In previous articles we have touched on some of the specialty testing that may requested for diagnosing and treating mold-injured patients. We have also discussed how successfully healing from mold can require some out-of-the-box thinking and digging into other potential sources of inflammation and immune suppression to get the body to return to homeostasis and health—heavy metals, pituitary damage, chronic Lyme, dental infections. Since gastrointestinal symptoms are often some of the most stubborn mold symptoms to finally resolve, I have quite a lot of patients ask me about stool testing, also referred to as comprehensive digestive stool analysis, to get further help with this area. And, while stool analysis may sound like a rather unsavory topic, it can certainly yield valuable information in some situations.
Comprehensive Digestive Stool Analysis
In traditional medicine, stool sample testing is performed in a narrow setting: most of these patients have either abdominal pain, diarrhea, bloating, or a few other specific digestive complaints. These would commonly include infections in the gastrointestinal tract, parasites, and, on rare occasions, poor digestions of fats. Comprehensive digestive stool analysis differs from this traditional type of stool testing, because it covers a much more broad and thorough range of issues and concerns that may be symptomatic of a specific parasitic or bacterial infection, but also may include more findings that impact the immune system as a whole. This includes information indicating food allergies, pancreatic function, cancer predisposition, and more.
Among the laboratories offering this type of testing, there are differing methodologies in carrying out the tests that can yield similar but different information. One example of this is in parasitology testing. Some labs use a “DNA probe” to detect even small amounts of DNA specific to certain parasites within stool samples. Other functional labs depend on either standard cultures and/or examinations under a microscope for the eggs or actual adult parasitic forms. Both methods have their pros and cons. I have used both and found valuable information either way.
Why is Stool Analysis Helpful?
You may ask, then, “If I don’t have specific GI complaints, why would digestive stool analysis be helpful for me?”
The first consideration is digestion. If digestion is impaired, then proper nutrients are not being absorbed into the bloodstream. Enzyme production by the pancreas is impaired when stress on the body is increased, not the least of which is overall toxicity from mold or other exposures. Enzyme production is a very energy-demanding process. In order to conserve cellular energy when bombarded by toxins and stress, the pancreas may respond by decreasing enzyme production. Poor enzyme production then leads to poor breakdown and absorption of essential fats (for cell health) and proteins, the building blocks of muscle tissue and the immune system. Supplemental pancreatic support with enzymes and bile salts is often necessary to aid in digestion and assimilation to get things back on track.
The Gut-Immune System Connection
Speaking of the immune system, part of the base of the immune system is in the wall of the small intestine and is measured by Immunoglobulin A (IgA). IgA levels can be measured in stool as an assessment of base immune function. Patients with mold toxicity often have suppressed immune function throughout the body, reflected by low levels of IgA. The suppressed immune function then predisposes the body to the overgrowth of candida, undesirable bacteria (SIBO), and microbial parasites. Elimination of these organisms with antibiotics, herbal compounds, and homeopathic formulas is limited, as complete eradication cannot take place as long as a compromise to the gut immunity continues. Reducing the toxic burden and current exposures are of first order, and specific immune-supporting supplements, such as colostrum, are needed to really get the microbiome back in order.
Conversely, there are times that toxic burden overstimulates the production of IgA in the gut lining. When this is the case, levels of IgA maybe 3- or 4-times normal levels, indicating that the immune system may be in overdrive. This is common in many types of autoimmunity, including thyroiditis, colitis, and rheumatic diseases. Again, identification and removal of the toxic burden are necessary to help restore balance overall.
Often when there is overstimulation of the gut, food allergies or food sensitivities may result. Some of the most common of these are gluten, dairy (particularly to the casein molecule), soy, and egg. These are all large molecules that are somewhat difficult to break down; their bombardment to the gut wall can result in allergic-type symptoms. Of course, food allergies/sensitivities are not limited to these foods; it can be to many foods commonly eaten. Some digestive stool tests include looking at elevations of food antibodies and can help to identify them through stool immunoglobulin levels.
Calprotectin
There are other markers in comprehensive digestive stool analysis that are also important when looking not only at digestive health but at overall health in general. One of these markers is calprotectin. Fecal calprotectin is a substance that your body releases when there is inflammation in your intestines. Elevated levels of fecal calprotectin—a protein biomarker—are associated with inflammatory bowel diseases. Furthermore, high levels of this substance can help distinguish between irritable bowel syndrome and ulcerative colitis or Crohn’s disease. Once again, mold-injured patients with a high body burden of toxins can develop inflammatory bowel diseases. I would not ever suggest that all who suffer from inflammatory bowel diseases can be treated only by the mold elimination techniques we have outlined, but the big takeaway is that if there IS mold or mycotoxin present in a patient’s environment, the success of other treatments will, at the very least, be hindered.
