Are Your Symptoms Are Caused By Toxic Mold? A Mold Questionnaire

Did you know: A previous exposure to toxic mold could be the cause of all your symptoms! 

Yes, even the strangest of symptoms – like those found in fibromyalgia and chronic fatigue syndrome – could be caused by toxic mold. What makes a mold diagnosis even more challenging is that the strange symptoms could be caused by a mold exposure that occurred years ago!

You don’t have to currently be living in a water-damaged or moldy home in order to experience the effects of toxic mold. 

Below you will find the initial screening form I use in the clinic to help diagnose toxic mold illness. It was devised by Dr. Ritchie Shoemaker – the world’s leading expert on mold toxicity, mold illness, and a strange condition known as Chronic Inflammatory Response Syndrome (CIRS).

When you’re going through the questionnaire, please ensure you answer the questions in numerical order. Don’t skip ahead to other sections.

Now, let’s find out if toxic mold is the root cause of all your symptoms!

Step 1: Mold exposure 

This section is an environmental exposure survey. Its purpose is to determine whether (or not) you have ever been exposed to an environment that might lead you to develop toxic mold illness.Please answer each of the following questions.

Mold exposure

• • 1) Do you have exposure to the interior of a water-damaged building and/or microbial growth? If yes, please answer the next three (3) questions:

    Yes

    No

    Maybe

 

• •   1a) Do you have samples/evidence of spore or genus and species of fungus (air test, ERMI test, etc.)

    Yes

    No

    Maybe

 

• •  1b) Is there visible microbial growth (mold)?

    Yes

    No

    Maybe

 

• •  1c) Is there a presence of musty smells?

    Yes

    No

    Maybe

Insect bites

 

• •  2) Do you remember a tick bite occurring before your illness began? If yes, please answer the next two (2) questions:

    Yes

    No

    Maybe

• •  2a) Did you have an unexplained rash after the bite?

    Yes

    No

    Maybe

 

• •  2b) Did you experience flu-like illness after the bite?

    Yes

    No

    Maybe

 

• •  3) Have you had a brown recluse or another poisonous spider bite? If yes, please answer the next 1 question

    Yes

    No

    Maybe

 

• •  3a) Did you experience flu-like illness after the bite?

    Yes

    No

    Maybe

Other possible causes

 

• •  4) Did you become ill after eating fish?

    Yes

    No

    Maybe

 

• •  5) Did you become ill after exposure to a body of fresh water?

    Yes

    No

    Maybe

 

• •  6) Did you become ill after exposure to the ocean during a “red tide” or other algae bloom?

    Yes

    No

    Maybe

 

• •  7) Did you become ill after exposure to an estuary fish kill?

    Yes

    No

    Maybe

 

• •  8) Did you become ill after exposure to a closed shellfish bed area?

    Yes

    No

    Maybe

Take a look at your responses. If you answered:

• Yes to any of the above questions, please mark this section as positive.
• No to all of the above questions, please mark this section as negative.
• Maybe to any of the above questions, please mark this section as indeterminate.

Step 1 results:

Positive
Negative
Indeterminate 

Step 2: Symptom cluster questionnaire

Toxic mold creates a group of symptoms that are rather unique. This second section is used to see if the symptoms you’re experiencing fit under the umbrella of toxic mold.

You’ll notice that each question lists multiple symptoms. You do not need to have every symptom for each question. If you have one (or more) of the symptoms listed for a question, please mark that question positive. If you do not experience any of the symptoms listed for a given question, please mark that question negative.

1. Fatigue/weakness

Positive
Negative

 

2. Headache

Positive
Negative

 

3. Aches, cramps

Positive
Negative

 

4. Unusual sharp, clawing, electrical or ice-pick pain(s)

Positive
Negative

 

5. Light sensitivity; red eyes; blurring, tearing

Positive
Negative

 

6. Shortness of breath; cough; sinus issues

Positive
Negative

 

7. Abdominal pain, secretory diarrhea; bile acid reflux

Positive
Negative

 

8. Joint pain; morning stiffness

Positive
Negative

 

9. Issues with memory, concentration, word assimilation, confusion, disorientation

Positive
Negative

 

10. Mood swings; appetite swings; sweats; challenges with temperature regulation (hypothalamic functioning)

Positive
Negative

 

11. Thirst; frequent urination; static shocks

Positive
Negative

 

12. Numbness, tingling, taste abnormalities

Positive
Negative

 

13. Vertigo; tremors; skin sensitivity to light touch

Positive
Negative

 

Please add up your number of positive scores for these questions. Your score is:

Positive: If you have eight or more positives

Negative: If you have seven positives or less

Step 2 results:

Positive
Negative

If your results for both step one and step two were negative, you do not need to complete this third step. Your symptoms are likely not caused by toxic mold.

