3 Reasons to Eat Organic and 4 Tests to Ensure Your Diet is Clean & Healthy for You

Eren Quense, RDN, MS

SUMMARY

Over the past few years, the health necessity to eat organic food has become more popular. Moms, athletes, and the chronically ill are more aware of the health risks associated with non-organic foods. While organically grown food is no doubt more expensive than conventional foods, there are health benefits that inspire me to eat organic and I know most integrative medicine practitioners agree that eating clean outweighs the cost of purchasing organic produce that isn’t ladened with toxic chemicals.

Why Eat Organic Despite the Cost

A USDA-approved organic product is one that is grown and processed without the use of pesticides, fertilizers, genetic engineering, antibiotics, growth hormones, artificial flavors, colors, or preservatives.1 These things have been introduced into our foods over decades to help minimize food waste, increase shelf life, decrease costs, and enhance eye appeal, flavor, and palatability. By eliminating these chemicals and additives we are left with fresher, cleaner, better-for-you products, but we are also left with less control over environmental events, increasing costs for growers, and therefore you, the consumer.

Here are three reasons you might want to consider spending the extra money to eat organic for improved health.

Reason #1: Less Exposure to Resistant Bacteria When Eating Organic

The overuse of antibiotics in conventionally produced food has led and continues to lead to the growth of resistant bacteria.2 This bacteria can be transferred to humans from meat that hasn’t been cooked or handled properly or from crops that were sprayed with fertilizer containing manure.3 This is concerning for our health because these bacteria have become immune to treatments that are designed to kill them, leading to infections that are harder, if not impossible to treat.3 

Organic foods decrease the probability of ingesting resistant bacteria due to the non-use of antibiotics in food production. Theoretically, the money spent on eating organically could save you later on healthcare costs!

Reason #2: No Synthetic Pesticides

Pesticides are chemicals that are used to eliminate or reduce organisms that could invade and damage crops. Unfortunately, the residue of these chemicals is found on the surface of fruits and vegetables even after being washed. A study conducted by the Environmental Working Group found that people who ate mostly organic food had a 65% lower risk of having detectable levels of pesticides in their bodies.4

The effects of synthetic pesticides on the human body are many and still being extensively researched, however, one reason to avoid pesticides is that they contain endocrine-disrupting chemicals (EDC). EDCs mimic our natural hormones and affect how they are made, used, and stored in the body.5  This disruption in hormones has been linked to a whole host of negative health outcomes including poor reproductive health, altered immune and nervous system functions, learning disabilities, obesity, metabolic issues, and more.5 EDCs enter the body through other avenues but limiting the exposure by choosing organic foods could help balance your hormones.

To understand the impact of pesticides on our health, organic acid tests can be used to identify biomarkers related to exposure to these chemicals. When humans are exposed to pesticides and other toxins, certain organic acids increase in the body, providing biomarkers that highlight the effect of toxins on our cellular metabolism. In addition, the presence of glyphosate, a very commonly used herbicide, as well as heavy metals that build up over time from pesticide use, can be assessed in the body through biomarkers.

Reason #3: Higher Nutritional Value

Organic food is generally more nutritious than its conventionally grown counterpart. Certified-organic food is farmed and raised using practices that prioritize soil health and biodiversity which can result in crops that are higher in vitamins, minerals, and antioxidants.6 These higher levels of nutrients promote a better immune system and overall health.

Organic food might be more expensive than conventionally grown foods but there are many health benefits that outweigh the cost. organic food is healthier and overall safer to eat but it is important to note that eating nutritious foods is the priority.  If eating all organic is not within your budget, choose just one or two foods you can swap for organic versions. 

4 Tests that Ensure Your Diet is Clean & Healthy

IgG Food Map

According to Lindsay Goddard, RD, Great Plains Laboratory Clinical Consultant, food can be healing or detrimental to your health if you’re eating food tainted with toxins or that cause immune responses or food sensitivities. For this reason, Goddard recommends the Great Plains Lab IgG Food Map, which tests for food sensitivities. Goddard says the test is easier for patients than going through an elimination diet. Goddard discusses the test in detail in this recorded webinar, “Using the IgG to Help Your Patients.”

Glyphosate & MycoTOX Tests

One inexpensive test to determine if you’ve been exposed to high levels of potentially harmful pesticides on your food is Great Plains Laboratory’s Glyphosate test. For less than $100, your functional medicine practitioner can have a test sent to your home to collect a urine sample to administer the test. The MycoTOX Profile can easily be added on to test for exposure to fungi and molds found in common foods like coffee and corn.

According to Shanhong Lu, MD, getting tested for glyphosate exposure is as important as your need for an annual exam.  Sadly, glyphosate is in 75% of rainfall, 75% of air, and 80% of adult American’s urine because of the amount sprayed on crops, lawns, golf courses, and grains.

Dr. Lu says the rise in the use of Roundup Herbicide (a pesticide that uses glyphosate as a main ingredient) and the rise in chronic illnesses such as digestive issues, asthma, Parkinson’s, and Alzheimer’s is not a coincidence. She has found a correlation among her patients who have chronic illness and have also lived on a farm or near a golf course.

Organic Acids Test (OAT)

Lastly, by using the Organic Acids test to identify biomarkers related to pesticides and toxins we can better understand the impact of these substances on our health and make informed decisions on what we eat.

The Organic Acids Test evaluates for 76 metabolites in the body, including oxalate levels. High oxalates can lead to kidney stones. Also, individuals with fibromyalgia and women with vulvar pain may suffer from effects of excess oxalates.

For more information about food sensitivity or testing of toxins in the body, work with your functional medicine practitioner for recommendations and protocols.

References

1.	McEvoy M. Organic 101: What the USDA Organic Label Means. Usda.gov. Published March 13, 2019. https://www.usda.gov/media/blog/2012/03/22/organic-101-what-usda-organic-label-mean
2.	Health benefits of organic food, farming outlined in new report. News. Published June 22, 2018. https://www.hsph.harvard.edu/news/features/health-benefits-organic-food-farming-report/
3.	Antibiotics in Your Food: Should You be Concerned? Healthline. Published June 17, 2017. https://www.healthline.com/nutrition/antibiotics-in-your-food#TOC_TITLE_HDR_4
4.	Environmental Working Group. EWG’s 2019 Shopper’s Guide to Pesticides in ProduceTM. Ewg.org. Published 2019. https://www.ewg.org/foodnews/summary.php
5.	Endocrine Disrupting Chemicals (EDCs). www.endocrine.org. Published January 23, 2022. https://www.endocrine.org/patient-engagement/endocrine-library/edcs
6.	Montgomery DR, Biklé A, Archuleta R, Brown P, Jordan J. Soil health and nutrient density: preliminary comparison of regenerative and conventional farming. PeerJ. 2022;10:e12848. doi:https://doi.org/10.7717/peerj.12848

Mycotoxin, Glyphosate & IgG: Q&A With Elena Villanueva, DC, Shanhong Lu, MD, William Shaw, PhD & Lindsay Goddard, RD

On June 10-12, 2022, GPL Academy hosted Beyond the Basics: Advanced Organic Acids Testing Strategies live-streamed online. This three-day event focused on advanced Organic Acids topics. Those who attended the summit learned how to use effective diagnostic and treatment protocols for their patients to help get them on the road to recovery.

The following Q+A is a grouping of responses from the Day 3 workshop presentations. Click each presentation title to expand the answers from each speaker.

The material contained within this article is not intended to replace the services and/or medical advice of a licensed healthcare practitioner, nor is it meant to encourage diagnosis and treatment of disease. It is for educational purposes only. Any application of suggestions set forth in the following portions of this article is at the reader's discretion and sole risk. Implementation or experimentation with any supplements, herbs, dietary changes, medications, and/or lifestyle changes, etc., is done so at your sole risk and responsibility.

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Day 3 Q+A: Toxin Exposure and More

William Shaw, PhD

Organic Acids and Mycotoxins: Correlations With Mold in Various Chronic Illnesses | Speaker Panel

Q: Why not add Volatile Organic Compounds to your MycoTOX Profile?

A: Volatile organics would have to be extracted by a different method than mycotoxins. 

Q: Farmed chickens are fed corn. Do you think chicken meat may contain mycotoxins?

A: Very likely, unless corn feed is tested for mycotoxins.

Q: Do you use 240 mg/kg/day to calculate the dosage of cholestyramine for children or how do you calculate pediatric dosage? Would you use cholestyramine in infants as well?

A: The usual dosage in children (0-17 years) is 240 mg/kg of body weight per day of anhydrous cholestyramine resin taken in 2 to 3 divided doses. Most children won’t need more than 8 grams per day.

Q: Which medication or herbal combinations are best for both Candida and Aspergillus simultaneously?

A: The big problem is that there is a lack of published studies for herbals used as antifungals. Amphotericin and itraconazole have been used for both Candida and many molds, but there are resistant strains that require other drugs.

Q: For children with liver toxicity due to Sporanox, how do you approach that? Maybe half dose for twice as long?  Do you have ideas for alternatives for Itraconazole/ Sporanox?

A: I would recommend oral nystatin, if there is evidence of liver toxicity with Sporanox. This is because nystatin is not absorbed from the GI tract.

Q: Why do some people get so sick when exposed to mold? Could it be the genetic component HLA gene possibly? 

A: All of the mycotoxins are extremely toxic and may be fatal. The dose of mycotoxin is likely the main factor determining the degree of illness. Neil Nathan, MD states that he found HLA testing of little use in mold treatment.

Q: What may be the other likely causes of mold exposure for adults apart from damp houses?

A: Food or water damaged buildings are the most common causes of mold exposure. Food is unlikely source in USA and EU where food testing is required for foods commonly mold contaminated.

Q: I was told that you should not use bleach because it causes the mold spores to open up and release the mycotoxins and that hydrogen peroxide is a better option. Can you comment on this? 

A: Chlorine bleach can help eliminate mold on hard non-porous surfaces like sinks, bathtubs, tiles, or glass. This is because the roots of the mold do not penetrate through this surface and so it is easily wiped off.

However, when mold grows on a porous material like wood or drywall, it spreads its roots deep into the material to reach more nutrients. So when you apply bleach to such a surface, you are merely changing the mold’s color on the surface. Bleach quickly dries off on the surface and will not reach into the deeper part of the material to the mold’s root. So, in a few days or weeks, the mold regains its color and grows back to become even worse than it was before you applied the bleach.

I would suspect that hydrogen peroxide would also be ineffective on these porous materials which is why replacement of these materials is the most effective treatment.

Q: Recently, it was suggested that we could use effective microorganisms (EM) to kill mold on the walls. Using good bugs to kill bad bugs. What are your thoughts on this?

A: I don’t know. Never saw articles on such treatment.

Q: If there is only an elevation of tartaric acid in the Organic Acids Test, can we be confident that the patient is definitely affected by Aspergillus?

A: Several pharmaceuticals contain tartaric acid salts in their drugs so you need a complete drug history before you can conclude that Aspergillus is the cause of high tartaric acid.

