What is Biotoxin Illness?

Updated on December 3, 2014

Laying the Groundwork


In articles to follow, I want to take a closer look at what I consider to be the most important steps that need to be taken to recover from Biotoxin Illness – also known as Chronic Inflammatory Response Syndrome (CIRS). These steps are foundational. In other words, you may also need to deal with adrenal fatigue, hormone and neurotransmitter imbalances, parasites, heavy metals, and so on. However, without realizing these basic steps, your chances of a lasting recovery are dramatically lessened.

Several of the steps outlined are those recommended by Dr. Shoemaker while others come from my own personal experience and having studied folks like Dave Asprey, Doug Kaufmann, Dr. Klinghardt, Dr. Shoemaker, and others. All of these steps specifically target Biotoxin Illness. Although Dr. Klinghardt and others believe it’s important to deal with larger “bugs” like parasites, protozoa, and bacteria before treating Biotoxin Illness, I do not believe this is critical in most cases. Certainly the work of Dr. Shoemaker supports this contention. Nonetheless, there are people that are particularly damaged by biotoxins that require extra care and I’ll try to outline what this entails.

Before I dive into how to start getting better, I believe it’s important to lay down some groundwork. You need to have a functional understanding of what Biotoxin Illness is all about. Otherwise, you won’t be able to appreciate the importance of the treatment steps. With a core understanding of what Biotoxin Illness is all about, you’re not going to be easily blown off course when the next person shows up espousing ways to get better from mold. I say this because I know first hand just how devastating is illness is and consequently how strong the impetus is to find that “magic bullet” – “Dear God, please just make it all go away”. If you don’t take the time to educate yourself about this illness, then you’re going to be tossed about by whomever or whatever the next promising remedy is that shows up on your radar.

The Definition of Biotoxin Illness

Petri Dish

According to Dr. Shoemaker’s website, Biotoxin Illness (also called CIRS – Chronic Inflammatory Response Syndrome) is defined as “an acute and chronic, systemic inflammatory response syndrome (a group of characteristic symptoms) acquired following exposure to the interior environment of a water-damaged building with resident toxigenic organisms, including, but not limited to fungi, bacteria, actinomycetes and mycobacteria as well as inflammagens such as endotoxins, beta glucans, hemolysins, proteinases, mannans and possibly spirocyclic drimanes; as well as volatile organic compounds”.

In other words, when you suffer from Biotoxin Illness, your body becomes inflamed like when you’ve got a really bad flu (only worse) so you feel awful. As the illness progresses, you can develop auto-immunities, hormonal imbalances, shortness of breath, chronic fatigue, not to mention the cognitive issues brought on by swelling of the frontal lobes, the hippocampus, and the cerebellum in the brain along with shrinking of the caudate – see NeuroQuant studies by Dr. Shoemaker. You can read my blog, Are You Moldy, where I present the extensive list of symptoms that ensues as a result of this body-wide inflammation. Note: Common inflammatory tests like CBC, SED rate, ANA, C-reactive protein, along with lymphocyte, immunoglobulins, thyroid, and a metabolic profile will typically be normal for patients suffering from Biotoxin Illness.

Brain On Fire: The Role of Toxic Mold in Triggering Psychiatric Symptoms

What’s also important to note in this definition, is that it’s more than just mold (fungi) that drives Biotoxin Illness. Most people focus on mold and in particular, the toxins that mold makes – mycotoxins. Although this makes a lot of sense given what is known about just how badly these toxins can damage health, there are many other “inflammagens” mentioned. Dr. Shoemaker says, “Approximately 98% of the problems with chronic inflammatory response syndromes are due to inflammagens and not to toxins themselves.” By the way, if you Google mycotoxins, agriculture, and livestock, you’ll see that the agricultural industry has known about the devastating effects of mycotoxins on animal health for at least 20 years – so why it is that conventional Doctors act like mold is no big deal is beyond me.

More to the point, mold never grows in isolation. Bacteria always join the party. Together, they release a whole soup of toxins and inflammagens that work together (synergistically) wherein the combination of toxins is worse than any one of them alone. You can read Lisa Petrison’s article, Losing My Defenses: An Interview with Dr. Enusha Karunasena on the Neurological Effects of Satratoxin where they discuss this toxin multiplying effect. The fact that it’s more than just mycotoxins that need to be removed will be important to remember later on when I discuss binders.

Although not mentioned in the definition above, there are other organisms besides fungi and bacteria that can induce Biotoxin Illness. Below, I’ve put together what I believe is a fairly comprehensive list of the organisms that produce problematic biotoxins (bio – meaning coming from living things) and inflammagens. It’s not important to memorize all the details, just know that biotoxins and inflammagens don’t just come from mold and that you need to clear all the different types of biotoxins from your body to get better.

