Mycotoxins and Neurotoxicity Part 3: What To Do About Mycotoxins

What To Do About Mycotoxins

When mold mycotoxins reach our brains, headaches, dizziness, and cognitive symptoms are some of the most troublesome of symptoms that are debilitating for most people. These symptoms prevent people from operating normally.  

Often, these mold mycotoxin symptoms create functional limitations:

• Reduced ability to work and financially provide for a family
• Reduced ability to spend quality time with family outside of work
• Reduced ability to engage in any extracurricular activities, exercise, or hobbies

Symptoms of neurological disorders caused by mycotoxins may include:

• New onset, or change in pattern, of headaches
• Headaches that gradually become more frequent and more severe
• Unexplained nausea or vomiting
• Vision problems, such as blurred vision, double-vision or loss of peripheral vision
• Dizziness
• Decreased motor function or gradual loss of sensation or movement in an arm or a leg
• Difficulty with balance
• Speech difficulties
• Feeling very tired or chronic fatigue
• Confusion in everyday matters
• Difficulty making decisions
• Inability to follow simple commands
• Personality or behavior changes
• Seizures, especially in someone who doesn’t have a history of seizures
• Hearing problems
• Anxiety or depression

These symptoms can be acute or in addition to any number of biological dysfunctions associated with short and long-term exposure to mycotoxins as well as the complexity of human biology and the brain. 

About Mycotoxins

Mycotoxins are secondary metabolites of specific fungi like Aspergillus, Alternaria, Fusarium, Penicillium, and Stachybotrys. Mycotoxins represent a very diverse group of 300–400 known different naturally occurring toxic chemicals.  These 300-400 differ from each other structurally and in their toxicity. Aflatoxin, ochratoxin, and trichothecenes are common subclasses of mycotoxins known for their public health impact via food and grain contamination. When ingested by animals or humans, mycotoxins cause a toxic response known as mycotoxicosis. Long term exposure can lead to nephropathy, various types of cancer, alimentary toxic aleukia, hepatic diseases, various hemorrhagic syndromes, and immune system dysfunction. These diseases that can be related to digested mycotoxicosis. You can learn more about mycotoxin poisoning HERE.

How do Mycotoxins Reach Our Brains?

For oral or injected medicines to reach the brain, they must cross the Blood-Brain-Barrier (“BBB”).  The BBB is highly selective, meaning it only allows certain substances to cross from the bloodstream into the brain. Before a medication can be considered to pass the BBB, it must first be orally bioavailable and get past liver metabolism before distribution into the blood supply.  After that, the molecule must have specific qualities to pass the BBB.  The BBB functions to protect the brain from toxins and pathogens. Only water, certain gases (e.g. oxygen), and lipid-soluble substances can easily diffuse across the barrier. In some situations, glucose can be actively transported across the blood-brain barrier.

There are no precise diagnostics for mycotoxins that can be relied upon for medical decisions.  Because of that, it is often important to identify the context of the exposure.  The physician may need to explore the environmental circumstances that exposed people to mycotoxins.  It requires the doctor to take more time with the patient.  Patients must provide current and historical information about their home to help determine the context and presence of mycotoxin exposure. 

Existing mycotoxin diagnostics are limited to urine testing and dust sampling that provide evidence of mold.   Mycotoxin testing is limited for a variety of reasons.   Only 16 mycotoxin assays have been developed for environmental testing in just a few laboratories in the country.  In addition, there is an expected false negative error from urine testing methods.  This limits the ability to make conclusive diagnosis with urine testing.  Environmental mycotoxin testing of dust in a home is considered circumstantial evidence that a person has been exposed to mycotoxins.

Direct Access to Brain

There is some research that suggests inhaled mycotoxins can reach the brain directly.  Because of the location of the sinuses and BBB, direct access to cerebral spinal fluid is possible.  In addition, the brain has a candida receptor that can be activated.  This could lead to hyphae growth that can penetrate brain tissue. 

Mycotoxins exposed to sinus and brain tissue are unlikely to pass through the gut, liver, and enter the blood stream.  Direct access to the brain can explain the myriad of neurological and cognitive symptoms associated with mycotoxin poisoning.

