Mold and Mycotoxins: The Hidden Puzzle Piece in Chronic Illness
What I have come to understand from my own story, from the biology of mycotoxins, and from years of clinical work. And why this topic could be the missing piece for many people with chronic illness.
Diagnoses such as irritable bowel, asthma, migraine, depression or "exhaustion without a clear cause". Countless examinations, blood values "fine", imaging unremarkable, and yet you still do not feel well.
From my perspective, mold is a topic that has so far received little attention, one that can play a role in chronic complaints but is rarely checked systematically in routine diagnostics.
How I label evidence in this cluster
A large part of what we know about mycotoxin effects comes from in vitro cell experiments and in vivo animal models. Human data exist but are thin. Where a statement rests on a specific paper, I name it right there. Where I am only describing a clinical observation, I say so explicitly.
The German AWMF guideline 161/001 on indoor mold exposure takes a clearly reserved position. It sees no indication for determining mycotoxins in blood or urine. It lists detoxification procedures such as cholestyramine therapy, and antifungal treatment not in line with guidelines, among the methods without sufficient scientific evidence. And it regards the link between indoor mold and complaints such as chronic fatigue, endocrinopathies, thyroid disorders, MCS, reproductive disorders or cancer as not established. It even explicitly obliges physicians to inform affected people about this objectively. That is exactly what I am doing here.
The counter-position in the literature belongs here too. In a widely cited review, Chang and Gershwin hold the concept of mold toxicity to be disproven and the measurement of mycotoxins in urine to be unvalidated. That criticism deserves to be taken seriously, and I do take it seriously.
What is well documented: mold can cause allergies and trigger asthma, certain forms can cause hypersensitivity pneumonitis, and in severely immunocompromised people invasive fungal infections are possible. The link between damp housing and respiratory complaints is among the best studied points in this whole field.
What I describe beyond that is a complementary perspective from my clinical work. It goes beyond the guideline, it does not replace it, and it does not stand on the same level of evidence. Read this text with that framing in mind.
Why mold is different from "normal" toxins
Heavy metals are substances. They can deposit in the body but do not multiply. Mold is a living organism. That makes it fundamentally different. Depending on how they are counted, the literature describes several hundred mycotoxins. For some of them, animal models have shown that they can accumulate in fatty tissue and organs. How much that weighs in humans under everyday conditions is an open question.
Mold does not have to be visible to be a problem indoors. It can sit behind wallpaper, in mattresses, in air conditioning units, in basements and in water-damaged building components. That is first of all a structural and hygienic question: moisture needs to be fixed, visible growth needs to be removed professionally, regardless of whether anyone has complaints. For the great majority of people that is exactly where it ends.
What brought me to this question
I deliberately leave out the detailed story here. Not because it did not shape me, but because a single course of illness proves nothing, and because such narratives invite readers to recognise themselves in them.
What a case in my own family taught me can be said in one sentence: since then, with every long, unexplained history of complaints, I also ask about the home environment. Whether anything comes of it is open. But the question costs nothing.
Incidentally, irritable bowel syndrome is a real and recognised diagnosis, and in the great majority of cases it is the right one. What occupied me was only the question of whether, in very long courses, we sometimes stop asking too early. That is not a criticism of colleagues, it is a point where I take more time myself.
Before anyone thinks about mold, the obvious needs to be ruled out. Chronic fatigue and brain fog have other reasons in the great majority of cases: sleep apnoea, an underactive thyroid, iron deficiency or anaemia, a vitamin B12 deficiency, diabetes, coeliac disease, depression. Serious illness can present this way too. That work-up is quick and it belongs at the beginning. The environment only comes into play once all of that has been properly excluded. The overview that follows describes what has been observed in laboratory models. It is not a symptom checklist for self-diagnosis.
The eight systems that mycotoxins can attack
What stands out in the laboratory models is that mycotoxins do not act on one organ but on several systems at once. That could explain why people with such a picture are often sent from one specialist to the next without any single finding explaining everything. Whether that is really the reason in everyday life, we do not know.