Biotoxins Sources

Brown Recluse Spider

  • Fungi (mold)
  • Apicomplexans (parasitic micro-organism like Lyme spirochetes)
  • Blue-Green Algae (aquatic cyanobacterium like microcystis and cylindrospermopsis)
  • Actinobacteria (certain Gram-positive bacteria like Streptomyces, Actinomyces, Nocardia, Propionibacteria, Cornynebacteria, Mycobacteria, Pseudomonas Fluorescens)
  • Reef Fishes (barracuda, snapper, moray eel, grouper, amberjack, triggerfish, and parrotfish containing dinoflagellate toxins like Pfiesteria, ciguatera and chattonella)
  • Brown Recluse Spider (Loxosceles illness)

Types of Biotoxins & Inflammagens

  • Mycotoxins exuded by fungi (Aspergillus, Cladosporium, Chaetomium, Penicillium, Stachybotrys, etc.)
  • Endotoxins also called Lipopolysaccharides (LPS) are cell wall components of Gram negative bacteria (E. coli, Pseudomonas, Enterobacter, Agrobacteria, Caulobacter, Stenophomonas, Chryseomonas and Acinetobacter)
  • Beta glucans are polysaccharides of the cell wall of fungi
  • Hemolysin are protein-based enzymes released by bacteria and fungi
  • Proteinases are enzymes produced by bacteria and fungi
  • Mannans are cell wall polysaccharides of fungi
  • Spirocyclic Drimanes are metabolites of Stachybotrys fungi
  • VOC – volatile organic compounds produced when mold and bacteria consume modern materials

While I’m on the subject, I’d like to take a minute to mention what Biotoxin Illness or CIRS isn’t. I get sense in talking to others that they believe that if they have one or more positive labs related to mold then it means they have Biotoxin Illness. It doesn’t. Here’s a list I put together to help clarify this.

What Biotoxin Illness Isn’t

  • It’s not mold and pollen allergies
  • It’s not fungal infections in the body like Farmer’s Lung
  • It’s not excess gut fungi like Candida – although Candida is typical in CIRS
  • It’s not the fungal growths found in the noses of 96% with chronic sinusitis
  • It’s not mycotoxins found in urine and saliva by RealTime labs

Specifically, Biotoxin Illness is chronic inflammation and the cascade of resulting ill health effects that come from the biotoxins and inflammagens mentioned above. Although, having a fungal infection of one sort or another in your body can certainly cause health issues, that’s not called Biotoxin Illness. I suppose it could be argued that if you do have fungi growing in your body in excess (not the kind found in a healthy gut that is loaded with helpful bacteria and fungi ready to help boost immunity, squelch other harmful bacteria, make vitamins and hormones, etc.), it is possible that they may produce biotoxins that are then making you sick, but this is a fine detail that deviates from the point at hand.

What Causes Biotoxin Illness?


OK, so now that we know what Biotoxin Illness is, how is it that these biotoxins and inflammagens can cause so much trouble? After all, it’s not like mold and bacteria aren’t everywhere. So what’s different?

From the definition, we know that it’s the biotoxins and inflammagens that are the cause of this debilitating illness. In practice, we know that when folks ill from Biotoxin Illness are cleared of these toxins and the effects of inflammation are squelched, they will remain healthy for as long as they avoid re-exposure. However, as soon as they spend as little as 5 minutes in a moldy building, they get sick all over again. And unlike allergies, they will not get better (in fact they will continue to decline) even when removed from the toxin source.

In other words, we know Biotoxin Illness is real because a whole host of labs outlined by Dr. Shoemaker will come back showing massive inflammation and when these symptoms are sequentially treated starting with avoiding exposure and binders to remove toxins, they get better. However, the question still remains. Why? Why are these toxins found indoors so problematic today (24% of the population is genetically susceptible to getting Biotoxin Illness)?

Research Committee Report on Diagnosis and Treatment of Chronic Inflammatory Response Syndrome Caused by Exposure to the Interior Environment of Water-Damaged Buildings

Indoor Versus Outdoor Mold

Old Building

The answer that is commonly given is that indoor mold is more toxic. After all, a lot of the mold found outdoors isn’t a problem for folks with Biotoxin Illness. Although, the work of Erik Johnson and Lisa Petrison along with my own experience indicates that outdoor molds are more troublesome than suggested by Dr. Shoemaker. Deviating from the topic momentarily, I believe their suggestion that we’re looking at a paradigm change when it comes to understanding disease as it relates to fungi is accurate. You can read more about outdoor molds in the article, Outdoor Toxins of Particular Relevance to Mold Illness Patients.

So the answer put forth as to why indoor molds are more toxic has to do with environment. Inside, the temperature is nearly constant – around 70 degrees Fahrenheit (20 degrees Celsius). The mold often grows hidden away from sunlight and isn’t subject to the elements. Furthermore, the amount of moisture present tends to be fairly constant – depending on the type of leak. All this tends to foster the few types of molds that grow in those specific conditions.

Mold – The New Hidden Pandemic Sweeping Across America

As a result, there is very little competition as there would be outdoors from other molds and bacteria that thrive under the much more varied outdoor conditions and compete for the same food sources. As such, indoor molds have the luxury of producing mycotoxins as a way of staking out their territory – mycotoxins fend off competing molds and bacteria. Due to the idyllic conditions, indoor molds don’t need to spend nearly as much of their energy just trying to stay alive as outdoor molds. Given the additional toxins indoor mold produces and the enclosed space of the building, the levels of toxins quickly rise to excess.

