Information Guide
A research-based clinical laboratory offering services worldwide. 1 William Shaw, Ph.D., Director | 11813 West 77th Street, Lenexa, KS 66214 | (913) 341-8949 | Fax (913) 341-6207 www.GPL4U.com call:| (913) 341-8949
The Great Plains Laboratory, Inc. (GPL) is a research-based clinical laboratory that offers testing for nutritional factors in chronic illnesses worldwide. Our company was founded in 1996 and is currently serving more than 100 countries. We provide a variety of metabolic tests that are not routinely available through other laboratories, and have tested more than 200,000 patients with autism and other related disorders. Our goal is to help people achieve their maximum potential through quality laboratory testing, knowledgeable staff, and excellent customer service.
Services we offer ■ Free shipping in the U.S.
■ Free webinars
■ Interpretation guides
■ Easy-to-read graphic results
■ Friendly customer service
■ Physician educational events
■ Free results consultation
■ Physician referral programs
■ BioMed Today e-newsletter
About the Director William Shaw, Ph.D., is board certified in the fields of clinical chemistry and toxicology by the American Board of Clinical Chemistry. Before he founded The Great Plains Laboratory, Dr. Shaw worked for the Centers for Disease Control and Prevention, Children’s Mercy Hospital, University of Missouri at Kansas City School of Medicine, and Smith Kline Laboratories. He is the author of “Biological Treatments for Autism and PDD,” originally published in 1998 and “Autism: Beyond the Basics,” published in 2009. He is also a frequent speaker at conferences worldwide. Dr. Shaw is the stepfather of a child with autism and has helped thousands of patients and medical practitioners to successfully improve the lives of people with autism, AD(H)D, Alzheimer’s disease, arthritis, bipolar disorder, chronic fatigue, depression, fibromyalgia, immune deficiencies, multiple sclerosis, OCD, Parkinson’s disease, seizure disorders, tic disorders, Tourette syndrome, and other serious conditions.
Our Mission Our mission is to improve health treatment outcomes for chronic illnesses by providing the most accurate, reliable, and comprehensive biomedical analyses available - using the latest technology and proven techniques – and by providing education to patients, families, and health care practitioners.”
Dr. Shaw’s research led him to discover the neurological effects that yeast and bacteria metabolites have on the behavior of children with autism. His research soon expanded to fungal metabolites, oxalate production, cholesterol deficiency, and specific mitochondrial markers. All these discoveries, combined with the latest computer technology, allowed Dr. Shaw to develop a very unique Organic Acids Test that measures specific markers from yeast and bacteria.
Contact Information Hours of Operation: 8 a.m. to 5 p.m. Central time USA 1400 (2 p.m.) to 2300 (11 p.m.) Coordinated Universal Time (UTC) 1
www.GPL4U.com
Customer Service: Toll Free: 800-288-0383 Local: 913-341-8949 Fax: 913-341-6207 General Inquiries: CustomerService@GPL4U.com
Billing/Insurance: Direct Line: 913-754-0459 Billing@GPL4U.com
Our laboratory offers comprehensive evaluation panels that provide physicians with the right tools for a more effective, individualized treatment. We are equipped with state-of-the-art instrumentation. Our superior technology allows us to develop more unique tests than regular commercial laboratories, while adhering to the strictest quality control and quality assurance guidelines of regulatory agencies.
Lab Certifications CLIA The Great Plains Laboratory is fully certified under the federally mandated Clinical Laboratory Improvement Amendments (CLIA). All referral laboratories used by The Great Plains Laboratory are also CLIA certified.
CAP The Great Plains Laboratory voluntarily participates in all proficiency programs offered by the College of American Pathologists (CAP). The CAP is the world’s largest association composed exclusively of board-certified pathologists and pathologists-in-training and is the worldwide leader in laboratory quality assurance. In this program, our laboratory must constantly demonstrate our ability to successfully identify and quantify unknown specimens.
Internal Quality Control In addition to inspections by the state and participation in external proficiency testing programs of the CAP, GPL also has a strong internal quality control program. We have a dedicated staff of scientific professionals whose focus is to monitor the effectiveness of our tests and to ensure the quality and integrity of all laboratory methods. Portions of quality control samples are analyzed with every test batch to ensure laboratory quality. Patient samples are also frequently split to make sure that different technologists perform similar work.
