Detection of Mycotoxins in Patients with CFS

[waiting]

I'm so sorry to hear this Sparrowhawk. I just had a major relapse as well and sure enough, my air conditoner had a blanket of black yuck in it. Going to send a sample in to be cultured. I'm sort of starting to come around after removing the a/c about 3 weeks ago.

I was already being treated by a mold literate doctor so thank goodness we're on top of it. But I developed symptoms I've not had before and it was very scary.

globalpilot, I'm glad you're getting back to baseline. May I ask if your mold literate doctor is in Ontario? I may be dealing with same. Also, are you sending your culture to Mycometrucs? I just did this ... waiting for results now.

 

[globalpilot]

No, my doctor is Dr Nathan and he is in California. I went to see him once and have been doing phone consults since.
I'm sending my culture to immunolytics - just collecting it today.
I'm still not back to baseline - maybe something else is going on.

 

[Ifish]

I am a patient of Dr. Brewer. I have had CFS since 1991 and I have two children and my wife diagnosed with CFS. Brewer (along with a couple others) published another paper:

Chronic Illness Associated with Mold and Mycotoxins: Is Naso-Sinus Fungal Biofilm the Culprit?
Joseph H. Brewer 1,* , Jack D. Thrasher 2 and Dennis Hooper 3

1 Plaza Infectious Disease and St. Luke's Hospital, 4320 Wornall Road, Suite 440, Kansas City, MO 64111, USA 2 Citrus Heights, CA 95610, USA 3 RealTime Laboratories, Carrollton, TX 75010, USA
* Author to whom correspondence should be addressed.
Received: 2 December 2013; in revised form: 16 December 2013 / Accepted: 17 December 2013 / Published: 24 December 2013

Download PDF Full-Text [506 KB, uploaded 24 December 2013 13:48 CET]
Abstract: It has recently been demonstrated that patients who develop chronic illness after prior exposure to water damaged buildings (WDB) and mold have the presence of mycotoxins, which can be detected in the urine. We hypothesized that the mold may be harbored internally and continue to release and/or produce mycotoxins which contribute to ongoing chronic illness. The sinuses are the most likely candidate as a site for the internal mold and mycotoxin production. In this paper, we review the literature supporting this concept.
Keywords: mycotoxin; biofilm; rhinosinusitis; chronic fatigue syndrome

http://www.mdpi.com/2072-6651/6/1/66

Brewer has treated over 200 patients using intranasal antifungal medications. I think there is alot of misconceptions about Brewer's prior paper and I hope to add some insight as I am able.

Here is another study that I think is noteworthy:
"Neurological Disease After Mold Exposure, Immune Risks & Response to Biofilm-Focused Antifungal Therapy"
http://www.icaaconline.com/php/icaac2013abstracts/data/papers/2012/M/2012_M-1063.htm

 

[dannybex]

Thanks for that second link -- I remember reading a year or so ago that Dr. Grant treats her mold patients with antifungals. Too bad the results of the antifungals weren't noted in the paper...

 

[globalpilot]

Dr Grant does use antifungals. She uses amph B as Dr Brewer reported in the paper above. However, she does something a little different in that she has the patient swallow it so it reaches all of the nasal, sinuses, throat, stomach, all way through the GI tract. i believe Dr Brewer is doing a sinus irrigation and it won't reach the intestinal tract.

I have an appt with Dr Grant next week and hoping to try this treatment.

 

[Sparrowhawk]

Dr Grant does use antifungals. She uses amph B as Dr Brewer reported in the paper above. However, she does something a little different in that she has the patient swallow it so it reaches all of the nasal, sinuses, throat, stomach, all way through the GI tract. i believe Dr Brewer is doing a sinus irrigation and it won't reach the intestinal tract.

I have an appt with Dr Grant next week and hoping to try this treatment.

Let us know how it goes! Hope it works for you.

