Clearing The Air on Mold & Mycotoxins


By Jason Earle, Founder & CEO, GOT MOLD?
09/06/2026

Key Takeaways

AIR MATTERS

Indoor air quality is foundational.

You breathe 20,000+ times every day and spend over 90% of your life indoors.

It is your single largest environmental exposure by orders of magnitude.

It either supports your health — or undermines it — more than almost anything else in your daily environment.

IT’S NOT JUST MOLD

One in five American adults meets the criteria for chemical intolerance.

When researchers asked those people what set it off, the single most common answer was mold.

  • Mold — 15.6%
  • Pesticides — 11.5%
  • Medical / surgical procedures — 11.3%
  • Remodeling and new construction — 10.7%
  • Combustion products — 6.4%
  • Implants — 1.6%

Mold plus remodeling and new construction accounts for more than a quarter of everything named — 26.3%.

The building is not a bit player. It is the leading named trigger.

Source: Miller CS, Palmer RF, Kattari D, et al. Environmental Sciences Europe 2023;35:65 (n = 7,997 U.S. adults). Percentages are of respondents naming that exposure.

MOLD IS A MOISTURE PROBLEM

Mold is natural. Indoor moisture problems are not.

Mold is nature’s great recycler.

Problems begin when moisture allows it to grow indoors.

Mold needs:

  • Spores
  • Moisture
  • Oxygen
  • Food source
  • Proper temperature

Mold control = moisture control

THE 24–72 HOUR WINDOW

Water damage becomes a mold problem fast.

First 24–48 Hours

  • Easier cleanup
  • Lower cost
  • Lower exposure risk
  • Less disruption

After 72 Hours

  • Costs rise dramatically
  • Insurance coverage is extremely limited
  • Greater health and contamination risk
  • Mold amplification becomes much more likely
  • Specialized remediation is often required

MOLD EXPOSURE IS MORE THAN MYCOTOXINS

Indoor mold environments may contain:

  • Spores
  • Microbial VOCs (mVOCs/musty odors)
  • Allergens
  • Fragments
  • Bacteria
  • Mycotoxins (in some cases)

Only a small percentage of molds produce mycotoxins, and the research is clear: most human mycotoxin exposure comes from food — not buildings.

THE PART ALMOST NOBODY TESTS FOR

Actinomycetes.

These are slow-growing soil bacteria with fungi-like characteristics. They grow right alongside mold in water-damaged buildings, and they produce microbial VOCs of their own.

They are potent chemical factories — roughly two-thirds of all antibiotics come from this class of bacteria.

And they are rarely included in indoor air quality assessments at all.

Emerging research indicates we are affected by them and their metabolites. A dust test that includes these organisms is in development.

WHY PEOPLE FEEL SYMPTOMS SO QUICKLY

Your body is sensing the environment in real time.

One important system involved is the trigeminal nerve — a major sensory nerve in the face that helps detect airborne irritants and environmental threats.

It works alongside your sense of smell, but is often more sensitive.

The trigeminal system can respond to:

  • Microbial byproducts
  • Airborne irritants and particulates
  • Chemicals/fragrances/VOCs
  • Smoke

Importantly:

  • Detection can occur below odor threshold
  • Symptoms do not automatically mean “toxicity”

Common symptoms include:

  • Headaches
  • Brain fog
  • Burning eyes
  • Sinus irritation
  • Fatigue
  • Nervous system activation
  • Downstream effects: inflammation, immune activation

THE PATTERN

Small exposure → fast signal → amplified response.

Common pattern:

  • Symptoms begin shortly after entering a building
  • Persist during exposure
  • Improve upon leaving
  • Return upon re-exposure

This is often driven by neurogenic inflammation — a nervous system-mediated inflammatory response triggered by environmental signaling.

MUSTY ODORS MATTER

mVOCs are biological signals.

Microbial VOCs (mVOCs) are gases released during microbial growth.

