What Lab Tests Can Help Identify Mold Illness?

Mold illness is a type of Chronic Inflammatory Response Syndrome (CIRS). CIRS is a complex, systemic illness triggered by exposure to harmful bioaerosols (tiny airborne particles of living organisms like bacteria, viruses, or mold that can be inhaled and may cause health issues), often found in water-damaged buildings. With mold and mycotoxin exposure, CIRS sets in when an individual’s immune system cannot properly process and eliminate these toxins, leading to ongoing inflammation. 

This article describes the different lab tests used to diagnose mold illness. By understanding these tests, patients and practitioners can better understand how to identify mold-related health issues. Accurate diagnosis is the key to addressing the root cause of the problem and developing a treatment plan that leads to recovery.

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Understanding Mold Illness and Its Symptoms

The symptoms of mold illness can seem vague because they appear all over the body rather than only affecting one or two body parts or systems. Seeing the person’s symptoms through a wider lens may help reveal the cause.

Common Symptoms of Mold Illness

Mold illness or CIRS can affect various systems in the body, resulting in a broad spectrum of symptoms that can make diagnosis challenging. These symptoms often develop over time, especially with prolonged exposure to mold or environments that harbor mold spores.

Some of the most common symptoms include:

• Fatigue: A hallmark symptom of mold illness, fatigue can become chronic and debilitating, making even simple daily activities difficult.

• Brain Fog: Many individuals experience cognitive difficulties, especially brain fog. This can include memory issues, difficulty concentrating, and confusion.

• Respiratory Issues: Mold exposure often affects the respiratory system, causing symptoms like coughing, sneezing, shortness of breath, sinus congestion, and wheezing.

• Joint Pain: Inflammation triggered by mold toxins can lead to widespread joint pain, which may mimic conditions like arthritis.

• Chronic Headaches: Persistent headaches or migraines are common in individuals suffering from mold illness, often due to sinus pressure or toxin-induced inflammation.

• Skin Irritations: Some people develop rashes or skin irritation, particularly if they have direct contact with mold or mold spores.

These symptoms can vary in severity and may overlap with other conditions, which is why mold illness is often misdiagnosed or overlooked.

The Role of Mycotoxins: What Are Mycotoxins, and What Do They Do?

Mycotoxins are toxic substances produced by molds that grow on crops like cereals, coffee, spices, and other foods, especially in warm, wet, or tropical settings. People can be exposed to mycotoxins by eating contaminated food, but they can also come into contact with them through skin contact or breathing them in.

• Mycotoxins can cause both short-term and long-term health problems. Common mycotoxins include aflatoxin, ochratoxin, fumonisin, zearalenone, and trichothecenes. When these spores are inhaled, ingested, or come into contact with the skin, they can trigger an inflammatory response in the body.

• Once inside the body, mycotoxins disrupt normal immune function and can lead to chronic inflammation. This inflammation is responsible for many symptoms associated with mold illness, including fatigue, respiratory problems, and joint pain. Mycotoxins can also have neurotoxic effects, contributing to cognitive symptoms like brain fog and headaches.

• In some individuals, particularly those with genetic predispositions, the body is unable to properly detoxify and eliminate these mycotoxins, leading to ongoing immune activation and worsening of symptoms. 

Lab Tests to Help Identify Mold Illness

Once mold symptoms are recognized, determining the appropriate testing is the next step. 

Mycotoxin Testing

Purpose: Mycotoxin testing measures the presence of mycotoxins in the body, usually through urine testing.

How It Works: When the body absorbs mycotoxins from mold exposure, it attempts to detoxify and eliminate them. However, sometimes mycotoxins can remain in the body due to slowed detoxification pathways or dysbiosis. This test detects the mycotoxins being excreted in urine.

When It’s Used: Clinicians often use this test when mold exposure is suspected and patients show symptoms like fatigue, brain fog, or respiratory problems, especially if they don’t improve with usual treatments.

Visual Contrast Sensitivity (VCS) Test

Purpose: The Visual Contrast Sensitivity (VCS) test assesses neurological function by measuring how well a patient can distinguish between shades of gray, which can be affected by mold exposure.