 

[Annesse]

I posted the following information on my Facebook page recently about why exposure to molds and mycotoxins may be linked to ME/CFS and fibro.
MOLDS AND MYCOTOXINS

Dangerous molds and the chemical toxins they produce (mycotoxins) have been linked to a number of different diseases including fibromyalgia, autoimmune disease, and chronic fatigue syndrome.

Molds and mycotoxins have been found to interfere with protein synthesis by targeting protease (enzymes that digest proteins).

According to Dr. Jack Thasher, PhD, a leading mold toxicologist: "Molds can affect humans and animals in several ways. These include infection and/or colonization. The most classic being aspergillosis. Molds can produce toxins that affect animals and humans through their toxicological actions. These include inhibition of protein systhesis...Four species of Aspergillus (flavus, niger, fumigatus, and terreus) which can cause aspergillosis have been identified as causative organisms. These four species produce a highly toxic mycotoxin, Gliotoxin."

As the following study shows, Gliotoxin inhibits protein systhesis by targeting "protease".

The secondary fungal metabolite gliotoxin targets proteolytic activities of the proteasome.
Kroll M1, Arenzana-Seisdedos F, Bachelerie F, Thomas D, Friguet B, Conconi M.Chem Biol. 1999 Oct;6(10):689-98

"The fungal epipolythiodioxopiperazine metabolite gliotoxin has a variety of toxic effects...How gliotoxin acts remains poorly understood...we decided to investigate its molecular mechanism of action. We show that gliotoxin is an efficient, noncompetitive inhibitor of the chymotrypsin-like activity of the 20S proteasome in vitro...Gliotoxin targets catalytic activities of the proteasome efficiently..."

If molds can inhibit protease then we should find that patients with mold exposure lack vitamin B12, since protease are responsible for the metabolism of vitamin B12. In the following study the researchers stated that patients with chronic toxigenic mold exposures manifest consistent vitamin B12 deficiency.

Metabolism of mycotoxins, intracellular functions of vitamin B12, and neurological manifestations in patients with chronic toxigenic mold exposures. A review.
Anyanwu EC1, Morad M, Campbell AW.ScientificWorldJournal. 2004 Aug 26;4:736-45.

"This paper evaluates the possible reasons for consistent vitamin B12 deficiency in chronic toxigenic mold exposures...Since patients with chronic exposures to toxigenic molds manifest vitamin B12 deficiencies, the role of mycotoxins in vitamin B12 metabolism is assessed..."

In our next study the researchers confirm the lack of vitamin B12 in patients with chronic toxic mold exposure and list some of the ramifications of this deficiency. These ramifications include: nerve damage and demyelination, progressive peripheral neuropathy, and spinal cord degeneration.

Biochemical impedance on intracellular functions of vitamin B12 in chronic toxigenic mold exposures.
Ebere C Anyanwu, et. al The Scientific World Journal 02/2007; 7:1649-57.

"A majority of patients with neurological disorders with chronic exposures to toxigenic molds and mycotoxins has vitamin B12 deficiency that is unrelated to dietary insufficiency...This paper examines and assesses various most likely biochemical reasons that could impede upon the normal intracellular functions of vitamin B12 that lead to neurological manifestations...such as nerve damage and, demyelination, degeneration of PNS leading to paralysis, progressive peripheral neuropathy, and spinal degeneration."

Take home message:

Patients with fibromyalgia and autoimmune disease lack the enzymes that digest dietary proteins and DNA (protease and DNase 1). Common toxic molds and mycotoxins interfere with protein synthesis by targeting protease. This would explain the association between chronic exposure to toxic molds and diseases such as fibromyalgia, chronic fatigue syndrome, and autoimmune disease.

Protease are also responsible for the metabolism of vitamin B12. A lack of vitamin B12 will lead to many of the symptoms associated with fibromyalgia and autoimmune disease; nerve damage and demyelination, progressive peripheral neuropathy, and spinal cord degeneration.

