The First Step In Recovering From Mold And Mycotoxin Related Illness

Be Sure You Are Living In A Mold-Free Home

When someone has been diagnosed with problems related to mold and mycotoxins (toxins from mold), the first step in recovery is to be sure you are living in an environment that is mold-free.  This step in recovery is ESSENTIAL.  Any supplements, herbs, binders and other therapies we use to treat mold and mycotoxin problems simply will not work if the person is still being exposed to mold.

Assessing a house or apartment for mold can be as hard (or even harder!) than trying to assess an individual patient.  I encourage folks to get a professional assessor that knows how to use the most sensitive techniques to determine the presence of mold in their home.  The two most sensitive tests to identify the presence of mold in a home are:

• Environmental Relative Moldiness Index (ERMI)
• Health Effects Roster of Type-Specific Formers of Mycotoxins and Inflammogens, Version 2 (HERTSMI-2)

These tests work by analyzing dust samples for the DNA of molds.  The ERMI tests for a bigger number of mold species, while the HERTSMI-2 looks at a smaller number of mold species which are the most highly associated with mycotoxin-related health problems.  The results of the tests involve some fancy math, logarithmic scales and take some training to learn how to read. But to sum it up simply: ERMI and HERTSMI-2 use a scoring system to determine if there is just ‘nearly zero’ versus ‘a little bit’ versus ‘a whole lot’ of mold present in the environment.  These tests work best when performed by a knowledgeable Indoor Environmental Professional (IEP).  Here’s a good list of professionals to get started:

• International Society for Environmentally Acquired Illness IEP Member List

However, if you would like to do your own ERMI and HERTSMI-2 testing, you can order the kits online and do them yourself. The test involves collecting dust samples from around your home, then mailing the dust samples to the lab for the tests to be performed. The companies doing the tests can also provide guidance on how to collect the samples.  Here are links to 2 reputable companies that perform ERMI and HERTSMI-2:

• Envirobiomics
  • Order Test #1 (ERMI) and Test #3 (HERTSMI-2)
• Mycometrics
  • Order Analysis Code: PCR 01.36 (ERMI) and Analysis Code 010.5 (HERTSMI-2)

There are many, many more ways to test for mold and other environmental contaminants in your home.  However, a DIY ERMI/HERTSMI-2 can be a good indicator to answer the following things:

• Is it worth investing in a professional opinion to have the residence remediated?
  • If either ERMI or HERTSMI-2 score is elevated, the answer is ‘DEFINITELY YES!’ With an elevation of ERMI and/or HERTSMI-2, a professional evaluation and remediation should be done as soon as possible.
  • If neither ERMI or HERTSMI-2 is elevated, the answer is ‘Maybe…’. This depends on the level of suspicion that there is a current mold exposure in the home. For example, if you know there was some sort of water damage to your home and you’re not 100% sure it was correctly dealt with, you should have a professional assessment anyway.  Even with these sensitive tests, they are not perfect. There can be errors in the way samples are collected and if the sample did not include the area of the home that actually has the mold, it will be missed. Finally, sometimes the problem isn’t just from mold, it is also related to bacteria, and these tests will not detect those issues.
• Is it safe for a mold/mycotoxin sensitive patient to live in this home?
  • A HERTSMI-2 score of 15 or higher means that a mold sensitive person is likely to do poorly in that environment.  If the HERTSMI-2 score is a 15 or higher, you should immediately move out of your home if you are sick from mold toxicity until the home is safely and fully remediated. However, we may use a lower threshold HERTSMI-2 score depending on other factors. For example, if the ERMI score is very high, a low HERTSMI-2 becomes less relevant because it tests for fewer molds and may be ‘missing’ part of the problem.  It also depends on how severe a person’s illness is and how sensitive they are to the presence of mold.
• What about other types of tests?
  • Many people will try using DIY mold culture plates and get very positive results like these:

• But they may not represent toxic molds.  ERMI/HERTSMI-2 testing is a more specific way to know which molds are present and better quantify how much is actually present.
• Many mold assessors use spore traps to look for mold in the air. These often miss significant amount of mold and the ERMI/HERTSMI-2 tests may be highly positive when the spore trap says ‘there’s no mold here.’
• Where is the mold coming from?
  • This is the one question an ERMI or HERTSMI-2 test cannot always answer.  Usually, the sample will come from multiple places in the residence and the exact origin of the mold cannot be determined.  Only a qualified assessor can help to answer that question.

These tests are a useful start to be sure you are in a mold free environment.  The information we get from these tests needs to be taken in the context of the whole home environment.  Whether you’re in Miami Beach or elsewhere, a good assessor will usually send at least two separate samples for testing. Just like caring for your own health, we encourage you to get professional support to be sure your home is healthy too.