Ochratoxin A: What It Is, Symptoms, Testing & Treatment

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Welcome to my blog on Ochratoxin A where I’ll discuss the whats, hows, whys and when of mycotoxin testing and treatment.

After writing the master blog called The Ultimate Guide To Mycotoxins I thought I would write smaller blogs on each of the main mycotoxins. Ochratoxin A is the most common mycotoxin I find in testing. I.

You might also be interested in the section of my blog deduced to the topic of mycotoxins, click here. Posts include:

Listen to the world renowned Dr. Crista discuss mycotoxins

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What Is Ochratoxin A?

Ochratoxin A (OTA) is a mycotoxin produced by several fungal species. Mycotoxins are naturally occurring toxins produced by certain moulds (fungi).

What Produces Ochratoxin A?

The following moulds produce Ochratoxin A: Aspergillus ochraceus, Aspergillus carbonarius, Aspergillus niger and Penicillium verrucosum.

What Foods Are High In Ochratoxin A?

  • Coffee
  • Oats and other unprocessed cereals including rye, buckwheat, wheat, maize, millet and barley
  • Dried vegetables and olives
  • Smoked and salted dried fish, dried beans, biltong, soya beans, chickpeas, rapeseed, pepper, dried fruit, and sesame seeds, nuts.
  • Grapes and grape products, including table grapes, wines, and dried vine fruits.
  • Apples, pears, peaches, citrus, figs, strawberries, mangoes, tomatoes, melons, onions, garlic, and yams.
  • Cheese, meat products.
  • Pork*

*It is frequently found in pork intended for human consumption. Ochratoxin is believed to be responsible for a ‘porcine nephropathy’ that has been studied intensively in the Scandinavian countries. The disease is endemic in Denmark, where rates of porcine nephropathy and ochratoxin contamination in pig feed are highly correlated

It is NOT recommended to avoid all these products – this list simply shows where Ochratoxin A has been detected.

For the coffee lovers among you, I highly recommend checking out Exhale Coffee. They have selected coffee beans which are have confirmed in laboratory testing to be free of mycotoxins and other nasties such as pesticides and metals, as well as being the highest in the good stuff such as chlorogenic acid – one of the most researched compounds in coffee that provides so many of its health benefits. Check out my blogs on coffee here.

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Ochratoxin A And Human Health

Ochratoxin A has been shown to be toxic and carcinogenic in animals.

The kidney is the main target organ for ochratoxin A. Other adverse effects include:

  • Liver toxin
  • Immuno suppressant
  • Inhibition of macromolecular synthesis
  • Increased lipid peroxidation (cellular damage)
  • Inhibits mitochondrial ATP production (effecting energy production)

The International Agency for Research on Cancer (IARC) has classified Ochratoxin A as a Group 2B possible human carcinogen, based on demonstrated carcinogenicity in animal studies.

A recent study showed Ochratoxin A triggered autism via epigenetic mechanism (Mezzelani et al., 2016).

Ochratoxin A altered nutrient absorption in the intestine and, in addition, Ochratoxin A-treated animals experienced faster and more harmful parasite infections. Also, OTA-has also been found to cause intestinal permeability via oxidative stress.

OTA exerted its effect on gut via the reduction of nutrient absorption, disruption of intestinal permeability, cell apoptosis, and modulation of immune system.

Tissue Distribution Of Ochratoxin A

Tissue distribution after exposure of animals to OTA has consistently revealed that the greatest concentration is in the kidneys followed by either liver or muscle and then fat, but tissues found to contain OTA also include the adrenal glands, skin, myocardium, gastric mucosa, and bone marrow.

In humans, OTA has been detected in blood, urine, and breast milk as well as renal cell carcinomas, breast cancer, inflamed bladder tissue, and a skin biopsy sample.

Recently, a case has been reported of OTA being found in the umbilical cord and placental tissue of a newborn whose mother had been exposed from a water-damaged home. In addition, the mother had OTA in her breast milk, urine, and nasal secretions. Also, other family members tested positive for OTA in urine and nasal secretion samples, while the pet dog was positive for OTA in its urine and an ear mass! When all members of a household (and pets!) appear to be suffering with health issues, it is certainly worth exploring whether they have been exposed to mould.

