What is CIRS? Understanding mold illness

Mold illness, a condition also known as Chronic Inflammatory Response Syndrome (CIRS), has become increasingly recognized in recent years. This article explores the fundamentals of mold illness, including the role of mold, mold spores, and mycotoxins. We’ll also look at the symptoms associated with mold illness, both physical and cognitive, and shed light on the challenges of accurate diagnosis.

Water-damaged buildings often hide mold behind walls, tile, and cabinetry — which is why an exposure can be real even when nothing is visibly growing in the open.

What is mold illness?

Mold illness, or Chronic Inflammatory Response Syndrome (CIRS), is an illness that often arises following significant exposure to a water-damaged environment. While the degree of exposure may vary among individuals, even short or repeated exposures can have adverse effects.

Over a quarter of buildings in the United States are estimated to suffer from water damage, providing a breeding ground for mold growth (1). This can lead to various symptoms and chronic health issues for susceptible individuals.

Mold, spores & mycotoxins

Mold: the culprit in the shadows

Molds are fungi that exist both indoors and outdoors. With tens of thousands to potentially hundreds of thousands of mold species, these organisms thrive in environments with moisture. When exposed to damp conditions, molds reproduce by releasing mold spores into the air, seeking new surfaces to colonize and digest. Moisture control is crucial in preventing mold growth, as mold can survive on various surfaces as long as moisture and oxygen are present.

Mold spores: tiny carriers of trouble

Mold spores are microscopic cells that float in the air, both indoors and outdoors. They are hardy and can survive in dry and harsh environments where mold itself may struggle. When these resilient spores land on a surface with moisture, they can initiate mold growth and begin deteriorating the material. While completely eliminating mold spores from the environment is impossible, managing moisture is key to preventing their proliferation.

Mycotoxins: the hidden dangers

Mycotoxins are toxic substances produced by molds, present on mold spores and mold fragments. These mycotoxins can easily become airborne and travel through the environment. They can enter the body through inhalation, skin contact, or ingestion of mold-contaminated foods (2). Once inside the body, mycotoxins can trigger the production of pro-inflammatory cytokines, which are small proteins involved in immune responses (3). The inflammatory response caused by mycotoxins can contribute to chronic health issues in susceptible individuals.

Mold illness symptoms & diagnosis

It’s important to remember mold illness is indeed an illness, not an allergy. There is a long list of symptoms that may arise with this illness. More apparent symptoms of mold exposure include respiratory issues, sneezing, nasal drainage, and skin issues (4).

Physical symptoms: unmasking mold’s effects

Mold illness can manifest in a wide range of physical symptoms. Some common symptoms include respiratory issues, sneezing, nasal drainage, and skin problems. Prolonged exposure to mold and water-damaged environments can lead to more severe manifestations, such as:

• Fatigue
• Muscle aches
• Joint pain
• Gastrointestinal disturbances

Identifying these physical symptoms and their correlation with mold exposure is essential for accurate diagnosis and effective treatment.

Cognitive symptoms: mold’s impact on the mind

In addition to physical symptoms, mold illness can affect cognitive function. Research has revealed structural brain abnormalities in individuals with CIRS, including atrophy of specific brain regions and enlargement of others. Cognitive symptoms commonly associated with mold illness include memory problems, difficulty concentrating, brain fog, and mood disturbances (5). Recognizing the cognitive impact of mold illness is crucial for the comprehensive evaluation and management of affected individuals.

Why is mold illness often misdiagnosed?

Patients often present with many bizarre symptoms that practitioners (or even family members) believe are all “in their head.” Other times, practitioners simply 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 mycotoxin levels were significantly elevated in patients with chronic fatigue syndrome (6). It’s imperative to consider mold when looking for a root cause in complex patient cases.

Like the patients with chronic fatigue syndrome, patients are often given various diagnoses that are either incorrect — or, if correct, often improve once the patient is 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

Recently, some more concrete evidence for neurological difficulties associated with mold illness has been found. 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, 9).

There is also research to support the inflammatory cytokine response that mold and mycotoxins induce. These inflammatory cytokines are also present in neurological conditions such as major depression — one more reason to test for mold as a possible root cause of neurological issues (10).