Lab Testing


Chances are that you have an insurance plan which dictates which blood tests are “medically necessary”. Because allopathic medicine and the insurance system are set up to look only for pathology, tests that assess general physiological function in absence of clear evidence of pathology are usually considered to be unnecessary. Sometimes, the tests your insurance company will authorize are simply not comprehensive enough to determine what is really going on. We order the tests we need to look for sub-clinical functional disorders, rather than ordering tests simply to confirm the presence of disease. While this may cost you more money in the short run, it provides significantly more information which we can use to find the root of your complaints rather than providing a band-aid solution. Blood work is ordered through Quest Diagnostics.


Urine is used to evaluating the nuances that may not show in blood work- how many times have you heard “blood work normal” yet you have every sign and symptom that clearly shows you are not functioning normally. Urine testing is convenient, non-invasive, and inexpensive, which allows for needed multiple tests over an extended period of time to design individual healing programs.

Hormone Metabolite Assessment:

This test measures estrogen, DHEA, testosterone, progesterone, and their metabolites. Serum and saliva testing cannot offer an extensive overview of sex hormone metabolites. How the body is processing and metabolizing estrogens and androgens is important in making sound clinical decisions. Estrogen metabolites show a fuller picture of estrogen status and can help reduce risks for estrogen-related cancers by optimizing metabolism.

Advanced Adrenal Assessment:

A complete overview of adrenal hormones includes DHEA, cortisol and cortisol metabolites. To fully understand HPA-Axis cortisol should be tested throughout the day to assess the diurnal pattern. Only this test includes all of these parameters merging the diurnal free cortisol pattern seen typically in saliva with the cortisol metabolism picture and DHEAS.

Lab Testing

Comprehensive Hormone Profile:

By combining the Hormone Metabolite Assessment and the Advanced Adrenal Assessment a comprehensive overview of sex and adrenal hormones is achieved to get to the bottom of a patient’s complex hormone-related health issues.

DUTCH Sample Collection is easier:

• No blood draw
• No 24-hour urine collection
• No spitting into tubes
• 4 simple dried urine samples
• Collect conveniently at home

DUTCH Testing is more comprehensive:

• Metabolism of Cortisol
• Metabolism of Progesterone, Testosterone, and Estrogen
• Diurnal pattern of free Cortisol
• Accurate and precise testing methods (LC-MS/MS GC-MS/MS)

•Adrenal Panel If you are having dramatic mood shifts, chronic stress and related health issues, low immunity, skin problems, lack of vitality and energy, muscle and joint pain, hypoglycemia, common digestive disturbances, migraine headaches, osteoporosis, sleep disturbances, poor memory, low sex drive, low body temperature, thyroid issues

•Female Hormone Panel We will use this test to assist us with fertility and/or severe PMS. This test takes a month to perform- you are monitoring your hormonal health with 11 samples over 28-32 days. This gives us a far clearer picture of what your hormones are doing every day of your cycle.

•Post-Menopause Panel If you are having bleeding irregularities, dryness, hot flashes/sweats, insomnia, headaches, mood changes, depression, osteoporosis, altered fat and carbohydrate metabolism, elevated blood pressure, gallbladder issues.

•Male Hormone Panel If you are having andropause symptoms, impaired libido, ED, baldness, thinning, fat accumulation around the waist, change in sleeping habits, lack of enthusiasm, increased cholesterol, nervousness, depression, inability to lose weight, or simply not feeling yourself.


If you are having chronic and vague GI symptoms –frequent bloating, gas, cramping, diarrhea, and constipation, travel within the U.S. and overseas, close living quarters, children in daycare.

This comprehensive profile helps pinpoint the causes of gastrointestinal symptoms and chronic systemic conditions and measures key markers of digestion, absorption, and inflammation. Using growth-based culture, the standard of practice in clinical microbiology, as well as sensitive biochemical assays and microscopy, this thorough profile evaluates the status of beneficial and pathogenic microorganisms including aerobic and anaerobic bacteria, yeast, and parasites. Antimicrobial susceptibility testing to prescriptive and natural agents is also performed for appropriate bacterial and fungal species at no additional charge. It also includes a 3-day collection of Parasitology.


Recent research indicates that immune sensitivity to gluten is exceedingly common, present in 30-60% of all Americans. Although these reactions can cause malnutrition, growth failure in children, osteoporosis, many autoimmune diseases (including colitis, diabetes, arthritis, and many others), most of the affected individuals are unaware they have it because there have been no sensitive tests capable of diagnosis.

Researchers have proven that 50% of patients diagnosed with Celiac disease do not respond to the one protein being assessed in the conventional tests, instead they react to one or more of the other gluten proteins that are not measured in those conventional tests. Additionally, more labs are switching to only offering deamidated gliadin because it is more sensitive for Celiac disease.

