Mycotoxin Testing

A Brand New Urine Test for Mycotoxin Exposure

Mycotoxins: A Major Cause of Many Chronic Illnesses

Mycotoxins are some of the most prevalent toxins in the environment. Mycotoxins are metabolites produced by fungi like mold, which can infest buildings, vehicles, and foodstuffs. A majority of mycotoxin exposures are through food ingestion or airborne exposure. In the European Union, 20% of all grains harvested have been found to be contaminated with mycotoxins. Unfortunately, mycotoxins are resistant to heat and many processing procedures.

Fungi are able to grow on almost any surface, especially if the environment is warm and wet. Inner wall materials of buildings, wall paper, fiber glass insulation, ceiling tiles, and gypsum support are all good surfaces for fungi to colonize. These fungi then release mycotoxins into the environment causing symptoms of many different chronic diseases. Diseases and symptoms linked to mycotoxin exposure include fever, pneumonia-like symptoms, heart disease, rheumatic disease, asthma, sinusitis, cancer, memory loss, vision loss, chronic fatigue, skin rashes, depression, ADHD, anxiety, and liver damage. With our new MycoTOX Profile, we can identify mycotoxin exposures and make recommendations for detoxification treatments that have been effective.

Advantages of the MycoTOX Profile

  • The MycoTOX Profile screens for 11 different mycotoxins, from 40 species of mold, in one urine sample.
  • The MycoTOX Profile is the most comprehensive and competitively priced mycotoxin test available.
  • The MycoTOX Profile uses the power of advanced mass spectrometry (MS/MS), which is necessary to detect lower levels of these fungal toxins. This test is optimal for follow-up testing to ensure that detoxification therapies have been successful.
  • The MycoTOX Profile pairs perfectly with the Organic Acids Test (OAT), GPL-TOX (Toxic Non-Metal Chemical Profile), and the Glyphosate Test. This gives you comprehensive testing to assess exposure to common environmental toxins and the damage that can be caused by this exposure, all at a great value, and all from one urine sample.

  Markers in the MycoTOX Profile

Aflatoxin M1 (AFM1)

Aflatoxin M1 (AFM1) is the main metabolite of aflatoxin B1, which is a mycotoxin produced by the mold species Aspergillus. Aflatoxins are some of the most carcinogenic substances in the environment. Aflatoxin susceptibility is dependent on multiple different factors such as age, sex, and diet. Aflatoxin can be found in beans, corn, rice, tree nuts, wheat, milk, eggs, and meat. In cases of lung aspergilloma, aflatoxin has been found in human tissue specimens. Aflatoxin can cause liver damage, cancer, mental impairment, abdominal pain, hemorrhaging, coma, and death. Aflatoxin has been shown to inhibit leucocyte proliferation. Clinical signs of aflatoxicosis are non-pruritic macular rash, headache, gastrointestinal dysfunction (often extreme), lower extremity edema, anemia, and jaundice.
The toxicity of Aflatoxin is increased in the presence of Ochratoxin and Zearalenone.

Ochratoxin A (OTA)

Ochratoxin A (OTA) is a nephrotoxic, immunotoxic, and carcinogenic mycotoxin. This chemical is produced by molds in the Aspergillus and Penicillium families. Exposure is primarily through contaminated foods such as cereals, grape juices, dairy, spices, wine, dried vine fruit, and coffee. Exposure to OTA can also come from inhalation exposure in water-damaged buildings. OTA can lead to kidney disease and adverse neurological effects. Studies have shown that OTA can cause significant oxidative damage to multiple brain regions and the kidneys. Dopamine levels in the brain of mice have been shown to be decreased after exposure to OTA.

