Frequently Asked Questions

What are mycotoxins?

Mycotoxins (Mold-Poisons) are small molecules produced by organisms of the fungi kingdom, and commonly known as molds that are toxic to humans and other animals. Although hundreds have been identified, only a small portion are associated with indoor molds and pose a risk to humans and animals.

Can you test for mycotoxins and mold inside of my body?

At RTL, we usually test for mycotoxins in urine, however, it is also possible to test tissue samples. We can test for the molds Candida and Aspergillus through sputum, nasal washes, tissue, BAL, and urine.

Do you test tissue samples for mycotoxins?

Yes. To have a tissue sample tested, the patient needs to send RTL the pathology report first, for review, to determine if the sample is suitable for testing.

Which mycotoxins do we test for?

RTL’s mycotoxin test panel is the most comprehensive test panel available, testing for 16 of the most toxic mycotoxins produced by indoor molds. This includes:
Ochratoxin A
Aflatoxin Group (B1, B2, G1, G2)
Trichothecene Group (Satratoxin G, Satratoxin H, Isosatratoxin F, Roridin A, Roridin E, Roridin H, Roridin L-2, Verrucarin A, Verrucarin J)
Gliotoxin derivative
Zearalenone

Can you test for mycotoxins in my blood instead of urine?

No. We test mycotoxins in urine because it is a less invasive and more stable option than serum testing.

How do I order the test?

A physician can order the test for you. Visit our “Find a Doctor” search feature to find physicians in your area who have already partnered with us.
Your current doctor can partner with us to order the test on your behalf. They will need to submit a request through our website. There is no cost to them, and we will ship the kit directly to the patient(s). We offer complimentary clinician-to-clinician consultations to assist medical professionals with interpreting results. 
You may order the mycotoxin urine test through a third-party such as Direct Labs or Any Lab Test Now. These companies sell our tests and utilize their own medical staff. 
You can order the test yourself through Direct Access Testing on our website. Please Note: In accordance with state laws, we are not allowed to directly sell clinical tests to individual in these states: AL, CA, CO, CT, FL, GA, HI, ID, IL, KY, MA, MD, ME, MI, NJ, NH, NV, NY, OR, PA, RI, SC, TN, WY.

Environmental and veterinary test kits can be ordered by anyone.

How much does the test cost?

Pricing for our tests ordered online can be found by clicking the Shop tab at the top of our website. Testing ordered through a healthcare provider or environmental inspector will vary in price. 

Does Medicare cover the cost of testing?

RealTime Lab is an Authorized Medicare Provider. If patients are choosing this option, please complete the credit card authorization form and submit it with the additional required documents. Your card will not be charged unless your claim is denied, and we will notify you before we charge the card. There is no filing fee for Medicare.

The following are required to be submitted with your sample:

A doctor’s order for testing
Valid diagnostic (ICD-10) codes
Signed Advanced Beneficiary Notice (ABN) of Non-Coverage form—this is located on the second page of the requisition form. Read and check off the test that you are taking and the options that are appropriate for you and your situation
Copy of your Medicare Insurance card (front and back)
Secondary Insurance card, which may also include Medicare Advantage plans (front and back)
Copy of picture identification for patient (i.e., driver license)

What diagnosis codes will get me the best reimbursement?

Diagnosis codes can only be provided by your healthcare provider based on their clinical evaluation of your symptoms and other relevant information.

Do you offer a cash discount price for patients without insurance?

We currently do not accept cash as a form of payment for our mycotoxin tests.

Do you offer rush/expedited testing?

No.

Should I go back to my moldy apartment to “get exposed” again before producing my urine sample? Will this give me better results. 

No. Our tests are extremely sensitive in detecting extremely low traces of mycotoxins (parts per billion = nanograms per milliliter). There is no need to further expose yourself. 

Do I need to fast before producing my specimen?

No. 

Are there any medications or supplements that affect the test results?

Please notify the lab if you are taking Methylene Blue, as it can affect your test results. Inform your healthcare provider about any medications you are taking. 

I am menstruating, will this affect the test results?

No.

I am on a medication (Rifampin, Pyridium, etc.) that turns my urine bright orange; will this affect my test results?

No.

Does my specimen need to be first-morning urine?

No.