Unfortunately, the larger percentage of the population, Non-Celiac Gluten Sensitive patients, has been shown to be more reactive …

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HPA Axis Dysfunction(Adrenal Fatigue)

 Tired for no reason?
 Having trouble getting up in the morning?
 Need coffee, colas, salty or sweet snacks to keep going?
 Feeling run down and stressed?
 Cant fall asleep and/or stay asleep?

If you answered “yes” to one or more of these questions, you may be experiencing adrenal fatigue.

The adrenals are walnut-sized glands located on top of each kidney and are important control centers for many of the body’s hormones. The outer layer of the gland, called the adrenal cortex, produces hormones including cortisol, DHEA, estrogen, and testosterone. The centers of the glands produce adrenaline, the hormone named after them.

The basic task of your adrenal glands is to rush all your body’s resources into “fight or flight” mode by increasing the production of adrenaline and other hormones. When healthy, your adrenals can instantly increase your heart rate and blood pressure, release your energy stores for immediate use, slow your digestion and other secondary functions, and sharpen your senses.

Every challenge to the mind and body creates a demand on the adrenal glands.

Unlike our ancestors, we live with constant, low-grade stress. Instead of occasional, acute demands followed by rest, we’re constantly over-worked, under-nourished, exposed to environmental toxins, and worrying about others – without a regular oasis of calm.

And the list of challenges is endless: lack of sleep, a demanding boss, the threat of losing your job, financial pressures, personality conflicts, yo-yo dieting, relationship turmoil, death or illness of a loved one, skipping meals, reliance on stimulants like caffeine and carbs, digestive problems, over-exercise, illness or infection, unresolved emotional issues from our past or present and more. The result is adrenal glands that are constantly on high alert. When the adrenal glands get to a stage where they are unable to regulate cortisol to respond to the normal stress of everyday life, it is referred to as HPA-D (hypothalamic-pituitary-adrenal axis dysfunction), more commonly referred to as adrenal fatigue or adrenal exhaustion.

Higher and more prolonged levels of circulating cortisol (like those associated with chronic stress) have been shown to have negative effects, such as:

 Impaired cognitive performance
 Dampened thyroid function
 Blood sugar imbalances, such as hyperglycemia
 Decreased bone density
 Sleep disruption
 Decreased muscle mass
 Elevated blood pressure
 Lowered immune function
 Slow wound healing
 Increased abdominal fat

Chronically lower levels of circulating cortisol (as in adrenal fatigue) have been associated with negative effects, such as:

Brain fog, cloudy-headedness, and mild depression
 Low thyroid function
 Blood sugar imbalances, such as hypoglycemia
 Fatigue – especially morning and mid-afternoon fatigue
 Sleep disruption
 Low blood pressure
 Lowered immune function

If this sounds like you, one of your main underlying problems may be HPA-D/adrenal fatigue.

What is Cortisol?

In its normal function, cortisol helps us meet stressful challenges by converting proteins into energy, releasing glycogen (sugar), and counteracting inflammation. For a short time, that’s okay. But at sustained high levels, cortisol gradually tears your body down. Sustained high cortisol levels destroy healthy muscle and bone, slow down healing and normal cell regeneration, co-opt biochemicals needed to make other vital hormones, impair digestion, metabolism, and mental function, interfere with healthy endocrine function; and weaken your immune system.

Ideally, cortisol is elevated in the morning to help you get going, lower but steady throughout the day to sustain energy, then falls in the evening to support restful sleep, this is called the circadian rhythm. And what happens after a constant demand for help? Eventually, the HPA axis can’t keep up with the demand for cortisol, and cortisol levels become dysregulated. You end up with a dysregulated circadian rhythm and a maladaptive stress response. The dysregulation of the HPA axis is what we refer to as “adrenal fatigue syndrome”.

Adrenal fatigue is a likely factor in several medical conditions such as the following:

 Chronic fatigue syndrome
 Premature menopause

Testing for HPA-D(Adrenal Fatigue)

Until recently we used saliva testing. It allowed for needed multiple tests to get an accurate picture of the circadian rhythm or the bodily level of hormones throughout the entire day. Saliva tested the free hormones, which are the correct reflection of the bioactivity of the hormones available for use to the bodily tissues.

However, newer testing is now available that measures important metabolites that saliva can’t. We can get a much more accurate picture of how your body is processing cortisol as well as producing it. This is called DUTCH (Dried Urine Testing Comprehensive Hormones) from Precision Analytics. 5 samples of urine are collected during the day and night. Strips of paper are dipped into the urine, allowed to dry, and mailed to the lab. It is an extremely easy, non-invasive, and relatively inexpensive test.

Conventional medicine will detect only the extremes of adrenal insufficiency when damage to the adrenals has already occurred (Cushing’s disease and Addison’s disease). Yet, within those extremes, you can feel miserable and still be told your cortisol levels are normal. This is known as a “sub-clinical” pattern, …

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