 

[katcoff]

I posted the following information on my Facebook page (Autoimmune The Cause and The Cure) recently about why exposure to molds and mycotoxins may be linked to ME/CFS and fibro.
MOLDS AND MYCOTOXINS

Dangerous molds and the chemical toxins they produce (mycotoxins) have been linked to a number of different diseases including fibromyalgia, autoimmune disease, and chronic fatigue syndrome.

Molds and mycotoxins have been found to interfere with protein synthesis by targeting protease (enzymes that digest proteins).

According to Dr. Jack Thasher, PhD, a leading mold toxicologist: "Molds can affect humans and animals in several ways. These include infection and/or colonization. The most classic being aspergillosis. Molds can produce toxins that affect animals and humans through their toxicological actions. These include inhibition of protein systhesis...Four species of Aspergillus (flavus, niger, fumigatus, and terreus) which can cause aspergillosis have been identified as causative organisms. These four species produce a highly toxic mycotoxin, Gliotoxin."

As the following study shows, Gliotoxin inhibits protein systhesis by targeting "protease".

The secondary fungal metabolite gliotoxin targets proteolytic activities of the proteasome.
Kroll M1, Arenzana-Seisdedos F, Bachelerie F, Thomas D, Friguet B, Conconi M.Chem Biol. 1999 Oct;6(10):689-98

"The fungal epipolythiodioxopiperazine metabolite gliotoxin has a variety of toxic effects...How gliotoxin acts remains poorly understood...we decided to investigate its molecular mechanism of action. We show that gliotoxin is an efficient, noncompetitive inhibitor of the chymotrypsin-like activity of the 20S proteasome in vitro...Gliotoxin targets catalytic activities of the proteasome efficiently..."

If molds can inhibit protease then we should find that patients with mold exposure lack vitamin B12, since protease are responsible for the metabolism of vitamin B12. In the following study the researchers stated that patients with chronic toxigenic mold exposures manifest consistent vitamin B12 deficiency.

Metabolism of mycotoxins, intracellular functions of vitamin B12, and neurological manifestations in patients with chronic toxigenic mold exposures. A review.
Anyanwu EC1, Morad M, Campbell AW.ScientificWorldJournal. 2004 Aug 26;4:736-45.

"This paper evaluates the possible reasons for consistent vitamin B12 deficiency in chronic toxigenic mold exposures...Since patients with chronic exposures to toxigenic molds manifest vitamin B12 deficiencies, the role of mycotoxins in vitamin B12 metabolism is assessed..."

In our next study the researchers confirm the lack of vitamin B12 in patients with chronic toxic mold exposure and list some of the ramifications of this deficiency. These ramifications include: nerve damage and demyelination, progressive peripheral neuropathy, and spinal cord degeneration.

Biochemical impedance on intracellular functions of vitamin B12 in chronic toxigenic mold exposures.
Ebere C Anyanwu, et. al The Scientific World Journal 02/2007; 7:1649-57.

"A majority of patients with neurological disorders with chronic exposures to toxigenic molds and mycotoxins has vitamin B12 deficiency that is unrelated to dietary insufficiency...This paper examines and assesses various most likely biochemical reasons that could impede upon the normal intracellular functions of vitamin B12 that lead to neurological manifestations...such as nerve damage and, demyelination, degeneration of PNS leading to paralysis, progressive peripheral neuropathy, and spinal degeneration."

Take home message:

Patients with fibromyalgia and autoimmune disease lack the enzymes that digest dietary proteins and DNA (protease and DNase 1). Common toxic molds and mycotoxins interfere with protein synthesis by targeting protease. This would explain the association between chronic exposure to toxic molds and diseases such as fibromyalgia, chronic fatigue syndrome, and autoimmune disease.

Protease are also responsible for the metabolism of vitamin B12. A lack of vitamin B12 will lead to many of the symptoms associated with fibromyalgia and autoimmune disease; nerve damage and demyelination, progressive peripheral neuropathy, and spinal cord degeneration.

