Confirming fungal systemic exposure

The EPA, in its effort to avoid and negate government liability, has failed to implement any regulations or standards for indoor mold contaminants. The CDC downplays the health effects, as well as the chances of becoming ill from fungal exposure. Sadly, this has made it exceedingly difficult to find reliable testing and treatment methods.

Likewise, there are no Threshold Limit Values (TLVs) for mold concentrations against which a room or building can be measured to determine if or to what extent humans have been exposed to molds in that building. There are certain physiological and statistical tests that can help indicate if a person might have been exposed to mold. It is important to remember, however, that these tests are not commonly used; instead, they measure human exposure to molds in extreme situations. Humans are exposed to molds in the natural environment on a daily basis without any adverse effect on their bodies.  Over prolonged exposure, molds that produce mycotoxins can cause serious problems including mycotoxicosis, autoimmune disease; such as Multiple Sclerosis and fibromyalgia, and even Cancer.

Environmental illness is on the rise and few physicians appear to be extremely concerned; mostly due to ignorance of the possible severe complications.  This is not just some abstract ailment that manifests itself in someone's mind.  Mold, with it's spores and sometimes deadly mycotoxins, can compromise the immune system and cause apoptosis (death of cells) that initiate the immune system's reaction to the body's own constituents, which can lead to serious illness. 

For example, most patients test positive for ANA, the classic biomarker for autoimmune, but, after effective treatment, avoidance and removing the source of exposure, these tests may possibly become negative, or at least reduced significantly. Medicine considers autoimmune problems currently as "idiopathic", that is, there is no known cause.  An unexplained oddity is that doctors have noticed their mold exposed patients have still have elevated B cell activity ten years after exposure, which suggests an over activated immune system.  Mycotoxins (which have been confirmed to be neurotoxins) are also a known carcinogen so this can actually play double jeopardy on a patient's health.  Additionally, these organic elements, according to New York physician Eckardt Johanning could perpetuate the allergy asthma 'epidemic.'

Besides costly environmental reports, there are numerous tests on the market to determine if one has been exposed to mycotoxins, spores and candida.  The following tests can detect what mold antibodies exist in your system, thus what one may have been exposed to.  Additionally, an environmental report of the "sick building" may be conducted, although not necessary, unless you would like to document your exposure. 

Available testing methods

Spirometric tests: “Spirometry” is a general term for a physiological test that measures lung function. These tests are much more commonly used in measuring human exposure to molds. There are many forms of spirometric tests, and they are often used in diagnosing other sorts of respiratory disorders (such as asthma). They may indicate human exposure to molds because inhaled fungus often results in impaired lung function or respiratory in humans. Here are some of the commonly used tests in measuring exposure to molds: 

Forced Expiratory Volume in One Second (FEV1): In this test, the subject tries to exhale this highest volume of air possible in one second of a forced expiration. A person with normally functioning lungs can typically exhale 75% or more of their total lung capacity within one second.

Forced Vital Capacity (FVC): This basic test measures the total amount of air that a person can exhale from their lungs. It differs from the FEV1 test because there is no timed expiration; instead, the important factor is the maximum expiration potential of the subject.

Single Breath Carbon Monoxide Diffusing Capacity (DLCO): This test, somewhat more complicated than the previous ones, measures the body’s ability to exchange gases within the lungs. In this test, subjects inhale gas containing carbon monoxide; doctors can then monitor the levels of carbon monoxide in the bloodstream to study how well the lungs are allowing gases exchange across capillary membranes.

Skin prick tests: In these tests, similar to how doctors test for allergies, a person may be pricked with a mold allergen. If an allergic reaction occurs, or there is measurable production of certain human antibodies known to fight molds, then that could indicate human exposure to molds. For example, “IgE” is a common mold-induced antibody within the human body. These tests, however, are not performed nearly as often as the spirometric tests and can often produce misleading results. Because humans are exposed to molds in small amounts on a daily basis, this test can produce a false positive even the person has not been exposed to a dangerous amount of mold.