Table of Contents Educational Resources.................................................1 Other Resources............................................................2 Payment Options ..........................................................3 Getting Started With Our Lab Services.....................4 Authorization Order a Test Kit Specimen Collection Shipping Results Cancellation Policy
Frequently Asked Questions ......................................5 Testimonials ..................................................................6
Tests Organic Acids Test (OAT) .............................................8 IgG Food Allergy Test w/ Candida...............................11 Metals Tests................................................................. 13 Phospholipase A2 Activity Test................................15 Gluten / Casein Peptides Test .................................. 16 Hormone Panels ........................................................ 17 Amino Acids Tests ...................................................... 18 Vitamin D Test ............................................................ 19 Advanced Cholesterol Profile .................................. 20 IgE Food and Inhalant Allergy Tests ....................... 21 Comprehensive Stool Analysis................................ 22 Copper / Zinc Profile ................................................. 23 Immune Deficiency Profile ...................................... 23
Food and Drug Administration (FDA) Approvals
Comprehensive Fatty Acids Test ............................. 24
The FDA regulates companies that sell instruments and reagents to clinical testing laboratories. The Great Plains Laboratory uses many FDA-approved instruments and reagents. In some cases, there are no commercially available instruments or reagents. Such tests, termed “home brew” tests, are regulated by the CLIA regulatory agencies. The FDA does not directly regulate clinical laboratories.
OAT + IgG Food Allergy Test w/ Candida Combo . 27
International Support:
GPL3 ............................................................................. 25 GPL4 ............................................................................. 26 OAT + Amino Acids Urine Test Combo ................... 27 Comprehensive Test Panels ..................................... 28 Comprehensive Autism Panel Comprehensive Mental Health Panel Other Available Test Panels: Comprehensive AD(H)D Panel Comprehensive Wellness Panel
Customer service support is available in multiple languages: Spanish, German, French, Portuguese, Italian, Japanese, and Chinese Direct Line: 913-754-0461 call: (913) 341-8949
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Educational Resources Interpretation Guides The Great Plains Laboratory offers a written interpretation with most test results. Any abnormal values that are uncovered in the analysis are considered and expanded upon in the interpretation. The information we provide will help the patient and the practitioner to understand the clinical significance of each abnormal value associated with a particular analyte. The significance of the result depends greatly on the individual value associated with the metabolite. The interpretation will narrow down the possible causes of the abnormality.
Free Consultation with Results We want our clients to receive the maximum value for their laboratory testing which is why we offer free 30-minute consultations to explain the test results in detail. Medical practitioners and patients are better equipped to move forward with the appropriate treatment once they have a clear understanding of the test results. Our staff has been observing trends in test results for over 10 years, and they are glad to provide their experience and expertise to the troubling cases that need more attention.
Educational Events GPL is dedicated to educating both patients and practitioners alike. We frequently host, sponsor, and attend educational events around the world. Our Organic Acids Test (OAT) Workshops provide practitioners the opportunity to learn about the OAT, a diagnostic tool that will allow them to help patients with difficult-to-diagnose and chronic health issues. Led by Kurt N. Woeller, D.O., this workshop will not only show attendees how the OAT can be used in clinical practice, but ways to use it along with other diagnostic assessments. In the workshop, practitioners will learn about the interrelationship between chronic yeast and various health issues, correlating oxalate problems, OAT testing and neurochemical imbalances, and successful strategies for practice marketing and profitability. We are the primary sponsor of the annual Integrative Medicine for Mental Health (IMMH) Conference. IMMH is an organization that supports a whole-body approach, utilizing multiple fields of medicine and nutritional sciences to help patients obtain mental wellness. The integrative approach includes metabolic testing, nutritional therapies, dietary interventions, and traditional medical treatments. IMMH organizes an annual conference that presents concepts and practical guidelines that can dramatically improve the quality of life of your patients. Practical applications and effective protocols are presented and can be easily applied in a clinical setting. To find out where GPL is participating in a conference, visit the Upcoming Events page on our website.
Free Webinars GPL offers webinars presented by physicians and other professionals on a variety of topics, including autism, mental health, and laboratory testing. A wide range of experts on the topic of biomedical treatment and testing conduct educational seminars via webinars. The information is designed to provide useful information about the clinical manifestations that occur in certain disorders. Presenters draw from years of experience to bring you important, helpful information about various situations that can occur in the body to create illness and disease. In additon, a large number of our webinars are archived in our Webinar Library and can be accessed any time. Find out more on our website www.GPL4U.com.
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BioMed Today Email Newsletter We provide a free newsletter publication called BioMed Today that includes a featured topic and related articles about new and updated discoveries in the biomedical field, as well as upcoming events, discussions, tips, recent news, and other resources. Sign up for our email updates for information on new and updated tests, conferences, and webinars. Don’t miss out on all that GPL has to offer! Visit www.GPL4U.com and click Email Signup.
