Unraveling the Complexities of Lyme Disease and Mold Toxicity: Insights from Dr. Steven Bock

With similar symptoms, such as brain fog, muscle pains, and flu-like symptoms, it can be easy to confuse Lyme Disease and the body’s response to mold toxins. While there can be a co-infection of the two, it is important to differentiate and properly diagnose the symptoms to best treat the issues at hand

“Lyme disease is a chronic infection that creates an inflammatory and immune response. Mold toxins or immunogenic toxic chemical components can affect the body in different ways,” Dr. Steven Bock, an integrative Lyme specialist explained.

“The way [mold toxins] affect the body includes inflammation. That can cause brain fog, dizziness, visual problems, and respiratory problems. It also can cause muscle aches, flu-like symptoms, and fatigue. Lyme is very similar, with less respiratory symptoms. Lyme causes brain fog, fatigue, muscle pains, flu-like symptoms, and many signs of chronic inflammation.” Lyme and mold toxins are both bad for the immune system and they are both detoxified through the same pathways in the body.

With the similarity in symptoms, Dr. Bock states the main difference is clinical. To best differentiate and properly diagnose, it is important to go over the patient’s history. In over 50% of Lyme cases, there is no tick bite and no bullseye rash. Therefore questions to be asked include: Does that patient have a dog? Does the patient hike? Do members of their family have Lyme Disease and if so what are their symptoms? It is also important to take into consideration the time of year. Is it between May and late fall? If one believes it is Lyme disease then the patient would need testing and to be treated with antibiotics.

However, if the patient believes mold is the cause of their symptoms, history is examined and questions are asked such as: What house have you lived in? Do you have a wet basement? Do you smell anything in any area? Has there been a flood? Are there leaks in any rooms? Is there  black mold in the bedroom? Do you have chronic sinus infections?

After a thorough look at the patient’s history, a visual contrast sensitivity test can be taken. This test can be done online, where the person taking it can set up the computer with certain lighting and answer questions on light perception.

“Mold toxins are very sensitive on the optic nerve, so if you receive a positive on that test, you are assuming that there are neurotoxins. You can then have tests done, like blood tests, to see if there is inflammation. But when you think there are neurotoxins from Lyme or mycotoxins, I can do tests that show cytokine balance.” Dr. Bock explained. “When testing for Lyme, an antibody test would be done; alongside an immunoblot test which can test for Lyme plus co-infections such as Bartonella, mycoplasma, and other viruses.”

“You have to first assess clinically, see what you think could be the cause. Is it Lyme alone? Is it mold alone? Is it both? Does the person have a lot of neurological problems? The second step is a regular MRI for Lyme. For mold, we do a Quant Brain MRI, which is a special program on top of an MRI that can show there is a tremendous diminution of certain areas in the brain like the hippocampus,” Dr. Bock explained.

“You always have to look at the whole picture.”

As Dr. Bock explained, mold creates neurotoxins. When someone has a mold problem, it is important to differentiate what happens when you have a mold allergy, which is different from most toxicity. “Mold allergy is an immune response, generally in sinuses and upper respiratory. However, with Lyme, mycotoxins are produced.”

Like anything with Lyme, if there is a previous or underlying condition, mold will make symptoms either worse or make it harder to treat. Treatment can also depend on the patient. “Some believe you have to treat mold before Lyme. Sometimes I am treating both. Sometimes I'll treat the Lyme and then all of a sudden they will manifest other symptoms that are coming out in their environment because now their immune system has been a little bit cleared. But now they have to take care of the mold,” according to Dr. Bock.

“For instance, I had a patient who I treated for Lyme and did relatively well. Then she started having these symptoms. I diagnosed her with mold toxicity with mold toxins. I treated her for the mycotoxins, she got better. Just recently, she started having symptoms again. I asked what's going on and it turned out that there were other mold problems. This time she'd been back to work. She said, ‘I'm sick most of the time when I go to work and on the weekends, I'm alright.’ She found out that there was a really bad mold problem at work since she was exposed to mold again. If someone had a mold problem, their body can be weakened because it's already been weak on that particular immune problem.”

There are mold allergies and mold toxicity, which are different, however, they can coexist. As mentioned, it is important to look at the person’s history. “Take a history, see if it's more localized. If symptoms are in the nose, see if the patient has sinus problems, past bronchitis, and things like that which are very localized. Then you do testing on them. You do either a blood test or you do intradermal testing on the skin. If they're positive for mold, and you've diagnosed that it's mold, respiratory allergy, then you could treat them with antihistamine,” explained Dr. Bock.

When you think that it's the mycotoxin problem, you can get a urine analysis. The urine will show the metabolites have the breakdown products of the mold in the urine. If those are positive, then you make a clinical diagnosis that they're reactive to mold toxins. And then what you have to do is give them a certain kind of diet, we usually put them on a very low sugar or low amylose diet.

The reason mold and Lyme are often associated with one another is due to their insults to the immune system, not that one directly leads to the other. However, when someone has had Lyme, the person may be more susceptive to problems from something like mold and mycotoxins, due to the weakened immune system. 

Those with a weakened immune system need to pay extra attention to their environment. If the mold in a household gets bad, it is essential to remove yourself from the household while it is being handled. If the residents decide to move homes to get away from the mold, they may need to buy new furniture and clothing to best ensure they are not bringing the mold with them into their new home. To treat mold, the residents can have a professional come in to clean the mold, then the patients can be treated with binders. According to Dr. Bock, in about 20 - 25% of cases the person needs to leave their home, but the majority can stay and close off the area where the mold is present.

To best protect yourself from mold, vigilance is required. If the residents know they have mold in their house it is important to take care of it right away. Similarly, if there is a leak or a build-up of water, it is important to not ignore that to best prevent mold. “They can't dismiss a leak, that all of the sudden can cause more growth. They have to watch for any odors that are in the basement, they have used humidifiers, maybe air cleaners, things like that. So with mold, the most important part is prevention,” said Dr. Bock.

For more information and to hear the whole interview, visit the Lyme Advise Youtube channel.