Confirming a diagnosis of mold toxicity begins with a good history, but laboratory testing is required for diagnostic confidence. We look at markers of biotoxin reactivity like Transforming Growth Factor Beta 1, C3a, and C4a among others. We also look at urine mycotoxin levels to confirm exposures and to which molds someone was exposed to. These labs confirm our clinical suspicions that someone is affected by mold toxins, but still do not explain why they are affected.

Beyond these tests, we could look at human leukocyte antigen (HLA) typing, a genetic test that tells how the immune system handles biotoxins, including the mold biotoxin. These HLA markers affect how antigens (biotoxins in this case) are processed. The differences in processing play a large role in influencing the patient’s ability to get rid of mycotoxins. The markers also tell about the expected intensity of a person’s response to these ubiquitous mycotoxins. Due to these HLA differences, biotoxins make some people sick even at levels which do not affect others.

While we looked at these genetic markers in the past, we no longer test these unless requested. If someone is demonstrating biotoxin reactivity by the other tests and have mycotoxins in their urine, we do not really need to speed a few hundred more dollars to tell them that they are sensitive to mold toxins. That is a foregone conclusion. We can move on and treat them without spending that money on tests which do not change how we treat them. We will need to do other tests down the road on their home and repeat blood work on them later. The money for genetic testing will be better spent on these other tests which do impact on how we treat patients.

Besides HLA differences, other genetic differences may magnify or diminish a patient’s sensitivity to mold. The glutathione pathway, given its role in detoxifying some mycotoxins, may play a role. It is likely that many other pathways interact as significant factors in a person’s ability to clear mold toxins. I would not be surprised if genetic variants in Transforming Growth Factor Beta 1, the inflammatory pathways, as well as other detoxification pathways are one day found to affect a person’s sensitivity to mycotoxins. Some of the information on these pathways is still being studied. Again, there is little need to test these in detail. Our protocol does not need that information in order to help patients recover their health and their lives.