Building Methods

It’s been argued that with the advent of tighter and tighter building practices, often including wrapping the interior of homes in plastic, indoor mold levels have gotten worse. Certainly builders do not spend enough time ensuring sufficient air exchanges of indoor air with fresh air from outside – especially in light of tighter building envelopes and all the toxic chemicals in modern building materials. Commonly, a 6” duct to outside is tied into the return plenum on a forced-air heating and air-conditioning system. It’s all about just meeting code and nothing more – most consumers just don’t know any better and resultantly won’t pay for better construction. Very little thought goes into sizing ventilation systems to provide healthy indoor air by completing 6-8 air exchanges in the house every 24 hours.

Setting air quality aside, when it comes to mold, its moisture that we’re really concerned about. In fact, whenever the humidity gets above 50% (doesn’t even have to be wet or even damp), some type of mold will begin growing. Given that mold spores are everywhere waiting for the right conditions and that it doesn’t take anything more than the debris from construction (let alone all the wood framing and paper on drywall) to provide enough food, it’s really all about controlling moisture.

Stepped Flashing

Being a former residential General Contractor, I cringe when I see new homes going up. No one spends the time installing flashing properly. For a case in point, take a look at roof intersections on just about every home that uses stone or brickwork around rooflines. If the roof intersects an exterior wall or chimney made of masonry, look to see if the metal flashing at that intersection is stepped and actually tucks into the mortar joints. I can’t believe what passes inspections now-a-days but typically the flashing is simply caulked to the stone or brick side-wall. Sometimes they’ll cut the flashing in a stepped fashion but it doesn’t even match up to the mortar joints let alone being tucked into those joints! I give these caulked joints 5 years tops before they start to leak. (The picture shows properly executed flashing just before the brick joints are tuck-pointed.)

Vinyl Window Corner Flashing

And don’t get me going on vinyl siding where somehow miraculously water running down the side of windows is suppose to find it’s way out onto the face of the siding below when there is an intentional ¼” or bigger gap between the siding and the window frame to allow for expansion. Is it any wonder that the 2011 NIOSH report indicated that 50% of buildings in the U.S. have a degree of water damage that make them uninhabitable by folks with Biotoxin Illness.

Chemicals in Agriculture Hypothesis

Given the above, we know indoor molds are more toxic and together with bacteria that keeps them company, they produce a toxic and inflammatory soup that is worse than either one of them could produce in isolation. We also know that buildings are more air-tight and have more water leaks than ever. These facts alone could explain why folks like me are getting sick in ways not seen before. However, I believe that with the advent of widespread use of agricultural chemicals that the situation has been made much worse.

I was first introduced to the implications associated with the fact that mankind has dramatically altered the microbiome consisting of bacteria and fungi (along with the whole host of microbes that feed off of them) in Dr. Shoemaker’s book, “Surviving Mold“. In the book, Dr. Shoemaker discusses the consequences of using the anti-fungal Benomyl produced by DuPont on everything from crops to household paints. By killing off most of the fungi with chemicals, you dramatically alter the natural balance of bacteria and fungi in the environment. This poisoning of the planet’s microbes has been going on for quite some time with the use of herbicides, pesticides, fungicides, Round-up, 2,4-D, fertilizers, and the like.

Glyphosate (Round-Up), Gut Health, and Chronic Disease

The consequences of killing off the natural biology that although somewhat troublesome from time to time for farmers is that the really nasty microbes that remain leave you with everything from barren soil, blue-green algae blooms in waterways, too many verroa mites that kill off honey bees, and so on. The natural microbes that would have normally worked synergistically with plants and organisms in order to promote health and vitality are gone. Consequently, when it comes to plants, you have to continually spray and fertilize in order to keep these nutrient deficient plants alive.

Mycorrhizal Fungi

Did you know that over 90% of plants rely on a wonderful mold called mychorizzal fungi? This fungus embeds itself directly into the roots of plants. Plants send 30% of their photosynthesis energy into the soil in the form of sugar and carbohydrates to feed the soil microorganisms including this important fungus. The fungus in turn extends the accessible soil from 10 to 1000 percent thereby providing more essential nutrients to the plant that would be otherwise unavailable. When we nuke the soil with chemicals, these fragile fungi are the first ones to go.

In a 2012 interview by Joe Rogan, Dave Asprey says, “… what benomyl did [was] it killed all fungus. Like 98% of fungus it touched would just die. Unfortunately, the other 2% would just get like X-men mutation turned on. Whole plasmid-level mutation it’s called. What this means is that instead of one gene mutating like nature does, whole groups of genes would mutate. And get this. A fungus can change plasmids with other fungus like baseball cards. So what’s going on here is we created X-men fungus that reproduced every 20 minutes thirty years ago. And some of these new toxic molds that are like uber-vicious that poison people in their houses and all… and I’ve had that happen to me.”

Transcript of the Joe Rogan Experience
with Guest Dave Asprey, The Bulletproof Executive

The Soil Food Web - Dr. Ingham

Dr. Elaine Ingham from the Soil Foodweb lectures about the importance of soil biology and how the use of chemicals just besets even more use of chemicals. So we’ve decimated soil biology so that fruits and vegetables could be grown in regions for which they are ill suited or so that they would show up on the grocery store shelves with fewer blemishes – the onset of natural decay vis-à-vis mold. Having studied this, it’s clear that the solution is to foster the living soil web of microbes through the use of managed grazing, compost, compost tea, soil mineral amendments, and the like.