Physician Referral Database We are happy to recommend the names of experienced medical practitioners to patients and parents who need help getting testing or treatment. In areas where there is not a medical practitioner nearby, we can recommend the medical practitioners who provide long-distance phone consultations. The medical practitioners we recommend are familiar with our tests and are qualified to help patients with recommendations, authorizations, and treatment options.
Online Test Orders Physicians can order our test kits online through ResultsPlus. This online portal also allows the physician to update account and billing information, send test kits directly to patients, and access the most up-to-date testing information. Find out more on our website under For Clinicians. Many of the tests we offer are also available through MyMedLab. This is an online test ordering system that provides patients with everything they need to test through The Great Plains Laboratory, including a medical practitioner’s signature and a professional blood draw. To learn more about MyMedLab, visit our website or go to https://greatplains.mymedlab.com.
Other Resources IMMH Clinician Registry and Resources A Clinician Registry is available through www.IMMH.org. The registry provides patients with a list of medical professionals who can assess and treat mental health disorders based on an integrative medical approach. Integrative medicine for mental health is a whole body approach utilizing multiple fields of medicine and nutritional sciences. The goal is to help patients regain mental wellness through the use of individualized metabolic testing, nutritional therapies, dietary interventions, along with traditional medical treatments, including medications and psychotherapy. The IMMH Clinician Registry eligibility is exclusive to practitioners who have attended an IMMH Conference. Find more about the IMMH Clinician Registry and upcoming events on the IMMH website. This website contains other resources such as research articles, webinars, blog posts, and other useful tools for integrative practitioners.
Nutritional Supplements New Beginnings Nutritionals provides specialized, high-quality nutritional supplements for adults and children on the autistic spectrum and other chronic health issues. They offer professionalquality products that contain pharmaceutical grade ingredients whenever possible and do not contain harmful or allergenic ingredients. Support for special dietary needs is available through a wide variety of supplements that provide help for, digestion, absorption, nutrient deficiencies, detoxification, immune dysfunction, and yeast and bacteria overgrowth. Website: www.NBNUS.com, Phone: (913) 754-0458 Address: 7797 Quivira Road, Lenexa, KS 66215 USA
We provide useful tools for practitioners to understand the clinical significance of biomedical testing and clear guidance for appropriate treatments.
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Payment Options Blue Cross and Blue Shield
Insurance Plans Not Filed
The Great Plains Laboratory is contracted with several Blue Cross and Blue Shield (BCBS) PPO plans.* Acceptable plans are recognized in one of two ways: the member’s BCBS insurance card will display a suitcase logo on the front with the letters PPO inside or will have a map of the United States on it. In addition, The Great Plains Laboratory will file the out-of-network claims for most other BCBS plans.*
We cannot bill State-Run Medicaid Programs, Humana, Aetna, or HMOs (check the website for HMO exceptions). If the patient subscribes to any of these insurance plans, the patient must pay in full by check or credit card.
*See the insurance section on our website for exceptions to the BCBS in-network program.
Tricare We are a participating provider with Tricare in every region of the United States. Patients should include a copy of the front and back of the insurance card and the member’s Social Security number. *See the insurance section on our website for exceptions to the Tricare program.
Medicare GPL is contracted with Medicare, and many of our tests are covered by Medicare. See the Advance Beneficiary Notice (ABN) for a list of non-covered tests. All patients who have Medicare must sign and return the ABN with the specimen. This form is included in the test kits (with the Test Requisition Form). We require a copy of the front of the patient’s Medicare card be sent with the specimen. If the patient is enrolled in a Medicare Advantage Plan, then we require a copy of the front and back of the patient’s Medicare Advantage Card. The Medicare Advantage Card is not the same as a Medicare card. Please contact our Billing Department with any questions concerning coverage.
Out-of-Network Insurance Plans The Great Plains Laboratory is considered “out-of-network” with some Blue Cross Blue Shield plans, United Healthcare, and Cigna. The laboratory will file out-of-network insurance on behalf of the patient, provided the patient includes a 20% out-of-network prepayment along with the insurance information on the Test Requisition Form. Prepayment is required for all out-of-network claims even when insurance states that full reimbursement will be made. Should the insurance pay for more than the patient balance, a reimbursement check will automatically be mailed to the patient. PPO insurance policies will usually cover our services once the patient’s out-of-network deductible has been met. The patient will be responsible for any co-insurance, co-payments, and any services denied as “not medically necessary.” However, some “out-of-network” insurance policies will pay in full for the tests performed at The Great Plains Laboratory.
