Chronic Fungal Infection as a cause of disease: the toxicity of mycotoxins

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Our Immune Defences are Impaired

The human body can be infected by any microbe. Western lifestyles (in particular high carbohydrate, micronutrient deficient diets, environmental pollution, vaccination and female sex hormones such as the Pill and HRT) have resulted in a progressive erosion of our immunity. High carbohydrate diets are providing a free lunch for yeast and fungi which love to ferment sugars. The upshot is that we are seeing epidemics of new infections. These microbes have been present for millions of years, but now they are starting to move in and colonise our weakened bodies. Obvious examples include the herpes viruses, Lyme disease, bartonella and mycoplasma but let’s not forget fungi.

Fungi can poison us

We have been woken up to this possibility by the work of Dr Joseph Brewer. The idea here is that with our weakened defences, fungi and yeast have started to occupy our bodies. Obvious examples include athlete’s foot, fungal nail infections and cradle cap to name just a few. A further hint of this came from the “candida” story where yeast move into the gut and ferment foods with toxic effects. Now we have fungi occupying the airways - see "Mycotoxins and Interstitial Lung Disease, Ghio et al"

Not only can we become allergic to these microbes, but they can poison us directly. Indeed, mycotoxins are associated with many diseases most notably chronic obstructive airways disease and autoimmunity, with cancer (brain, oesophagus), heart disease and dementia all being likely associated pathologies. Now we know they are a major cause of ME.

What are the symptoms of Chronic Fungal Infection with mycotoxin production?

These are explained by inflammation and poisoning which may be acute and chronic.

  • Allergy/infection symptoms – ie local inflammation which may start as rhinitis, sinusitis, pharyngitis, tonsillitis etc and then progress to bronchitis, bronchiectasis and chronic obstructive airway’s disease. Indeed a colonisation of the airways by fungi may start with allergy (typically to dairy products) and so explain the common progression I see clinically of rhinitis, sinusitis and asthma to CFS and ME.
  • OR general inflammation symptoms such as pain and soreness in the muscles, joints and connective tissue. This is due to allergy to fungi and possibly infection with fungi.
  • Poisoning by mycotoxins in the short term – chronic fatigue syndrome
  • Poisoning by mycotoxin in the long term………… almost any organ pathology from kidney and liver failure to heart and brain failure.

Test for mycotoxins

This is easily done, if a bit pricey - see Great Plains Laboratory MycoTOX Profile (Mold Exposure)

ME patients often carry a mycotoxin load

Dr Brewer developed a test to look for mycotoxins in the urine and applied this to patients with ME. In his first paper "Detection of mycotoxins in patients with chronic fatigue syndrome, Brewer et al" he found that 93% of 112 ME patients had at least one mycotoxin in their urine, with ochratoxin being the commonest. 90% of those gave a history of exposure to moulds from water damaged buildings. The idea here is that these patients were infected with moulds and, perhaps because of poor immunity, the fungi remained in the upper and lower airways. Here they ferment to produce mycotoxins such as aflatoxin, ochratoxin, gliotoxin, sterigmatocystin, mycophenolic acid, roridin E, verrucarin A, Enniatin B, zearalenone, chaetoglobosin A and citrinin, probably many others! For example, many antibiotics such as penicillin and Streptomycin are also mycotoxins.

This mycotoxin load comes from fungi and moulds fermenting in our airways

In his second paper "Intranasal Antifungal Therapy in Patients with Chronic Illness Associated with Mold and Mycotoxins: An Observational Analysis, Brewer et al", Brewer hypothesised that although the problem may be triggered by contamination from the environment it was maintained by infection ie fungi in the airways. Many of the patients had no symptoms of rhinitis or sinusitis. Then he treated the 151 ME patients who tested positive for urinary mycotoxins with intranasal antifungals. 34% could not tolerate the treatment. Of those that did, 94% saw “marked improvement” with some patients considering themselves to be “cured”. Dr Brewer continued treatment for 12 months and followed up regularly, Patients improved clinically and this was paralleled by falling levels of mycotoxin in the urine.

So ………… kill off the fungi and you can get die off (Herxheimer) reactions

The 34% of ME patients who could not tolerate the intranasal antifungals suffered two sorts of adverse events:

  • Those local to upper airways such as burning, congestion, nosebleeds, stuffiness, rhinorrhoea, and nasal/sinus pain.
  • Systemic reactions such as exacerbation of baseline symptoms such as fatigue (most common), headache, body aching and cognitive dysfunction.

These are typical die off or Herxheimer reactions - interested readers should see the Wikipedia page on Jarisch–Herxheimer reactions. Knowing what we know now I would have encouraged those patients to plug on with the therapy, perhaps reducing the treatment to a level that was tolerable then increasing. Indeed, Brewer noted that in those who did stick the treatment, the reactions subsided within 4 weeks.