 

[katcoff]

I haven't been following this thread for a while, but I did notice that someone asked whether Dr. Brewer could present concrete results, i.e., has anybody really been significantly helped or cured via mycotoxin therapy? Yet, all I seem to find is more circumloquacious techo-babble. I'm tempted to conclude that this thread is bunk.

 

[globalpilot]

I haven't been following this thread for a while, but I did notice that someone asked whether Dr. Brewer could present concrete results, i.e., has anybody really been significantly helped or cured via mycotoxin therapy? Yet, all I seem to find is more circumloquacious techo-babble. I'm tempted to conclude that this thread is bunk.

If you google around a bit you will find several that have been helped by cholestryamine. I have found several, but, unfortunately didn't save the links.
This work is really in its infancy so I wouldn't write it off as bunk just yet.

 

[Skyline]

@katcoff
There is more "data" on people being helped with Mycotoxins than any other area I've looked at - and I've looked into most serious avenues and have seen significant recovery (as have many others I've spoken to).

I'm commenting on this because I didn't want others to get the wrong idea and lose hope, or decide not to pursue the mycotoxin angle. That would do many people a big disservice.

Check into the work and research of Ritchie Shoemaker who has collected a lot of data on treatment of what he calls CIRS (I think of it as a subset of CFS, potentially a very large subset).

 

[Ifish]

Brewer and Grant are significatly different than Shoemaker in that they believe there is an ongoing colonization of mold in the body which causes a continuous supply of mycotoxin in the body. I am aware that many of Brewer's patients have improved significantly with his protocol, some dramatically. I will be seeing him later this week and I will know more then. Grant has published some results. Here they are:

M-1063

Neurological Disease After Mold Exposure, Immune Risks & Response to Biofilm-Focused Antifungal Therapy

J. F. Rini, MS - ., I. H. Grant, MD (Doctor of Medicine) - Clinical Assistant Professor, Department of Family and Community Medicine;
New York Med. Coll., Valhalla, NY.

Background: Stachybotrys (St) and Aspergillus-Penicillium (Asp-Pen) biofilm products may cause symptoms (sxs) without invasion. Amphotericin B (Ampho), the only mold biofilm-eradicating antifungal, cannot cross tissues. Since mold toxins may cause neurological (neuro) sxs, upper-respiratory/GI biofilm-focused antifungal therapy (Rx) was studied, correlating neuro sxs with immune risks, antibodies (AB’s), urine mycotoxins (MCT’s) and Rx response. Methods: Monitored 25 patients with neuro sxs after proven mold exposure (11M,14F,age 27-91) for immune risks, specific AB’s, urine MCT’s and response to oral-nasal Ampho +/- systemic azoles or capsofungin. Results: Debility paralled exposure intensity, impaired immunity, or multiple MCT’s.

Response to RX was striking with 21/23 (91%) unequivocally improved, most in 1-3 months. Penetration markers(adenopathy, nodules, calcification) required prolonged(>1 year)relapsing with interruptions.

Data

DOCUMENTED ENVIRONMENTAL
EXPOSURES

Aspergillus-Penicillium
21 (84%)

Stachybotrys
18 (72%)

SYMPTOMS

Severe 14
-7 Life-altering
-10 disabled)

Moderate
9

Mild
1

IMMUNITY RISK
23/25
(92%)

Innate Defects
(60%)

vitamin D deficient
15

Neutrophil Defects
(40%)

Protein deficient
10

Steroid Rx
6

Zinc deficient 5

TITERS

A.fumigatus

IgG + 15/15
5 (33%) elevated

S.chartarum

IgG + 12/18
2 elevated

IgA + 1/18

IgE undetectable 18/18 (100%)

MYCOTOXINS
(13 excreted multiple MCT’s)

Ochratoxin
19

Tricothecenes
(neurotoxic)
15

Aflatoxin
8

RX RESPONSE
21/23 (91%) unequivocally improved, many in 1-3 months

12 (48%) completed RX, 8 with residual disability

14 (67%) relapsed on interruption
- 13 improved on retreatment

Of 2 not treated & 3 discontinued:
-2 steadily deteriorated
- 3 were lost


Conclusion: Since Stachybotrys & Aspergillus-Penicillium exposure can result in neuro sxs that dramatically reverse with combined biofilm-focused/systemic antifungals, such sxs may result from toxin mediated fungal disease and should trigger mold exposure inquiry and screening for immune defects, quantitative mold IgG and mycotoxins. Controlled clinical antifungal trials are needed.