Sterigmatocystin (STG)

Sterigmatocystin (STG) is a mycotoxin that is closely related to aflatoxin. STG is produced from several species of mold such as Aspergillus, Penicillium, and Bipolaris. It is considered to be carcinogenic, particularly in the cells of the GI tract and liver. STG has been found in the dust from damp carpets. It is also a contaminant of many foods including grains, corn, bread, cheese, spices, coffee beans, soybeans, pistachio nuts, and animal feed. In cases of lung aspergilloma, STG has been found in human tissue specimens. The toxicity of STG affects the liver, kidneys, and immune system. Tumors have been found in the lungs of rodents that were exposed to STG. Oxidative stress becomes measurably elevated during STG exposure, which causes a depletion of antioxidants such as glutathione, particularly in the liver.

Roridin E

Roridin E is a macrocyclic trichothecene produced by the mold species Fusarium, Myrothecium, and Stachybotrys (i.e. black mold). Trichothecenes are frequently found in buildings with water damage but can also be found in contaminated grain. This is a very toxic compound, which inhibits protein biosynthesis by preventing peptidyl transferase activity. Trichothecenes are considered extremely toxic and have been used as biological warfare agents. Even low levels of exposure to macrocyclic trichothecenes can cause severe neurological damage, immunosuppression, endocrine disruption, cardiovascular problems, and gastrointestinal distress.

Verrucarin A

Verrucarin A (VRA) is a macrocyclic trichothecene mycotoxin produced from Stachybotrys, Fusarium, and Myrothecium. Trichothecenes are frequently found in buildings with water damage but can also be found in contaminated grain. VRA is a small, amphipathic molecule that can move passively across cell membranes.
The primary tissues affected by VRA are intestinal and gastric mucosa, bone marrow, and spleen. VRA causes damage to human cells by inhibiting protein and DNA synthesis, disrupting mitochondrial functions, and by producing oxidative stress (due to generation of free radicals). Exposure to VRA can cause immunological problems, vomiting, skin dermatitis, and hemorrhagic lesions. 

Markers in the MycoTOX Profile  

Enniatin B1

Enniatin B1 is a fungal metabolite categorized as cyclohexa depsipeptides toxin produced by the fungus Fusarium. This strain of fungus is one of the most common cereal contaminants. Grains in many different countries have recently been contaminated with high levels of enniatin. The toxic effects of enniatin are caused by the inhibition of the acyl-CoA cholesterol acyltransferase, depolarization of mitochondria, and inhibition of osteoclastic bone resorption. Enniatin has antibiotic properties and chronic exposure may lead to weight loss, fatigue, and liver disease.

Zearalenone (ZEA)

Zearalenone (ZEA) is a mycotoxin that is produced by the mold species Fusarium, and has been shown to be hepatotoxic, haematotoxic, immunotoxic, and genotoxic. ZEA is commonly found in several foods in the US, Europe, Asia, and Africa including wheat, barley, rice, and maize. ZEA has estrogenic activity and exposure to ZEA can lead to reproductive changes. ZEA’s estrogenic activity is higher than that of other non-steroidal isoflavones (compounds that have estrogen-like effects) such as soy and clover. ZEA exposure can result in thymus atrophy and alter spleen lymphocyte production as well as impaired lymphocyte immune response, which leads to patients being susceptible to disease.

Gliotoxin

Gliotoxin (GTX) is produced by the mold genus Aspergillus. Aspergillus spreads in the environment by releasing conidia which are capable of infiltrating the small alveolar airways of individuals. In order to evade the body’s defenses Aspergillus releases Gliotoxin to inhibit the immune system. One of the targets of Gliotoxin is PtdIns (3,4,5) P3. This results in the downregulation of phagocytic immune defense, which can lead to the exacerbation of polymicrobial infections. Gliotoxin impairs the activation of T-cells and induces apoptosis in monocytes and in monocyte-derived dendritic cells. These impairments can lead to multiple neurological syndromes.

Mycophenolic Acid

Mycophenolic Acid (MPA) is produced by the Penicillium fungus. MPA is an immunosuppressant which inhibits the proliferation of B and T lymphocytes. MPA exposure can increase the risk of opportunistic infections such as Clostridia and Candida. MPA is associated with miscarriage and congenital malformations when the woman is exposed in pregnancy.

