164: Mold Illness vs. Mold Allergy w/ Dr. Kasey Holland

Many think they're interchangeable, but mold allergies and mold illness are actually different things! They affect the body in different ways, as my guest today will explain.

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My guest today, Dr. Kasey Holland, is a licensed Naturopathic doctor.

She earned her Doctorate in Naturopathic medicine at Bastyr University in Seattle, WA through a four-year CNME accredited program. While there she completed specialty rotations in environmental medicine, immune wellness, oncology, IV therapy, Parkinson’s disease, emergency medicine and mind body medicine.

After this, she worked in an Integrative health clinic that incorporated functional medicine during her residency. This has provided her with exposure to a wide variety of pathologies and patient care in order to serve you better.

She has always been passionate about helping people overcome mystery and chronic illnesses. This was further solidified after her own health obstacles.

Dr. Kasey's specialties include the toxic trio: chronic EBV, Lyme disease, mold exposure.

Join us as we talk about mold allergies and mold illness.

Are you allergic to mold? Let me know in the comments!

In this episode:

  • How common is mold in the home?
  • Mold illness vs. mold allergy
  • How can mold cause mold illness?
  • Is mold illness connected to fungal organisms (like candida)?
  • Can mold suppress the immune system?
  • Is mold illness a lifelong condition?


“According to OSHA, approximately one in four homes can have water damage that has promoted mold that could cause harm to their health.” [1:11]

“Mold illness is when you've actually been exposed to mold and the mycotoxins, and it's affecting your system on a much deeper level.” [2:35]


Find Dr. Kasey online

Healthy Skin Show ep. 150: Understanding Epstein-Barr Virus + Skin Rashes w/ Dr. Kasey Holland

Healthy Skin Show ep. 134: Dealing with Mold & Opening Detox Pathways w/ Toréa Rodriguez, FDN-P

Dr. Shoemaker's mold lab test list

Follow Dr. Kasey on Instagram

164: Mold Illness vs. Mold Allergy w/ Dr. Kasey Holland FULL TRANSCRIPT

Jennifer: Dr. Holland, thank you so much for coming back to the show. I'm so glad to have you back after we talked about Epstein-Barr the last time, and now we're going to talk about mold.

Dr. Holland: Yeah, Jen. Always a pleasure to join you. Looking forward to talking about mold. As frustrating as mold is, thanks for having me.

Jennifer: Yeah. You know what, the reason I wanted to talk to you about this is because we've never really tackled the topic of mold and skin per se. Many of you might remember Torea Rodriguez touched on it in the more practical sense of how it can show up in your home or in your car and how you would deal with it emotionally and some remediation techniques and things like that. But we didn't really dig into the issue of mold itself and how mold could be a hidden problem driving your skin rashes. So I think a good place to start is just how common is it to have mold in your home because I think people think they don't have mold, but a stat you just shared with me was pretty surprising. And I would like you to share that with the listeners.

Dr. Holland: Yeah. So according to OSHA, approximately one in four homes can have water damage that has promoted mold that could cause harm to their health. So that gets a little complicated because we do see that some people are more sensitive to mold and some people have true allergies to mold. Whereas others have where they are actually getting sick from the mold spores and mycotoxins. So there's also a difference there in how that can present. But yeah, it's a lot more common than we think. I mean, one in four buildings, that's a lot.

Jennifer: So you actually brought up a good point just a moment ago. I think we need to circle back to. So you're saying there's the exposure piece. So you could just have mold in your environment and the mold itself is making you sick. But then there are people, you're right, that have an actual allergy to mold. They show up with allergy panels from the allergist and they have mold allergies. Is there a difference in how those can impact you or is it all the same?

Dr. Holland: Yeah. So allergies that are that IgE response in our body where we're fighting off an invader. So it's like seasonal allergies to pollen or whatnot. You're going to have sneezing. You might get hives. That type of picture. And then mold illness is when you've actually been exposed to mold and the mycotoxins, and it's affecting your system on a much deeper level. I mean, I guess you could be allergic and have illness if it's over time. But a lot of times when people go to get tested for mold, they're only thinking about mold allergy and that might show up negative. And you might not have allergy symptoms so to speak, but you might have all these other symptoms that you don't realize are from mold and are related to mold illness.

