoms, such as skin rashes, respiratory distress, various types of inflammation, cognitive issues, neurological symptoms, and immune system suppression. In day-to-day clinical practice, the most common symptoms associated with mold exposure that we’re likely to see are allergic rhinitis and new onset asthma.
When in Doubt, Ask
I believe we need to raise our index of suspicion about mold exposure among our patients with chronic inflammatory conditions, especially when those conditions do not resolve with typically effective treatments.
I start to think about mold exposure whenever I see patients with the following:
- Fatigue and weakness
- Headache, light sensitivity
- Poor memory, difficulty finding words
- Difficulty concentration
- Morning stiffness, joint pain
- Unusual skin sensations, tingling and numbness
- Shortness of breath, sinus congestion, or chronic cough
- Appetite swings, body temperature dysregulation
- Increased urinary frequency or increased thirst
- Red eyes, blurred vision, sweats, mood swings, sharp pains
- Abdominal pain, diarrhea, bloating
- Tearing, disorientation, metallic taste in mouth
- Static shocks
- Vertigo, feeling lightheaded
To be sure, there are many conditions that can lead to each of these symptom patterns, and mycotoxin exposure may not be the sole explanation for any of them. Yet many clinicians do not even consider the possibility, though given the prevalence of water damaged homes in many parts of the country, we certainly should.
Whenever I suspect that mold exposure may play a role in the underlying causes of someone’s symptoms, I like to ask the following questions from a checklist developed by the Environmental Health Center-Dallas (EHCD).
- Do musty odors bother you?
- Have you worked or lived in a building where the air vents or ceiling tiles were discolored?
- Have you noticed water damage or discoloration elsewhere?
- Has your home been flooded?
- Have you had leaks in the roof?
- Do you experience unusual shortness of breath?
- Do you experience recurring sinus infections?
- Do you experience recurring respiratory infections and coughing?
- Do you have frequent flu-like symptoms?
- Do your symptoms worsen on rainy days?
- Do you have frequent headaches?
- Are you fatigued and have skin rashes?
A few “yes” answers to these questions, should prompt you and your patient to get serious about looking for—and eliminating—household or worksite molds, and doing whatever else is necessary to minimize exposure.