Nervous system: brain fog, anxiety, inner restlessness
Several mycotoxins act neurotoxically in laboratory models. Ochratoxin A can cross the blood-brain barrier and has been linked to Alzheimer-like disease mechanisms. In laboratory models, T-2 toxin can trigger oxidative stress and neuroinflammation. Whether that explains brain fog in humans under everyday conditions has not been studied.
Obafemi BA et al., Toxicology 2023;497-498:153630. Review of cell experiments, animal models and limited biomonitoring data. doi:10.1016/j.tox.2023.153630Immune system: between exhaustion and constant alarm
In laboratory models, mycotoxins show a bidirectional immune effect. At low doses they can activate inflammatory reactions. At high doses or with long exposure they can suppress the immune system. Which doses are reached indoors at all is disputed, and whether a clinical picture follows from this in humans is an open question.
Mitochondria: when the power plants fail
Many of the mycotoxins studied can damage mitochondria through a similar mechanism, shown mostly in vitro and in vivo: ROS overproduction, collapse of the membrane potential, cell death. Glutathione is one of the systems with which the body can neutralise such reactive compounds. Whether this store is actually depleted under everyday exposure has not been shown in humans.
Cancer risk: what is officially established
Aflatoxins in their naturally occurring form are the only mycotoxins the IARC lists in Group 1, that is, as established human carcinogens. Aflatoxin B1 is the most potent single compound among them. AFB1 can be converted in the liver into a highly reactive epoxide that can bind to DNA; at high exposure, a particular mutation in the TP53 gene is found more often. Other mycotoxins such as ochratoxin A are in IARC Group 2B, not established as carcinogenic in humans but tumour-inducing in animal experiments. Important for context: the relevant route of exposure to aflatoxins worldwide is contaminated food, not indoor mold.
Ostry V et al., Mycotoxin Research 2017. Review of the IARC classification. doi:10.1007/s12550-016-0265-7Hormone system: mycotoxins as false estrogens
Zearalenone binds to estrogen receptors in laboratory models and is considered one of the most potent known myco-estrogens there. The available data come from cell experiments and animal models, and the best studied line concerns male reproduction. Whether relevant cycle or fertility consequences follow from this in humans has not been studied. I write this out so plainly because a great deal is claimed here: if your hormone labs are unremarkable, that is good news first of all, and not a hint of a hidden problem.
Balló A et al., Int J Mol Sci 2023;24(2):1578. Review of cell and animal data, exclusively on male reproduction. doi:10.3390/ijms24021578Gut and barriers: the gateway
Deoxynivalenol can damage the tight junction proteins in cell and animal models, the molecular "rivets" that hold the intestinal epithelial cells together. What is described there is an increased permeability that can let bacterial components and toxins into the blood. Whether irritable bowel or leaky gut develops from this in humans is an open question. More in the leaky gut spoke.
Fan L et al., Environ Int 2024. Animal model and mechanism review. doi:10.1016/j.envint.2024.108450Skin and mucous membranes
Itchy, shifting rashes and burning eyes are frequently reported, but the data on them are thin. The airways, by contrast, are well studied. A widely cited US analysis from 2007 estimated that around 21 percent of asthma cases in the USA could be connected with dampness and mold in homes, with a range of 12 to 29 percent. That is a model calculation for the USA and not a measurement, and it does not transfer readily to Germany. What is solid about it: the link between damp housing and respiratory complaints is among the best studied points in this whole field.
Mudarri D, Fisk WJ. Public health and economic impact of dampness and mold. Indoor Air. 2007;17(3):226-35. doi:10.1111/j.1600-0668.2007.00474.xCirculation, temperature, energy
Racing heart without a finding. Dizziness when standing up. Temperature chaos between feeling cold and hot flushes. Daytime crashes in which all energy is suddenly gone. This is a description of what I meet in my consulting room, without study evidence and without attribution to a cause. Racing heart and dizziness always belong in a cardiological and general medical work-up first.
The four most discussed mycotoxins in profile
The carcinogen
Naturally occurring aflatoxins are in IARC Group 1, that is, established human carcinogens. Main producer Aspergillus flavus. Hepatotoxic; at high exposure a particular mutation in the TP53 gene is found more often. Main source worldwide: contaminated foods such as peanuts and maize.