How It Works: VCS is a non-invasive test that evaluates a patient’s ability to see contrast. Mold illness can impair visual processing, and this test helps identify those with potential neurological effects.

When It’s Used: the VCS test is often used as an initial screening tool to determine if additional testing for mold illness is necessary.

HLA-DR Genetic Testing

Purpose: This test identifies genetic susceptibility to mold illness by examining variations in the HLA-DR gene, which can impact how well the body clears toxins.

How It Works: The test looks for specific gene variations that may make it harder for a person to detoxify from mold, increasing their risk of developing mold illness.

When It’s Used: Clinicians may recommend this test for patients with a family history of mold illness or those with chronic, unexplained symptoms that could be linked to mold exposure.

Inflammatory Markers (C4a, TGF-β1, MMP-9)

Purpose: This blood test measures inflammatory biomarkers that are often elevated in people with mold illness.

How It Works: Mold exposure can trigger an immune response that raises levels of specific proteins like C4a, TGF-β1, and MMP-9. These tests help detect ongoing inflammation.

When It’s Used: These tests are commonly ordered alongside other tests to confirm chronic inflammation caused by mold exposure.

MARCoNS (Multiple Antibiotic Resistant Coagulase Negative Staphylococci) Testing

Purpose: MARCoNS test identifies bacterial infections, often in the nasal passages, which can develop in individuals with mold illness.

How It Works: A nasal swab is used to detect antibiotic-resistant bacteria that may colonize the sinuses and worsen mold-related symptoms.

When It’s Used: This test is usually recommended when patients report persistent sinus issues or if other tests show signs of immune system problems.

MSH (Melanocyte-Stimulating Hormone) Testing

Purpose: This test measures MSH, a hormone involved in immune regulation and inflammation, which is often low in people with mold illness.

How It Works: This is a blood test that detects levels of MSH. MSH deficiency is associated with dysregulation of immune and inflammatory responses, and it’s considered a hallmark abnormality seen in CIRS-WDB patients, making its deficiency significant in confirming CIRS-WDB.

‍When It’s Used: Clinicians use this test to assess hormonal imbalances that may be contributing to chronic symptoms in mold-exposed patients.

Urine Organic Acids Test

Purpose: The Urine Organic Acids Test is used to assess metabolic function at a cellular level, particularly focusing on mitochondrial health and biochemical pathways involved in energy production. 

In the context of mold sickness, this test can provide insights into potential mitochondrial dysfunction, oxidative stress, detoxification capacity, and overall metabolic imbalances triggered by chronic inflammation and immune dysregulation associated with Chronic Inflammatory Response Syndrome (CIRS).

How It Works: Chronic inflammation and immune dysregulation, as seen in CIRS, can lead to mitochondrial dysfunction due to oxidative stress and impaired cellular energy production. 

The Urine Organic Acids Test measures the byproducts of various biochemical reactions, giving a detailed look at how well the body's cellular processes are functioning. Elevated or abnormal levels of specific organic acids may indicate mitochondrial damage, impaired detoxification pathways, and disrupted energy metabolism.

When It’s Used: The Urine Organic Acids Test is used in patients with mold toxicity or CIRS, especially when mitochondrial dysfunction, chronic fatigue, or impaired energy metabolism are suspected. It helps assess detoxification capacity, neurotransmitter imbalances, and oxidative stress. 

Clinicians use it to evaluate cellular damage, monitor treatment progress, and guide interventions targeting energy production and detoxification, especially in patients with persistent symptoms.

EMMA (Environmental Mold and Mycotoxin Assessment) Testing

Purpose: EMMA testing assesses for the presence of mold spores and mycotoxins in the environment. This test identifies current mold exposure within a home or workspace.

How It Works: This test analyzes dust samples from a building to detect mold species and measure the levels of mycotoxins present. It identifies both active mold colonies and residual mold toxins, which may contribute to ongoing health issues.

When It’s Used: While not medically diagnostic, clinicians recommend EMMA testing when mold exposure is suspected, especially if a patient shows persistent symptoms despite remediation efforts. 