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Self Pay We offer a prompt-pay discount by paying in full at the time of testing. We accept checks and all major credit cards including: Visa, MasterCard, Discover, American Express, JCB, and Diners Club. We will send a statement of services for you to file with your insurance company.
PayPal GPL accepts payments made through PayPal. Signing up for a PayPal account only takes a few minutes and is an alternative to using checks, credit cards, or wire transfers to pay for your testing. If you choose to send payment via PayPal, you must complete the “Email to recipient” section within PayPal when sending money. Please include the patient’s name, date of birth, and billing address so we can match your payment with the correct account. Send PayPal payments to Payment@GPL4U.com.
Insurance Coverage Verification Guide We provide an Insurance Coverage Verification Guide. This helpful tool includes an insurance overview that patients can use to determine eligibility, restrictions, and requirements. By calling your insurance provider, you can verify your coverage and gather information to determine any out-of-pocket expenses. For the Insurance Coverage Verification Guide, visit Pricing and Payment Options on our website, or contact Customer Service.
Method of Payment Payment information must be received by the time the specimen arrives at our laboratory for the specimen to be processed. For questions, please contact the Billing Department at 913-754-0459 or Billing@GPL4U.com.
Getting Started With Our Lab Services Authorization
Shipping
Our laboratory requires an authorization from a medical practitioner on all tests performed in the United States. Authorization is not required for patients who reside outside the United States. We do not provide testing for any patient or medical practitioner who resides or practices in New York.
Shipping in the United States is free. Patients within the United States will not need to pay FedEx when sending samples to our laboratory. After collecting the sample, please call 1-800-463-3339 (1-800-GoFedEx) for pick up. Remember to mention you have an overnight FedEx billable stamp return.
We will gladly refer patients to medical practitioners who use The Great Plains Laboratory tests. These practitioners are more likely to provide authorization or treatment based upon results.
International
Order a Test Kit Test kits can be ordered online, by phone, by fax, or by a medical practitioner. The kits are usually mailed directly to the patient and will include everything the patient needs to collect and submit the specimen. We do not require patients to have the practitioner’s authorization before ordering a test kit. However, a prescription or signed requisition must be returned with the specimen or sent to our lab directly by the practitioner. A kit order must be signed by a practitioner to be considered authorized. Practitioners can submit signed kit requests to our lab via fax or through our Online Test Requisition Form. A completed copy of the Online Test Requisition Form will be included in the patient test kits for convenience. Faxed authorizations will be kept on file at the lab to be matched with patient specimen upon arrival. No payment is necessary to order a test kit within the United States. Test kits ordered from within the United States will include a Test Requisition Form, payment, insurance, and privacy forms, instructions, specimen collection components, and a pre-paid FedEx overnight clinical pack.
International Payment is required for kits ordered from outside the United States. These test kits will include a Test Requisition Form, payment form, instructions, commercial invoice, specimen collection components, and a pre-paid international FedEx priority clinical pack.
Specimen Collection
Patients who reside outside the United States are responsible for the cost of shipping test kits both into and out of the laboratory. Shipping charges will vary depending on the country. Patients will need to provide the laboratory with a method of payment upon ordering their test kit. We include a prepaid FedEx International Priority Service bag in our international test kits. The charges for inbound shipping are applied to the patient’s account once the specimen has been received by our laboratory. We have distributors in many countries that can provide our test kits to patients at a reduced cost. Please contact International Support at 913-754-0461 to find out if there is a distributor in your country.
Results Results are sent out according to the parameters established by the practitioner on the New Client Form. Our laboratory will automatically mail a copy of results to the patient. The patient can also request that the laboratory send out results via secure email or secure fax after they are completed. Customer Service will make every attempt to accommodate the patient’s request for results. In some cases, the patients will have to obtain results from their medical practitioner.
Cancellation Policy The Great Plains Laboratory must be notified by the medical practitioner, patient, or parent/guardian to cancel a test. Cancellations will be honored if requested within 24 hours of receipt of the sample by the laboratory. Because testing processes begin within 24 hours, requests for cancellation beyond this time will not be honored.
Test collection instructions are included with all test kits. The urine, stool, hair, and IgG dried blood spot (DBS) specimens can all be collected from home by the patient. Blood kits will need to be taken to a phlebotomist to perform the blood draw. The majority of blood-draw sites will ship the blood for the patient using the test kit provided. Those that do not ship the specimen should return the specimen to the patient for return shipment. Our Customer Service staff is available to answer questions about specimen collection. A list of frequently asked questions for patients is on our website.
