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Mold 101

Updated: Jan 13

This article is not intended to be used as medical or healthcare advice. Before starting any medical or health related regimen seek the advice your Primary Care Physician or an M.D.


A portion of my clients have dealt with or are dealing with symptoms related to mold (mycotoxin) related illness. There has been alot that has been written about this by Richie Shoemaker (www.survivingmold.com) and others, and new information comes out every year, sometimes enhancing our understanding and sometimes dismissing prior conclusions. This whole area is fraught with humans, trying to make a buck, trying to prove they are right, trying to say they have the right protocol, and also fraught with supplement hocking pyramid marketing companies (hello CellCore / Microbe Formulas). Sigh.


With all this said, testing to see if you have mold should be easy right! Wrong! Here again we have polarized camps on which test technology is best, and what test methodology is best. I will try and share what i feel is an objective assessment here. First, there are two basic ways to assess what mycotoxins (what mold gives off) you have in your body that may be causing an immune reaction and potential sickness. First, are the more well known urine based excretion tests from Mosoaic (fka Great Plains Laboratories), RealTime Laboratories, and Vibrant America. Each uses slightly different technologies, but important is the fact that these are excretion tests, not body burden tests, and they don't tell us if you are "sick" or having an immune reaction. The coverage of these tests varies widely. RealTime and GreatPlains have some overlap, but test different mycotoxins from each other - both about a dozen, with some overlap, but different technologies.


The Mosaic (fka Great Plains Mycotox) panel tests for 11 mycotoxins, the list includes: Aflatoxin M1, Ochratoxin A, Gliotoxin, Sterigmatocystin, Mycophenolic Acid, Roridin E, Verrucarin A, Enniatin B, and Zearalenone. Cost is around $350 and can be had on line direct to consumers from mymedlab.com or mylabsforlife.com.


The RealTime Labs test covers 15 mycotoxins, and includes: Ochratoxin A, Aflatoxin Group: (B1, B2, G1, G2), Trichothecene Group (Macrocyclic): Roridin A, Roridin E, Roridin H, Roridin L-2, Verrucarin A, Verrucarin J, Satratoxin G, Satratoxin H, Isosatratoxin F, Gliotoxin Derivative, and Zearalenone. Cost is around $375, practitioner ordered only.


The Vibrant America MycoToxin Panel costs $375 and covers 31 mycotoxins, practitioner ordered only. Aflatoxin A1, B1, B2, M1, M2; Ochratoxin A, Sterigmatocystin, Zearalenone, Enniatin B1, Fumonisins B1, Fumonisins B2, Fumonisins B3, Citrinin, Patulin, Gliotoxin, Mycophenolic Acid, Dihydrocitrinone, Chaetoglobosin, A, Roridin E, Verrucarin A, Deoxynivalenol Vomitotxin (DON), Nivalenol (NIV), diacetoxyscirpenol (DAS), T-2 toxin, Satratoxin G, Satratoxin H , Isosatratoxin F, Roridin A, Roridin H, Roridin L-2, and Verrucarin J S.


My favorite, for two reasons, Vibrant, because of coverage, and cost. If you bundle their Mycotoxin Panel with Heavy Metals, Chemicals/Environmental Toxins its $480 for all 3, or add on Organic Acids and its $600. There is alot of value there- versus $375+ for Mosaic and RealTime with far less coverage.


The other test methodology is a blood test that measures the levels of immune antibodies in your blood, from MyMycoLab. Its $380 + cost of a blood draw, so figure your at ~$425 in all. It measures 12 different mycotoxin anti-bodies, both for IgE and IgG. However, this is also not body burden to be clear. This will tell you if you are having an immune reaction from one of the 12 mycotoxins it covers. From the MyMycoLab.com website, "IgG antibodies to mycotoxins indicate that currently the immune system is reacting to mycotoxins. It is not an indicator of past exposure. IgG to a toxin such as mycotoxins, mercury, pesticides is current exposure; IgG to viruses, bacteria, molds, and parasite is an indication of past exposure. IgE is an indication that mycotoxins are stimulating mast cells, causing an inflammatory reaction and can result in Mast Cell Activation Syndrome (MCAS)." The list of mycotoxins MyMycoLab tests for includes: Penicillium (mycophenolic acid), Alternaria, Aspergillus (gliotoxin), Stachybotrys, Cladosporium, Aspergillus auto-toxin, Aspergillus/Penicillium neurotoxic mycotoxin, Ochratoxin, Satratoxin, T-2 Toxin, Vomitoxin, Verrucarin and verrucarol


