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Each patient completed a questionnaire previously utilized by several groups [6, 16, 17], including ours [18], which also let specifically trained nurses know individual injection sites, where skin lesions were then looked for, according to a structured protocol

Elshorbagy AK, Nurk E, Gjesdal CG, Tell GS, Ueland PM, Nygard O, et al

10.1183/13993003.02146-2015 134 TiberiS.SotgiuG.D'AmbrosioL.CentisR.ArbexM

Functional laboratory evaluation may include: Mycotoxin testing Inflammatory and immune markers Metabolic and mitochondrial indicators Gut and microbiome assessment Hormonal and stress-response evaluation Visual contrast sensitivity (VCS) testing (7) Functional markers commonly evaluated in suspected mold-associated CIRS include: Complement C4a Transforming Growth Factor Beta-1 (TGF-1) Matrix Metalloproteinase-9 (MMP-9) Vascular Endothelial Growth Factor (VEGF) Melanocyte-Stimulating Hormone (MSH) ACTH/cortisol patterns (2325) When interpreted alongside detailed environmental history and symptom patterns, these findings help clarify whether mold exposure is acting as a primary driver of illness