It helps confirm environmental contamination, allowing for more targeted remediation and treatment strategies to reduce ongoing mold exposure and related health risks.

How Practitioners Use These Tests in Diagnosis

These tests are often used in combination to determine the presence of mycotoxins as well as their effects on health (through testing inflammatory markers and organic acids).   

Comprehensive Diagnostic Approach

Practitioners use a combination of tests to diagnose mold illness because no single test provides all the answers. Tests like mycotoxin detection, inflammatory markers, and genetic testing are used together to confirm mold exposure and assess the body’s treatment response over time, allowing for a more complete diagnosis.

Interpreting Results

Appropriate interpretation of test results is necessary to understand the type of mold or mycotoxin present, the degree of severity of the mold toxicity for that person, whether they are currently being exposed to mold, and to monitor treatment response.

Results from tests like mycotoxin levels and inflammatory markers (e.g., C4a, TGF-β1) help confirm mold exposure and the body’s level of inflammation. Genetic testing (HLA-DR) can show if someone has trouble detoxifying mold toxins. 

EMMA testing identifies current mold and mycotoxin exposure, allowing for identification and treatment of environmental mold. Clinicians look at these results along with symptoms to confirm the diagnosis and decide on treatment.

Importance of Symptom Correlation

Test results must be matched with the patient’s symptoms and environmental exposure. A person with fatigue and respiratory issues in a damp environment is more likely to have mold illness if their lab tests also show high mycotoxins and inflammation. This correlation helps avoid misdiagnosis.

Next Steps After Diagnosis

If you’ve been diagnosed with a mold illness, it’s important to work with a trained functional medicine provider who can create an monitor an individualized treatment plan for you that will likely involve the following:

Detoxification Protocols

The first step after diagnosis is detoxifying the body. Binders like activated charcoal or cholestyramine help remove mycotoxins from the body. Supporting liver function with diet or supplements may also improve detoxification. 

Environmental Remediation

It’s critical to address the source of mold exposure by testing and removing mold from the home or workplace. Without environmental remediation, symptoms can return, even after detox.

Ongoing Monitoring

Mold illness requires regular follow-up to monitor progress. Clinicians use repeat testing to check for remaining mycotoxins or inflammation, adjusting treatments as needed to prevent flare-ups.

When to Consider Mold Testing

Consider testing for mold illness in patients who have chronic, puzzling symptoms without an identifiable root cause.

Symptoms that Warrant Testing

Testing for mold illness should be considered when a person experiences:

• Persistent fatigue, brain fog, or memory issues

• Respiratory problems like coughing or wheezing

• Chronic headaches, joint pain, or skin rashes

If symptoms worsen in damp environments or resist conventional treatments, mold illness is a likely suspect.

Who is Most at Risk?

Those most at risk include people with known mold exposure, immune-compromised individuals, and those with unexplained chronic symptoms. 

Individuals with genetic susceptibility to mold illness (HLA-DR gene variations) or family history of mold-related conditions are also more likely to benefit from testing.

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Key Takeaways

• Common tests for mold illness include mycotoxin urine testing, inflammatory markers, genetic testing, and environmental assessments like EMMA. These tests help identify mold exposure, assess inflammation, and determine genetic susceptibility, guiding effective treatment strategies.

• People experiencing symptoms like chronic fatigue, brain fog, or respiratory issues should consult a healthcare provider to determine if mold exposure is the cause and get the appropriate tests and treatments.

• Early detection and treatment of mold illness are necessary to prevent long-term health complications and improve quality of life. Addressing both the environmental source and the body’s inflammatory response is essential for recovery.

Additional Resources

Surviving Mold - A comprehensive resource by Dr. Shoemaker on mold illness, including diagnosis, treatment protocols, and patient stories.

The International Society for Environmentally Acquired Illness (ISEAI) - Offers educational resources for both patients and practitioners on mold-related illnesses.

The ISEAI also offers a list of practitioners, resources, and support for those suffering from environmentally acquired illnesses, including mold toxicity.

Environmental Protection Agency (EPA) - Information on mold prevention, health impacts, and guidance on how to deal with mold contamination.