How do you decide between blood and urine based testing ? If you are convinced that the person has all the symptoms of mold, and has known exposure, then the real question is - which mycotoxins do you have so you can design a detox protocol around them. I go for urine in this case, and always choose Vibrant given the value. If I am unsure if the person has had mold exposure, and symptomology is unclear, i go for the blood based antibody test.


Folks often ask me how I look at mold toxicity and differ from the 'shoemaker protocol'. I will offer the following observations and reflections to consider:

  1. I don't require a $500 intake and $2,500 of testing at an initial appointment.

  2. I don't look at primarily one gene (HLA) and a narrow set of biomarkers, and then determine that there is a one size fits all protocol (often costing $30K-100K) for everybody. All this with an approximate 10% success rate at completing the protocol with symptom resolution. I usually assess 1,000+ genes.

  3. Why wouldn't we look at the genes within the 7 phase 2 detox pathways (sulfation, acetylation, glucuronidation, methylation, glutathione, amino acids, and pon1), especially after we know which pathways will be primarily used if we know the mycotoxin present ? Why wouldn't we look at the phase 1 CYP450 detox pathway ? Why wouldn't we look at phase 2.5 (BSEP) ? Why wouldn't we look at sulfur sensitivity ? Why wouldn't we look at histamine, mast cell, and EMF related issues ? Why woldn't we look at critical antioxidant genes like : HMOX1, Keap1, NRF2, SOD1, SOD2, SOD3, the more than dozen GST genes, GPX1-7, GSR, SIRT1-3, and the list goes on......

  4. I don't turn people away because they are still living in an environment with mold.

  5. I offer a range of alternatives to consider based on financial constraints. As one example if two binders have essentially identical molecular structures, and one is typically $300-$1,000; while another is around $40-100, why spend the money on the former ?

  6. When somebody is hell bent on having formal publications with their name on it, yet every two years re-writes the story of what is 'right', do we not begin to question that their polarized assertions may be more from a need to be right than actually a sound comprehensive understanding of what is really going on ? Each year or two, there is a change in direction, once again asserting that only they have the complete truth - after 3-4 of these changes in direction, don't we question what is going on here ?


The issue of whether to 'provoke'. In general i think this can be done, in a non-aggressive, non invasive way. No 500mg/day of glutathione and daily saunas for a week - that is pure non sense and may very well make the person more un well. Open some common phase 2 pathways (see other blog article on phase 2 pathways), along with phase 2.5, and support methylation just a bit for 5-10 days and that should be enough.


Other testing that can be informative and why with mold exposure are listed below:


  1. Genetic testing - i recommend a kit i sell ($319) and combine with 23andme ($79-119), together these two kits give me access to 1,080 genes across over 80,000 locations. This is a lot of data to consider when dialing in a detox regimen.

  2. Organic Acids (Genova, Moasic, Vibrant). Mosaic is available on line direct to consumers. Key markers for : Candida, Mold Colonization in the gut, Clostridia bacteria unavailable through stool testing, some nutritional status markers, methylation markers, fungus markers, phosphorous wasting, mitochondrial markers, krebs cycle markers, glutathione markers, neurotransmitter markers. Urine based ($238 Vibrant to $400).

