How to Identify and Treat Mold Illness (CIRS) | Ariana Thacker EP 228
In a Nutshell
Mold illness (CIRS) triggers chronic inflammation via biotoxins in water-damaged buildings, affecting ~25 million Americans with symptoms like fatigue, brain fog, hormonal issues, weight gain, and multi-system failures; 50-70% of homes and 85% of commercial buildings have mold, often misdiagnosed as autoimmune or mental health conditions. Mold Co offers accessible virtual treatment using Shoemaker protocol—lab tests (MMP9, MSH, TGF-beta1, HLA genetics, ERMI home testing), colesevelam binders, EDTA nasal spray for MARCoNS, and VIP—achieving 70-90% recovery for most after remediation and relocation. Start with bloodwork, dust tests, air purifiers (e.g., IQAir), and professional inspection; overlaps with Lyme, Long COVID; kids recover faster, with emerging links to PANS/PANDAS and autism.
These notes were generated by AI and may contain inaccuracies.
There isn't an ICD code for mold related illness, but there is a code for being bit by a turtle. Over the last 200 years, people have been exposed to chemicals like lead without knowing they were sick; lead was used in face makeup and only banned in gasoline in the 1980s. People have been exposed to biotoxins repeatedly.
Ariana Thacker welcomes Michaela to the podcast to discuss mold and immune system issues. Mold awareness needs to grow as it's everywhere, making people sick and leading to misdiagnoses with autoimmune symptoms. Ariana founded and is CEO of Mold Co after her personal health journey; previously a chemical engineer and built Conscience VC, a firm focused on early-stage pre-seed and seed investments in bio health and deep tech.
Ariana moved to Miami into a unit with mold throughout the HVAC system. Despite no prior health issues, in six and a half months she developed CIRS (Chronic Inflammatory Response Syndrome), experiencing near-debilitating symptoms: handful of functional hours per day, largely bedridden, purchased hospital bed tray to work from bed, extreme fatigue requiring rereading emails multiple times. Symptoms present as symptom clusters online. Mold causes health issues beyond asthma, allergies, or fungal infections—it's distinct.
CIRS symptoms differ between people:
- Fatigue: push-crash phenomenon, feeling good some days, set back after exertion like workouts.
- Brain fog: fuzzy feeling, inability to learn new information or poor knowledge assimilation; peculiar experience of seeing people speak English but not absorbing words; brain feels on fire from inflammation.
- High TGF beta 1 levels cause hair falling out (e.g., furry critters when brushing).
- Weight gain (majority due to leptin resistance), small subset with extreme weight loss.
- Gastrointestinal issues: IBS-like alternating constipation/diarrhea, often first to present.
- Sleep issues, frequent nighttime urination, overcompensating by drinking more water.
- Multi-system: cognitive, hormonal (especially women, 3:1 ratio), impacts 60% of women with heavy periods (10+ pads/day), extreme menstrual pain, inconsistent periods, multiple miscarriages, infertility, early menopause.
It's chronic inflammation impacting brain, gut, vascular, hormonal, respiratory systems—not just acute reaction like allergy.
Host tracked childhood autoimmune issues, severe psych issues, chronic fatigue to every building lived in having severe water damage (e.g., ceilings fell in university housing). Diet band-aided symptoms; after 6 years on diet, moved to moldy Miami place—symptoms returned despite unchanged diet (autoimmune resolved previously by diet). Previous Miami building also moldy, had miscarriage there. Symptoms: debilitating insomnia, chronic fatigue, weakness (couch-bound 4 months), waking at 3-4 AM panicking, heart palpitations, inability to process emails cognitively (can't chain solutions). Pieced together mold from prior podcasts; flew to doctor for binder to detox. Mold Co solves access issues.
Mold Co shortens patient pain cycle with evidence-based solutions from 30 years of research:
- Lab testing: Shoemaker biomarkers (highest signal for CIRS: MMP9, MSH, TGF beta 1, C4A, VEGF); HLA genetic susceptibility testing (cheek swab, affects 1 in 4 Americans); ERMI test for fungal strains in home.
- Virtual clinic protocol (translates Dr. Shoemaker's approach):
- Cholestyramine binders (instead of cholestyramine).
- EDTA and xylitol nasal spray for MARCoNS in nasal passages.
- VIP (vasoactive intestinal polypeptide). Labeled: detox, clear, repair.
- Concierge care: ping specialist anytime.
- Costs 1/10th to 1/100th of traditional care; live in 8 states for care, 46 for labs, all 50 by Q1 2026.