Q: If you are only treating the GI tract, why not use amphotericin, which isn't absorbed?   I use itraconazole nasal spray as I find colonization is usually cured by treating sinuses. 

A: Amphotericin B is comparable to itraconazole for several molds and may be preferable since it is not absorbed from the GI tract so will not cause liver toxicity. However, amphotericin B may be liver toxic when administered intravenously rather than given orally. I know one physician who lost his medical license because of his use of amphotericin given orally. His medical board did not appreciate the difference in toxicity between oral and IV administration.

Q: Shoemake and Heyman have indicated that the mold smell had a higher correlation to the bacteria actinomycetes than mold. Could that explain inconsistencies at times?  Have you seen WDB with actinomycetes and have you treated it any differently than you would mold, i.e. antibiotics, and which one?

A: I would not use smell to determine mold contamination. The best way is to use a professional mold inspector who uses laboratory testing.

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Lindsay Goddard, RD

Food to Treat: Using the IgG to Help Your Patients | Speaker Panel

Q: Is a dried blood spot (fingerstick) sample as accurate as a blood draw?

A: Yes. The accuracy is the same. The option is given to accommodate patients who blood draws are more complicated.

Q: In your clinical experience, do people who have candida or aspergillus overgrowth react badly to saccharomyces boulardii?

A: That has not been my overall clinical experience. There have been patients that have reacted poorly to it, but not the majority. Since it is not consistent, it is one of the benefits to running the test, to understand how an individual might respond based on their own individual immune response.

Q: Is there any way to get the OAT and /or MycoTOX Profile covered by insurance?

A: The OAT can sometimes be covered by Medicare or TRICARE (military), but the MycoTOX Profile is rarely covered.

Q: Is it of benefit to also check peptide level reactions to food in addition to whole blood protein?

A: Testing the peptide levels makes a case by eluding that they are measuring individual parts of the protein versus the whole protein. However, they are still measuring IgG4 and IgA, which do not induce complement, and therefore not inflammation.. I was not able to find any studies showing the efficacy of this method in the literature. If you find any independent studies on this methodology, I would be very interested to see them.  

Q: Can you see certain trends in OAT markers for Long Covid patients?

A: Not specifically. Quinolinic acid is often elevated in the beginning, and/or recently post infection or vaccines. There are times the mitochondria are also stressed.  

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Shanhong Lu, Md

Glyphosate and GBH as an EDC, a Slow, Multisystem Corruptor to Hormone Optimization and How to Become Glyphosate Resilient

Q: Thank you for your mineral connection (i.e. mercury and iodine). You mentioned Hyper Zinc. What should I be thinking with high zinc if there is no obvious source? Or high ferritin, if there is no obvious HFE or fatty liver?

A: A complete mineral profile will be extremely important and also GPL-TOX Profile and Glyphosate Test will also help to determine where the excessive zinc comes from as many pesticides use zinc as a carrier. 

Q: Can glyphosate pass to cow's milk which is sold to humans?

A: Yes

Q: If we see neuroinflammatory symptoms when we give patients glutamine, should that excessive glyphosate exposure be on the differential diagnosis?

A: Absolutely – I have tested so many people with autoimmune, cancers, ALS MS PD and endocrine disruption and elevated SHBG. Glyphosate is always present.

Q: When should we suspect a glyphosate problem and do a glyphosate test?

A: I recommend getting that test done right away along with a mineral heavy metal profile and genomic test. Do an environmental workup, if supplements do not work.

Q: In your experience, when you removed glyphosate load from the Parkinson's/ dementia patients, do their symptoms reduce substantially?

A: With immune – depolarization, removing glyphosate as soon as possible absolutely improve symptoms. One patient with PD over 10 years on triple drugs improved walking down stairs and started riding horses and hiking. Neuroinflammation in the brain is definitely a result of M1 M2 polarization.

Q: How do you determine Individual Tolerant Level?

A: I look at genetic (such as methylation, PON1, COMT, SOD, Dopamine receptors, Vitamin D receptor IL6 TNFa) plus their hormonal age (adrenal sex thyroid and pituitary) people with traumatic brain injuries are more sensitive also.

Q: Do you recommend intermittent fasting as a way to trigger autophagy and a means to help the body become more resilient?

A: I no longer recommend fasting because it causes more stress. Many women are genetically in-between-meal eaters, compliance is low, and the pituitary is not working well when fasting.

Q: What do you do for patients that are deficient in glutathione synthetase?

A: I use systemic detox binders (cleardrrops www.zoiglobal.com/drlumd and practitioners with a license can apply professional detox pro), Ca-D-glucarte 2000 mg a day and skip the conjugation relying glutathione pathway, which is not strong for BPA metals and so on.

Q: Could you explain once more how to increase/support phase 1 detoxification of the liver?

A: Metals and glyphosate both block phase 1 cytochrome P450 and drugs too. Decreasing exposure and systemic detox support is the key. Genetic studies on cytochrome P450 and PON1 are important.

Q: Is there a way that you can perform the OligoScan on somebody that is not in your presence? (e.g. via some sample of skin or something?)

A: Unfortunately no. A pathologist is needed for biopsies and I recommend going to www.theoligoscan.com to find providers. Feel free to text me at 530-925-0565.

Q: It seemed that you were saying in your presentation that PON1 acts on phase 1 intermediates. Did I hear that correctly, and if so, is PON1 considered a phase 2 enzyme? 

A: For water soluble pesticides (organophosphates ) PON1 is much needed to render the intermediate substrate nontoxic – still phase 1 process. 

Q: Which nutrigenomic software do you use?

A: I use puregenomic from pure encapsulation the most and I also use gxsciences.com.

Q: Since you listed X39 and AEON in association with stress control and other products that balance the branches of the ANS, does that mean you find that they help to balance the ANS? I use them but had not known of a mechanism that would affect the ANS aside from reducing oxidative stress.

A: X39 has been studied to balance blood flows in various regions and enhancing GABA Dopamine and Otropin has been tested by MAX pulse machine using HRV.   We have found over 90% people with significant improvement of SNS vs PSNS balance-parasympathetic improvement with 3 minutes after 4 sprays of Otropin.

Q: What do you use as an immune modulator?

A: I use ultimate immune (containing a patented formula muramyl peptide beta glucan and Glucarate). Please email me drlu@drlumd.com and we can open an account for you.

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Elena Villanueva, DC

Managing the Complex Patient: Using the GPL-TOX and OAT in Clinical Practice | Mycotoxins: Considerations, Case Studies and Protocols

Q: What are the top three mind therapies that you have found to be most effective for healing? 

A:  It really depends on what is going on with the individual as to which tools and modalities will be the most effective. If we are looking at how to down regulate the SNS using mind-based therapies, tools like QTT (quantum time therapy), perceptual positions exercises, resonance repatterning, hypnosis, hypnobreath therapy, and meditation exercises can be super beneficial.  

If a client has dis-ease that is rooted in unresolved trauma or unprocessed emotions, incorporating a sequence of a combination of both mind and body therapies is how I see the best outcomes. For example, first teaching the client awareness of how their thoughts, emotions, trauma can effect their physiology and mental health. Then teaching them to master their own down regulation of their SNS and how to activate their PNS using tools like breath therapy, yoga breath therapy, EFT tapping, bilateral touch, and watching their stress metrics improve as they master their own 'circuit board'. Then moving into teaching them awareness around their conscious and unconscious mind, their thoughts, and what tools are available to address and resolve their unprocessed emotions and unresolved trauma using tools like somatic experiencing, QTT, parts integration, P positions, language, light, color, sound therapy, etc.

Q: What are the top three spiritual therapies that you have found to be most effective for healing? 

A: Teaching awareness of who we are as humans has been very powerful with my clients. 'Who we are' being a mind, body, and a spirit with both a conscious and an unconscious mind. And teaching our clients how to integrate their 'parts' so they can speak and live their authentic truth without shame, fear, anger, etc.

Helping them become aware also that they are living a human experience and that all they experience is happening for them, not 'to' them; that THEY are the ones creating their realities through their thoughts, stories, beliefs, and actions. The power for them to heal comes from within them more so than anything outside of them.  

I wouldn't say that we teach spiritual therapies, but rather we teach awareness of the power they have within ourselves to master our own minds, and ultimately our own realities. We focus on empowerment and awareness of their sovereignty. 

Q: How long do your patients/clients typically stay on maintenance? How often do they return for visits? 

A: Once our clients are back to 'baseline' with their health, we start teaching them about longevity and anti-aging and how to biohack for higher performance without compromising their long-term health. We encourage them to do their full functional blood labs, and hormones annually and we encourage them to do their toxins labs every other year to ensure they are not unknowingly building up and re-exposing themselves to toxins. They typically see us 2 to 3 times per year for their wellness programs with us. 

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Learn new ways to help patients with difficult-to-diagnose and chronic health issues.

The tests discussed throughout each workshop are all used to help identify exposure sources and biochemical imbalances in individuals with chronic health conditions. The Organic Acids Test (OAT) contains multiple markers which may be influenced by environmental and mold toxins. Often, the combination of the OAT, MycoTOX Profile, and GPL-TOX Profile can be used to help identify how a patient might be getting exposed, as well as assist with correlating their symptoms back to these sources. Determining the underlying causes of chronic illnesses for patients is the key to integrative medicine, not just treating the symptoms. The Great Plains Laboratory continues to find new ways to detect these causes of many illnesses and study the correlations between the results and conditions.

Registration includes:

1. 60-day access to the full conference recordings.

2. Permanent PDF access to each speaker’s slides.

3. The option to purchase continuing education credits (5 credits per day), whether you attend in-person, watch Live Online, or watch the conference recordings at a later date! See detailed information about credits.

4. An interactive Workshop Hub website where you can live chat and network with attendees and ask questions to the speakers.

5. And last, but most certainly not least, qualified practitioners will receive a free OAT.

Webinar Q+A: Autoimmune Disease and Fungal Infections

On May 19, 2022, The Great Plains Laboratory hosted Autoimmune Disease and Fungal Infections webinar with Kurt Woeller, DO. Fungal infections of various types can initiate immune dysfunction leading to systemic infection and serious disease. The overuse of antibiotics and subsequent microbiome disruption, along with other factors, e.g., nutrient imbalances, mucosal surface damage, can increase the potential for autoimmunity and related diseases. Various immune cells and their cytokines are intimately involved in regulating mucosal reactivity to opportunistic fungus. It is the dysregulation of these factors which create the potential for fungal related autoimmunity. This webinar will explore these details and more.

The following Q+A is a grouping of responses from Dr. Woeller’s presentation.

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Webinar Attendee Q+A

Q: Should I be concerned about fungal resistance to fluconazole?

A: There is the potential for resistance to any antifungal or antibiotic. However, for the most part it still works well against many yeast species, including Candida.

Q: What factors make a fungal infection chronic and persistent, prone to relapse?