What if my urine is highly diluted?

This will not affect the test results.

My doctor asked me to take glutathione and use the sauna before producing my urine sample. Will I get better results?

Our observation is that you may have high mycotoxin levels in the urine as the above are detoxifying methods.

Is the lab able to send me results directly?

1. Yes. Per the following, patients have the right to request and receive their lab reports directly from the clinical laboratory: CLIA Program and HIPAA Privacy Rule; Patients’ Access to Test Reports a Rule by the Health and Human Services Department and the Centers for Medicare and Medicaid Services on 02/06/2014
2. https://www.federalregister.gov/articles/2014/02/06/2014-02280/clia-program-and-hipaa-privacy-rule-patients-access-to-test-reports
3. We must have a signed information release form. This can be found in the Frequently used Documents section of our website. Results are sent to the patient in an encrypted e-mail for confidentiality and can also be sent via USPS mail or Fax. 

Which molds produce the mycotoxins we test for?

Species———————————Mycotoxin
Aspergillus flavus ——————-Aflatoxin (AT)
Aspergillus ochraceus ——————- Ochratoxin A (OTA)
Aspergillus niger ——————- Ochratoxin A (OTA)
Penicillium verrucosum ——————- Ochratoxin A (OTA)
Stachybotrys chartarum ——————- Macrocyclic Trichothecenes (MT) 
Aspergillus fumigatus ——————- Gliotoxin
Fusarium ————————————– Zearalenone 

Can I get a positive urine mycotoxin test result from eating food?

Aflatoxin and Ochratoxin producing molds can grow on various crops and food items. The government regulates levels for these mycotoxins and crops and suspect food items are routinely tested. There is not enough information on this subject to rule out food as a source of aflatoxin or ochratoxin positive urine. Macrocyclic Trichothecenes (the ones detected by RTL) and Gliotoxin are not produced by food contaminating molds and a positive urine test is therefore not caused by eating foods. 

Is my positive level good or bad?

A positive mycotoxin test may be a risk factor for a variety of health issues. We recommend consulting your healthcare provider.

My daughter’s test results are completely negative, but the rest of my family is positive for mycotoxins. She is the sickest of all of us, how can her test results be entirely negative?

We see mycotoxins in urine with the body is working to detoxify and remove them. It is possible to be negative for mycotoxins in urine, but the mycotoxins are still present in the cells in the body where they are causing damage. Talk to your healthcare provider and discuss the clinical history of exposure. 

From my positive results can you tell me if I am currently being exposed or if it is from a previous exposure?

It is not possible to determine this based on your positive test results alone. Mycotoxins can be stored inside cells and released later, especially during detoxification treatments. We would recommend having your home tested for mycotoxins using one of our Environmental Tests. If the test is positive, you are still being exposed. 

What is the standard treatment for mycotoxins in humans?

1. There is not a generally accepted “standard treatment.” There are many protocols developed by individual doctors who specialize in mold and mycotoxin associated illnesses. These include FIR Sauna, Glutathione, use of sequestering agents such as Cholestyramine or charcoal, antioxidants, probiotics, and intra-nasal anti-fungal treatments. 
2. It is important to note that avoidance is the most important criteria. Leave the dwelling where you are being exposed until it is inspected by an Environmental Inspector and if necessary, remediated.

Do patients ever completely get rid of mycotoxins in their body and get well?

Yes. We have seen many patients who did follow up testing that are negative for mycotoxins after treatment by their healthcare provider. 

How can my doctor learn to treat me for mycotoxins?

The medical team at RTL provides clinical consultations with your healthcare provider to discuss possible treatment options. 

How do I know where I am being exposed to these mycotoxins?

1. Start by assessing your home. Make a visual inspection yourself. Are there obvious signs of mold growing in the house? Are there obvious signs of dampness that can lead to mold growth? Do the house or certain areas smell “musty?” Do you experience more symptoms when you are in the house such as itch eyes, nausea, fatigue, headaches, frequent respiratory infections, difficulty concentrating, etc.?
2. Do other family members who work in a different environment experience these when they are at home? If the answer to use of these is yes, the house should be tested for mold and mycotoxins using a reputable Environmental Inspector. If the results come back showing high indoor spore counts and/or positive environmental mycotoxin testing, it is likely this is where you are being exposed.
3. Some conditions that have been found to be associated with chronic exposure to mycotoxins include:Cancer
1. Kidney toxicity
2. Immune Suppression
3. Neurotoxicity
4. Depression

What is the best panel to test my sinuses for mold?

