How to Identify and Treat Mold Illness (CIRS) | Ariana Thacker EP 228

In this podcast episode, Michaela interviews Ariana Thacker, founder and CEO of Mold Co., who shares her personal health journey with mold-related illness, specifically Chronic Inflammatory Response Syndrome (CIRS). They discuss how mold exposure impacts the immune system, the complexity of diagnosing and treating mold illness, related symptoms, the role of genetics, environmental factors, and the broader implications for public health. Ariana also explains the protocols Mold Co. uses for testing and treatment, shares insights into pediatric cases, and touches on the emerging research linking mold to chronic conditions and neurodegenerative diseases.

Ariana Thacker's Background and Personal Journey

Ariana recounts her transition from being a chemical engineer and venture capitalist to becoming a patient of mold illness, which ultimately led her to start Mold Co. After relocating to Miami, she unknowingly lived in a mold-contaminated apartment where the HVAC system was infested. Within six months, she developed near-debilitating symptoms consistent with CIRS. Despite a previously healthy background, she experienced extreme fatigue, brain fog, hormonal disruptions, and immune challenges. Her journey highlights the difficulty many face in finding knowledgeable care, as traditional doctors often lack awareness of mold's severe impact beyond allergies or infections. Ariana's personal experience underlines the importance of recognizing mold as a distinct biotoxin illness.

Understanding Chronic Inflammatory Response Syndrome (CIRS)

CIRS is a complex, multi-system illness triggered by exposure to biotoxins such as mold. It presents beyond typical allergic reactions or asthma, involving persistent inflammation affecting the brain, gut, vascular, and hormonal systems. Common symptoms include severe fatigue characterized by "push-crash" cycles, cognitive dysfunction like brain fog and impaired information assimilation, hair loss, unexpected weight gain linked to leptin resistance, gastrointestinal issues resembling IBS, hormonal irregularities especially heavy menstrual bleeding and miscarriages in women, disrupted sleep, and frequent nighttime urination. The condition disproportionately affects women at a ratio of three to one, often causing menstrual changes and infertility. Unlike acute mold allergies, CIRS is progressive and remains present even outside moldy environments.

Diagnosis and Biomarkers

Diagnosing mold illness demands specialized laboratory testing beyond standard panels used for autoimmune or allergic diseases, which often come back normal and mislead patients. Mold Co. uses Dr. Shoemaker's biomarkers for CIRS, including tests measuring MMP9, MSH, TGF beta 1, C4A, and VEGF, reflecting immune and inflammatory dysregulation caused by mold exposure. Genetic testing of HLA-DR and HLA-DQ haplotypes is crucial due to its role in determining susceptibility; roughly one in four Americans carry genetic predispositions linked to CIRS. These tests combined with symptom cluster analysis and environmental exposure history form the basis of a reliable diagnosis. Mold Co. facilitates at-home cheek swab testing and lab access across multiple states to make evaluation accessible.

The Impact of Environment and Remediation Challenges

Mold exposure is widespread, with estimates that 50% to 70% of homes in the U.S. harbor mold contamination, often invisible or hidden behind walls, under flooring, or inside HVAC systems. Older buildings, military housing, dormitories, and water-damaged sites are frequent sources. The condition of buildings—such as sealed modern homes with poor air exchange—exacerbates mold proliferation. Mold Co. advocates for remediation of affected homes as a necessary first step, but recognizes that effective removal is complicated and cost-intensive. Many patients initiate treatment even while still in contaminated environments when remediation is not immediately possible. Air purifiers and isolation techniques may offer temporary relief, but full recovery usually requires both environmental correction and medical intervention.

Treatment Protocols

The treatment developed from Dr. Shoemaker's approach begins with binding agents to remove mycotoxins from the body, where Mold Co. favors the use of cholestyramine alternatives like cholestyramine's oral tablet form called Cholelaim due to its easier compliance and reduced side effects. This binder stage is followed by nasal sprays containing EDTA and xylitol targeting persistent microbial colonization known as MARCoNS in the nasal passages, which often complicate mold illness and contribute to ongoing inflammation. The final stage involves administration of vasoactive intestinal peptide (VIP) to promote immune regulation and repair. Patients often experience initial intensification of symptoms when starting treatment, but most show significant symptom improvement within weeks. Ongoing clinical observation suggests 70 to 90% of patients improve substantially, although highly sensitive individuals may require longer or more tailored care.

