MycoTOX Profile

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Insight Into a Growing Health Threat

Mycotoxins, produced by certain mold species, are some of the most prevalent toxins and can come from many sources including buildings, vehicles, and food. These compounds have been recognized as a growing global health concern due to their acute and chronic adverse health impacts. Mycotoxin exposure can be difficult to diagnose without proper testing due to vague and often varied symptoms.

The MycoTOX Profile is Mosaic Diagnostics’ most comprehensive assessment of mycotoxins. Our state-of-the art urine-based assay accurately assesses levels of 11 different mycotoxins, including Aflatoxin M1, Ochratoxin A, Zearalenone, and Trichothecenes. The MycoTOX Profile has been designed to support clinicians uncover mycotoxin exposure – and guide a therapeutic strategy for prevention and treatment.

Urine
Turnaround Time: 1-2 weeks

Turnaround times are estimates. Detailed order tracking is available in the MosaicDX Portal.

MycoTOX Profile
* Available in English, Spanish, Japanese, Portuguese, French, Italian, German, Polish, Hungarian, Ukrainian
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What Patients Might Benefit from the MycoTOX Profile?

Exposure to molds can negatively impact health either directly due to inhalation or dermal contact with mold or mold spores – or secondarily due to the concomitant presence of their secondary metabolites, mycotoxins.

Symptoms and disease states that have been associated with mycotoxin exposure include the following:

  • Alzheimer’s
  • Anxiety/Depression
  • Asthma
  • Autism
  • Bronchitis
  • Cancer (e.g., Hepatic, Esophageal)
  • Chronic Fatigue
  • Cognitive Impairments
  • Headaches
  • Infertility
  • Inflammatory Bowel Disease
  • Intestinal Permeability
  • Multiple Sclerosis
  • Other Mood Impairments
  • Parkinson's Disease

Details

Why Test for Mycotoxins?

Mycotoxins cause adverse health effects that may be acute and chronic in nature that can manifest in various and ambiguous symptoms, 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. Providers assessing symptomatic patients with known mold exposure or with an environmental history concerning mold exposure, will also need to consider the concomitant presence of mycotoxins and their potential negative health impacts as proper testing is essential for accurate treatment. The MycoTOX profile is specifically designed to help healthcare practitioners identify mycotoxin exposure and guide a targeted prevention and treatment plan.

How Can Someone Be Exposed to Mycotoxins?

Common routes of exposure 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). Mold contamination can also affect nearly all indoor materials, including drywall, paint, wallpaper, carpeting, and more, posing various routes of exposure. 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.

How Does the MycoTOX Profile Measure Mycotoxins?

The MycoTOX profile utilizes state of the art liquid chromatography tandem mass spectrometry (LC-MS/MS) technology to ensure high specificity (or fewer false positive results) and capture free (unconjugated) mycotoxin presence even at low levels, this is crucial as mycotoxins, even at low levels of exposure, can cause serious health problems. Our test is so sensitive that we can detect amounts of many compounds in parts per trillion (ppt). To account for variations in fluid intake, we utilize creatinine correction to ensure accurate and reliable results. By utilizing LC-MS/MS technology, we can precisely identify all our analytes, reducing the risk of false positives. With the MycoTOX Profile, you can trust that you are receiving the most accurate and reliable results possible.

Learn More About the MycoTOX Test: Explore FAQs

Analytes

The MycoTOX urine-based assay assesses levels of 11 different mycotoxins.

Below is a list of all all analytes included in the test along with a brief description.

An aflatoxin of concern, AFM1, is a hydroxylated metabolite of AFB1 and is secreted in the milk of both humans and animals.

Ochratoxin A (OTA) which is the most prevalent, toxic, and clinically relevant fungal toxin of this mycotoxin group. While it has been associated with numerous negative health impacts, the kidney has been noted to be its main target organ – and studies indicate its association with nephrotoxicity in humans and animals.

Tricothecenes are extremely potent inhibitors of protein synthesis and have been described to have wide-ranging negative systemic effects including immunotoxicity (immunosuppression), gastrointestinal toxicity, neurotoxicity, and dermatologic manifestations.

The main toxic effect of Zearalenone relates to its endocrine disruptive capabilities and as such, resultant negative reproductive effects in humans and animals.

Chaetomium globosum is frequently isolated from materials found in water-damaged buildings – and is often referred to as ‘black mold.’

ENB has been shown to have endocrine disrupting properties as well as the ability to cross the blood brain barrier in in vitro assays.

