Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Detecting Mycotoxin Subgroup
- Alison Bested, MD – College of Osteopathic Medicine
- Irina R. Rozenfeld, MS – College of Osteopathic Medicine
- Violetta Renesca, MS – College of Osteopathic Medicine
- Maria Vera Nunez, MD – College of Osteopathic Medicine
- Nancy Klimas, MD – College of Osteopathic Medicine
- Brandon Laporte, MS – College of Osteopathic Medicine
- Andrew Hayman, MD – George Washington University School of Medicine and Health Sciences
- Elaine Wallace, D.O., M.S., M.S., M.S. – College of Osteopathic Medicine
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a chronic, debilitating and complex medical condition. The disease remains poorly understood and ME/CFS research has been underfunded compared with other diseases. There is no speciﬁc test to diagnose patients with ME/CFS. A battery of laboratory tests rules out other diseases. Clinical symptom criteria are used to diagnosis ME/CFS. Historically, most patients who develop ME/CFS become ill after suﬀering from an infection e.g. viral, bacterial or parasitic and never fully recover after the infection. They have constant ﬂu-like symptoms, severe postexertional fatigue, memory problems, muscle or joint pain, unrefreshed sleep, dizziness, appetite problems, immune system problems with recurrent infections, allergies and new sensitivities to chemicals and foods. ME/CFS is disabling in many patients and some are bedridden. Research shows ongoing immune dysfunction in patients with ME/CFS. At the Institute for Neuro-Immune Medicine (INIM) Clinic, our clinicians discovered that some of their patients diagnosed with ME/CFS also had a mycotoxin exposure. Mycotoxins are toxic metabolites produced by molds/fungi. In a retrospective analysis, 111 ME/CFS patients' charts were reviewed in the INIM Clinic. The majority were women, aged 23-77 years old. They found 81 percent tested positive for mycotoxins, with Gliotoxin the most common
(Laroche et al., 2017). The exposure to molds and mycotoxins can occur from contact with water-damaged buildings from dust from inhalation, contaminated foods or skin penetration. Mycotoxins trigger diseases including cancer, asthma, allergies and toxicity.
In this pilot study, we aim to build on our early retrospective clinical ﬁndings and explore whether exposure to mycotoxins is detectable in patients with ME/CFS by using the Environmental Exposure Questionnaire (EEQ), and laboratory testing for mycotoxins. As part of the INIM Clinic's goal of monitoring disease activity and response to treatment, at each INIM Clinic visit, patients ﬁll out seven questionnaires to assess their current physical and mental functioning. This study will assess if the addition of mycotoxin exposure results in more severe symptoms in these ME/CFS patients. Blood will be stored from these patients for future analyses to discover if there is a speciﬁc immune or metabolic dysfunction, or epigenetic changes associated with mycotoxin exposure in these patients.
The signiﬁcance of ﬁnding an ME/CFS subgroup of patients with mycotoxin exposure is that new treatment protocols can be developed and as a result to improve the quality of life of these severely ill patients. Additionally, this can serve as an additional precautionary note regarding the dangers of mycotoxin exposure, which can be publicized to decrease future exposures to mycotoxins.