  3. Stool testing - my favorites here are Thorne Gut Health Test (consumer direct for $199) and Vibrants Gut Zoomer $478. Both best in their price ranges, but you will need to get the raw data from the Thorne test and have somebody skilled to sort through it. Once i see the bacteria profile i dont really need a breathe test for SIBO, the bacteria tell the story. Almost everybody who has mold, has gut issues.

  4. Iron/Iron Sat%/Ferritin - super important, excess iron and low iron, seen in about 15%, is a major cause for oxidative stress and fatigue respectively.

  5. Porphyrin's Profile - Doctors Data via mymedlab.com. Without a doubt one of the most important tests for anybody with environmental exposures from mold, metals, or chemicals. Informs how our body makes heme (that helps make hemoglobin which carry oxygen). Most practitioners never use this, and do not know how to interpret. Its critical, and why some folks really struggle with detox. I couple this with the genetics across a dozen genes in the heme pathway and get to the root cause.

  6. Inflammatory Cytokine Panel - Il2, Il-4, Il-6, IL-8, IL-10, Il17, IL-33, TNFA, NFKB, Rantes, VEGF, SCD40L. Bruce Patterson design a long haul covid panel with these markers, its $415, and available through his long haulers website. You will need a docs rx. Its valuable, BUT these markers are almost always consistent with the genetics, so optional if you have the genetics done.

  7. MARCONS - available through several on line labs, and you will need an RX. Informs if you have nasal colonization of mold. A portion of mold folks do. And it usually comes later, and is pretty simple to treat - netti pots, herbal nasal rinses, some silver, all work well, and in some cases peptide sprays can help this, but they are expensive.

  8. MicroNutrient Panel (Vibrant $358, Genova Nutreval $525, Spectracell ) - you will need a practitioner to order. I consider this pretty fundamental - almost everybody with mold has gut issues, and almost everybody with gut issues has nutritional deficiencies. A partial listing of what is covered in Vibrant's micronutrient panel (both serum blood, and intracellular levels) : Vitamins: A, B1,B2,B3,B5,B6,B9,B12, Inositol, C, D, D3, E, K1, K2, MMA. Minerals: Zinc, Magnesium, Calcium, Potassium, (Anti oxidants Coq10, Glutathione), Selenium, Manganese, Iron, Copper, Chromium. Aminos: Leucine, Iso Leucine, Valine, Arginine, Citrulline, Serine, Asparagine, Glutamine, Cysteine. Fatty Acids: DHA, DPA, EPA, Linoleic Acid, Arachadonic Acid.

  9. Hair Mineral Test - Doctors Data on Amazon $125. There are some markers here that are super important for blood sugar (glucose) regulation - Chromium, Vanadium, and Rubidium. Some of these markers are signs of nutritional status, but some are not, you will need a practitioner who knows how to interpret the patterns. A dozen or so heavy metals are included - but note this (hair) is just one excretion pathway for metals (urine, skin, stool) are the others. So low hair levels do not mean your body burden is low. High levels are definitely a problem. The heme pathway above is inhibited at certain points by lead, and if you have one specific genetic mutation even minor mercury exposure (think tuna, salmon, mercury cavity fillings) will cause major issues.

  10. Other miscellaneous Tests: CMP, CBC with Diff, PLA2, MPO, HS-CRP, Homocysteine


Binders - A Basic Overview


Everybody talks about which are their favorite binders, but lets get to the pragmatic considerations. Before i do that , there are certain binder blends on the market - namely GI Detox by Biobotanical Research and Ultra Binder by Quicksilver Scientific. These are good blends, they have 5-6 different binders in them - so if you are guessing what mycotoxin you have - its a decent place to start if you decide to fly blind.


However, once you know the mycotoxin you have via testing, selecting a binder that is a good match for the specific mycotoxins you have will increase the rate of extraction of the mycotoxins DRAMATICALLY. There are 3 main considerations if binders, and 2 ancillary ones:

  1. Charge - polarity, like a magnet. Some mycotoxins are positively charged, and some are negatively charged. You will want to select a binder that is opposite charged to the mycotoxin you have.