A Bridge to Other Testing
Digestive analysis may also open the door to other testing and indicate a need for further examination. For instance, if occult or hidden blood in the stool is found, then referral to a gastroenterologist sooner than later may be preventive in colon cancer or other serious conditions. Additionally, looking at the acidity of the body by analyzing stool pH levels can be a sign of malfunction of upper digestion or liver influence and is not uncommon in mold toxicity. High stool pH may be due to a lack of normal acid production of the stomach, which is more common than we realize. Low stomach acid may lead to upper digestive symptoms such as heartburn which is actually due to poor digestion, not high acidity, which then leads to taking acid suppressors to quell the symptoms, creating a cycle that continuously makes the entire situation worse.
In Conclusion
The gut is the beginning of the immune system and holds clues to what ails the body. Thus, seeing exactly how it may have become impaired after toxic exposure to mold by analyzing a patient’s stool also reveals steps to aid in recovery. For full recovery from mold exposure, most of us need probiotics, many need digestive enzymes and liver support, and an increasing number of patients need immune balance as well. With that in mind, adding digestive stool analysis can provide a more targeted and individualized approach to patient treatment.
Susan Tanner has practiced medicine for over 33 years, concentrating primarily on chronic illness and the impacts on the individual, the family and the community. Her driving curiosity into why people are made ill caused her to pursue education in Environmental Medicine, completing coursework, exams, and necessary practice years to earn board certification in this area in 2009. Her own struggles with mold-related illness drove her desire to teach those similarly affected. While in clinical practice, Dr. Tanner wrote and contributed to a number of publications on environmental health, prepared narratives for understanding in legal matters, and researched new techniques for modulating the body’s ability to clear toxins and infections. She now has a fitness and health website www.thebodynexus.com, where she writes articles and shares education on utilizing the various body systems into improve overall health.
lindsay boychuk
December 3, 2020 at 2:18 pm - Reply
Thank-you Dr. Tanner!
Lindsay Boychuk
December 1, 2020 at 3:16 pm - Reply
Thank-you for this excelling overview. Can I ask what testing companies you tend to gravitate towards for analysis? Do you use a combination? Such as GI-MAP by Diagnostic Solutions with say a calprotectin and Zonulin add on in combo. with a Dunwoody Labs Advanced Intestinal Barrier Assessment and potentially a Genova Diagnostics 3 day GI Effects Stool Profile (Comprehensive) with add-ons? Just wondering what combination of diagnostic labs you like to use in addition to clinical hx in order to put the whole picture together. Understandable it will be different for each patient but just wanting to see what you gravitate towards for company testing panels and potential add-ons. Thank-you very much!
We all gravitate toward our favorites, but I tend to go with either the 3 day with Doctor’s Data or the comprehensive two day with DiagnosTechs. The food sensitivities that are identified with Diagnostechs are nice to have in some patients even though it is limited to soy, gluten, casein, and egg.
I personally have not found zonulin to be all that helpful or accurate in assessment, much as I felt it should be!. Have had patients who very clearly had intestinal barrier issues and normal zonulin.
Genova’s testing is also good, but just personal preference has tended to go more with DD or DT. I have found results with them to be consistent.
I have not used Diagnostic Solutions, so can’t really comment on that one.
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Thank-you Dr. Tanner!
Thank-you for this excelling overview. Can I ask what testing companies you tend to gravitate towards for analysis? Do you use a combination? Such as GI-MAP by Diagnostic Solutions with say a calprotectin and Zonulin add on in combo. with a Dunwoody Labs Advanced Intestinal Barrier Assessment and potentially a Genova Diagnostics 3 day GI Effects Stool Profile (Comprehensive) with add-ons? Just wondering what combination of diagnostic labs you like to use in addition to clinical hx in order to put the whole picture together. Understandable it will be different for each patient but just wanting to see what you gravitate towards for company testing panels and potential add-ons. Thank-you very much!
We all gravitate toward our favorites, but I tend to go with either the 3 day with Doctor’s Data or the comprehensive two day with DiagnosTechs. The food sensitivities that are identified with Diagnostechs are nice to have in some patients even though it is limited to soy, gluten, casein, and egg.
I personally have not found zonulin to be all that helpful or accurate in assessment, much as I felt it should be!. Have had patients who very clearly had intestinal barrier issues and normal zonulin.
Genova’s testing is also good, but just personal preference has tended to go more with DD or DT. I have found results with them to be consistent.
I have not used Diagnostic Solutions, so can’t really comment on that one.