Lisa Lusk, now 47, first met with the Roanoke-based osteopath more than two years ago. At the time, Lusk lived with her husband and two children in a house on Avenham Avenue in Roanoke. The family since has abandoned the home, which has an assessed value of $442,700, because of mold.
“We fled,” she said. “We spent our retirement to go into the new home.”
Lusk said her health steadily had been deteriorating and her quest for answers and treatments — both mainstream and alternative — had yielded no answers and no relief.
“I thought I was dying,” she said. “There were so many symptoms. I was having such joint pain, chronic sinus problems, very bad headaches and dizziness. I was getting to the point where I could not walk. It was severe exhaustion.”
Lusk said she worried she might have multiple sclerosis or another potentially debilitating disease.
“It felt like a gigantic physical breakdown,” she said. “I really thought I was going to become an old lady in a wheelchair.”
Some people believe with unwavering conviction that the mold in their homes has waged against them a silent, insidious biological warfare.
They report symptoms ranging from respiratory distress to depression, from joint pain to chronic exhaustion.
Yet many others, including a Roanoke man who blames “mold hysteria” for the ruination of his marriage, express skepticism with equal conviction.
The debate about indoor mold has received renewed attention in the wake of catastrophic flooding in North Carolina this fall tied to Hurricane Matthew. A related article by North Carolina State professor Sarah Kirby noted, “Once flood waters recede, it is essential to take steps to prevent mold growth.”
Separately, in early August, the town council in Elkton, Virginia, voted during an emergency meeting to temporarily close the town’s historic municipal building because of mold found after a burst pipe flooded its basement.
A few of the region’s believers and doubters interviewed for this story displayed one common characteristic: They voiced a reluctance to share their often wrenching stories publicly.
They said the debate about mold as a health menace remains divisive enough to cause or worsen rifts with friends or relatives, stoke teasing of their children or turn away customers from their businesses.
Lusk and Roanoke native Courtney Hladky, 45, were willing to be named and quoted to share their stories of recovery.
“I’m at a beginning of a path where I feel it is my obligation to help others,” Lusk said.
Both say two regional physicians whose specialties include the treatment of mold biotoxin disease have saved their lives.
Hladky for years endured symptoms that she says mainstream medicine failed to address.
“I suffered from constant migraines, debilitating fatigue, insomnia, brain fog, memory issues, shortness of breath and facial flushing, among other symptoms,” Hladky said.
She sought help in the Richmond area from two general practitioners, an endocrinologist, a rheumatologist and a chiropractor before her mother learned about the Lexington practice of Dr. Cathryn Harbor.
Hladky and Harbor first met in September 2013.
“Before I had my appointment with her, I literally thought I was not going to make it,” Hladky said. “It was so very frightening, so she was a godsend when I had no hope.”
The facts on mold
The U.S. Environmental Protection Agency notes that molds are part of the natural environment and can be found both indoors and outdoors. The EPA notes: “Mold is not usually a problem, unless it begins growing indoors. The best way to control mold growth is to control moisture.”
Molds can produce allergens; some molds also produce potentially toxic substances known as mycotoxins, the EPA reports.
Ritchie Shoemaker, a Maryland-based physician and author renowned in some circles for his focus on mold, suggests that mold illness is an acute and chronic, systemic inflammatory response syndrome that can develop after exposure to “toxigenic organisms” that can reside inside water-damaged buildings.
Those troublesome organisms can include indoor molds such as cladosporium, stachybotrys, alternaria, penicillium or aspergillus, he said.
Similarly, the World Health Organization’s 2009 Guidelines for Indoor Air Quality reported that excess moisture “on almost all indoor materials” can foster the growth of mold, fungi and bacteria and related effects on indoor air that can affect health.
The Centers for Disease Control and Prevention advises that mold can cause respiratory infections and worsen illnesses such as asthma. But there is no conclusive evidence that indoor mold is associated with a multitude of other health problems, such as pulmonary hemorrhage, memory loss and lack of energy, the agency’s website says.
Dr. Thomas Kerkering, chief of the infectious disease department at Carilion Clinic, noted that there is no scientific evidence that mold causes anything other than allergic reactions and respiratory syndromes.