  2. Size of binding site - imagine legos. Each mycotoxin has its own binding site, and so does a binder, and like legos they need to be the same size, so the binder is not only attracted through opposite charge, but can 'grab' and lock onto the mycotoxin.

  3. Number of right sized binding sites per molecule - this is essentially density - how many molecules of the molecule can one molecule of the binder grab ? The difference between how much mercury chlorella can grab versus a very specific micronized silica binder is 300X! So one can see, the potency of certain binders can be dramatically different.

  4. pH - some binders like clay can alter the ph of the gut which can have ancillary effects

  5. Probiotics - there are two ways some probiotics can be used to help facilitate the removal of mycotoxins. One is that some act like a binder, and another is that some pro biotics - biologically transform and process the mycotoxin (break it down).


So, one can see there are some considerations to which binders may work best for each situation. Starting with one binder at a time can be helpful to verify you do not have any reactions to it before ramping up. This is a big downside to the binder blends - many people react - and then they are left guessing what is causing the reaction. Having the knowledge of which binder to select for each mycotoxin is super helpful. Another downside to the binder blends is that you do not optimize the binder for the situation. If someone is only dealing with Ochratoxin A, why would i give them 4 other binders that do not help, instead of just loading up on the binder that is really optimized for Ochratoxin A ?


Just like for binders, each mycotoxin, uses its own unique set of detox pathways. Knowing if you are compromised genetically in certain pathways, what the cofactors are for each pathway, and knowing what mycotoxin uses which pathways, informs how to optimize what supports you take to help facilitate the detoxification of the mycotoxins you have. And now, it becomes apparent why a micro nutrient panel can be so helpful. In general the detoxification process can be broken down into:


Phase 1 (CYP450 genes) - knowing which phase 1 genes are compromised will help inform supplement selection. Some supplements use certain phase 1 genes - and if you are compromised - you may very well react to them.


Phase 2 (Sulfation, Glucuronidation, Methylation, Acetylation, Amino Acid Conjugation, Glutathione, Pon1). Knowing the status genetically for these pathways, and the status of the nutritional cofactors for each of these pathways is super helpful.


Phase 2.5 - Toxins are released from the liver to the gallbladder through the BSEP - Bile Salt Export Pump. When MRP2 (see below) gets over whelmed, it shuts down the valve between the liver (BSEP) and gallbladder and puts the bile into the blood with the toxins. The toxins then hit the brain (cause neuro symptoms), the kidneys (cause lower back pain), and the bile salts get excreted through the skin (causing rashes). People call this a 'herxheimer' reaction. But technically your MRP2 proteins are overwhelmed and or the BSEP is closed. Knowing your genetic status here and how to support this is critical, so the right herbs and compounds can be selected to support your healing process.


Phase 3- Toxins are escorted through the liver by MRP2 protein. Knowing if MRP2 is compromised, and how to support it can be super helpful.


I often get questions around how to test your house for mold, and remediation. This is worthy of a whole book. If there was one resource i would trust here - it would be Carl Grimes - you can find him on facebook. He went through mold many years ago, recovered, and wrote a book and became an expert on how to test, how to look, how to remediate. In sum, mold needs a constant water source. You can do EHRMI and HERTSMI testing - but these tests are also flawed (only assess a very small number of molds). You will eventually need to 'find' where in the heck mold is located. A very simple inexpensive way to do this is to use mold spore dishes and see which room the counts are highest. The dishes are $3 each at immunolytics.com. People will argue with me but you can find where the likely source is (which room) for less then $50, that seems like a bargain to me. Once found, the mold needs to be removed and the water source eliminated.


May 2024 be a year in which you progress through recovery if you are suffering from mold exposure. If you would like to learn more or explore this topic in more detail with me, schedule an appointment on line. There are many other issues commonly encountered in mold related illness - such as histamine and mast cell issues, EMF sensitivity, food sensitivity, sulfur sensitivity, etc, each worthy of their own exploration.

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