EnviroTOX Suite of Panels

Several substances measured by the TOXDetect Profile may come from various sources of exposure. The panel cannot determine the specific origin of the toxicant, but it can provide information on the most common sources. By collaborating with your healthcare provider, you can investigate and eliminate potential sources of exposure. 

•Organic acidic products of cellular metabolism that are excreted in urine (in mammals)

oProduced by living organisms including humans, bacteria, and fungi

oEvaluation of these downstream products of metabolic pathways provides insight into potential nutrient deficiencies, inflammation, toxicity, and other imbalances that could be contributing to clinical complaints

•Origins of Organic Acid Testing

oTo rule out rare Inborn Errors of Metabolism (IEM)- usually in infancy

oElevations of these organic acids (OA) reflect dysfunction in specific metabolic pathways

§Accumulation of these toxic metabolites can by life-threatening

§Symptoms observed in the newborn period include poor feeding and weight gain; nausea and vomiting; neuromuscular issues (e.g., poor tone, seizures); and susceptibility to infection

•Use of OAs have evolved from investigating IEM to providing insight into functional metabolic imbalances.

Patients with high toxic levels are at greater risk of concomitant exposure from all toxins. For patients with specific exposure history, practitioners can order individual panels or combine profiles to identify or more rapidly reduce or remove multiple sources of toxin exposure:

These test can all be done from one urine sample:

• Glyphosate
• TOXDetect Profile
• Heavy Metals
• MycoTOX

The following tests provide valuable insight into metabolism, nutrient needs, food sensitivities and metal toxicity.

• IgG Food Map with Candida + Yeast
• Heavy Metals Hair
• Organic Acids Test

The Organic Acids Test by Mosaic Diagnostics evaluates levels of oxalates in urine. Oxalate (and its acid form, oxalic acid), is an organic acid that is primarily derived from three sources: the diet, fungus (such as Aspergillus and Penicillium), possibly Candida, and also human metabolism. Oxalic acid is the most acidic organic acid in body fluids and is used commercially to remove rust from car radiators. Antifreeze (ethylene glycol) is toxic primarily because it is converted to oxalate in the body. Two different types of genetic diseases are known in which oxalates are high in the urine, hyperoxalurias type I and type II, which can also be determined from the Organic Acids Test. 

Foods especially high in oxalates are often foods thought to be otherwise healthy, including spinach, beets, chocolate, peanuts, wheat bran, tea, cashews, pecans, almonds, berries, and many others. People now frequently consume “green smoothies” in an effort to eat “clean” and get healthy, however, they may actually be sabotaging their health. The most common components of green smoothies are spinach, kale, Swiss chard, and arugula, all of which are loaded with oxalates. These smoothies also often contain berries or almonds, which have high amounts of oxalates as well. Oxalates are not found in meat or fish at significant concentrations. Daily adult oxalate intake is usually 80-120 mg/d. A single green smoothie with two cups of spinach contains about 1,500 mg of oxalate, a potentially lethal dose. 

High Oxalate Food List

External sources of oxalates include ethylene glycol, the main component of antifreeze. Antifreeze is toxic mainly because of the oxalates formed from it. In addition, some foods also contain small amounts of ethylene glycol. Vitamin C (ascorbic acid or ascorbate) can be converted to oxalates but the biochemical conversion system is saturated at low levels of vitamin C so that no additional oxalate is formed until very large doses (greater than 4 g per day) are consumed. The high correlation between arabinose and oxalates indicate that intestinal yeast/fungal overgrowth is likely the main cause for elevated oxalates in the autistic spectrum population. The deposition of oxalates in critical tissues such as brain and blood vessels, the oxidative damage caused by oxalate salts, and the deposition of oxalate mercury complexes in the tissues.

Mosaic Diagnostics offers written interpretations within test reports and complimentary consultations with our clinical educators for qualified practitioners. To schedule a consultation, simply sign in to your MosaicDX account and book a consultation online. 

We encourage all patients to discuss results with your practitioner.

Our Resources tab also contains educational materials that you may find useful, we also offer MosaicEDGE workshops for qualified practitioners to better understand the fundamentals of lab testing.

As expected with the clinical standard of care, results from any diagnostic test – including those of the MycoTOX profile – should always be considered within the context of each patient’s unique history and clinical presentation. Given that, the information provided on potential therapeutic support for patients with mycotoxin exposure is provided for educational purposes only.

In general, practitioners working with patients with mold and/or mycotoxin exposure focus on three key clinical areas:

• Addressing Mycotoxin Exposure
• Supporting the Foundations of Health
• Judicious Use of Supplements and/or Pharmaceuticals

Address Mycotoxin Exposure

First-Line Remediation/Defense: Removal/Avoidance of the Offending Agent

The first line of defense against mycotoxin exposure – as with any toxin or toxicant – is identification and remediation of the source of exposure with the goal of preventive exposure strategies going forward.

Support the Foundations of Health

Focus on Critical Lifestyle and Physiologic Elimination Functions

Optimize Elimination

• Gut Function
  • Support phase 1 and 2 liver detoxification
  • Provide treatments aimed at abnormalities in gut microflora and functioning; probiotics, treating infections and avoiding food allergens.
• Hydration
  • Support elimination/excretion via the kidney
• Sweating (movement, saunas, etc.)
  • Support elimination/excretion via dermal routes

Optimize Nutrition

• Focus on a whole foods diet to maximize fiber and nutrient density

Judicious Use of Supplements and/or Pharmaceuticals

Personalization of the therapeutic journey is key as each patient’s presentation and history is unique.