The kidney and brain toxin
IARC Group 2B. Main producers Penicillium and Aspergillus. Nephrotoxic and neurotoxic in laboratory models, can cross the blood-brain barrier. Main sources of exposure are contaminated grain, coffee and dried fruit.
The immune system killers
Main producer Fusarium, indoors also Stachybotrys (black mold). Highly potent immunosuppressive and protein-synthesis inhibiting in laboratory models. DON can additionally damage the gut barrier there. Whether the concentrations reachable indoors are enough to matter in humans is disputed.
The myco-estrogen
Main producer Fusarium. Binds to estrogen receptors and can act in an estrogen-like way in cell and animal models. Reproductive effects are documented there, best studied in male animals. Human data are largely lacking. The relevant route of intake is contaminated grain.
The common denominator: Cell Danger Response
Robert Naviaux proposed an explanatory model that could in theory frame multi-system pictures. The concept is called Cell Danger Response (CDR). A cell that is repeatedly or permanently exposed to toxic or infectious burden can switch into a protective mode. This mode can be useful for short crises and could become problematic when it is not switched off again. Neil Nathan brought this model into the clinical discussion about mold. Whether it explains the clinical pictures described here is an open question.
Naviaux describes the Cell Danger Response as an evolutionarily conserved cellular protective response and assigns a whole range of chronic illnesses to it. Mold, Lyme, MCAS and MCS are expressly not among the examples named in that paper. Transferring the model to these pictures is a hypothesis from the clinical discussion and not content of the cited work. It is a model and not a demonstrated shared mechanism.
The four cPNI lenses on mold burden
1. Nervous system
In the laboratory models, neurotoxic mycotoxins such as OTA and T-2 take centre stage. Clinically, I often notice a dysregulation of the autonomic nervous system in these patients, along with brain fog and sleep disturbances. That is my observation and not an established rule, and a heart rate variability finding proves no cause. What I can say: these complaints are not imagined. That we do not yet have a reliable measurement for them does not mean they are not real.
2. Immune system
Mast cell activation, low-grade systemic inflammation and a Th1/Th2 shift are discussed. MCAS and histamine intolerance are talked about clinically in this context, but a causal connection with indoor mold is not established. Markers such as CRP, IL-6 or tryptase can be abnormal, but they neither prove nor exclude anything.
3. Metabolism
Mitochondrial dysfunction, glutathione depletion and a methylation bottleneck are discussed. Clinically I often see chronic fatigue, cold hands and feet, exercise intolerance. There is no established routine test for mitochondrial function. Specialised laboratories offer surrogate parameters that can be interesting, but they neither make a diagnosis nor exclude one. I mention this so that you know what you are getting and what you are not, if such an offer comes your way.
4. Hormone system
Myco-estrogens such as zearalenone can disturb the hormonal signal in cell and animal models. I often see a permanently activated HPA axis with cortisol dysrhythmia, without being able to derive a cause from it. The AWMF guideline 161/001 explicitly regards a link between indoor mold and endocrinopathies or thyroid disorders as not established. I still name the observation, but I label it as what it is.
The treatment pyramid: order is everything
The staging below describes how I think clinically. It is not a protocol to copy, it does not replace a medical examination, and from stage 2 onwards it leaves what the guideline covers. I write it down anyway, because you should know what is behind such offers if someone sells you a mold therapy.
Stop the exposure
Without a mold-free environment everything else is limited. Anyone still sleeping in a contaminated home is cleaning with the tap turned on. The first measure is always analysis of the environment and remediation or relocation.
Why binders are not a harmless natural measure
The prerequisite is always the simple things first: regular bowel movements, sufficient fluids, stable sleep. If binders are discussed after that, the full context belongs with them.
Cholestyramine is a prescription-only medicine, approved for lowering raised blood lipids and for bile acid diarrhoea. Use for mycotoxin burden would be off-label, that is, outside the approval: separate patient information, a particular duty of justification, as a rule no reimbursement, and liability with the prescribing physician. Constipation is common, and it must not be given in complete biliary obstruction. The AWMF guideline 161/001 lists this use among the procedures without sufficient scientific evidence. I deliberately give no dosages here, that belongs in the medical consultation.
