When You Seem to be Sick Outside as Much as Inside….
My ultimate goal with this blog is to attempt to make this whole “mold thing” simpler. The concept of mold cross contamination happens to be one of the more confusing and debated pieces of the mold puzzle. I am going to try to tackle some of the difficult to understand, confusing, and conflicting information on that topic today and to break it down and present it to you in a way that makes some sense. In doing so, I hope each of you will feel empowered to use some of the tools and protocols I write about (that actually work, might I add) to take control of your situations and environments, so that you can get better and get on with your lives. That is also the main reason why I like sharing reader Q & A’s so much. I believe that by sharing some of my one-on-one correspondence, I can help others who have the same or similar questions–if there is one thing I’ve learned, it is that many people have questions, but very few actually take the time to ask.
That being said, not all personal advice is universally viable, because each of us is unique and should tweak and omit things according to what works best for our lives and bodies. Overall, though, I believe our goals are the same and hinge on adopting a “new normal” that
1) works to attain and keep wellness, and
2) doesn’t create fear or anxiety in the process.
To achieve those goals, you have to
1) learn as much information as possible about mold and why it makes you sick, and
2) learn as much information as possible about products and treatments that work for mold-related illness.
There is no magic cure, obviously, but there are some things that have, over time, proven to be more efficacious than others. That is where today’s reader Q & A comes in. It is a discussion that starts with a question about cross contamination, but that spans much more than that. It gets into the topic of cumulative body burden from previous mold exposures, how much your surroundings and outdoor environment matter to your recovery, and how using what you already know about your body’s reaction to mold helps you to make informed choices about your future.
To bring you up to speed with exactly what this reader is dealing with, I will share some portions of her email:
(Note: I have altered details and exact geographic references to maintain her identity and privacy.)
Hi Catherine,
Thank you so much for all of the helpful information on your blog – it’s so nice to have some direction when there is so much conflicting information out there. I have been reading your posts and am beginning to realize how important it is to properly remediate after any exposure.
I need your advice: I’m not entirely sure how to do this, so I wonder if you might be able to provide some guidance on an issue we’re currently facing?
My husband and I had a period of serious mold exposure, from which we never fully recovered. We recently moved from our home on the West Coast to a much more humid and moldier climate further east and began getting sick again. Our HERTSMI results taken from our home only showed low levels of Aspergillus (score of 6, which is considered safe for those with CIRS-Chronic Inflammatory Response Syndrome).
(Note: To Understand what a HERTSMI is, you must first understand an ERMI. 
ERMI stands for Environmental Relative Mold Index. The ERMI test was developed by scientists at the EPA to quantify the indoor mold load present in a building. To do this, a dust sample is collected and sent to a lab, where lab analysis classifies any mold DNA present in the dust. Molds that cause health problems are listed in one group on the ERMI report and molds that “don’t cause health problems”—I don’t agree with this—are listed in another group. The ERMI score is the difference between the “bad mold group” and the “ok mold group.” ERMI scores range between -10 (really good) and +20 (really bad.) A HERTSMI test works just like the ERMI test, but reports the mold burden of only 5 molds most likely to cause health problems. Thus, it is shorter and less expensive. According to Dr. Shoemaker’s studies, many mold patients can tolerate a HERTSMI score of 10 or lower, but will get sick with a HERTSMI score higher than 15. It has been my experience, though, that if there is a recognizable and quantifiable presence of any of the “bad” molds in an indoor space, it is too much for someone with previous or current mold illness.)
Nevertheless, out of an abundance of caution, we left the home and all furniture, and put everything else into storage. Following our doctor’s recommendation, we rented another home where we were much less reactive. We have very few items in our new home and washed or wiped down everything we brought in with vinegar/borax/tea tree oil. Now, 3 months later, we are experiencing low-grade mold symptoms again, but this isn’t just in while we are at home. Strangely enough, we seem very reactive to the climate in general. (We know this because we feel significantly better when we travel to other geographic locations with less humidity). Our symptoms now are not nearly as severe as previous exposures, but still noticeable. If you are able to comment, does cross contamination sound like an issue here?
We also purchased a latex mattress when moving into the new apartment three months ago – is there a way to remediate it, so that we can take it with us? Fogging and ozonation have both been suggested by our doctor, but with little guidance. I’ve read a few of your posts on cold fogging, and plan to utilize this for many of our possessions, but will it work on a latex mattress or down bedding? Do you have experience with ozone? Is there another remediation technique you might recommend instead? We are moving back to the West Coast at the end of this week and would like to avoid cross contamination – would you have any tips in our particular situation? Thanks so much!
So, let’s break this down:
Here is a couple who have already been through this once, never completely recovered health-wise, and are now facing the upheaval of moving again in order to be in an environment that feels less inflammatory from a mold standpoint. In every action, they seem to be doing everything right, testing, and consulting with a doctor who obviously understands mold and their unique situation, but who also is guiding them with an abundance of caution and care—kudos to that doctor—to not aggravate symptoms and inflammation unnecessarily. Unfortunately, though, it just seems like nothing is enough. So, what now? What advice can I give them? Can they save or take anything with them this time around?