Environmental Diagnostics

Mold Testing

Testing for molds that produce mycotoxins is the most straightforward manner to determine whether mycotoxin poisoning is a possibility.  These tests will not conclusively identify mycotoxins; however, significant toxic mold contamination due to water damage combined with presented symptoms provide ample evidence for physicians to begin treatment.   Condensation is very common in all homes.  Read more HERE.

ImmunoLytics Mold Test Kits offer the flexibility to use plates or swabs to identify mold species present in your home.  The identification of mycotoxin producing molds is very accurate, whether by microscopy or DNA. This test kit is the most comprehensive culture test available with easy-to-understand instruction, chain of custody, and analysis reports at affordable prices. In addition, ImmunoLytics provides free phone consultations for customers for both testing methods and interpreting the analysis report.  

Mold Testing Methods

PCR testing is the other common method for detection of mold.  A specific mold species DNA sequence is required for testing.  Many professionals prefer the perceived precision of DNA testing; however, only a portion of fungi have been sequenced.  There are various panels from between 2 and 36 species that are commonly tested. The methodology used is very expensive when professionals appropriately collect multiple samples from throughout the house to ensure statistical confidence.  A species-specific primer has to be used for each specific mold that you would like to detect, so the majority of molds are not detected using commercially available PCR analyses (EMRI, HERTSMI, etc.)

Microscopy, in contrast, will identify cell walls and shapes.  For example, an “aspergillus/penicillium like” spore can be identified, making it more likely that mold problems are not missed.  The analysis done with microscopy can explore approximately 36,000 species.  This is adequate information to begin remediation planning.

It’s important to note that while PCR DNA testing is a highly sensitive technique, it does not provide information on the viability or quantity of the mold present in a sample. Additionally, PCR results should be interpreted in the context of other information, such as visual inspection and culture-based methods, to obtain a comprehensive understanding of the mold present in a sample.

ERMI testing is commonly used by mold professionals.  This methodology tests for 36 representative mold species via PCR.  The results are then calculated into a score.  Unfortunately, ERMI was developed as a research tool for water damaged homes and a universal scale for all geographies.  ERMIs scores are not useful as a result.  The DNA analysis results must still be interpreted by the professional.

Physicians Diagnostics

In the event that a person has severe symptoms or organ failure, physicians have a few options.  These options lack precision so they cannot be completely relied upon.

1. Make an association between blood serum antibodies, IgE / IgG by using a modified RAST (radioallergosorbent) with the presence of mycotoxin producing molds in your home or work. 
2. Mycotoxin urine testing is used to detect the presence of mycotoxins that have been absorbed by the body after exposure to contaminated food or environments. The test results can be indicative of mycotoxin exposure.  There are urine mycotoxin tests available through a few laboratories in the US; however, these test only a small number of toxins (~15 out of 300-400) and methodology precision is poor and may not be relied upon.  I have spoken to numerous doctors, environmental and IAQ specialists that confirm their lack of confidence or validation of home testing cross-referenced with urine laboratory results shared by patients. Read more about Mycotoxin testing HERE.

 

Methods of Mycotoxin Urine Testing:

1. 1. Enzyme-linked immunosorbent assay (ELISA) – This is a commonly used test that uses antibodies to detect the presence of specific mycotoxins in a sample.
   2. High-performance liquid chromatography (HPLC) – This test separates the different components of a sample, allowing for the specific identification of mycotoxins.
   3. Gas chromatography-mass spectrometry (GC-MS) – This test uses a combination of gas chromatography and mass spectrometry to identify and quantify mycotoxins in a sample.
   4. Thin-layer chromatography (TLC) – This test separates the different components of a sample, allowing for the identification of mycotoxins based on their chemical properties.

Discussion

There is a lack of precise diagnostics to measure mold and mycotoxins in the environment or human body.  Physicians and patients must follow the clues provided by the body. Antibody blood tests aid physicians with the diagnosis.  These tests are inexpensive and provide sufficient confidence in the test’s ability to recognize the presence of mold. 

Environmental testing can identify mycotoxin producing molds. The stacking of circumstantial evidence may be the best avenue to begin the environmental remediation and detoxification process.  Mycotoxin urine tests lack the breadth and accuracy to make medical decisions.  A small panel of toxins with a limited accuracy may not be sufficient for medical decision making.

1. C.R. Armendáriz, … A.H. de la Torre,”Mycotoxins”. Encyclopedia of Toxicology (Third Edition), 2014