Measuring white blood cell counts: Though this test is not widely used when determining mold exposure, a person’s white blood cell (WBC) count can indicate that exposure has taken place. A higher than normal number of T-lymphocyte cells and natural killer cells—the body’s generalized defense system against foreign substances—can indicate higher than normal activity of the immune system, perhaps because of mold exposure.

The first commercial application of this chemiluminescent assay (CLA) is the measurement of total IgE and allergen-specific IgE in human serum. The CLA system is a second-generation adaptation of the MAST RIA allergy profiling system. The MAST CLA system assay protocol consists of three steps: overnight incubation of serum, a 4-h incubation with enzyme-labeled antibody, and a 30-min chemiluminescent reaction, which produces a visible image (immunograph) on high-speed Polaroid instant film. The densities of the bands produced on the film are quantified with an inexpensive microprocessor-controlled infrared transmittance densitometer. The novel luminogenic substrates used yield a constant light output for over 2 h with an intensity at least 10-fold greater than that of commercial chemiluminescent reagents. The MAST CLA system exhibits sensitivity, specificity, and precision equal to that of the MAST RIA system (r = 0.96 for 40 serum samples analyzed with 25 allergens). As many as 35 different allergens per sample can be quantified in a single assay. The MAST CLA system requires no standard curve or volume-dependent pipetting steps, incorporates both positive and negative controls for each sample, and quantifies allergen-specific IgE at picomolar concentrations.

Airborne fungi have been postulated as a cause of symptoms among office workers. Using the MAST chemiluminescent system, this study evaluated 36 IgG and 36 IgE antibody levels in 47 office workers from an area with elevated airborne fungal concentrations and 44 office workers from an otherwise similar area with lower airborne fungal exposure. No difference was found in IgG antibody to fungi between the lower and higher exposure areas, but high IgG antibody to one or more of the fungi studied was detected in 67% of all the workers tested. IgE antibody to one or more antigens was detected in 40% of the participants. Workers who reported atopic symptoms (sneezing, runny nose, and itchy eyes) or "sick building" symptoms (any three of the following temporally related to work: headache, fatigue, stuffy nose, irritated eyes, or sore throat) were more likely to have one positive IgE antibody test. Type I hypersensitivity to aeroallergens besides fungi may play a role in some symptoms reported by some participants in this office building.

Dr. William Croft in Wisconsin is currently conducting a urine tricothecene test. The test is simple, yet a bit costly.  Soon, there will be more types of these tests available to the public.  There is also the availability of a series of *serum antibodies tests available through Immunosciences Lab, Inc. Additionally, Great Smokies Laboratories also has many tests that can be taken to determine antibodies levels as well as environmental toxic levels.  Their tests are easy to take, yet costly. 

Because stachybotrys doesn't sporulate in the bloodstream the same as the other molds, it is very difficult to detect in a blood antibody test, so one of these serum tests can be fruitless if a patient is looking primarily for stachybotrys.  Stachybotrys, however, is almost always found in families with many other molds which are toxic and these molds can be measured by the blood antibodies tests.

Some important things to remember about testing:

  1. Allergy evaluation by skin or an invitro test for the detection of IgE mediated allergies are not enough for patients exposed to toxigenic molds in water-damaged building environments.
     
  2. Depending on the individual immune response to toxigenic mold antigens, some people may respond by producing IgG, while others may produce IgM and IgA antibodies against different fungal antigens.
     
  3. The measurement of IgG, IgM and IgA antibodies against toxigenic molds is necessary for the detection of exposure to mold spores antigens and mycotoxins.
     
  4. Intranasal and enteric exposure to mold antigens and mycotoxins leads to the production of specific IgA antibodies in saliva and other secretions.
     
  5. In addition to IgG, IgM and IgA antibodies in the blood, the measurement of total specific salivary IgA against mold antigens and mycotoxins is necessary in order to increase the sensitivity and specificity of mold exposure detection.
     