CIRS has peer-reviewed research on biomarkers like C4A, MMP9 (often 10x upper limit). Standard autoimmune tests normal, leading to gaslighting (anxiety meds, burnout). Progressive illness worsens with continued exposure.
Host's family: familial depression (great-grandpa couch-bound last 30 years, grandpa deteriorated mid-50s) likely mold-related; diet helped but didn't resolve root.
Parent: Immune Co; spun out Mold Co, next Lime Co, Long Co. Largest dataset: thousands of biop specimens, ~10,000 patient histories (environmental history, HLA, biomarkers, past medical history, symptoms, RNA seq). Aims to address medical blind spots, drive standard of care, reverse chronic illness (76% US adults have ≥1, 90s% over 64).
US HVAC recirculates indoor air (not fresh unless ERV or HRV attached); leads to mold recirculation. Switzerland mandates ERVs.
Step 1: remediate. Can start treatment even in moldy environment if safe (majority of patients). Renters: break lease, cure notice, work with landlord (new tenant-favoring laws); relocate; isolate source. Owners: remediation via IEP (qualified environmental professional). Network of IEPs for sensitive patients. Start care early as progressive. Air purifiers help as band-aid for stability.
Host's experience: cheap Amazon air purifier by bed increased deep sleep from 6 minutes to 2 hours (thought allergy to carpet). IQ Air purifiers recommended. CIRS causes anxiety, depression, suicidal ideation; upregulated trauma gene in subset (intruder in home wrecks health/life). Easy to misattribute to situational stress (relationships, work).
Roughly 50% of homes are impacted by mold, with estimates as high as 70%. Trends supporting higher numbers include increased natural disasters and flooding, energy-efficient buildings promoting microbial growth, and remediation lagging behind damage due to costs. If not in the home, mold can be in offices or schools. 85% of commercial buildings have historic water damage; 45% have ongoing water damage (EPA stat). Mold grows in 24-48 hours after water intrusion. Best guess is north of 50%, probably closer to 50-70%.
Huge housing growth over 30 years ago means many current homes are old with past water damage. Military housing cites mold as the number one issue on bases; over 20,000 work orders in a two-year period. Military families are advocating in DC for reform; organizations like Change the Air and Operation Counter Mold are helping. Increase in lawsuits for schools and universities, e.g., $35 million claim by students in dorms. More emails from concerned parents and reports from law firms suggest uptick in legal claims against universities for mold in dorms. Dr. Haymon (Shoemaker-certified physician) partnered with Normie to certify inspectors/remediators and create informed guidelines for military bases to reduce mold exposure, aiding military readiness.
Long COVID treatment can be triggered by biotoxins including mold. Most published work focuses on water-damaged building subtype of CIRS, but also pfiesteria, ciguatera, dinoflagellates. COVID may prime for worse mold outcomes. Later-stage patients show upregulated Epstein-Barr virus, Lyme antigens, Bartonella antigens, parasites—patterns of microbial burden leading to worse inflammatory outcomes. Mold is a large percentage and best starting point, hence MoldCo vs. LymeCo.
Recommend for Lyme or long COVID patients to check CIRS blood work and mold exposure. CIRS blood work is sensitive but not specific—requires exposure (e.g., mold in home), representative symptoms, lab testing, and genetic susceptibility. Over 90% of CIRS patients have specific HLA-DR types that make them susceptible to CIRS from mold exposure.
More diagnostics needed for personalization, but start with mold assessment. MoldCo will layer on more specific lab testing/treatments.
Exciting data potential from MoldCo users. Treatment for long COVID/Lyme with CIRS symptoms may align with Shoemaker protocol—some symptom resolution seen in post-Lyme syndrome (not acute Lyme) and long COVID clinically. Need more research for best, safest solution; tracking university/private research (Mount Sinai, independents).
Turning point this year: George Washington University launched first medical program following Shoemaker protocol; Dr. Shoemaker involved. Cultural awakening; clinics/providers reaching out to learn/refer. Governmental research organizations interested. MoldCo research will ignite field. NIH updated website to include non-infection/allergy/asthma mold issues: immune/inflammatory responses, mental health.
Mold disrupts leptin, causing hunger/resistance; significant factor in obesity epidemic (per Dr. Shoemaker, Dr. Scott McMahon). ~25 million Americans severely impacted by CIRS. Also at root of neurodegenerative issues (e.g., Dr. Dale Bredesen's inhalational Alzheimer's from mycotoxins), IBS, fibromyalgia, ME/CFS, mental health.