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Frequently Asked Questions Do I need to have a medical practitioner’s I have already done testing with you. Is my approval to get testing performed at The Great insurance information on file? Plains Laboratory? Yes, your insurance information is on file. However, we request that A medical practitioner’s approval is necessary if you are a resident of the United States. It is recommended, but not obligatory, for residents of other countries. An approved medical practitioner could be any of those listed in the following question.
an updated copy of your insurance card be sent with your sample.
What type of medical practitioners can authorize tests?
Coverage is determined by a number of factors, including the type of procedure, the medical diagnosis, and the insurance policy guidelines. We encourage patients to call their insurance company to find out if tests may be covered. An Insurance Coverage Verification Guide is available on our website to help determine coverage.
The Great Plains Laboratory recognizes Medical Doctors (MD), Osteopathic Doctors (DO), Chiropractic Physicians (DC), Naturopathic Physicians (ND), Doctors of Philosophy in Psychology, Biochemistry, Toxicology, and Nursing (PhD), Doctors of Oriental Medicine (DOM), Licensed Acupuncturist (Lac), Physicians Assistants (PA), Nurse Practitioners (ARNP), Nurse Midwives (CNM), Certified Nutritionists (CCN), and Registered Dietitians (RD). It is the practitioner’s responsibility to work within the rules and guidelines of the state in which they practice.
How do I find a doctor familiar with GPL’s testing? We have a national database of over 3,000 medical practitioners. Please call Customer Service at 1-800-288-0383 to locate a medical practitioner in your area. Authorization does not have to come from your primary care physician; any licensed health professional can order testing in your state.
Where can I go to get blood drawn? We are contracted with national phlebotomy services which can provide blood draw services for our testing. In addition, many children’s hospitals and national laboratory chains have walk-in phlebotomy clinics that will perform a blood draw using a GPL blood kit. Please call Customer Service for recommended blooddraw facilities in your area. Patients are responsible for any fees associated with a blood draw. Additionally, phlebotomy services can be arranged either at home or an agreed upon site for an added fee. More details regarding blood collection can be found on our website under the For Patients section.
When should I expect the test results? All tests have different turn around times. Most test results take 1-3 weeks to be completed. Our standard procedure is to release a faxed copy and mail a hard copy of the test results to the authorizing medical practitioner. A hard copy of the results can be mailed to the patient on their request.
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How do I find out if my insurance will cover your tests?
It is helpful to provide CPT and ICD-9 codes to the insurance company when calling for pre-approval. The CPT codes are provided by the laboratory and are located on the page associated with the test in this Information Guide and also on our website. The ICD-9 codes are provided by the practitioner.
Can I test my child who is not potty-trained? Yes, we provide pediatric collection tape-on bags to collect the urine from infants or children who are not potty-trained. Please request the pediatric collection bags when ordering tests through Customer Service or online.
Can I perform multiple urine tests using one specimen? Yes, you can perform many of the urine tests with one urine sample. Each test has a specific volume requirement. The urine collection container holds about 70 mL. You will need a special collection jug to perform the timed and 24-hour urine tests, which require at least 40 mLs of urine.
More Frequently Asked Questions are available on our website. Please contact customer service if you have any other questions not listed: CustomerService@GPL4U.com | 913-341-8949
Testimonials “Great Plains Laboratory provides me with information which has not only changed the lives of my patients and their families for the better but enables me to link otherwise puzzling symptoms with correctable causes far more completely than other labs I have used. It has been extremely interesting and just plain FUN to see patients with “chronic” illnesses improve dramatically or even recover as a result of using information from Great Plains. The reports are easy to read and arrive in a timely manner. Helpful, friendly technical support is readily available when needed. The clinician training courses the Great Plains Lab provides are invaluable too; these are a great way to learn about the science behind the tests, the pathology and treatments, as well as to meet the people you’ll be dealing with at the lab.” – Deborah Nash, MD “Your lab has a very appropriate name that suits its mission: ‘Great.’ I would like to thank you for the excellent consultation I received and friendly and knowledgeable customer service assistance. It is especially nice for the clients to receive the service in their native languages! I consider your laboratory not regular, but special, and it’s great to have these non-traditional tests available.” – Anna “I would like to thank you from my heart for the way you’ve helped our kids — especially Dr. William Shaw. May God bless him and all of you and give you a thousand years to live for continuing to help our kids to leave this cloudy road of autism and related disorders. Again, a thousand thanks!” – Mother of a girl with autism in Venezuela “I just want to express my sincerest gratitude for your research and commitment to helping people. If it were not for your work, I honestly believe that my son would not be talking, socializing, nor making the remarkable progress that he has been making in the past five months since starting the GFCF diet.” – Email to The Great Plains Laboratory