If you scored positive for any or all of the previous steps, please continue with this third step.

Step 3: VCS testing

VCS stands for visual contrast sensitivity. This is not a vision test. It does not test your eyes. It tests your brain. This test measures your brain’s ability to detect different contrasts. Contrast is your ability to discern black from white, and also between different shades of gray.

Toxic mold decreases blood flow to your optic nerve, a phenomenon called peripheral hypoprofusion. When mold toxicity affects your optic nerve, it is difficult to notice changes in contrast.

Please note that this is a screening tool and does not diagnose toxic mold. However, it is 92% accurate, meaning that 92% of those who failed the VCS test had mold toxicity or Chronic Inflammatory Response Syndrome. (1, 2)

To perform a VCS test, please visit Dr. Shoemaker’s website. The cost to perform this test is $15usd. You can also do the test for free at this website.

Are YOUR symptoms caused by toxic mold? 

Chronic Inflammatory Response Syndrome (CIRS) is different than mold illness or mold toxicity. Both are caused by mold so they are related, however there are a number of differences. Read more about the differences between CIRS and toxic mold.

The general difference between CIRS and mold toxicity has to do with exposure and genetics. Mold toxicity is caused by a current exposure to mold – it happens when you’re living or working in a water-damaged building. Once you are no longer in the mold-damaged building, your symptoms disappear.

CIRS occurs in an individual with a certain set of genes who has been exposed to mold. The symptoms remain, and can even worsen, once you are no longer exposed to mold.

The first two sections of this questionnaire determine if you’ve been exposed to mold and if the symptoms you’re experiencing are those of a toxic mold illness. But do keep in mind that mold is sneaky. More often than not, you can’t see mold. It’s often hiding behind walls, in crawl spaces, or heating/ventilation (HVAC) ducts. The only reliable way to know if your home is free from mold is via specialized testing methods.

If you test positive in all three sections (Exposure, Symptoms, and VCS) there is a 95% likelihood that you have mold toxicity and/or CIRS. (3)

I want to be crystal clear that these 3 steps are only a screening tool and are not to be used as a diagnosis. Even if you test positive in all three sections, it does not confirm you have mold toxicity. Instead, it shows that it is highly likely mold is causing your symptoms. Further laboratory testing will be required to accurately assess and diagnose your condition.

If you test negative in any of these sections, it is less likely that you are suffering from mold toxicity or CIRS. However it does not rule it out completely. But it does warrant an investigation into your health issues outside the context of mold/mycotoxin illness.

What to do if you’re suffering from toxic mold

If you do test positive all three sections, you need to find a mold-literate practitioner to confirm a diagnosis of CIRS and/or mold toxicity. Do not expect your family physician to be well versed in toxic mold. Dr. Ritchie Shoemaker has a list of Shoemaker trained practitioners on his website.

The gold standard for dealing with mold toxicity or CIRS is training by Dr. Ritchie Shoemaker. I’m confident there are other non-Shoemaker trained practitioners who are well versed in mold toxicity. But at the time of this writing, I do not have a comprehensive list of who they are nor where they practice.

Many mold-literate practitioners will be able to work with you via skype/zoom consults. You do not have to be living in their place of residence in order to become a patient under their care.

If you suspect you have mold toxicity or CIRS after completing the three steps outlined in this post, you need to immediately remove yourself from the source of mold. Have your home and workplace tested to ensure there is no mold growth. Then, look to find a Shoemaker-trained practitioner to help guide you out of mold toxicity symptoms and back to health.

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Now, I want to hear from you!

What did this 3-step screening reveal regarding your health?

Share your answers in the comments section below!