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.
Labs and resources
- 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 five-species subset of ERMI that produces a 0–15 score. Interpretation depends on the framework being used and does not establish whether a building is safe.
Labs and resources
- EnviroBiomics — HERTSMI-2Tests 5 water-damage molds. Frequently referenced in CIRS discussions.
- Mycometrics — HERTSMI-2Direct-pay option alongside their ERMI testing.
Bacterial Dust Tests
Endotoxin dust test
Measures endotoxin, a component of Gram-negative bacteria. It can add context after flooding, sewage exposure, contaminated water, or other water-damage concerns.
Labs and resources
- EnviroBiomics — E-EndotoxinDust testing for endotoxin from Gram-negative bacteria.
Actinobacteria (Actino) dust test
Uses DNA analysis to look for Gram-positive Actinobacteria in dust. It can help investigate microbial growth associated with persistently damp or water-damaged building materials.
Labs and resources
- EnviroBiomics — Actino Dust TestDust DNA testing for selected Actinobacteria.
Air Testing
Air sampling — spore traps
Captures airborne spores at one point in time. Results can miss hidden growth or conditions that change throughout the day.
Labs and resources
- Local mold or IAQ inspectorsUsually direct-pay; no insurance required.
- MoldCo — online mold testingOnline service offering home mold-testing options.
Visible Growth Testing
Surface tape lift / swab
Identifies material collected from a visible surface. It does not show what is airborne or hidden behind walls.
Labs and resources
- Mold inspectors, IAQ companies, and some local labsOften inexpensive and direct-pay. Answers "what is this spot?" — not "is the house safe?"
- Immunolytics — swab testingDirect-order surface sampling with laboratory analysis.
DIY Screening
Settle plates (petri dish)
A simple screen for particles that settle onto a plate. Results are limited and should not be used alone to judge a building.
Labs and resources
- Immunolytics — petri-dish testingDirect-order settle plates with laboratory analysis.
- DIY kits — hardware stores or local mail-in labsA rough first look, not a complete building assessment.
A test alone does not capture moisture history, building dynamics, or seasonal patterns. Combine results with documentation and a walkthrough.
Water Quality
Testing the water.
Water testing can answer a specific question about the sample collected. Choose a panel based on whether you use city or well water and the contaminants you want measured.
Mail-in laboratory water testing
Collect a tap-water sample at home and send it to a laboratory. Available panels vary by water source and may test for metals, minerals, bacteria, PFAS, VOCs, disinfection byproducts, or other selected contaminants.
Labs and resources
- Tap Score — home water testingCity-water, well-water, and targeted test kits with laboratory analysis and a results report.
A result describes the sampled tap at that moment. Plumbing, filters, sampling method, and the water source can affect what is found.
Mold — Body
Testing the system.
These tests look at different things: urinary compounds, blood markers, vision screening, genetics, or antibodies. None can confirm a mold-related illness on its own. A functional medicine clinician or another qualified clinician can decide what to order and review the results in context.
Urinary mycotoxin panels
These urine panels look for selected mycotoxin metabolites. Results vary with exposure timing, hydration, and laboratory method and do not diagnose illness on their own.
Labs and resources
- MosaicDX — MycoTOX ProfileUrine panel for selected mycotoxin metabolites.
- RealTime Labs — Mycotoxin PanelUrine panel for selected mycotoxins.
GPL-TOX / TOXDetect — environmental toxicants
This MosaicDX test is an environmental toxicant panel. It is not a urinary mycotoxin panel.
Labs and resources
- MosaicDX — GPL-TOX / TOXDetectEnvironmental toxicant panel; not a urinary mycotoxin panel.
Shoemaker biomarker panel
A group of blood and urine markers used within the Shoemaker / CIRS framework. The markers are considered together and are not specific to mold exposure.
Markers and purpose
- C4aA complement marker used to look at immune activation.
- TGF-β1A signaling protein used to add context about immune regulation and inflammation.
- MMP-9An enzyme marker used to add context about inflammatory signaling and tissue remodeling.
- VEGFA blood-vessel signaling marker used to add context about oxygen delivery and vascular response.
- MSHA regulatory hormone included in this framework; availability varies by laboratory.
- ADH with osmolalityReviewed together to assess water-balance regulation.
- ACTH with cortisolReviewed together to assess adrenal signaling.
VCS — Visual Contrast Sensitivity
A short online vision screen. It may add context, but it is not a diagnostic test.
Labs and resources
- VCS TestOnline visual contrast sensitivity screening.
