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Chronic sinus problems are present in 10 to 15% of the child and adult population in the USA. About 200,000 sinus surgeries are performed annually in the USA. Sinus problems are often related to growth of molds (fungi) in the nasal passages and/or to exposure to high levels of indoor molds. 


Donald Dennis, David Robertson, Luke Curtis, and Judson Black. Fungal exposure endocrinopathy in sinusitis with growth hormone deficiency: The Dennis-Robertson Syndrome. Toxicology and Industrial Health 2009;25:669-680.

Various studies of chronic sinus patients report growth of mold and/or mold fragments found in the sinus mucous in 75% to 100% of all chronic sinusitis patients. Chronic sinusitis patients often experience chronic fatigue, asthma, and many other chronic health problems.

A retrospective study was conducted on 79 consecutive patients (30-77 years old) with chronic sinus problems, chronic fatigue, and history of significant indoor mold exposure. All of these patients had high levels of indoor mold on settle plates (more than 4 colonies). Testing for pituitary hormones revealed that 40 of these patients (51%) were deficient in growth hormone, 64 patients (81%) were deficient in thyroid hormone, and 59 (75%) were deficient in adrenocorticotrophic hormone (ACTH). These pituitary hormone level deficiencies are quite high, as growth hormone is deficient in about 1.6% of USA adults and thyroid hormone is severely deficient in about 1 to 2% of USA adults. Deficiencies of growth hormone, thyroid hormone, and ACTH can cause many health problems including chronic fatigue, reduced memory and concentration, depression, reduced immunity, and loss of muscle and bone mass.

The patients were treated with a multi-faceted treatment regime included saline (salt) nasal sprays, antifungal and antibiotic nasal sprays, oral antibiotics and antifungal drugs, vitamin supplements, and hormone replacement when indicated. Patients were also urged to remediate the mold and water problems in their home or workplace. Resolution of chronic sinusitis patients was seen in 93% (41 of 45) patients who were able to reduce their indoor mold exposure (to 4 of fewer colonies per settle plate), with most of these patients also experiencing resolution of chronic fatigue as well. Resolution of chronic sinus problems was only seen in about 50% (17 of 34) patients who were not able to reduce their indoor mold exposures. Fatigue was also significantly reduced in all 37 patients treated with growth hormone, cortisol, and/or thyroid hormones.

This study suggests that mold related sinusitis may be a major cause of both growth hormone and thyroid hormone deficiency. The exact mechanism in which mold and mycotoxin exposure can damage the pituitary gland is not known. One hypothesis is that the lenticulostellate cells of the anterior pituitary gland bind to the fungal cell walls, activate the innate immune system, and stimulate macrophages (white blood cells) which destroy both the fungi and the pituitary gland. The damage to the pituitary gland can then significantly reduce production of both growth hormone and thyroid hormone.





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