 

[dannybex]

Thanks @Annesse for those interesting studies linking mycotoxins with protein digestion issues and B12 deficiencies. Very helpful.But them I'm curious as to why in your book you advise people not to take sublingual B12?

 

[katcoff]

Brewer and Grant are significatly different than Shoemaker in that they believe there is an ongoing colonization of mold in the body which causes a continuous supply of mycotoxin in the body. I am aware that many of Brewer's patients have improved significantly with his protocol, some dramatically. I will be seeing him later this week and I will know more then. Grant has published some results. Here they are:

M-1063

Neurological Disease After Mold Exposure, Immune Risks & Response to Biofilm-Focused Antifungal Therapy

J. F. Rini, MS - ., I. H. Grant, MD (Doctor of Medicine) - Clinical Assistant Professor, Department of Family and Community Medicine;
New York Med. Coll., Valhalla, NY.

Background: Stachybotrys (St) and Aspergillus-Penicillium (Asp-Pen) biofilm products may cause symptoms (sxs) without invasion. Amphotericin B (Ampho), the only mold biofilm-eradicating antifungal, cannot cross tissues. Since mold toxins may cause neurological (neuro) sxs, upper-respiratory/GI biofilm-focused antifungal therapy (Rx) was studied, correlating neuro sxs with immune risks, antibodies (AB’s), urine mycotoxins (MCT’s) and Rx response. Methods: Monitored 25 patients with neuro sxs after proven mold exposure (11M,14F,age 27-91) for immune risks, specific AB’s, urine MCT’s and response to oral-nasal Ampho +/- systemic azoles or capsofungin. Results: Debility paralled exposure intensity, impaired immunity, or multiple MCT’s.

Response to RX was striking with 21/23 (91%) unequivocally improved, most in 1-3 months. Penetration markers(adenopathy, nodules, calcification) required prolonged(>1 year)relapsing with interruptions.

Data

DOCUMENTED ENVIRONMENTAL
EXPOSURES

Aspergillus-Penicillium
21 (84%)

Stachybotrys
18 (72%)

SYMPTOMS

Severe 14
-7 Life-altering
-10 disabled)

Moderate
9

Mild
1

IMMUNITY RISK
23/25
(92%)

Innate Defects
(60%)

vitamin D deficient
15

Neutrophil Defects
(40%)

Protein deficient
10

Steroid Rx
6

Zinc deficient 5

TITERS

A.fumigatus

IgG + 15/15
5 (33%) elevated

S.chartarum

IgG + 12/18
2 elevated

IgA + 1/18

IgE undetectable 18/18 (100%)

MYCOTOXINS
(13 excreted multiple MCT’s)

Ochratoxin
19

Tricothecenes
(neurotoxic)
15

Aflatoxin
8

RX RESPONSE
21/23 (91%) unequivocally improved, many in 1-3 months

12 (48%) completed RX, 8 with residual disability

14 (67%) relapsed on interruption
- 13 improved on retreatment

Of 2 not treated & 3 discontinued:
-2 steadily deteriorated
- 3 were lost


Conclusion: Since Stachybotrys & Aspergillus-Penicillium exposure can result in neuro sxs that dramatically reverse with combined biofilm-focused/systemic antifungals, such sxs may result from toxin mediated fungal disease and should trigger mold exposure inquiry and screening for immune defects, quantitative mold IgG and mycotoxins. Controlled clinical antifungal trials are needed.

The above symptoms do not really match CFS. Thanks for posting them though.

