Mycotoxin Testing: Urine Panels, Lab Comparison, and What Results Mean
A mycotoxin urine test shows which mold toxins are in your body and at what levels. Great Plains (Mosaic Diagnostics) MycoTOX panel uses mass spectrometry and costs about $300. RealTime Labs uses ELISA and costs about $700. Elevated mycotoxins confirm mold exposure and guide treatment. Pair with an ERMI dust test to find the environmental source.
What are mycotoxins?
Mycotoxins are toxic chemicals produced by certain mold species. Not all molds produce them. The species that do are called toxigenic molds. The most dangerous mycotoxins found in water damaged buildings include aflatoxins (from Aspergillus species, a known carcinogen), ochratoxin A (kidney damage, neurological effects), trichothecenes (from Stachybotrys, some of the most potent biological toxins known), and gliotoxin (immune suppression).
You are exposed to mycotoxins by breathing contaminated air, touching contaminated surfaces, and eating contaminated food (coffee, grains, wine, and peanuts are common dietary sources). Your body tries to eliminate mycotoxins through bile (into stool) and through urine. This is why urine testing can detect exposure.
Leading environmental health researchers estimate that 10 million Americans have mold toxicity. About 24% of the population carries HLA-DR genetic variants that make their immune system unable to tag and clear mycotoxins normally. These people accumulate mycotoxins over time, leading to chronic illness.
RealTime Labs vs Great Plains (Mosaic Diagnostics)
RealTime Laboratories: Uses ELISA (Enzyme Linked Immunosorbent Assay) antibody testing. Tests for 15 mycotoxins. Cost is approximately $700. Requires a healthcare provider to order in most cases. Leading environmental health researchers use RealTime Labs extensively in clinical practice and has published protocols based on their results. Results take 10 to 14 business days.
Great Plains / Mosaic Diagnostics (MycoTOX panel): Uses LC-MS/MS (Liquid Chromatography Tandem Mass Spectrometry), which is considered more precise and specific than ELISA. Tests for 11 mycotoxins. Cost is approximately $300. Can be ordered directly by consumers through their website. Leading naturopathic mold experts specifically recommend Great Plains for its mass spectrometry method. Results take 10 to 14 business days.
Vibrant Total Tox Panel: A newer comprehensive panel that tests mycotoxins alongside heavy metals and environmental chemicals. Used by genetic health researchers and some integrative practitioners. More expensive but gives a broader picture of total toxic burden.
Which to choose: For most people, the Great Plains MycoTOX panel is the best starting point. It is less expensive, uses the more precise testing method, and is available without a prescription. If your practitioner specifically uses RealTime Labs protocols, go with RealTime for consistency in tracking your treatment progress.
How to interpret your results
Your results will show each mycotoxin tested with a concentration level and a reference range. Values are reported in parts per billion (ppb). Results within the reference range are considered normal. Results above the range are flagged as elevated.
Aflatoxin M1 elevated: Indicates exposure to Aspergillus species or dietary aflatoxin (peanuts, corn, grains). Aflatoxin is a Group 1 carcinogen. Even low levels warrant investigation of your home and diet.
Ochratoxin A elevated: The most commonly elevated mycotoxin on urine tests. Comes from Aspergillus and Penicillium species, which are the most common indoor molds. Also found in coffee, wine, and dried fruits. If elevated, test your home with ERMI and evaluate dietary sources.
Trichothecenes elevated: Points to Stachybotrys (black mold) or Fusarium exposure. Trichothecenes are among the most dangerous mycotoxins. If your trichothecene levels are elevated, there is almost certainly an active Stachybotrys colony in your environment. Find it immediately.
Gliotoxin elevated: Comes from Aspergillus fumigatus. This mycotoxin suppresses the immune system. Elevated gliotoxin is commonly seen alongside chronic sinusitis because Aspergillus fumigatus colonizes the sinuses.
Important note: A low or negative mycotoxin test does not mean you are not exposed. Some people do not excrete mycotoxins efficiently. Leading environmental health researchers recommend a glutathione challenge (taking glutathione before the test) to mobilize stored mycotoxins and get a more accurate reading. Discuss this with your practitioner.
What to do with elevated results
Step 1: Find the source. Order an ERMI dust test for your home. If HERTSMI-2 score is above 11, your home is the likely exposure source. Also evaluate your workplace and car.
Step 2: Remove from exposure. Every expert agrees: you cannot heal in a moldy environment. If your home tests positive, you need remediation or relocation. Leading naturopathic mold experts note that 50% of patients recover by simply leaving the moldy environment.
Step 3: Work with a mold literate practitioner. A physician trained in mold illness (search survivingmold.com/physicians or ifm.org/find-a-practitioner) can guide treatment based on your specific mycotoxin profile. Treatment typically includes binding agents to remove mycotoxins from your body and supporting your detox pathways.
Step 4: Retest in 3 to 6 months. Repeat the urine mycotoxin test after treatment to track progress. Declining levels confirm the exposure source has been addressed and treatment is working.
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Get Early AccessFrequently Asked Questions
What is a mycotoxin urine test?
A mycotoxin urine test measures the levels of mold toxins being excreted by your body. Mycotoxins are poisonous chemicals produced by certain mold species. When you breathe in or ingest these toxins, your body tries to eliminate them through urine. The test identifies which specific mycotoxins are present and at what concentration, which helps determine the type of mold exposure and guides treatment.
Which lab is best for mycotoxin testing?
The two most used labs are RealTime Laboratories and Great Plains Laboratory (now Mosaic Diagnostics). RealTime Labs uses ELISA antibody testing and costs about 700 dollars. Great Plains uses mass spectrometry (LC-MS/MS), which is considered more precise, and costs about 300 dollars for the MycoTOX panel. Leading naturopathic mold experts recommend Great Plains for its mass spectrometry method. Leading environmental health researchers use RealTime Labs extensively in practice.
What mycotoxins does the test look for?
Most panels test for Aflatoxins (from Aspergillus), Ochratoxin A (from Aspergillus and Penicillium), Trichothecenes (from Stachybotrys and Fusarium), Gliotoxin (from Aspergillus fumigatus), Citrinin (from Penicillium), and Zearalenone (from Fusarium). Each mycotoxin is linked to specific mold species, which helps identify the exposure source.
Do I need a doctor to order a mycotoxin test?
It depends on the lab. Great Plains (Mosaic Diagnostics) allows direct to consumer ordering through their website. RealTime Labs typically requires a healthcare provider to order. Some functional medicine practitioners and naturopaths will order the test as part of an initial mold illness evaluation. If you are self-ordering, Great Plains MycoTOX panel is the most accessible option.
