What test will diagnose me with Mould Illness/CIRS?

Diagnosis should first and foremost be made by a Mould Illness/CIRS-aware health practitioner looking at a patient’s symptoms and diagnoses, health history, and environmental history in conjunction with biomarker testing. No one test, or even a panel, can diagnose Mould Illness/CIRS with 100% accuracy.

How many of the tests below need to be abnormal for a CIRS diagnosis?
Short answer

In 2003 Dr. Shoemaker said at least 3 of  6 of biomarkers (known at that time) if symptom and environmental criteria were met. Speaking on the Low Tox Life podcast (#55, 50m02s) Dr. Sandeep Gupta said “Once you have around 3 abnormal markers, that should be sufficient.”

Other doctors will diagnose on other testing such as a positive urinary mycotoxin test. Whether this means the patients has CIRS, mycotoxicosis or mycotoxins coming from a normal diet is matter of some debate.

Long answer

From Dr. Shoemaker’s original Sick Building Syndrome (SBS) criteria from 2003 (note, this was before the discovery of C4a and TGF-b1 being elevated, and VIP being lowered, in CIRS):

1. We propose that a definition of a case of SBS include each of the following elements
– potential for exposure to buildings with a documented toxigenic fungi, evident fungal growth or a history of water intrusion with musty smells;
– presence of multiple symptoms in at least 4 of 8 system categories
– absence of confounders
2. At least 3 of the following 6
– VCS deficits
– MSH deficiency
– MMP9 elevation
– HLA genotype
– ADH/osmolarity dysregulation
– ACTH/cortisol dysregulation
3. Final criteria for case management
– Response to CSM, with abatement of symptoms and resolution of VCS deficit to control levels
– Reduction of leptin, if elevated, with treatment
– Reduction of MMP9, if elevated, with treatment
4. Clinical note needs to be made of
– Presence of MARCoNS in deep nasal spaces
– Elevated levels of myelin basic protein antibodies”

From a 2020 paper:

…The difference is that CIRS literature has data on many recognized biomarkers and a published treatment protocol [7], but PICS does not. These biomarkers include symptom clusters for CIRS acquired following environmental exposures to biotoxins and inflammagens in water-damaged buildings (WDB), finding at least 8 of 13 clusters present.
Proteomic biomarkers compared to controls [4] include
(i) increased relative risk for specific HLA haplotypes;
(ii) presence of a distinctive deficit seen in visual contrast sensitivity (VCS);
(iii) reduction of mean levels of melanocyte-stimulating hormone (MSH);
(iv) dysregulation of ACTH to cortisol and
(v) ADH to osmolality;
(vi) elevated C4a,
(vii) TGF beta-1, and
(viii) MMP9;
(ix) suppression of vascular endothelial growth factor (VEGF);
(x) increased incidence of antigliadin and
(xi) anticardiolipin antibodies [7].
Functional CIRS WDB biomarkers include
(a) a distinctive “fingerprint” of volumetric abnormalities [22-24] seen on NeuroQuant™;
(b) reduction of VO2 max and
(c) anaerobic threshold shown by pulmonary stress testing;
(d) elevated pulmonary artery pressures at rest, or (e) after exercise on echocardiogram;
(f) transcriptomics.

CIRS Focused Tests

These tests predominantly concern the mechanism of innate immune activation, often diagnosed using the case definition of CIRS—chronic inflammatory response syndrome.

Vision test

Visual Contrast Sensitivity (VCS)

The VCS is a simple visual test used to screen patients to see if they are affected by biotoxins/toxicants, as these cause inflammation that results in hypoperfusion (lack of blood flow) throughout the optic nerve. The test measures your ability to distinguish between finer and finer increments of light versus dark (contrast).  It is available as a handheld version at a doctor’s office or online via the Surviving Mold website.

Research from Dr. Shoemaker suggests an accuracy of 92% (8% false negatives, 2% false positives) for the handheld kit, which is the gold standard. Accuracy of the online versions has only been recently studied (with results yet to be published) but, anecdotally, practitioners find it less than those numbers. MAC advises to try both the Surviving Mold ($15 USD) and VCSTest (free or contribution) and stick with the test that you find most accurate, usually the one where you get more fails.

