What environmental medicine is
Environmental medicine looks at how the places we live and work, and the things we’re exposed to, affect our health. When symptoms persist despite “normal” labs and repeated appointments, an unrecognized exposure is one of the possibilities worth investigating.
Toxic burden rarely shows up on routine testing, and its effects can look like many other conditions: fatigue, brain fog, pain, sleep problems, digestive issues, mood changes, hormone disruption and sensitivity to foods, smells or chemicals.
Mold and mycotoxins
Water-damaged buildings can harbor mold and other microbes that release mycotoxins and inflammatory compounds into indoor air and dust. Leaks, flooding, condensation, crawl spaces and HVAC systems are common sources, and growth is often hidden inside walls, under floors or in ductwork.
Recovery from mold illness typically starts with the environment itself: identifying and addressing the source of exposure, often with the help of a qualified indoor environmental professional, before or alongside treatment.
More about mold illness and mycotoxins → · Free home checklist →
Heavy metals
Metals such as lead, mercury, arsenic and cadmium can accumulate from sources including older homes and pipes, certain foods and water supplies, occupational exposures and some consumer products. Assessment considers your exposure history together with appropriate testing, interpreted in context.
More about heavy metal toxicity →
Sewer gas and other environmental toxins
Dry drain traps, cracked plumbing vents and failing seals can let sewer gas into a home, an exposure that’s easy to miss. Other environmental chemicals, from solvents to combustion byproducts, can also add to the body’s overall burden.
More about sewer gas exposure →
CIRS and MCAS
Chronic Inflammatory Response Syndrome (CIRS) is a diagnostic framework that conventional medicine doesn’t yet recognize. It describes a group of symptoms making up a chronic illness in people affected by water-damaged buildings, including mold, actinomycetes and endotoxins.
Mast Cell Activation Syndrome (MCAS) involves mast cells releasing chemical mediators too readily, which can cause symptoms across many systems, such as flushing, hives, digestive upset, rapid heartbeat and reactions to foods, scents or chemicals.
The two can overlap, often alongside mold illness. Your symptoms are real, and people living with them deserve to be believed and to have a careful, patient approach rather than a quick fix.
More about CIRS → · More about MCAS →
How Dr. Madeira helps
With 14 years of clinical experience, Dr. Madeira follows the naturopathic therapeutic order: start by identifying and removing obstacles to health, then support the body’s natural ability to heal.
- A detailed health and exposure history, including your home and work environments
- Review of your previous records and labs
- Targeted testing where it adds useful information
- Guidance on reducing ongoing exposure
- Botanical medicine, personalized nutritional medicine, detoxification therapies and mindfulness practices, with other therapies added only as needed
- Coordination with other professionals when your situation calls for it
Are you a mold inspector or indoor environmental professional? See how Dr. Madeira works with inspectors. Physicians and practitioners can refer a patient here.
Common questions about environmental medicine
What does an environmental medicine doctor do?
An environmental medicine doctor looks at how your home, workplace, food, water and air may be affecting your health. That starts with a detailed exposure history, then testing where it adds useful information, reducing the exposure, and supporting recovery.
What symptoms can environmental exposures cause?
It depends on the exposure. Common concerns include fatigue, brain fog, headaches, breathing and sinus problems, pain, sleep trouble, digestive issues and sensitivity to foods, smells or chemicals. All of these have other possible causes too, so an individual assessment matters.
How can I tell if my home is affecting my health?
Notice whether your symptoms ease after several days away and return when you’re back, and look for musty smells, water damage or sewage odors. The free mold and toxin checklist walks you through your home step by step.
Can environmental medicine be done by telemedicine?
Yes. Your history, record review, lab planning and treatment plan all work by secure video or phone, and labs can be completed locally. Dr. Madeira sees adults who live in Arizona, Montana or Washington and are in one of those states during their visits.
This page is general education, not medical advice. Whether an environmental exposure is contributing to your symptoms can only be assessed individually.
Sources
- Dr. Ritchie Shoemaker, MD: Surviving Mold: Life in the Era of Dangerous Buildings (Otter Bay Books, 2010), and Mold Warriors (Gateway Press, 2005)
- Dr. Ritchie Shoemaker, MD, Surviving Mold: Diagnosing CIRS (definition of CIRS and the organisms and inflammagens found in water-damaged buildings)
- Indoor Environmental Professionals Panel of Surviving Mold (2016): Consensus statement on medically sound investigation and remediation of water-damaged buildings in cases of CIRS-WDB
- Dr. Neil Nathan, MD: Toxic: Heal Your Body from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness (Victory Belt Publishing, 2nd edition, 2025)
- Dr. Jill Crista, ND: Break the Mold: 5 Tools to Conquer Mold and Take Back Your Health (Wellness Ink Publishing, 2018)
- EPA: Introduction to Indoor Air Quality
- CDC: Mold
- NIEHS: Lead
- ATSDR (CDC): ToxFAQs for Hydrogen Sulfide