We can see just how bad the problem is getting. In any given year, at least 25% of the worlds grain supply is contaminated with mycotoxins – even using threshold levels that are set way too high. Many of these molds are not the same ones our grandparents had to contend with. These grains are then fed to animals. The mycotoxins are sequestered in their fat. Later, we eat these same animals. There’s no avoiding mold.

If we get a leak in our homes, my belief is that many of the molds that are showing up for the party are far more toxic than those just a few generations ago. Is it any wonder that the immune systems of folks can no longer keep up? If we’re not careful, it’s not a solar storm or nuclear war that’ll be the undoing of mankind, but mutant microbes. In whatever way you can, support more organic ways of growing food.

Moldy – The Movie
The Intricate Relationships Between Mycotoxins, Fungi and Farming Systems

The Health Effects of Biotoxin Illness

Biotoxin Pathway

We’re now at a place where it’s time to look at how biotoxins wreck havoc in the body. With any luck, I’m going to compress the cascading effects of Biotoxin Illness laid out in Dr. Shoemaker’s most recent two books, “Surviving Mold and Mold Warriors“, into a page or so. Let’s start by looking at the immune system.

The Immune System

The body’s immune system consists of two sub-systems that it uses to clear foreign invaders (pathogens). These are the “acquired” and the “innate” immune systems. The acquired immune system creates antibodies custom designed to latch onto each specific pathogen encountered. It does this through an elaborate, multi-step process involving dendritic cells, T-cells, and B-cells. According to Dr. Shoemaker, the body relies on antibodies to clear out biotoxins and their related inflammagens and somewhere along the line, the process of creating antibodies for these types of toxins fails.

Unfortunatley in Biotoxin Illness, the body loses the ability to create antibodies to mold toxins. For those with Biotoxin Illness, also called Chronic Inflammatory Response Syndrome (CIRS), a portion of the acquire immune system stops working. In other words, the acquired immune system of a certain number of the 24% of the population that has susceptible genes breaks – not everyone with susceptible genes has trouble making antibodies to mold inflammagens. How many of the 24% of the population actually have CIRS is unknown. What is known, according to the work of Dr. Shoemaker, is that it appears that an inflammatory illness like Mono, Lyme, Coxsackie, lung inflammation, or other inflammatory diseases can set the stage for a breakdown in proper antibody creation.

Even when the acquired immune system is working properly, it takes time for the body to create antibodies and besides, not all pathogens’ can be removed through antibodies. Fortunately, this is when the more fundamental “innate” immune usually steps in. The innate immune system consists primarily of pre-formed proteins and specialized white blood cells. When activated, the pre-formed proteins “cleave” producing a cascade of new proteins that either kill the pathogens directly or help in painting a target on the back of the pathogens so they can be readily identified and removed by specialized blood cells called “phagocyte”. Phagocyte cells gobble up the foreign invaders. Unfortunately, biotoxins and inflammagens can not be removed by the innate immune system. What’s worse, these toxins nonetheless activate this “complement” system and this is where all the trouble (inflammation) begins – we’ll talk more about this in the Cytokine and subsequent sections.


Given the failing of both the acquired and innate immune sub-systems, the liver globs onto the toxins in its bile ducts and then dumps the toxin-laden bile into the gallbladder before it is excreted into the small intestine in a last ditch effort. Unfortunately, the toxins are reabsorbed by a recycling process in the body called enterohepatic circulation that serves to reuse bile and bilirubin. As a result, the toxins are never eliminated and end up back in the bloodstream. That’s strike three. In biotoxin ill people, the toxins perpetually circulate throughout the body and keep the innate immune system in overdrive resulting in massive inflammation. Note: It’s actually the increase in innate immune system constituents that produce symptoms when you get sick – fatigue, aches, brain fog, etc.

Note: Common inflammatory tests like CBC, SED rate, ANA, C-reactive protein, along with lymphocyte, immunoglobulins, thyroid, and a metabolic profile will typically be normal for patients suffering from Biotoxin Illness.


Biotoxins and inflammagens that are not cleared from the body temporarily bind onto what are called “Toll” receptor sites on the outer membrane of fat cells. When this happens, the toxins inappropriately trigger the fat cells to produce special protein molecules called “cytokines”. Cytokines of one type are used by the innate immune system to signal for an increase in the immune response (up-regulate). Later on when the invaders have been cleared, cytokines of another type signal the immune system to quiet down (down-regulate). Due to the fact that biotoxins and inflammagens can not be removed by the immune system in folks with Biotoxin Illness, cytokine levels remain high along with other innate immune system proteins, enzymes, and polypeptides. These abnormally high levels then lead to the whole host of adverse health conditions associated with CIRS.

Let’s look at some of the consequences of having a perpetually up-regulated immune system beginning with cytokines. In order for cytokines to do their job of directing the immune response, cytokines have the ability to move through out the body freely. This includes being able to readily cross gut and brain barriers. In the brain, they bind onto receptor sites in the hypothalamus that are normally reserved for a protein called Leptin. When this happens the person becomes “Leptin resistant” as many of the sites reserved for Leptin are now occupied by cytokines.


