Mold Wars | Part 1

Battleground 1 — Diagnosing CIRS

Posted in

Dr. Aaron Hartman

June 21, 2023

MW Battleground 1

The Controversy

There’s a lot of debate, even in the functional medicine world, about chronic illness related to mold toxicity. Practitioners don’t always agree about how to diagnose it or how to treat it.

This series will take a deep deep dive into the controversies within the mold world. I will address:

  • How is CIRS diagnosed?
  • Is CIRS only related to mold?
  • How is CIRS treated?
  • How can someone with CIRS clean up their environment?

Before We Jump In…

This series will dig a little deeper into CIRS than I’ve previously covered on this blog, and it will build on some of the details I’ve addressed previously. If you are new to CIRS or biotoxin-related illness, I recommend you begin by reading my series on mold-related biotoxin illness. I’ve also written multiple other blogs on our website that talk about this topic of mold. This series will go a little deeper for those who want to learn more about the controversies of CIRS and biotoxin illness. So let’s begin.

Diagnosing CIRS

Mold Wars

The controversy begins with how we actually diagnose a person with CIRS. CIRS is a complex disease, and so is the diagnosis process. But diagnosis will invariably require lab tests. Which tests should we rely on to identify exposure to a mold-based biotoxin? There are two major camps on this question of testing.

Camp One: Urine Testing

Urine mycotoxin testing simply looks for signs of mold in the urine. However, most molds found in urine come from food, not the environment. Most toxins that are inhaled, in contrast, are detoxified through the liver and bile. So if you’ve eaten something contaminated with mold, say some moldy cheese or bread, it might show up in this kind of urine testing. However, inhaled mycotoxins from your environment would not be identified in this kind of testing.

Another issue with urine mold testing is that some people are better at detoxifying than others. One person who eats some moldy corn, might efficiently excrete it through their urine. In this case, we might see lots of mold in the urine, but it simply means that they are great at detoxifying it, not that they have CIRS. In contrast, if a urine mold test result is normal, it could just be a case of someone who is not effective at detoxifying and is actually very sick with mold-related illness. In order for that person to detoxify, they would have to chelate it or boost detoxification in some way — for example with sauna use or dry brushing.

There are too many variables in urine mold toxin testing to make it reasonably accurate.

Camp Two: Blood Testing

In blood testing, we’re not actually looking for mold toxins. Instead, it gives us a picture of the response of the immune system. This is important because, in reality, mold is everywhere. All of us are exposed to mold nearly every day — whether it be in our homes, offices, walking outside near leaves and trees, or eating it in our food.

The issue is not whether someone is exposed to mold. The question is: What does your immune system do when it is exposed to mycotoxins? This is what blood testing seeks to answer.

Blood testing for mold-related illness looks for biomarkers in the blood instead of for the mold itself. This method looks for evidence of an upregulated, abnormal immune system and seeks to answer the question: Is the immune system dysregulated?

These tests evaluate your regulatory brain — your hypothalamus and pituitary gland. They also look for dysregulation in your innate immune system, which is the most immature part of your nervous system. A dysregulation in the innate immune system is actually a case definition for serious chronic inflammatory response syndrome (CIRS).

Blood Testing for the Win

Mold Wars

Which method of testing is the most effective? Urine mycotoxin testing only reflects exposure, primarily from food, while blood testing seeks the status of your immune system and brain’s response to the exposure to toxins.

Blood testing for inflammatory markers and immune system dysregulation is a better way to diagnose mold-related biotoxin illness (CIRS) than urine mycotoxin testing.

Next week, we’ll jump into defining CIRS. You may be surprised at how much controversy there is around simply the definition of chronic inflammatory response syndrome, which is another battleground of its own. In the meantime, check out our blog where we’ve written many articles on CIRS.


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