Comprehensive Toxin Testing: What It Looks At

What is comprehensive toxin testing?

Toxin tests like these are a kind of biomonitoring: measuring chemicals, or the substances the body turns them into (metabolites), in samples such as blood or urine. Levels in urine reflect how much of a chemical got into the body by all routes, including eating, breathing and through the skin.^{1, 6}

Vibrant Wellness describes its Total Tox Burden as "a comprehensive urine-based panel." It combines three Vibrant tests, Mycotoxins, Heavy Metals and Environmental Toxins, and reports 87 toxins in all: 29 mycotoxins, 20 heavy metals and 38 environmental chemicals.^{1, 2}

Vibrant also offers a separate Heavy Metals Test, and a larger panel, the Toxin Zoomer, that also measures 17 PFAS compounds, often called "forever chemicals." Vibrant notes that clinicians may order smaller panels with fewer markers, and that the report covers only the panels ordered.^{1, 4}

Vibrant lists the Toxin Zoomer as "Clinician Order Required," and says that for the Total Tox Burden, "Your wellness provider orders your lab test." Both can be collected at home.^{1, 4}

What the tests look at

The Total Tox Burden uses a urine sample that you collect at home, first thing in the morning, following the kit's instructions. Vibrant reports the results in three panels:^{1, 2, 3}

• Environmental chemicals (38 markers): Vibrant groups these into pesticides, weedkillers (herbicides) such as glyphosate and atrazine, phthalates, parabens, phenols such as BPA (bisphenol A) and triclosan, and volatile organic compounds (VOCs), plus a few others, such as perchlorate.^{1, 2, 3, 11}
• Heavy metals (20 markers): lead, mercury, arsenic and cadmium, plus others such as aluminum, nickel, thallium and uranium.^{1, 2}
• Mycotoxins (29 markers): toxins made by certain molds, such as aflatoxins, ochratoxin A and a group called trichothecenes. Vibrant says the panel looks for mycotoxins "from both food and environmental molds."^{1, 2, 3, 13}

Where these substances come from

CDC notes that for most chemicals, people are exposed to low levels in the food they eat, the water they drink and the air they breathe, and also from products and containers they use.⁸

Many of the environmental chemicals come from everyday products. BPA is used to make polycarbonate plastics and epoxy resins, which may be found in the lining of some canned foods and drinks. Phthalates are a large group of chemicals used as liquid plasticizers and found in hundreds of products, including some food packaging, cosmetics and fragrances. The National Institute of Environmental Health Sciences (NIEHS) lists both among the chemicals that may disrupt the endocrine system: chemicals that may mimic, block or interfere with the body's hormones. VOCs are gases given off by certain solids or liquids, and products that can release them include paints, many cleaning products and fuels.^{11, 12}

Heavy metals are found naturally in the environment, and also in certain medicines, supplements and foods. Chemicals used in industry and farming may also contain heavy metals, which can end up in the air, soil and water.¹⁴

The Toxin Zoomer also measures PFAS, a large group of chemicals used widely in industry, such as in firefighting foam, nonstick pans and coatings for paper and fabrics.^{4, 11}

How the tests are made and what that means

Vibrant says it measures the mycotoxins and environmental chemicals with a lab method called tandem mass spectrometry (LC-MS/MS), and the heavy metals with inductively coupled plasma mass spectrometry (ICP-MS).³

Urine can be more or less dilute depending on how much you drink, so the lab also measures creatinine, a substance in urine that comes in part from muscle. Vibrant reports each result adjusted for creatinine "to account for urine dilution variations." CDC notes that results corrected this way can also partly reflect differences in muscle mass or kidney function between people.^{3, 10}

To keep the sample from being too dilute, Vibrant's instructions say not to drink more than 8 ounces of water in the hour before you collect it, because overly diluted urine may be rejected.¹

Each result is compared with a reference range. Vibrant says the ranges for some heavy metals and environmental chemicals are based on data from NHANES, a national CDC health survey, where available. The others, including all the mycotoxin ranges, come from urine samples from 1,000 "apparently healthy" people. Vibrant says ranges for children have not been established.^{3, 8}

Vibrant colors each result by percentile: up to the 75th percentile of its reference group is green, the 75th to 95th percentile is yellow ("moderate exposure"), and above the 95th percentile is red ("high exposure").³