“In terms of all the other things that are attributed to it, that’s probably because we have nothing else to attribute them to,” Kerkering said.
David Straus, a retired professor of immunology and molecular microbiology at Texas Tech University Health Sciences Center, said Stachybotrys chartarum, a type of black mold, produces mycotoxins that are considered biological warfare weapons by the U.S. Army. He said he believes mold might be a factor in reactions or illnesses above and beyond those identified by the CDC.
“There are many different mycotoxins produced by fungi, some of which we have not discovered yet, so these things are possible,” Straus said. “So, I would say we don’t know all the things these mycotoxins can do.”
Straus said he personally experienced physical reactions he ascribed to fungi inside a notoriously mold-filled home in Dripping Springs, Texas. He later told The New York Times, “Walking into that house was one of the biggest mistakes I ever made,” noting in the 2001 article that he was not wearing gear to protect himself from biotoxins.
Straus ended up sprawled for about four hours in a truck outside the house, the newspaper reported, “crawling out only to vomit.”
Wayne Gordon, a professor and vice chairman of the Department of Rehabilitation Medicine at the Icahn School of Medicine at Mount Sinai in New York City, said mold exposure can be associated with cognitive impairment that can range from minor memory loss to debilitating cognitive failure.
Asked whether his conclusions were based on research or seeing patients, Gordon responded: “Both.”
‘I had no hope’
Lusk said she initially resisted when advised by friends to consult Dr. Janine Talty, an osteopath seen by some people as an unconventional practitioner. Lusk said she had tried everything, ranging from mainstream allergy treatments to acupuncture, and was skeptical.
Talty immediately suspected Lusk had been exposed to water-damaged buildings and mold. It turned out that both Lusk’s home and the building she leased for her business had sustained water damage. Each harbored mold at high levels, Lusk said.
Lusk’s daughter, now 12, had begun to complain of fatigue and exhibited other symptoms the family thought were likely mold-related.
Lusk’s husband, Rob, and their son were symptom-free, a reality she said seems to fit a pattern identified by Shoemaker, Talty, Harbor and others.
In his book, “Surviving Mold,” Shoemaker writes: “The truth is that while the substantial majority are not permanently harmed by mold, plenty of people are — about 25 percent.”
He also writes, “As today’s mold and other pathogens in water-damaged buildings evolve, more of us or our children may become victims due to our own genetic make-up.”
David Bailey, a Richmond-based lawyer whose environmental law practice includes a specialty in mold-related lawsuits, said some people seem to be more sensitive to mold than others. That scenario can cause friction in a household when one person is sick and a spouse is not, and the well person expresses skepticism about mold being the culprit, he said.
“I have a lot of mold cases that end up in divorce,” Bailey said.
Chris, 48, said his marriage ended after his wife moved out of the family’s Roanoke home on the advice of her physician, who had attributed the woman’s varied symptoms to mold. The Roanoke Times could not reach Chris’ ex-wife for comment and is not reporting his last name.
Chris said he believes that many middle-aged women experiencing symptoms with no clear cause might embrace any diagnosis that seems to explain their symptoms. He contends “mold biotoxin disease” is a scam and a sham designed to enrich physicians.
Talty, who was involved in treating Chris’ former wife, said she could not provide specific comments because of patient confidentiality. But she said lab work supported the diagnosis of mold biotoxin disease, which Talty cited in a letter to the owner of the house the couple once shared in Roanoke.
Talty said it was a diagnosis, not a neurosis. She said Shoemaker has suggested that women can be more susceptible to mold biotoxin disease due to hormonal shifts, especially around pregnancy and menopause.
Chris said testing of the house failed to demonstrate a significant presence of mold. Yet he noted that Talty wrote a letter declaring that the home “has been found to contain a large amount of toxic mold species that are known to cause illness.”
Talty’s letter of March 2015 noted that a variety of symptoms indicated Chris’ wife suffered from “severe Mold Biotoxin Disease.”
Roughly a decade earlier, Drs. Christopher Chang and M. Eric Gershwin published a paper titled “Mold hysteria: Origin of the hoax” in the journal Clinical & Developmental Immunology.