A: There are many including poor overall health, lack of microbiome diversity, ongoing inflammation, particularly in the digestive system, chemicals like glyphosate, mold and mycotoxin exposure, poor diet, etc.

Q: What are the implications of a leaking breast implant and how that affects thyroid autoimmune and inflammatory autoimmune, and would this eventually help to cause fungal infection/candida?

A: Fungus could certainly take advantage of a situation like this. You will need to research the specific mechanisms involved regarding breast implants, but I am sure it involves immune dysregulation involving Th1, Th2, and Treg cells.

Q: Can systemic candida infections be the root cause of seborrheic eczema, dermatitis, and dandruff?

A: I am sure they could be or at least play a role. Do some research into this area as this would be worth knowing more about.

Q: I have sometimes seen slightly high chloride in serum of my patients.  Does the hypochlorous acid release during the Neutrophil activity ever account for the finding of slightly high Chloride in serum of patients with CFS and Candidiasis?

A: Good question, but I do not know. Most likely is it not a major factor as the hypochlorite ion is acting at a local area.

Q: How can the Innate immune system have a memory component?

A: I am not aware of innate immunity with regards to memory cells, but certain B-cells, specifically B-1 B cells (from the spleen, bone marrow, and peritoneum) and MZ B cells (spleen), produce natural antibodies like polyreactive IgM or Natural IgM (nIgM). Perhaps there is a recall mechanism in place for these nIgM? The role of nIgM is significant, including in the assistance of phagocytic cell activity in engulfing an apoptotic cell. Other mechanisms include complement cascade activation against pathogens, e.g., bacteria and direct pathogen neutralization, e.g., virus. Check out the article by Panda and Ding titled Natural Antibodies Bridge Innate and Adaptive Immunity in the Journal of Immunology, September 2021.

Q: What is an example of a genetically susceptible individual?

A: Certain types of human leukocyte antigen (HLA) patterns are genetic linked. For example, HLA-B27 is associated with increased risk for reactive arthritis secondary to certain gut bacteria. Ankylosing Spondylitis is another disease where the immune system attacks the spine and is linked to cross-reactivity to various PAMPs in B27 individuals.

Q: Does the website https://candidamasterycourse.com/ go over protocols for overcoming candidiasis?

A: Yes. We go into intervention, testing, pathogenicity mechanisms and much more in the Candida Mastery Course.

Q: Can you link here the website to get the bonus sheet?

A: https://integrativemedicineacademy.com/webinar-bonus/

The material contained within this article and webinar is not intended to replace the services and/or medical advice of a licensed healthcare practitioner, nor is it meant to encourage diagnosis and treatment of disease. It is for educational purposes only. Any application of suggestions set forth in the portions of this article is at the reader's discretion and sole risk. Implementation or experimentation with any supplements, herbs, dietary changes, medications, and/or lifestyle changes, etc., is done so at your sole risk and responsibility.

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Kurt Woeller, DO

FOUNDER OF INTEGRATIVE MEDICINE ACADEMY
Kurt N. Woeller, DO, has been an integrative medicine physician and biomedical Autism specialist for over 20+ years. He is an author of several health books including Autism – The Road To Recovery, Methyl-B12 Therapy For Autism, Methyl-B12 for Alzheimer’s Disease and Dementia, and 5 Things You MUST Do Right Now To Help With Your Rheumatoid Arthritis. He is an international speaker, educator, and practicing clinician offering specialized interventions for individuals with complex medical conditions. His health consulting practice for Autism alone is multinational with families from various countries. Dr. Woeller serves as a clinical and lab consult for Functional Medicine Clinical Rounds, as well as provides educational seminars for Great Plains Laboratory. He is co-founder of Integrative Medicine Academy (www.IntegrativeMedicineAcademy.com), which is an online training academy for health practitioners learning integrative medicine.

Organic Acids and Mycotoxins with William Shaw, PhD

The Great Plains Laboratory has been educating practitioners for over 15 years on how to help patients heal through cutting-edge testing, research and protocols. In our recent 3-Day Environmental Toxin Summit, speakers focused on the epidemics of environmental toxins and pathogen exposure after a foundation of the OAT is presented. Speakers reviewed patient cases and present testing and treatment protocols for toxin and mold-induced illnesses.

The following Q+A is a response to remaining questions Dr. Shaw was unable to answer during his presentations.

The material contained within this article is not intended to replace the services and/or medical advice of a licensed healthcare practitioner, nor is it meant to encourage diagnosis and treatment of disease. It is for educational purposes only. Any application of suggestions set forth in the following portions of this article is at the reader's discretion and sole risk. Implementation or experimentation with any supplements, herbs, dietary changes, medications, and/or lifestyle changes, etc., is done so at your sole risk and responsibility.

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William Shaw, PhD

Organic Acids and Mycotoxins

William Shaw, PhD, is board certified in the fields of clinical chemistry and toxicology by the American Board of Clinical Chemistry. Before he founded The Great Plains Laboratory, Inc., Dr. Shaw worked for the Centers for Disease Control and Prevention (CDC), Children's Mercy Hospital, University of Missouri at Kansas City School of Medicine, and Smith Kline Laboratories.

Q: What if the client presents with muscle wasting, severe weight loss and high CRP marker?  Can food sensitivities be a cause?

A: Yes. Food sensitivities can be the cause.

Q: Were the IgG antibodies to Casein A or Casein B or both?

A: They are to both. A and B are not distinguished.

Q: When you have multiple IgG food reactions, I would think leaky gut first and it’s not the “foods fault.” If you remove all the elevated IgG food reactions most patients might develop problems with eliminating too many nutrients from their diet. Can you discuss how you approach this?

A: Initially remove the offending foods that the immune system is overreacting to while treating the cause. If the cause is leaky gut, candida, mold, or other toxicities removal/treatment should reduce the sensitivity. At this point you can retest or challenging the offending foods beginning with the lows, moderates, then highs.

Q: Would IgG or OAT be useful in managing G6PD deficiency?

A: Both profiles would be useful. The IgG Food Map would identify immune stimulating foods that would increase inflammation and oxidative stress in an already compromised client. The Organic Acids Test can show you what gut organisms are impacting their function, mitochondrial distress and nutrient needs that can be met. By addressing the concerns on these profile, you can take the stress off of the genetic code and help the client to reduce symptoms.

Q: If someone has intestinal permeability is it more likely that he/she will show multiple sensitivities on testing?

A: Yes

Q: If a patient tests positive for Brewers Yeast and Bakers Yeast, do they have to stop eating bread?

A: If the bread they eat has yeast in it, they should abstain.

Q: How does mold increase oxalate urinary excretion?

A: Mold and yeast create the precursor to oxalates, glyoxylate. Our body then takes this in the liver and creates the oxalic metabolites and then we excrete them in the urine. This happens in normal, non-moldy, conditions due to the normal levels of yeast residing in the body. The over exposure to mold/yeast growth increases their production/excretion.

Q: When are systemic drugs indicated and is mitochondrial toxicity a significant concern?

A: Symptom severity and extent mold colonization and exposure level are wonderful guides for judgement on need for drugs. Mitochondrial toxicity from mold is a concern and can be a concern when using drugs. Also be sure to assess liver function tests depending on which drug you use.

Q: After mold remediation how long should you wait before your test again to se if antifungal medication is required?

A: Retest the OAT and MycoTOX three months after remediation and antifungal therapy. If you want to wait for testing to see if you need antifungals until after remediation, test immediately after remediation is complete.

Register now for our upcoming events and workshops.

Q: Can mold be seen coming out of the skin from detoxing? My son does have one marker indicating possible mold. He details car, wears latex gloves, his hands sweat inside and has black color all over his fingers and hands is coming out. Could that be mold?

A: I’ve not heard of mold coming out of the skin in this way. But since he is a car detailer you may look into the GPLTOX/heavy metal testing to see if he’s detoxing anything other chemicals that he could be exposed to at work.

Q: It the ochratoxin is extremely high but on oat test no aspergillus, it is because of food and not colonized? How can you tell if it is colonized or just need detox? Does the mold recirculate or the mycotoxin?

A: Ochratoxin A also comes from Penicillium mold and the OAT doesn’t directly test for Penicillium. This is more than likely the cause of the Ochratoxin A elevation on the MycoTOX. Foo exposure can cause colonization in the same way water damage building exposure can. The only way to know if it is food exposure is to test and rule out environmental exposures. In most cases mold has colonized. At this time the OAT can only give you specific colonization info regarding Fusarium and Aspergillus. Other molds will need to be clinically assessed to determine if colonization has occurred. Mold organism is not recirculated just mycotoxins.

Q: Is there a way to know how long the mold has been in our bodies?

A: That would be awesome but unfortunately no.

Q: Did he just say the sig for cholestyramine was 4 gr bid WITH food?  But just before that...was saying not to take any of the binders with food as these will bind vitamins and minerals?

A: Cholestyramine can be harsh on the stomach and may cause it to be upset. It can also have an unfavorable taste and is recommended with food. It shouldn’t however be taken with a large meal for interference with nutrient absorption. Consider adding to applesauce or crushed pineapples. See more info HERE.

Q: Would cutting mold off soft fruit or other food, but perhaps consuming the hyphae confer infection or mycotoxin exposure?

A: Cutting away the moldy portion of food would be helpful. There is just no way of knowing for sure you have removed all hyphae/spores. Also eating commonly contaminated foods in moderation you should be able to clear this exposure. This practice would be best for someone dealing with an over exposure of mold toxicity.

Q: Is there a preferred anti-fungal drug or regime for Penicillium mold?  I have a patient with very high values of Mycophenolic acid.

A: Itraconazole is the drug of choice.

Q: Do herbal antifungals work as well as pharmaceutical antifungals?

A: The short answer is no. This is because herbal agents are non-specific, unlike there man made and design antifungal counter part pharmaceuticals. Herbal agents can be utilized and do work, but you should not expect the same timeframe of completion of treatment in relation to that of pharmaceuticals.

Q: Do You recommend OAT urine-test in 24-h urine with HCl?

A: The HCl shouldn’t affect the OAT. It’s not necessarily recommended but it doesn’t have to be discontinued.

Q: How can you tell if the mold is somewhere else than intestinal tract- sinus? How would you treat the sinus, or should you automatically treat sinus as well? Do you need to use biofilm support with mold? Do you always use the binder and how high do you go with binder?

A: Sputum and nasal culture will tell you if there is respiratory/sinus colonization, but clinical symptoms can allude to that as well. Treatment is with oral and intranasal antifungals. If symptoms or culture alludes to mold you should treat. Biofilm disruptors can be helpful and should be considered. Binders are necessary for proper clearance of mycotoxins. They can be given 1-2x a day depending on client bowel movements.

Q: If patient has + organic acids for aspergillus and high levels of mycophenolic acid and citrin do you have to rx with antifungals or can you use herbals and remediation? or does it depend on symptoms?

A: You don’t have to treat with pharmaceuticals, but you should base that decision on clinical presentation.

