Abstract
Environmental medicine is an often-overlooked area of focus when approaching complex, chronically ill patient presentations. This case involves a 64-year-old female who presented to the National University of Natural Medicine teaching clinic with long term complaints of fatigue, brain fog, chronic sinusitis, and gastrointestinal disturbances including small intestine bacterial overgrowth of unknown origin. Both previously completed and newly obtained laboratory evaluation revealed extensive hormonal and gastrointestinal imbalances; the patient was recommended targeted treatments for each separate diagnosis without notable improvements. Upon an ND student's thorough review of the patient's history, it was gathered that she had a long-time exposure to mold and mycotoxins in her home that was verified with testing and ultimately required remediation. The role of mycotoxins in chronic and systemic illness has gained increasing notoriety due to multiple mechanisms and effects on host systems. This report focuses on their role in chronic illness and ways to approach their resolution with a comprehensive approach beyond the use of gastrointestinal binders, as well as highlighting the often-long recovery timeline in these complex cases.
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