Chang and Gershwin, both specialists in immunology and allergy with the University of California at Davis School of Medicine, expressed skepticism about toxic mold syndrome. They wrote that there were “currently no studies proving that toxins released by black mold cause the constellation of symptoms commonly described by patients claiming to have ‘toxic mold syndrome.’”
Chang and Gershwin wrote, “In no cases is the data convincing. The data is filled with exaggerations and half-truths.”
Neither doctor responded when attempts were made to contact them to see whether their views have changed since 2005.
The mold doctors
Harbor, 56, whose office is in Lexington, and Talty, 54, whose practice is in Roanoke, already were considered by some in mainstream medicine as outliers for their aggressive treatment of Lyme disease. Patients have come from near and far for treatment of symptoms conventional medicine seemed unable or unwilling to address.
“It’s remarkable how far people will come just to have someone listen carefully and not dismiss their symptoms as psychosomatic,” Harbor said.
Separately, the doctors noticed that some of their Lyme patients weren’t getting better.
Then Harbor happened to hear part of a presentation about mold-related illness by Shoemaker at a medical conference. She said Shoemaker’s description of a cluster of symptoms fit the profile of many of her patients who had failed to respond to treatments for Lyme disease.
Talty said Harbor made the connection with mold and patients not responding to Lyme disease treatments before she did.
“I am a complete doubting Thomas,” Talty said. “I am like the most skeptical person in the world until I see it working with my own eyes.”
Ultimately, both Harbor and Talty began to incorporate testing suggested by Shoemaker to identify patients for whom mold might be a contributor to what has been described as chronic inflammatory response syndrome, or CIRS.
Dr. Dale Bredesen, a neurologist with the Easton Center for Alzheimer’s Disease Research at the University of California, Los Angeles, has written that the most common cause of CIRS is exposure to mycotoxins, typically associated with molds such as Stachybotrys, in water-damaged buildings.
Bredesen said CIRS also can be associated with Lyme disease or other tick-borne pathogens.
Harbor said it is often challenging to identify all the factors causing CIRS.
“Usually, when a person is suffering with chronic health issues, the answer is not mold, the answer is not Lyme and the answer is not gluten,” she said.
“The answer is complex and unique to the person who is suffering,” Harbor said. “That person’s suffering can’t be dismissed as psychological until we consider the many complex factors genetic and environmental that might trigger and fuel it.”
Mold, tick-borne diseases and poor diet “can each be very inflaming and need to be considered as part of the puzzle,” she said.
Treatments can range from the use of cholestyramine, a cholesterol drug which is said to bind biotoxins in the small intestine to help eliminate them from the body, to the inhalation of myrrh, an essential oil.
But Shoemaker, Harbor, Talty and others say treatment won’t be effective as long as a person continues to be exposed to indoor mold.
The Lusks moved into a new home that a company had inspected for mold and cleared. Lisa Lusk continued to experience symptoms. Later, mold was discovered, she said, in the home’s HVAC system. A remediation company responded. And, Lusk said, her health began to improve.
Construction of housing after World War II and during the decades that followed emphasized features that ended up being mold friendly. They included more bathrooms and more plumbing, boosting the potential for leaks and water damage. Basements became more popular, as did air conditioning and, for a sustained period, wall-to-wall carpeting. As buildings became more airtight, the reduced circulation of fresh air increased condensation.
“Instead of open windows and doors, we closed everything up and put in an HVAC unit,” said Bailey.
Heating, ventilation and air conditioning systems required duct work throughout the house and the ducts collected condensation, he said, and helped spread mold spores once the mold began to grow.
Then came paper-faced drywall, described by Bailey as the perfect food for mold. According to Building Science Corp., a Massachusetts-based building technology consulting and architecture firm, the food that mold likes best is cellulose — “the more processed the better. Mold really likes wet paper. It kind of likes wet wood, but not as much as it likes wet paper. It likes processed wood better than it likes real wood.”
Building Science Corp. advises: “Mold is the result of a water problem. Fix the water problem. Clean up the mold. And you have fixed the mold problem.”
The cleanup seems to be the trickiest and potentially most expensive part of ridding a house of mold that could cause health problems.
Straus, the microbiologist, was asked what he would do if he discovered a significant amount of mold in his home.
