Reference Library
Understanding the options.
One test at a time.
A grounded guide to what different tests look for — helping you understand what may be useful, what each test can (and cannot) tell you, and where they fit into the bigger picture.
Mold — Home
Testing the building.
No single test gives the full picture. Different tests capture different patterns — what is in the air, what has settled over time, or signs of microbial activity. Context and visual inspection still matter.
Dust DNA Tests
ERMI — Environmental Relative Moldiness Index
Lab-analyzed dust sample scored against 36 mold species. Produces a single index value. Designed as a research tool; widely adopted in CIRS / Shoemaker frameworks.
Direct-pay options
- EnviroBiomics — ERMI TestSwiffer or vacuum dust sample. One of the most commonly used options in CIRS / mold groups; qPCR DNA analysis of 36 species.
- Mycometrics — ERMI TestEstablished direct-pay option. Dust-cloth collection available.
- EMSL — ERMI KitDirect-purchase kit with lab processing included.
HERTSMI-2
A 5-species subset of ERMI scored 0–15. The threshold commonly used to evaluate whether a building is "safe enough" for someone in mold-illness recovery is ≤ 10.
Direct-pay options
- EnviroBiomics — HERTSMI-2Tests 5 water-damage molds. Frequently referenced in CIRS discussions.
- Mycometrics — HERTSMI-2Direct-pay option alongside their ERMI testing.
Air Testing
Air sampling — spore traps
Captures airborne spores at one moment in time. Useful when active growth is suspected; less sensitive to hidden or intermittent contamination.
Direct-pay options
- Local mold or IAQ inspectorsUsually direct-pay; no insurance required.
- Sporecyte — professional samplingUsed by some inspectors for air sampling.
Visible Growth Testing
Surface tape lift / swab
Confirms what is growing on a visible surface. Does not reflect what is airborne, or what may be hidden behind walls.
Direct-pay options
- Mold inspectors, IAQ companies, and some local labsOften inexpensive and direct-pay. Answers "what is this spot?" — not "is the house safe?"
DIY Screening
Settle plates (petri dish)
Cheap and approximate. Misleading on its own — useful only as a rough screening step before more targeted testing.
Direct-pay options
- DIY kits — Amazon, hardware stores, or local mail-in labsInexpensive and widely available. A rough first look, not a decision-making tool.
A test alone does not capture moisture history, building dynamics, or seasonal patterns. Combine results with documentation and a walkthrough.
Mold — Body
Testing the system.
Mycotoxin and biotoxin testing measure different things — toxin metabolites, inflammatory markers, genetic susceptibility. Each adds context. None confirm or rule out illness on their own.
Urinary mycotoxin panels — GPL-TOX, MycoTOX Profile (Mosaic / Great Plains), RealTime Labs
Measures mycotoxin metabolites in urine. Provoked (post-glutathione or sauna) and non-provoked protocols return different patterns; methodology varies between labs.
Shoemaker biomarker panel
Blood markers used in CIRS diagnostic criteria — C4a, TGF-β1, MMP-9, VEGF, MSH, ADH / osmolality. Read together as a profile, not in isolation.
VCS — Visual Contrast Sensitivity
A short online screening for neurotoxin-mediated vision changes. Free; not diagnostic on its own; useful as a recurring touchpoint over time.
HLA-DR genetic typing
Identifies HLA haplotypes associated with impaired biotoxin clearance. Context, not diagnosis — and it does not change with treatment.
Mycotoxin antibody panels (IgG / IgE)
Measures immune response to mycotoxins rather than toxin load itself. Less established than urine panels; interpretation requires care.
Toxin presence does not equal active illness, and absence does not rule out exposure. Hydration, recent exposure, and detox capacity all influence results.
Lyme & Co-Infections
Testing for tick-borne disease.
Standard CDC two-tier testing has a high false-negative rate in chronic or late-stage cases. Specialty labs and ILADS-aligned interpretation often surface what conventional panels miss.
Two-tier serology — ELISA then Western blot, CDC criteria
The standard insurance-covered protocol. Frequently negative in chronic Lyme; useful as a starting point, not a final word.
IGeneX Western blot
Expanded band reporting and broader species coverage than CDC criteria. Interpretation aligns with ILADS guidelines.
DNA Connexions
PCR-based urine panel for borrelia and several co-infections. Often collected after physical activity to mobilize organisms.
iSpot Lyme & TickPlex (ArminLabs)
T-cell response assay measuring active immune engagement. Useful when antibody-based tests are inconclusive.
Co-infection panels — Bartonella, Babesia, Mycoplasma, Anaplasma, Ehrlichia
Combinations of FISH, PCR, antibody, and microscopy. Co-infections often drive more symptoms than borrelia itself.
Tick-borne testing is imperfect across the board. Clinical history and symptom pattern remain at least as important as the lab values.
Viral Burden
Testing chronic viral activity.
Many people carry latent viruses without symptoms. The question is whether one or more may be reactivating during periods of immune or environmental stress — sometimes reflected in specific antibody or titer patterns.
EBV panel — VCA IgG, VCA IgM, EBNA-1, Early Antigen (EA)
The combination distinguishes past infection, recent infection, and reactivation. Persistent EA elevation is the typical reactivation signal.
CMV (IgG, IgM)
Latent in most adults. Rising titers or active IgM can indicate reactivation under stress or immune dysregulation.
HHV-6
Antibody titers and PCR. Chronic reactivation has been reported in subsets of ME/CFS and post-viral profiles.
Parvovirus B19
IgG / IgM panel. Can persist or reactivate; occasionally tied to autoimmune flares and cytopenias.
Adjacent titers worth reading in context
Coxsackie, HSV-1/2, varicella-zoster, mycoplasma pneumoniae. Patterns matter more than any single value.
Nearly everyone carries multiple latent viruses. Elevated titers alone do not equal active illness — read trend over time, not snapshots.
VOCs & Indoor Air
Testing the air itself.
VOCs, microbial VOCs (mVOCs), formaldehyde, carbon monoxide, and carbon dioxide each tell a different part of the story. Continuous monitoring and lab-based testing often provide the clearest picture when used together.
Lab-analyzed VOC samples — Prism Analytical (Home Air Check), Enthalpy Analytical
Passive sampler placed in a room for 24–72 hours, then lab-analyzed for hundreds of compounds. Identifies categories and likely sources.
Photoionization detectors (PIDs)
Real-time total VOC reading. Excellent for source-hunting and ventilation testing; will not identify specific chemicals.
MVOC (microbial VOC) panels
Targets compounds produced by mold metabolism. Sometimes catches hidden growth that spore traps and dust tests miss.
Formaldehyde-specific kits
Short-term color-change badges or lab-analyzed canisters. Common offender in new construction, cabinetry, and pressed-wood furniture.
CO, CO₂, and humidity monitors
Continuous-reading consumer devices. Reveal combustion safety, ventilation adequacy, and moisture risk over time — not point-in-time numbers.
Single readings miss daily and seasonal variation. Most consumer tools tell you something is elevated — not exactly what or where.
Reading results
No single test tells the whole story.
Testing is most useful when results are read against your symptom history, the buildings you spend time in, and your timeline. A clinician familiar with environmental illness will weigh patterns more than any single value.
Back to next steps →This page is educational and not a medical diagnosis. Test names and labs are listed for reference, not endorsement. Always consult a clinician about which tests are appropriate for you and how to interpret results.