Mycotoxin Testing: What to Consider If You Think or Know You Have Been Exposed to Toxic Indoor Mold

Let’s discuss this head on: there is no one all encompassing test when it comes to exploring mycotoxin associated harm to humans. Due to this, it is crucial to look at various mycotoxin related testing options (and the sequelae from it) when assessing the body.

While there is not one consensus on the “best approach” to mycotoxin testing for the human body, doing nothing in spite of lack of consensus on “perfect” testing isn’t a good option either as it is well documented in medical literature (>1000 studies) that there is known bodily harm from mycotoxins (the toxic part of mold).

Imperfect testing > burrying head in the sand

The ongoing debates in mycotoxin testing doesn’t necessarily mean that test results can’t be useful — they should be taken with a grain of salt in conjunction with the big picture for each person. Many functional medicine aligned practitioners argue doing something is better than nothing especially when the test and/or treatment is low to no risk and high reward. There is literally no good attributes or benefits of toxic indoor mold or mycotoxins and only degrees of harm; so it’s important to find it, the sequelae from it, and adequately deal with it.

We can all agree that indoor air circulating with mold spores and mycotoxins are injurious (and can be fatal). Big picture when it comes to mycotoxin testing: if a person is continually exposed to toxic indoor mold from a water damaged building, health will likely start to deteriorate and how that manifests depends on each person’s constitution.

This short blog focuses on options to test the body when mold is questioned as a culprit for subtle to serious health issues. Note that it is also just as important to test the environment too (start with an ERMI at home dust kit #1). It’s heavily debated which should “happen first:”

1) should we see if mycotoxins are in the body and then go digging in the home environment? Or

2) should we check the home environment first and then see if it has impacted the body?

My opinion – just put the ball in motion. Start over turning stones when mold is questioned whatsoever.

Most “direct” testing for mycotoxins

• Urine mycotoxin testing – link to self order
• CIRS lab panel – link to self order a CIRS labs is here
• VCS testing – a free at home screening tool.
  • Those the have a positive VCS test coupled with common CIRS symptoms have about a 98% likelihood of having CIRS which is typically caused from mold exposure or other microbes from indoor water damage.

Less direct “downstream” labs/biomakers that when abnormal CAN be an effect from ongoing mold exposure [non exhaustive list below]

• SIBO testing
• MARCoNS
• Lipid panel
• Leptin
• Fasting insulin, hemoglobin A1c
• Thyroid antibodies/full thyroid panel
• Total Gluthathione
• CoQ10
• Iron panel
• Vitamin D
• C reactive protein
• DUTCH testing/Sex hormones
• OAT testing
• Candida antibody testing
• CMP – to check GFR
• Neuroquant/MRI

With any functional testing (which is in the scope of practice of a registered dietitian if being monitored as a part of nutrition related interventions), you have to look at the big picture when doing a nutrition related assessment: patient reported symptoms, signs, test results, was exposure confirmed through an ERMI or mold inspector confirmed? Dietitians often get involved with mycotoxin impacted people because nutrition and targeted nutraceuticals are studied, powerful interventions to mitigate and repair mycotoxin harm.

***A note on MOLD IgG & IgE antibody testing: this is not the same as MYCOTOXIN IgG & IgE antibody testing (offered by Mymycolab). Mold IgE antibody tells us if an allergic reaction to mold is/has occurred (which is different then toxic responses [neurotoxic, nephrotoxic, hepatoxic, etc.]). Mold IgG antibody testing tells us that an exposure happened but it does not allude to if that exposure “made someone sick” or harmed the person. Mycotoxin testing (not mold testing) is much more relevant outside of the allergic and/or pulmonary issues.

Let’s break down some of the direct mycotoxin tests above:

Urine Mycotoxin Testing 

Urine mycotoxin testing is a measurement of various mycotoxins and how much is “coming out” not what is “still inside” (but yes mycotoxins are inside the body). Urine mycotoxin tests can’t 100% confirm if it’s a current exposure but that there has been either an old and/or current exposure. Results typically show mycotoxins from either their indoor environment and/or resulting from internal colonization from long term exposure.

It is important to take into consideration if it was an old exposure that mycotoxins were not previously detoxified efficiently/timely and possibly once metabolic detoxification is/was more supported, levels in the urine could be a positive sign that one is moving in the right direction as the mycotoxins are at least leaving the body (there are so many factors that upregulate or downregulate metabolic detoxification). Once found in the urine, next is getting clinical symptoms to improve and fully detox. Another consideration is the urine test could be picking up consumption of moldy food but some argue moldy foods don’t make us “mold sick” as the amounts we would have to eat would be astronomical.

Serum (Blood) Mycotoxin Testing 

Blood tests for mycotoxins measure IgG and IgE mycotoxin antibodies, which have been shown to be elevated among people who have been exposed to mold.

