Mold Allergies: When pollen is gone and symptoms drag on

Mold is a tricky, complex allergy, but successful treatment has been found for many patients through allergy drops using the La Crosse Method™ Protocol. Thanks, in part, to farmers. Dr. George Kroker, partner at Allergy Associates of La Crosse, told the story. “For a while at our clinic, early on, shots and drops were both offered and many of the farmers that our founder, Dr. David Morris, treated who were mold allergic would get sore arms and feel poorly after a shot for mold, whereas drops worked very well for them,” Dr. Kroker explained, “so after a couple years, so the story goes, people who were on shots migrated to drops, and people on drops stayed with drops.” Soon enough, allergy drops caught on, and thousands of mold allergic individuals have reaped the benefits.

What is mold?

While there are many different kinds of mold, they all seem to thrive in the same places. In a general sense, mold can surface any place that is damp, dark and warm. This is often associated with the home, where mold is found in kitchens, crawl spaces, bathrooms, and dark basements. Dr. Kroker would call this category of mold, simply, composting mold. Composting molds also grow outdoors, in places like compost piles, rotting logs and leaf piles. One common composting mold is called aspergillus.

Another category is field mold, outdoor molds that blow through the air on nice, windy and sunny days. Outdoor molds, such as alternaria, grow best in the Midwest, due to the nature of the climate – frequent rain, temperate conditions, and the Mississippi River, which provides a verdant climate for hundreds of miles. Interestingly, alternaria can also survive in the desert, pushing that damp and dark cliché aside.

Symptoms of Mold Allergy

The prevalence of mold is a large issue for thousands of Americans due to its allergic tendencies. For some patients, it is challenging for doctors to come to the conclusion – this is a mold allergy – because the symptoms are very dependent on the patient and can look extremely different from one patient to the next. Additionally, each type of mold brings on different symptoms. For example, field molds are commonly responsible for aggravated asthma conditions, and perhaps eye itching and sneezing. Other types of molds, like composting molds, may bring on sinus pressure, aching, exhaustion or throat drainage. To complicate it further, Dr. Kroker states that, “In general, it’s rare to find a patient with just one mold allergy. It is common to see one mold being a lot worse than others.” One day a patient might experience one set of symptoms, and the next day another.

While indoor mold can grow year round, outdoor mold has a typical season that starts when the ground thaws and finally declines in the late fall after a few frosts. Dr. Kroker says that, “people have a long season of exposure. Because of it, and because of the inflammation the mold can cause in the sinuses, one of the common complications we’ll see is chronic sinus infections.” He explains that the most common complication for those with mold allergies, on top of the usual symptoms, is frequent infections, another tipping factor that a patient may have a mold allergy. Studies indicate that the majority of chronic sinusitis cases (roughly 80%) are triggered by mold colonizing in the sinus cavity. Surgical interventions on their own typically provide only temporary relief – treating the underlying allergic issue is critical to better long-term outcomes.

Diagnosis and Treatment

The first step in treating the allergy is diagnosing it and skin testing to molds can be very helpful in this regard. Reactions on skin testing to molds are not always immediate if someone is allergic to them as sometimes the reaction is delayed and the skin test takes a day or two to fully develop. For example, a patient may be exposed to mold on Monday but not feel the effects until Friday, which Dr. Kroker referred to as delayed reaction. These reactions are not seen on an immediate, in-clinic skin test. Dr. Kroker says that, “(Diagnosis) is missed because many allergists just look for the immediate reaction to mold and don’t look for the delayed reaction.” Allergy Associates of La Crosse and the La Crosse Method Protocol helps uncover delayed mold allergies by having patients complete in-clinic skin testing and reporting delayed reactions by examining the test site the next day and also at 48 hours, waiting for a reaction. “It’s not that the delayed reaction is more important, it’s that they’re both important,” he explains.

As for treatment, Dr. Kroker says there are three options. With any sort of allergy, you only have three choices:
  1. Avoid the allergen.
  2. Take medicine for the allergen to address symptoms temporarily.
  3. Take immunotherapy for the allergen to build long-term tolerance.

“Those are the same three choices for a lot of things in medicine,” continues Dr. Kroker. “If you have a bad knee, your choice is 1: avoid walking, using a crutch. Choice 2: take a pain medicine. Or, choice 3: have surgery. You would opt for the latter, even though it’s arduous and it takes time, because you really want to restore function.”

Dr. Kroker advocates for sublingual immunotherapy (SLIT) because, as explained in terms of knee surgery, it is the only option to get a patient healed and back to walking on two feet again. Sublingual immunotherapy is designed to get patients further exposed to mold, so that when they are exposed naturally, they are able to tolerate it and experience fewer or no symptoms. He also explains that SLIT treats both immediate and delayed reactions to mold, whereas other forms of immunotherapy only treat immediate reactions. The La Crosse Method Protocol, which is advocated by Allergychoices, treats the specific molds at very precise levels that are custom to each patient, providing an added measure of safety.

Avoiding Mold

Of course, there are ways to combat mold, too. When indoors, be sure to keep windows shut and run an air conditioner regularly. Dr. Kroker suggests leaving the relative humidity at around 40-45% as any higher leaves room for mold growth. When spending time outdoors, make sure to shower, change clothes and use a little saline irrigation in your nose. He says, “You carry mold in your hair and your clothes, so you want to get rid of that and not be carrying it around all day.”