GAtherton

🏠 Awaab’s Law: What It Means for Social Housing Tenants

Awaab’s Law is one of the most important housing reforms in years.
It aims to protect tenants from damp, mould and unsafe living conditions — problems that can seriously affect health, especially for people with asthma, bronchiectasis or fungal lung disease.

The law starts to take effect in October 2025 and is named in memory of Awaab Ishak, a two-year-old who tragically died from prolonged exposure to damp and mould in a housing association flat in Rochdale.
His case led to new, legally enforceable time limits for social landlords to investigate and repair health hazards in rented homes.

📜 Where the Law Comes From

Awaab’s Law forms part of the Social Housing (Regulation) Act 2023.
It adds a new legal duty (Section 10A) to the Landlord and Tenant Act 1985, requiring every social landlord to comply with “prescribed requirements” about how quickly hazards must be investigated and repaired.

These rules are set out in the Awaab’s Law Regulations, published on GOV.UK, and enforced by the Regulator of Social Housing.

👥 Who the Law Covers

Awaab’s Law applies to:

  • Social landlords in England, such as housing associations and local authorities

  • Tenants living in social housing under secure, assured, or introductory tenancy agreements

Awaab’s Law does not yet apply to:

  • Private landlords or the private rented sector (PRS)

  • Owner-occupiers or leaseholders

The Government has confirmed that lessons from this law will inform future private-rented-sector reforms.
(Official source: GOV.UK – Awaab’s Law Guidance)

🏘️ What Is Social Housing?

Social housing is housing owned or managed by public or not-for-profit organisations and rented out at below-market rates to people in housing need.
It provides secure, long-term homes and is regulated by the Regulator of Social Housing.

(Official source: Regulator of Social Housing – GOV.UK)

🧱 Who Provides It

  • Local authorities (councils) – council housing

  • Housing associations – independent, not-for-profit registered providers

  • Charitable or community landlords – smaller providers that must still meet national standards

These organisations are known as registered providers under the Housing and Regeneration Act 2008.

💰 How Social Housing Differs from Other Tenancies

Feature Social Housing Private Rented Housing Shared Ownership / Leasehold
Who owns it Council / housing association Private landlord / company Part tenant part provider
Rent level Below market (50–80%) Market rate Rent on unsold share + mortgage
Tenancy type Secure / assured (long-term) Assured shorthold (short-term) Leasehold ownership
Regulation Regulator of Social Housing Local authority & housing law Leasehold law
Repair standards Decent Homes Standard + Awaab’s Law General HHSRS duties As defined in lease
Who qualifies Based on housing need Anyone meeting market criteria Specific financial criteria

⚙️ What Landlords Must Do Under Awaab’s Law

Social landlords must:

  1. Investigate reported hazards quickly

  2. Provide written findings after inspection

  3. Repair and make safe within legal deadlines

  4. Offer temporary accommodation if the home cannot be made safe in time

These duties cover damp and mould and any emergency hazard posing serious risk to health or safety.

🕒 Timeframes Landlords Must Follow

Stage Time Allowed Example
Emergency hazard Make safe immediately / within 24 hours Gas leak, severe mould, electrical fault
Significant hazard Investigate within 10 working days Damp, cold, structural issues
Tenant update Written summary within 3 working days Explain findings + repairs
If not safe in time Provide alternative accommodation Until repairs complete

(Source: GOV.UK – Draft Guidance)

💬 Why Mould and Damp Matter

Damp and mould are common and dangerous in UK housing and can worsen or trigger asthma, ABPA, CPA, and COPD.
The English Housing Survey (2023) found 1 in 10 social homes had damp or mould problems.

Mould exposure can cause:

  • Asthma flare-ups and new respiratory infections

  • Worsening of fungal lung disease

  • Eye, throat, and skin irritation

Awaab’s Law recognises that poor building design and ventilation, not “tenant lifestyle,” are usually to blame.

🏘️ Why Shared and Multiple-Occupancy Homes Are Higher Risk

Buildings converted into Houses in Multiple Occupation (HMOs) are prone to damp and mould because they:

  • House many people in small spaces

  • Were often converted without proper ventilation or insulation

  • Rely on multiple tenants to report and manage repairs

HMOs are mainly in the private rented sector and not covered by Awaab’s Law.
They are regulated separately under the Housing Act 2004 and inspected by councils using the Housing Health and Safety Rating System (HHSRS).

These homes frequently house students, low-income workers, and people with chronic illness, making damp-related respiratory illnesses a particular concern.

🧱 Why HMOs Need Stronger Oversight

Local authorities can issue Improvement Notices or prosecute landlords for neglecting repairs, but Awaab’s Law’s fixed deadlines do not yet apply.
Government statements indicate future reforms will extend similar protections to private and HMO tenants.

💬 Why This Matters for Health

For anyone with chronic lung disease (ABPA, CPA, asthma, bronchiectasis), damp and mould can trigger flare-ups and new infections.
Awaab’s Law now forces social landlords to act promptly within set legal time limits.

Tenants can:

  • Use the landlord’s complaints procedure

  • Contact the Housing Ombudsman Service

  • Report serious risks to the Regulator of Social Housing or local council

🏛️ Does Awaab’s Law Apply to MOD, NHS, and Other Service Housing?

