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@jeff1047

@nrd1 -
I have done challenge testing after a cleanup period. When the outdoor mold levels are low I can turn off my mold-related symptoms for a couple of weeks by staying in a highly-filtered ‘residential clean room’, wearing a hooded PAPR (powered air purifying respirator) with a HEPA cartridge when I am ‘dirty’ areas of the house, and staying on a mold-free diet. It doesn’t take a lot of mold to trigger my brain fog and other mold-related symptoms after I have ‘stayed clean’ for a week or so.

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@winnievo-
I would be interested in hearing any details of your treatment protocol and any associated symptom improvements that you are comfortable sharing.
I am a retired, non-medical research scientist who has lived with a mold-induced multisystem/multisymptom illness for over 50 years. For the past 20 years I have maintained online access to a medical school library and regularly search Pubmed for articles that are relevant to my illness.
When articles about mold-induced illness began to appear in the popular media, I knew that I responded to both indoor and outdoor molds. The mold toxicity theories that were originally put forward by Shoemaker and others were limited to indoor mold species that were known to produce highly toxic bioaerosols.
I decided to consult a ‘mold doc’ in 2002 and I selected Vincent Marinkovich from the group of qualified MD’s. (https://www.globalindoorhealthnetwork.com/marinkovich). My choice was primarily based on his academic credentials and research accomplishments.
Marinkovich did not know the specific mechanisms that caused mold-induced illness but his patients (myself-included) typically presented with significant levels of mold specific IgG, little/no IgE. and systemic symptoms. In 2004 he published a paper in Medical Mycology (https://docslib.org/doc/5581273/fungal-hypersensitivity-pathophysiology-diagnosis-therapy) that summarized his diagnostic criteria and treatment protocol. He did not think that mycotoxins caused mold-related illness and wrote: “Hyperactive immune systems responding to the influx of fungal antigens following chronic exposures are much more likely to be a cause of symptoms in most individuals.”
The research papers on fungal immunology that have been published in reputable scientific and medical journals for the past 20 years have supported Marinkovich’s conclusion. For example, the recognized North American authority on mycotoxins and mycotoxin-related illness (J David Miller https://carleton.ca/chaimcentre/2016/david-miller/ ) published a paper in 2023 in which he clearly states that the health effects of mycotoxins are insignificant in comparison to the innate immune response to a fungal beta glucan compound. He also talks about this in Episode #731 of IAQRadio (https://www.iaqradio.com/j-david-miller-phd-bioaerosols-health-effects-secondary-metabolites-endotoxins-more/). The relevant portion of the interview video begins at the 42:10 time mark and ends at 56:00.

Marinkovich’s treatment protocol can be described in one word – avoidance. In his 2004 paper he wrote that “it is important to recognize that there are three sources of exposure: The airborne particles, mostly spores, which result from water intrusion at home, school, and work; ingestion (as in the enormous amounts and types of fungal products used by the food industry); and colonization of skin, lung, sinuses, and other mucosal surfaces.” In my case, Marinkovich’s treatment has worked, and I am currently able to stay symptom-free for weeks at a time. Unfortunately the lifestyle modifications, financial investment, and engineering skills that were required to get to this point were significant. For this reason, I don’t think that most people who suffer from mold-related illness will be able to reduce their symptoms to a negligible level. The good news, however, is that almost every reduction in my mold exposure has resulted in a noticeable health improvement. You don’t have to be symptom free in order to feel a whole lot better and I believe that almost all reductions in exposure level are helpful.

I don’t know if I can sustain my current level of avoidance as I age and wouldn’t hesitate to make an appointment with a CIRS-certified physician if I knew that Shoemaker’s treatment protocol was effective. I have searched for detailed ‘success stories’ from people who have gone all the way through the Shoemaker Protocol and so far I haven’t found any. I would appreciate any detailed info that you and other members who are currently on the Shoemaker protocol are willing to share.