Jennifer: Okay. And actually that's a really helpful distinction because we talk a lot about mold these days, and as you were saying that, I'm like, “You know what, I do think I know some people that have thought they had mold issues because they had an allergy to mold.” And it's interesting. I'm just going to throw this out there. There is some digestive enzymes where the enzymes are made from aspergillus, which that's like a form… Is that a form of black mold? You know better than me.

Dr. Holland: Yeah. So aspergillus and penicillin are of the same nature. So we do use things or we ferment things or some supplements are fermented where somebody that doesn't have an overburden of a fungal load does fine with them, whereas somebody that has a higher fungal load, those supplements are going to make them feel awful and/or contribute to the problem.

Jennifer: Wow. What if somebody is actually allergic to, so they have that IgE response to mold. So those supplements might not be ideal for them either?

Dr. Holland: I guess it would depend on if it's just being fermented and the actual response that's triggering the allergic responses there. You know what I mean?

Jennifer: Right. So you'd need to make sure that it's not just a byproduct that's left as opposed to the mold itself. I think that's where you'd have to contact the company. But that was one thing recently that I've come across is seeing those mold spores being listed on certain supplements and digestive. And I was like, “Oh, back up. Hold on. We've got some issues here. I don't know if that's really a good fit.” So that's a good point that you make. And you also said about fungal issues. So with skin, we know that there's a lot of different things with skin that can impact it, and we know that it can come from all different avenues. And we've talked a bunch on this show about candida, but…

Jennifer: So let's talk first because I want to circle back because now I'm thinking this through. How can mold really cause mold illness? Or if you can, how is it connected to fungal, the fungal organisms like candida or geotrichum or any of these other fungal organisms?

Dr. Holland: Yeah. So when you're in an environment that has mold, there's a couple things happening. So you can be exposed to actual mold spores. Those spores can also break apart and form smaller spores, which you can breathe in through your lungs and be absorbed there, and that can cause a lot of problems. And then the mycotoxins is the byproduct of… It's like the gas that mold is producing, and that's what causes a lot of problems as well. So when we're exposed to it, it's going into our body and it's effecting our lungs. It's effecting our gastrointestinal tract. It is extremely inflammatory and causes a lot of oxidative stress.

Dr. Holland: So when we talk about illness, mold illness and everything, we see a lot of people that have histamine problems. We see a lot of inflammation. It's linked and being looked at in association with autoimmune conditions as well. It's causing all this oxidative stress on the body.

Dr. Holland: And when we look at the connection with candida, so a lot of people when I first started talking about mold, they'll be like, “Well, mold is everywhere. It's in buildings. I'm going to be exposed to it.” It's true. It is everywhere, but so is bacteria. So is candida. We can have healthy levels of candida bacteria in our gastrointestinal tract. It's when those become an overload that we see the problem. And with mold, there's actually a genetic component to it. So one in four people have an HLA variant in their genetics that they don't breakdown and detox mold as well. So if they're exposed to mold, they're going to have a lot more symptoms than other people.

Dr. Holland: When we talk about the fungal load… So that's kind of with bacteria in the gastrointestinal tract, we talk about how important the microbiome is and we don't want too much of that gram negative bacteria. Gram negative bacteria secretes an endotoxin known as LPS that causes a lot of inflammation. But there's different types of bacteria that secrete LPS. So mold and candida are different, but they are both fungal. So if you have candida and you're exposed to mold, then you just increase your fungal load a lot. Or if you have been exposed to mold and then having the same lifestyle diet as before, the healthy amount of candida might be able to overcome those healthy levels and be more pronounced. And then you have candida and mold problem. So that's what we were talking about when we're talking about somebody's overall fungal load.

Jennifer: And with the gene that you mentioned, out of curiosity, how would you find out if you have that gene? Is that just from the 23andMe test or one of the detox profiles that you can get with the data? There's some companies that offer those sometimes. How do you know if you are one of those people who has difficulty clearing it?