No — not directly.
Awaab’s Law covers registered social housing providers in England (local authorities and housing associations).
It does not extend to housing owned or managed by the Ministry of Defence (MOD), NHS Trusts, or other public-service employers, unless they are formally registered social landlords (which is rare).

Housing Type Covered by Awaab’s Law? Notes
Council / Housing Association Homes ✅ Yes Registered providers under the Regulator of Social Housing
Private Rented Sector ❌ No (not yet) May be included in future reforms
MOD (Service Family Accommodation) ❌ No Managed by Defence Infrastructure Organisation; standards set by policy, not law
NHS Staff Accommodation ❌ No Governed by occupational licence terms and health & safety law
University or Key Worker Housing ❌ No Treated as private or institutional housing
Charitable / Supported Housing ⚠️ Sometimes Only if registered with the Regulator of Social Housing

These providers must still maintain safe conditions under Health and Safety law, but they do not yet have the same legal repair timescales as social landlords.
The Government has stated that principles from Awaab’s Law may be used to improve MOD and NHS housing standards in future.

(Sources: legislation.gov.uk, GOV.UK – Awaab’s Law Guidance, Parliament.uk HCWS423)

🧩 Summary

Key Point What It Means
Who it covers Tenants in social housing (England only)
What it covers Damp, mould, and serious health hazards
When it starts From 27 October 2025
Who it excludes Private, MOD, NHS and service housing
Why it matters Protects tenants from unsafe homes and poor health
Who enforces it Regulator of Social Housing / Local Authorities
Official sources GOV.UK / legislation.gov.uk / Parliament.uk

🔗 Official References

by GAtherton

🌿 Will My Body Start Making Cortisol Again After Long-Term Prednisolone?

Many people with Allergic Bronchopulmonary Aspergillosis (ABPA) take prednisolone (a corticosteroid) for long periods to control inflammation and prevent flare-ups.
A common concern is whether the body will ever start producing its own natural steroid hormone, cortisol, again after so many years of treatment.

💡 Why Cortisol Matters

Cortisol is a vital hormone made by your adrenal glands.
It helps your body manage stress, maintain healthy blood pressure, control inflammation, and balance energy levels.
Your brain normally regulates this through the HPA axis (Hypothalamus–Pituitary–Adrenal axis).

When you take prednisolone, your body senses there’s already enough steroid circulating, so your brain switches off the signal that tells the adrenals to make cortisol.
Over time, the adrenal glands can “go to sleep”.

⏳ After Long-Term Prednisolone Use

If you’ve taken prednisolone for months or years, your adrenal glands may not restart immediately — and sometimes not completely.
Recovery depends on several factors:

Factor How It Affects Recovery
Length of treatment The longer you’ve been on steroids, the slower recovery tends to be
Average daily dose Higher doses suppress the adrenal glands more strongly
Tapering speed A gradual, careful reduction helps the adrenals “wake up” again
Individual differences Some people recover in months, others may need lifelong steroid replacement (hydrocortisone tablets)

📅 What to Expect

  • After short courses (a few weeks), cortisol production usually returns quickly.

  • After many months or years, recovery can take months or even years.

  • Some people never regain full adrenal function and need lifelong replacement therapy.

Your specialist will usually assume your adrenal glands are suppressed until tests prove otherwise.

⚠️ Why Adrenal Suppression Is a Safety Concern

If your adrenal glands are not producing cortisol and you suddenly stop prednisolone, or become ill, have an accident, or need surgery, your body can’t produce the extra steroid it needs to handle stress.
This can cause a serious medical emergency called adrenal crisis, which may lead to low blood pressure, collapse, or shock if untreated.

That’s why it’s vital to:

  • Carry a Steroid Emergency Card or Medical Alert bracelet at all times

  • Tell healthcare staff (doctors, dentists, pharmacists, A&E teams) that you’re on or recently stopped steroids

  • Never miss a dose and never stop suddenly without medical advice

  • Use “stress-dose” steroids during illness, surgery, or injury as advised by your doctor

These simple precautions can be life-saving if your body can’t make enough cortisol during stress.

💨 What About Inhaled Steroids?

Many people with ABPA or asthma also use inhaled corticosteroids (such as fluticasone, budesonide, or beclometasone) in combination inhalers like Seretide, Symbicort, or Fostair.
These medicines mainly act in the lungs and only a small amount enters the bloodstream — but at high doses or with long-term use, they can still partly suppress the adrenal glands, especially when combined with oral steroids or certain antifungal medications.

Adrenal suppression is more likely if:

  • You use high-dose inhaled steroids for many months or years (e.g. fluticasone >500 µg/day)

  • You also take oral steroids (even at low doses)

  • You’re on antifungal medicines such as itraconazole, voriconazole, or posaconazole, which slow steroid breakdown

  • You are particularly sensitive to steroid effects

If suppression occurs, you might feel unusually tired, dizzy, or weak — especially when unwell or under stress.

Your doctor may test your morning cortisol or do a Synacthen test if there’s any concern.
In some cases, patients on high-dose inhaled therapy are also advised to carry a steroid card for safety, just like those on oral steroids.