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Q: Have several patients with torticollis (neck dystonia), any relationship comments?

A: Since this is due to contraction of the neck muscles there could be a neurologic issue causing this. That may be due to mold illness and is an option to consider.

Q: No connection to schizophrenia?

A: There is a potential connection to any neurologic condition. Ruling mold out should be considered.

Q: Is there any association of mold or mycotoxin with PTSD?

A: There is a potential connection to any neurologic condition. Ruling mold out should be considered.

Q: What do you think of anti-fungal herbs?

A: I think they are great. They can be used for antifungal therapy. Check these blog post for more info:

·         https://www.greatplainslaboratory.com/gpl-blog-source/2021/12/essentialoils

·         https://www.greatplainslaboratory.com/gpl-blog-source/2021/01/5herbal

Q: Does hydrogen peroxide kill mold? The companies that fumigate with it state it will penetrate and kill everything, so you don’t have to move. Is this accurate?

A: It has the potential to kill mold. I’m not sure if it penetrates porous materials. You may ask a company that doesn’t use this product for another point of view.

Q: Does the generation of Glutamate in the mercapturic acid formation pathway act as a neurostimulator? can it cross the BBB?

A: Glutamate can cross the BBB, and excess levels can cause increased excitation of the nerve cells, however it is not clear that the glutamate production via the mercapturic pathway is going to the brain directly.

Q: Is bromopropane affecting pituitary hormones such as prolactin similarly to bromocriptine and thus causing HPA disruption?

A: The current studies available on pituitary influences from 1 bromopropane’s  are not strong enough to make that association.

Q: With the increase of the use of e cigarettes with teenagers, are their markers within this test measuring the chemicals found within these products?

A: E cigarettes have been found to have acrolein and benzenes, both measured on the GPL tox. They have also been found to have cadmium, nickel, tin, and lead, so a heavy metal test might also be warranted.

Q: Almost all our homes have some PVC piping. What do you recommend handling this common toxic exposure?

A: Utilizing a water filtration system that includes Reverse Osmosis and Activated carbon.

Q: Does phthalate contamination hold true for all enteric coated medications and supplements?

A: It would depend on the actual medication or supplement.

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Q: Please speak to toxin metabolites not readily released in urine but stored in body.

A: Based on the current research that is available on these toxins, it appears we remove a significant amount of the exposure. However, there may be some residuals left over in the body that are not being excreted, but this is incredibly difficult to account for unless various other tissue samples could be obtained.

Q: How can we detoxify from each of these major chemical groups?

A: Most of the toxins measured can be eliminated by removing the exposure, and utilizing sauna, and glutathione and/or NAC.

Q: Does the type of sauna used i.e. Infrared or moist heat, make a difference in clearance of toxins?

A: The premise of using a heat source is to get the body temperature elevated and create a perspiring effect. When the initial research on this was first conducted, a regular sauna was utilized, and it worked. With the evolution of different heat sources, it certainly has become more sophisticated, but the basics are the same, so the answer is technically, no.

Q: If mitochondria are damaged, can they be repaired?

A: Depends on the extent of damage, but in general, yes.

Q: When you see these compounds elevated in your urine, do you know when thes exposures have occurred? Is this only a test for recent exposure?

A: They are likely recent/current exposure.

Q: Why kind of insect repellants have xylene?

A: You can find out which ones you have questions about using the app “Think Dirty” or EWG’s “Healthy Living.”

Q: Are pyrethrin’s the same as pymethrine for tick prevention?

A: Both compounds have the same mechanism of action (disrupting sodium channel currents, causing loss of motor coordination, paralysis, and death of the insect), and they are very similar in chemical structure. Exposure to either would likely show up on the GPL Tox.  The only real difference is Permethrins are synthetically derived, while pyrethrin is derived from Chrysanthemums. Although pyrethrin is allowed in organic farming when it is not combined with other synthetic ingredients, it is still extremely harmful to the environment, especially to the bees.

Q: Do you see diphenyl phosphate as a listed ingredient on nail polish?

A: It is usually listed as Triphenyl Phosphate (TPHP)

Q: If we can only do so much to avoid phthalates, how do we handle keeping our toxicity as low as possible?

A: Avoiding the most likely sources as much as possible and supporting the body’s natural elimination of them.

Q: Are the phthalates in the medication itself or could it be coming from the plastic bottle the medication comes in?

A: The medications themselves.

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Q: Do you have any data on leaching from implanted devices such as ports?

A: Not that I am aware of.

Q: Can you speak to low long you can show elevated phlalate levels in the urine after exposure?

A: The data is limited on time frames regarding excretion, but the half-life can be somewhere between hours and days within the human body. Excretion is also going to be somewhat individualized based on the patient’s overall clinical picture, and highly dependent on the length of time and amount of exposure.

Q: Is there a risk of Bromopropane absorption in foam mattresses? I have a few patients that felt flu like after getting new foam mattresses.

A: It is very possible.

Q: When our children are jumping on the foam cushion furniture are they out gassing these VLCs.

A: This would be highly dependent on what type of furniture it is, where it is from, and the age of the furniture piece.

Q: Have several patients presenting with torticollis, (neck dystonia) and links that you have seen.

A: Not specifically, but it might be worth testing for toxins, especially if they are within the same geographical region.

Q: How does the amount of glutathione in the body affect the results of the tests?

A: There is no definitive data to support that high levels of glutathione would increase certain levels on the test, but in theory, it is possible. However, it is not advised to take glutathione prior to testing, since the values that are being compared are based on individuals who were not utilizing glutathione, and it would make it difficult to evaluate the levels if it did increase them.

Q: Maybe his grain alcohol consumption is causing an elevate glyphosate level?

A: It is a possibility.

Q: Glyphosate and Chewing tobacco - also in regular tobacco or marijuana (edible or smoking).

A: Smoking tobacco and Marijuana, likely, but would be dependent on the farm that is cultivating it, and what chemicals are being utilized.

Q: if glyphosate can disturb aromatic amino acids, can lower values for HVA and 5-HIAA be related to glyphosate presence (75th %)

A: It is one possibility.

Q: How do I find out the glyphosate in water in specific places where I lived? How much is absorbed through the skin (a bath for example )?

A: Great Plains can test water for glyphosate.

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Q: Recent study reported high unconjugated 4-cresol correlated with kidney disease. this might connect glyphosate with CKD.

A: This is a very interesting connection.

Q: I am hearing that glyphosate is now found in rain. Can you speak to this?

A: Glyphosate is very water soluble and has been found in water and air samples.

Q: Does Glyphosate persist in conventionally fed chickens and their eggs?

A: Previous evidence suggested this was not an issue. LINK. However, a more recent study was able to detect glyphosate in the eggs of Quails that were exposed at high levels, so it seems it may be a potential issue. LINK

Q: With testing well water, with well within 8 feet of corn and soy farm; will testing the nitrates/nitrates within water be enough to glean whether glyphosate is a problem in the well water?

A: No, because there are a lot of factors that contribute to nitrogen sources and levels.

Q: I’m assuming that pesticide spraying over a period of years and in home raise Glyphosate levels..  The patient eats organic non-GMO foods, no Clostridium markers but has Aspergillus/Penicillium markers on OAT.  What type of rx can help besides detox of mold? Thanks

A: Glyphosate levels are measured based on recent exposure.  If they are currently spraying Glyphosate or there is left over amounts in the surrounding soil (usual half-life in the soil is somewhere between 2 and 197 days), there could still be exposure. Glyphosate is not related to mold directly. Sweating, and removal exposure is the best way to eliminate glyphosate. Additional Binders and Glutathione or NAC for mycotoxins.

Q: Do you recommend sauna for children? infrared?

A: If the child can tolerate it, and hydration is monitored, then it can be a therapy utilized in the pediatric population.

Q: Should NAC be taken on empty stomach?

A: It is preferred.

Q: What type of Sauna is effective?

A: The premise of using a heat source is to get the body temperature elevated and create a perspiring effect. When the initial research on this was first conducted, a regular sauna was utilized, and it worked. With the evolution of different heat sources, it certainly has become more sophisticated, but the basics are the same.

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Oxalates, Mold & Bacteria - Q&A with Andrew Rostenberg, DC, James Neuenschwander, MD & Emily Givler, DSC

The Great Plains Laboratory has been educating practitioners for over 15 years on how to help patients heal through cutting-edge testing, research and protocols. In our recent 3-Day Master Practitioner Workshop, speakers shared detailed information on how the MycoTOX Profile, IgG Food MAP and Glyphosate Test can work for you. As well as gave additional information about markers in the OAT and GPL-TOX.

The following Q+A is a response to remaining questions speakers were unable to answer during their presentations.

The material contained within this article is not intended to replace the services and/or medical advice of a licensed healthcare practitioner, nor is it meant to encourage diagnosis and treatment of disease. It is for educational purposes only. Any application of suggestions set forth in the following portions of this article is at the reader's discretion and sole risk. Implementation or experimentation with any supplements, herbs, dietary changes, medications, and/or lifestyle changes, etc., is done so at your sole risk and responsibility.

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Andrew Rostenberg,
DC, DIBAK

Bacterial Phenol Overload - A Hidden Cause of Gut-Brain Dysfunction

Andrew Rostenberg, D.C., DIBAK, is a chiropractor, kinesiologist, functional medicine expert, methylation researcher, author, and director of Red Mountain Natural Medicine in Boise, ID.

Q: So if patient with likely phenol overload from SIBO, but also has mycotoxin and oxalic acid issue, what to treat first - the gut?

A: The gut is Phase 0 detoxification – literally detoxification starts in the gut before it even begins in the body. If we are trying to cleanse the metabolic tissues of a toxic patient, but the gut is completely out of order and dysfunctional, then we will not see the best results. Always treat SIBO and other chronic, hidden gut infections first as that opens up the pathways for improved detoxification as the treatment process goes on. You might treat SIBO for 3- or 4-months max, then shift to helping with mycotoxins, mold, heavy metals, xenoestrogens, etc…just depends on what your patient needs.

Q: What if a patient with this high dopamine presentation does WORSE on taurine and TUDCA bile salts?

A: Some people just do not tolerate taurine well. It is a very small minority of people, but they do exist. Studies have shown a relationship to people with psoriasis and an intolerance to taurine. So even though certain supplements are very neutral and well tolerated, you will always find one or two people who are just sensitive in ways that are different from everyone else.

Q: What if someone is missing their Ileocecal valve, (cancer cut out), PLUS no gall bladder? Plus, daily PCN due to no spleen and immune deficiency? What is this person at risk for and how do they fix SIBO?

A: In our experience herbs and natural anti-microbials are well tolerated even by complex patients such as this. Someone without their ICV could perform bowel massages to help regulate peristalsis in the correct direction. They will likely need long-term herbal support to kill excess bacteria and yeast that inevitably get into the small intestine. They will need support for their upper GI tract like betaine HCl, pancreatic enzymes, and bile support (choline, methionine, taurine, ox bile, etc.). They can only fix SIBO by helping to correct the environment in the small intestine, and that will require consistent attention.

