First, a Caveat
Only a doctor or nurse practitioner with the right knowledge and experience can accurately diagnose mold disease. I say “right knowledge and experience” because mold disease is not a commonly known entity within conventional medicine–I would estimate that less than 1% of doctors around the world know about Chronic Inflammatory Response Syndrome (CIRS), the official term for mold disease. It is not taught in medical schools, with one exception, and not taught in residencies. In fact, the disease was discovered less than twenty years ago by Dr. Ritchie Shoemaker, a doctor and researcher from Pocomoke, Maryland. The community of medical practitioners who are familiar with mold disease discovered it through their own study in the course of caring for patients (my case) or–this is fairly common–learned about it when they got the disease themselves and began the search for answers, sick doctors seeking answers about their own illness.
How a Doctor Diagnoses Mold Disease
The classical definition for diagnosing mold disease involves four elements.
- Exposure to Mold in Water-Damaged Buildings
- Symptoms Consistent with CIRS
- Labs Consistent with CIRS
- Improvement with Treatment
Dr. Ritchie Shoemaker has used the above definition as has an agency of the federal government called the Government Accountability Office, a branch of the federal government tasked with researching and auditing different claims. (In 2008, it confirmed the existence and scientific validity of CIRS.)
Below we will go into greater detail about each of these four elements.
1. Exposure to Mold in Water-Damaged Buildings
Exposure to water-damaged buildings can be confirmed in one of the following three ways.
- Detecting a musty or moldy smell
- Seeing mold
- Specialized lab testing that is positive for mold species known to cause CIRS in susceptible individuals. The two best tests are called the Environmental Relative Mold Index (ERMI) and the Health Effects Roster of Type Specific (Formers) of Mycotoxins and Inflammagens (HERTSMI-2).
2. Symptoms Consistent with CIRS
There are 37 common symptoms in CIRS. Not every symptoms will be present and confirmation of the symptoms requires a qualified health professional. However, to give you an idea of what these symptoms are, here are the 37 symptoms that Dr. Shoemaker found to be present in at least 30% of his CIRS patients.
- unusual pains
- ice pick pains
- lightning bolt pains
- light sensitivity
- blurry vision
- red eyes
- sinus problems
- shortness of breath
- abdominal pains
- joint pains
- morning stiffness
- metallic taste
- memory problems
- difficulty assimilating new knowledge
- word loss
- skin sensitivity
- excessive thirty
- excessive urination
- static shocks
- excessive sweating
- mood wings
- temperature dysregulation
- appetite swings
On average, a patient under age 19 will have 19 out of 37 symptoms; infants and younger children will tend to have fewer symptoms. In patients over age 19, the average patient will have 25 out of 37 symptoms. Fatigue is almost universally present and represents the most common symptom. Note that multiple organ systems are affected from memory (brain), diarrhea (gut), cough (lungs) and cramps (muscles), which is a hallmark of CIRS and a reason for its complexity. It is multi-system, meaning it affects many organs.
3. Labs Consistent with CIRS
One of the most persuasive lines of evidence for the existence of CIRS is found in blood work. CIRS is a metabolic disease and, as such, metabolic abnormalities are evident in the blood work. This evidence establishes a physiological basis for disease and CIRS is ruled out if the labs are normal or if not enough of them are abnormal. Under the Shoemaker (classical) criteria for diagnosis, at least five of the 8 blood protein CIRS bio-markers are abnormal:
- Vasoactive Intestinal Polypeptide (VIP)
- Melanocyte Stimulating Hormone (MSH)
- Complement component C4a
- Vascular Endothelial Growth Factor (VEGF)
- Transforming Growth Factor Beta-1 (TGF B-1)
- osmolality/Antidiuretic Hormone (ADH) balance
- cortisol/Adrenocorticotropic Hormone (ACTH) balance
4. Improvement with Treatment
Response to treatment is required to confirm the diagnosis. The full treatment is a 12-step protocol and 90% of patients will recover to a significant degree if they stick with the treatment. As veteran CIRS practitioner Paula Vetter, N.P says, “The protocol works if you work the protocol.”
So What’s the Next Step?
Seek a certified CIRS specialist if you recall a past or current exposure to mold and have fatigue and some of the other symptoms listed on the list of 37 symptoms. There is a high chance of CIRS if your symptoms started after a move to a new home or a new workplace and your symptoms seem mysterious because of their diversity and multi-system nature. Many of the patients who call for a consultation have been misdiagnosed with fibromyalgia, chronic fatigue syndrome and depression. You can schedule an appointment with the Pasadena Chronic Fatigue Center at 626.838.5485 or find a certified doctor or nurse practitioner on Dr. Shoemaker’s certified provider list.