Dr. Holland: Yeah. So you can have it ordered through PCR testing at LabCorp or Quest or something like that. I think LabCorp is what Dr. Schumacher recommends in his panel when he does it. So you can have it done through a blood test, and that's the HLADR done through PCR.

Jennifer: And do you know which gene? Which gene are you looking for? Is it a panel or…

Dr. Holland: Yeah, it actually has a full little panel and is looking at different variants of that.

Jennifer: Oh, wow. Okay. So it's like a mold gene panel. Interesting.

Dr. Holland: Mm-hmm (affirmative).

Jennifer: Cool. We'll have to take a look at that and link up to those resources. Do you have that linked on your website someplace?

Dr. Holland: I don't have it on my website, but I should add it. But Dr. Shoemaker has a full list of it, and there's the explaining what each of the labs is. And then there's also an actual physician order sheet that you could take to your doctor and be like, “This is what I'm talking about.” It includes the diagnostic codes and everything. So we can definitely put that in the show notes.

Jennifer: That would be perfect.

Dr. Holland: Yeah.

Jennifer: I've read online where it's like mold can depress your immune system and make it difficult for you to even control populations of maybe certain viruses like Epstein-Barr or candida or what have you. Is that true?

Dr. Holland: Yeah. So it does suppress the immune system, and then what it does is it effects the immune cells memory. So with viruses, you won't remember that you saw that virus before. And then beyond that, a lot of times depending on what species it is, it might be causing more problems in the respiratory tract. So you a lot of times will see really chronic sinusitis. Mold hangs out in the sinuses. You get this chronic sinusitis. Your immune system is suppressed. Say you get the flu or something, it's so hard to get rid of it because you have all this post nasal drip and mucus that is happening. Your immune system is suppressed. Your body's trying to fight this virus, and your response is completely confused. So we see a lot of times when people are dealing with mold, they'll be like, “I got the flu three times, and it turned into bronchitis or pneumonia. I can't get rid of it. I went on antibiotics. As soon as I go off the antibiotic, it comes back.” We've seen that happen a lot with mold.

Jennifer: If someone's listening to that, they're like, “That's me,” that's a red flag.

Dr. Holland: Definitely.

Jennifer: And since we're talking about the skin, let's pretend in my house I've got black mold behind the walls. I have no idea. All right?

Dr. Holland: Mm-hmm (affirmative).

Jennifer: So is it the mold spores that are in the air that could be irritating the skin itself or is it more that I'm inhaling them. They get into the system and then the mycotoxins are then, and maybe even the mold itself are causing the problem. Is there an exterior component to this for skin where it could be causing irritation?

Dr. Holland: Yeah. So I think that that's kind of complex because of where the mold is located. So if it's behind a wall and closed off and you have no idea it's there, what's really causing problems is the mycotoxins. And those are really small. They can seep through walls and you can still be absorbing them. I would say that when I see mold, I don't see a ton of skin response. But if you are somebody that's having an allergic response or something, then that could happen. And then the mycotoxins, when they are moving through, you breathe them in. They can get into your body that way. They can also settle in your sinuses and your gastrointestinal tract and then that cascade. Then we see intestinal permeability is increased and more self infections, candida, inflammation, and then we have this storm where you're also having acne and things happening and it's kind of out of nowhere.

Dr. Holland: So I would say that it's not impossible that the actual exterior on your skin is causing a problem, especially if it's you see the mold or the mold has touched you or something while you're cleaning it. But the problem that is really happening is people not knowing it's there and developing all these weird symptoms, and then, “Oh, now I have skin things happening too. What's going on?” Honestly, that's the more typical picture that I see.

Jennifer: And with testing, so if we're going to figure out testing, there is certain allergy test to see if there is an IgE response. But then looking for the toxins, typically it's a urine test looking for the mycotoxins. I assume there's no stool test to look for this. Usually it's urine is the best you'd consider to be.