The good news is that inhaled steroids are much safer than long-term oral prednisolone, and the risk of serious adrenal problems remains low when used correctly.

🧪 How Doctors Check for Recovery

Your respiratory or endocrine team may arrange:

  • Morning cortisol blood test (before your usual dose)

  • ACTH stimulation test (Synacthen test) – to see how well your adrenal glands respond

These tests help guide your doctors in determining whether your body is producing enough cortisol naturally or if you require a maintenance or replacement dose.

💊 Why Some Patients Move from Prednisolone to Hydrocortisone

If you’ve been on long-term prednisolone and your body is no longer making enough cortisol, your doctor may switch you to hydrocortisone.
Hydrocortisone is almost identical to the natural cortisol your body should produce.

Feature Prednisolone Hydrocortisone
Strength 4–5 times stronger than cortisol Matches the body’s natural cortisol
Duration of action Long-acting (12–36 hours) Short-acting (6–8 hours)
Typical use Controls inflammation during flares Replaces missing cortisol when adrenals are suppressed

Hydrocortisone is used as replacement therapy, not as an anti-inflammatory drug.
It’s given when your adrenal glands are “asleep” after long-term steroid use — or permanently if they no longer recover.

Doctors may switch to hydrocortisone if:

  • Tests show adrenal suppression (low morning cortisol or poor Synacthen test results)

  • You’ve finished tapering off prednisolone, but still feel unwell or fatigued

  • You have symptoms of adrenal insufficiency, such as dizziness, nausea, or low blood pressure

  • You need more precise stress dosing during illness or surgery

Hydrocortisone more closely mimics the body’s natural rhythm, usually taken two or three times a day, with an increased dose during illness or stress.

If you’re on hydrocortisone:

  • Carry a Steroid Emergency Card and make sure it’s visible to healthcare staff.

  • Never stop suddenly.

  • Increase (“double”) your dose when you’re ill or having surgery, as advised by your doctor.

  • Seek urgent medical help if you vomit and can’t keep tablets down — you may need an injection.

For many ABPA patients, hydrocortisone is temporary, helping to support the body until natural cortisol production recovers.
In others, especially after many years of prednisolone, it may become a lifelong replacement, which is safe and well managed under specialist supervision.

💉 The Future: Reducing Dependence on Prednisolone

The good news is that newer treatments called biologics are changing how ABPA is managed.
Biologics such as mepolizumab, benralizumab, dupilumab, and omalizumab target specific immune pathways involved in ABPA rather than suppressing the whole immune system.

For many patients, biologics:

  • Reduce or replace the need for long-term steroids

  • Lower the risk of adrenal suppression

  • Control symptoms more precisely, with fewer side effects

This means more people with ABPA may, in the future, safely taper off prednisolone and give their adrenal glands a chance to recover — always under close medical supervision.

🌤️ In Summary

After many years on prednisolone for ABPA, some people’s adrenal glands do recover, while others remain partially or fully dependent on replacement steroids.
Recovery is slow, varies between individuals, and must be guided by your specialist.
Be aware that both oral and inhaled steroids can suppress the adrenals if used long-term or at high doses.
Carrying a steroid emergency card and knowing what to do in an emergency is essential for safety — especially while your adrenals are still “waking up.”
With newer treatments like biologics and careful follow-up, the goal is to reduce steroid dependence and protect your long-term health.

by GAtherton

🧠 Can Aspergillosis Spread to the Brain?

You may have read headlines saying “Aspergillosis can spread to the brain and is one of the world’s deadliest fungal infections.”
That sounds frightening — but here’s what’s really known.

💬 The truth behind the headline

It’s true that the Aspergillus fungus can affect the brain, but this is very rare and happens only in people who are severely unwell or have very weak immune systems (for example, after chemotherapy, bone-marrow transplant, or very high-dose steroids for long peroids).

For most people with aspergillosis — whether allergic (ABPA) or chronic (CPA) — the infection stays in the lungs or sinuses. These forms do not usually spread to other parts of the body.

⚙️ How brain infection can happen

When it does occur, the fungus can reach the brain in two ways:

  1. Through the bloodstream — from an invasive infection in the lungs.

  2. By direct spread from the sinuses — through the bone between the sinuses and the brain.

These situations are very unusual and normally occur in patients whose immune defences are severely damaged.

📉 How common is it?

CNS (brain) aspergillosis makes up only a small fraction of all cases worldwide.
Even in high-risk hospital patients, it affects fewer than 1 in 10 people with invasive aspergillosis.
In people with allergic or chronic forms like ABPA or CPA, it’s almost unheard of.

❤️ What this means for you

If you have ABPA or CPA, the fungus in your lungs is not invading tissue in the same way.
It causes inflammation, allergy, or slow-growing cavities, but not deep invasion into blood vessels or brain tissue.
So, the risk of it spreading to the brain is extremely low.

Keep up with your usual care, medications, and check-ups — these control the lung disease and help prevent complications.

⚠️ When to seek medical advice

Contact your doctor urgently if you ever notice:

  • New or severe headaches

  • Changes in vision

  • Seizures or sudden weakness

  • Confusion or loss of balance

These symptoms are not common, but they’re always worth checking.

