There are two ways to test for mould exposure in the blood: the direct, and, the indirect way.
- The Direct Way: Mycotoxin antibody testing. Mycotoxins are metabolites of mould that we breathe in.
- The Indirect Way: Biomarkers associated with mould exposure – this comes from The Shoemaker Protocol.
Test For Mould Exposure: Understanding Different Available Tests
Before focusing on blood testing for mould, let’s summarise all the options available. Five primary types of tests are available, each with its benefits and limitations.
- There are urine tests that look at the ‘‘body burden’’ of mycotoxins. I have blogged extensively on mycotoxins, and you can find the section of the blog dedicated to this topic here.
- There are blood tests that look at how the immune system is reacting to mycotoxins.
- There are blood tests that look at various biomarkers, including certain hormones, that are known to be affected by mould exposure.
- There are tests that evaluate your exposure by assessing dust samples from your property.
- And there is the visual contrast sensitivity test.
It’s important to appreciate that the research on all of these tests is limited, and there is no perfect test. It is, therefore, really important to work with a practitioner who is experienced and knowledgeable on the pros and cons of each test.
There are currently no FDA-approved laboratory tests for mycotoxins.
Why Do Some Get Sick, And Others Don’t?
What can make this whole process very confusing for people is the fact that two people may have similar levels of exposure to a toxic mould but be affected by it very differently. I have seen couples become divided because one of them is healthy and one is unwell and considering their options (which sometimes include remediation, or moving property!).
There are different reasons why this may be the case, ranging from their health status at the time of the exposure to their genetics and the amount of time they spend in the property.
The first two factors contribute to the couple having very different capacities to detoxify the toxins.
I read an interesting question in a blog once (I can’t remember the source): What question are you trying to answer: “Have I been exposed to mould?” or “How is my body handling the exposure?”
Blood Mycotoxin Testing
MyMycoLab is a laboratory specialising in blood serum antibody testing for mycotoxins. The laboratory tests for 12 different mycotoxins for both IgG and IgE antibodies.
So, this test can tell you how your body is currently reacting to specific mycotoxins by measuring markers of immune system reactivity.
But again, research is limited for this test. It also can’t inform you how much mycotoxin you’re eliminating, which, clinically, can be incredibly helpful to know.
The counterargument to this is that some people have a reduced capacity to eliminate mycotoxins, and thus, you can get false negatives or don’t get an accurate idea of their total body burden or mycotoxins. This might be a time when serum testing for antibodies makes sense?
Interestingly, the lab says this about the results:
IgG antibodies to mycotoxins indicate that, currently, the immune system is reacting to mycotoxins. It is not an indicator of past exposure. IgG to any toxin, including mycotoxins, is current exposure.
As a lot of us know now since the pandemic, IgG to organisms such as viruses and bacteria, (but also moulds and parasites) is an indication of past exposure.
The lab also says that if you have a positive IgE result, that is an indication that the mycotoxins are activating mast cells, resulting in an inflammatory reaction. This could lead to MCAS – mast cell activation syndrome.
There are other markers in the blood that some specialises recommend, though. These primarily come from the Richie Shoemaker Protocol.
Other Blood Markers Indicative Of Mould Exposure
VIP – Vasoactive Intestinal Polypeptide
Vasoactive intestinal polypeptide (VIP) is a gut peptide hormone originally reported as a vasodilator (something that promotes the dilation of blood vessels) (source). It also regulates smooth muscle activity, blood flow in the digestive system, and regulates inflammatory responses throughout the body. (source)
In the gut VIP influences things like nutrient absorption, gut motility and imbalances can therefore lead to chronic, watery diarrhoea. (source)
Another role of VIP is to enhance blood circulation to the heart and lungs. Imbalances can, therefore, lead to unusual shortness of breath, especially in exercise.
According to survivingmold.com, every multiple chemical sensitivity patient Dr. Shoemaker has seen (over 500) has had low VIP.
MSH – Melanocyte Stimulating Hormone
Alpha melanocyte stimulating hormone (MSH) reduces the concentration of proinflammatory molecules.
It does this by inducing cyclic adenosine monophosphate (cAMP) and inhibiting of NF-κβ (an inflammatory pathway in the cell), thus protecting the brain and peripheral organs from inflammatory disorders. (source)
According to Richie Shoemaker, in mould illness, MSH will be too low in over 95% of patients.