If you test negative, you should go onto other screening and diagnostic testing to confirm or rule CIRS out, but you may still be able to rely on VCS to track treatment progress.


Surviving Mold
VCSTest.com

Blood tests (Medicare rebate)

The following are blood tests with Medicare item numbers. To have these bulk billed will depend on the willingness of your physician to tick the direct bill (DB) box on a test requisition form. VIP and Leptin are the only two tests that fasting is required.

HLA DR/DQ Gene Test
The HLA DR/DQ gene test show haplotypes (gene combinations) of susceptibility to CIRS-WDB/mould illness, Post Lyme Syndrome (PLS) and multi-susceptible (susceptibility to mould, PLS and dinoflagellates/ciguatera/toxic algae).

Having a HLA positive does not mean you have CIRS or are destined to develop CIRS but you may be more susceptible to develop it after sufficient exposure to damp and water-damaged buildings or other biotoxin exposures.

Correct laboratory group — Sonic Pathology

Sonic Pathology Australia are a network of pathology laboratories in every Australian state. See their website or the picture on the right (or above) for locations in your state.

Test information: HLA Panel Screen (DR and DQ)

Test name: Ask the GP to request “HLA DR-DQ typing” — Do NOT write coeliac

Medicare rebate

It can be fully or partly Medicare rebateable depending on your practitioner and laboratory. Medicare item number 71151. No rebate is available via NutriPATH.

Price varies from lab to lab but ranges from $119 to $180.

NutriPATH

NutriPATH do report the HLA DR/DQ test in the correct format also.

Test name: HLA DQ/DR Genetic Studies
Test number: 3401
Test cost: $180

Interpretation

Interpretation can be done by a Mould Illness/CIRS-aware health professional or via the HLA calculator. If you are still unsure please post your results in the TMSA Facebook group.

Vasoactive Intestinal Polypeptide (VIP)
FASTING TEST

What it Is: VIP is produced in many tissues including the gut, pancreas, and suprachiasmatic nuclei of the hypothalamus in the brain. VIP stimulates contractility in the heart, causes vasodilation, increases glycogenolysis, lowers arterial blood pressure and relaxes the smooth muscle of trachea, stomach and gallbladder.

Significance in CIRS: VIP is  often, but not always, low in CIRS. Low levels can lead to inflammation, immune dysregulation, post-exertional malaise/exercise intolerance and, according to Dr. Shoemaker, multiple chemical sensitivity (MCS). Replacement via VIP nasal spray is the last step in CIRS therapy.

Collection: Most Australian pathology labs can collect and send to Royal Prince Alfred/Sydney Southwest Pathology. A special collection tube is required and will usually have to be ordered in before the blood draw. Consult with your local path lab to arrange. VIP collection and information page.

Medicare: Medicare item number 66695.
Normal Range:  6.81-18.65 pmol/L (23-63 pg/mL, conversion ref).

Osmolality (serum)
About: Serum (or plasma) osmolality measures the body’s electrolyte–water balance.

Significance in CIRS: Dr. Shoemaker has found 60% of biotoxin illness patients have dysregulated ADH/osmolality — seen as low ADH with high serum osmolality. Such patients have excessive thirst and may need to urinate every 30 minutes, or more, due to low ADH causing an inability to retain the water that has been drunk. As the salt level in blood rises, due to the lack of free water, some salt is released on the skin creating a battery like effect leading to frequent static shocks. Additionally migraine-like headaches due to dehydration may occur.

Notes: This should be drawn at the same time as Copeptin (see below).

Medicare: Medicare item number 66563.
Normal Range: 280-295-297 mmol/kg.

Testosterone & Oestradiol
What it Is: Testosterone is often low while Oestradiol is often elevated in CIRS due to upregulation of the aromatase enzyme. Testosterone replacement is not generally recommended in CIRS as it will just convert to Oestradiol.
ACTH & Cortisol AM
What it Is: Adrenocorticotropic Hormone (ACTH) is a hormone made by the pituitary gland and controls the production of another hormone called cortisol. Cortisol is made by the adrenal glands, two small glands located above the kidneys and helps to respond to stress among other functions.

