Mould Illness, Mould Toxicity & CIRS: What’s the Difference?
Mould illness is perhaps one of the most misunderstood and divided topic in the holistic health world. There are different camps, different theories, strong opionions and very different app
roaches to testing and treatment.
We are getting a big number of people coming to us because they suspect mould may be contributing to their symptoms. At the same time, we are seeing practitioner mould masterclasses popping up daily on social media.
Mould is finally coming into the spotlight. Though there is still a significant gap between the attention it receives within functional medicine and the understanding of mould-related illness within conventional medicine.
So, how worried should we actually be about mould?
Mould matters, but context matters too
Mould exposure is not something we want to dismiss, particularly when exposure has been significant or chronic.
A water-damaged building can expose people to a complex mixture of mould spores, fragments, microbial compounds and mycotoxins. But importantly, two people living in exactly the same building may not experience the same health effects.
Why?
Because the person matters just as much as the exposure.
When we assess someone with suspected mould-related illness, we need to consider the bigger picture. Their genetics and individual susceptibility, existing health problems, immune function, gut health, bowel regularity, other environmental exposures, chronic infections, stress and nervous system regulation may all influence how well their body copes with an environmental stressor.
This is why we don't believe that everybody who has been exposed to mould should automatically be put on the same “mould detox” protocol.
Mould can affect people in different ways
One of the biggest sources of confusion is that the term “mould illness” is often used to describe several different things.
For some people, mould exposure may contribute to allergic symptoms, and mould-specific IgE testing can sometimes help identify differentiate the underlying mechanism.
For others, the concern is the overall burden associated with prolonged exposure to a damp or water-damaged building and how this interacts with a system already at capacity
And then there is CIRS, or Chronic Inflammatory Response Syndrome. This is a particular framework used by some practitioners to describe a chronic inflammatory illness associated with exposure to biotoxins, often in genetically susceptible individuals.
Sometimes the relationship with the environment is very obvious
We see some people who have become incredibly sensitive to particular environments.
They may walk into a damp building and notice symptoms immediately. They may crash badly when they return home and improve significantly when they spend a few days somewhere else.
When there is a clear and repeatable relationship between a particular environment and symptoms, that information is extremely valuable.
But other cases are much less obvious.
Someone may have been chronically unwell for years and discover mould in their home. They may wonder whether they have finally found the explanation for everything.
And mould may absolutely be one piece of their puzzle.
The mistake is assuming that it must therefore be the whole puzzle.
The “bucket” analogy can be helpful
We often describe chronic illness using the analogy of a bucket.
Imagine that your body has a certain capacity to deal with physiological stress.
Into that bucket we might put poor sleep, psychological stress, infections, gut dysfunction, nutrient deficiencies, hormonal changes, environmental exposures, inflammation, alcohol, medications and many other factors.
Mould may be a very large contributor for one person.
For somebody else, it may represent another cup being poured into an already overflowing bucket.
This may also help explain why someone can live in a particular property for years before suddenly becoming unwell, or why one family member is struggling while another seems completely unaffected.
It isn't necessarily as simple as: Mould = illness.
We need to understand the exposure and the person being exposed.
What happens when everything gets blamed on mould?
This is where we think a more measured approach becomes important.
We have seen people who have spent months following aggressive mould detoxification protocols without experiencing any meaningful improvement.
At some point, we have to ask: what are we missing?
Perhaps mould is still relevant, but something else also needs addressing. Perhaps there is significant gut dysfunction. Perhaps the person is constipated and struggling with elimination. Perhaps there is a persisting infection, significant mast cell activation, hormonal imbalance, nutrient deficiency, autonomic dysfunction or an overwhelmed nervous system.
Or perhaps mould was never the primary driver in the first place.
Continuing on the same protocol isn't always the answer.
Sometimes we need to take a step back and explore what is being missed.
Your timeline can tell us a lot
One of the most useful things you can do when investigating possible mould illness is build a detailed timeline.
When did your symptoms begin?
Where were you living or working at the time?
Was there a known leak, flood or significant condensation problem?
Did anything else happen around the same time, such as an infection, COVID, pregnancy, hormonal change, major psychological stress, surgery or medication change?
Do you improve when you go away?
Do symptoms return when you come home?
Are there particular buildings where you consistently feel worse?
What symptoms came first, and what came later?
These patterns don't necessarily prove the cause, but they can help us decide whether investigating the environment further is reasonable and where mould sits within the wider health picture.
Not every black spot means you have mould illness
This is another message we think is incredibly important.
We do not want people becoming paranoid of their homes.
Finding the occasional small area of surface mould around a window where condensation has collected is very different from discovering extensive hidden mould following a long-standing leak or living in a significantly water-damaged building.
When we are concerned about exposure, we are particularly interested in things such as previous flooding, roof or plumbing leaks, persistent damp, extensive condensation, visible mould growth, musty smells and hidden areas where moisture can accumulate.
Something as simple as a large wardrobe positioned tightly against a cold external wall or heavy curtains that are rarely moved can reduce airflow and allow condensation and mould to develop behind them.
The answer isn't to become afraid of every mould spore.
It is to identify and appropriately address meaningful sources of damp and water damage.
Be cautious of one-size-fits-all mould protocols
There is no single protocol that is right for every person who believes mould is affecting their health.
One person may need the environment addressed first and foremost.
Another may have significant allergy or mast-cell symptoms that need supporting.
Someone fitting a CIRS picture may require a very different assessment and approach.
Another person may need us to focus initially on their gut, bowel motility, nutrition, nervous system or another significant contributor before they tolerate more targeted interventions.
And sometimes our job as practitioners is to say: yes, mould could be contributing, but I don't think it explains everything.
That isn't dismissing mould.
It is practising good functional medicine.
A more balanced approach to mould illness
If you suspect mould is affecting your health, try not to begin with the question:
“How do I detox mould?”
Start with:
“What happened to my health, when did it happen, what was I exposed to, and what else was happening at the same time?”
Look at your environment.
Look at your timeline.
Look for patterns.
Consider the rest of your health picture.
And then decide what deserves investigating.
Mould can be an extremely important piece of the chronic illness puzzle. For some people, it may be a major driver of their symptoms. For others, it is one of several factors contributing to an already overwhelmed system.
If you are living with chronic health problems and suspect that mould or a water-damaged environment may be contributing, this is something we can explore with you explore with you at The Autoimmune Clinic.