✅ Bottom line

The media headline is partly true — aspergillosis can reach the brain, but this happens almost only in people who are very immunocompromised.
For patients with ABPA or CPA, it is extremely rare and not something to fear day-to-day.

by GAtherton

🌧️ Damp Homes and Aspergillosis: Why This Matters

If you live with aspergillosis, asthma, or other chronic lung conditions, your home environment plays a vital role in how well you stay.
Dampness, mould, and poor ventilation allow fungi — including Aspergillus — to grow and release spores into the air. Breathing in these spores can irritate airways, trigger allergic reactions, or worsen infection risk.

That’s why the NAC CARES team has gathered the latest UK policy, research, and practical guidance on this issue — all now available on our new information hub:
👉 Damp Homes – UK Policy and Research

🏠 What’s New on the Aspergillosis.org Damp Homes Page

Over the past week, the NAC CARES team has published a series of new articles and updates that help you:

1. Understand the Health Risks

  • How damp and mould can worsen breathing symptoms or trigger flare-ups in conditions like Chronic Pulmonary Aspergillosis (CPA) and Allergic Bronchopulmonary Aspergillosis (ABPA).

  • Why people with weakened lungs or immune systems are especially at risk.

  • The hidden signs of mould exposure — condensation, musty odours, or discoloured walls — even when no visible black mould is seen.

2. Learn About Your Rights and What to Do

  • What to check if you rent your home and find damp or mould.

  • Step-by-step guidance on how to report problems, who is responsible for fixing them, and what help is available if landlords or councils don’t act.

  • Links to official UK guidance, including the Awaab’s Law updates, which strengthen tenants’ rights to safe housing.

3. Keep Up with the Latest Research and Policy

  • Summaries of recent UK housing and health studies connecting damp homes to respiratory illness.

  • Insights into national policy changes — including new housing safety standards and public health responses.

  • Easy-to-read summaries of scientific studies showing how mould affects airways and immune response in vulnerable patients.

🧰 How to Use the New Page

  1. Start with the main hub: Damp Homes – UK Policy and Research.
    This gathers all the latest NAC CARES articles, research links, and resources in one place.

  2. Explore by topic:

    • Health & Risk – what damp means for your lungs.

    • Practical Advice – how to spot and deal with mould.

    • Policy & Research – what the UK government and researchers are doing to address the problem.

  3. Take action:
    Use the linked materials when talking with your GP, local council, or housing officer. Having official NHS and government evidence can help you get faster results.

💬 Key Takeaways for Aspergillosis Patients

  • Keep your home dry, warm, and well-ventilated.

  • Report damp or mould promptly to landlords or housing providers — and keep written records.

  • If your symptoms worsen and you suspect environmental triggers, speak with your care team at NAC or your respiratory specialist.

  • Use the NAC CARES Damp Homes page as a trusted, evidence-based guide to understanding your risks and your rights.

 

by GAtherton

🌬️ Inhaled Antifungal Treatments for Chronic Pulmonary Aspergillosis (CPA)

Updated: October 2025

💡 Why are inhaled antifungals being developed?

For people living with Chronic Pulmonary Aspergillosis (CPA), treatment usually involves long courses of oral antifungal tablets such as itraconazole, voriconazole, or posaconazole.
These medicines circulate through the whole body to reach the lungs — but sometimes they cause side-effects, interact with other drugs, or fail to reach high enough levels in thick mucus, cavities, or scarred areas of lung tissue.

Inhaled antifungal therapy aims to solve this problem by delivering medicine directly to the lungs using a nebuliser or inhaler device.
This can potentially mean:

  • ✅ Higher drug levels exactly where infection is active

  • ⚡ Faster local action

  • 🚫 Fewer whole-body side-effects

  • 🧩 Fewer drug interactions

This approach is especially promising for patients with localized lung disease, such as CPA or aspergillus bronchitis, where the fungus lives in damaged parts of the lung.

💊 Current inhaled antifungal options (used off-label)

🧪 Nebulised Amphotericin B

At the moment, nebulised amphotericin B is the only inhaled antifungal used in hospitals, although it is off-label for CPA.

It is more commonly used to prevent infection in people who have had a lung transplant or who are severely immunocompromised.
In some specialist centres, it may be used as maintenance therapy or an add-on for CPA if other antifungals have not worked or cannot be tolerated.

Advantages

  • High concentration in lung tissue

  • Minimal effects on other organs (especially the kidneys)

Drawbacks

  • Possible airway irritation (cough, tight chest, wheezing)

  • Requires specialist supervision and appropriate nebuliser equipment

🔬 New treatments in development

💨 Opelconazole (also called PC-945)

Opelconazole is a new inhaled triazole antifungal developed by Pulmocide Ltd in the UK.
It works in the same way as existing azole antifungals — by blocking the fungal enzyme CYP51 — but has been specially designed to stay in the lungs and minimise side-effects elsewhere.

In laboratory and early human studies, opelconazole has shown:

  • Strong activity against Aspergillus fumigatus

  • High and lasting drug levels in the lungs

  • Very low blood levels (reducing risk of toxicity and drug interactions)

  • Good tolerability in early trials

Although not yet licensed, it has been used compassionately in small numbers of patients with difficult-to-treat lung aspergillosis at centres such as Manchester and London.