Q: So then what can that patient do? Also they have PPI due to GESR and ever increasing brain fog (used to think just due to chemo but suddenly has worsened significantly in the last year, since the pandemic).

A: PPI therapy is a guarantee of nutritional deficiency. That is what we see in practice as the number one problem in our patients – poor nutrient status be it Vit. C, or Vit. D, or any other of the 50 nutrients we need. The goal is to get patients off these PPI medications using any and all available natural medicine tools. Anything that improves the stomach function of our patients will improve their health, and any drug that interferes with normal stomach physiology is a big problem for the long-term health of our patients.

Q: Is this why certain service dogs can smell BS, blood sugar drops? Cancer etc.? phenols vocs, mind blowing…

A: Most likely yes.

Q: What causes flushing when taking high quality B complexes-- SIBO?

A: Any strange or paradoxical reaction to supplements should be investigated as a hidden gut problem until proven otherwise.

Q: So mycotoxins increase aldehydes and also clog up pathway towards COMT and glyphosate can inhibit aromatic aminos, so could things "balance" out, but still be toxic?

A: It’s possible that there are many mechanisms at play and that people can be “balanced out” but still heavily toxic. Best idea is to test and treat these hidden problems and get the balanced without the toxic side effects.

Q: How does mold affect dopamine?

A: Mold inhibits the ability of the body to breakdown catecholamines, so the higher the mold the more slowly dopamine and other catecholamines will be processed which can lead to dangerously high levels of half-way-broken-down dopamine. Mold produces toxic VOC chemicals (essentially indoor pollution) that must be metabolized through Phase 2 pathways in the liver and kidney. If mold levels are high, there is less bandwidth available for dopamine to get processed correctly. We tend to see people with mold exposure as individuals who cannot adequately metabolize their catecholamines due to the interference from the mold poisons the liver is trying to break down.

Q: Could you provide references for the nutrients to decrease/increase Dopamine?

A: References can be found by searching the PubMed library…sorry nothing convenient to share or hand out on this one.

Q: Patient with intermittent PVCs for several years after mold exposure intermittent anxiety completely resolved with B6 50mg daily. What’s the mechanism?

A: Could be multiple things, but B6 with lower SIBO and it is a cofactor for ALT enzyme in the Liver so it will upregulate detox reliably as well.

Q: Same protocols for SIFO as SIBO…. ? What do you think SIFO is?

A: SIBO protocol is more strict than a protocol required to treat SIFO, so if you treat SIBO you will also help reduce the fungal burden in parallel with the bacterial overgrowth.

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James Neuenschwander, MD

Identifying and Treating Complex Patients with Mold Toxin Induced Illness

A graduate of the University of Michigan with both a Bachelor of Science degree in Molecular and Cellular Biology as well as a MD degree. He is dually board certified in both Emergency and Integrative Medicine and has been the owner of the Bio Energy Medical Center since its opening in 1988.

Q: Prefer IV Voriconazole or oral, and what doses?

A: Oral: 200mg twice daily.

Q: Are there special considerations for treating a patient with diverticulitis (on a third round of antibiotics) with Hx of chronic fatigue, ebv, and mold. I’m not her physician, she’s my sister.

A: I can’t give treatment recommendations for someone that is not my patient.

Q: What do you think about testing as a preventative - even if you don’t have symptoms - it may be brewing and present as a problem later on?

A: Testing for mold toxins is not that helpful if you are not symptomatic—most people don’t have problems.

Q: Have you found any treatment particularly useful to eradicate MARCONS, possible explanations for non-resolution of MARCONS and how do you treat low MSH?

A: Usually from persistent exposure. Need to regular Neti pot or saline rinses in addition to the antiseptic nasal sprays. Can use PT141 to try to increase MSH, but MARCONS will continue to break it down.

Q: On one panel, all mycotoxins were 0 except for OCHRATOXIN, which was high. Could this be from her excess coffee drinking alone?

A: It depends on the degree of elevation. Food sources will typically elevate levels slightly.

Q: I've heard other practitioners say that S.boulardi produces oxalates, so not good for those who already have mold/fungal issues and too much oxalates. Do you have any thoughts on this?

A: Not in my experience. The balance of the microbiome by S. boulardii usually reduces oxalates. There are some people that don’t tolerate any yeast.

Q: Do you check for adrenal fatigue and how do you treat it if present?

A: That is a two hour lecture.

Q: Do you consider EMFs in your patients?

A: Yes, but extremely difficult to treat.

Q: How do you give Itraconazole dose and interval ? With binders?

A: I use voriconazole.

Q: How do you fix VAGAL dysfunction in your practice? fix underlying mold, but how do you stimulate MMC after the eradication of toxicity?

A: I typically use DNRS. LINK

Q: What is the electron transport chain test called?

A: MitoSwab

Q: Any specific lab for AVH alpha MSH?

A: Not really—you need to know your ranges.

Q: Any recs for alternative to tenting for termites?

A: Not an exterminator.

Q: Vocabulary check POP (persistent organic pollutants)?

A: Yes.

Q: Can you say more about the origins and mechanisms involved in generating high osmolality / low sodium?

A: Don’t know the specific mechanism, but has to do with both renal and brain signaling dysfunction.

Q: What is the conference you were referring to in August in Arizona and are you presenting?

A: August 2021 is Integrative Medicine for Mental Health in Atlanta - use promo code: 50MPW21 for $50 off! The Arizona Conference is MAPS and will be 9/30-10/2 in Scottsdale.

Q: High ANA but no other elevated typical Autoimmune panel-would mycotoxins and/or environmental toxins be a potential cause?

A: Yes.

Q: Since binders are absorbing toxins why would too much of a binder cause a Herxheimer Reaction

A: Too quick of a detox will create symptoms.

Q: Can mycotoxins be responsible for persistent fever?

A: Any immune activation can cause a persistent fever.

Q: In the chronically ill patient with known history of Lyme, co-infections, mold toxicity, long term antibiotics, does the OAT help you differentiate what issues are still active and priorities? Any pearls?

A: It won’t differentiate between Lyme and co-infections, but will tell you about mold and toxicity.

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Emily Givler, DSC

Oxalates & Mold: A Hidden Source of Inflammation

Emily Givler, DSC is a Functional/Genetic Nutrition Consultant and Dietary Supplements Counselor with the NutriGenetic Research Institute and Tree of Life. She specializes in food sensitivities, utilizing genetically influenced dietary protocols designed to maximize health outcomes while maintaining a healthy relationship with food.

Q: Anything to consider during treatment for clients with NO gallbladder?

A: These individuals are vulnerable to hyperoxaluria without adequate digestion support with something like TUDCA or ox bile. They may benefit from including calcium alongside higher oxalate foods to aid in the excretion of oxalic acid in stool.

Q: Could you recommend a lab for urine sulfate testing?

A: I use over the counter Quantofix sulfite and sulfate test strips. These are a urine dipstick and are good for home testing.

Q: I've heard Dr. Grace Liu say that O.forminges gets too much attention and that other bifido bacteria and lacto bacteria are actually powerful oxalate degraders.  What are you thoughts on this?

A: There are other organisms that can degrade oxalate under various conditions, but the research currently shows that O formigenes plays a primary role in degrading oxalic acid under any physiological conditions. Ideally, we should have a robust microbiome that has a large diversity of symbiotic organisms. I agree that we should not overstate the importance of any one organism. I do find the association between disruption of O formigenes by certain classes of antibiotics helpful to know when taking a history.

Q: How can you increase O. formigenes if not in a probiotic?

A: I try spore-based probiotics like MegaSpore. The goal would be to create diversity even if we cannot target that specific species.

Q: Please be specific with the prebiotics that you use that help the body regrow O.Formigenes

A: I have had good success with MegaSporebiotic, but there aren’t any studies that I can point to on it, only anecdotal evidence.

Q: Lichen Sclerosis not on list, do you suspect any link here?

A: I see associations in my own clients, but it isn’t there in the literature yet. LINK

Q: Where do you get the sulfate test strips?

A: Amazon.

Q: So, what comes first treating the mold or the oxalates? Or do you treat both at same time?

A: This must be an individual decision, but you can start reducing oxalate at any point (as long as a slow reduction approach is taken). You may not see full resolution of the oxalate issue until the mold is addressed if that is the primary driver, but it does not need to be gone before you start the oxalate reduction process.

Q: Do you ever use a Ca Mg citrate combo or the like?

A: Yes, that can be a great choice with meals.

Q: Which product or manufacturer for urinary sulfate testing and what was the range?

A: Quantofix Sulfite optimal 0-10; Sulfate range 400 - 800 optimal; <200 is insufficient, >1200 consider sulfate dumping.

Q: If you see high glycolic or glyceric but oxalic in normal range.  We think Genetic, but how do you get them to start excreting the oxalate?  Sulfate supplementation?

A: Yes, sulfate is likely going to be effective to start mobilizing trapped oxalate, but I would always start slowly in these cases. Epsom salts are generally my starting point. If sulfite is elevated, molybdenum can increase sulfate. Adding B6 can also help reduce oxalic acid production in cases where there is a genetic cause.

Q: Can you use P5P instead of B6 therapy when glyceric or glycolic markers elevated?

A: Yes, that would be my own preference.

Q: Could a patient's worsening of Symptoms if supplemented with B6 or zinc or B1 be because the oxalates where dumped more?

A: Potentially.

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The MycoTOX Profile in Action - Elaboration from William Shaw, PhD

The Great Plains Laboratory has been educating practitioners for over 15 years on how to help patients heal through cutting-edge testing, research and protocols. In our recent 3-Day Master Practitioner Workshop, speakers shared detailed information on how the MycoTOX Profile, IgG Food MAP and Glyphosate Test can work for you. As well as gave additional information about markers in the OAT and GPL-TOX.

The following Q+A is a response to remaining questions Dr. Shaw was unable to answer during his presentations.

The material contained within this article is not intended to replace the services and/or medical advice of a licensed healthcare practitioner, nor is it meant to encourage diagnosis and treatment of disease. It is for educational purposes only. Any application of suggestions set forth in the following portions of this article is at the reader's discretion and sole risk. Implementation or experimentation with any supplements, herbs, dietary changes, medications, and/or lifestyle changes, etc., is done so at your sole risk and responsibility.

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William Shaw, PhD

IgG Food Allergy Testing: Scientific Evidence of its Validity in Chronic Illness

William Shaw, PhD, is board certified in the fields of clinical chemistry and toxicology by the American Board of Clinical Chemistry. Before he founded The Great Plains Laboratory, Inc., Dr. Shaw worked for the Centers for Disease Control and Prevention (CDC), Children's Mercy Hospital, University of Missouri at Kansas City School of Medicine, and Smith Kline Laboratories.

Q: Could you explain a little bit about the process of testing the environment and mold removal techniques from home/car for patient tested positive?