Research has associated mVOCs with many symptoms blamed on mycotoxins:

  • Allergic reactions
  • Inflammation
  • Auto-immune disease
  • Gut dysregulation
  • Headaches
  • Nausea
  • Dizziness
  • Fatigue
  • Brain fog
  • Increased asthma risk

MYCOTOXIN CONFUSION

Important facts:

  • Only a small percentage of molds produce mycotoxins
  • Production occurs under specific stress conditions
  • Most mycotoxin exposure comes from food
  • Mycotoxins generally do not become airborne independently

Symptoms alone cannot determine causation.

WHERE MYCOTOXINS ACTUALLY COME FROM

Food. Overwhelmingly.

The long-cited FAO estimate was that about 25% of global food crops are contaminated with mycotoxins. A 2020 reassessment found that figure holds for contamination above EU and Codex regulatory limits — but that it greatly underestimates contamination at detectable levels, which runs as high as 60 to 80%.

Three things make this hard to escape:

  • Mycotoxins bioaccumulate. Individual foods often test below threshold but still positive; the load adds up.
  • They are heat resistant. You cannot cook them out.
  • Most are hydrophobic and lipophilic. They do not excrete easily, and they lodge in fat tissue.

Commonly affected foods: grains · nuts · sugar · spices · berries · coffee · chocolate · dried fruits · conventional dairy · conventional meats · alcoholic beverages · apple and tomato sauces.

Reducing exposure:

  • Reduce or eliminate sugar, grains and processed foods
  • Choose fresh, whole nuts; very fresh or frozen berries
  • Choose fresh, organic, domestic produce
  • Choose organic, grass-fed and pastured dairy and meats
  • Limit dining out
  • Source grains domestically if you eat them

Unlike a building, the food supply cannot be remediated.

And on how mycotoxins actually move: they are essentially non-volatile. They do not evaporate into a gas. They can become airborne, but bound to particulates — spores and fine fragments — not as a free vapor. The Stachybotrys macrocyclic trichothecenes (satratoxins) are the semi-volatile exception, and even those are detected on particles.

That is the reason a urine panel cannot be read as a building measurement.

Source: Eskola M, Kos G, Elliott CT, et al. Critical Reviews in Food Science and Nutrition 2020;60(16):2773–2789.

URINE MYCOTOXIN TESTING

Detection does not equal causation.

Urine mycotoxin testing has become one of the most misunderstood tools in the mold world.

A positive urine result does not automatically prove:

  • A building problem
  • Ongoing indoor exposure
  • “Toxic mold illness”
  • Mold colonization
  • That symptoms are being caused by mold

Important context:

  • Most human mycotoxin exposure comes from food
  • Mycotoxins are common in the global food supply
  • Many are durable, fat-soluble, and biologically persistent
  • Detection alone cannot determine the source

Common mistake:

Symptoms + urine panel + ERMI score does not automatically equal:

“Your house is making you sick.”

Without proper environmental context, these tests are highly vulnerable to:

  • Confirmation bias
  • Overinterpretation
  • Misattribution
  • Fear-based decision making

The environment still has to be investigated properly.

What the CDC has published on these tests:

  • “There is no FDA-approved test for mycotoxins in human urine.”
  • “Low levels of mycotoxins are found in many foods; therefore, mycotoxins are found in the urine of healthy persons.”
  • “Mycotoxin levels that predict disease have not been established.”

These tests have real value. The problem is not the assay — it is the inference being drawn from it.

Source: CDC. Notes from the Field: Use of Unvalidated Urine Mycotoxin Tests for the Clinical Diagnosis of Illness — United States, 2014. MMWR 2015;64(6):157.

WHY CONTEXT MATTERS

No single test tells the whole story.

Proper interpretation requires:

  • Visual observations
  • Spore counts
  • Odors
  • Building history
  • Moisture history
  • Symptoms
  • Current environmental conditions

Context matters.

WHEN TO HIRE A PROFESSIONAL

Not every mold issue requires major remediation.

However, professional evaluation should be considered when:

  • Visible growth covers more than a small isolated area
  • There is persistent moisture, dampness, or repeated leaks
  • Musty odors persist without an obvious source
  • Symptoms reliably improve outside the environment
  • Water damage involved HVAC systems, crawlspaces, or wall cavities
  • Flooding or major water intrusion occurred
  • Hidden mold is suspected despite low or normal spore counts
  • Occupants are medically vulnerable or highly sensitive

A qualified inspector should focus primarily on:

  • Moisture detection
  • Building science
  • Source identification
  • Environmental context

—not fear-based interpretation of isolated test results.