Dr. Holland: Yup. Urine is the best for looking at the mycotoxins. Great Plains Laboratory has a really good one. And then with blood draws, Dr. Shoemaker uses a lot of different labs to check on how your body's doing. So it's not looking at what mycotoxins are there and how much are there. But it's looking at things like your vasoactive intestinal polypeptide, your TGF beta, which is your transforming growth factor beta, and a lot of inflammatory markers that change when mold is there. So depending on what you're doing for treatment or how severe it is, monitoring those to make sure that treatment is working can be helpful. But the urine test is important and that will tell you what species of mold as well as how much. And then you got to piece that with your exposure and how long we think it's been going on and all that. It really is difficult sometimes to figure out all the pieces with mold because sometimes you can be exposed in the past and it's still a problem later on down the road if those mycotoxins are still in your body and haven't been moved out properly.

Jennifer: And I think one thing that I'm gathering from this conversation, and when I've talked to others about mold is that mold illness is not a DIY type of scenario. It tends to be complex. You probably need help to address it, and I frankly that if you're going to get help, you really should work with a doctor that is trained and understands how to help you. I don't work with people vast. They're like, “Can you work with mycotoxins?” I'm like, “Nope. Nope. It's beyond my scope of practice. That's not something…” because it's complicated. So say somebody has all these symptoms. They've got a stool test, and they know that they've got some gut bugs that shouldn't be there. And they've got rashes and all sorts of things. But they also find out that they've got high mycotoxins in their system. Where do you start? Do you start with them… Because I just think it's helpful for someone to know do you start with the gut stuff? Do you start with the immediate symptoms, or are you like, “No, we know that the mycotoxins are one of the root causes of some of these other issues. So we got to clear the mold before we can go to get after the rest of whatever's left.” So where do you start generally?

Dr. Holland: So the expert in this is Dr. Jill Crista. I have people read her book Break The Mold because when you're dealing with mold and depending on how long your illness has been, it's also really hard to understand how big of an effect it's having. And a lot of people have a lot of brain fog. So they feel trapped because they feel so crummy. So step one is always avoidance of mycotoxins. And I do think that when we're talking about looking at all the problems, that mold really does feed into all of it. So until you address that, that you can be pouring supplements and trying to correct other things, and you probably won't really see much movement. Personally, I was exposed to mold. Didn't know I was. So I did all these tests, and EDD popped up. And I was like, “Oh, I'll just deal with the EDD.” Nothing happened to get better until I got away from the mold. So that's what really taught me about mold too when I started learning about it.

Dr. Holland: So we really do have to deal with the mold, and the first step is to get away from it. So for a lot of people, that means either they are remediating, maybe somewhere else while that remediation is happening, or maybe they're choosing to move somewhere else and that's really hard. Mold makes you feel so exhausted, and you have extreme brain fog. And there's also this thing that happens where you just want to stay in your surrounding, and the thought of having to leave that and deal with that is just really hard to do. So that's I think also is why mold is just so hard to deal with is it's the first thing is getting away from it, and that first step is really, really hard.

Jennifer: It's almost like your locked in this abusive relationship with it.

Dr. Holland: That's the perfect way…

Jennifer: You can't break free. You're like, “I don't know why I just want to stay home.” You just want to stay with it.

Dr. Holland: Yeah.

Jennifer: But you really need to get away.

Dr. Holland: Yeah. That's a perfect way of describing it. And then from there we can also start building up systems and getting a lot of antioxidants involved because there's so much oxidative stress caused from mold. So we have to refill that tank, and when we talk about avoiding that, that also means foods. So things like kombucha, mushrooms, things that are fermented. We want to take down that fungal load as much as possible. So avoiding things like that are part of that process too.

Jennifer: Do you find that mold, if you do have mold illness, is this a lifelong thing? Or is it something where it's going to take time, folks? I don't think Dr. Holland's going to tell you this is a three month journey. From everybody I know who's dealt with this, and she can probably share it from experience, this is a long road. So you should be prepared if that's the case. But can you really get better?