The Molecular Fungal DNA panel by RTL. Molecular Fungal Testing uses Real Time PCR (Polymerase Chain Reaction) and specific, patented DNA probes to accurately determine the presence of a variety of pathogenic and/or toxigenic fungi. This test must be ordered by your healthcare provider. 

I have been in treatment for 3 years and I feel great! I just did a follow-up test, and my ochratoxin level is 15ppb! It was completely negative 6 months ago. What happened?

Are you still under treatment? If yes, it might be working, and your body is detoxifying the mycotoxins. Are you still in the same environment? We recommend discussing this with your health care provider. 

I received a kit in the mail from my doctor, but the paperwork is blank. What do I do?

Fill out your personal information, the sample collection information, and any payment forms required. We will have your doctor’s order and signature on file. 

How do I find a doctor to order this test for me?

Visit our “Find a Doctor” search feature to find healthcare providers in your area who have already partnered with us. Your current clinician can partner with us to order a test on your behalf. They will need to submit a request though our website. There is no cost to them, and we will ship the kits directly to the patient(s).

Will the EMMA identify the origin of the mold?

No. Mold spores and mycotoxins can travel through the air and therefore can circulate through your HVAC system. The EMMA is designed to test if a certain area of your home is positive for mold and mycotoxins, not where they originated. 

Can I test ingestible items such as coffee or dietary supplements?

No.

Can I test my pet?

Yes, as long as the animal produces urine. A veterinary order is only required in the case of tissue testing. Otherwise, you can order a test for your furry friend under our Shop tab.

My pet is positive for mycotoxins, what do I do next?

Consult with your vet. We recommend getting your vet’s opinion on binders. Many MDs use Glutathione, but it is important to talk with a medical professional that are used to dealing with four-legged friends. If you do not have a vet, we recommend looking into a Naturopath vet. 

How do I get my home tested?

RTL offers environmental testing for molds and for mycotoxins. The samples can be collected by an environmental inspector or directly by the homeowner by obtaining kits from RealTime Lab. The mold testing determines the presence of mold in a sample taken from the building. The mycotoxin testing is virtually identical to that used to test clinical samples and determines the presence of 16 mycotoxins. Our comprehensive test is called EMMA, which stands for Environmental Mold and Mycotoxin Assessment. It utilizes the same sample for both tests to yield a thorough investigation into what mold and toxins might be permeating your space. 

What is the best source for environmental samples?

The 3” x 3” piece of an HVAC filter gives the best composite of dust from the building. Ideally the filter should be in the space for at least six weeks. We also recommend using our provided swabs and gauze from our kits to take samples from your vent, A/C return, or places where you seed or suspect mold to be growing.

I need to provide to my property owner (or employer) evidence that the mold in my apartment (or office) is causing my illness. How can I link my positive urine mycotoxin test to my apartment (or office)?

Submit 3 samples from various locations in the house (or office) for us to perform the EMMA. Ideally, the tests show the presence of the same mycotoxins as detected in your urine, and the presence of organisms that produce those mycotoxins. The presence in the environment of the same mycotoxins is most critical. For many reasons (e.g., see later question on Stachybotrys), sometimes the mycotoxin producing fungal spores are not detected. 

I am positive for Trichothecenes but the mold testing done in my home is not positive for Stachybotrys. Is this normal?

This is not unusual. We see many cases where we do not detect Stachybotrys spores in the environmental sampling, but do detect Macrocyclic Trichothecenes, produced by Stachybotrys. Stachybotrys spores are large, heavy, and generally wet, since Stachybotrys requires elevated levels of moisture to thrive. This makes it more difficult for the spores to be disseminated throughout the house like smaller Penicillium or Aspergillus spores. However, the presence of the Trichothecenes is key. 

How do I get my things tested (clothes, car, couch, carpet, bed, etc.)?

Send 3” x 3” inches of the unwashed material or sample swabs to RTL.

If there are mold/mycotoxins in my home, how can I get rid of them?