  6. Different parameters pertaining to the cellular (T-cell, B-cell, helper’s suppressor cell numbers, NK cell activity, T- and B-cell function, apoptosis) and the humoral immune system (immunoglobulins, C3 and C4 complement, immune complexes, ANA, thyroid and other tissue antibodies) should be measured for documentation of immune competency dysfunction in patients exposed to toxigenic molds. 
     
  7. Detection of auto-antibodies against MBP, MAG, gangliosides, sulfatide, chondroitin sulfate, glutamate receptor, cerebellar, Purkinje cells, neuron-axon filament protein, glial fibrillary acidic protein, tubulin, and other neurological antigens, indicating a neurotoxicity process initiated by toxigenic molds, which may result in: chronic sensory neuropathy, demyelinating sensorimotor neuropathies or Multiple Sclerosis-Like Syndrome.

To order testing with your local physician's approval, contact Immunosciences Lab, Inc. by clicking on this form, Mycotoxin Antibodies Test and printing it out and asking your physician to have your blood tested.   They have updated some of their tests, you may want to inquire. 

The University of Texas has been successful with DNA testing, at such a precise level, that one can even determine the origin of the fungi in question.  Additionally, some cutting edge physicians have been effectively using a DNA saliva tests to detect mold exposure in patients since  2001.  This was was noted especially in one particular patient whom  was suspected of past stachybotrys exposure.  This test revealed that the patient who had previously been suspected of formaldehyde exposure, had indeed been exposed to stachybotrys. The date of exposure was approximately nine years prior to the testing date.

Many physicians have stopped invasive testing such as the Methacholine Challenge, needle prick testing, and biopsies, unless they are absolutely necessary, as they are considered inhumane to most ethical physicians.  The Methacholine Challenge can be harmful, painful, and inconclusive.  This cruel test basically requires the patient to inhale irritating chemicals and a placebo through a nebulizer, while the patient does not know when each is administered.  Additionally, the only irrefutable way that a Methacholine Challenge test would be conclusive, is if the patient had the same test conducted prior to exposure and the test at that time was negative.  Injections of fungal properties to determine hypersensitivity can be dangerous as it could put the patient in an anaphylaxis shock.  The other tests listed on this page are the most conclusive, efficient, and ethical.  These types of tests are not advised, especially if you feel as though you suffer from multiple chemical sensitivity or mid to late stage mycotoxicosis as they could cause harmful effects.  You have a right to decline any type of testing or treatment, especially if you feel it to be barbaric in any way.

Questionnaires designed to study mold exposure can help determine if statistically a person (or building) is at risk for mold exposure. A standard environmental questionnaire generally inquires if a patient has experienced symptoms common to those experienced by people with mold exposure, the severity of those symptoms, and possible exposures to mold-contaminated facilities.

Prolonged and intense exposure to toxigenic molds and mycotoxins is associated with disorders of the respiratory and central nervous systems, the mucous membrane, mucosal immunity, as well as cellular and humoral immune dysfunction. Fungal antigens are able to cause occupational asthma, rhinoconjunctivitis, hypersensitivity pneumonitis and organic dust toxic syndrome (ODTS).  Growth of commonly occurring filamentous fungi in foods may result in production of toxins known as mycotoxins, which can cause a variety of ill effects in humans, from allergic responses to immunosuppression and cancer. The most dangerous mycotoxins are aflatoxins, ochratoxin A, fumonisins, trichothecenes and zearalenone. Aflatoxins are potent carcinogens and, in association with hepatitis B virus, are responsible for many thousands of human deaths per annum, mostly in non-industrialized tropical countries.  Ochratoxin A is a carcinogen, and has caused urinary tract cancer and kidney damage in people from northern and eastern Europe.  Fumonisins appear to be the cause of oesophageal cancer in southern Africa, parts of China and elsewhere. Trichothecenes are highly immunosuppressive and zearalenone causes oestrogenic effects in animals and man (see hidden mold for more information).