Peer-reviewed studies on sick building syndrome, wet/dampness syndrome (Europe), inhaled neurodegenerative disorders. Research under different names worldwide; listed on biotoxin.com. No ICD code for mold-related illness—only suspected exposure or turtle bite.
Historical parallels: lead in makeup/gasoline (banned 1980s), asbestos poisoning (e.g., relatives died from work exposure/clothes washing).
If mold at root of chronic conditions, requires retooling infrastructure—rip out/replace buildings. Ignorance is bliss blocks addressing it; progressive illness demands awareness. 50-80% houses impacted is catastrophic; even non-genetic people shouldn't live in moldy homes.
Environmental innovation emerging despite building variability (e.g., mismatched drawings, rain-exposed materials, loose nails). No holy grail yet, but national attention spurs entrepreneurs.
Took 8 years to diagnose mold after 2015 illness; lived with air purifiers, but prior sickness made it insufficient. Family sick (mom, dad, dog), brother fine despite same exposure. Example: 1915 Toronto house had black mold behind drywall from plumber's uncapped pipe for 18 years.
Not everyone impacted equally—mysterious sickness in home is canary in coal mine. Optimize home buying with mold inspection.
Common signs (no visible mold): earthy/musty odor, peeling paint, cracks, high indoor humidity >70%, dust on HVAC vents (mold triangle: water, no airflow, dust primes microbial growth including endotoxins/bacteria). Americans spend 90% time indoors—optimize.
Not just black mold—several bad molds; use ERMI/HERTSMI-2 tests scoring inflammation-causing species vs. human health data. Also fragments, mycotoxins, VOCs, bacteria (endotoxins, actinobacteria); airborne traps miss fragments (possibly 100x levels).
Proper testing: certified inspector (Normie, IICRC, ACAC), highly rated, specialized (not pest subset), in-demand (late/not returning calls good sign), full toolkit—visual, air trap, bulk, thermal gun behind walls, move items, check signs (peeling paint), common places like under
Couple ERMI/EMMA testing with a dust test for a historical fingerprint of everything a room has been exposed to. Keep it to one test per room. Dust test uses a Swiffer pad wiped on at least 10 different surfaces, saturated, then mailed in. Helps pick up hidden mold issues.
If people are overwhelmed, get blood work done and start there.
Black mold in the back of toilets indicates moldy air, as flushing drags in bathroom air with mold fragments that grow where water is present. Good for checking rentals: clean house but mold in toilet tank means moldy air. Inspectors check there. Sump pump or dirty diaper smell indicates sewage issue, a source of biotoxins like endotoxins—investigate beyond mold.
Carnivore diet works for random people likely with CIRS but doesn't solve root problem. Host's husband on diet had weight gain, cognitive issues from broken pipe leaking under floor next to bathroom—water damage dried with fan only. Proper remediation requires cutting out drywall, per John Bant's approach: focus on removal, avoid biocides as they create problematic fragments and dead species worse than live mold. Patients can get sicker post-remediation without small particle cleaning or thorough cleaning. New builds have wet concrete under LVP vinyl flooring causing hidden mold. Common issues: under flooring, crawl spaces, basements—know home anatomy for investigation.
Patients without HLA genetic susceptibility can recover after leaving home (anecdotal). Some without susceptibility still don't feel fully themselves after leaving. If sick with CIRS in the environment, won't get better and will deteriorate.
Harsh reality: can't live in severe water damage/mold environment. Must remove mold growth then treat, especially with genetic susceptibility.
Use colesevelam instead of cholestyramine (better tolerated, less constipation, oral tablet vs. gritty suspension, taken before meals with reminder). Similar symptom improvement in weeks—binding sites commentary overstated; Dr. Shoemaker and Dr. McMahon never stated quarter binding sites, and it doesn't map to symptoms. Field moving to colesevelam.
Ideal: blood work, fix mold exposure, start treatment simultaneously with colesevelam initially.
After symptoms plateau, treat MARCONS (problematic microbial colonization in deeper nasal passages; 90% of patients have it, drives down MSH). Use EDTA + xylitol nasal spray (biofilm disruptor, addresses other species). Improves symptoms even without MARCONS.
Host skeptical but felt better after moving and cholestyramine; EDTA spray caused intensification reaction (numbness, nerve pain like mold die-off), but persisted and improved. Husband unaffected. Intensification rare; push through for improvement. Stubborn MARCONS if sporadic treatment or reexposure. Need full steps for max recovery: ~90% of patients (excluding hypersensitive 10%) get 70-90% better per Dr. Shoemaker/Dr. McMahon. Goal: 100% of patients to 100%.