The Role of Genetics and Susceptibility

The genetic component of CIRS centers around specific HLA haplotypes that impair antigen presentation, causing immune systems to misidentify biotoxins and trigger chronic inflammation. Approximately 90 to 95% of patients diagnosed with CIRS carry these genetic markers, strongly correlating genetics with the illness but not excluding others from being affected. People without genetic susceptibility may recover simply by leaving moldy environments, while those with it often require comprehensive treatment. Understanding these genetic factors helps explain why family members sharing an environment respond differently to mold exposure.

Mold Illness in Children

Though Mold Co. primarily treats adults, Ariana and her medical director Dr. Scott McMahon acknowledge increasing evidence of mold illness in children. Pediatric symptoms include neuropsychiatric manifestations such as frequent nightmares, enuresis (bedwetting), constancy in respiratory infections like bronchitis and pneumonia, and developmental issues. Children demonstrate faster recovery rates when removed from exposure and treated appropriately. There is ongoing research exploring connections between mold biotoxins and conditions such as PANS/PANDAS and autism spectrum disorders, with data collection underway to clarify causation or correlation.

Broader Health Implications and Connections to Chronic Diseases

Mold illness, or more broadly biotoxin exposure, is gaining recognition as a possible contributor to various chronic illnesses including fibromyalgia, IBS, ME/CFS, neurodegenerative diseases such as Alzheimer's and Parkinson's, and complex immune dysfunction. The intersection of mold with these conditions is supported by emerging research and updated public health information like the NIH's acknowledgment of mold-induced immune and inflammatory responses. Additionally, mold's effect on metabolic regulation such as leptin resistance may be a factor in the obesity epidemic, suggesting this environmental toxin influences appetite and weight independent of diet. The accumulation of microbial and chemical exposures, or the exposome, impacts disease susceptibility and severity.

Current State of Medical Awareness and Future Directions

Mold illness remains underrecognized in mainstream medicine, often dismissed or misdiagnosed due to lack of education, standardized ICD codes, or accessible protocols. However, 2024 marked a turning point with institutions like George Washington University launching clinical programs based on Dr. Shoemaker's work, and increased governmental interest. Mold Co. is expanding lab and care services across the U.S., aiming to reduce diagnostic delays and costs for patients. Their extensive bio-specimen and patient history database seeks to drive research and establish an evidence-based standard of care. The company also plans to address other biotoxin-related conditions through sister ventures Lime Co. and Long Co., focusing on Lyme disease and Long COVID respectively.

Practical Advice on Testing and Identifying Mold in Homes

Ariana emphasizes the importance of professional mold inspections by certified industrial hygienists who employ thorough visual assessment, air trap sampling, bulk testing, and dust sampling to detect microbial contamination. Many mold inspectors lack appropriate expertise, making careful selection vital. Dust testing offers a historical view of contaminant exposure in the environment. Signs of hidden mold include musty odors, peeling paint, high indoor humidity, and accumulation of dust on vents serving as "mold food." Simple homeowner checks like examining behind or inside toilet tanks for mold growth can serve as initial clues to air quality issues. Timely detection can prevent prolonged exposure and worsening illness.

Environmental and Societal Challenges

Addressing mold contamination on a societal level poses enormous challenges due to the widespread and hidden nature of the problem, varying building ages and construction methods, and costly remediation requirements. Energy-efficient, sealed modern homes have inadvertently reduced airflow, contributing to microbial overgrowth indoors. Additionally, frequent flooding and natural disasters exacerbate mold spread. The invisible and progressive nature of CIRS makes it a difficult public health issue to tackle. Awareness, improved building standards, tenant rights, and innovative tech solutions are emerging but it will take coordinated efforts from patients, scientists, healthcare providers, and policy makers to effect meaningful change.