COMMONLY MISUSED METHODS

These tools are frequently overinterpreted or used without proper context:

  • Urine panels
  • Petri dish tests
  • Misapplied ERMI/HERTSMI scoring
  • Instant mold tests
  • Swabs
  • Pen-style tests

THE ERMI PROBLEM

ERMI was designed as a research tool — not a diagnostic tool.

Key limitations:

  • Only 36 species
  • Ignores building context
  • Prone to misleading interpretations
  • Uses a limited targeted MSqPCR approach
  • Developed as a research tool by EPA researchers
  • Derived from a study of 17 homes in Ohio — not the 1,096 figure commonly cited, which built the scale, not the health associations
  • Alarmingly prone to false positives
  • Does not account for a building’s age, setting or location

We do not have to argue against ERMI. The EPA already did.

“ERMI has been peer reviewed for research purposes but has not been validated for non-research purposes… For this reason, EPA does not recommend the routine public use of ERMI in homes, schools, or other buildings.”

— U.S. EPA, Environmental Relative Moldiness Index fact sheet

This applies equally to HERTSMI-2 and to any product built on the same 36-species panel, however it is branded.

Source: https://www.epa.gov/air-research/environmental-relative-moldiness-index-ermi

PCR VS NGS

Targeted PCR asks:

“Is this specific organism here?”

NGS asks:

“What is actually here?”

Whole-community analysis provides broader environmental context and pattern recognition.

MYCOBIOME DUST TEST — COMING SOON!

A different question, answered with modern technology.

Science has been very good at finding specific organisms once we identify them as problematic. Advances in genomics now let us ask a bigger question. Not “are these 36 molds present?” but “what is actually here, in what proportion, and how is it interacting?”

Using MSqPCR to characterize a building’s ecology is like driving down the highway at night with a laser pointer instead of headlights.

THE TECHNOLOGY

GOT MOLD? holds a global exclusive license on a Yale patent for the underlying technology, the Mold Classification Tool (MCT), developed by Dr. Richard Shaughnessy and Dr. Jordan Peccia — both past presidents of the International Society of Indoor Air Quality and Climate. The research is HUD-funded, published, peer-reviewed and patent pending.

It applies next-generation sequencing to dust samples, then runs the result through a machine-learning classifier trained on a large database of homes across the United States and Australia.

WHAT IT ANSWERS

  • Is there a mold or moisture problem in need of further investigation or remediation?
  • After remediation, has the building’s fungal ecology been restored to normal?

Validated against professional inspector ground-truth at approximately 95% agreement.

WHAT THE REPORT GIVES YOU

  • A Mold Classification Index from 0 to 100 for each sample, scored on its own
  • Plain-language status: normal, slightly disrupted, moderately disrupted, significantly disrupted
  • The fungi present and in what proportions, from millions of DNA reads
  • Indoor samples anchored to a paired outdoor reference
  • Detailed appendices with deep ecological data for advanced users

HOW IT WORKS

Sample → Send → Sequence → Classify → Report

The base kit includes one outdoor and three indoor collections. Add-on indoor swabs scale to any building size without a redundant outdoor sample. All swabs from one building, ideally collected the same day, roughly ten minutes. Prepaid mailer to the University of Minnesota Genomics Center. Results in about one week.

WHAT IT IS NOT

This matters as much as what it is:

  • It is not a home score
  • It is not a dose measurement
  • It is not a diagnosis
  • It does not replace a professional inspection

It is one coordinate — a very good one — weighted alongside spore traps, building history, visual indicators, odors, and whether people feel better away.

Finding more things is not the breakthrough. Reading the system is.

To register for early access and updates: https://www.mycobiome.ai/

Source: Environmental Science & Technology 2020;54:15968–15975.

WHAT A GOOD INVESTIGATION LOOKS LIKE

Indoor environmental investigations are not about finding a single “bad mold.”