A: Clients can choose from about 3 different choices of home testing. The ERMI, mold air sampling plates, and a home inspector are the most common options. Here is a resource for more info on all of these options.

Q: If the OAT is not to be used in place of the MycoTOX Profile, and a client cannot follow up with a MycoTOX Profile after findings of mold in the OAT test, should one address it in some way? I am guessing it is wise to do so.

A: If mold is showing up on the Organic Acids Test and the client cannot test the MycoTOX Profile further investigation of the home/workplace/car/school should take place. This will help you as a practitioner know if they are currently exposed to mold. This will guide your treatment in whether or not to address the fungus with antifungals right away or post remediation/removal of exposure source. Retesting should include at lest a MOAT/OAT and MycoTOX.

Q: Does eating mushrooms or using medicinal mushrooms contribute to mycotoxins in your body?

A: If the mushrooms are contaminated with mold, then they can contribute to mycotoxin exposure. Also, they would most likely need to be ingested at extremely high levels to cause substantial mycotoxin increases. It would be best to investigate a WDB exposure prior to saying it is just the medicinal mushrooms.

Q: If someone is doing a mold protocol and is getting inflammation in the joints how can you support these toxins from excreting properly do you support more of lymph?

A: Lymphatic support is beneficial. Also consider increasing the binder dose if the client’s bowels can handle it. Consider reducing detox support during flares. This may be an aggravation reaction of detoxing too quickly. Supporting oxalate reduction and increasing anti-inflammatory support will also reduce joint pain.

Q: If a patient has a furan-2,5 dicarboxylic value above the average (15), would you treat him with antifungals?

A: This is not a positive result and should be confirmed with a positive MycoTOX Profile. If after consistent detox there is a plateau of progress, antifungals can support healing. I am finding most often people must do antifungal therapy for full resolution in most cases.

Q: How do you gauge whether the oxalate level on the organic acids can be from food? Is there a range that dietary oxalates can fall into?

A: There is not a specific range for any one person. It would be dependent on oxalate food intake you may see from a diet diary or diet history during your intake. Also if fungal markers are elevated on the OAT then its more than likely from that unless they eat a high amount of oxalate rich foods.

Q: Any hypothesized connection between autism, vaccines and mold?

A: Mold and mycotoxins have been implicated in autistic children. There may be a possibility of potential immune alteration of mycotoxins potentially causing adverse effects after vaccination administration.

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Q: How do you manage a patient with autism who has a severe herxheimer reaction during treatment with itraconazole? do you keep the same dose?

A: This is up to the you and client. If they aggravate where they cannot function you can give them permission to reduce or skip a dose until symptoms subside. You may find that some clients that herx give up due to being uncomfortable and not feeling they have any control over their treatment if it gets to be too much. Giving an option to reduce can increase compliance. Also consider increasing the binder dose if their bowels can handle it.

Q: A patient has low Pyroglutamic and Oxalic, but high Glycolic, Glyceric and N Acetylaspartic - what significance of that?

A: These values don’t directly have anything to do with each other at the levels described but, low pyroglutamic acid means glutathione is being made sufficiently. Low oxalic and elevate glycolic and glyceric may be from fungal overgrowth, collagen, or bone broth intake, genetic hyperoxaluria (rare), B6 deficiency. Elevated N-acetylaspartic is associated with Carnavan’s disease (rare) if severely elevated. If mildly elevated this is more than likely due to increased nutrient need and/or gut dysbiosis.

Q: How would one test well water for mold?  and wouldn’t you be able to smell or taste it?

A: Mold testing plates could be used. Just add you water to the plate and see if mold grows. Could have it analyzed by Immunolytics potentially.

Q: What botanicals work against aspergillus?

A: Many antifungal botanicals work against molds like oregano and garlic. Please see 5 Herbal Agents for Antifungal Therapy for more information.

Also check out www.nbnus.net for herbal supplements that will kill mold and fungus.

Q: To clarify, Dr. Shaw believes that no glutathione should be used before mycotoxins testing because the toxins will bind to the glutathione and not be assessed correctly by the mass spec?

A: Correct. We are looking at the toxin unbound NOT bound to glutathione. It will be missed if its bound.

Q: Dr. Shaw disagrees with Shoemaker’s refusal to use anti-fungal drugs. Presumably, this not for all cases? Which molds typically require drugs to kill the organism? Only cases where repeat testing shows returning toxins despite removal of contaminants?

A: If the person is not colonized, then anti-fungal therapy is not needed. However, if continued detox of toxins and removal from exposure source still populates toxin on the MycoTOX Profile, then more than likely this person is going to need anti-fungal therapy. Also, any mold, if colonized, typically needs antifungals to kill them. Pharmaceuticals are beneficial in killing almost all species of mold. There is no one mold that absolutely NEEDs drugs to be killed. Mold is susceptible to natural agents.

Q: Is the mold on cheese toxic? How about if you trim it off and eat the rest? Are some cheeses more prone to toxic molds?

A: Mold on cheese is typically penicillium. In the case of blue cheese mycophenolic acid, a mycotoxin from penicillium, is the main ingredient that gives the cheese its blue color. So yes, mold on cheese can be toxic. If you are to remove the visibly molded spots you are more than likely reducing your exposure but there is no way to rule out microscopic mold growth and mycotoxins that are not visible. If you are not mold toxic then it should not harm you to eat this, but you may want to avoid molded foods to not add to the toxic load.

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Q: Why do males have worse mycotoxin reactions than females?

A: I not sure this is a proven observation. There are many cases where men and women have the same exposure, and the woman has the worst reaction. All vice versa happens. It is more dependent on the individual and their susceptibility to the toxic effects of the mycotoxins.

Q: What is the glutathione challenge? and what were you trying to imply re it? To just not do before testing or you might not pick up the mycotoxins?

A: Glutathione challenge is giving the compound to provoke toxins prior to testing. GPL does not recommend doing this as the mas spec if not looking at the toxin bound to glutathione but unbound toxin. Bound toxin will be missed during sample testing.

Q: What over the counter antifungals were you referring to instead of the prescription ones?

A: Herbal and nutraceutical supplements. Check out www.nbnus.net for OTC anti-fungal options.

Q: Is there a marker in the OAT for actinomycetes?

A: No

Q: Just confirming the need to test liver enzymes twice a week? While on Sporonox.

A: Once a week is sufficient unless they increase and you want to assess sooner that that, then 2x that week would be warranted.

Q: And if mycotoxins are positive, how do you know which species of mold you have?  or does it even matter to know?  in other words, sporonox will treat them all?

A: You can evaluate which species of each genus excretes which mycotoxins to know which mold species you are directly dealing with or at least narrow it down. You could also do a sputum/nasal culture to determine which species is present. In the grand scheme of things, the specific species isn’t necessary to treat as Sporonox works on the ergosterol in the fungal cell wall to kill fungus in general.

Q: How likely are organic blue corn chips to be free of mycotoxins?

A: Not very likely. Corn is a commonly contaminated grain. Also, organic foods do not use pesticides so there is nothing there to kill the potential mold. In other words, organic food has an increased risk of being moldy due to the lack of fungicide use.

Q: What’s the research on seizure disorders and the testing?

A: Here is some info.

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The Evidence Behind Mycotoxins in Food

By LINDSAY GODDARD, MS, RDN, LD

Without a doubt, mycotoxins can be harmful to our health, especially if we are inundated with mold within closed home or office spaces. When it comes to food sources, however, questions arise as to whether certain foods should be eliminated to reduce exposure to mold, and if there are health implications to consuming foods with mycotoxins. Dietary restrictions should not be implemented frivolously, especially for individuals who may already be overwhelmed with nutrition interventions and eliminations. Documentation within the literature and through clinical practice has shown the demise of patients with regards to their nutritional status, microbiota function, and quality of life, due to restrictive diets. The decision to remove certain foods should be evidence-based, and a diet plan should present a clear benefit to the patient. Thus, the goal of this article is to provide substantiation for the idea that eliminating certain foods can reduce mycotoxin exposure in many situations. We begin by looking at the most relevant mycotoxins in our food supply, and then examining the data regarding mycotoxins frequently found in food, along with assessing the possible role of food mycotoxins in the development of mycotoxicosis.

Before we delve into a literature review of mycotoxins in foods, let us briefly discuss why these mycotoxins are pertinent to our health. Included are the most relevant of the common mycotoxins, along with their potential impact on biological systems.

Toxicity and carcinogenicity have been found in both human and other animal populations. High acute exposure can lead to death, while chronic exposure can cause immune suppression and even cancer. The liver is the main organ affected in several animal classes (fish, birds, rodents, and primates).

Nephrotoxic to all animal species, and in most animals, a hepatotoxic , immune suppressant, a teratogen, and a carcinogen. Primarily, its biggest impact seems to be inhibition of the enzyme involved in synthesizing the phenylalanine-tRNA complex, as well as, affecting ATP production in the mitochondria, and lipid stimulating peroxidation.

(ex: Deoxynivalenol, or DON): Cause various symptoms, from alimentary hemorrhaging and vomiting after high consumption, to dermatitis from smaller exposures. In several vertebrate organisms, studies have shown an impact on almost every major system, mostly associated with gastrointestinal, dermatological, and neurological symptoms.

Very toxic in high concentrations, but evidence of poisoning in a natural environment is still inconclusive.

A wide range of effects on various mammals have been observed, centering mainly on interference with sphingolipid metabolism. Studies have demonstrated leukoencephalomalacia in equines and rabbits, pulmonary edema and hydrothorax in swine, and hepatoxic and carcinogenic effects in rats.

Effects mainly involve hormone disruption. This mycotoxin’s structure resembles 17Beta- estradiol, as expected, it impacts estrogen levels, and ultimately fertility.

Nephrotoxic to all animal species, but the threshold of acute toxicity is highly variable among species. Simultaneous exposure to both Citrinin and OTA can depress RNA synthesis in kidneys.

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A glance back in history reminds us of the detrimental impact that mold and mycotoxins has had on our food supply: ergot poisoning from contaminated rye (“St. Anthony’s fire”, 1100 BCE-1800 CE); cardiac beriberi associated with Penicillium molds in rice (“yellow rice toxins”, 2006 in Brazil; 1937, 1948, and 1951 in Japan); and alimentary toxic aleukia associated with Fusarium molds on overwintered wheat, millet, and barley (USSR, World War II era).  In 1974, acute Aflatoxin poisoning from moldy corn in Western India caused 100 deaths, and evidence suggests that the adults may have eaten 2 to 6 mg of aflatoxin in a single day. This event led to the calculation of 10 to 20 mg of aflatoxins as the acute lethal dose for adults. In 2004, Aflatoxin poisoning fatal to 125 people occurred in Kenya from contaminated corn (estimated contamination rate ranged from >20 to >1,000 µg/kg). Continuing investigation of mycotoxin-contaminated food suggests that it is still quite common, but to a much lesser extent, at least in developed countries. The UN Food and Agriculture Organization (FAO) assessment indicates that 25% of global fodder crops are contaminated with mycotoxins. Shiratori N, et al. investigated penicillium contamination on rice in Thailand, and found that only 1 of 10 samples contained Aflatoxin B mycotoxin (5.9 μg/kg), although 7 of 10 samples did have trace amounts of Penicillium species isolates. A study conducted on Green Coffee Beans from Brazil found that 91.7% of the 60 samples were contaminated with mold isolates (mainly aspergillus), but only 33% had OTA (0.2- 7.3 μg/kg). Keep in mind, this is below the acceptable limit proposed by the European Union (<8 μg/kg), and below the US limit of <20ppb. So wait, it’s being monitored? Yes! To some extent.