“This is very easy to answer,” Straus said. “First, I would find the source of the water leak and correct it. And, second, I would replace all the building material with mold growing on it with clean building material.”
Easy to answer but not necessarily easy to accomplish. Remedies for indoor mold can cost tens of thousands of dollars — which can put such work out of reach for many families who also cannot afford to move.
Virginia law briefly required licensure for mold inspectors and mold remediators. It took effect July 1, 2011, but was repealed the following year by the General Assembly as recommended by then-Gov. Bob McDonnell’s Reform & Restructuring Commission.
Del. Danny Marshall, R-Danville, introduced the licensing legislation in 2009 after learning of an incident in North Carolina involving a mold remediator performing unsatisfactory work for a neighbor of Marshall’s daughter.
Marshall said he was under the impression that one reason the governor’s commission recommended repeal of the licensing for mold regulations was that few people or businesses sought licensure. Mary Broz-Vaughan, a spokeswoman for the Virginia Department of Professional and Occupational Regulation, said 484 people obtained licenses as mold remediators and inspectors during the law’s brief life.
Marshall said people looking to hire mold inspectors or remediators should take a “buyer beware” approach.
“We can’t regulate everything,” he said.
Peter Palmer, 60, an indoor air quality inspector who helped develop the state’s licensing standards for mold inspectors and remediators, said the measures weren’t perfect but could have been tweaked if the law had not been repealed.
“There are a lot of people who claim they are mold remediators but only a few who really are,” said Palmer, who’s based near Staunton. “That’s why I think we need licensure.”
Quinn Mongan, who co-owns the regional Servpro franchise, agrees. The company’s services include mold remediation.
He said he spent about $8,000 to train his employees so they could be licensed as mold remediation workers in Virginia before legislators repealed the law.
“It’s crazy out here, with no regulations, no standards,” Mongan said, noting that consumers sometimes get fleeced.
Julie Wheeler, president and CEO of the Roanoke-based Better Business Bureau of Western Virginia, said the bureau’s database of current inspectors and remediation firms lists no complaints.
In 2011, the bureau issued an advisory about a company that advertised services for cleaning duct work for HVAC systems. The company would inform customers they’d found mold in their home’s ducts, using “reportedly bogus mold detection tests,” and then offer estimates for remediation that totaled thousands of dollars, Wheeler said.
Given that legitimate mold remediation by reputable companies can cost thousands of dollars, the bureau recommends getting a second opinion. Wheeler said people should do research before they hire a mold inspector or remediator and school themselves to ask informed questions.
Meanwhile, homeowners and businesses should be prepared to pay for the first step in the process: mold inspections.
Palmer charges an hourly rate of $120. Mongan said Servpro charges $125 for a visual inspection for mold. That fee is applied to the cost of any remediation if mold is found and the customer hires Servpro to do the work.
Mongan emphasized that Servpro does not perform testing to confirm the presence and species of mold. Instead, the company leaves that work to mold inspectors and the labs they use. To do otherwise, he said, would leave the fox guarding the hen house.
Greg Whitt, 51, manages industrial hygiene and environmental services in the Roanoke region for Lynchburg-based Hurt and Proffitt. He performs moisture and mold assessments for commercial and residential customers.
Whitt said the company’s inspection fees typically range from $500 to $1,200, with the variation reflecting the extent and complexity of the work required. For example, he said, a house might harbor mold that visual inspection and modest sampling methods fail to detect.
A real life-saver
Whitt has conducted mold and moisture assessments for about 14 years. It said it is clear to him that water-damaged buildings harboring mold can cause respiratory problems.
“Mold is a real health concern and there are plenty of adults and children being affected,” he said. “Some have no clue why their 10-year-old is on breathing treatments and, from what I see, some doctors are missing the mold factor.”
Low-income families in rundown rental housing can be especially vulnerable, he said.
Whitt said it is less clear-cut to him whether mold can cause cognitive decline and other serious medical conditions or symptoms. But he said he admires Harbor and Talty for considering mold as a contributor to their patients’ medical problems.
“My hat’s off to them for looking,” he said. “They’re looking in a direction traditional medicine is not.”
Lisa Lusk needs no convincing. Mold nearly destroyed her life, she said. She credits her recovery to Talty.
“I owe her my life,” Lusk said.