One point that almost always gets lost with binders, and that matters more than any dosage question: activated charcoal and cholestyramine bind not only toxins in the gut but also medicines. Thyroid hormone, the contraceptive pill, anticoagulants, antiepileptics, antidepressants and digoxin can be rendered ineffective. The fat-soluble vitamins A, D, E and K are bound too, with a risk of deficiency over longer use. Bentonite and zeolite are mineral products and can contain aluminium and lead depending on their origin. Chlorella can contain heavy metals and relevant amounts of iodine, which matters in thyroid disease. If you take medication regularly, a binder without medical advice is not a harmless natural measure. In pregnancy and breastfeeding, and in children, binders do not belong in self-treatment. More in the detoxification spoke.
Stabilise gut, liver, lymph
Gut: a fibre-rich, low-inflammation diet, targeted probiotics. Liver: the central transformation organ, phase 1 and phase 2 support. Lymph and kidney: gentle movement, sufficient water, breathwork, dry brushing where appropriate. With pre-existing liver or kidney disease, every such measure needs to be checked medically beforehand. This too is complementary experience-based medicine: the AWMF guideline lists dietary changes and holistic intestinal cleansing for this indication among the procedures without sufficient scientific evidence.
"Mold in the body": what is wrong with that idea
A clear word at this point about a widely held idea. A systemic mold colonisation in the body does not exist in people with an intact immune system according to current knowledge. Invasive fungal infections affect almost exclusively severely immunocompromised patients and belong in hospital care.
Antifungals such as itraconazole or fluconazole are prescription-only. They can burden the liver, prolong the QT interval and interact with numerous other medicines via the enzyme CYP3A4. The AWMF guideline 161/001 explicitly lists antifungal treatment not in line with guidelines among the procedures without sufficient scientific evidence. If this topic comes up at all, then only after a confirmed diagnosis and in medical hands. Here too I give no dosages.
Why do-it-yourself attempts can be dangerous
Mold is not something for self-experiments following a YouTube protocol. Your body is not a bucket that you "rinse out", but a highly complex system. Therapy without medical supervision can worsen rather than improve things.
The three most common mistakes in do-it-yourself attempts:
- Antifungal medicines on your own initiative: it is discussed whether dying fungi might briefly release more toxins. This is not proven in humans, and deterioration under therapy can have many other reasons. Prescription-only antifungals never belong in self-treatment in any case.
- Binders alongside ongoing medication: activated charcoal, chlorella, zeolite and cholestyramine bind non-specifically in the gut and can bind medicines and fat-soluble vitamins along with everything else. Anyone taking thyroid hormone, the contraceptive pill, anticoagulants, antiepileptics, antidepressants or digoxin risks the effect of their own treatment.
- "Pushing" detoxification without an elimination pathway: the idea that toxins are then redistributed within the body rather than excreted is an explanatory model, not an established fact. What matters practically: people with constipation or a low fluid intake tolerate such measures poorly in my experience.
"I am not broken. My system was overloaded."
This reframe changes everything. Anyone who understands that many chronic complaints can have a measurable cause stops blaming themselves. "What is wrong with me?" becomes "What overloaded my system?" That question is therapeutically fruitful.
Three levers if you suspect mold
Go through your home and work history honestly
The last 10 to 20 years. Were there water damages, damp basements, leaking roofs? Did the onset of complaints coincide in time with a move or a water situation? Anyone who feels noticeably better on holiday and worse again at home has a clue worth following up. It is not conclusive, because many things change at once on holiday: sleep, stress, food, movement.
After the standard work-up, go deeper into the history
A history that works systematically through home and work environment takes time, but it needs no device and costs nothing extra. The order still matters: first have the common causes ruled out, then look at the environment. Anyone who sells you a test first is going in the wrong direction.
Do not detox rashly, but proceed in a structured way
Patience is part of the therapy. Anyone who wants too much too fast risks deterioration. A good therapy begins with stabilisation, then exposure, then a targeted approach. That is slower, but more sustainable.