 

[Ifish]

The above symptoms do not really match CFS. Thanks for posting them though.

katcoff,

True, but Brewer's patients in his first paper do meet the criteria for CFS and Brewer is now using this method to treat CFS patients.

 

[Ifish]

globalpilot,

I would be interested to find out what Grant has to say. You might be interesed to listen to a radio interview she did a few years ago which can be downloaded here:
http://recordings.talkshoe.com/TC-1547/TS-733733.mp3

 

[globalpilot]

Thanks Ifish. I actually have listened to that in the past and found it very interesting. I think she is onto something.

globalpilot,

I would be interested to find out what Grant has to say. You might be interesed to listen to a radio interview she did a few years ago which can be downloaded here:
http://recordings.talkshoe.com/TC-1547/TS-733733.mp3

 

[Ifish]

I was in to see Brewer. In his original paper it was stated that 104 of 112 patients were positive on mycotoxins. After the paper was published 7 of the 8 negatives retested and all 7 were positives, so now it is over 99%. Dr. Paul Cheney is now testing some of his CFS patients and is getting similar results. Cheney is apparently quite enthusiastic.
Brewer has tried a variety of treatment methods and is now has it down to a fairly precise treatment protocol using atomized antifungals and bioifilm breakers. He is working to develop additional treatment options.
He has had some patients dramatically improve and is now doing some retesting. None have gotten their mycotoxin levels to zero but some are close. There is a direct correlation between mycotoxin level and state of health. He hopes to publish this information eventually.
Brewer emphasized he did not cherry pick the 112 patients. They were long standing CFS patients that were give the option to do the mycotoxin tests. The discovery of a pattern of mold exposure came later. It was a question that hadn't been asked before because it wasn't on the radar.
It is also important to note that many of the patients were still sick despite the fact the exposure took place long ago and they were no longer exposed. The fact they tested positive shows it is not a detox problem. The fact you pee it in a cup means it is leaving the body. The problem isn't with detox. Instead it is an illness caused by mold spores settling into the sinuses where they continue to grow and produce mycotoxins and other toxins etc. This is completely different than the Shoemaker way of thinking.

 

[soulfeast]

I was in to see Brewer. In his original paper it was stated that 104 of 112 patients were positive on mycotoxins. After the paper was published 7 of the 8 negatives retested and all 7 were positives, so now it is over 99%. Dr. Paul Cheney is now testing some of his CFS patients and is getting similar results. Cheney is apparently quite enthusiastic.
Brewer has tried a variety of treatment methods and is now has it down to a fairly precise treatment protocol using atomized antifungals and bioifilm breakers. He is working to develop additional treatment options.
He has had some patients dramatically improve and is now doing some retesting. None have gotten their mycotoxin levels to zero but some are close. There is a direct correlation between mycotoxin level and state of health. He hopes to publish this information eventually.
Brewer emphasized he did not cherry pick the 112 patients. They were long standing CFS patients that were give the option to do the mycotoxin tests. The discovery of a pattern of mold exposure came later. It was a question that hadn't been asked before because it wasn't on the radar.
It is also important to note that many of the patients were still sick despite the fact the exposure took place long ago and they were no longer exposed. The fact they tested positive shows it is not a detox problem. The fact you pee it in a cup means it is leaving the body. The problem isn't with detox. Instead it is an illness caused by mold spores settling into the sinuses where they continue to grow and produce mycotoxins and other toxins etc. This is completely different than the Shoemaker way of thinking.

Has Brewer published his protocol? I think I read recently some vague specifics and wondering how to share this info with my doctor. I have had sinus surgery and was full of infection and also test highly for mycotoxins via Real Time Lab. Unfortunately, the ENT did not take samples for testing from my sinuses. I've used some Ampho B but ENT switched to Vancomycin. Also did not use a biofilm buster, though encouraged daily rinsing/irrigation with a citrus seed extract/saline solution as well.

 

[soulfeast]

http://cfspatientadvocate.blogspot.com/2013/10/normal-0-false-false-false-en-us-ja-x.html This is an interview with Dr Brewer.