Mycotoxin urine tests, mold detox and CIRS: what the experts say

What is a mycotoxin urine test?

A mycotoxin is a chemical some fungi produce. A urine mycotoxin test measures traces of these chemicals, such as ochratoxin or trichothecenes, in a urine sample. The tests are often sold directly to consumers or ordered by “functional” or “integrative” practitioners as a “mold toxicity test,” with the claim that a high result shows your home is poisoning you.

The American Academy of Allergy, Asthma & Immunology (AAAAI) describes how this market grew. Functional medicine providers began offering urine mycotoxin testing to determine “exposure level,” along with detoxification programs, and for-profit companies began selling test kits direct to consumers. AAAAI says these non-FDA-approved tests “lack standardization, can produce false positives or negatives” and have no established thresholds for what counts as a harmful level in the body.

That last point matters most. A lab can report a number. But without a validated cutoff linked to disease, nobody can say what the number means for your health. This page explains what CDC, AAAAI, the American College of Medical Toxicology (ACMT), the US Navy and UCLA Health say about these tests, about “mold detox,” and about CIRS. For the wider evidence on mold and health, see our mold symptoms guide, and for practical help, our mold hub.

Is there an FDA-approved test for mycotoxins in urine?

No. CDC’s National Institute for Occupational Safety and Health (NIOSH) stated it plainly in a 2015 report in Morbidity and Mortality Weekly Report: “There is no FDA-approved test for mycotoxins in human urine.” The Navy and Marine Corps Force Health Protection Command repeated the same point in a November 2024 fact sheet, and reported that TRICARE, the military health plan, does not cover the test.

Some labs note on their reports that they are CLIA-certified. CDC explained why that does not settle the question. CLIA rules require labs to meet quality and analytic standards, so the lab measures accurately. But CDC says CLIA does not address clinical validity, meaning whether the result actually identifies or predicts a patient’s condition. FDA clearance or approval is what provides assurance that a test is clinically validated, and urine mycotoxin tests do not have it.

CDC’s conclusion: people using direct-to-consumer tests that are not FDA-approved for diagnosis, and their health care providers, “need to understand that these tests might not be valid or clinically useful.”

Why can’t a urine test show whether mold in your house made you sick?

Three reasons come up across CDC, ACMT and AAAAI.

Food is the main source. CDC says low levels of mycotoxins are found in many foods, so mycotoxins are found in the urine of healthy people. ACMT’s 2025 position statement says diet is “the most important source of human exposure to mycotoxins,” naming aflatoxins in corn, nuts and dairy, trichothecenes in cereals and fermented drinks, and ochratoxins in coffee, wine and dried fruit.

Indoor air levels are tiny. ACMT says mycotoxins are large, non-volatile molecules whose concentrations in indoor air are “exceedingly low.” Exposure modeling has found that even in moldy buildings, the maximum inhaled dose is generally orders of magnitude below levels shown to cause harm.

The timing does not fit. ACMT notes that most mycotoxins leave the body quickly. It says it is “inappropriate” to attribute mycotoxins found in urine to a supposed earlier inhalation exposure.

ACMT adds that “mycotoxin antibody testing” is not an accepted way to assess exposure and has not been validated. Standard allergy antibody tests can help diagnose allergies and hypersensitivity pneumonitis, but ACMT says they say nothing about mycotoxin exposure.

What happened when someone relied on a urine mycotoxin test?

CDC’s 2015 report described a real workplace case. An office worker with symptoms across several body systems found a lab online offering “toxic mold testing” and sent a urine sample, even though her office had no musty odor or signs of fungal growth. The lab reported “positive” results for ochratoxin and trichothecenes using its own cutoffs, and referred her to a clinic specializing in “mold illness.” There she was diagnosed with mold toxicity and prescribed an antifungal drug, a restrictive diet, and several nonstandard treatments, including colonic irrigation and cupping.

CDC pointed out that antifungal medications treat fungal infections, not illness caused by fungal toxins. Two consultants then did destructive testing in her office, removing drywall, carpet and ceiling tiles. They found no water damage or significant fungal growth. CDC says the cost to the building manager exceeded $25,000. Some coworkers, aware of the testing, began blaming their own nonspecific symptoms on mold.