Given that Leptin suppresses appetite and stimulates our metabolism, as well as stimulating the production of MSH (Melanocyte-Stimulating Hormone), you can begin to see how the trouble starts. Related to MSH, this is a master regulatory hormone that controls many functions including melatonin and endorphin production. When melatonin is low due to low MSH, you won’t sleep well. When endorphins are low, everything hurts more and you lose your love for life. MSH also regulates the cytokine response in the GI tract, nasal membranes, and lungs resulting in a tendency for gut issues like Candida or alternating constipation and diarrhea, MARCoNS, and asthma like symptoms respectively.

In addition, MSH modulates a gland called the pituitary in the brain. When MSH is low, then the thyroid, ACTH (Adrenocorticotropic Hormone), sex hormones (progesterone, and testosterone), and ADH (Antidiuretic Hormone) are all adversely effected. Getting into details, cytokines and low MSH reduce the conversion of T4 to T3 in the thyroid. The hormone T3 is like the temperature setting on your thermostat. When it’s low, your body’s metabolism will be suppressed resulting in low energy, low basal temperatures, cognitive difficulty, and so on. Furthermore, over time ACTH and cortisol both become depressed in CIRS resulting in an inability to handle stress.

In an act of self preservation, your body prioritizes the production of cortisol to handle the eminent stress of dealing with an over-amped immune system. It does this to the detriment of the sex hormones in a process called “pregnenolone steal”. Consequently, testosterone is low in men and progesterone is even lower in women – due to all the chemicals in our environment, most women are notoriously low in progesterone even without having CIRS – see the work of Dr. John Lee. To top it off, when low MSH causes ADH to be out of balance with your body’s Osmolality (the ratio of electrolytes to water in your body) you end up urinating frequently, get lots of static shocks, and tend to get dehydrated that then leads to a whole new set of symptoms.

More specifically, when Osmolality gets too high, then the electrolytes are too concentrated and your body should respond by increasing ADH so your body hangs onto water. Unfortunately, folks with Biotoxin Illness will have relatively high Osmolality and yet ADH will be low. In other words, even though your body is dehydrated, you end up having to urinate shortly after having a drink of water. Always being dehydrated hurts your body’s ability to heal.

For example, lets say someone has an Osmolality of 295 (normal range: 280-300 mosmol) and an ADH of 2.5 (normal range: 1.0-13.3 pg/ml). We can calculate what ADH should be for a given Osmolality using a little algebra and the normal ranges. Specifically, if plasma Osmolality (not urine Osmolaity) is 295 then ADH is calculated using the formula ((295-280)/(300-280))=(X/(13.3-1)) >>> (15/20)=(X/12.3) so X=9.225 and ADH should be around 1+9.225=10.225 (+/-) 2.5. Clearly, ADH is way too low for someone that’s fairly dehydrated. In CIRS individuals, it’s not uncommon to find osmolality is in the high range of normal while ADH is in the lower range of normal – you have to look at osmolality and ADH as a pair on the labs.

The story of Leptin resistance doesn’t end with MSH. In response to Leptin not getting through to the hypothalamus, the body boasts the Leptin signal by increasing Leptin levels. Unfortunately, Leptin levels determine how tightly the body hangs onto its fat stores. When Leptin is high, the body hangs onto fat. I highly recommend you read the work of Dr. Jack Kruse as it relates to resetting Leptin resistance through diet and increasing MSH using “Cold Thermogenisis”.

Dr. Jack Kruse: Leptin Reset Easy Start Guide

VEGF-TGF-beta 1

As the illness progresses, folks pick up weight and additional biomarkers go afield like low VEGF (Vascular Endothelial Growth Factor) and high TGF-beta 1 (Transforming Growth Factor beta-1). When VEGF is low, your veins narrow and your body is easily starved of oxygen – oxygen is delivered throughout the body by red blood cells zipping along through your veins. As a result, when folks with CIRS try to do a normal days work; they end up burning through their glucose (sugar) energy stores. This happens because they’re only able to make 2 units of ATP energy compared to 38 units for a given amount of glucose due to the lack of oxygen. Given that it takes time to replenish glucose stores, it takes days for CIRS people to recover from what for others is a normal day’s work. Note: Lack of energy in CIRS folks is not due to the malfunctioning of the cells that produce energy – mitochondrial cells. If you don’t have oxygen, you can’t make energy!

Bathroom Scale

Now you might think that with all that extra fat, that there should be plenty of energy to burn. Unfortunately, when Leptin is high, energy stored in fat is unavailable. Hating the fact that they’ve been reduced to a shell of their former selves, CIRS folks valiantly push on in spite of the extreme fatigue and depression. With Glucose depleted and fat stores unavailable, this leaves protein as the only other source resulting in muscle wasting – muscles are mostly protein.