Mold and mycotoxin contamination prevention have become part of the food and agricultural industry, which continues to work on monitoring and reducing it, in part by developing with regulatory standards. Aspergillus, Penicillium, and Fusarium are the most common molds affecting our food supply. Guidelines are in place for the most prevalent mycotoxins and the most common contaminated foods in order to prevent toxic levels.

** Beer, wine, dried beans, dried fruits, vegetables, spices, and fermented beverages have been found to be susceptible to OTA contamination, but the FDA does not mention these as potential sources.

Allowance levels differ based on the mycotoxin, the crop, and its destination. Below is a table that provides some information for the mycotoxin allowance in the United States. Please note, that this list is not exhaustive, but serves as a tool for insight into allowance levels.  As noted previously, the European Union is also monitoring, and may differ on amount allowance. For the scope of this article, US standards will be the focus.

MYCOTOXIN	FOOD	ALLOWANCE
Aflatoxin (Aspergillus flavus and A. parasiticus)			Action level/limits
	Corn and peanuts intended for beef cattle	300 ppb
	Corn and peanut products intended for swine greater than 100 lbs	200 ppb
	Cottonseed meal intended for beef, cattle, swine, or poultry (regardless of age, breeding status or finishing status)	300 ppb
	Corn and peanuts intended for breeding livestock	100 ppb
	Corn, peanut products, and other animal feeds and feed ingredients (excluding cottonseed meal), intended for immature animals	20 ppb
	Brazil nuts	20 ppb
	Foods for human consumption	20 ppb (Europe is 0.1-2 µg/kg)
	Peanut and peanut products	20 ppb
	Pistachios	20 ppb
Aflatoxin M1	Milk	0.5 ppb
Ochratoxin A (Aspergillus and Penicillium)	Rye flour, wheat flour, some corn products, barley (cereals), oats, both whole and cereals, dried beans, cornmeal, raisins, coffee, soy flour, soy based baby foods, and ground ginger	Less than 20 ppb does not require reporting, more tan 20 ppb needs to be sent off for evaluation by the FDA.
Deoxynivalenol DON (Fusarium)			Advisory Limits
	Corn and grains intended for immature animals and for dairy animals	1 ppm
	Corn and other grains intended for breast feeding beef cattle, breeding swine, or mature poultry	5 ppm
	Corn and other grains intended for finishing swine of greater than or equal to 100 lbs	10 ppm
Fumonisins			Action level/limits
	Foods for human consumption	2 - 4 mg/kg * (Max allowed set by FDA)
	Foods for animal consumption	1-100 ppm, depending on animals
Patulin (Penicillium, Aspergillus, and Byssochylamys)	Apple juice	50 ppb	Action level/limits

**1ppb = 1µg/kg

There is a difference between an action level and an advisory limit. If the mold level in a food is at or above the Action Level, the FDA will take legal action to remove the product from the market. If a food mold level meets an advisory limit, governmental recommendation indicates that it may be a potential health hazard.

Only corn and peanuts are tested for aflatoxin, per the FDA. They state that “nuts (almonds, Brazil nuts, macadamias, pecans, pistachios, walnuts, and hazelnuts) are susceptible to aflatoxin contamination, but samples of these nuts have been largely in compliance [less than 1% ] for several years. Per the FDA, OTA is being monitored and measured, but a limit for ochratoxin in the food supply has not yet been established. A sample is reported if the ochratoxin result is above a certain threshold (>20 ppb).

Statements from the US FDA conflict with the scientific literature; the FDA notes limited data on OTA while the literature contains a significant amount of data on ochratoxin effects, especially nephrotoxicity.  The International Agency for Research on Cancer (WHO) has rated OTA as a possible human carcinogen (Category 2B). The European Union Scientific Committee recommends the OTA be reduced to <5 ng/kg, but the allowance varies by country and by crop.  Because OTA appears to be less heat-stable than Aflatoxin or DON (which is extremely stable during food processing), the FDA considers it less of a threat for human consumption. A 2016 study out of the University of Idaho tested OTA levels at different temperatures, times, and pH conditions. The largest degradation of OTA (90%) was at 200°C (almost 400 °F), except for samples at a pH of 4. The US does not have contamination standards on zearalenone levels, but the EU requires < 75-350 µg/kg, depending upon the food category. Even a level of 1ppm has been shown to lead to hyperestrogenic syndromes in swine. The FDA categorizes it in a similar manner to OTA contaminated samples, and reports them to the Center of Veterinarian Medicine to determine if regulatory action is required.  Citrinin is not monitored, although it is known to be commonly associated with human food.

Organic foods deserve a special mention when considering mycotoxin avoidance. Quite a few studies support the claim that organic foods do tend to have more mycotoxin contamination, mainly due to use of less potent fungicides. In a 1995 study, conventional and alternatively grown rye and wheat were found to have to have a significant difference of DON mycotoxin levels.  Conventional rye had an average of 160 µg/kg, while the organically grown rye had an average of 427 µg/kg. Zearalenone in wheat was also investigated and found to have an average of 6 µg/kg in conventional, compared to 24 µg/kg in the alternatively grown crops. A French study comparing organic and conventionally grown wheat generated similar findings: the organic version had an average of 106 µg/kg of DON, whereas conventional wheat had only 55 µg/kg. Apples have also been investigated, with similar results; conventionally grown apples had a median of 35.85 µg/kg of patulin mycotoxins, while the organic apples had a median of 211 µg/kg. This presents a significant barrier to reducing mycotoxins in the diet, since organic foods are a large part of nutrition therapy in Integrative Medicine.

The scientific community is continuing to discover the intricacies of mycotoxins interactions with organisms, and their resulting impact on the food supply and on human health. To date, 300 mycotoxins (and counting) have been identified, although 100,000 mold species (still counting) have been discovered, requiring effort to understand how they affect us. Along with monitoring at least the highly susceptible food sources, considerable resources are expended to hinder food contamination.  Prevention seems to be the key aspect to reducing mycotoxins and mold in food. New and fresher solutions to lowering mycotoxins in food include earlier detection of fungus (i.e., biosensors), breeding host plants for greater fungal resistance or using genetic engineering to add antifungal genes, and even targeting genes that regulate mycotoxin synthesis in fungal species, along with the standard approach of applying fungicides at various stages of growth, harvesting, transportation, and sale of foodstuffs.  

In summary, we have discussed the most frequent sources of mycotoxin contamination, the most susceptible foods, and strategies in place for monitoring and preventing mycotoxins from entering our food supply, now, how do we apply this information to clinical practice?

It appears that some exposure to mycotoxins is almost inevitable, and a truly “low mycotoxin” or “low mold” diet would leave one with very few food options. Before embarking on a project to eliminate mold exposure from food, it is imperative to take in the entire clinical picture as individual reactions vary widely. Ranges for potential exposure have been developed based on available data and clinical observation . However, it is necessary to consider a person's; age, body composition, nutrient status, comorbidities, allergen sensitivities, genetics, current toxin burden, the effect of a combination of different mycotoxins, etc., etc., as all have shown to impact the severity of symptoms and their progression. A look into the literature suggests that some diseases may be associated with food mycotoxins, but the evidence is incredibly difficult to assess over a lifetime. For example, epidemiological studies have shown correlations with increased incidence of hepatic carcinoma in populations with higher dietary aflatoxin exposure in addition to diagnosis of hepatitis B. An overall strategy, particularly for high-risk populations may involve reducing or removing foods , likely to have fungal contamination, with the clear understanding that individual response to mycotoxin exposure is not predictable.

Dietary restrictions to avoid mold exposure should be decided between provider and patient, with the assumption that it is probably not possible to be completely free of mycotoxins in food.  The goal should be to reduce the load as much as is practical for the individual. We hope this evidence-based discussion will help in designing individual versions suitability of the “mold diet”.

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References

1. Ehling, G., Cockburn, A., Snowdon, P., and Buchhaus, H. (1997) The significance of the Fusarium toxin deoxynivalenol (DON) for human and animal health. Cereal Research Communications, 25: 443-447.

2. Khera KS, Arnold DL, Whalen C, Angers G, Scott PM. Vomitoxin (4-deoxynivalenol): effects on reproduction of mice and rats. Toxicol Appl Pharmacol. 1984 Jul;74(3):345-56. doi: 10.1016/0041-008x(84)90288-6. PMID: 6740683

Kuiper-Goodman T. Mycotoxins: Risk assessment and legislation. Toxicol Lett. 1995 Dec; 82-83:853-9. doi: 10.1016/0378-4274(95)03599-0. PMID: 8597153

Vanhoutte I, Audenaert K, De Gelder L. Biodegradation of Mycotoxins: Tales from Known and Unexplored Worlds. Front Microbiol. 2016; 7:561, Published 2016 Apr 25. doi:10.3389/fmicb.2016.00561

Horgan, J. (2020, July 17). St. Anthony's Fire. Ancient History Encyclopedia. Retrieved SOURCE

Shiratori N, Kobayashi N, Tulayakul P, et al. Occurrence of Penicillium brocae and Penicillium citreonigrum, which Produce a Mutagenic Metabolite and a Mycotoxin Citreoviridin, Respectively, in Selected Commercially Available Rice Grains in Thailand. Toxins (Basel). 2017;9(6):194. Published 2017 Jun 15. doi:10.3390/toxins9060194

Martins ML, Martins HM, Gimeno A. Incidence of microflora and of ochratoxin A in green coffee beans (Coffea arabica). Food Addit Contam. 2003 Dec;20(12):1127-31. doi: 10.1080/02652030310001620405. PMID: 14726276

Wan, J, Chen, B, Rao, J. Compr Rev Food Sci Food Saf. 2020; 1– 27.

U.S. Department of Health, Education, and Welfare, Public Health Service, National Institutes of Health, National Institute of Environmental Health Sciences. Environmental Health Perspectives. Volume 107, 10/1999. Pg A515

Haschek WM, Voss, KA, Beasley VR. Handbook of Toxicologic Pathology (Second Edition), 2002. SOURCE

Bennett JW, Klich M. Mycotoxins. Clin Microbiol Rev. 2003;16(3):497-516. doi:10.1128/cmr.16.3.497-516.2003

Riches, E. Organic Food- The Hazard of Mycotoxins. CABI. 2003. SOURCE

Marx, H., Gedek, B. and Kallarczik, B. 1995. Vergleichende untersuchungen zum mykotoxikologischen status von ökologisch und konventionell angebautem getreide. Zeitschrift für Lebensmitteluntersuchung und –forschung. 201: 83-86.

