01/23/2026
Disclaimer: This is not a real patient but if it sounds like you ....(you're probably a moldie). 😅 Sorry...
45 year old female presents to the office with a myriad of symptoms. She has chronic sinusitis that is incredibly stubborn; she takes a course of antibiotics only to have them fail and need a second, more potent round. She has developed sudden onset asthma, yet has no history of this otherwise. She has had random hives pop up and she is not sure of the trigger. She saw an allergist and was basically allergic to everything. They tried various medications for her and of course, she had every side effect on the pamphlet. Can she live in a bubble? That seems like the only option at this point. Rheumatology said this is not auto-immune.
She has had constipation throughout her life but more recently things have taken a turn for the worse with severe bloating, gas, and reflux. She has seen gastroenterology and told that she has IBS and to follow a low FODMAP diet. For a time she could control her symptoms by eating gluten-free, but now it seems like everything that she eats causes a reaction. This has led her to feel very confused, as she doesn't know what to eat or what to avoid.
She comments of severe brain fog, leaving her concerned that she has early onset dementia. Headaches have increased over time, to a point that she has them more days than not. Neurology at least gave comfort that she does not have MS. Somehow, despite her fatigue and brain fog, her brain is in overdrive as soon as she lays down at night.
Her menstrual cycles are all over the place; lots of clotting, discomfort, often feeling like she's battling an underlying yeast infection but her cultures are otherwise normal. She had a bout of interstitial cystitis in her 20s that has now come back with a vengeance. OB/GYN has said that these concerns are normal for her age but she could get a hysterectomy.
She works in education; a fast paced, high-stress job. She has noticed that her symptoms are worse when she is at work, better on the weekends, and there's a vast improvement during the summer months. She does note that there are water stains on the ceiling tiles and her classroom often smells musty. She isn't sure if she feels better being away from her job because of all of the stress, or if because something in her environment is making her sick.
She presented to our office, as she is at her wits' end and she feels like she is out of options.
I wish I could say that this is an unusual kind of case to see, but honestly, it screams mold. What about this kind of case makes for a "moldie"?
✅She experiences an "unveiling". She works in a water damaged building and when she has a decent chunk of time away it her symptoms noticeably lift. Not perfectly so, but often for moldies, this is the only thing that budges symptoms. Sometimes this can be noticeable within an hour. Sometimes it takes a week. But for moldies, unveiling will be there.
✅If someone can identify "it all started when"--I started that job, we moved into that house, after the basement flooded, etc, this is notable.
✅Mold is one of the most histamine-rich illnesses and initially starts out with: sniffles, runny nose, congestion, mucus, allergies, hives. Over time that histamine-rich state overwhelms the system and catapults into side effects, chemical sensitivities, anxiety, irritability, headaches, overstimulation/agitation, and insomnia.
✅Over time, mold colonizes in the nasal passages and sinuses. Sinus infections are very common. Because of the physical location of this colonization, the neurological system can be heavily effected: headaches, brain fog, floaters, light sensitivity, random eye prescription changes, mood changes. Mold is also an avid bio-film former leading microbes to become more resistant and more difficult to treat over time. Several rounds of antibiotics might be needed for an infection and still not work. Cultures can come back negative and are missed due to this as well.
✅Different kinds of molds produce different kinds of mycotoxins. The most common molds in water damaged buildings include Aspergillus and Penicillium. These molds produce mycotoxins like Ochratoxin A, Citrinin, Gliotoxin, Aflatoxins. Each of these mycotoxins have special affinities within the body, where they like to wreak havoc. Some are more kidney focused (dehydration, POTS/dysautonomia), liver focused (fatty liver, gall bladder issues, sludge), gut focused (IBS, "leaky" gut, resistant SIBO cases), reproductive (endometriosis, hormone imbalances), immune focused (immune function, acute illness, but also leukemias and lymphomas). Some mycotoxins are recognized as known carcinogens as well. Thus, the symptoms that someone can experience can be very broad and typically it is not restricted to just one part of the body.
✅Often times symptoms don't come out of the blue. Whatever weakness someone might have had before that mycotoxin exposure, it might be more glaring and angry after the fact.
✅Many times, moldies have a multitude of symptoms, have seen many specialists, and have little answers. They are "healthy" on their bloodwork, but not healthy in their daily quality of life.
Luckily, mold and mycotoxins can be combatted. It takes a lot of patience, time, and perseverance from the patient (along with an experienced provider) but the work can get done.
Dr. Crista created a Mold Questionnaire that helps to assess risk for mycotoxicity. It does NOT diagnose mycotoxicity. But it can be a useful tool because if a score is high--there is certainly good reason to move forward with testing for mycotoxins. I use this all of the time. First, to validate a patient's concerns (and remind them they aren't "making up their symptoms"). Second, as confirmation, as a clinician, that I am not having tunnel vision of mold, but there's enough proof to ask a patient to invest the time and money into doing a Mycotoxin test.
I will put the link to her Questionnaire in the comments if you want to check it out.
Next up, we will talk about how to test bodies for mycotoxin burden. I'm taking the weekend off, so we will cover this (and more) next week. Stay tuned!