These are laboratory-developed tests (LDTs): tests made and used within a single lab. Vibrant says its tests were developed, and their performance characteristics determined, by its own laboratories, which are certified under CLIA, the federal program that regulates labs to help ensure accurate and reliable results. Vibrant also says the tests have not been cleared or approved by the US Food and Drug Administration (FDA).^{1, 5, 20}

Laboratory-developed tests generally have not gone through FDA premarket review, which checks both how accurately a test measures and how well it identifies a health condition. CLIA reviews whether a lab's test finds what it is meant to find, but the CLIA program does not address clinical validity: how accurately a test identifies or predicts a health condition in a patient.²⁰

In 2024, the FDA issued a rule to include tests made by laboratories in its definition of diagnostic products. A federal court vacated (set aside) that rule in March 2025, and in September 2025 the FDA reverted its regulation to the earlier text.²¹

What the results can and can't tell you

Finding a chemical in your urine shows that you were exposed to it. It does not, by itself, mean the chemical is causing disease. CDC says separate research is needed to learn which levels are safe and which are linked to disease, and for many chemicals those levels are not known.^{6, 7, 8}

People often have measurable levels of heavy metals without being poisoned. Heavy metals are just about everywhere, so it's normal to have some level of them in your body, and detectable levels of lead and mercury are common in people with no signs of poisoning.^{14, 15, 16}

Comparing your result with other people's can show whether an exposure is unusual, but that alone does not show whether it is harmful. CDC publishes national data like these partly so doctors can tell whether a person has an unusual exposure, and notes that the 95th percentile helps show whether levels are unusual. But CDC's national report does not decide whether levels are safe or linked to health effects.^{7, 8, 9}

CDC notes that a urine level reflects overall exposure from all sources together, so it can't show where an exposure came from or how it got into the body.⁷

In CDC's national testing, most chemicals measured in urine are ones that do not stay in the body a long time, while chemicals that do stay a long time are usually measured in serum, part of the blood.⁹

Vibrant's own report states limits. It says the heavy metals and environmental toxins panels do not show "absolute positive and negative predictive values" for any condition, and that their "clinical utility has not been fully established." It says results should be used as one part of a clinician's assessment, along with your history and symptoms. Vibrant also says its information is not intended to be used by the patient for any diagnostic purpose.^{1, 3}

Vibrant's sample report also lists "detox suggestions" for flagged results, such as diet changes, supplements, sauna sessions, activated charcoal and, for lead and arsenic, chelation therapy (medicines that bind metals so the body can pass them out). These are the lab's suggestions, not medical advice, and Vibrant advises talking with your healthcare provider before starting any medication, supplement or diet change.³

In their Choosing Wisely lists (2013 and 2015), two medical toxicology groups, the American College of Medical Toxicology (ACMT) and the American Academy of Clinical Toxicology (AACT), say that promoting sweating doesn't remove toxins in amounts that matter for health.¹⁶

Heavy metals: standard tests and "provoked" urine tests

Heavy metal testing measures possibly harmful metals, such as lead or mercury, most often in blood or urine. It is used to help diagnose heavy metal poisoning, and a provider uses the results along with your symptoms and exposure history. A high level may mean poisoning, but not always, and more tests may be needed to confirm or rule it out.¹⁴

The ACMT and AACT advise against heavy metal screening tests for symptoms that are not specific, unless there has been excessive exposure to metals. They say testing that isn't targeted can cause needless worry when a result falls outside a "normal" range, and that diagnosing metal poisoning requires an exposure history and clinical findings that fit poisoning by that metal.¹⁶

For lead, CDC recommends testing blood, and studies have given a good understanding of the health risks linked to different blood lead levels. A blood lead level test measures the amount of lead in your blood.^{7, 17, 18}

Some practices give a chelating medicine before collecting urine, which is called a "provoked" or "challenge" urine test. Chelating drugs raise the amount of metals in urine even in healthy people, and there are no scientifically accepted normal ranges for provoked samples.^{15, 16}

In a 2010 position statement, the ACMT says that post-challenge urine metal testing "has not been scientifically validated, has no demonstrated benefit, and may be harmful," and it warns against comparing provoked results with normal urine reference ranges. Vibrant says its heavy metal ranges come from national survey data where available, and otherwise from people who were "unprovoked, unmedicated and unsupplemented."^{3, 15}