Airborne Aspergillus fungal spores are ubiquitous in many environments making potential exposure to gliotoxin common. Gliotoxins have been found on linoleum flooring and wallpaper in water damaged buildings, as well as silage and other animal food stocks.

MPA is used as an immunosuppressive drug for the prevention of transplant rejection in the form of sodium mycophenolate (Myfortic™, Novartis) and a pro-drug, mycophenolate mofetil (CellCept™, Roche) – and as a result, its levels may be elevated on diagnostics in patients using these pharmaceuticals.

Sterigmatocystin is a precursor of aflatoxin B1 in fungi capable of producing aflatoxins. Despite the similarity of chemical structure of these two mycotoxins, Sterigmatocystin has been noted to be a less potent carcinogen than Aflatoxin B1 (AFB1). It is classified as a Group 2B carcinogen by the International Agency for Research on Cancer.

Exposure to CTN has been linked to the development of nephropathy, which is caused by CTN’s ability to increase the permeability of mitochondrial membranes in the kidneys. Rat studies have demonstrated that CTN is carcinogenic. Furthermore, several studies have linked exposure to CTN with a suppression of the immune response.

Sample Reports

The MycoTOX test report is a useful resource for practitioners who want to gain valuable insights into the underlying causes of illnesses.

Test Prep and Instructions

MosaicDX offers patient-friendly sample collection kits that simplify testing. Our kits include visual, step-by-step instructions for test preparation and sample collection, personalized shipping cards, and pediatric collection bags if needed. With MosaicDX, patients can easily collect samples for testing with confidence and accuracy.

Related Symptoms and Conditions

Mycotoxins, the toxic secondary metabolites of many fungal (mold) species, are ubiquitous in our environment and can interfere with crucial cellular structures and processes. These compounds exert immunosuppressive effects and many are cytotoxic and thus could potentially damage skin, lungs, and the gut microbiome. Exposure can result in mitochondrial damage as well as glutathione depletion, damage macrophage systems and raise sensitivity to bacterial endotoxins; and be associated with numerous health concerns such as cancer.

These compounds can suppress the immune system, cause cellular damage, and result in a range of health problems, including cancer. Exposure to mold and mycotoxins can occur through inhalation, skin contact or secondarily due to the concomitant presence of their secondary metabolites, mycotoxins.

Individuals exposed to molds may exhibit a wide array of non-specific, acute symptoms consistent with allergen or irritant exposure including the following:

  • Headache
  • Allergic conjunctivitis (red, itchy, watery eyes)
  • Sinus congestion
  • Nasal congestion, running and irritation
  • Sneezing
  • Sore throat
  • Coughing, shortness of breath
  • Asthma attack (in individuals with underlying reactive airway disease)
  • Development of mold allergy
  • Development of mold-induced asthma (in children).

Symptoms and disease states that have been associated with mycotoxin exposure include the following:

  • Alzheimer’s
  • Anxiety/Depression
  • Asthma
  • Autism
  • Bronchitis
  • Cancer (e.g., Hepatic, Esophageal)
  • Chronic Fatigue
  • Cognitive Impairments
  • Headaches
  • Infertility
  • Inflammatory Bowel Disease (IBD)
  • Intestinal Permeability
  • Multiple Sclerosis
  • Other Mood Impairments
  • Parkinson’s Disease

Discover how Dr. Neu, MD, leverages MycoTOX to improve patient outcomes.

“Reactions to mycotoxins can cause a whole host of symptoms, so anytime you have a group of symptoms that your puzzled about, I think of mycotoxins as a possible cause.” – Dr. Neuenschwander, MD

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Frequently Asked Questions

The ordering process for MosaicDX tests starts with your healthcare practitioner assessing your symptoms and recommending the most appropriate test.

Once a test has been recommended, collection kits can be conveniently ordered and delivered straight to your doorstep. If you already have a collection kit, you can register your test and begin the process at your convenience.

It is important to carefully follow the collection instructions and include all required information about yourself and your specimens when registering your test. When your specimens are collected, you can use the prepaid shipping materials provided in your kit to ship them to MosaicDX. Your results will be accessible online via the MosaicDX portal. We recommend scheduling an appointment with your healthcare practitioner to discuss your results and develop a plan for your healthcare

If you are located outside of the U.S., our customer service team can assist you in finding a distributor in your country. In countries where a distributor is not required, you can place an order through our international patient ordering site. Please note that all international shipping costs must be paid prior to shipping the kit.  

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:

Treatment is different for mold IgE allergy vs. mycotoxin toxic burden responses, identifying the type of response aids in treatment decision-making.