TGF-beta 1 is interesting in as much as when it’s high, there is an increase in the production of T-regulatory and TH-17 cells that are important for preventing auto-immunity. Unfortunately in CIRS, T-regulatory cells are inappropriately converted into pathogenic cells that then prompt even more TGF-beta 1 production creating a feedback loop. As a result of high TGF-beta 1 autoimmunity to gluten, cardiolipins, the myelin sheathing around nerves, actin (coeliac disease), anca (ulcerative colitis), and others are common.


Although I haven’t covered all the dysregulation that happens as a result of Biotoxin Illness, this discussion wouldn’t be complete without mentioning VIP (Vasoactive Intestinal Peptide). MSH, VIP, and ADH are all linked. When one of the three falls then the others follow and if one is raised the other two also increase. When VIP is low, artery pressure will be too low and the body will compensate by increasing heart rate (acquired pulmonary hypertension). Furthermore, tachycardia, palpitations, and shortness of breath can be caused by low VIP.

Repairing VIP levels will restore vitamin D3 levels, up-regulate MSH, VEGF, ADH, and androgens, increase levels of CD4+CD25 combo cells and pulmonary artery pressure while down-regulating aromatase, TGF-beta 1, and MASP-2 (one driver of high C4a that auto-activates – see my blog Are You Moldy for more on C4a). You can see why Dr. Shoemaker’s protocol is all about getting CIRS folks to a place where they’re healthy enough to engage VIP therapy. It can make a huge impact.

Vasoactive Intestinal Polypeptide (VIP) Corrects Chronic Inflammatory Response Syndrome (CIRS)

Other Good Summaries

The Biotoxin Pathway
Introduction to “Excerpts from Dr. Ritchie Shoemaker’s book, “Surviving Mold”
Review of the Works of Dr. Ritchie Shoemaker
Mold Toxicity
CIRS – Overview, Diagnosis, and Treatment by Dr.Berndtson
Are Mold Biotoxins Making You Fatigued and Sick by Dr.Berndtson
Biotoxin CIRS Help
Toxic Mould Support Australia

Mold Toxins Making You Fatigued & Sick?

Dr. John Whitcomb – News and Nutrition

Wrapping It Up

Well, that’s enough groundwork. I’m guessing your head is swimming just like mine was when I first started studying about Biotoxin Illness. Nevertheless, I do believe it’s important to understand the basics of what you’re up against. At a minimum, you should get the sense that this is a major illness. It will most likely take time to heal and require real diligence to remain healthy. In a future blog, I’ll dive into what I consider to be the basics steps that everyone must take to get better.

11 thoughts on “What is Biotoxin Illness?

  1. Dear Greg,
    I presume that is your name since it’s the only name I saw at the bottom of your post. First, I would like to commend you for your excellent work and the way you’ve presented it. You speak from the heart and make a technical subject less difficult to understand. Your blog has become my reference guide that I look at daily and for that I am grateful.
    Thank you,

    • Kimberly,

      Thanks for the nice comment. I’m actually surprised to realize this about myself but I find interacting with others interesting and fun – assuming it doesn’t get to be too many questions. From a health standpoint, this is a good sign. Folks with chronic illnesses tend to withdraw from interactions with others in part because of messed up hormones and brain neurotransmitters. Life just gets to be too much. Also, it’s real work writing this blog so it keeps me motivated to hear that it is of some use to others.

      So in part, Biotoxin Journey is turning out to be a way for me to tentatively step back into the world and interact a little with others. In fact, I find that without a bit of dialog after posting a blog is like having someone walk away without saying a word after you’ve just taken the time to try and tell them that you noticed the air pressure was low on one of their car tires – you don’t know if they’re offended by supposing they didn’t know this for themselves, if they’re grateful, or something else.

      Thanks for taking a minute to say Hi. BTW, you presumed correctly.

  2. Immensely helpful post, above. Also enjoyed reading your main post (Finding A Mold Doctor) liked from Lisa’s blog this morning. It makes a difference when someone is writing about this in concrete terms, from lived experience. Plus you have the background as a contractor so you understand and can explain the implications of the shift in building practices since the turn of the century.

    Thanks for this valuable work, and I hope more folks confronting their own bio toxin situations will be able to find it and benefit thereby.

    • It’s important for me to hear the blog is of some use. Otherwise, what’s the point. It’s interesting to watch as I write about CIRS/Biotoxin Illness. One goal that seems to be unfolding is to provide a basic framework from which others with impaired immune systems to toxins and inflammagens can work from. Not that others haven’t done lots of great work. It’s just another reference point that I hope rounds out the chronic illness landscape. Sure, maybe folks will also need to address Lyme, methylation, heavy metals, parasites, and so on but my hope is that they’ll realize it’s essential to make sure the mold factor is looked into wholeheartedly – not just as an aside. Like you, I engender the wish that this blog might be of benefit to others.