If you are currently in a depressive episode: do not change anything about an ongoing treatment on your own and do not stop any medication. A question about your environment is never a reason to postpone or delay psychiatric or psychotherapeutic treatment. If you are thinking about suicide, get help immediately. In Germany, Telefonseelsorge on 0800 111 0 111 or 0800 111 0 222, around the clock and free of charge. In an emergency, call 112.
Frequently asked questions about mold and mycotoxins
What are mycotoxins?
Mycotoxins are toxic metabolic products formed by molds. Depending on how they are counted, the literature describes several hundred mycotoxins. Frequently named ones are ochratoxin A, trichothecenes such as T-2 and deoxynivalenol, aflatoxins and zearalenone. They can be taken up through the airways, the gut or the skin. By far the most important route of intake in humans is contaminated food, not indoor mold.
Can molds trigger chronic illness?
Several mycotoxins are described as neurotoxic, immunomodulating, hepatotoxic and endocrine active in in vitro models and animal studies. Human data on this are thin. The professional societies take a reserved view: the AWMF guideline 161/001 regards a link between indoor mold and complaints such as chronic fatigue or hormonal and thyroid disorders as not established, and a widely cited review by Chang and Gershwin holds the concept of mold toxicity to be disproven. What is well documented are allergies, asthma triggering and the link between damp housing and respiratory complaints. Everything beyond that is an open question and not settled knowledge.
Which symptoms may point to mold?
The complaints named are brain fog, chronic fatigue, shifting muscle and joint pain, digestive complaints, chronic sinusitis, asthma that flares in certain rooms and mood swings. Important: these are non-specific complaints that in the great majority of cases have other reasons. Sleep apnoea, hypothyroidism, iron deficiency and anaemia, vitamin B12 deficiency, diabetes, coeliac disease, depression and also serious illness need to be ruled out first. That work-up comes first.
How is mold burden diagnosed?
Here, diagnostics means above all history-taking: home and work history, the time course, basic labs and the work-up of the common differential diagnoses. Urine mycotoxin profiles are offered by specialised laboratories but are not validated, and the AWMF guideline 161/001 explicitly sees no indication for determining mycotoxins in blood or urine. I mention them so that you know what you are getting into if someone sells you such a test: it is a self-pay service, it can neither prove nor exclude a burden, and a result on its own does not justify any therapy. Whether there is a damp or mold source is clarified at the building, not in the urine. More in the mycotoxin test spoke.
Which mycotoxins are particularly relevant?
Ochratoxin A can act neurotoxically and nephrotoxically in laboratory models. Aflatoxins in their naturally occurring form are the only mycotoxins the IARC lists in Group 1, that is, as established human carcinogens; aflatoxin B1 is the most potent single compound among them, and the main source of exposure worldwide is contaminated food. Trichothecenes such as T-2 are considered highly potent immunosuppressants in laboratory models. Zearalenone can act in an estrogen-like way in cell and animal models. Deoxynivalenol can damage the gut barrier in cell and animal models. Most other mycotoxins are less well researched.
How is mold approached therapeutically?
The first and most important step is structural: fix the moisture, have visible growth removed professionally. For the great majority of people that is where it ends. Everything beyond that is an individual medical decision, and it needs the full context. Cholestyramine is a prescription-only medicine approved for lowering raised blood lipids and for bile acid diarrhoea; use for mycotoxin burden would be off-label, that is, outside the approval, with separate patient information and as a rule without reimbursement. Cholestyramine and activated charcoal bind non-specifically in the gut and can markedly reduce the absorption of other medicines such as thyroid hormone, the contraceptive pill, anticoagulants, antiepileptics, antidepressants and digoxin, as well as the fat-soluble vitamins A, D, E and K. The AWMF guideline 161/001 lists detoxification procedures such as cholestyramine therapy among the methods without sufficient scientific evidence. None of this belongs in self-treatment, and I deliberately give no dosages.
Is mold connected to other chronic illnesses?
Links are discussed with mast cell activation syndrome (MCAS), multiple chemical sensitivity (MCS), ME/CFS, fibromyalgia, irritable bowel syndrome, histamine intolerance and leaky gut. These links are not established, and the AWMF guideline 161/001 explicitly regards them as unproven. Robert Naviaux proposed the Cell Danger Response as an explanatory model that could in theory frame such multi-system pictures. Neil Nathan brought it into the clinical discussion about mold. It is a model and not a demonstrated shared mechanism.