“I am very happy with the IgG test results from Great Plains. I always say that without this valuable test, I would not be in practice. It has helped so many of my patients! Recently, I had a patient with the most severe case of eczema I had ever seen in my practice. We did the Great Plains IgG testing [and] we saw he was sensitive to the usual gluten, dairy and eggs, and promptly removed these foods. Beef had also come up very elevated, but I had initially ignored that result, thinking that beef is a rather ‘benign’ food. Finally once we removed beef, the eczema cleared completely! So if it were not for this testing, this child would still be suffering.” – Elaine H., MS, RN, APN “Thank you so much for all your help! Thank you also for taking the time to talk to me on the phone. Jacob has had an incredible breakthrough! He is in a more receptive mood, with better eye contact, language, etc.! Thank you for helping my son to feel better and his body to work more efficiently! We look forward to taking your test again and seeing where he stands in a few months. ” – Parents of a child with autism in Burlingame, CA “I like the work of The Great Plains Laboratory and the book and conferences by Dr. Shaw. I have sent samples of my patients’ for detection of organic acids and morphine peptides in urine and now they are improving greatly with the results you have recommended.” – Pediatrician from Barcelona, Spain “I’m sending you this note to express my appreciation to your company and recognize your Customer Service consultants. You need to know that I am a demanding customer with high expectations, and it is not often that I come across companies/individuals that compel me to send a thank you note such as this. Customer Service followed through on every commitment; was prompt, knowledgeable, friendly; and bottom line helped me solve my issues. I didn’t get double talk or company policy talk – the representative took the time to listen to me and worked the problem to resolution.” – Shane
“As always, it was a great pleasure and comfort to speak with you today (re: dimethylglycine and trimethylglycine). I cannot imagine ourselves without the generous and knowledgeable service you, Dr. Shaw, and all the staff at GPL provide. We are eternally grateful for your support in the amazing and continuing progress our son, Eli, has achieved in the past 3 years -- ever since we first had him tested by GPL (and your help with his GFCF diet). Thank you.”
“We have noticed ... much improvement in hyperactivity, more eye contact, increased vocalization, better sleep pattern, better concentration, and decrease of compulsive behaviors, and self injury. The positive impact of your findings on our son’s life and our family cannot be described in words.” – A.E., father of a child with autism in Paramus, NJ
– Email from a father regarding his child
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Tests Organic Acids Test (OAT) IgG Food Allergy Test w/ Candida Metals Tests Phospholipase A2 Activity Test Gluten / Casein Peptides Test Hormone Panels Amino Acids Tests Vitamin D Test Advanced Cholesterol Profile IgE Food and Inhalant Allergy Tests Comprehensive Stool Analysis Copper / Zinc Profile Immune Deficiency Profile Comprehensive Fatty Acids Test GPL3 & GPL4 Panels OAT + IgG Food Allergy Test w/ Candida Combo OAT + Amino Acids Urine Test Combo Comprehensive Test Panels
Other Available Test Options Visit us online at www.GPL4U.com for details. ■ C-Reactive Protein Test (hs-CRP) – Serum ■ Celiac Disease Test – Serum ■ Ceruloplasmin Test – Serum ■ Copper Test – Serum ■ Kryptopyrrole Test – Urine ■ Prealbumin Test – Serum ■ Streptococcus Antibodies Profile – Serum ■ Uric Acid Test (24 hr. or Random) – Urine ■ Yeast Culture w/ Sensitivity Test – Stool 7 ■ Zinc Test – Serum www.GPL4U.com
Providing Comprehensive Nutritional Analysis and Individualized Treatment Options
Organic Acids Test (OAT) General Description
Recommendations
The Organic Acids Test (OAT) provides information about the body’s biochemical balance by measuring metabolic byproducts in urine. The 74 metabolites, including creatinine, detected in the OAT can indicate vitamin and hormone metabolism, energy cycle function, intestinal wall integrity, neurotransmitter metabolites, and muscle function. Specimens from individuals with a chronic illness, allergic condition, or neurological disorder often have one or more abnormal organic acids. Some organic compounds are produced by an overgrowth of gastrointestinal yeast or bacterial species due to impaired immune function, exposure to broad-spectrum antibiotics, or high consumption of simple carbohydrates. The OAT reliably detects the overgrowth of yeast and bacteria species commonly missed by conventional culture methods. These organisms and their metabolites can produce or magnify symptoms of many medical conditions. Identification of yeast or bacterial overgrowth paired with successful treatment increases the chance of recovery.
Depending on test results, follow-up may include:
The Organic Acids Test report includes: markers of nutritional deficiency, intestinal dysbiosis, oxalate metabolism, detoxification, bone disorders, amino acid, neurotransmitter, ketone, and fatty acid metabolism.
