The Simplicity of Mold Plate Testing to Help Diagnose and Inform Mold Treatment

by Dr. Donald Dennis, MD

In my experience, now that I have been treating fungal sinusitis and mycotoxicosis in my practice for over 20 years, testing patients for environmental mold spores during office visits and having patients test their own indoor living environments are some of the simplest, but most useful screening tests we do. We have even found that using simple mold screening plates to perform these tests, removes the intimidation factor and barrier to entry, while still allowing us to glean valuable and actionable information. There is nothing like actually seeing mold growing on a petri dish from a sample taken from a patient’s clothing, hair, or living room to spur them into action and out of disbelief that mold is likely what is causing their chronic sinusitis or other debilitating and treatment-resistant symptoms.

Taking Mold Off the Table

When patients come in, we routinely do what we call “TAP” tests on almost everyone just to get environmental illness (namely mold exposure) off the table as the cause of the symptoms. I have found that I should test everyone for mold because it is such a prevalent and underappreciated underlying cause of most chronic sinusitis. (A 1999 Mayo Clinic study found that 93% of chronic sinusitis is caused by a reaction to environmental mold/fungus.) Additionally, as building practices have changed, making building envelopes tighter, building materials more absorbant, and ventilation systems more energy efficient with less capacity to remove humidity and condensation, homes and indoor environments seem to be becoming greenhouses for mold and other microbial growth that has the capacity to interfere with our health and our immune systems. As a matter of fact, the increasing number of asthma cases and chronic sinusitis cases I am seeing in younger and younger patients is truly astounding. In my opinion, this is a health crisis being caused by indoor air quality, and mold is the chief disruptor! Thus, you see why TAP testing for mold has become part of what we do during initial screening at my office.

When we TAP test our patients, we do so by opening the mold plate (we use SDA Agar plates designed to culture mold), putting the media side face-down, and firmly tapping the clothing using 3-4 taps. We do this on all clothing, including legs, and front/back of shirts or tops. Then we cap the plates and send them to a lab. In the office, we use lab analysis because knowing the mold species helps us coordinate and decide upon more focused and specific treatment. If a person is wanting to save money and do this on their own, lab analysis is not always necessary. A colony-forming unit count, or how many round circles of mold grow out on a plate during incubation, can yield a good indication as to whether or not environmental mold is a problem. Normal is 0-4 colonies; above 4 colonies indicates elevated levels of environmental mold. (Note: Most plates come with a “key” indicating how to read your results. Realize that many molds are not culturable on plates. So, if your air is testing at 5 colony-forming units or more, you likely have more going on that will not grow out on the plates. This means your indoor air has an elevated level of mold spores that could be contributing to your health condition.)

When Does More Info About the Mold Become Important?

Information beyond colony counts, like species and genus information, becomes most helpful when the patient is digging into their environment and the possible locations of the mold source. For example, taking mold plate TAP and air samples in every room will help a patient find the general source locations of the mold. Then, certain species, like Mucor, for example, require active dripping water to exist. Thus, if that particular mold is present, you are generally looking for hidden leaks, trapped and wet moisture or condensation, a fish tank, etc. In other words, a good amount of wetness. Penicillium, Aspergillus, and Fusarium are very neuro and immunotoxic, and carcinogenic and indicate a definite moisture intrusion or increased humidity problem. Cladosporium and Mycosporum tend to be in HVAC systems and ductwork due to increased humidity housed in the duct system itself or coil box, most of which are lined with exposed fiberglass which is an additional great food source for mold.

Thus, you see, something as simple as mold plate testing can be exceeding valuable given that it gets both the patient and the doctor focused on the cause of the symptoms. When the cause is the focus, rapid progress can be made in health restoration. Without resolving environmental issues there can be no long-term wellness with any treatment protocol because the average human takes in 2,904 gallons of air per day; pills, irrigation, and surgery will not be effective unless causation is addressed.

Where Should You Test?

I ask the patients to test their homes, offices, cars, and washing machines to find likely exposure sources. We ask them to do two different mold plate tests. The air test is done in the bedroom, kitchen, den, basement, attic, crawl space, and washer/dryer. An air test consists of opening the plate and leaving it open for 1 hour with the agar media facing up. After an hour, the plate is capped, wrapped in foil, and sent and placed in a warm dark place to culture or sent to a lab. The TAP test is for a quick read on what has been happening for the last several months as it measures mold spores that have fallen from the air and settled on objects. We ask that TAP testing be done with different mold plates on mattresses, pillows, bedroom carpet or rugs, hanging clothes (with one plate used to tap a row of clothes), drawer clothes (with one plate used to tap all clothes in a drawer), car carpet and seats, and furniture where you sit most in house. After tapping, close the plates, label them, wrap them in foil, and leave them alone to culture or send them to a lab for analysis. The EC3 Mold Screening Test Plates that I recommend come with a key for analyzing your results, but I want my patients to have no more than 4 colonies per plate in order to heal in their environment.

You’ve Tested. Now What?

If you have high counts you need to set up a band-aid environmental treatment system which consists of a HEPA air filter, EC3 Candles which remove mold and mycotoxins from the air (not contents) in a 12-foot x 12-foot room in 3 hours, using an EC3 fogger to fog the entire house 2-3 times per week, and EC3 Laundry Additive to wash all clothes and bedding with. This can be done until you can either get into a safe place where you know you are improving or until remediation is complete and you are improving.

Meanwhile, you can begin the process of removing mold from your body by cleaning your nose, the entry point for mold into the body and also where the mycotoxin levels are the highest, with nasal irrigation with 4 drops of CitriDrops Dietary Supplement per 8 ounces of saline and CitriDrops Nasal Spray. You can also help regain the proper immune response to mold with Sinus Defense and Beta Glucans. Detoxification can also be assisted with MycoDetox Liver Support, and a supplement combinaton of N-Acetyl Cysteine(NAC), and L-Glutathione, the master antioxidant.

Test, Test, and Test Again

After remediation, you can check the results with mold plates as well, but remember no environment is safe for you unless you know you feel well in it and are improving in it. Your health and energy levels are the best litmus test of all. This is because mold plates are a great screening tool, but you can have false negatives. If more than one of your plates culture zero colonies, then the plates can be bad. Get new ones and try again. If you have any colonies growing on the plate before you start, then get new plates. Trust your body, and keep testing if things do not feel right.

Another environmental test that is valuable is the Environmental Mold and Mycotoxin (EMMA) test and the Environmental Mycotoxin Test on dust which can be from your dirty HVAC filter or vacuum hose. Frequently patients are sick but mold plates are only mildly elevated. Measuring mycotoxin load in the environment is important not only because it is exactly the cause of the illness, but because the common commercial mold testing, whether it’s Standard Air Tests, ERMI, HERSTMI, or other tests, all have one important flaw: the counts the tests consider to be too high for human health are much higher than where most mold sensitive people get sick. This is because there was virtually no objective patient medical data that was measured to determine an accurate number for those tests. They literally took testing on many different houses and made up a high number that they considered to be toxic. In reality, most patients who have mold illness get sick at much lower levels than those tests consider to be “dangerous”. Therefore, I find the mycotoxin testing both in the environment and in the urine valuable because no one should have elevated mycotoxins in their urine or air and consider it to be normal.

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