🧾 Current and recent clinical trials

Trial ID Treatment Condition Purpose / Summary Status
NCT06447402 Nebulised Amphotericin B vs Saline Chronic Pulmonary Aspergillosis Tests whether regular nebulised amphotericin can help prevent CPA relapse compared with saline. Recruiting
NCT03656081 Itraconazole ± Nebulised Liposomal Amphotericin B CPA Compares oral itraconazole alone versus itraconazole plus inhaled amphotericin for symptom and scan improvement. Completed – results pending
NCT05238116 Inhaled Opelconazole + Standard Therapy Refractory Invasive Pulmonary Aspergillosis Phase 3 trial evaluating safety and added benefit of inhaled opelconazole. UK, EU, and US sites. Recruiting
NCT05037851 Inhaled Opelconazole (PC-945) Post-Lung Transplant Prophylaxis Assesses prevention of fungal infection after transplant. Found well tolerated. Completed
PubMed 34058036 Nebulised Amphotericin B vs Oral Itraconazole Pulmonary Aspergilloma (CPA subset) Six-month open study found similar improvement rates between inhaled amphotericin and oral itraconazole. Completed

👉 You can look up any of these studies on ClinicalTrials.gov by entering the trial ID (e.g. NCT06447402).

⚠️ Things to keep in mind

  • Not yet routine — Inhaled antifungals are available only in research or specialist centres.

  • Limited evidence — Most data come from transplant or invasive aspergillosis studies, not chronic infection.

  • Delivery challenges — Damaged or scarred areas of lung may be hard for inhaled drugs to reach.

  • Possible side-effects — Coughing or mild bronchospasm are common; pre-treatment with an inhaler may help.

  • Monitoring still needed — Even with inhaled therapy, your care team will continue to check symptoms, lung scans, and blood markers (such as Aspergillus IgG).

🧭 Questions to ask your specialist

If you are interested in this type of therapy, you could ask:

  • Does my centre offer nebulised amphotericin as part of CPA care?

  • Are there any clinical trials nearby (for example NCT06447402 or NCT05238116)?

  • Could an inhaled antifungal be used with my current oral treatment?

  • What are the side-effects and how are they monitored?

  • What nebuliser device is required and how often would I use it?

🏥 UK research centres involved

Current UK involvement is mainly through:

  • National Aspergillosis Centre, Wythenshawe Hospital (Manchester)

  • Royal Brompton and Harefield Hospitals (London)

  • UK transplant centres participating in Pulmocide’s opelconazole studies

🗝️ Key takeaway

Inhaled antifungal medicines are an exciting development that could make CPA treatment safer and more targeted in the future.
For now, they are mainly available through clinical trials or specialist centres, but the early results are promising — especially for those who have struggled with oral antifungal side-effects or limited success.

If you’re interested, speak to your CPA specialist or the National Aspergillosis Centre team about ongoing research and eligibility.

by GAtherton

Damp, Mould and Health: Be Careful About Unvalidated Tests and “Detox” Treatments

Updated 2025 – by the NAC CARES team

When you’re desperate for answers

If you live in a damp or mouldy home and your health has suffered, it’s natural to want clear answers. Many people experience coughing, fatigue, sinus trouble or breathing problems and wonder if mould exposure could be the cause.

Unfortunately, the internet is full of misleading claims about “toxic mould”, “biotoxin illness”, or “mould detox”. Some websites and private clinics sell unvalidated medical tests or promote expensive supplements claiming to “flush mould toxins” or “reverse mould illness”.

People often turn to these options out of frustration and desperation when they feel ignored or dismissed by health or housing services. But it’s important to know that these tests and products are not scientifically proven — and in some cases, they may cause harm.

The truth about “mould illness” testing

At present, there is no validated medical test that can prove a person is ill because of mould exposure in their home.

Tests often sold online or through private clinics — such as urine mycotoxin tests, mould antibody panels, or chronic inflammatory response syndrome (CIRS) profiles — are not recognised by the NHS, NICE, or the World Health Organization.

These tests may detect trace amounts of mould-related compounds that appear even in healthy people. There are no agreed normal or abnormal levels, and results can vary dramatically between labs. This means a “positive” test result does not prove illness or guide treatment.

When functional, integrative, or alternative practitioners use these tests

It’s not just online sellers. Some functional medicine, integrative health, or alternative practitioners — including some with medical or allied health qualifications — also use these same mould or mycotoxin tests in private practice.

They may genuinely want to help and believe in “root cause medicine,” but:

  • Many of these tests have never been validated in peer-reviewed clinical studies.

  • Their results cannot reliably distinguish between normal environmental exposure to fungi and actual infection or allergy.

  • People are sometimes told they have “mould toxicity” or “mycotoxin poisoning” without any scientific evidence.

Why this matters

  • It can lead to unnecessary fear and anxiety.

  • Patients may spend hundreds or thousands of pounds on testing, supplements, or “detox” treatments that do not work.

  • Most importantly, genuine medical conditions — like aspergillosis, asthma, or COPD — may be diagnosed late or missed entirely.

Even if the practitioner sounds credible, unvalidated tests remain unvalidated.
If it isn’t approved by NICE, the NHS, or recognised respiratory specialists, it isn’t a reliable diagnostic test.