Dihydrocitrinone

Dihydrocitrinone is a metabolite of Citrinin (CTN), which is a mycotoxin that is produced by the mold species Aspergillus, Penicillium, and Monascus. CTN exposure can lead to nephropathy, because of its ability to increase permeability of mitochondrial membranes in the kidneys. The three most common exposure routes are through ingestion, inhalation, and skin contact. CTN has been shown to be carcinogenic in rat studies. Multiple studies have linked CTN exposure to a suppression of the immune response.

Chaetoglobosin A

Dihydrocitrinone is a metabolite of Citrinin (CTN), which is a mycotoxin that is produced by the mold species Aspergillus, Penicillium, and Monascus. CTN exposure can lead to nephropathy, because of its ability to increase permeability of mitochondrial membranes in the kidneys. The three most common exposure routes are through ingestion, inhalation, and skin contact. CTN has been shown to be carcinogenic in rat studies. Multiple studies have linked CTN exposure to a suppression of the immune response. 

  Common Genera of Mold Tested by MycoTOX Profile  

Aspergillus

Aspergillus is the most prevalent mold group in the environment. It has caused billions of dollars of in damage to crops and livestock. Two of the most common Aspergillus mycotoxins are aflatoxin and ochratoxin. The main target of these toxins is the liver. These toxins have been found in all major cereal crops including peanuts, corn, cotton, millet, rice, sorghum, sunflower seeds, wheat, and a variety of spices. They are also found in eggs, milk, and meat from animals fed contaminated grains. Diseases caused by Aspergillus are called aspergillosis. The most common route of infection is through the respiratory system. Aspergillus can cause severe asthma when the mold colonizes the lung, forming a granulomatous disease.

Penicillum

There are over 200 species of Penicillium that have been discovered. Penicillium chrysogenum is the most common of these species. It is often found in indoor environments and is responsible for many allergic reactions. Penicillium is also a known contaminant in many different food items. Many different types of citrus fruits can become contaminated with Penicillium, but it can also contaminate seeds and grains. One reason that Penicillium is such a common infestation is because of its ability to thrive in low humidity. In the home, Penicillium can be found in wallpaper, carpet, furniture, and fiberglass insulation. The most common mycotoxin produced by Penicillium is ochratoxin (OTA). Ochratoxin is nephrotoxic, which means that it damages the kidneys. It is also carcinogenic.

Stachybotrys

Stachybotrys is a greenish-black mold. This mold can grow on materials with high cellulose and low nitrogen content such as gypsum board, paper, fiberboard, and ceiling tiles. Stachybotrys is known for its production of the highly toxic macrocyclic trichothecene mycotoxins. Two of the more common mycotoxins produced by Stachybotrys are roridin E and verrucarin. In addition to these mycotoxins, the fungus produces nine phenylspirodrimanes, as well as cyclosporine, which are potent immunosuppressors. These immunosupressors along with the mycotoxin trichothecenes may be responsible for the high toxicity of Stachybotrys

Fusarium

Fusarium’s major mycotoxins are zearalenone (ZEN) and fumonisin. Fusarium fungi grow best in temperate climate conditions. They require lower temperatures for growth than Aspergillus. Fusarium grows worldwide on many different types of grains including corn and wheat. Exposure to mycotoxins from Fusarium can lead to both acute and chronic effects. These symptoms can include abdominal distress, malaise, diarrhea, emesis, and death. ZEN possesses estrogenic effects and has been implicated in reproductive disorders.

The 40 Species of Mold and the Mycotoxins They Produce  

  Common Sources of Mold Exposure in the Home

Treatment Recommendations & Associated Disorders  

Recommendations for Treatment of Mycotoxins

If you or a patient has done a MycoTOX Profile and the results show moderate to high levels of mycotoxins there are things you can do to help the body eliminate the toxins and prevent future exposures. The first step is to eliminate or reduce exposure to mold. The majority of exposures result from contaminated food, skin contact, and inhalation of spore-borne toxins, which is often caused by water-damaged buildings. Inhalation of spore-borne toxins can be limited by detecting and eliminating damp and moldy environments, both indoor and outdoor.