■ ■ ■ ■ ■ ■ ■
Specimen Requirements 10 mL of first-morning urine before food or drink. Patient must avoid apples, grapes (including raisins), pears, cranberries, and their juices 24 hours prior to specimen collection.
CPT Codes 82131 82507 82570 83150 83497 83605 83921*63 83945 84207 84210 84585 84591 *For add-on Phospholipase A2 Activity Test: 84999
The Microbial Organic Acids Test report includes: markers of dysbiosis, inflammation, beneficial and harmful bacteria, Clostridia, Candida, and other yeast and fungal species.
Clinical Usefulness ■ ■ ■ ■ ■ ■ ■ ■ ■ ■
Dietary modification Probiotic supplementation Nutritional supplementation Oral anti-fungal or anti-bacterial medications Antioxidant therapy Initiation of detoxification protocols Follow-up genetic testing
Understand vitamin and hormone metabolism Determine capacity to generate energy Evaluate intestinal wall integrity Assess performance of the central nervous system Evaluate muscle function Reveal excessive levels of gastrointestinal (GI) yeast Reveal excessive levels of GI bacteria Detect nutritional or antioxidant deficiencies Determine problems in fatty acid metabolism Identify oxalate imbalances
When ordering an Organic Acids Test in urine, patients have the option of adding our Phospholipase A2 Activity Test or Uric Acid Test* for a discounted price. *See Phospholipase A2 Activity Test on page 15 for more details. *See www.GPL4U.com>Select a Test>Other Screenings for details about the Uric Acid Test.
Microbial Organic Acids Test (21 components, including creatinine) This test is included in the Organic Acids Test and primarily shows metabolites produced by yeast and bacteria. Additional indicators of yeast and bacterial metablism are also included. The Microbial Organic Acids Test (MOAT) is ideal for followup to the OAT and may be recommended by practitioners looking for a specific abnormality, monitoring certain microbial balances, or assessing treatment efficacy. We strongly recommend the OAT as the initial screening test.
Specimen Requirements 10 mL of first-morning urine before food or drink. Patient must avoid apples, grapes (including raisins), pears, cranberries, and their juices 24 hours prior to the specimen collection.
CPT Codes 82570 83921*20
U.S. Patent # 5,686,311 Certain uses of the compounds arabinose, citramalic, tartaric, 3-oxoglutaric, carboxycitric, 3,4-dihydroxyphenylpropionic (DHPPA), and 3-(3-hydroxyphenyl)-3hydroxypropionic (HPHPA) acids in their application to autism in the Organic Acids Test and Microbial Organic Acids Test are protected by USA patent 5,686,311 granted November 11, 1997.
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Requisition #:
998877
Physician:
Patient Name:
Date of Collection:
Patient Age:
10
Time of Collection:
Patient Sex:
M
Print Date:
Metabolic Markers in Urine
Reference Range
Patient
(mmol/mol creatinine)
02/02/2015
Reference Population - Males Under Age 13
Intestinal Microbial Overgrowth Yeast and Fungal Markers 1 Citramalic
≤
5.0
0.80
0.80
2
5-Hydroxymethyl-2-furoic
≤
28
1.8
3
3-Oxoglutaric
≤
0.46
0
4
Furan-2,5-dicarboxylic
≤
18
1.9
5
Furancarbonylglycine
≤
3.1
0.12
0.12
6
Tartaric
≤
6.5
0.31
0.31
7
Arabinose
≤
50
8
Carboxycitric
≤
25
0
9
Tricarballylic
≤
1.3 Requisition #:
0.40 998877
H
1.9 Requisition #: Patient Name: Patient Age:
60
Comprehensive IgG
0.00
0.40 Physician: Date of Collection:
Metabolic Markers in Urine
≤
680
46
≤
0.86 Glutathione
0.20
12
4-Hydroxybenzoic
≤
3.0
≤ ≤
DHPPA (Beneficial Bacteria)
Reference Range
(mmol/mol creatinine)
Indicators of Detoxification
2-Hydroxyphenylacetic
4-Hydroxyhippuric
Sex:
60
The Great Plains Laboratory, Inc.
11
14
0.00
Patient Name:
Bacterial Markers 10 Hippuric
13
1.8
58 59
30
62
1.0
0.19
-
2.0
0.50
12
0.04
-
0.80
0.28
≤
1.2
0.40
Aspartame, salicylates, or GI bacteria 61 2-Hydroxyhippuric
0.08
0.59
0.20
-
2-Hydroxybutyric ä
Reference Population - Males Under Age 13
46
13
Pyroglutamic ä
Ammonia Excess 60 Orotic
Patient
0.08
15
15
1.0
0.50
0.28
12
0.40
ä A high value for this marker may indicate a Glutathione deficiency.