Significance in CIRS: ACTH and cortisol are often high early in the disease while later they may drop to low-normal or below normal levels. Ideally measure these in blood, as opposed to saliva or urine, in the morning.

DHEA
What it Is: Dehydroepiandrosterone (DHEA) is a hormone that your body naturally produces in the adrenal gland. DHEA helps produce other hormones, including testosterone and estrogen. Natural DHEA levels peak in early adulthood and then slowly fall as you age.

Significance in CIRS: DHEA is often low in CIRS. Ideally test blood levels of DHEA-sulphate (DHEA-S).

Antigliadin antibodies IgA/IgG
Significance in CIRS: Sometimes elevated in CIRS due to low MSH and not coeliac disease.

Normal Range: 0-19

Cardiolipin antibodies IgA/IgG/IgM
What it Is: Cardiolipin antibodies are autoantibodies produced by the immune system that mistakenly target the body’s own cardiolipins, substances found in the outermost layer of cells (cell membranes) and platelets. These autoantibodies can affect the body’s ability to regulate blood clotting.

Significance in CIRS: These are sometimes elevated in CIRS due to its dysregulation of the immune system.

Normal Range: IgA – 0-12; IgG 0-10; IgM 0-9

Private ordering (no doctor referral needed / non-Medicare)
iMedical allow patients to build their own blood tests with no doctor’s referral needed.

  • $19 – base fee
  • $39 – VIP
  • $29 – ACTH
  • $29 – Cortisol
  • $29 – Osmolality (Serum)
  • $29 – DHEA-S
  • $49 – Testosterone Free/Total + SHBG
  • $29 – Antigliadin antibodies
  • $86 – Antiphospholipid antibodies

Note: The HLA DR/DQ test is not available via iMedical. Prices current as of January 2025.

Blood tests (Out-of-pocket)

Leptin
FASTING TEST

What it Is: Leptin is an adipokine, a cytokine released by adipose (fat) tissue. High levels can lead to persistent weight gain that is unresponsive to diet and lifestyle interventions.

Significance in CIRS: It is frequently, but not always, elevated in cases of CIRS. It is hypothesised by Dr. Shoemaker that inflammatory cytokines damage the leptin receptor in the hypothalamus thus not allowing leptin to dock and instead recirculate.

Collection: Most Australian pathology labs can collect and send to Royal Prince Alfred/Sydney Southwest Pathology, but total cost (collection plus test) varies from lab to lab. Prices for collection vary so check with your local pathology centres for the best price. In Queensland QML are the cheapest ($60). Leptin collection and information page from SSWP.

Dr. Shoemaker’s normal range: Depends on age, sex and BMI. Dr. Shoemaker gives the following normal range: Male: 0.5-13.8 ng/mL; Female: 1.1-27.5 ng/mL.

Copeptin (was ADH)
INTERPRET WITH SERUM OSMOLALITY (SAME DRAW)

What it Is: Antidiuretic Hormone (ADH) or vasopressin is a neuroimmune peptide hormone made by the hypothalamus in the brain and stored in the posterior pituitary gland. It tells your kidneys how much water to conserve. ADH constantly regulates and balances the amount of water in your blood.

Significance in CIRS: Dr. Shoemaker has found 60% of biotoxin illness patients have dysregulated ADH/osmolality — low ADH with high serum osmolality. Such patients have excessive thirst and may need to urinate every 30 minutes, or more, due to low ADH causing an inability to retain the water that has been drunk. As the salt level in blood rises, due to the lack of free water, some salt is released on the skin creating a battery like effect leading to frequent static shocks. Additionally migraine-like headaches due to dehydration may occur.

Notes: Most labs including the one below now offer the precursor C-Terminal Pro Arginine Vasopressin (copeptin) as a marker which has 1:1 compatibility with ADH.

Collection: Most Australian pathology labs can collect and send to Royal Prince Alfred Hospital via Sydney Southwest Pathology. Prices for collection vary so check with your local pathology centres for the best price. Copeptin collection and information page.

Dr. Shoemaker normal range: 1.0-13.3 pg/ml.
RPA normal range: < 15.2 pmol/L (fasting) < 16.3 pmol/L (non-fasting), < 14.5 pmol/L (non-fasting paediatric)
Quest (US) normal range: < 14 pmol/L

VEGF
What it Is: Vascular Endothelial Growth Factor (VEGF) is a protein produced by many cells that stimulates the formation of blood vessels.

Significance in CIRS: VEGF can be low, normal, or high in CIRS patients. Low levels may be due to increased TGF-b1 levels, and contribute to capillary hypoperfusion, causing symptoms such as fatigue, muscle cramps, and shortness of breath due to mitochondrial dysfunction.

Significance in other diseases: High levels are seen in bronchial asthma, diabetes mellitus, some cancers and Bartonella infection.

Collection: Most Australian pathology labs can collect and send to Peter MacCallum Cancer Centre, Royal Melbourne Hospital. Prices for collection vary so check with your local pathology centres for the best price. In Queensland the cost is $200, via QML.

Dr. Shoemaker/Quest (US) normal range: 31-86 pg/mL

Private ordering (no doctor referral)
iMedical allow patients to build their own blood tests with no doctor’s referral needed.

  • $19 – base fee
  • $98 – Copeptin
  • $76 – Leptin
  • $189 – VEGF

Blood tests (Non-NATA accredited)

TGF-b1, C4a, MMP-9, MSH
Many of Dr Shoemaker’s core CIRS tests — the inflammatory markers Transforming Growth Factor Beta-1 (TGF-b1), Complement C4a (C4a), and Matrix Metalloproteinase 9 (MMP-9), plus the protective neuropeptide hormone alpha-Melanocyte Stimulating Hormone (MSH) — are not currently available via any NATA accredited Australian laboratories.

More details on these tests, including normal ranges, can be found on Surviving Mold’s Lab Tests for Mold Illness.

GENIE
The GENIE transcriptomic test looks at the RNA expression of 215 genes, developed by Dr Shoemaker and Dr Jimmy Ryan, PhD to diagnose, track, and enable subtyping of, CIRS. It is only available in Australia via Mycotox at present.

Blood tests (NutriPATH)

NutriPATH’s blood tests and biotoxin/mould panel (apart from HLA DR/DQ and MARCoNS) cannot be recommended at this time due to inaccuracies compared to Quest Diagnostics. Ref: Mold Illness in Children webinar (35m) and Low Tox Life #55 (39m22s).

Nasal Swab for MARCoNS and Fungi (Out-of-pocket)

MARCoNS

Multiple Antibiotic Resistant Coagulase Negative Staphylococci are organisms that colonise in the nasal areas due to low MSH. They produce toxins and deplete MSH further.