Luckily, I do have some experience with a similar situation myself. Thus, I had a few things to share and hopefully was able to provide some helpful information/advice.
Here is my reply:
Hi!
I am so happy that you found my blog. I am also happy that it has been helpful to you.
I completely hear you on the outdoor environment and it causing a reoccurrence of symptoms. We now live in Memphis, and upon moving here, my health faltered. The humidity is unbelievable and the outdoor mold index is incredibly high all year round. At first, I didn’t think I was going to be able to handle it, but with some guidance from my doctor to help me institute some structured body mold maintenance, I can now get through my day-to-day, symptom free and full of energy. I know that isn’t your question, but I wanted to share my “body maintenance plan” with you too, for whatever it is worth, because it directly addresses mold exposure from both the outdoor and indoor environments. Once you learn how to control the entrance of mold into your body and how to mitigate its effects, you will gain freedom, because you won’t experience as many symptoms or health consequences no matter where you are geographically.
My Body Maintenance Plan for Mold:
1.) I rinse my nose using the Nasopure Nasal Wash System at least 2 times per day. I always include the CitriDrops Dietary Supplement in the wash, because it is a natural antifungal/antimicrobial.
Using it once in the morning and once at night, or more often, if I have symptoms, really helps me cut mold off at the pass, removing the spores from my nose, so that they cannot cause as much inflammation in the first place. It really is prevention at its most fundamental level.
2.) I carry and use the CitriDrops Nasal Spray when out and about. I use it to squirt my nose immediately, if I sense an exposure, or if my nasal passages feel like they are swelling or becoming inflamed from being outside in the humidity and mold.
3.) I use Sinus Defense 2-3 times a day. This stimulates my immediate, natural, immunity to mold (T cells and Natural Killer Cells), because it contains colostrum with resitence to molds and other indoor allergens. Like a vaccine, Sinus Defense helps your immune system to identify, tag, and remember specific mold antigens. When I want to amp the efficacy of the Sinus Defense, I take 2 capsules of Beta Max 500 that day as well. The Beta Max contains 1,3 beta glucans, which have been clinically proven to increase the number of the body’s macrophages which clear dead antigen debris, like mold, from the body. Both supplements have been so important for my health when living in Memphis, because I feel like I never get a reprieve from the mold exposure here.
4.) I use CellTropin 1-2 times per day to support growth hormone production, cellular regeneration, and the pituitary gland. As I am sure you know, mold illness causes significant stress on the pituitary, which negatively affects growth hormone levels and the body’s ability to heal itself.
CellTropin supports recovery at the cellular level, so that rather than living with damaged, aging cells, you can experience higher energy levels as the pituitary and growth hormone rebalances and cells regenerate.
5.) I take either IntraMax or Complete Thymic Formula multivitamin/multimineral supplements every day. 
These prevent nutritional and mineral depletion, which also prevents proper natural detox of toxins and recovery.
6.) Occasionally, I add a binder, like activated charcoal or bentonite clay to bind to any mold toxins and get them out of my body. If I use one, I usually only implement this once per week or less. This should be done under a doctor’s guidance.
7.) I make sure to get regular exercise–daily even. 
Movement promotes life, energy, oxygen in your cells, and a “good” inflammation that elicits positive adaptation and change, and a sense of well-being, just to name a few. Exercise is so important to healing that many of the top environmental health practitioners believe that true recovery cannot occur without exercise as part of the protocol. If chronic fatigue plagues you, moving your body, even if that means a slow, steady walk outside for 15 minutes, will help your body to heal. (I actually intend to write a separate post on this!)
8.) I make sure to eat a diet full of vegetables, meat and fish, with some fruits, and as little processed carbohydrates and sugar as possible. 
What you eat is as important to your recovery as the air you breathe. If you are doing everything right in your environment, but are eating a diet full of sugar and processed foods, you will not get better.
9.) I drink only purified or spring water. Omitting tap water from your diet (this includes in coffee and tea drinks) will save your gut and your digestive system from unnecessary chemical additives and metals.
Those are the basics. It may seem like a long list, but nothing on it is difficult or expensive. Each one is something you can do on your own. There is definitely more that you can do to add to it, but adopting some or all of these things will help you tremendously in your recovery. It is ongoing maintenance that I am happy to do, because I feel such a difference in my mood and energy levels. I also find that sporadic mold exposures don’t affect me as much when my self-care is on point.
Ok. Now, to answer your questions as best I can:
First, I want to address something about your HERSTMI score in your previous apartment: If you are mold sensitive, especially if you have already suffered through a major mold exposure and illness, (this is why I do not agree with lots of the Shoemaker protocol, nor do my physicians, scientists and building science experts I have been fortunate and lucky to know agree) it is my experience and opinion that NO levels of Aspergillus in an indoor environment are safe. For example, the toxicologist I worked with (Dr. Jack Thrasher) always wondered why the dangers of Aspergillus were downplayed in comparison to Stachybotrys. (Much lower levels of Stachybotrys are considered “acceptable” on the HERSTMI.) Aspergillus is more invasive and can become a systemic infection, even though the HERSTMI allows higher levels before a space is designated as unsafe. This is NOT meant to frighten or scare you—you are out of that environment. I just want to always give the facts as I understand them. I also think that your increased sensitivity to everything now may have something to do with that more recent exposure to the Aspergillus that never cleared your body. As you know, mold has a cumulative effect.