Mold can enter homes through open windows, vents, doorways, and heating and air conditioning systems. Mold grows well on organic products such as paper, wood, cardboard, and ceiling tiles. Mold can also grow on insulation, drywall, wallpaper, carpet, fabric, and upholstery. Mold can be controlled by cleaning and drying after
water intrusion; having proper ventilation for showers, laundry, and cooking areas; making sure that windows, roofs, and pipes are free of leaks; and by controlling humidity levels. After moisture problems are alleviated it is recommended that mold removal be performed by a licensed contractor. Attempts to remove mold may cause mold spores to scatter and spread to other areas. In addition, treating mold without proper ventilation could result in health problems caused by the release of mycotoxins from the mold spores.

Treatment for mold exposure should include fluid support to prevent dehydration. The drug Oltipraz can increase glutathione conjugation of mold toxins while inhibiting the toxic effect of P450 oxidation, reducing liver toxicity and promoting safer elimination. A diet of carrots, parsnips, celery, and parsley may reduce the carcinogenic effects of mold. Bentonite clay and zeolite clay are reported to reduce the absorption of mold found in food. Supplementation with chlorophyllin, zinc, A, E, C, NAC, rosmarinic acid, and liposomal glutathione alone or in combination have been shown to mitigate the oxidative effects of mold toxins.

Disorders and Symptoms Associated with Exposure to Mycotoxins

Testing that Pairs Well with the MycoTOX Profile

When you order the MycoTOX Profile, we recommend adding any of the following tests that will provide additional information about markers correlated with mycotoxin exposure, most of which can be added to the same urine sample:

  • Organic Acids Test
  • GPL-TOX (Toxic Non-Metal Chemical Profile)
  • Glyphosate Test

Specimen Requirements for the MycoTOX Profile

10 mL of the first morning urine before food or drink is suggested. Fasting for 12 hours may increase the excretion of mycotoxins from the adipose tissue. However, fasting is not recommended if running this test in combination with other urine tests.

Sample Report and Interpretations

For a list of references, go to: www.greatplainslaboratory.com/gplmycotox

Frequently Asked Questions

HOW DOES THE GREAT PLAINS LABORATORY TEST FOR MYCOTOXINS?

The MycoTOX Profile at The Great Plains Laboratory uses the power of advanced mass spectrometry combined with liquid chromatography (LC/MS/MS) to test easily collected urine samples for very low levels of these fungal toxins. The technology used here is considered the best available anywhere in the world. In addition, In addition, The Great Plains Laboratory has pioneered the development of artificial intelligence software to improve the detection of chromatographic peaks in a manner superior to that of human analysts.

WHY DOES THE GREAT PLAINS LABORATORY PERFORM A CREATININE CORRECTION FOR MYCOTOXINS?

Application of the creatinine correction is a technique to reduce excessive variation in urine test results due to differences in fluid intake prior to collection of urine samples. It is a technique used by all reputable laboratories such as Mayo Clinic. It is not done by our competitors. Dividing the amount of a substance in urine by creatinine corrects for cases in which the patient may be dehydrated or excessively hydrated. In the case of dehydration, failure to perform creatinine correction might indicate that the person has toxic levels of mycotoxins when, in fact, the values are high just due to dehydration. With creatinine correction, such an error is avoided.

WHAT DISEASES ARE ASSOCIATED WITH MYCOTOXINS?

Virtually every neurological disease has been associated with mycotoxin exposure: autism, Alzheimer’s disease, amyotrophic lateral sclerosis, multiple sclerosis, and Parkinson’s disease. There is a strong association between mycotoxin exposure and cancers, especially liver and kidney cancers. Diseases and symptoms linked to mycotoxin exposure include fever, pneumonia-like symptoms, heart disease, rheumatic disease, asthma, sinusitis, nose bleeding, cancer, memory loss, vision loss, chronic fatigue, skin rashes, depression, ADHD, anxiety, and liver damage. A study of patients with chronic fatigue found that all the patients had high levels of mycotoxins in the urine.