They are about understanding:

  • Moisture dynamics
  • Building history
  • Air quality
  • Hidden contamination
  • Occupant patterns
  • Environmental context

A proper assessment may involve:

  • Visual inspection
  • Moisture mapping
  • Infrared imaging
  • Humidity evaluation
  • HVAC assessment
  • Spore trap air sampling
  • Surface sampling where appropriate
  • Odor evaluation
  • Dust analysis
  • Building history review

No single test result should ever be interpreted in isolation.

The goal is pattern recognition and contextual understanding.

REMEDIATION: WHAT ACTUALLY MATTERS

The purpose of remediation is not sterilization.

The goal is to:

  1. Correct the moisture problem
  2. Remove contaminated materials
  3. Restore a normal indoor ecology

Proper remediation generally includes:

  • Identifying and correcting the water source
  • Containment when appropriate
  • Removal of damaged porous materials
  • HEPA vacuuming
  • Detailed cleaning of surfaces and contents
  • Drying the structure properly
  • Post-remediation verification when necessary

Important:

Dead mold can still remain allergenic and inflammatory.

For this reason, remediation is primarily about:

  • Removal
  • Cleaning
  • Moisture correction

—not simply “killing mold.”

REMEDIATION RED FLAGS

Be cautious of approaches heavily focused on:

  • Fogging
  • Ozone
  • Fragrances
  • Routine biocide spraying
  • Encapsulating visible mold without removal
  • Extreme tear-outs without confirmed moisture damage
  • Fear-based sales tactics
  • Overreliance on ERMI scores or urine mycotoxin tests alone

The focus should remain on:

  • Identifying moisture
  • Correcting water intrusion
  • Removing damaged materials
  • Restoring healthy indoor conditions

PREVENTION: THE CLEAN & DRY PRINCIPLE

Healthy buildings are not sterile buildings.

They are buildings that stay:

  • Clean
  • Dry
  • Ventilated
  • Well maintained

Prevention strategies include:

  • Addressing leaks quickly
  • Monitoring humidity
  • Using bathroom and kitchen exhaust ventilation
  • Managing drainage around the structure
  • Drying wet materials rapidly
  • Using dehumidification where necessary
  • Inspecting vulnerable areas periodically
  • Using leak detectors in high-risk areas

Moisture that persists eventually becomes biology.

HOW PEOPLE ACTUALLY GET BETTER

After 25 years of investigations, one pattern stands out:

Air. Food. Attitude.

Air

Reducing or eliminating exposure to:

  • Mold
  • Dampness
  • VOCs
  • Water-damaged environments

Food

Many people report improvement with dietary changes such as:

  • Reducing sugar
  • Reducing ultra-processed foods
  • Prioritizing whole, nutrient-dense foods

Attitude

Supporting the nervous system through:

  • Neural retraining (e.g., Primal Trust, DNRS, and others)
  • Stress reduction
  • Nervous system regulation
  • Better sleep and recovery

The environment matters first.

THE FAST FIVE – Intake Questionnaire

Five questions to add to your initial intake, or to ask whenever a patient presents with a new health challenge.
1. HISTORY — Is there a history of mold, leaks, water damage or dampness?
2. VISUAL — Do you see any signs of dampness or mold?
3. ODORS — Is there a musty or damp smell? Any fragrances, chemicals, or a “new home / new car” smell?
4. SYMPTOMS — Do you feel better when you leave, and worse when you return?
5. CHANGE — Has there been any renovation, new construction, or new materials — carpet, paint, furnishings?
An affirmative answer to any one of these warrants further action: a test kit, or a professional inspection.
The Fast Five does not diagnose mold. It is a signal-detection framework.
The fifth question does double duty. A renovation is a confounder — VOC off-gassing from new materials can mimic a mold signal — and it is also a cause, because wet materials get sealed into a tight new envelope before they can dry. New symptoms after a change point at the change.
Test, don’t guess.

GOT MOLD? LET’S FIND OUT.

The GOT MOLD? Test Kit Includes:

  • Professional air sampling
  • World-class lab analysis at Eurofins
  • Clear, intuitive reporting
  • Legendary support
  • All-inclusive pricing

Starting at just $199, everything included!