HLA-DR genetic testing
Identifies HLA-DR variants that some clinicians consider when evaluating immune response to environmental exposures. It does not measure toxin clearance or diagnose illness.
Labs and resources
- Life Extension — HLA-DR Mold Genetic TestDirect-access genetic testing; results should be interpreted with a qualified clinician.
Mycotoxin antibody panels
Measures selected antibody responses rather than the amount of mycotoxin in the body. Clinical meaning and interpretation are still debated.
Labs and resources
- MyMycoLab — patient informationInformation about the laboratory’s serum antibody panel.
Results need clinical context. A positive result does not prove that a current symptom came from mold, and a negative result does not rule out an exposure.
Lyme & Co-Infections
Testing for tick-borne disease.
Testing choices depend on symptoms, timing, and possible tick exposure. CDC recommends two-step antibody testing for Lyme disease; a clinician can decide whether targeted co-infection testing is also appropriate.
Tick-borne disease panels
Specialty panels combine tests for Lyme disease and selected co-infections. Methods and interpretation differ, so review the exact panel with a clinician.
Labs and resources
- Vibrant Wellness — Tickborne Diseases 2.0Clinician-ordered specialty panel.
- IGeneX — Lyme & Tick-Borne PanelsSpecialty Lyme and tick-borne testing options.
- ArminLabs — TickPlexSpecialty tick-borne testing options.
Conventional laboratory testing
A physician or other qualified provider can order standard Lyme serology and targeted tests for specific co-infections.
Labs and resources
- Labcorp Test MenuSearch the current physician-ordered test menu.
- Quest Test DirectorySearch the current physician-ordered test directory.
Antibody tests can be negative early, before antibodies develop. Results should be interpreted with exposure history, symptoms, timing, and the limits of the specific method.
Viral Burden
Testing chronic viral activity.
Many viral antibodies reflect a past infection, not current activity. A clinician can choose targeted antibody or PCR testing and interpret the pattern alongside symptoms and timing.
Specialty viral panels
Broader panels may combine antibody markers for several viruses. Clinician ordering and review are required.
Labs and resources
- Vibrant Wellness — Viral InfectionsClinician-ordered testing that includes EBV, CMV, HHV-6, HHV-7, HSV-1/2, and related immune-response markers.
Targeted physician-ordered testing
A provider can order individual serology or PCR tests when clinically appropriate, including tests for EBV, CMV, HHV-6, Coxsackievirus, parvovirus, HSV, VZV, or Mycoplasma.
Labs and resources
- Labcorp Test MenuSearch the current physician-ordered test menu.
- Quest Test DirectorySearch the current physician-ordered test directory.
Direct-access individual markers
Direct-access services may offer individual markers without a specialty panel. Availability and ordering rules vary by location.
Labs and resources
- Goodlabs — direct accessSelf-order options for selected individual laboratory markers.
A single positive IgG result usually shows past exposure. It does not, by itself, establish active or reactivated infection.
VOCs & Indoor Air
Testing the air itself.
Different tools measure different concerns: formaldehyde, VOCs, microbial VOCs, combustible gas, carbon monoxide, carbon dioxide, particles, temperature, or humidity.
Lab-analyzed indoor air testing
Mail-in samplers are available for formaldehyde, VOCs, and microbial VOCs. Each kit measures a defined group of compounds, so select the test for the question you are trying to answer.
Labs and resources
- Home Air CheckHome kits for VOCs, formaldehyde, and microbial VOCs, with laboratory analysis.
Combustible-gas detector
A handheld detector can help locate possible combustible-gas leaks near appliances, fittings, and pipes. It is not a carbon-monoxide alarm.
Labs and resources
- Gas-Mate combustible-gas detectorPortable source-checking tool for combustible gas.
Carbon-monoxide alarm
A dedicated CO alarm provides an alert when carbon monoxide reaches its alarm thresholds. Follow placement and replacement instructions from the manufacturer.
Labs and resources
- Kidde carbon-monoxide alarmConsumer carbon-monoxide alarm.
General air monitor
A multi-sensor monitor can show trends in particles, VOC estimates, temperature, or humidity. Check the product specifications because included sensors vary.
Labs and resources
- Indoor air monitorConsumer monitor for ongoing indoor-air trends.
Carbon-dioxide monitor
Indoor CO₂ trends can help show how ventilation changes with occupancy. CO₂ is different from carbon monoxide.
Labs and resources
- CO₂ monitorConsumer monitor for indoor carbon-dioxide trends.
Use the right tool for the right question. A consumer monitor shows trends; a laboratory sample identifies selected compounds; safety alarms are designed for specific hazards.
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.