I tend to treat a lot of mold biotoxin illness and a good bit of Lyme disease in my practice. I’m not officially “Shoemaker certified” (Dr Ritchie Shoemaker is the pioneer of treatment of biotoxin illnesses), but I borrow many of his treatment approaches. There’s a lot of overlap in these two types of patients.

Lyme is a spirochete bacteria that comes from (usually) a tick bite, though there are other organisms that can transfer it too. Toxic mold comes from exposure to a water damaged building. You wouldn’t expect there to be any relationship between these two scenarios… and at least according to the CDC, Lyme should be quite rare (though from what I’ve seen, it’s very underdiagnosed.) So why do these two illnesses so often coexist?

Unfortunately I haven’t been able to find a definitive answer—the experts seem to agree that they do go together, but the closest I’ve found to a possible explanation is that the biotoxins from one increase the immune system’s susceptibility to the biotoxins of the other.

With that in mind, here’s what we do know.

TGFb1: A Marker for Biotoxins

The TGFb1 blood test is a marker for biotoxins from one of two sources: toxic mold, or Lyme. Because it only spikes from one or the other, my next step is typically to run a Lyme Western Blot. If Lyme is as under-diagnosed as I think it is, then it might just be an incidental finding: we find it because we’re looking for it, and it’s more prevalent than we think it is.

HLA DR: A Genetic Test for Post-Lyme Syndrome, Mold Biotoxin Illness, or Both

The HLA DR blood test helps determine whether a patient is genetically susceptible to toxic mold (about a quarter of the population is), and it also happens to test for whether a patient is susceptible to Post-Lyme Syndrome—or lingering fatigue, joint pain or muscle aches even after Lyme is gone. According to the CDC, the cause of Post-Lyme Syndrome is not known. My suspicion, since these are all biotoxin-related illnesses and Lyme does produce neurotoxins, is that Post-Lyme Syndrome is a result of the body’s inability to detoxify Lyme neurotoxins.

So again: susceptibility to biotoxins often overlaps, regardless of the source.

Detoxification Problems

I have yet to see a toxic mold patient who is not also sensitive to everyday household chemicals such as perfumes, cleaning agents, detergents, and the like. Most of them also have increased intestinal permeability, or “leaky gut syndrome”: that is, they’re sensitive to lots of different foods. I often see this in Lyme patients, as well. Here’s why.

Think of your liver like a big trash bucket. When you’re born, it’s empty (or at least it is for most of us). As you go through life, you encounter toxins, chemicals, organisms, and complex molecules that your body has to break down in order for them to be eliminated. These molecules get funneled into your “trash bucket”… and as long as it can keep up with the demand, you’re okay. But as soon as the trash bucket gets too full, suddenly anything you try to throw into it spills out onto the floor (which in this case is your bloodstream). Now, even the most minor encounter with a substance that your liver would ordinarily need to process in order for elimination to occur will lead to symptoms.

Here’s my theory on why this is connected: biotoxins (from mold and Lyme both) have to get processed by your liver, too—and in the sicker patients, there are a lot of them (indirectly measured by either TGFb1, c3a, or c4a). This means the bucket fills up faster.

But it’s also possible (and common, from what I’ve seen) for patients susceptible to biotoxin illnesses to also have less efficient liver detoxification mechanisms in the first place. (To continue the analogy, they have smaller trash buckets.) This can be measured with genetic testing of SNPs (mutations) in the liver’s various cytochrome enzymes. While genes can’t be fixed, we can at least optimize their function by giving the less efficient enzymes the vitamins and minerals they need to work as well as they can.

I don’t think this explains the connection between mold and Lyme, but it does at least in part explain why the symptom pictures often look so similar.

The Upshot

If you have a biotoxin-induced illness, even if you know you were exposed to a water-damaged building and that is likely the cause, I’d recommend getting checked for Lyme Disease anyway. (This requires a Western Blot, and chances are quite high that it will be officially negative—but the bands present will give away whether you have been exposed to Lyme or not. This, combined with a CD-57 test and the symptom picture, will usually determine whether or not Lyme is a current contributing factor to your illness.)

While you’re at it, check your HLA-DR. If you have a clear biotoxin illness and you’re genetically susceptible to either mold or Lyme but not the other, that can help point you in a clear clinical direction.