If you would like to try a GOT MOLD? Test Kit, go to www.gotmold.com and enter code MBKS2026 at checkout for 20% off, or click here. Good through Friday October 02, 2026. Reduced to 10% off October 3rd onward.

Mycobiome (MCT) Dust Test

To register for early access and updates: https://mycobiome.ai

ARTICLES

  1. Petri Dishes: The Mood Rings of Mold Testing
  2. The Problems of ERMI
  3. The Myth of Black Mold
  4. Say “No” To Biocides

LINKS

Main site

www.gotmold.com

Free Resources

  1. How To Find Mold [eBook]
  2. Neurogenic Inflammation Cascade [Infographic]

Suggested Reading

  1. Breath by James Nestor
  2. Never Home Alone by Rob Dunn
  3. Carpet Monsters & Killer Spores by Nicholas Money
  4. Entangled Life by Merlin Sheldrake
  5. I Contain Multitudes by Ed Yong

REFERENCES & CITATIONS

I. Building Dampness, Mold, and Population-Level Health Signals

Ponikau, J. U., Sherris, D. A., Kern, E. B., Homburger, H. A., Frigas, E., Gaffey, T. A., & Roberts, G. D. (1999). The diagnosis and incidence of allergic fungal sinusitis. Mayo Clinic Proceedings, 74(9), 877–884.
https://doi.org/10.4065/74.9.877

Fisk, W. J., Lei-Gomez, Q., & Mendell, M. J. (2007). Meta-analyses of the associations of respiratory health effects with dampness and mold in homes. Indoor Air, 17(4), 284–296.
https://doi.org/10.1111/j.1600-0668.2007.00475.x

Mudarri, D., & Fisk, W. J. (2007). Public health and economic impact of dampness and mold. Indoor Air, 17(3), 226–235.
https://doi.org/10.1111/j.1600-0668.2007.00474.x

Shenassa, E. D., Daskalakis, C., Liebhaber, A., Braubach, M., & Brown, M. (2007). Dampness and mold in the home and depression: An examination of mold-related illness and perceived control of one’s home as possible depression pathways. American Journal of Public Health, 97(10), 1893–1899.
https://doi.org/10.2105/AJPH.2006.093773

Lawrence Berkeley National Laboratory. Prevalence of Building Dampness.
https://iaqscience.lbl.gov/prevalence-building-dampness

Miller, C. S., Palmer, R. F., Kattari, D., et al. (2023). Mast cell activation may explain many cases of chemical intolerance. Environmental Sciences Europe, 35, 65.

World Health Organization. (2009). WHO Guidelines for Indoor Air Quality: Dampness and Mould. https://www.who.int/publications/i/item/9789289041683

II. Fungal Volatile Organic Compounds (mVOCs): Source, Emissions, and Airborne Exposure

Morath, S. U., Hung, R., & Bennett, J. W. (2012). Fungal volatile organic compounds: A review with emphasis on their biotechnological potential. Fungal Biology Reviews, 26(2–3), 73–83.
https://doi.org/10.1016/j.fbr.2012.07.001

Hung, R., Lee, S., & Bennett, J. W. (2015). Fungal volatile organic compounds and their role in ecosystems. Applied Microbiology and Biotechnology, 99, 3395–3405.
https://doi.org/10.1007/s00253-015-6494-4

Inamdar, A. A., Masurekar, P., & Bennett, J. W. (2014). Volatile organic compounds from fungi isolated after Hurricane Katrina induce developmental defects and apoptosis in a Drosophila melanogaster model. Environmental Toxicology, 29(12), 1345–1356.
https://doi.org/10.1002/tox.21933

Macedo, G. E., Vieira, P. B., Rodrigues, N. R., Gomes, K. K., Martins, I. K., Franco, J. L., & Posser, T. (2020). Fungal compound 1-octen-3-ol induces mitochondrial morphological alterations and respiration dysfunctions in Drosophila melanogaster. Ecotoxicology and Environmental Safety, 206, 111232.
https://doi.org/10.1016/j.ecoenv.2020.111232