As for your question about cross-contamination, yes, I think cross contamination could definitely be an issue too, especially if your bodies were affected by the Aspergillus. This is because, now, even with low levels of Aspergillus, miniscule even, on the things you brought into your new apartment, your bodies cannot handle it.
I am not a scientist, obviously, but I find that with mold, or any toxin that makes us sick, our cells remember. They tag and identify the mold as “invader,” and the immune response of inflammation begins. The problem with us “moldys” is that we cannot clear the toxin and continual inflammation ensues. (This is especially the case, if you have the genetic susceptibility for mold illness or have an MTHFR mutation that impedes your body’s natural detoxification processes. Both of these could be helpful to look into with the guidance of your doctor, because you may require additional support for detox.) So, even with the thorough cleaning that you did of the things that you now have in your apartment, if any mold is still present, you could be reacting to it x 1000.
To help the situation, if I were you, I would remove any pieces that you react to. I definitely think you can try fogging them. It will not hurt anything and can only help. Another thing I would suggest is to actually do a little scientific work yourself. Get some EC3 Mold Plates and TAP test your mattress and other furnishings. See which things, if any, have high mold counts. This would help you to focus your efforts. You can also test after you treat things, so that you KNOW if what you did worked or not. Honestly, this is the cheapest way to get some solid answers. Then, you can keep treating or throw things out to save your health.
For fogging, the only fogger and solution I use are the Sanitizer fogger and EC3 Mold Solution Concentrate from MicroBalance Health Products. 
You can even use the fogger to fog your entire apartment. I think this would be a good idea since you find that you are reacting to everything now. While a temporary solution, it will bring the indoor mold count down significantly, so that you won’t feel as crummy inside the apartment. You can fog regularly (weekly). Once the air load is lowered, it takes time for mold to reproduce enough to get a foothold and grow to the size where the spores can become airborne.
Another less expensive solution would be burning EC3 Air Purification Candles in all rooms in the apartment while you are there. 
The candles will not treat your furnishings, but will bring the indoor mold spore counts down in the air to basically zero with continual use. If you decide to fog, just make sure to dry everything out thoroughly afterwards by turning on fans and increasing indoor air circulation. I would also consider purchasing a HEPA air purification unit, like an IQ Air or Blue Air. 
That will filter out VOCs and other particulates that might be making you sick. Placing one in your main living areas and/or bedroom will be tremendously helpful for your symptoms.
Another important remediation piece that most people miss (especially if you decide to fog) is the fact that you have to physically remove mold and mold spores, even after they are not living. For this, you will need a HEPA-certified vacuum, like a Miele. After fogging, and everything is completely dry, you need to HEPA vacuum your floors, furnishings, drapes, etc. You will find this to be so helpful. It will remove dust and mold spores that fogging leaves behind. I try to vacuum our home 2 times per week with ours.
Now to address the mattress. Mattresses are HARD. I know many folks (professionals in the IAQ and remediation business) who say mattresses cannot be remediated. Here is what I will tell you: You can try. TAP test the mattress. See where you stand to begin with. Then, strip it completely. Wash all bedding in hot water with an unscented, mild detergent. As the washer is filling up, pour 1 cup of Borax into the water. Allow the basin to fill and agitate and then turn it off to soak. After about an hour, pour 1 cup of EC3 Laundry Additive into the water. 
Turn the washer back on and allow it to run its course. Then, dry as usual. DO NOT USE FABRIC SOFTENER. You can do this with all linens and clothing to remove mold. For the mattress, going one side at a time, mist or fog one entire side with the EC3 Mold Solution Concentrate. Allow to dry completely. Do not saturate. Use your HEPA vacuum with the upholstery attachment to vacuum that entire side of the mattress. Sides included. Flip the mattress and repeat fogging and vacuuming as before on the other side. Once you are finished, you can TAP test it again. If you still find mold, I would repeat the procedure again as before, but also use a handheld steamer to steam clean both sides of the mattress after vacuuming it. The only caveat is that the steamer must be able to achieve super high-heat steam settings. I use the Smart Living Steam Jr. 
and really like it. Steam is really great for both microbials and mold. If your test is still high, I would (I hate writing this) get rid of it and get a new mattress.
To address the down bedding/pillows, unfortunately, I have not had a good experience with and am not a fan of down for mold sufferers. It holds onto allergens. You are better off to replace your down bedding with allergy-free versions that can be washed and cleaned a little more easily.
As for ozone—no. I just have heard more harm than good. Even over time, residual ozone can still be present. It can also really irritate and cause reactions in some mold patients. Not worth it, in my opinion.
I hope I have helped in some way. Please let me know if you have any other questions. I would be happy to share what I know.
Sincerely,
Catherine