  • Obtaining the collection tube
    1. Direct from Microbiology Dx
      Order swab kit from Microbiology Dx free of charge. Go to the ‘Order Collection Kits’ page and fill in the details. You’ll need to put Australia onto the ‘City, State, Zip’ field. You will need to include your doctor’s details on the web form. Ideally email them and ask for the Remel® BactiSwab™ wire shaft transport swab – although the default swab will suffice.
      Alternatively you can use an aerobic nasal swab from your doctor and get your doctor to fill out the requisition form.
    2. NutriPATH
      Order a kit via NutriPATH, who send it on to Microbiology Dx.
  • Performing the swab
    • This can be done by a doctor or patient. The swab needs to go through the nose rightA summary of an integrated protocol might look like this:upA summary of an integrated protocol might look like this: to the back of the throat, about 3 inches. Swivel the swab for 3-5 seconds when you reach the throat. It is unpleasant but not painful. Read the Microbiology Dx instructions or read the blog post on Biotoxin Journey for directions.
  • Sending swab to Microbiology Dx
    • When used with the correct swab, the sample is viable for up to 30 days. There are several options for sending it to Microbiology Dx. Write “non-infectious sample” on the customs form.
      1. Australia Post air mail letter. The cheapest option.
      2. Australia Post’s EMS Courier.
      3. FedEx. Supplied with the kit from Microbiology Dx.
  • Sending swab to NutriPATH
    • Follow the instructions in the NutriPATH kit.
  • Cost
    • Currently the cost for MARCoNS and other bacteria with sensitivities is US$85. The results will be emailed to your doctor. NutriPATH is more expensive (AU$150).
  • Fungal culture testing
    • This is available at an additional cost (US$80) and takes longer to report than MARCoNS.
  • Biofilm testing
    • This is optional (US$100) but can be useful as it tells you if any biofilm is present and at what strength. Dr Shoemaker originally deduced that MARCoNS produced biofilm when they were resistant to 2 or more antibiotic classes but this may not always be the case.
  • Interpretation
    • If the culture reveals coagulase negative staph which are resistant to two or more antibiotics then you are positive for MARCoNS and should be treated with a suitable nasal spray (see 5.2 MARCoNS Treatment). The amount (“large amount” etc.) is not important. If the culture is methicillin resistant you may herx more when using anti-microbials. Staph coag positive (golden staph), staph coag neg with only one antibiotic resistance, non-staph bacteria are common findings and do not need to be treated generally.

Microbiology Dx (USA)NutriPATH (Aus)
Microbiology DX
19A Crosby Drive
Bedford MA 01730, USA
P: +1 (781) 265 4956
W: microbiologydx.com

Ordering: Microbiology DX will FedEx collection kits free worldwide, visit the Order Kits page (add Australia to the “City, State, Zip” field) . You don’t have to use FedEx to send the sample back, simple Australia Post Airmail letter ($2.75) is usually fine. Requisition form (PDF).

Add on tests including a biofilm test which will rate the strength of the biofilm from 0 to +3 (only done if MARCoNS is present) and a fungal culture test.

Instructions: Nasopharyngeal Culture Collection Procedure

Costs
MARCoNS/bacterial culture: USD $85  (main one to get)

Fungal culture: USD$80
Biofilm analysis: USD$100

Melbourne based NutriPATH can also be used.

Test name: MARCoNS culture
Test code: 3404
Cost: AUD$150

Test name: MARCoNS & Fungal culture
Test code: 3418
Cost: AUD$300

NeuroQuant® (volumetric MRI) (Part Medicare rebate)

NeuroQuant® by Cortech Labs is a software program that can map and quantify brain regions for microscopic changes via an MRI scan. NeuroQuant® is not used for diagnosis per se but more for tracking neuroinflammatory and atrophic changes.

Dr Mary Ackerley believes the Triage Brain Atrophy Report (TBAR), that takes into account normal ranges for patient sex and age, is more accurate than the general morphology report alone.

SE QLDSydneyMelbournePerthNZMedicareInterpretation
X-ray & Imaging Maroochydore
49 Baden Powell Street
Maroochydore QLD 4558
P: 07 5409 2800
www.xrayimaging.com.au

Note: Primarily only for the patients of Doctors Sandeep Gupta and Georgina Hale.

Mermaid Beach Imaging and Radiology
2469 Gold Coast Highway
Mermaid Beach QLD 4218
P: 07 55619 9499
mermaidbeachradiology.com.au

St Vincent’s Hospital
Level 3, Xavier Building
360 Victoria Street
Darlinghurst NSW 2010
P: 02 8382 3495
svhm.org.au

I-Med Network Radiology
Suite 3, Level 1
38B Albert Ave
Chatswood NSW 2067
P: 02 8440 3100
i-med.com.au

Not available at present
Envision Medical Imaging
178-190 Cambridge St
Wembley
P: 08 6382 3888
W: www.envisionmi.com.au
Auckland Radiology Group
101 Remuera Road
Auckland
New Zealand
P: 09 529 4850
W: arg.co.nz
The MRI portion can be covered by Medicare if you fulfil the criteria for “unexplained seizure(s)” or “chronic headaches with suspected intracranial pathology” item number 63551 if referred by a General Practitioner.  Although this ultimately rests with the requesting practitioner.