The IgE Mold Allergy Test is a serum profile that provides insight into the presence of mold allergens, while the MycoTOX Profile is a urine assay that assesses the levels of mycotoxins – low molecular weight, secondary metabolites of molds – excreted from the body.

These complementary profiles each provide a unique lens to assess potential mold-related illness in symptomatic individuals or those with known mold exposure and treatment.

  • Patients who do not have mold IgE allergies may still have mycotoxin burden.
  • Patients with positive mold IgE test results are more likely to have been exposed to mycotoxins.
  • IgE levels may indicate reactivity to mold species whose mycotoxin products were not excreted at the time of the mycotoxin test or are not among the mycotoxins included in the MycoTOX Profile.

Measuring mold allergen specific IgE levels may help predict an individual’s acute immune response to molds in their environment which can range from mild to severe. MosaicDX’s IgE Mold Allergy Test assesses 13 mold allergens, including several that commonly cause symptoms.

Individuals with chronic exposure to molds may exhibit symptoms that are not a result of an acute response to the mold, but rather to their mycotoxins – toxic, secondary metabolites that are produced by molds in the environment. The MycoTOX profile is a urine-based assay that assesses levels of 21 different mycotoxins, including metabolites of the most toxigenic classes: Aflatoxins, Ochratoxins, Zearalenones, and Trichothecenes.

Because it’s possible to have an allergenic reactivity to a mold species whose mycotoxin excretion is not included in the MycoTOX profile – or for an individual to have exposure to a mycotoxin producing mold not included in the IgE Mold Allergy Test – combining both the IgE Mold Allergy and MycoTOX Profile tests can provide a more complete assessment of an individual’s mold exposure.

Different states have regulations that define the scope of practice for practitioners. It is the practitioner’s responsibility to abide by these rules. Check with your state board of health to determine any restrictions related to laboratory testing. Please note, Mosaic Diagnostics does not offer testing in New York. 

Once you have opened your account, you have the options of ordering kits to stock in your office or drop-ship kits directly to your patients through your MosaicDX portal.   

Watch our short tutorial videos on how to conveniently  

Already have a kit? Watch this video on how to place an order for your patient using a kit from your inventory.   

Please refer to your test’s specific Test Preparation and Instructions for more information regarding the potential effects of medications, foods, and supplements on this test. 

You make also consult your healthcare provider prior to making any changes to your medications.

Acremonium sp.
Aureobasidium
F. graminearum
Phoma sp.
Alternaria
Chaetomium
F. incarnatum
Rhodotorula
A. flavipes
Cladosporium
F. moniliforme
Scopulariopsis
Aspergillus flavus
Cunninghamella
F. solani
Stachybotrys
A. fumigatus
Cylindrocarpon
F. verticillioides
S. chartarum
A. niger
Dendrodochium
Myrothecium roridum
Trichoderma viride
A. ochraceus
Exophiala
M. verrucaria
Ulocaldium
A. parasiticus
Fusarium avenaceum
Penicillium carbonarius
Verticillium
A. sydowii
F. cerealis
P. nordicum
 
A. versicolor
F. clumonrum
P. stoloniferum
 
A. viridictum
F. equiseti
P. verrucosum
 

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. 

Visit the payment information page for an overview of payment options and procedures along with insurance coverage overview.

NOTE: Insurance coverage for testing is based on several factors such as the type of procedure, diagnosis, and insurance policy guidelines. Patients are encouraged to contact their insurance company to check for coverage and to provide the procedure codes (CPT codes) and diagnostic codes (ICD-10 codes). The CPT codes can be found on the billing information page, while ICD-10 codes are provided by the practitioner.

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. 

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.

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).

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.

MosaicDX offers pediatric collection bags with adhesive tape for pediatric patients who have not been toilet trained. These bags can be used to collect urine from infants or young children. To request pediatric collection bags, please contact our Customer Service team

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 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.

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.

Together they provide necessary information about mycotoxin burden, nutritional need, mitochondrial function and detox capability in one, easy, urine sample.

Mold OvergrowthOrganic Acids Test:
GI tract invasive growth of metabolites of mycotoxins – aspergillus and fusarium
MycoTOX Profile:
Toxicity can happen independently or simultaneously with growth and colonization
Mycotoxin Potential ExposureX – 2 metabolites metabolite indicators aspergillus and fusariumX – 20 tests
Mycotoxin Toxic BurdenX
Mycotoxin Specific InfoX
Nutritional NeedX
Mitochondrial functionX
Detox capabilityX

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.

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Clinical References