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Is there a way to assess for mold toxicity/CIRS through functional lab values?

Chronic Inflammatory Response Syndrome (CIRS) is characterized by a non-specific array of symptoms including pain, fatigue, respiratory issues, gastrointestinal distress, and cognitive and neurological deficits.

There is not an abundance of literature defining functional blood chemistry patterns for CIRS. However, some research suggests that abnormal results from more specialized laboratory tests suggest the presence of CIRS, especially when coupled with exposure to toxins such as ciguatoxin, mold, or other microbial exposure from water-damaged buildings.        

Shoemaker, Ryan. "RNA-Seq on patients with chronic inflammatory response syndrome (CIRS) treated with vasoactive intestinal peptide (VIP) shows a shift in metabolic state and innate immune functions that coincide with healing." Medical Research Archives 4.7 (2016).

For adults, if 5 of the following were abnormal, CIRS was considered likely:

  • HLA haplotypes in the DRB1, DQ and DRB3, B4 or B5 loci
  • VIP
  • MSH
  • ADH with serum osmolality
  • ACTH with cortisol
  • TGF-β1
  • MMP-9
  • C4a
  • Significant ACLA or AGA antibodies

McMahon, Scott W. "An evaluation of alternate means to diagnose Chronic Inflammatory Response Syndrome and determine prevalence." Medical Research Archives 5.3 (2017).

Urinary mycotoxins are more commonly used to assess mold exposure.

Evaluation of 112 patients with a diagnosis of chronic fatigue syndrome revealed that 93% (104 patients) were positive for at least one urinary mycotoxin. Urine was tested for aflatoxins, ochratoxin A, and macrocyclic trichothecenes. Routine blood chemistries may be normal in chronic fatigue though abnormalities in natural killer cell function may be seen as well as hypogammaglobulinemia.    

Brewer, Joseph H et al. “Detection of mycotoxins in patients with chronic fatigue syndrome.” Toxins vol. 5,4 605-17. 11 Apr. 2013

One previously healthy 25-year old male presented with refractory ulcerative colitis, CFS, and CIRS following exposure to water damage and toxic mold Stachybotrys chartarum. Chronic inflammatory response syndrome was diagnosed due to genetic propensity (HLA-DR/DQ positive), elevated TGF-beta and C4a levels, and undetectable vasoactive intestinal peptide. Colitis symptoms did not subside until extraction of two molars and resolution of occult infection associated with periodontal disease.      

Gunn, Shelly R et al. “Reversal of Refractory Ulcerative Colitis and Severe Chronic Fatigue Syndrome Symptoms Arising from Immune Disturbance in an HLA-DR/DQ Genetically Susceptible Individual with Multiple Biotoxin Exposures.” The American journal of case reports vol. 17 320-5. 11 May. 2016