Unfortunately, due to rising power from profits in the pharmaceutical industry and their strong influence within AMA, FDA, and CDC, the traditional medical practice tends to favor treating a patient's symptoms and not the actual illness.  the profits from Prilosec (one of many common acid reflux symptoms 'remedy') earns its manufacturer, AstraZeneca approximately $6 billion dollars a year.  In most cases, mold patients suffer from acid reflux, yet 99.9% of all physicians would rather prescribe this type of temporary 'remedy' to treat the symptoms, rather than try to resolve the cause of the disease.  Further testing could help evaluate the real problem and advocating for those tests is an integral part of identifying the illness and conclusive treatment.

Remember, you are the only one who is able to understand and relate to your body's needs.  Always be in tune to what your symptoms are telling you.  It is your body's entire communication system.  Taking an active role in initiating tests, documenting symptoms and treatment methods, avoidance, and maintaining a positive attitude can be very helpful in the success of the diagnostic science of any medical condition. In some cases, this can be your best defense.

 

Below is a listing of research/services that Immunosciences Lab is currently offering:

* Comprehensive Metabolic Panel

 

 Included Tests:

Albumin, Ser/Plas

Alk P'tase, Total, Ser/Plas

ALT (SGPT), Ser/Plas

Anion Gap

AST (SGOT), Ser/Plas

Bilirubin, Total, Ser/Plas

Calcium, Ser/Plas

Chloride, Ser/Plas

CO2, Ser/Plas

Creatinine, Ser/Plas

Globulin

Glucose, Ser/Plas

Potassium, Ser/Plas

Protein, Total, Ser/Plas

Sodium, Ser/Plas

Urea Nitrogen,Ser/Plas

 

 

 Basic Metabolic Panel

            Included Tests

                Anion Gap

Calcium, Ser/Plas

Chloride, Ser/Plas

CO2, Ser/Plas

Creatinine, Ser/Plas

Glucose, Ser/Plas

Potassium, Ser/Plas

Sodium, Ser/Plas

                Urea Nitrogen,Ser/Plas

 

Hypersensitivty Pneumonitis Screen

            Included Tests:

IgG Antibody Panel

Interpretation

 

Sources:

 

AARC Clinical Practice Guideline (1999): Single Breath Carbon Monoxide Diffusing Capacity, 1999 Update. From Respiratory Care 1999;44(5):539-546. Available at: http://www.hsc.missouri.edu/~shrp/rtwww/rcweb/aarc/scmdccpg.html

 Bishop, C: Molds. Available at: http://www.aehf.com/articles/molds.html

 Hodgson, M. et al (1998): Building-Associated Pulmonary Disease from Exposure to Stachybotrys chartarum and Aspergillus versicolor. Journal of Occupational Medicine 1998; 40(3): 241-249.

 Kilpelainen, M. et al (2001): Home dampness, current allergic diseases, and respiratory infections among young adults. Thorax 2001; 56(6): 462-467.

 Page, E. and Trout, D. (1998): Mycotoxins and Building-Related Illness. Journal of Occupational Medicine 1998; 40(9): 761-763. 

Priory Lodge Education Limited (1997): Spirometry Questions and Answers. Available at: http://web.archive.org/web/20030605130937/http://www.priory.com/med/spiromet.htmmpty%20Reference!)

Respiratory Physiology Department – Prospectus. Available at: http://www.papworth-hospital.org.uk/what%20we%20do/thoracic/resp%20phys.htm

Robinson JM, Hong LH., A study of fungal exposure and accepted testing standards 2005; 32-45 (4)

Sampo S, Bergero R, Buffa G, Luppi-Mosca AM., 1997 Soil fungal communities in a young and an old Alnus viridis coenosis Mycologia 89:837-845

 

 

 

 

 

 

 

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This site is not intended to give medical advice.  Seek the advice of a professional for testing, medication, treatment options, and complete knowledge of any illness.  The opinions expressed here are exclusively my personal opinions do not necessarily reflect my peers or professional affiliates. I am not a physician, nor an expert on this subject.  The information here does not reflect professional advice and is not intended to supersede the professional advice of others

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