Patients who are not responding to a standard allergy work up are often suffering from mould sensitivity. This is not an easy diagnosis to make because skin prick tests for mould allergy are unreliable. Furthermore it is uncertain whether symptoms are due to allergy to moulds or to sensitivity to mould fumes. This is a little bit like yeast overgrowth in the gut - for some people this causes a problem because they are allergic to yeast and for some because they react to the products of fermentation.
The best bet for mould allergy is neutralisation and provocation injections, but there are only a few clinics that offer these,a namely The Burghwood Clinic (Dr Shideh Pouria), the Airedle Clinic(Dr Apelles Econ), The Breakspear Clinic (Dr Munro,) and Dr David Freed in Salford, Manchester.
The key to diagnosing mould allergy is the history and if patients are improved in a mould free or low mould environment then this is highly suggestive that moulds are a problem. In order to survive moulds have to get their water from air, therefore they do not exist either in very dry climates (which may be hot dry or cold dry), above three thousand feet where the air is too thin to hold sufficient moisture, or on sea fronts where the prevailing winds are onshore. Since moulds do not live in oceans, their spores are constantly blown in land.
Therefore, to diagnose mould allergy I currently recommend that people have a two week holiday in such a mould free environment. They may have already done this and not realised that their improvement was actually due to the control of their mould allergy and ascribe improvement to other factors such as freedom from stress, or sunshine, or whatever.
Being free from moulds in our temperate climate is extremely difficult. To reduce mould counts in houses one has to take away obvious sources, such as house plants, or cure a damp problem. The next step is to reduce the humidity inside the house to less than 40% using a dehumidifier and this will kill any moulds living in the house. Reducing the humidity is helped by trying to avoid moisture creating activities such as keeping houseplants, drying clothes, boiling pan, etc. Once the atmosphere is dried up, an air filtration system helps to get rid of the moulds in the air. Visit the website of the Healthy House, who do a range of excellent products.
Getting the relative humidity below 40% is critically important and one can now buy a little gadget from ETI Ltd called a Digital hygro-thermometer 0.1 °C/F and 1% RH. This will tell you if you have got the humidity down to an acceptable level. Contact them on 01903 202151 or e-mail firstname.lastname@example.org (quote order code 810-155). This costs £16 + VAT + £3.50 P&P at time of writing.
In the early stages of mould allergy one often gets local symptoms such as rhinitis, conjunctivitis and sore throat, but as the symptoms become more systemic they can present with foggy brain and chronic fatigue. Patients who come to see me usually present with the latter symptoms.
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