HOW DO MYCOTOXINS AFFECT INDIVIDUALS WITH NEUROLOGICAL DISEASES LIKE PARKINSON’S DISEASE?

Ochratoxin A is the most common mycotoxin produced by both Aspergillus and Penicillium species. It causes acute depletion of brain striatal dopamine and its metabolites, accompanying evidence of neuronal cell apoptosis in the substantia nigra, striatum and hippocampus. Depletion of dopamine in these areas of the brain are commonly associated with Parkinson’s disease which is frequently treated with L-DOPA to replace dopamine in the areas of the brain depleted of dopamine.

SHOULD I USE PROVOKING AGENTS TO INCREASE EXCRETION OF MYCOTOXINS PRIOR TO URINE COLLECTION?

A number of provoking agents such as glutathione, clay, charcoal, and others increase excretion of mycotoxins. However, the people used to produce the reference ranges for each of the mycotoxins did not use any of these agents. Therefore, the use of such agents would be like comparing apples to oranges. We strongly advise you not to use such agents.

Arrange to get a urine mycotoxin test (MycoTOX Profile) from The Great Plains Laboratory. Any health care practitioner can order the test. Sometimes you may be frustrated if your regular health care provider is not knowledgeable about testing and treatment for mold. In such cases, call customer service to get a good referral. Although food may be a source of mold, in the USA water-damaged buildings in your, office, school, or car are much more frequently a source of mold-related illnesses. Quite frequently, a person may also be colonized in their gastrointestinal tract with mold they were exposed to in a previous location.

If an experienced mold inspector cannot detect mold in your current home or office, you might have gastrointestinal mold colonization. In such cases, the person may need to have antifungal treatment to get well. Mold inspection of buildings is quite challenging and may be more of an art than a science. When buildings are contaminated by flooding or major leaks from storms, finding mold may be relatively straightforward. In such cases, effective treatment will not be accomplished until remediation has been completed. This can be expensive, and the owner of the damaged building may want to get several bids and references from the contractors performing such work. If you live in an apartment or rental house, you will need to get your landlord to take care of the repairs. Since the work is often expensive, you may also need to contact a lawyer with experience in such cases.

SHOULD I ONLY ATTEMPT TO TREAT MYCOTOXINS THAT ARE VERY HIGH?

Studies have shown that even low levels of mycotoxins over a long period of time can cause serious illness.

ARE MYCOTOXINS ONLY DUE TO MOLDS?

No, some mycotoxins are produced by poisonous mushrooms.

ARE THERE OTHER WAYS THAT I CAN BE EXPOSED TO MOLDS?

Individuals may be exposed to molds in a variety of pharmaceutical products that were not adequately sterilized after preparation.

WHAT AGENTS HAVE BEEN USED TO REDUCE MYCOTOXINS FROM MOLDS?

The drug Oltipraz can increase glutathione conjugation of mold toxins while inhibiting the toxic effect of P450 oxidation, reducing liver toxicity and promoting safer elimination. A diet of carrots, parsnips, celery, and parsley may reduce the carcinogenic effects of mold. Bentonite clay and zeolite clay are reported to reduce the absorption of mold found in food. Supplementation with chlorophyllin, zinc, A, E, C, NAC, rosmarinic acid, and liposomal glutathione alone or in combination have been shown to mitigate the oxidative effects of mold toxins. Charcoal is also a very effective agent in binding most mycotoxins.

I HAD A MYCOTOXIN TEST AND ALL THE VALUES WERE IN THE NORMAL RANGE. IS THERE SOMETHING WRONG?

Remember there are over 200 kinds of mycotoxins that have been identified. The mycotoxin test at The Great Plains Laboratory has been designed to detect many of the most well-known mycotoxins that are associated with diseases, but it does not detect all mycotoxins. Also remember that there are many illnesses with the same symptoms that may be caused by different causes. A negative test can be very important in telling the physician and patient to look elsewhere to find the cause of an illness.