Side note: measuring mycotoxins is different from conventional care mold allergy testing. Note that mold allergies (that cause an allergic reaction when exposed) and mold mycotoxin toxicity (that can harm the majority of our organs in various ways) are distinct and seperate responses to mold. Here is how to keep it straight:

1. Mold Allergy is an IgE immune mediated response with typical allergic reactions symptoms to mold spores
2. Mycotoxin Toxicity is the buildup of harmful mycotoxins in the body (what this blog post is speaking to – you can be hurt from mold regardless of allergy status)
3. Mold Colonization is when mold has colonized in your body and is releasing mycotoxins within the body – so wild! (Usually accompanied by Mold Toxicity and symptoms too) 

“Molds are the gun, mycotoxins are the bullet. Mycotoxins affect health more severely.” – Andrew Campbell, MD

Serum mycotoxin tests can tell you how your body is currently reacting to mycotoxins by measuring reactivity markers of the immune system. This helps us known if it’s a “current exposure;” The downside is it doesn’t tell us in serum testing how much the body is excreting (just “what is inside”), and the Mymycolab test is significantly more money ($380) compared to several mycotoxin urine tests.

Mymycolab looks for IgG and IgE antibodies to mycotoxins – kinda like looking for antibodies to an infection rather than looking for the antigen itself. An immune response to mycotoxin(s) suggests the immune system is currently “seeing” one or more of the 14 different mycotoxins tested for on this panel. IgG antibodies may be from current exposure and/or colonization; this means the indoor home environment usually needs to be explored to see if this is driving the health problems. The immune system has a memory for pathogens, but not for toxins so if IgG & IgE mycotoxins are showing up in the blood, then likely there is a consistent current mycotoxin exposure. Consistent almost always means the home but could also be indoor work environment.

Antibodies are believed to go down quickly after the mold remediation and associated projects have occured and were done well …which is a whole other conversation. Note that food is not believed to impact the myMycoLab results the way it theoretically can on urine tests if a person is eating a lot of moldy foods.

Visual Contrast Sensitivity Testing (VCS) 

Visual Contrast Sensitivity (VCS) testing aims to measure a component of neurological function that may be affected by exposure to mycotoxins and other biotoxins. This method looks at your ability to see details in varying contrasts of black, white, and grey on a computer screen.

 VCS testing is free, easily accessible, quick & simple. However, the VCS testing is limited in the sense that it is “pass/fail,” doesn’t quantify much and doesn’t tell what mycotoxins you are exposed to the way that urine and blood can. Many will use the VCS as an initial “screening tool” and for initial “buy in” to see that there is a mold or biotoxin problem, and then the patient will do a urine mycotoxin or blood test next and indoor home evaluation. VCS testing was originally developed and used in the military as a quick screening tool for chemical exposure as it can pick up other biotoxins too which is a limitation if you are trying to just isolate if or what and how many mycotoxins are the problem.

CIRS PANEL:

CIRS is a multi symptom multi system illness from biotoxin exposure (commonly mold). It is a “downstream effect” of having been exposed to mold leading to chronic inflammation. About 25% of the population have a genetic susceptibility to developing CIRS when exposed to biotoxin. This is why some families get sick and some are fine all living under the same roof. I go over lots of details about CIRS in my Healing from Mold program.

While there is so much “back and forth” on mold and mycotoxin testing for the human body, many in the Integrative/Functional healthcare space debate that action is better than inaction even if there isn’t one standard of care written. We can’t continue to sit by and watch people suffering from mold and mycotoxins because the harm they cause is extremely well documented. In progress algorithms over not exploring mycotoxins as a culprit and allowing someone to suffer unnecessarily. As with everything in healthcare, ongoing studies and research is needed.

And while anecdotal, we cannot continue to shut down people’s lived experiences like my own family’s story: almost losing my son to mold (over 30 instances of acute respiratory distress and one ICU admission for respiratory failure), and we did also lose a 3 year old pet to lung failure from mold. It took awhile to figure out what was contributing to our signs and symptoms (which varied from person to person in our home) and we had several crappy inspectors before quality ones found it and ultimately saved my son’s life. Visit www.iseai.org to find certified, quality mold inspectors. Post remediation, we are all stable and overall doing well.

I will continue to advocate for mycotoxin awareness, mycotoxin testing, and medical nutrition therapy for mold impacted people. Schedule a consult package for medical nutrition therapy and/or take my Healing from Mold Program.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5666377

https://pubmed.ncbi.nlm.nih.gov/29861191

https://pubmed.ncbi.nlm.nih.gov/34208182

https://pubmed.ncbi.nlm.nih.gov/32197491

https://pubmed.ncbi.nlm.nih.gov/30856502

https://pubmed.ncbi.nlm.nih.gov/20818517

https://pubmed.ncbi.nlm.nih.gov/29048356

https://pubmed.ncbi.nlm.nih.gov/22840705

https://pubmed.ncbi.nlm.nih.gov/35051019

https://pubmed.ncbi.nlm.nih.gov/21553028

https://pubmed.ncbi.nlm.nih.gov/21708211

https://pubmed.ncbi.nlm.nih.gov/16019804

https://pubmed.ncbi.nlm.nih.gov/33546479

https://pubmed.ncbi.nlm.nih.gov/19468319

https://pubmed.ncbi.nlm.nih.gov/25209565

https://pubmed.ncbi.nlm.nih.gov/34941686

https://pubmed.ncbi.nlm.nih.gov/25042512

https://pubmed.ncbi.nlm.nih.gov/15259425

https://pubmed.ncbi.nlm.nih.gov/15143854

https://pubmed.ncbi.nlm.nih.gov/15143855

https://pubmed.ncbi.nlm.nih.gov/11249927

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802005

https://pubmed.ncbi.nlm.nih.gov/31003600

https://www.survivingmold.com/store/online-vcs-screening

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