When should I think about mold?
Visible mold or water damage in a home or office is a reason to have the moisture source fixed, regardless of any complaints. As a medical question, the environment comes into consideration once the common causes have been properly ruled out and complaints are clearly tied in time to one place. Even then it remains an open question and not a diagnosis. The order matters: first the obvious, then the environment.
30 spokes for the cluster "Mold and Mycotoxins"
- Spoke 1: Histamine intolerance and mycotoxins
- Spoke 2: Fibromyalgia and mold
- Spoke 3: Irritable bowel and mycotoxins
- Spoke 4: Leaky gut and mycotoxins
- Spoke 5: Mold, what to do
- Spoke 6: Brain fog symptoms
- Spoke 7: Brain fog causes
- Spoke 8: Chlorella and mycotoxins
- Spoke 9: MCAS and mold
- Spoke 10: Chronic sinusitis and mold
- Spoke 11: Detox done right instead of wrong
- Spoke 12: Mitochondria and mycotoxins
- Spoke 13: Zeolite for mycotoxins
- Spoke 14: Mold symptoms overview
- Spoke 15: Oxidative stress and mycotoxins
- Spoke 16: Candida and mold
- Spoke 17: Mold in the home
- Spoke 18: Aspergillus
- Spoke 19: Bentonite as a binder
- Spoke 20: Cholestyramine for mold
- Spoke 21: Chronic fatigue and mold
- Spoke 22: Aflatoxin B1 in detail
- Spoke 23: Mold allergy vs toxicity
- Spoke 24: Mycotoxin basics
- Spoke 25: Eliminating mycotoxins
- Spoke 26: Glutathione deficiency and detox
- Spoke 27: Ochratoxin A
- Spoke 28: Realistic mold remediation
- Spoke 29: Mold in pregnancy
- Spoke 30: Zearalenone and hormones
The connection to my other areas of focus
For the connections below there are considerations and in part observational data, but no established causality. I link them because these topics meet in the consulting room, not because one explains the other.
Mycotoxins can damage tight junctions in cell and animal models. Whether irritable bowel or leaky gut develops from this in humans is an open question.
It is discussed whether a mold burden draws on detoxification pathways that are also needed for heavy metals. This connection is not established, it is a consideration from practice.
Whether a toxin burden can trigger or intensify depressive symptoms is not settled. A 2024 review found links between dampness and mold in the home and poorer mental health, but points expressly to considerable methodological limitations.
Whether a toxin burden influences how well someone responds to antidepressant treatment is not scientifically settled. Ketamine is a prescription-only anaesthetic, used in depression treatment mostly off-label. It can raise blood pressure and pulse, trigger dissociative states, damage the bladder with repeated use, and it has abuse potential. It is not a treatment for mold burden and appears here only because the two topics sometimes meet in the consulting room.
Sources and evidence classification
For many mycotoxin effects the main evidence comes from in vitro cell experiments and in vivo animal models. Human data exist but are thin. For each source I mark the study type, and where a paper contradicts my account I state its position explicitly. What sounds biologically plausible is not thereby established in humans.
- Hurraß J et al. AWMF mold guideline "Medical clinical diagnostics for indoor mold exposure", Update 2023, AWMF Register No. 161/001. Allergol Select. 2024;8:90-198. PMID 38756207. doi:10.5414/ALX02444E [Consensus Guideline, Authority Document] Core statements: no indication for the determination of mycotoxins in blood or urine; detoxification therapy such as cholestyramine, dietary changes, holistic intestinal cleansing and antifungal treatment not in line with guidelines are listed among the treatment methods without sufficient scientific evidence; physicians are explicitly obliged to inform affected people objectively about the lack of evidence for suspected associations with CFS, endocrinopathies, thyroid disorders, MCS, reproductive disorders and cancers. I cite the guideline with its core statements because it contradicts my complementary view on essential points.