Interestingly, there have been some recent reports about the direct antimicrobial activity of α-MSH against various microbes belonging to both fungal and bacterial pathogens. (source)
TGF Beta-1 – Transforming Growth Factor Beta-1
TGF beta-1 plays an important role in numerous cell functions, including:
- Proliferation: which is the growth and division of cells.
- Differentiation: which means the ‘‘maturation’’ of cells so they can carry out specific functions.
- Motility: i.e cell movement
- Apoptosis: which is the technical term for ‘‘controlled cell death’’.
So it clearly has a very broad impact on many processes, and as a result, TGF beta-1 plays a role in:
- Embryo development
- Wound healing.
- Tissue regeneration
- The formation of new blood vessels (called angiogenesis)
- Immune system regulation.
Too much or too little of this protein can have detrimental effects.
C4A is part of a “complement” group of proteins. The term complement simply means it is able to kill bacteria and is involved in immunity. The problem arises when there are too many compliments; this can result in tissue damage and trigger an allergic reaction.
C4A also activates other complement proteins, including mast cells and neutrophils (key immune cells).
ACTH is a hormone released from the anterior pituitary gland in the brain. Many of us are familiar with cortisol which is often discussed as a key stress hormone but it has a significant role within immunity and our circadian rhythm too.
VEGF – Vascular endothelial growth factor
VEGF is a substance made by cells that stimulates new blood vessel formation and increases blood flow in the capillary beds.
Deficiency of VEGF is quite common and is a serious problem in those with mould illness and must be corrected. If you don’t have blood flow, cells won’t receive the nutrients they need to function optimally.
Antidiuretic hormone (ADH)
ADH is a substance produced naturally by the hypothalamus and released by the pituitary gland. The hormone controls the amount of water your body removes.
Symptoms associated with imbalances in ADH include dehydration, frequent urination, edema, excessive thirst, and static electrical shocks.
Another symptom can be weight gain as a result of fluid retention during the initial stages of rebalancing ADH levels.
Leptin is associated with CIRS – chronic inflammatory response syndrome.
Leptin is a hormone that regulates food intake, body mass, and reproductive function and plays a role in proinflammatory immune responses. Leptin is a product of the ob gene and is produced by fat cells.
Several studies have now implicated leptin in the development of chronic inflammation. The elevated leptin levels seen in obesity may contribute to a low-grade ‘‘inflammatory background’’ which makes people who are obese more susceptible to developing cardiovascular diseases, type II diabetes, autoimmunity, and cancer. (source)
Recommended test: Leptin blood test.
IgE & CC16
To finish, let’s summarise a paper published in 2022 entitled What should be tested in patients with suspected mold exposure? Usefulness of serological markers for the diagnosis.
The researchers investigated the associations of mould exposure, IgE-mediated sensitisation, inflammatory markers, and respiratory symptoms in 46 exposed and 23 non-exposed individuals.
IgE to mould was significantly higher and found more frequently in exposed (41%) than non-exposed individuals (17%), which was not observed for sIgG.
In addition, the serum concentrations of club cell protein (CC16) were significantly lower in exposed subjects, especially in asthmatics.
The authors concluded that sIgE is a useful diagnostic marker to verify mould-associated respiratory symptoms. (source)
Other Mould Exposure Tests
As you’re here, let’s just mention the other tests we mentioned at the beginning:
- Visual contrast test.
- Urine mycotoxin testing
- Environmental testing.
Visual Contrast Sensitivity Testing (VCS)
I have discussed this test as part of the blog:
The good thing about the VCS test is that it is very inexpensive, fast, and simple. It can also be easily repeated throughout treatment to gauge how effective the treatment is.
One study found that VCS scores were lower among employees of a school that had been exposed to water damage than employees at an unaffected school. (source)
Environmental Mould Testing
There are numerous do-it-yourself kits that are available to test for mould in your home if you suspect a problem.
Limited research has shown that the popular ERMI (Environmental Relative Moldiness Index) test can detect environmental mould that correlates with asthma (source).
One of the problems with these tests, certainly if done alone, is that they obviously don’tdon’t tell you how your body is responding to that mould. That said, done alongside a urine mycotoxin or blood test can help connect the dots.
Urine Mycotoxin Testing
These can help assess someone’s total body burden’’ and also shed light on their capacity to actually eliminate the toxins. I find these tests to be the most helpful in clinical practice.
There are numerous blood markers that may be helpful when considering testing for mould and how it is affecting your health. It is important to know though, that mould and mycotoxins are not the only thing that will influence these blood markers. So, they must be considered alongside a person’s symptoms, health history, and lifestyle.