What is the treatment?

Dr Brewer used the antifungal drug amphotericin. We cannot get that in UK although nystatin should work well too. However, I have been using iodine. The joy of iodine is that it contact-kills all microbes, is cheap, easy and extremely safe. Already I have had some good clinical feedback. But the best clinical results will come from a multipronged approach:

Mechanism Why Action
Improve the immune defences! This is a war not a battle. Without such then the fungi will simply recolonise for the same reasons they originally invaded See My Book, “The Infection Game” and especially Groundhog CHRONIC – the starting point to treat any chronic infection AND to live to our full potential.
PK diet (see My book - Paleo-Ketogenic: The Why and The How).
Basic package of supplements (see Nutritional Supplements - what everybody should be taking all the time even if nothing is wrong.
Quality sleep (see Sleep is vital for good health).
Vitamin C to bowel tolerance - see Vitamin C - learn to use this vital tool well – the key is getting the dose right
And possibly other such….
Water damaged buildings will be mouldy To prevent future inoculation with moulds and fungi Any mould in your house? Exposure to water damaged buildings?
Damp environments eg cellars, Autumn, British weather..will be mouldy To reduce the load of exogenous mycotoxins Do your best! See Mould Sensitivity. If the humidity is more than 40% moulds can grow. Consider holiday in hot dry, cold dry, right on the coast (moulds cannot grow on salt water) above 3,000feet (air too thin to hold the moisture essential for moulds to grow)
Some foods are mouldy…. Avoid
Reduce the fungal load in the airways To prevent endogenous production of mycotoxin Use a salt pipe (cost about £15). Drizzle Lugol’s iodine 15% 1-4 drops (whatever is tolerated) into the mouth piece– inhale through the mouth blow out through the nose. Iodine is volatile. Use Valsalva manoeuvre to blow the iodine into the middle ear and sinuses. See "Go Flight Med" Website - clearing your ears AND/OR sniff directly into the nose. See Iodine - another vital multitasking tool that should be a household word Keep going until the iodine smell goes – iodine gets everywhere, and tiny amounts kill all microbes! Also sniff this directly into the nose. Do this at least three times daily but as often as convenient………..………..indeed any chronic infection, bacterial viral or fungal would be killed with this. See Sales at Dr Myhill salt pipe and Sales at Dr Myhill Lugol's 15% Iodine

Also see My Book, “The Infection Game”

Reduce the fungal load in the gut ditto PK diet - (see My book - Paleo-Ketogenic: The Why and The How)
Vit C to bowel tolerance - see Vitamin C - learn to use this vital tool well – the key is getting the dose right
Possibly add in nystatin powder (prescription only) See Nystatin - how to take it
Get rid of any fungi on skin ditto Topical iodine – use iodine oil eg 100ml coconut oil mixed with 10ml of 15% Lugol’s iodine. Apply ad lib. See Iodine - another vital multitasking tool that should be a household word
Treat possible infection elsewhere in body….. ditto Itraconazole 100mgs daily (prescription only) for some weeks (check Liver Function Tests (LFTs) at 1,3 and 6 months)
Mop up mycotoxins in the gut (much of the load of mycotoxin will end up here) ….to reduce the mycotoxin load… …….with a clay such as Toxaprevent 3 grams at night on an empty stomach away from food and supplements. See Sales at Dr Myhill Toxaprevent sachets
Sweat out mycotoxins with………… ….to reduce the mycotoxin load… …..any heating regime eg FIR sauna, traditional sauna, hot bath with Epsom salts, sunbathing etc. See Detoxing - Far Infrared Sauna (FIRS) and Detoxification - an overview
Expect die off “Herx” reactions that may last up to 4 weeks, possibly longer (Yes, sigh, there is another book in the pipeline that explains more!)
Perhaps recheck urinary mycotoxins to make sure of progress – Brewer’s experience is that one expects to reduce the load substantially but perhaps not eliminate completely. Keep at it! It is a war not a battle…….and one that you must win!

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Literary Aside

Aficionados of science fiction novels may be aware of a sub group of literary works called 'fungoid fiction'. These books centre around the 'otherness' of fungi, with it neither fitting neatly into 'animal' or 'plant' categorisation. As such fungi have often generated a slight feeling of unease. Perhaps the earliest modern example [1907] of fungoid fiction is "The Voice in the Night" by William Hope Hodgson which tells the story of a shipwrecked man who stumbles upon an island covered in a thickening, spreading fungus, which slowly spoilers here!

Postscript - Groundhog Regimes

I have developed general strategies for good health, and for dealing with both acute and chronic infections. Please see:

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