Bennett, J. W. (2015). Are some fungal volatile organic compounds (VOCs) mycotoxins? Toxins, 7(9), 3785–3804.
https://doi.org/10.3390/toxins7093785

Bennett, J. W. (2015). Silver linings: A personal memoir about Hurricane Katrina and fungal volatiles. Frontiers in Microbiology, 6, 206.
https://doi.org/10.3389/fmicb.2015.00206

Andersen, B., Dosen, I., Lewinska, A. M., & Nielsen, K. F. (2017). Pre-contamination of new gypsum wallboard with potentially harmful fungal species. Indoor Air, 27(1), 6–12.
https://doi.org/10.1111/ina.12298

Tabbal, S., El Aroussi, B., Bouchard, M., Marchand, G., & Haddad, S. (2022). A new headspace solid-phase microextraction coupled with gas chromatography-tandem mass spectrometry method for the simultaneous quantification of 21 microbial volatile organic compounds in urine and blood. Chemosphere, 293, 133901.
https://doi.org/10.1016/j.chemosphere.2022.133901

III. Airborne Chemical Exposure & Trigeminal Activation

Mølhave, L., Bach, B., & Pedersen, O. F. (1986). Human reactions to low concentrations of volatile organic compounds. Environment International, 12(1–4), 167–175.
https://doi.org/10.1016/0160-4120(86)90005-0

Mølhave, L. (1991). Volatile organic compounds, indoor air quality and health. Indoor Air, 1(4), 357–376.
https://doi.org/10.1111/j.1600-0668.1991.00001.x

Cometto-Muñiz, J. E., & Cain, W. S. (1995). Relative sensitivity of the ocular trigeminal, nasal trigeminal, and olfactory systems to airborne chemicals. Chemical Senses, 20(2), 191–198.
https://doi.org/10.1093/chemse/20.2.191

IV. Environmental Chemosensation & Sensory Detection

Simons, C. T., & Carstens, E. (2008). Chemesthesis. In The Senses: A Comprehensive Reference. Elsevier.
https://www.sciencedirect.com/topics/neuroscience/chemesthesis

Slack, J. P. (2016). Molecular pharmacology of chemesthesis. In Chemosensory Transduction. Elsevier.
https://doi.org/10.1016/B978-0-12-801694-7.00021-4

Green, B. G. (2012). Chemesthesis and the chemical senses as components of a “chemofensor complex.” Chemical Senses, 37(3), 201–206.
https://doi.org/10.1093/chemse/bjr119

Gerhold, K. A., & Bautista, D. M. (2009). Molecular and cellular mechanisms of trigeminal chemosensation. Annals of the New York Academy of Sciences, 1170, 184–189.
https://doi.org/10.1111/j.1749-6632.2009.04359.x

Bessac, B. F., & Jordt, S.-E. (2008). Breathtaking TRP channels: TRPA1 and TRPV1 in airway chemosensation and reflex control. Physiology (Bethesda), 23, 360–370.
https://doi.org/10.1152/physiol.00026.2008

Nassenstein, C., Kwong, K., Taylor-Clark, T., Kollarik, M., Macglashan, D. W., Braun, A., & Undem, B. J. (2008). Expression and function of the ion channel TRPA1 in vagal afferent nerves innervating mouse lungs. The Journal of Physiology, 586(6), 1595–1604.
https://doi.org/10.1113/jphysiol.2007.148379

V. Environmental Irritants & Dose-Dependent Activation

National Research Council (US) Committee on Toxicology. (1986). Organic solvents and the central nervous system. National Academies Press (US).
https://www.ncbi.nlm.nih.gov/books/NBK215642/

Inoue, T., & Bryant, B. P. (2005). Multiple types of sensory neurons respond to irritating volatile organic compounds (VOCs): Calcium fluorimetry of trigeminal ganglion neurons. Pain, 117(1–2), 193–203.
https://doi.org/10.1016/j.pain.2005.06.012