The risks of “detox” and self-treatment

Many websites and practitioners also recommend “detox” products such as activated charcoal, bentonite clay, chlorella, ozone therapy, or special anti-fungal diets. None of these have been proven to remove mould or mycotoxins from the body.

Some are unsafe or can interact dangerously with prescribed medicines — especially antifungal or steroid treatments used for aspergillosis. Others can damage the gut, lungs or kidneys.

No supplement, spray, or air treatment can replace medical therapy or proper repair of damp housing.

Why these products are still allowed to be sold

These tests and supplements often remain on sale because of regulatory loopholes:

  • They’re marketed as “wellness” or “informational” tests rather than diagnostic tools.

  • Supplements are classed as foods, not medicines — they must be safe, but not proven effective.

  • Many sellers are based overseas, outside UK or EU enforcement.

That’s why public awareness is crucial. Legal does not mean scientifically valid.

If you see misleading health claims, you can report them to:

What is proven to help

Here’s what current evidence supports:

  • Talk to your NHS doctor or respiratory specialist. They can arrange validated tests for fungal disease and lung health.

  • Fix the source of damp or mould. That’s the key to protecting your health — not detox kits.

  • Seek help early from housing officers, environmental health, or Citizens Advice if your home is unsafe.

  • Work with your care team — they can support housing letters or referrals if damp is affecting your condition.

See our practical guides:

If you feel dismissed or desperate

You’re not alone. Many people living in damp conditions feel frustrated and unheard. But unvalidated tests and detox programmes will not provide the answers you deserve.
You will get more meaningful, safer support through:

🛡️ Why We Take a Cautious Approach

Some people wonder whether organisations like ours are “allied to big pharma” or dismiss alternative approaches because of financial or legal pressures.

The truth is: we are cautious because of evidence and patient safety, not loyalty to industry.

  • We recommend only treatments or tests that are scientifically proven to be safe and effective.

  • NHS and charity organisations must follow regulatory standards and cannot endorse unvalidated products.

  • Our priority is protecting patients from harm, wasted resources, and delays in care.

Being cautious doesn’t mean rejecting innovation. If a new antifungal therapy, dietary approach, or environmental test is genuinely effective, it will be validated through peer-reviewed research — and we will share it.

Until then, our guidance focuses on evidence-based medicine and environmental interventions, because those are proven to help people with aspergillosis.

Key message

Damp and mould can make you unwell — but there is no quick test, no secret biomarker, and no miracle detox that can prove or cure it.
Stick with evidence-based medicine, protect your living environment, and seek support from trustworthy sources.

Save your money, protect your health, and trust science.

by GAtherton

When Sleep Won’t Come: Coping with Anxiety and Restless Nights in Aspergillosis

“My GP prescribed 5 mg diazepam. I’m desperate for sleep. Could I take more than this, do you think?” — R, ABPA patient

R’s words echo the experience of many people living with aspergillosis. Between breathlessness, coughing, and the anxiety that chronic illness brings, nights can become long, restless, and exhausting. Sleep problems are one of the most common — and most distressing — challenges faced by people with Aspergillus-related lung disease.

But when medication doesn’t seem to help, it’s important to know what’s safe and what other strategies might make a difference.

💊 Understanding Diazepam and Sleep Medication

Diazepam (Valium) is sometimes prescribed by GPs to help with acute anxiety or severe insomnia. However, it’s a powerful sedative, and taking more than prescribed can be dangerous — leading to confusion, slowed breathing, or even overdose, especially if mixed with alcohol or other medications.

If your prescribed dose isn’t helping, don’t increase it on your own. Contact your GP or specialist nurse; they can safely adjust your treatment or explore alternative medications that are gentler and more effective for long-term sleep support.

🌙 Safer, Soothing Sleep Strategies

While medication can help in the short term, many people with aspergillosis find that calming the body and mind before bed can make a big difference over time.

🫁 1. The 4–7–8 Breathing Technique

  • Inhale quietly through your nose for 4 seconds

  • Hold for 7 seconds

  • Exhale slowly through your mouth for 8 seconds
    Repeat several times — this pattern lowers your heart rate and helps trigger your body’s relaxation response.

🧘 2. Progressive Muscle Relaxation

  • Start from your toes: tense the muscles for 5 seconds, then release.

  • Move upward through your body — legs, stomach, shoulders, face.
    This can reduce muscle tension from coughing or pain, and helps the mind unwind.

🧠 3. Grounding Exercise (5–4–3–2–1)

If anxiety or breathlessness make your thoughts spiral:

  • 5 things you can see

  • 4 things you can touch

  • 3 things you can hear

  • 2 things you can smell

  • 1 thing you can taste
    This brings your attention gently back to the present moment.

🛏️ 4. Your Sleep Environment

  • Keep lights dim and screens off before bed.

  • Try a cool, comfortable room (around 18°C).

  • Avoid clock-watching — it increases stress.

  • Gentle background noise, like soft music or a fan, can help mask coughing or household sounds.