An environmental inspector can help you clean up the mold in the house.

The air testing results in my home are not that bad. What is an acceptable amount of mold to have in a normal home?

Any house will have spores from many different fungi. These usually come into the house from the outdoors, but may also be on building materials, furniture, carpet, etc. This is not usually a problem unless the house becomes wet and the spores germinate and begin to colonize damp areas, where some fungi grow and can produce toxic mycotoxins. 

Is there an acceptable level of mycotoxins for an attic or below home crawl space that is acceptable versus my living space?

Anything positive for mycotoxins, at any location in the house, could pose a major health risk. 

What personal things can I take with me when I move into a new home?

Cross contamination is something to seriously consider when moving items from a mold/mycotoxin contaminated home into a new, non-contaminated environment. We recommend you consult with your environmental inspector and specifically ask which items will be safe to move into your new, non-contaminated environment.

How do I find a home/apartment that is safe and does not have mold or mycotoxins?

Utilize the services of environmental inspectors in your area.

Can I use a Swiffer for collecting dust samples?

We do not suggest using a Swiffer to collect your sample, as they are too big and bulky and potentially have chemicals on them that could interfere with your test results.

Do I need to have a car/be in a car for testing?

No.

Do I need to fast before the antibody test?

No, please eat and drink normally before testing.

I am prone to nose bleeds. Will this impact my PCR testing?

No.

Do you test infants?

Yes.

I am under 18, do I need an adult with me for testing?

No.

Can I get pre-surgical RT-PCR testing done at RTL?

Yes.

Does RealTime Lab offer a physician’s stamp for countries that require it for travel?

Yes. If you need a stamp, please notify the medical assistant that is taking your sample. Please Note: There is an additional fee for receiving a stamp.

How do I change my appointment time?

Please call us at 972-492-0419 or email info@realtimelab.com

I did not receive my appointment confirmation email.

1. Email info@realtimelab.com with the following information so we can assist you:
Full Name
Date of Birth
When you would like to be tested in case your appointment did not schedule
Email Address
Type of testing ordered

I need to cancel my appointment. 

To cancel your appointment and receive a refund, email info@realtimelab.com with the following information:Names and dates of birth of all patients in the order
Date of appointments to be cancelled
Email address
Last 4 digits of credit card used to purchase test
Amount of refund
Reason for cancellation

Do we take walk ins?

Currently, we do not take walk ins. 

Will insurance cover my test?

We can bill to Insurances, Medicare, and Medicaid ONLY if you are presenting with symptoms or have suspected/confirmed exposure to someone who has tested positive for COVID-19. We do not bill insurance for regular travel testing. Uninsured patients are required to pay out of pocket for their tests.

Is RTL covid testing approved for travel by the Chinese Embassy in Washington D.C.?

Yes.

If I am travelling to China, does RTL send my results to the Chinese Embassy?

Yes. You will be required to sign a HIPAA authorization form when you arrive for your test. If you do not fill out a HIPAA authorization form, RTL will not submit your test results to the Chinese Embassy and your travel application will not be approved by the embassy.

What are the requirements for traveling to China?

Please visit the Chinese Embassy’s website for the latest requirements.

What Covid-19 tests do you offer?

RT-PCR, Rapid Antibody, and Rapid Antigen

What is the difference between Rapid Antibody and Rapid Antigen?

An antigen is a molecule (such as the surface proteins of COVID-19 virus) that can stimulate the body’s immune response. The rapid antigen test is used to detect COVID-19 ANTIGEN MOLECULES FROM A SWAB FROM THE PATIENT’S NOSE. Positive results show the presence of viral antigens in the patient’s body and may reveal that a patient is currently or recently infected. An antibody is produced by the body’s immune system in response to an infection. The rapid antibody test is used to detect COVID-19 antibodies in the patient’s blood or serum. Positive results show that the patient may have had an immune system response to COVID-19 exposure. 

My destination requires a COVID PCR test from a ISO15189 certified laboratory. Can I test at RTL?

Yes. ISO15189 is an international certification for medical testing laboratories. RealTime Laboratories is accredited by CLIA and CAP, which satisfies this requirement. RTL can provide a copy of this accreditation to those individuals that need it for travel.