Fungal mycotoxins & ME/CFS could this be why you're tired?

Science is all about observation and forming hypotheses to answer questions. For scientists like myself, I’m interested in how the environment affects health, and specifically, how water-damaged buildings and exposure to poor indoor air quality can affect quality of life. For this week on The Mould Show, we're going to be talking about fungal mycotoxins and myalgic encephalomyelitis termed ME for short and chronic fatigue syndrome (ME/CFS).
The reason I've chosen this topic is that I've met a family whom I've now done three separate mould inspections for. Why this is unusual is that the symptoms experienced by the female occupant and her daughter are classic ME/CFS symptoms. Across all 3 of the different properties hidden mould problems were discovered. That information in itself was useful for this family and helped them to break their lease due to the fact that there was verified mould present. However, that's not the point of this podcast and even the positive mould confirmation as an environmental trigger didn’t help the mother and daughter from understanding why they reacted so strongly when indoors. They thought they were going crazy, since how could 3 different properties cause them so much trouble? They couldn’t understand why some buildings caused no issues, and the 3 they’d chosen to rent all set them off?
This has bothered me all year. I know mould is a huge issue for some people – but what exactly might be going on for THIS family?
A very interesting article on Substack focuses on his experience with chronic pain and ME/CFS and how after 25 years of suffering, he discovered by chance, following a recommendation from a friend to read a book that talked about the connection between ME and chronic fatigue syndrome and mitochondrial dysfunction. So that is the true focus of the topic today.
• Could exposure to fungal mycotoxins be the reason why they were tired and experiencing pain?
• Could this be the reason you’re tired? Is this another aspect to environmental illness?
• And could this be classified as Myalgic Encephalomyelitis or Chronic Fatigue Syndrome (ME/CFS)?
• Are there any patient-specific tests to verify ME/CFS or mould exposure and what can be done to alleviate the symptoms?
Firstly, let's define what ME/CFS is. There are three core symptoms + at least one or more other symptoms which include:
1. an inability to participate in routine activities that would have been possible before becoming ill and that lasts for greater than six months.
2. the fatigue which is also a primary symptom tends to worsen after physical, mental or emotional effort.
3. and does not resolve after sleep, termed ‘unrefreshing sleep’.
Other problems include:
a) an inability to concentrate or memory impairment and/or
b) something called orthostatic intolerance. This means that when people stand up, they feel lightheaded or dizzy and can even faint.
The family that moved into those three different properties all complained that after a few days of occupying the mould-contaminated building the wife especially experienced episodes of unexpected fainting and collapsing into her husband's arms.
Those 3 inspections coupled with reading the Substack article led me to investigate further whether there was any published literature, focusing on exposure to fungal cells or their mycotoxins in the ME/CFS literature.
Very recently a publication appeared in the International Journal of Environmental Research and Public Health that has looked at exactly this topic. These scientists looked at the levels of Aspergillus toxins like aflatoxin, ochratoxin, and gliotoxin in the urine of 236 ME/CFS patients who had a known exposure to mould from water-damaged buildings.
The evidence from two types of urine mycotoxin testing from Real-Time