Bhatnagar, D., Payne, G.A., Cleveland, T.E., Robens, J.F. Mycotoxins: Current issues in U.S.A. Proceedings of the 2nd Second World Mycotoxin Forum, February 17-18, 2003, Noordwijk, The Netherlands.

Guidance for Industry: Action Levels for Poisonous or Deleterious Substances in Human Food and Animal Feed. 2000. Food and Drug Administration. SOURCE

Brown, R. L., D. Bhatnagar, T. E. Cleveland, and J. W. Cary. 1998. Recent advances in preharvest prevention of mycotoxin contamination, p. 351-379. In K. K. Sinha and D. Bhatnagar, (ed.), Mycotoxins in agriculture and food safety. Marcel Dekker, Inc., New York, N.Y

Food and Drug Administration. CVM Annual Report on Mycotoxins in Animal Food Report for Fiscal Year 2016. SOURCE

Food and Drug Administration Office of Regulatory Affairs ORA Laboratory Manuel Volume IV Section 7. Mycotoxin Analysis. 2020. SOURCE

Sudhakar P, AswaniKumar YVV, Bodaiah B, Mangamu UK, Vijayalakshmi M and Renuka RM (2016) Mycotoxin Strategies: Impact on Global Health and Wealth. Pharm Anal Acta 7: 498. doi:10.4172/2153-2435.1000498

Mateo, R., A. et.al, 2007. Intl. J. Food Microbiol. 119 (1–2): 79–83. 11. Yin, YN et al., 2008, J Zhejiang Univ. Sci. B 9 (10): 787–92

IgG FOOD MAP FAQs

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LINDSAY GODDARD, MS, RDN, LD

Great Plains Laboratory recently launched a new IgG panel, utilizing an upgraded methodology with additional food antigens. I want to take this opportunity to answer some frequently asked questions, in the hopes it will save some time in literature reviews and data interpretation of results. I’ve provided an overview of IgG testing here, but to reduce repetition and for more information on methodology, please visit the main page for the IgG testing.

Why IgG?

When trying to heal the system, or relieve idiopathic symptoms, identifying food sensitivities can be a piece to the puzzle, or sometimes the direct cause. When IgG immune complexes are over produced due to a specific antigen, and unable to clear, they can cause significant inflammation throughout the body. IgG Food Sensitivity testing can be a simple and effective way to identify foods that are causing an inflammatory response without having to implement an elimination/reintroduction diet, which can take a significant amount of time and effort. This is especially true since reactions to foods can take up to several days to create noticeable symptoms. Furthermore, testing for IgG reactivity has numerous published case reports showing positive results with implementation.

What’s new about this test?

Prior to this, our laboratory used the long-accepted ELISA methodology, but when a substantially improved method becomes available, it is important to evolve. Our new XMAP technology increases the precision of identification by using intense signaling from fluorescents; the testing procedure is fully automated for greater precision and reliability, produces less waste by using multiplexed magnetic beads and requires less blood to run the sample for easier collection. We have also added specific allergens to problematic food categories, providing a more inclusive panel.

Why are Candida albicans and Saccharomyces cerevisiae on separate reports?

Yeasts’ primary antigens are not appropriate for protein-specific assays because their antigens are richer in glycans. Therefore, ELISA is the better methodology for assessing the immune response as it relates to yeasts, so sub-samples are run on separate equipment, generating a separate report. We are still able to use the same sample for both methods.

How does it compare to other food sensitivity testing?

There are several tests available, employing different methodologies, all claiming to be the best for food sensitivities. Below is a table that describes the differences, and how they compare with IgG.

It should be noted that GPL includes all 4 subtypes of IgGs, to ensure more accuracy and we are only measuring IgG levels responses, not IgAs, since IgA is unable to bind complement and trigger generalized inflammation. To read more about why this is important, CLICK HERE

What is meat glue?

Meat glue is one of the new antigens on the test, interestingly enough, it is common for it to be elevated. Its source seems to be a bit obscure to some, but there may be more to the story than just an addition to processed foods. Meat glue is the transglutaminase enzyme, which can be derived from multiple sources: animals (vertebrates and invertebrates), plants, and bacteria (mainly the Streptoverticillium sp), the latter being the most common sourcing in commercial food products. Culinarily speaking, it is helpful in forming isopeptides between proteins, increasing viscosity, elasticity, firmness, and water-binding capacity in foods. The most common source of meat glue is in processed or imitation meat, cheese and other dairy products, and baked goods. Since it is considered vegan when derived from plants or bacteria, it may be in some plant-based products, as well. If you are trying to avoid meat glue, look for TG enzyme or TGP enzyme in the ingredients. Also be aware of manufactured meats, and meats described as reformed or formed. The USDA requires all companies disclose this ingredient on the food label, and there are no exemptions.  

Transglutaminase is also involved in our biological chemistry. Transglutaminases are a family of enzymes categorized as transferases and mainly catalyze isopeptide bond formation, which can be difficult to degrade.  You know, kind of like glue. They are found in several organs, and their specific functionality is dependent on their location: intracellular versus extracellular, as well as the type of tissue. For example, intracellular tissue transglutaminase plays an important role in apoptosis, while extracellular tissue transglutaminase can influence extracellular matrix stabilization, likely from its ability to bind fibronectin.

Although transglutaminase enzymes are diverse, they do have significance in several diseases. The disease most associated with this enzyme is celiac disease. Tissue transglutaminase cross links to gluten, stimulating a specific B-cell response that can result in production of anti-transglutaminase antibodies, which are measured as a part of the diagnosis of Celiac. The dysregulation that follows may impact the intestinal lining, causing the structural changes seen in Celiac disease.  A high reactivity to meat glue on the IgG test is not diagnostic of Celiac Disease, but can provide justification of further testing of anti-transglutaminase antibodies if other factors are pointing to Celiac as well.

Why are there different derivatives of the same food?

First, it will be helpful to review how food proteins, which can serve as food antigens, bind to antibodies.

Adapted from Fundamentals and Methods for T- and B- Cell Epitope Prediction. Sanchez-Trincado JL,  Gomez-Perosanz M, Reche PA. Journal of Immunology Research, vol. 2017

In this figure, we can see that on the antigen, the epitopes (i.e., where the antibody molecules dock) are very specific and end up with somewhat different structures, even though they may originally be from the same source. This is in part because protein structure can change significantly during food processing, potentially creating structures and epitopes so different they are not recognized by antibodies nor do they bind.

Measuring various components of a food allows for more detailed analysis as to which compound may be causing the inflammatory response, as well as increasing specificity and decreasing the chance of missing a potential source of inflammation. This not only pertains to the dairy section (cows’ and goats’ milk, casein, whey, beta-lactoglobulin, sheep’s yogurt, yogurt, mozzarella and cheddar cheese), but also gluten components (Wheat gluten, whole wheat, gliadin, barley, rye), and  pineapple components (bromelain).

Does the casein differentiate between A1 vs A2 Casein?

No. The ability to differentiate between A1 and A2 caseins is not possible at this time.

If I stopped eating a particular food, and it is not showing up on the results as a problem, do I still need to remove it?

It can take up to 6 months after removing a food from the diet to not see an elevated IgG response to that particular food antigen. If a person is not consuming the food (or hasn’t done so in over 6 months), it likely will not trigger a large immune response, and will not show up as elevated on the test. A low reactivity to a certain food does not indicate that the person is now able to tolerate it or that the food can be safely reintroduced. It only means they have been vigilant in keeping it out of their diet. On the other hand, if the person has abstained from consuming a specific food and it does show positive on the test, then cross contamination with structurally similar proteins in the diet is likely the culprit.

Will the lipid derivative of foods on the IgG test be a problem?

The IgG response is to proteins, not lipids. However, people often question if they are sensitive to casein, can they consume butter? Or if they are sensitive to soy, can they consume soy lecithin? During the processing of extraction for these components, trace levels have been found of the corresponding protein, however, the protein is in such small amounts it is unlikely to be a problem. Most people seem to be able to tolerate it, though there are a select few who do not. An elimination/reintroduction phase may be helpful for further investigation in those rare cases.

Hopefully, this blog helps answer some of the common questions. If you still need help before ordering, you may contact customer service, or if you have a result that you need help interpreting, please schedule a consultation with the consultant staff.

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Resources: 

1. Sanchez-Trincado JL, Gomez-Perosanz M, Reche PA, "Fundamentals and Methods for T- and B-Cell Epitope Prediction", Journal of Immunology Research, vol. 2017, Article ID 2680160, 14 pages, 2017. SOURCE

2. Kemeny DM, et al Sub-class of IgG in allergic disease. I. IgG sub-class antibodies in immediate and non-immediate food allergy. Clin Allergy. 1986; 16:571-81.

3. Williams F. Use of the LEAP mediator release test to identify non-IgE mediated immunologic food reactions that trigger diarrhea predominant IBS symptoms results in marked improvement of symptoms through use of an elimination diet. American Journal of Gastroenterology: October 2004 – Volume 99 – Issue – P S277-S278. SOURCE.

4. Lomangino, Kevin Food Sensitivity Testing: Evidence-Based Practice or Pricey Placebo?, Clinical Nutrition Insight: March 2013 - Volume 39 - Issue 3 - p 1-5 doi: 10.1097/01.NMD.0000428066.22177.2

5. Mullin, GE, Swift, KM, Lipski L, Turnbull LK, Rampertab SD. Testing for Food Reactions: The Good, the Bad, and the Ugly. Nutrition in Clinical Practice: April 2010-Volume 25-Issue 2-pg192-198 SOURCE

6. Kieliszek M, Misiewicz A. Microbial transglutaminase and its application in the food industry. A review. Folia Microbiol (Praha). 2014;59(3):241-250. doi:10.1007/s12223-013-0287-x

7. United States Department of Agriculture, Food Safety and Inspection Service. Safety of Transglutaminase Enzyme (TG enzyme). 2017. SOURCE

8. Sakly W, Thomas V, Quash G, El Alaoui S. A role for tissue transglutaminase in alpha-gliadin peptide cytotoxicity. Clin Exp Immunol. 2006 Dec;146(3):550-8. doi: 10.1111/j.1365-2249.2006.03236.x. PMID: 17100777

9. Patel S, Patel H. Technical Report: Understanding the Role of Dairy Proteins in Ingredient and Product Performance. U.S. Dairy Export Council. 2015. DMICMAIM5063_Dairy_Protein_Report_r6.pdf

10. Griffin M, Casadio R, Bergamini CM. Transglutaminases: nature's biological glues. Biochem J. 2002 Dec 1;368(Pt 2):377-96. doi: 10.1042/BJ20021234. PMID: 12366374

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