Chelation therapy uses medicine, by mouth, by injection or through an IV, to help remove metals from the body through urine. A provider may recommend it in certain cases of heavy metal poisoning, but it can have serious side effects, so the risks and benefits need careful thought. The ACMT and AACT advise against chelation except for metal poisoning that has been diagnosed with validated tests in appropriate samples. Even when it is used for poisoning that has been properly diagnosed, they note, chelating drugs may have significant side effects.^{14, 16}

Mold and mycotoxins

Mycotoxins are natural toxins made by certain molds. These molds grow on crops and foods such as grains, nuts, spices, dried fruits, apples and coffee beans, often in warm, humid conditions. CDC notes that mycotoxins can cause illness mainly after people eat contaminated food. Vibrant links them to water-damaged buildings as well as food.^{4, 13, 19}

Low levels of mycotoxins are found in many foods, so mycotoxins are found in the urine of healthy people. Levels of mycotoxins in urine that predict disease have not been established, and there is no FDA-approved test for mycotoxins in human urine.¹⁹

Vibrant's own report says that measuring mycotoxins in urine is not an FDA-recognized way to diagnose mold exposure, and that the results do not show "absolute positive and negative predictive values for mold related illnesses." It says your clinical history must be part of any diagnosis.³

In a 2015 report, CDC said it does not recommend biologic testing (testing of body samples such as urine) for people who work or live in water-damaged buildings. CDC also warned that using unvalidated lab tests to diagnose illness from exposures at work can lead to incorrect diagnoses and to unnecessary, inappropriate and potentially harmful treatment.¹⁹

The ACMT and AACT also advise against ordering tests to diagnose "mold toxicosis," saying evidence-based assessments do not support it as a disease.¹⁶

If you are worried about mold where you live or work, CDC says a visual inspection is the first step, and that finding and fixing sources of moisture and cleaning or replacing moldy materials is essential.¹⁹

How our care fits alongside your primary care doctor

Avicenna Functional Medicine does not replace your primary care doctor or the treatment they prescribe. Our role is to add to your care, not to take its place.

A licensed clinician on our team decides whether a toxin test, such as Vibrant's Total Tox Burden, is likely to be useful for you, and orders it if so. These tests do not replace standard tests, such as a blood lead test, that your own doctors may use.

If testing is chosen for you, the results are reviewed together with your history, symptoms, possible exposures and any standard test results, alongside the care from your own doctors. A toxin test result is one piece of the picture, never a diagnosis on its own.

We do not promise that chelation, sauna sessions, supplements or any "detox" program will remove toxins from your body or improve your health. If a result or your history suggests a heavy exposure, for example at work, your doctor can refer you to a medical toxicologist or a doctor who specializes in occupational and environmental medicine.⁸

Please do not stop or change any prescribed medication without talking to the doctor who prescribed it. Before collecting your sample, follow your kit's instructions, and ask your clinician if you have questions about your medicines or supplements.¹

What to expect at Avicenna

All visits are by telehealth, for patients located in Florida and Texas. We are a cash-pay practice, and we accept HSA and FSA. Care usually follows these steps:

• A free, 30-minute discovery call to talk about your health and whether our approach is a good fit for you
• A full intake visit with our health coach, under clinician supervision, covering your history, symptoms, current treatment and goals
• Testing chosen for you, where it is likely to be useful
• A personalized plan, with follow-up visits to review how you are doing and adjust the plan as needed

When to get urgent care

Poisons can include pesticides, household products and metals such as lead and mercury. If you think someone has been poisoned, call your local poison control center at 1-800-222-1222 right away, rather than waiting for a toxin test result.²²

If you or someone in your household works with lead, tell your doctor. Lead poisoning can be missed, because its symptoms are similar to those of other illnesses. Exposure to high levels of lead over a short time may cause a metallic taste, belly pain, nausea, vomiting, headache, weakness, and pain or tingling in the hands or feet.¹⁸

Telehealth visits with our team are not for emergencies. Call 911 right away if you have warning signs of a medical emergency, such as:²³

• Chest pain or pressure that lasts two minutes or more²³
• Trouble breathing or shortness of breath²³
• Sudden confusion, unusual behavior or trouble waking up²³
• Fainting or passing out²³
• Sudden dizziness, weakness or changes in vision²³
• Being unable to speak²³
• Severe belly pain, or sudden severe pain anywhere in the body²³
• Coughing up or vomiting blood²³
• Thoughts of suicide or of harming someone else (you can also call or text 988)²³