- WHO Guidelines for Indoor Air Quality: Dampness and Mould. World Health Organization. 2009. who.int [Authority Document]
- Nathan N. Toxic: Heal Your Body from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness. Houndmills. 2018. [Clinical review]
- Naviaux RK. Metabolic features of the cell danger response. Mitochondrion. 2014;16:7-17. PMID 23981537. doi:10.1016/j.mito.2013.08.006 [Review, narrative, no quantitative synthesis] Mold, Lyme, MCAS and MCS are not named in this paper.
- Obafemi BA, Adedara IA, Rocha JBT. Neurotoxicity of ochratoxin A: Molecular mechanisms and neurotherapeutic strategies. Toxicology. 2023;497-498:153630. PMID: 37709162. doi:10.1016/j.tox.2023.153630 [In vitro, in vivo, mechanism review]
- Wang Y et al. T-2 toxin neurotoxicity and signaling pathways. Mycotoxin Research. 2024. doi:10.1007/s12550-023-00505-2 [In vivo, review]
- Ratnaseelan AM et al. Effects of Mycotoxins on Neuropsychiatric Symptoms and Immune Processes. Clinical Therapeutics. 2018. doi:10.1016/j.clinthera.2018.05.004 [Review]
- Chang C, Gershwin ME. The Myth of Mycotoxins and Mold Injury. Clin Rev Allergy Immunol. 2019;57(3):449-455. PMID 31608429. doi:10.1007/s12016-019-08767-4 [Review, counter-position] The authors hold the concept of mold toxicity to be disproven and the measurement of mycotoxins in urine to be unvalidated. I cite them deliberately, because this criticism deserves to be taken seriously and belongs in the reading of my text.
- Ostry V et al. Mycotoxins as human carcinogens, IARC classification update. Mycotoxin Research. 2017. doi:10.1007/s12550-016-0265-7 [Authority Document, Review]
- Balló A et al. Estrogenic and Non-Estrogenic Disruptor Effect of Zearalenone on Male Reproduction: A Review. Int J Mol Sci. 2023;24(2):1578. PMID 36675103. doi:10.3390/ijms24021578 [In vitro, in vivo, review] Concerns male reproduction only, on a cell and animal data basis.
- Fan L et al. Deoxynivalenol-induced gut microbiome interaction. Environ Int. 2024. doi:10.1016/j.envint.2024.108450 [In vivo, mechanism review]
- Gatto MR, Mansour A, Li A, Bentley R. A State-of-the-Science Review of the Effect of Damp- and Mold-Affected Housing on Mental Health. Environ Health Perspect. 2024;132(8):86001. PMID 39162373. doi:10.1289/EHP14341 [Review, human, observational studies] Summarises 19 observational studies, finds links between dampness and mold in the home and poorer mental health, but points expressly to considerable methodological limitations.
- Mudarri D, Fisk WJ. Public health and economic impact of dampness and mold. Indoor Air. 2007;17(3):226-35. PMID 17542835. doi:10.1111/j.1600-0668.2007.00474.x [Meta-analysis-based estimate, human, USA] Source of the 21 percent figure for the asthma fraction, confidence interval 12 to 29 percent, not readily transferable to Germany. The figure does not come from the WHO.
- Afriyie-Gyawu E et al. NovaSil clay intervention in Ghanaians at high risk for aflatoxicosis. I. Study design and clinical outcomes. Food Addit Contam. 2008;25(1):76-87. PMID 17852392. doi:10.1080/02652030701458105 [RCT, human] Randomised study on reducing the uptake of aflatoxin from contaminated food in Ghana; the endpoints were biomarkers, not symptoms. Not transferable to indoor mold and not to binder therapy for symptoms.
This article serves general information purposes and does not replace individual medical advice, diagnosis or treatment. It is not a guide to self-treatment and not a recommendation to change or stop any ongoing treatment. In case of acute breathlessness, chest pain or other emergency signs, call the emergency services, in Germany 112. Some of the substances mentioned are prescription-only or are used outside their approval (off-label); their use belongs exclusively in medical prescription and supervision. Where anthroposophic or experience-based methods are mentioned, they are based in part on clinical tradition and are not in all respects backed by large randomised studies. Results are individual and are not a guaranteed treatment outcome. Author: Shukri Jarmoukli, ViveCura practice, Skalitzer Straße 137, 10999 Berlin.