  3. This was incredibly helpful and unbelievably relieving to read I’m not alone!
    I was exposed to indoor house mold 4-5 yrs ago after floods in our area. The house literally grew over night!
    I spent 3 months continually cleaning and scrubbing walls and furniture to get rid of it. During that time my health plummeted. I was sick with cold after cold. I became increasingly sicker and more and more breathless. I couldn’t explain it or understand how unfit I was. It got so bad one day I noticed I suddenly couldn’t even walk up my driveway without stopping for a rest 3 times. This wasn’t a huge driveway either. Sure it was steep but not too bad.
    Then I noticed even walking up our stairs to the second storey I couldn’t do.
    3 days later I had incredible pain in my shoulder blade and chest. I couldn’t stand, sit or lay down. I had to drive my s aught er to an appointment and thought I am not going to make it. My husband thinking I was being dramatic said you will be fine. So, I left him with the two younger children and we went.
    I couldn’t breathe, the pain was unbelievable and by the time I got to the appointment they made me go to the doctor across the road.
    I was tested with suspected pleurisy. I had blood in my sputum.
    They said if the pain didn’t get under control with panadeine forte to get an ambulance or drive to the hospital.
    Me being stubborn and not realising how serious it was rang my Mother and she said it sounded like P.E. Please take some aspirin just incase and go to the dr in the morning.
    So I did. The doctors confirmed the pleurisy and yelled at me for not going to the hospital like directed. They said I should go straight there.
    By the time I got to the car I could hardly breathe let alone walk ie drive the 1.5km to the hospital and rang a friend.
    She got me to the hospital and I collapsed. I spent 24hrs in resuss in the E.R. and nearly died of multiple clots in my left lung.
    Following this I just kept getting sicker. I was bed ridden for a whole year with chronic fatigue and fibromialgia and on massive pain medication for the pain of the P.E.
    We eventually moved so I could be close to family for support with our children should I get another flare up and my husband is in the army and works away.
    Over the last 2 yrs I have become ill again in March this year from a massive cfs/fibromialgia flare up.
    It wasn’t until all my support has stopped from family and friends that I’ve been thinking why am I so sick again.
    It clicked yesterday! We moved but took our furniture with us. Our room had just been closed up due to a wet winter and was covered in Mold!
    My boys are constantly sick with colds and their room I notice on the weekend as I changed it around is also covered in Mold.
    I did your test! I am suffering from biotoxic illness.
    Thank you so very much.
    It’s time to rid the house of carpet and furniture, clean and repaint.

    • Wow, that’s an intense story. I’m so sorry you’ve had to suffer so. It’s a testament to your character that you’ve been able to do as well as it sounds like you have.

      As you’ve discovered, mold is serious business. If you do in fact have Biotoxin Illness (you’ll need some lab work like HLA DR and C4a to confirm this), then simply cleaning, painting, and getting rid of porous furniture and household items isn’t going to be enough 🙁 I say this because it sounds like you’re seeing visible mold in various parts of your house. Please realize that just one square inch of indoor mold is more than enough to produce enough toxins to make someone with Biotoxin Illness very sick.

      I would be very careful about how you go about cleaning up any mold ❗ It’s quite possible that you can make the situation worse because when you disturb mold, you end up sending lots of toxins into the air. The mold may be visibly gone after cleaning but the air quality will be much worse without proper procedures. Just to give you and idea, you really need to partition off the space that will be cleaned, use large fans exhausting out windows to create a slight vacuum in the place you’re working, carefully bag all materials you remove, use hydrogen peroxide or another anti-fungal that remains in contact for at least 10 minutes, “air wash” the space with an electric leaf-blower after the remediation is done, and so on and so on. If you do have Biotoxin Illness, you should never take on such a project for yourself because even the best P100 masks with carbon will not provide enough protection.

      By the way, with the level of exposure it sounds like you got cleaning up flood damage, it is possible that mold has taken up residence in earnest in your lungs, sinuses, or elsewhere. This is different from Biotoxin Illness. With Biotoxin Illness, you don’t have a fungal infection growing in your body. Instead, with Biotoxin Illness your body is unable to eliminate the toxins from mold that is in the air (and perhaps even on food). Both are very serious.

      There is some interesting information on Dr. Shoemaker’s website about moldy military housing.
      Moldy Military Housing – Norfolk, VA

      I know this probably sounds a bit overwhelming. It takes time to learn about this illness and get better. The first place to start is to confirm with lab testing that you do indeed have Biotoxin Illness (sure sounds like it). If you do, then I’ve roughed out the first few steps in the blog Are You Moldy.

  4. Always great info and blog. Thank you. I’d like your input on something not often mentioned. Dr Shoemaker mentions Mold Illness Patients have “claw hands”. I believe he is referring to Dupuytren’s Contracture, of which I have acquired about 5 of, so far. It starts with a lump in your palm that develops into cords which contract your fingers, eventually needing surgery. They say there is no known cause. Mine came along with all my mold illness problems, and actually hurt when I get a mold exposure along with all my other symptoms. Research says when Biopsied they are full of TGF Beta-1. My TGF Beta-1 is 7300. To me this is a simple 2+2=4. Have you heard of any other mold patients with this? My Orthopedic Hand Dr seems somewhat interested, but not much. Thank you so much for your time in advance. Persistent.