CDC warned that unvalidated tests can lead to fear, incorrect diagnoses, unnecessary and potentially harmful treatment, and unnecessary building investigations. It also said CDC does not recommend biologic testing of people who work or live in water-damaged buildings, or routine environmental mold sampling.

What do medical groups say about “mold detox”?

“Mold detox” programs typically combine a urine test with supplements, binders, antifungal drugs, special diets, saunas or IV therapies, all aimed at clearing toxins from the body. The major medical organizations that have reviewed the evidence do not support them.

ACMT’s summary is the most direct: there are no medical-toxicology-based lab tests or treatments that support inhaled mycotoxins acting as a whole-body poison from mold in damp buildings. None of this means mold in your home is fine to ignore. It means the fix is in the building, not in a detox regimen.

What is CIRS?

CIRS stands for chronic inflammatory response syndrome. UCLA Health’s physicians describe it as a condition proponents believe is a body-wide inflammatory reaction, involving multiple organ systems, to mold, fungi or other toxins in water-damaged buildings. AAAAI notes that the same cluster of nonspecific symptoms, including fatigue, headache, “brain fog” and mood changes, is often called “toxic mold syndrome,” or CIRS in the integrative medicine community.

UCLA Health says CIRS “is not widely seen as an established medical diagnosis,” and that almost everything about it, including the diagnostic criteria, the biomarkers and the treatment, remains under research and debate. AAAAI says both the Institute of Medicine and the World Health Organization reviewed the evidence and found it insufficient to support a link between inhaled mycotoxins and the symptoms reported as toxic mold syndrome or CIRS. The Institute of Medicine’s 2004 review placed fatigue and neuropsychiatric symptoms in its inadequate-evidence tier.

The symptoms people describe are real and can be disabling. The disputed part is the cause. ACMT says that when people have persistent neurological, cognitive or nonspecific symptoms weeks or months after a suspected mold exposure, those symptoms should not be attributed to mold, and other causes should be sought.

What is the Shoemaker protocol, and what is the evidence?

The Shoemaker protocol is the best-known CIRS treatment. UCLA Health describes it as a multi-step approach: test the building for mold or moisture, remove the person from exposure, test for biomarkers believed to signal CIRS, and then give off-label medications intended to bind toxins so they are excreted in the stool. UCLA Health says the protocol “is as disputed as the syndrome it is meant to treat,” and warns that focusing on CIRS may delay other diagnoses.

The main review arguing that the protocol works is a 2024 literature review by Dooley, Vukelic and Jim in Annals of Medicine and Surgery. Its own tables show that the only randomized controlled trials it found for CIRS treatment were two cholestyramine studies with 8 and 13 participants, both from the Shoemaker research group. The rest were case series, open-label trials and case reports, mostly from the same group. The authors disclose that two of them provide expert witness testimony in CIRS cases, and the paper thanks Dr. Shoemaker for reviewing the manuscript before submission.

That is a thin and closely connected evidence base for a protocol involving prescription drugs. Any decision about it belongs with a licensed physician who has done a broad evaluation.

What should you do instead?

Split the problem in two: the building and your health.

For the building, follow CDC and EPA. If you see or smell mold, find and fix the moisture, then remove the mold. EPA says patches under about 10 square feet can usually be cleaned yourself with detergent and water, with an N95 respirator, gloves and goggles. Our guide on how to get rid of mold covers the steps. CDC does not recommend routine mold testing, but a qualified professional inspection can help when you suspect hidden water damage or need documentation. Our pages on home mold test kits, mold inspection cost and the difference between a mold assessor and a remediator explain when that is worth paying for.

For your health, see your primary care doctor. UCLA Health lists conditions a conventional workup may look for when someone has fatigue, cramps or brain fog, including endocrine disorders, vitamin deficiencies, electrolyte imbalances, nervous system disorders, undiagnosed asthma, Lyme disease, sleep disorders and autoimmune conditions. If your symptoms are allergy-like, an allergist can test you properly; see our mold allergy guide.