In conclusion, it would be prudent for the medical commu- nity to pay closer attention to the possibility of ochratoxin toxicity in patients with symptoms of renal pathology

How common is human exposure to ochratoxin A?

Studies from Canada, Sweden, West Germany, and Yugoslavia detected ochratoxin in human blood and serum. Analyses of urine from children in Sierra Leone detected both ochratoxin and aflatoxin throughout the year. Also it has been suggested over 25% of the world’s crops are contaminated with mycotoxin. Some wonder whether this may partly explain the benefit some people experience from going on a paleo style diet?

What Are The Symptoms of Ochratoxin A?

Symptoms will vary from person to person depending in their individual health status but common symptoms include:

  • IBS
  • Chronic fatigue
  • Depression or low mood
  • Skin conditions such as rashes
  • Sinusitis
  • Cognitive symptoms such as brain fog
  • Allergies and histamine issues

The list could go on and on but these are certainly the most common symptoms I see in my clientele.

Testing & Treatment For Ochratoxin A?

You can test for mycotoxins in the urine. Great Plains Laboratory (a US based lab) have a mycotoxin urine profile, available in the U.K from Regenerus Labs. The below is a sample of my own mycotoxin test results indicating an abnormal range for Ochratoxin A. Re-testing may be helpful to understand how successful you have been in treatment of Ochratoxin A.

 

There are other tests that can be considered to have a more complete understanding of an individuals health. These include:

  • Microbiome testing – mycotoxins can cause significant disruption to the gut function.
  • Organic acid testing – this is a urine test that both looks as fungal metabolites but also nutrient status. Nutrient deficiencies may impact on many aspects of health including detoxification capacity which is essential to optimise when wanting to heal from mould illness. One test, available from Genova, looks at lipid peroxides – which was mentioned earlier can be elevated as a consequence of ochratoxin exposure.
  • Functional blood testing.

How Do I Avoid Exposure To Ochratoxin A?

Treatment of ochratoxin A requires a reduction in exposure to the toxin. The World Health Organisation advise the consumer to:

  • Carefully inspect whole grains and nuts for evidence of mould, and discard any that look mouldy, discoloured, or shriveled.
  • Buy grains and nuts as fresh as possible; that have been grown as close to home as possible, and which have not been transported over a long time
  • Buy only reputable brands of nuts and nut butters – moulds are not entirely killed by processing or roasting, so can show up in products e.g. peanut butter
  • Make sure that foods are stored properly and are not kept for extended periods of time before being used
  • Try to ensure his/her diet is diverse; this not only helps to mitigate aflatoxin exposure, but also improves health and nutrition. Consumers who lack dietary diversity need to pay extra attention to minimize the risk of high exposure to aflatoxins. For example, extensive aflatoxin exposure has been reported from areas where people get a major part of their daily calorie intake from maize; this foodstuff is commonly contaminated with aflatoxins and needs to be handled properly both before and after harvest.

However, this is not considering the mycotoxins that might be produced from water-damaged buildings – really the most common cause of mould illness. In these situations, leaving the property *may* be needed. There are other considerations also, as I appreciate this is sometimes just not achievable. I have had clients sleep in tents in the garden, when levels of mould were significant, because they were aware of how they felt on entering their home.

Check out my article The Ultimate Guide To Mycotoxins for more information.

How Do You Treat Ochratoxin A?

Treat the individual, not the disease.

Check out my article ‘Ochratoxin A Toxicity: Antioxidants To The Rescue!’

What the above quote means is we need to focus on your unique case. There are numerous things that may require support ranging from small intestine bacterial overgrowth, to bile support, histamine issues and mast cell activation syndrome to fibromyalgia. Treatment will require layering and must be sequential – I often describe it as chapters in a book.

Check out my article The Ultimate Guide To Mycotoxins which provides a more in-depth summary of testing and treatment for  mycotoxins.

I would like to point out straight away that first off you HAVE to ensure you are no longer being exposed to mould. There is a saying in Functional Medicine which is “you can’t get well in the same environment that made you sick”.

Once you have removed yourself from the exposure we need to understand how these mycotoxins have effected you, and where there may have colonised.

The sinuses is a common place of colonisation (contributing to sinusitis for example) and a great product to help with this is a nasal spray which can be found here on Amazon.