Clinicians working with patients with mycotoxin exposure and/or symptoms may consider working with the following:

• Foundational support
  • Multivitamin/mineral, probiotic (acidophilus + bifidus strains), antioxidants, and essential fatty acids
• Detoxification support
  • NAC, glutathione
• Binders
• Anti-fungals
  • These pharmaceuticals should be assessed for use on a clinical case-by-case basis ONLY given challenges related to their potential, significant side-effects.

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. 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.

Mycotoxins are low molecular weight, secondary metabolites of fungal (mold) compounds which are increasingly recognized as a global health threat given their role in precipitating both acute and chronic adverse health outcomes.

• Common fungi sources of mycotoxins include species such as Fusarium, Aspergillus, Penicillium, Alternaria, and Claviceps. To date nearly 400 potentially toxic mycotoxins produced by more than 100 fungi species have been identified, although research has focused on the most toxigenic in the public health, veterinary, and agricultural realms.
• Exposure to mycotoxins may occur through a variety of routes such as inhalation, ingestion, and dermal contact from airborne mold spores, food contamination, and water-damaged building environments.
• Susceptibility to mycotoxins is influenced by a patient’s age, sex, presence of other underlying diseases and/or exposures, nutritional status, and length of exposure.
• While mycotoxin toxicity may present as an acute state marked by rapid onset with potential life-threatening illness, most of the negative health impacts observed in the developed (Western) world are due to chronic, low-dose exposures. These long-term exposures have been associated with a variety of systemic effects (mycotoxicoses) in both humans and animals – and most commonly manifest as nephrotoxicity, hepatotoxicity, immunosuppression, carcinogenicity, and teratogenicity.

Acute mycotoxin effects are characterized by rapid onset and toxic response in the target organ most affected by the offending agent.

As an example, consumption of large doses of aflatoxins can result in life-threatening, acute poisoning (aflatoxicosis) due to detrimental impact on the liver.

Acute mycotoxin effects are more frequently observed in economically poorer global areas where sub-optimal food cultivation, harvesting, and storage practices are common; malnutrition is a constant presence; and a poor regulatory environment exists.

Chronic mycotoxin effects are characterized by lower exposure doses over longer periods of time – and symptoms attributed to chronic mycotoxin exposure are wide-ranging in their impact on an array of physiologic systems and functions.

Mycotoxins are toxic metabolites produced by certain types of molds – microscopic filamentous fungi that are pervasive in both outdoor and indoor environments. Common routes of exposure to these low-molecular weight compounds include inhalation, dermal contact, and ingestion via common contaminated food sources (corn, cereals, ground and tree nuts, spices, dried fruits, apples, coffee, meat, milk, and eggs).

Attention is increasingly being given to indoor air pollution resulting not only from the influx of irritant agents (spores, pollens) from the outdoor environment, but also from the growth of molds, fungi and bacteria on almost all indoor materials (drywall, paint, wallpaper, carpeting, etc.) when excessive moisture is present in high humidity geographic areas or water-damaged buildings. The growth of these biological agents in damp environments leads to the production of spores, cells, fragments and volatile organic compounds which have been linked to a wide range of health hazards, including exacerbation of asthma as well as allergic and infectious respiratory diseases infections.

Adverse health effects may be acute or chronic in nature, and the degree of impact can vary depending on the age, sex, genetics, and underlying health status of the exposed individual, as well as the duration and dose magnitude of the offending substance and their synergistic effects with other mycotoxins.

Because mycotoxins are byproducts of mold metabolism, clinicians assessing symptomatic patients with known mold exposure – or with an environmental history concerning for mold exposure – will also need to consider the concomitant presence of mycotoxins and their potential negative health impact as well.

The MycoTOX profile is designed to accurately detect mycotoxins produced by various toxic molds. However, it does not indicate the location or source of the mold, whether it is in your home, workplace, or elsewhere. Mycotoxin exposure can come from both dietary and environmental sources. Spoiled food is a dietary source, while living or working in water-damaged buildings, airborne or physical contact with outdoor molds, and airborne dust in buildings containing mold spores are environmental sources. 

Currently, there are no established guidelines for retesting mycotoxins after intervention. However, some healthcare providers recommend retesting at 3-6 months, 12 months, and annually as part of a wellness screen. Individuals with severe mold and mycotoxin-related illnesses may require more frequent testing. 

Molds thrive in warm, damp, and humid conditions, and exposure to mold-rich environments may result in a variety of health effects ranging from mild to severe depending on an individual’s sensitivity or underlying allergy to mold.

Given their ubiquitous presence, testing should be considered in anyone with signs and/or symptoms of mold exposure – or an environmental history for a known current or past exposure to mold.

Individuals at highest risk for health problems when exposed to mold include those with:

• Underlying immune system dysfunction (history of atopy, immune suppression, or immunodeficiency)
• Underlying chronic lung disease
• Infants, young children, and the elderly
• Workers employed in jobs that result in high and ongoing levels of exposure (farm/dairy workers, lumber/wood workers, winemakers).