Host's family in 10%; dad's markers worse despite no mold exposure (on tour), EBV off charts—immune system not functioning.
Accumulation of fungal, bacterial, viral exposures dysregulates innate immune system, leading to chronic inflammation. Explains Lyme, long COVID burden.
Exposome (total exposure): bad diet, health history, immunocompromise worsen outcomes. Athletes recover quickly, fewer symptoms but body-aware. Low amylose diet responsive (eliminates starches, gluten—higher antigliadin antibodies). Resilient without genetic susceptibility.
HLA genetics: antigen presentation issue—microbes mimic security guards, alarm (inflammation/cytokine storm) disregulated continuously.
Celiac, ankylosing spondylitis also HLA genes; possible ancient benefit (e.g., celiac better virus detection) but modern gluten harmful.
5-7% get CIRS without HLA susceptibilities (single-digit).
Typically 5 abnormal markers (e.g., HLA, MMP9, MSH, TGF-beta1, C4a, VIP), 8 symptom clusters (adult), known exposure (mold, Pfiesteria, Stachybotrys, cyanobacteria; increasingly endotoxins/actino bacteria). Water damage creates microbial stew not fully tested by inspectors. Dust testing accumulates more data; need mapping like Hermie/Hershey (1,000 data points home dust to health outcomes). Early data: genes tied to endotoxins/actino bacteria via RNA seq.
Case studies (Dr. Scott/Dr. Shoemaker): MS, Alzheimer's, Parkinson's-like reversed.
Unclear why US worse than high-humidity countries. UK/Europe impacted (patients travel for US care). Theories: sealed modern homes less airflow; 1980s antifungal paints bred super molds (directed evolution).
High levels of mold found in air spore trap sample in the HVAC system and black mold under the sink. Suspected mold behind walls due to staining and water damage in one closet. There was a pervasive mold issue.
And then did you move out and did you immediately start CIRS treatment or did you try some other things first and how long did it take you to start feeling better?
Found a Shoemaker-certified physician early, but before that ping-ponged to ENT specialists, immunologist, allergist, pulmonologist, neurologist. Did battery of lab tests despite needle phobia, got therapist to overcome it. Went to functional health clinic; low ferritin but not anemic, tried iron pills and felt slightly better but still sick. Started Shoemaker treatment end of December 2022 or early January 2023. Noticed significant difference on binders within two weeks. Fell to the floor crying because felt like got brain back—thought it was lost forever. Felt defeated, couldn't think, process information, learn, or have energy to build anything; was doom-lining future.
Host hit rock bottom with diet turnaround after 15 years in medical system on many medications, thought trajectory downhill meant death. Got symptoms under control with diet until Nashville unit flooded while visiting London; moved to different unit, cleaned, moved stuff back. Thought severe tree allergies—face puffy, no internal dialogue, couldn't think. Had podcast episode showing it. Moved to Miami into another moldy house, then third one, realized it was mold. Terrifying.
Get blood work done. Health problems like heightened food sensitivities big sign, especially gluten and IBS-type symptoms as early presentation. Suspect mold if multi-system: brain fog, fatigue, frequent urination, hair loss, hormonal issues.
Scarlet got sick with genetics; nightmares in Nashville (new), accidents at older age in Miami (urgency). Bronchitis and pneumonia all the time—sick all winter in Nashville and sunny Miami. No bronchitis since moving. Main symptoms in kids: accidents/urgency, respiratory issues.
What have you seen in kids? How would a parent know?
Treat adults currently; medical director Dr. Scott has pediatric background. Increased PANS/PANDAS, neuropsyciatric issues. Looking at autism connection—early data supports correlation; organizing memo, pulling biobank data, getting more samples. Kids show 6 symptom clusters (vs. 8 in adults) and same dysregulated lab tests.
Scarlet improved fast despite poor genetics similar to parents; moving out helped her more than adults. Adults flattened without binders—host couldn't walk upstairs without breather, couldn't answer emails; started cholestyramine, felt garbage with intensification. About 2 weeks to feel better, month later not winded, no lactic acid burn upstairs (realized not gaining muscle). Kids bounce back incredibly faster than adults—promising for parents.
moldco.com: free online education, free guide, starter panel lab test at cost (includes MMP9, MSH, TGF-beta 1—highest signal markers). Dust test online, fraction of inspector cost to check for mold issue. Care in 8 states, expanding to all 50. [email protected]—read almost every email, incorporate patient feedback to co-create value.
Thank you very much for coming on. Excited to see this blow up—in 5-10 years, everyone will know.
I hope so. Thank you so much for having me.
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