2013年7月15日 星期一

What Everyone Should Know About Mold

I was recently watching an HGTV program where a prospective home buyer was shown a house with obvious mold in the basement after flooding. The discussion that took place between the host and the guest was similar to talking about the black plague. Similarly, even in my practice, many patients are at their wits' end trying to rid their houses or apartments of mold.

But as I look at it, molds, yeasts and fungal infestation or infection, although harmful, may not be as pernicious as the press and the media would like to have you believe. Here's why.

Why Mold Is Not Our Enemy

Molds, funguses and yeasts, called collectively as fungi, are different from bacteria, plants or animals. They are widely present throughout the world, and are an important part of our earth's ecosystem. However, just like bacteria, pollens, dust, gluten, or milk, modern humans have developed sensitivities to normal substances in our environment. There are a number of different explanations for this phenomenon, including living in relatively more sterile environments, or having toxic infiltration of chemicals into our food and water supply. Children growing up in farms or third world countries, for example, are found to have less allergies.

Our modern times have been called the "age of anxiety," and this includes our body's over-reaction to normal substances, situations or environments. To understand why this is so, it's helpful to go over what happens in a stressful event. Robert Sapolsky, in his classic book, Why Zebras Don't Get Ulcers, explains that when a zebra is running away from a lion, every aspect of the zebras' physiology is being geared up to avoid being eaten by the lion.

This means that the nervous system and the immune system are extremely heightened thereby increasing reflexes and stimulating the immune system. This short burst of intense sympathetic activity, lasting seconds to minutes, is what's called the "fight or flight response" by endocrinologist Hans Selye. You hear about mothers lifting cars to save their children, and other amazing stories. But what if this beneficial response is happening all the time, but at lower levels?

This is exactly what Sapolsky describesthat modern societies, with its' constant and incessant little stresses, is what's killing usliterally. Some examples include the honk behind you as soon as the traffic light turns green, the rude cashier at the store, deadlines, crisis management at home, and various other issues at work.

During a major stressful event, your cortisol levels (your stress hormone) and your sympathetic nervous system increases greatly, but once the stressful event is over, your hormonal and nervous system responses return back to normal levels. Actually, with the immune system, as it drops back to normal levels, it dips below normal for a short period of time before going back to normal levels. This may be one explanation why people get sick only after a major stressful event.

But if you have multiple small stressful events throughout the day, you don't have time to recover, and your baseline stress levels remain constantly elevated.

If you add to this any form of sleep deprivation, than you'll be adding to this chronic stress state even more. Moreover, if you have obstructive sleep apnea, it's a given that you'll have more physiologic stress, proven by numerous studies. Add any additional sources of emotional, psychological or physical stress, and it can make your internal stress levels even worse.

Coming back to the mold example, if you have an underlying sleep-breathing problem such as obstructive sleep apnea, you'll be extra sensitive to molds compared with someone without sleep apnea. However, if you add to this the anxiety of media driven shows that multiply fears about the dangers of any kind of mold, then your baseline response to molds will be further increased.

Can Mold Cause Sinusitis?

One recent theory about the origin of chronic sinusitis is related to moldsthat your nasal cavity is filled with normal mold spores that come in from your natural environment. Once it settles into your mucous membrane layer, it eventually gets slowly passed into your throat by the mucous blanket that gets pushed back into your throat. However, if you are overly sensitive to molds, then white blood cells are recruited from the surrounding blood vessels that eventually reach the mucous membrane layer, releasing toxic chemicals that end up destroying the molds. Phagocytic cells then come in to clean up the mess.

However, as a result of the release of toxic chemical, the underlying mucous membrane is damaged, and becomes "leaky", allowing normal bacteria that live in your nose and other toxic substances to leak into the tissues of the nose and sinuses. This same concept has been used to describe food sensitivities that can lead to a "leaky gut" with its' various gut-related symptoms.

I'm not discounting the legitimacy of mold hypersensitivites, but I do want to emphasize the fact that any kind of allergic reaction or hypersensitivity (pollen allergies, certain foods, weather, etc.) can be aggravated by an underlying sleep-breathing problem. If you do have a known sensitivity to molds, you have to either remove the mold, or remove yourself from the moldy environment. But at the same time, this should be a signal for you to investigate if there isn't another stressor, like a sleep breathing condition, that's aggravating your mold allergies even more.

As such, mold problems, like any other health problem, don't occur in isolation. Just as a migraines is caused by a number of different triggers that can add up until you have your headache, your mold problem will worsen if you have a number of other factors that stimulate your nervous system, such as whether changes, allergies, sleep quality, emotional stress, nasal congestion, etc.

There's no doubt that millions of people are suffering from mold or yeast related health problems unnecessarily. But at the same time, there are also many people who are taken advantage of by industries playing to their fears and anxieties about the dangers of mold. Whether or not you have potential mold problem, it's important to evaluate your sleep quality. Knowing that a significant proportion of Americans have undiagnosed obstructive sleep apnea, treating this condition will not only improve your mold-related health problems, but improve numerous other aspects of your health as well.



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