❤️ When to Reach Out

If you’re still struggling, please reach out for help — to your GP, specialist team, or the Aspergillosis Trust or NAC Patient Support Group.
And if you ever feel overwhelmed or hopeless, you’re not alone. In the UK, you can call Samaritans (116 123) for free, 24 hours a day.

As R’s story reminds us, it’s okay to feel desperate for rest — but help is available, and there are safe, gentle ways to support your body and mind until better nights return.

by GAtherton

🌿 Aspergillosis in the Sinuses (Allergic Fungal Rhinosinusitis – AFRS)

It’s quite possible for Aspergillus to affect both the lungs and the sinuses.
The sinuses are small air-filled spaces behind the nose, eyes, and cheeks that normally drain mucus freely. When Aspergillus spores become trapped there, they can trigger an allergic or inflammatory reaction — rather like ABPA in the lungs.

This allergic form is called Allergic Fungal Rhinosinusitis (AFRS).
It isn’t a contagious infection — it’s an overreaction of the immune system to fungal spores. Over time, it can lead to thick mucus, nasal blockage, and sometimes nasal polyps.

🩵 Common symptoms

  • Persistent nasal congestion or blockage

  • Thick or sticky mucus (sometimes with brown or dark flecks)

  • Reduced or lost sense of smell

  • Facial pressure, pain, or fullness (especially around the eyes or cheeks)

  • Post-nasal drip (mucus running down the throat)

  • Fatigue or worsening asthma symptoms

🔬 Diagnosis

  • CT scan of the sinuses – shows thickened or blocked areas

  • Nasal endoscopy – a tiny camera used to look inside

  • Fungal culture or microscopy from mucus samples

  • Blood tests – sometimes show raised total IgE or Aspergillus-specific IgE

💊 Treatment

  • Topical nasal steroids (sprays or rinses) or short courses of oral steroids to reduce inflammation

  • Saline rinses to help keep the sinuses clear

  • ENT surgery if sinuses are blocked or filled with thick fungal debris

  • Antifungal medication in some cases, especially if fungal growth is confirmed

🌸 The Main Types of Aspergillus Sinus Disease

There are several recognised types of sinus aspergillosis. Most people with ABPA or asthma experience only the allergic form (AFRS).

1️⃣ Allergic Fungal Rhinosinusitis (AFRS)

  • Caused by an allergic reaction to Aspergillus

  • Leads to inflammation, thick mucus, and polyps

  • Non-invasive – the fungus stays on the surface

  • Managed with steroids, nasal rinses, and sometimes surgery
    ✅ This is the type most relevant for ABPA patients.

2️⃣ Fungal Ball (Mycetoma)

  • A clump of fungus (usually A. fumigatus) in a single sinus, often the cheek (maxillary) sinus

  • Common in otherwise healthy people

  • Causes chronic congestion or facial pain

  • Treated surgically – antifungals rarely needed

  • Not allergic and not invasive

3️⃣ Invasive Aspergillus Sinusitis

  • Rare, seen mostly in people with severely weakened immunity (e.g., chemotherapy, bone marrow transplant, uncontrolled diabetes)

  • The fungus invades surrounding tissue and blood vessels

  • Causes severe facial pain, swelling, fever, sometimes affecting the eyes

  • Needs urgent treatment with antifungal drugs and surgery
    ⚠️ Very rare in people with ABPA or CPA.

🤝 Specialist care

If you have lung aspergillosis (such as ABPA or CPA) and start noticing more nasal congestion, sinus pressure, or post-nasal drip, it’s sensible to mention it to your respiratory or mycology team.
At the National Aspergillosis Centre (NAC), sinus disease is often co-managed by ENT surgeons, respiratory physicians, and mycology specialists, ensuring coordinated care.

With the right combination of treatments — and early recognition of symptoms — most people find their sinus symptoms improve, and controlling sinus inflammation can even help with overall breathing and energy.

by GAtherton

🩵 Coughing and Aspergillosis: Why You Might Still Cough Even When You Feel Well

Many people living with Allergic Bronchopulmonary Aspergillosis (ABPA) or bronchiectasis notice that they still cough regularly — even when their blood tests and scans show their condition is stable. It can be confusing to feel well and yet still have daily coughing or occasional coughing fits.

This article explains why that happens and when you should be concerned.

🌿 Why coughing can continue between flare-ups

ABPA and other forms of aspergillosis can cause long-term changes in the airways. Even when the allergic inflammation has settled and your Immunoglobulin E (IgE) levels are back to baseline, the airways may remain a little widened or scarred. This means:

  • Mucus can collect in the airways more easily.

  • The lining of the bronchi can stay slightly “twitchy” or reactive.

  • Your lungs may continue to produce small amounts of sticky, clear mucus that needs to be cleared out.

Coughing is your body’s way of keeping those airways clear — so a light, regular cough can actually be a sign that your lungs are doing their job.

💨 Why you might not cough during exercise

Many patients notice something surprising:

“I can walk or exercise in the gym for a couple of hours without coughing at all — but later, I get a coughing fit and bring up mucus.”

This is quite normal. When you exercise, you breathe more deeply and more rapidly. This helps:

  • Keep the airways open

  • Move mucus towards the larger airways

  • Reduce the irritation that triggers coughing

When you stop exercising, mucus that’s been loosened can settle again — and that’s often when a coughing fit happens to clear it out. It’s part of your lungs’ natural “housekeeping” system.