There will usually be an additional charge for NeuroQuant processing by Cortechs labs ($200 AUD).

Surviving Mold now have an online NeuroQuant analysis available that you can enter your General Morphology report and be given a mold and/or Lyme score and also looks at multi-nuclear atrophy, traumatic brain injury and asymmetry. Cost is $25 USD.

Non CIRS Tests

Urinary Mycotoxin tests (Out-of-pocket)

Urinary mycotoxin testing has proven an increasingly popular biomarker test in mould illness. There are three main laboratories in the US doing this testing; Great Plains Laboratory (GPL), Realtime Labs (RTL) and Vibrant. The first two are available in Australia.

Realtime in their Mycotoxin panel use enzyme-linked immunosorbent assay (ELISA) technology while Mosaic in their MycoTOX profile use liquid chromatography tandem mass spectrometry (LC-MS/MS) technology.

Mosaic Diagnostics (formally Great Plains)
MycoTOX Profile [info page]

Australian distributor: RN Labs
Cost: AUD$515 (+ $20 postage)
Client ordering: No
Mycotoxins tested: Aflatoxin M1, Ochratoxin A, Sterigmatocystin, Zearalenone, Roridin E, Verrucarin A, Enniatin B, Gliotoxin, Mycophenolic acid, Citrinin, Chaetoglobosin A

RealTime Labs
Mycotoxin Testing [info page]

Australian distributor: NutriPATH
Cost: Initial #3413 AUD$630 / Extensive #3419 AUD$770
Client ordering: Maybe, contact NutriPATH for details.
Mycotoxins tested: Aflatoxin group, Trichothecene group, Ochratoxin A, Gliotoxin derivative (extensive only)

Science supporting urinary mycotoxin testing

Data on mycotoxins due to inhalation or colonization:

  • Brewer, J., Thrasher, J. & Hooper, D. (2013). Chronic illness associated with mold and mycotoxins: is naso-sinus fungal biofilm the culprit? Toxins, 24, 6(1), 66-80. doi: 10.3390/toxins6010066  PMID 24368325
  • Brewer, J., Thrasher, J., Straus, D., Madison, R. & Hooper, D. (2013). Detection of mycotoxins in patients with chronic fatigue syndrome. Toxins, 11, 5(4), 605-17. doi: 10.3390/toxins5040605 PMID 23580077
  • Brewer, J., Hooper, D. & Muralidhar, S. (2015). Intranasal antifungal therapy in patients with chronic illness associated with mold and mycotoxins: an observational analysis. Global journal of medical research: K interdisciplinary, 15(1). PDF
  • Hooper, D., Bolton, V., Guilford, F., & Straus, D. (2009). Mycotoxin Detection in Human Samples from Patients Exposed to Environmental Molds. International Journal of Molecular Sciences, 10(4), 1465–1475. MDPI AG. http://doi.org/10.3390/ijms10041465
  • Shaw, W. & Pratt-Hyatt, M. (2019). Biochemical Markers in the Urine Associated with Gastrointestinal Mold-Overgrowth Are Linked with Elevated Urinary Mycotoxins in Patients with Suspected Mold Illness. Townsend Letter, 436.
Dr Shoemaker's view
Dr Shoemaker’s perspective from 2019:

Even if we are presented with impeccable lab results from ELISA and thorough use of standard differential diagnosis (we aren’t), based on world-wide control data, and a robust literature on CIRS, there is no basis to ascribe any diagnostic significance to urine mycotoxin testing. ref

Serum Mycotoxin antibodies (Out-of-pocket)

myMycolab
Serum antibody testing for mycotoxins [FAQ page] Cost: USD$380
Client ordering: Yes. Have to arrange shipping via FedEx.
Info: MyMycoLab based in Florida USA, of which Dr Andrew Campbell is the medical director, performs serum IgE and IgG mycotoxin antibody testing for 12 different mycotoxins (24 results when combined). From the FAQ:

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).

Science supporting serum mycotoxin antibody testing

  • Vojdani et al. (2003). Saliva secretory IgA antibodies against molds and mycotoxins in patients exposed to toxigenic fungi. Immunopharmacol Immunotoxicol. 25(4):595-614. https://doi.org/10.1081/iph-120026444
  • Vojdani et al. (2003). Antibodies against molds and mycotoxins following exposure to toxigenic fungi in a water-damaged building. Arch Environ Health. 58(6):324-36. PMID 14992307
  • Campbell et al. (2003). Neural autoantibodies and neurophysiologic abnormalities in patients exposed to molds in water-damaged buildings. Arch Environ Health, 58(8):464-74. https://doi.org/10.3200/aeoh.58.8.464-474
  • Brasel et al. (2004). Detection of trichothecene mycotoxins in sera from individuals exposed to Stachybotrys chartarum in indoor environments. Arch Environ Health, 59(6):317-23. https://doi.org/10.3200/aeoh.58.6.317-323
  • Campbell et al. (2004). Mold and mycotoxins: effects on the neurological and immune systems in humans. Adv Appl Microbiol, 55:375-406. https://doi.org/10.1016/s0065-2164(04)55015-3

Organic Acids Testing (OAT) (Out-of-pocket)

An OAT can show a number of markers of fungal and bacterial GI colonisation. In addition it reports markers of glutathione status, oxalate status, vitamin B status and metabolism.

Mosaic Diagnostics
Organic Acids Test (OAT) [info page]

Organic acids are chemical compounds excreted in the urine of mammals that are products of metabolism. The Organic Acids Test (OAT) offers a comprehensive metabolic snapshot of a patient’s overall health with 76 markers. When elevated, markers 1-9 can indicate yeast and fungal overgrowth (dysbiosis) in the GI tract. Elevations of markers 10-18 can indicate bacterial overgrowth.

Australian distributor: RN Labs
Cost: AUD $359 (+$20 shipping)
Patient ordering: No

NutriPATH
Organic Acids Metabolomic Profile

The Organic Acids Metabolomic Profile is a nutritional test providing insights into organic acids and a view into the body’s cellular metabolic processes. Additionally, children’s reference ranges are designed to provide more accurate paediatric nutritional evaluations. Identifying metabolic blocks that can be treated nutritionally allows individual tailoring of interventions that maximise patient responses and lead to improved patient outcomes.

Australian lab: NutriPATH #4041

Mould Allergy/Fungal Infection Testing

Mould Allergy Testing
Mould allergy may exist in conjunction with other forms of mould illness, or it can be the sole issue.

    • Skin prick testing – Small amounts of the mould antigen can be put on the skin to see if a welt forms. May be a mould mix or an individual fungal genus/species including: Penicillium, Cladosporim, Aspergillus, Alternaria, Tricophyton, Candida albicans, Curvulaira 
    • IgE RAST testing – A blood test that can test for IgE antibody reactions to similar moulds as the skin prick testing.
    • Total IgE – In allergic conditions the total IgE level is often elevated.
    • Eosinophils – A type of white blood cell that can also be elevated in allergic conditions.

Fungal Infection Testing
Mycoses or fungal infections occur when fungus from the skin or GI tract migrate into, the bloodstream or an organ causing a serious infection.

  • Candida antibodies – Elevated Candida albicans antibodies can be an indicator that the yeast has migrated from the GI tract into the bloodstream, where it can cause invasive Candidiasis. Candida dysbiosis, where Candida is overgrown in the GI tract, is usually found via a stool/microbiome test and not via serum antibodies.
  • Aspergillus antibodies – Elevated Aspergillus fumigatus IgG, and sometimes IgE, antibodies can indicate chronic pulmonary aspergillosis, aspergilloma or aspergillus rhinosinusitis. Elevated IgE antibodies can indicate Aspergillus allergy/sensitisation although skin prick testing is a more sensitive method.
  • Culture – Both candidiasis (via blood or tissue) and aspergillosis (via sputum or tissue) can be cultured and examined via microscopy.

References

  • Lab tests for mold illness. n.d. SurivingMold.com
  • Berry, Y. (2014). The physician’s guide to understanding and treating biotoxin illness. SurvivingMold.com. Link.