Dr. Holland: I think you can. So once you move out of the mold, once you start preparing the body to be at a point where you can really work on clearing the mold out. And there's a lot of different ways to do that. Some people will use antimicrobial herbs. Some people will actually take oral antifungals. That's the part where you're fighting the mold. You're fighting to get it out of your system, get rid of it. And that can be hard too because sometimes the way the body is releasing those mycotoxins and moving them out, you have to have your bowel helping you do that. So that's why regular bowel movements are so important, but also we want to make sure that those bowel movements are… A lot of bile is flowing. We're really moving those out because if we start to mobilize mycotoxins and try to get them out, people can go worse.

Dr. Holland: But one of my favorite things, so Dr. Jill actually has a website of practitioners that had done her training on mold literate. And she teaches that once you fight that mold, that you then can go back in and make the body happy, better than it was before microbiome when it comes to fungal levels.

Jennifer: Wow.

Dr. Holland: So re-putting in healthy fungal and medicinal mushrooms and things like that. So that then not only did you get rid of that mold, but your body is populated with healthy things to prevent that from happening again or being susceptible to that.

Dr. Holland: On the other side of that, sometimes the real healing part that gets us back to normal can be through retraining our body and our brain and what it sees as a threat. So what happens a lot of time with mold is all of a sudden people are like, “I can smell it. I can smell it a mile away. I can smell it a mile away for sure.” And the body has adapted to protect itself because it recognizing that this is poisoning me and I need to protect myself. So it magnifies these skills that we have to do that as an alert of, “That building has mold, so you're going to smell it from far away because we're not going in there.”

Dr. Holland: But it can also cause a cascade of response in the body that is associated with when you are really in mold, and that can be hard to break. So there's things like DNRS, which is neural retraining system, to help with that. And things like biofeedback, mind body medicine, all of that can be helpful too. But sometimes we really have to retrain our body to say, “We don't have to be on high alert for that anymore.” And I think there's also almost like an anxiety piece of, “What if I go out and I am exposed to mold? I worked so hard. I moved out of my house. I felt terrible. And then what if I get re-exposed and go backwards?” So those things are just as real in the healing process too, and those all do take time. But you can get past it.

Dr. Holland: guess I can attest to this. I was really scared to travel with my husband. I'd be like, “I'm just scared to go into an Airbnb or a hotel.” And we would walk into a hotel, and I would tell him, “I can't stay here because I can smell it.” And at that point in how sick I was, if I was in the room for 15 minutes with mold, I would feel it. And now I don't feel scared about that. My brain fog is continuing to decrease, but it is a slow journey. But there definitely is light at the end of the tunnel, and you can end up being stronger and more resilient to these things that are in our environment than you were before.

Jennifer: That's awesome. Oh, I'm glad to here that because a lot of times people do worry. They're like, “What if I do all of this and I just still don't feel well?” I think that's why, especially with mold illness, you have to work with somebody that is going to help you through this because it's complex, and it's going to take time. There's a lot of factors here that are involved, and that's why I think it's great that we have these conversations so that people can know and be… I think it's important. It's not just the steps you take, but it's also being mentally prepared for the journey ahead, and that is a really big deal to me as someone that has been through this with skin issues and gut issues and all sorts of things. I'm like, “Tell me what I should expect so that I'm mentally ready for it,” and mold is quite an opponent to deal with. But I'm glad to know from your experience that it is something that you can really… If you know what you're dealing with and you're working with somebody that can help you, this is great to know that you can actually overcome it and feel well.

Jennifer: So anyway, I want to make sure everybody can find you and go check out your website, which is fantastic. I mean, I learned about you, I stumbled across you on Instagram. So for anybody who's on Instagram, go follow Dr. Holland @drkaseyholland. And her website is drkaseyholland.com. And she's got articles and all sorts of things there and other resources that you can check out. I really appreciate you coming on to talk about this. I think it's interesting that we also clarify the issue between an allergy and mold illness because they aren't the same, and it's probably wise not to assume that they are. You could have both, but maybe you don't.

Jennifer: But thank you so much for joining us, Dr. Holland. I really appreciate it.

Dr. Holland: Thank you for having me, Jen. I really enjoyed it.

“According to OSHA, approximately one in four homes can have water damage that has promoted mold that could cause harm to their health.”