🌬️ What you can do to help

  • Stay active: Gentle exercise is good for your lungs. It keeps the airways open and improves mucus clearance.

  • Hydration helps: Drinking enough water or warm fluids keeps mucus less sticky.

  • Airway-clearance techniques: Ask your physiotherapist about huff coughing or devices like the Aerobika or Acapella, which help loosen and move mucus.

  • Watch for changes:

    • Mucus turning yellow, green, or brown

    • Increased shortness of breath or fatigue

    • A rise in IgE or worsening symptoms

If any of these occur, contact your respiratory or mycology team — it might mean an infection or early flare-up.

💙 The key message

A mild, regular cough between flare-ups is normal for many ABPA or bronchiectasis patients.
It doesn’t mean your condition is worsening — it’s often your lungs simply clearing secretions.
If your IgE levels are stable and you feel well, that’s a strong sign your disease is under good control.

by GAtherton

💚 Living With Aspergillus fumigatus and Starting Antifungal Treatment

Question: “I have Aspergillus fumigatus and I’d like to ask a few questions.
After starting antifungal treatment, how long did it take before you noticed improvement or a stop in the bleeding cough?
Has anyone reached a stable condition or full recovery?
Please share your experiences — it would really help to hear from you.” 💚

🌿 A Supportive Note

Many people ask this question when they first begin treatment — and it’s a very normal concern. Aspergillus fumigatus can cause a range of lung problems such as chronic pulmonary aspergillosis (CPA), aspergilloma, or Allergic Bronchopulmonary Aspergillosis (ABPA), and each responds differently to antifungal therapy.

Improvement can take time and patience.
Some notice changes within weeks, while for others, it can take several months before symptoms start to ease or stabilise.

💊 Understanding How Antifungal Treatment Works

Antifungal medicines — such as itraconazole, voriconazole, or posaconazole — don’t destroy Aspergillus overnight.
They work by slowing or stopping fungal growth, allowing the body’s immune system and lung healing processes to gradually take over.

Because these infections are often chronic, the goal is usually to:

  • Control symptoms

  • Prevent further damage

  • Reduce inflammation and flare-ups

  • Stabilise lung function

For most patients, this means aiming for long-term stability rather than complete eradication of the fungus.

⏳ How Long Before You Feel Better?

Every patient is different, but this is a general pattern doctors often see:

Time after starting treatment What you might notice
First few weeks Some reduction in coughing or mucus; fewer night sweats; side effects settling as your body adjusts.
1–3 months Energy may start to improve; less coughing or blood in sputum; breathing slightly easier.
3–6 months Signs of stability — symptoms no longer worsening, CT scans showing improvement, or blood markers (e.g. Aspergillus IgG) falling.
6–12 months Some people achieve remission or long-term stability. For others, antifungal therapy continues as maintenance.

If you have a fungal ball (aspergilloma), improvements are often slower, and sometimes bleeding episodes take longer to settle.

🩸 About Bleeding (Haemoptysis)

Coughing up blood can be one of the most distressing symptoms.
It usually improves once antifungals reduce inflammation, but if bleeding continues:

  • Doctors may prescribe tranexamic acid to help the blood clot more easily.

  • In some cases, embolisation (a targeted procedure to seal a bleeding blood vessel) may be needed.

  • Ongoing bleeding should always be reported — even small amounts — so your team can reassess treatment or check for infection changes.

🫁 Why “Stable” Can Be a Positive Outcome

Although “cure” is possible in some early or mild cases, most people live with aspergillosis as a chronic condition.
With consistent antifungal therapy, airway clearance, and monitoring, many reach a stable stage — where symptoms are minimal, life feels more predictable, and flare-ups are rare.

This stability is a real success.
It means your body and treatment are keeping the infection under control, preventing further lung damage.

💚 Real Experiences

Patients often describe:

  • Energy and breathlessness improving slowly

  • Bleeding stopping after several months

  • A new sense of normality once medication side effects settle

Some take antifungals for a set course (e.g. 6–12 months), while others remain on long-term maintenance to stay stable.
It’s common for treatment to be adjusted based on blood levels, side effects, or new sputum results.

💬 Patient Voices

Many people in our community say they wish they’d known:

  • “Improvement isn’t quick — it’s gradual, but it does come.”

  • “Side effects can be managed — don’t stop without advice.”

  • “It’s okay to ask your team what ‘stable’ looks like for you.”

  • “You’re not alone — others have been through this too.”

🧭 Looking After Yourself Along the Way

  • Keep up airway clearance (physiotherapy, saline nebulisers, or airway devices).

  • Attend regular clinic appointments for blood levels and liver tests.

  • Report side effects early — dose adjustments or switching antifungals often helps.

  • Maintain good nutrition and hydration.

  • Reach out for emotional support. Living with a chronic infection can be mentally exhausting; anxiety and fatigue are common.

💬 We’d Love to Hear From You

If you’ve been through antifungal treatment, please share your story:

  • How long it took before you felt a difference

  • What helped you most

  • How you manage side effects or flare-ups

Your experience could make a real difference to someone who’s just starting this journey. 💚

by GAtherton

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