VI. Neurogenic Inflammation & Local Tissue Response

Meggs, W. J. (2007). Neurogenic inflammation and sensitivity to environmental chemicals. Pharmacology & Therapeutics, 113(2), 281–292.
https://doi.org/10.1016/j.pharmthera.2006.08.001

Holzer, P. (2006). Neurogenic inflammation: Mechanisms and implications for health and disease. European Journal of Pharmacology, 533(1–3), 182–193.
https://doi.org/10.1016/j.ejphar.2005.08.044

O’Connor, T. M., O’Connell, J., O’Brien, D. I., Goode, T., Bredin, C. P., & Shanahan, F. (2004). The role of substance P in inflammatory disease. Journal of Cellular Physiology, 201(2), 167–180.
https://doi.org/10.1002/jcp.20061

VII. Neuro-Immune Integration & Reflex Pathways

Chiu, I. M., Heesters, B. A., Ghasemlou, N., Von Hehn, C. A., Zhao, F., Tran, J., Wainger, B., Strominger, A., Muralidharan, S., Horswill, A. R., Bubeck Wardenburg, J., Hwang, S. W., Carroll, M. C., & Woolf, C. J. (2013). Bacteria activate sensory neurons that modulate pain and inflammation. Nature, 501(7465), 52–57.
https://doi.org/10.1038/nature12479

Pavlov, V. A., & Tracey, K. J. (2012). The vagus nerve and the inflammatory reflex—linking immunity and metabolism. Nature Reviews Endocrinology, 8(12), 743–754.
https://doi.org/10.1038/nrendo.2012.189

VIII. Central Processing, Sensitization & Modulation

Ji, R.-R., Nackley, A., Huh, Y., Terrando, N., & Maixner, W. (2018). Neuroinflammation and central sensitization in chronic and widespread pain. Anesthesiology, 129(2), 343–366.
https://doi.org/10.1097/ALN.0000000000002130

Hummel, T., Croy, I., & Sinding, C. (2023). Chemosensation in anxiety: The trigeminal system matters. Chemical Senses.
https://doi.org/10.1093/chemse/bjad010

IX. Clinical Phenomena: Environmental Intolerance

Binkley, K. E. (2023). Multiple chemical sensitivity/idiopathic environmental intolerance: A practical approach to diagnosis and management. Journal of Allergy and Clinical Immunology: In Practice, 11(12), 3645–3649.
https://doi.org/10.1016/j.jaip.2023.08.039

Molot, J., Sears, M. R., & Anisman, H. (2023). Multiple chemical sensitivity: It’s time to catch up to the science. Neuroscience & Biobehavioral Reviews.
https://doi.org/10.1016/j.neubiorev.2023.105094

X. Mycotoxins: Occurrence, Volatility and Dose

Centers for Disease Control and Prevention. (2015). Notes from the field: Use of unvalidated urine mycotoxin tests for the clinical diagnosis of illness — United States, 2014. MMWR, 64(6), 157. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a7.htm

Eskola, M., Kos, G., Elliott, C. T., et al. (2020). Worldwide contamination of food-crops with mycotoxins: Validity of the widely cited ‘FAO estimate’ of 25%. Critical Reviews in Food Science and Nutrition, 60(16), 2773–2789. https://doi.org/10.1080/10408398.2019.1658570

Kelman, B. J., Robbins, C. A., Swenson, L. J., & Hardin, B. D. (2004). Risk from inhaled mycotoxins in indoor office and residential environments. International Journal of Toxicology, 23(1), 3–10.

Brasel, T. L., Douglas, D. R., Wilson, S. C., & Straus, D. C. (2005). Detection of airborne Stachybotrys chartarum macrocyclic trichothecene mycotoxins on particulates smaller than conidia. Applied and Environmental Microbiology, 71(1), 114–122.

World Health Organization. Mycotoxins fact sheet. https://www.who.int/news-room/fact-sheets/detail/mycotoxins

XI. Testing Methods and Validation

U.S. Environmental Protection Agency. Environmental Relative Moldiness Index (ERMI) fact sheet. https://www.epa.gov/air-research/environmental-relative-moldiness-index-ermi

Environmental Science & Technology. (2020). 54, 15968–15975. [Mold Classification Tool — Yale]