Options for ochratoxin A treatment may include:

  • Binders such as GI Detox by Bio-Botanical Research.
  • Anti-fungals such as Biocidin Broad SpectrumLiquid (US audience: click here. UK and EU audience: click here) .
  • Glutathione to support detoxification. Certain mycotoxins have been found to inhibit the enzymes required for the endogenous production of glutathione and thus supplementation may be important. Another option is NAC which supports glutathione status.
  • Anti-inflammatories and anti-oxidants such as turmeric, rosemary and omega 3 fatty acids, vitamin C, selenium.
  • Probiotics – certain strains have been found to assist the detoxification/binding of mycotoxins.
  • Biofilm disruptors: As well as NAC having biofilm properties this is a good option for my US audience: Biofilm Defence by Kirkman Labs.
  • Bitters or phosphatidylcholine for bile/detox support.

Melatonin and liquorice root extract have also been shown to be helpful.

The Importance Of Gut Health

Given the important metabolism of OTA that occurs in the gut, and evidence of increased toxicity when gut microbiome is disturbed with an antibiotic, it would pay to direct attention toward achieving and maintaining healthy gastrointestinal functioning. In fact, there is evidence that some beneficial gastrointestinal flora can have positive effects on decreasing toxicity from OTA including specific strains of yeast (12).

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Sauna therapy may also be helpful in ochratoxin A treatment because it has been detected in human sweat.

Mycotoxins, as with any condition/topic, needs to be put in context with everything else that might be going on in the individual – small intestine bacterial overgrowth and GI dysfunction (as mentioned above) is extremely common and thus treatment may need to be sequential – focusing on different bodily systems in a logical way.

Climate And Mycotoxins

A paper entitled Aflatoxins in the Soil Ecosystem: An Overview of Its Occurrence, Fate, Effects and Future Perspectives states:

“Current regulations provide minimal options for the disposal of aflatoxin-contaminated crops, amongst which is the incorporation of residues into the soil for natural degradation. This form of mycotoxin loading into the soil could potentially change its physicochemical characteristics and biotic parameters. Recent studies suggest that as climate conditions change, the occurrence and geographical distribution of aflatoxins might increase, posing significant health risks to the soil ecosystem, food crop production and human health.”

While this is specifically talking of aflatoxin, a different mycotoxin, it may be true for ochratoxin and ether way, is an important message to spread.

The likes of Dr. Jill Carnahan suggest that one possible reason for people responding so well to a paleo diet is the natural reduction in intake of mycotoxins from food.

Books On Ochratoxin A Treatment And Testing:

Websites For Ochratoxin A Treatment And Testing:

Podcasts On Ochratoxin A Treatment And Testing:

Research For Ochratoxin A Treatment And Testing:

  1. Detection of Mycotoxins in Patients With Chronic Fatigue Syndrome
  2. Dampness and Mold Hypersensitivity Syndrome and Vaccination as Risk Factors for Chronic Fatigue Syndrome
  3. The Putative Role of Viruses, Bacteria, and Chronic Fungal Biotoxin Exposure in the Genesis of Intractable Fatigue Accompanied by Cognitive and Physical Disability
  4. Chronic Illness Associated With Mold and Mycotoxins: Is Naso-Sinus Fungal Biofilm the Culprit?
  5. Mycotoxin: Its Impact on Gut Health and Microbiota
  6. A Review of the Mechanism of Injury and Treatment Approaches for Illness Resulting From Exposure to Water-Damaged Buildings, Mold, and Mycotoxins
  7. Deficient Glutathione in the Pathophysiology of Mycotoxin-Related Illness
  8. Role of Mycotoxins in the Pathobiology of Autism: A First Evidence
  9. Mycotoxins and human disease: a largely ignored global health issue
  10. Mycotoxins
  11. Ochratoxin A and human health risk: A review of the evidence
  12. A Review of the Diagnosis and Treat of Ochratoxin A Inhalational Exposure Associated with Human Illness and Kidney Disease including Focal Segmental Glomerulosclerosis 
  13. Milićević, D. R., Škrinjar, M., and Baltić, T. (2010). Real and perceived risks for mycotoxin contamination in foods and feeds: challenges for food safety control. Toxins 2, 572–592
  14. Mycotoxins by Bennett and M. Klich.
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