    • Hi Persistent,

      Here’s what my notes say:

      High TGF-beta1 (normal range: <2380 pg/ml) is associated with tissue remodeling such as bronchial tube lining fibrosis (tough fibroblasts), hair loss, nasal and vocal cord polyps, and skin keratosis. Fixing TGF-beta 1 will help clear up most autoimmune illnesses, lung symptoms, neurological problems, autoimmunity, tremors, seizures, learning disabilities, multiple sclerosis (MS) and transverse myelitis (TM) associated with biotoxin illness. To improve TGF-beta1, complete steps 1-11 in Dr. Shoemaker’s Protocol then use Losartan (Cozaar – blood pressure pill) making sure to monitor for low blood pressure. Otherwise, wait for VIP as it will fix TGF-beta1 (last step in Dr. Shoemaker’s protocol)…

      Low VEGF (normal range: 31-86 pg/mL) in the face of block capillaries due to cytokines causes hypoxia resulting in more lactic acid due to the incomplete energy conversion of glycogen. Roughly 60% of CIRS people having cramping that often leads to permanently curled toes or fingers. To improve VEGF, complete steps 1-8 in Dr. Shoemaker’s Protocol then employ mold avoidance, high dose fish oil, no amylose diet, aerobic exercise, creatine (.3 g/kg)…

      The No-Amylose Diet
      Shoemaker And Improving Vo2 Max/Anaerobic Threshold

      Given that Dupuytren’s contracture is a “fibroproliferative disorder of the hand characterized by an abnormal myo/fibroblast proliferation”, I’d say you’re right on in your analysis with the added caveat of low VEGF. How are you doing with getting treatment for Biotoxin Illness?

      • Thanks Greg! Thank you for asking. I’m doing OK at my treatment, but as most mold patients, it’s a struggle to get all the tests done correctly and paid for by insurance. So far so good, thanks to Dr Shoemaker’s Physician Order Sheet. So far I have TGF B-1 at 7300. MSH 16. VIP 25. VEGF 81. The VEGF was a surprise.
        No AGA antibodies. Still waiting on results of the rest of the tests, as they were the second round. My Dr. (not a mold Dr) is coming along slowly, but allowing tests and Welchol. Do you happen to know the timing on the Welchol as far as taking it with meals, or a certain amount of time before? I get mixed advice on that. I Take lots of good supplements, and get fresh air. My house is good as far as exposure, we remediated a prior one. However, the world is a very moldy place, and I am very reactive. I follow the no amylose diet. But struggle to keep weight ON and have Type-II Diabetes. Another gift from this illness. I practice avoidance 24/7, but the world and a lot of people are moldy. Thank you so much, Greg, you are really making this easier for a lot of people. Persistent.

        • It’s good to hear more details about where you’re at. I remember when I first started getting blood work that I was surprised to learn that lab results work could be so far off if the draw was not done properly – it all seemed so “official” to me before I learned that everything from using the proper tube to how well the phlebotomist pours off the separated serum matters. It’s important to call ahead so the lab has time to contact the main office and get exact directions as they probably haven’t done many of the “mold” labs.

          I really do appreciate hearing the blog is helpful. Sometimes I wonder if what I’m doing makes any difference. In part, this is because what I’ve realized about people is they all have their own paths. Until the time is right, certain information just can’t be taken in. Everyone has to sort through the myriad of factors that influence how they prioritize information that ranges between everything from how it’ll affect their spouse, to finances, to socially accepted norms, to what they had for breakfast. All I can do is try to present what I think I’ve learned and then wait and watch. Your kind comments make me want to finish the next blog on mold testing – a huge subject.

          Like you, I have normal VEGF and difficulty keeping on weight – one of the side effects of Cholestyramine (CSM). I attribute my higher than expected VEGF in part to having continued to work construction even when I was quite sick. Exercise helps improve VEGF so long as you don’t get out of breath.

          Whelcol can be taken with food – that’s what I like about it. If I take a mold hit and can’t wait the required 30 minutes for Cholestyramine (CSM), I pop a couple Whelcol. Unfortunately, its binding capacity is only about 25% of that of CSM.

          I would seriously look at doing everything you can to improve gut health. Per Dr. Shoemaker, we know low MSH impairs gut health. However, gut health is not addressed by Dr. Shoemaker’s protocol but it is clearly vital. There are also several sources making the connection between Diabetes, fungi, and gut health. A good place to start is with Doug Kaufmann in Diabetes and the Fungus Link – Know The Cause. I’ve covered some of the more basic treatments that helped me in the Alternative Mold Therapies blog, but some day I’ll get around to more advanced therapies like diet in combination with anti-fungals like Nystatin and Diflucan. I’m almost going to have to write a separate blog on each as there are more caveats and I want to try and be as precise as I can.

          As you work to reduce inflammation through following a mold protocol, improving gut health, reducing stress, and the like, you’ll find that you become less and less reactive. Be well.

          • Thanks, Greg. Keep blogging. There are so many beginners out there that need this kind of useful information, and links. Also thanks for the info on Welchol timing. A big question answered. Your explanation on the VEGF and exercise fits my situation, too. Taking a good probiotic daily for 4 years has been a Godsend with gut issues for me. I also am a firm believer in antifungals, and don’t think enough is said about them. Especially the big guns like Voriconazole (Vfend), Itraconazole (Sporanox), and the rest. Fluconazole (Diflucan) is easier obtained from insurance and has been very helpful. Antifungals will actually bring down my Glucose fasting numbers. Again, thank you for the time and effort you put into helping people.

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