Clostridia Bacterial Markers 15 4-Hydroxyphenylacetic
(other pathogenic clostridia species)
-
Amino Acid Metabolites
32
5.1
5.1
62
2-Hydroxyisovaleric
≤
0.55
0
0.00
63
2-Oxoisovaleric
≤
2.5
0
0.00
64
3-Methyl-2-oxovaleric
≤
1.1
0.48
65
2-Hydroxyisocaproic
≤
0.68
0.01
≤
0.46
0.04
16
HPHPA
≤
220
17
4-Cresol (C. difficile)
≤
84
18
9
2.0
(other pathogenic clostridia species)
3-Indoleacetic
www.GPL4U.com
0.60
-
66 14
96
4.5
0.99
2-Oxoisocaproic
4.5 0.99
67
2-Oxo-4-methiolbutyric
≤
0.33
0.06
68
Mandelic
≤
0.30
0
69
Phenyllactic
≤
0.19
0.03
70
Phenylpyruvic
≤
4.0
0.29
71
Homogentisic
≤
0.61
0.01
72
4-Hydroxyphenyllactic
-
1.1
0.17
73
N-Acetylaspartic
≤
5.9
0.32
74
Malonic
Mineral Metabolism
0.05
96 0.48
0.01 0.04 0.06 0.00 0.03 0.29 0.01 0.17 0.32
Organic Acids≤Test and 1.2 18 - Nutritional 1.2 Metabolic Profile
The IgG Food Allergy Te is introduced to protein e proteins and the patient’ can be established base
High levels of IgG antib questionnaire regarding a published study, IgA o Candida may be due to p may trigger autoimmune study, individuals with pi antibodies are elevated i antibodies to Candida di amounts of IgG antibodie chronic fatigue, thyroid d chemotherapy, and anticause a rise in cases of
IgG antibodies to Saccha disease, and Behcet’s di Saccharomyces cerevisi boulardii. Individuals with to Saccharomyces boula
High amounts of antibo these elevated antibodie Celiac Disease Test with Great Plains Laboratory, to implementation of a g Page 1 of 8 please see The Great Pl
Organic Acids Test (OAT) ...continued
Report Analysis Glycolysis: Elevations may result from infection, exercise, or B vitamin deficiency. Very high levels may result from genetic metabolic disorders. Krebs cycle: Abnormalities may result from nutrient deficiencies, microbial overgrowth, or glutathione (GSH) synthesis deficiency. 2-oxoglutaric: Regeneration of amino acids to remove excess ammonia may result in low levels. Neurotransmitters: Metabolites of dopamine, norepinephrine, adrenaline, and serotonin are measured. Abnormalities may result from stress or poor detoxification, toxic metal exposure, and rarely, specific tumors. Low levels may be associated with mood disorders or depression. Pyrimidines: Slight elevations may occur from folic acid deficiency. Significant elevations can indicate possible genetic disorders. Fatty acids: Elevations can result from ketogenic diets or fasting, intake of medium-chain triglycerides, carnitine deficiency, diabetes, or genetic disorders. Toxic indicators: Abnormalities can result from a deficiency of glutathione, poor ammonia detoxification, or the ingestion of aspartame or salicylates. Physician Name: Date of Collection: Time of Collection: Print Date:
Vitamin indicators: Abnormalities involving B12, B6, B5, B2, CoQ10, absorbic acid, biotin, and ascorbic acid are measured. Amino acids: High elevations are associated with possible genetic errors in metabolism. These markers are deaminated by-products of amino acids themselves. Low levels do not indicate inadequate protein intake. Slight elevations of valeric acid analogs may indicate a greater requirement for thiamine (B1). 3-Methylglutaric or 3-methylglutaconic Acid: Elevated levels indicate reduced capacity to metabolize leucine. Small elevations may accompany impairment of mitochondrial function. 3-Hydroxyglutaric Acid: Elevations indicate deficiency in the enzyme involved in the breakdown of lysine hydroxylysine and tryptophan. Phosphate: Low phosphate is primarily associated with vitamin D deficiency. Individuals consuming a low grain diet may have lower phosphoric acid compared to those on a conventional “Western Diet.” More rarely, hypoparathyroidism may be involved.
A booklet explaining the complete clinical significance of each metabolite included in the Organic Acids Test is freely available to all physicians.
IgG Food Allergy Test + C. albicans, S. cerevisiae (94) Comments
The Great Plains Laboratory, