Diagnostic Tests
Routine Tests
Depending on the person and their story, these are some routine tests to rule out other diseases and detect dysfunction that needs to be treated:
Complete Blood Count Useful for detecting anemia, chronic or acute infection, allergic responses. Usually normal in biotoxin illness.
Comprehensive Metabolic Panel (includes glucose) Glucose problems as well as elevated liver enzymes or electrolyte imbalances will be seen here. Usually normal in biotoxin illness.
Hemoglobin A1C Unless glucose issues, normal in biotoxin illness.
Fasting Insulin Especially if weight gain is present with biotoxin illness, can be abnormal showing insulin resistance. Lipid Panel Measures cholesterol and the other lipids. Usually normal in biotoxin illness.
C Reactive Protein Inflammatory marker that is usually normal in biotoxin illness unless there is injury or autoimmune disease present.
Erythrocyte Sedimentation Rate Inflammatory marker that is usually normal in biotoxin illness unless there is injury or autoimmune disease present.
Antinuclear Antibody with Reflex Testing Usually normal in biotoxin illness unless autoimmune disease is present. Serum Haptoglobin Can indicate red cell destruction, such as when there is Babesia infection present.
Thyroid Stimulating Hormone Measures thyroid function, which may be compromised with biotoxin illness.
Free T3 Measures thyroid function, which may be compromised with biotoxin illness.
Free T4 Measures thyroid function, which may be compromised with biotoxin illness.
Thyroid Peroxidase Antibodies Measures thyroid antibodies, which may be elevated in biotoxin illness.
Thyroglobulin Antibodies Measures thyroid antibodies, which may be elevated in biotoxin illness.
Tissue Transglutaminase Antibody Measures antibodies to gluten and gliadin in wheat, which may be elevated in biotoxin illness. 25-OH Vitamin D Often low in biotoxin illness as vitamin D is hormone that your body uses up during inflammation.
Estradiol, Progesterone, Free and Total Testosterone Often low in biotoxin illness as hormone production is compromised with low pituitary hormone production, especially MSH.
Specialized Biotoxin Tests
Lab testing for biotoxin illnesses, including mold illness, are listed below. Treatment depends on which tests are abnormal, and there is an order to treating them (see My Approach). Usually there are several of these that are abnormal, while most routine tests are normal.
HLA-DR haplotype (DRB1, DQ, DRB 3,4,5) are gene combinations that show susceptibility to inflammatory and autoimmune conditions due to their combination of immune response genes. There are several types that have been identified, and over 25% of the world population has one of these susceptible types. This test must be done by PCR at Lab Corp.
Melanocyte Stimulating Hormone (MSH) If MSH production is blocked by inflammation due to a biotoxin illness or by MARCoNS bacteria (see below), levels of MSH fall. Low MSH results in low melatonin production, causing sleep problems. Endorphin production will also be low resulting in excess chronic pain and perhaps depression. MSH controls pituitary hormone production and if MSH is low, there will be a loss of hormonal control with several other types of hormones like testosterone. Low MSH causes leaky gut and the development of food sensitivities. Most importantly, low MSH prevents you from controlling your own inflammation, meaning that future exposures cause continued out-of-control inflammation. Normal MSH: 35-81.
Anti-diuretic hormone (ADH) ADH production by the pituitary is often disrupted in biotoxin illness, resulting in excess urination (even to the point of dehydration) with excess salt remaining in the blood (measured by serum osmolality). There may also be a layer of sodium chloride on the skin making the person extra-conductive of electricity; many patients have problems with increased static electric shocks. Low ADH but in-range or high osmolality can result in chronic dehydration, urinary frequency, excessive thirst, static shocks, and edema.
C3a and C4a These are split products of complement activation from the immune system. Each activates inflammation and stimulates smooth muscle spasm in small blood vessels, amongst other duties. C3a and C4a are often both high in current Lyme infection and other bacterial infections. Often, C3a is low or low normal and C4a is high in other biotoxin illnesses, most commonly mold toxin illness. C4a elevation also promotes histamine intolerance. This test must be done via Quest Lab.
Matrix Metalloproteinase-9 (MMP-9) MMP-9 is released in response to inflammatory chemicals produced by your immune system. High MMP-9 is a sign that you have an inflammatory response happening in your body due to a biotoxin illness. MMP-9 can destroy tissue, and has been implicated in demyelination in diseases such as MS. Lowering MMP-9 can improve headaches, neurological issues, cognitive brain function, muscle pain, breathing, static shocks, and urinary frequency. Normal MMP-9 is 85-300 ng/mL; optimal levels are under 250. The blood for this test must be spun and gotten into the freezer within 15 minutes of drawing or levels are unreliable.
Transforming growth factor beta one (TGF b-1) TGF b-1 is an inflammatory marker high in mold toxin illness but also in those with connective tissue disorders and especially prevalent in those with the 11-3-52B haplotype as well as those with ciguatera poisoning (another biotoxin illness that comes from consuming poisoned reef-caught fish). High TGF beta-1 causes shortness of breath due to remodeling of lung tissue from normal, fluffy cells to fibrotic, stiff cells that have trouble taking in oxygen efficiently. TGF beta-1 also drives autoimmunity.
Normal TGF b-1 is under 2380; optimal level is under 1800.
Vascular endothelial growth factor (VEGF) VEGF can be low in biotoxin illness, indicating reduced oxygenation, or can be high, indicating that your body is trying to compensate for low oxygen levels. Normal VEGF 31-86 pg/mL, high is over 86.
Vasoactive intestinal polypeptide (VIP) VIP is a pituitary hormone that regulates inflammatory responses from the immune system as well as regulating processes such as pulmonary artery pressure. Low levels are common in biotoxin illnesses, and symptoms of low VIP include having shortness of breath with exertion, and exercise intolerance due to low oxygen levels. Normal VIP range is 23-63 pg/mL.
MARCoNS MARCoNS (mulitply antibiotic-resistant coagulase negative staphylococcus) or other coagulase negative staph bacteria colonies that live in the deep nasal passages is common in all biotoxin illnesses. These are not an infection, but a commensal colonization. These bacteria send chemicals into the blood that increase inflammation and lower MSH which in turn creates more inflammation.
Visual Contrast Sensitivity (VCS) testing Over 90% of people with biotoxin illness will have a “fail” score on this visual test. Some people are good at compensating for visual deficits and will pass despite having biotoxin illness.
VCS testing asks you to look at lines of gray against a gray background and identify which direction they point. Biotoxin illnesses often produce a decline in the ability to see the edges of things, and is a reflection of inflammation in the brain that presses on the optic nerve. I use this test to monitor improvement in my patients during the initial part of treatment.
Great Plains Lab Mycotox test This test measures a selection of mycotoxins in the urine. I use glutathione (or sauna) prior to the test to help liberate mycotoxins so that we can see them. A few months into treatment, levels may actually be higher as you improve your ability to detox.
Tick-borne illness panel from DNA Connexions Many people with mold illness have tick-borne illness as well. Ticks produce tiny biotoxins that are similar to mold toxins. This is a urine test that tests for many species of Borrelia (Lyme and related bacteria), Babesia (a red cell parasite), Ehrlichia, Anaplasma, and Bartonella. It is a DNA test, so it’s not just checking for antibodies, which would show only what you’ve been exposed to but not what is actually there right now. Tick-borne bacteria like tissues such as bladder tissue, so this test uses urine to detect bacterial (and parasitic) fragments in DNA.
Walsh Nutrient Testing Panel I have training through the Walsh Institute in test for and treating mental health issues such as anxiety, depression, OCD, bipolar disorder, ADD and ADHD, amongst others with nutrient therapy. I got this training because it’s so powerful for resolving this issues, and much more effective, in many cases, than the standard pharmaceuticals. Tests for histamine, copper, zinc and kryptopyrroles are done through DHA Lab to help with diagnosis and treatment planning.
GI Map Biotoxin illness lowers immune function and low MSH exacerbates leaky gut issues. This test is done with any patient who has gut issues, especially if their issues don’t get better during the initial stages of detox. I also like to do the test on any patient who has autoimmune disease or autoimmune markers because 99% of the time there is gut dysfunction. This test will tell us about bacterial balance, yeast overgrowth, parasites, worms, digestive ability, gluten intolerance, and much more. It’s superior to most of the GI tests out there that I’ve used before. If indicated, further specialized testing for SIBO or autoimmune gut conditions can be performed.
Dr. Robin Thomson
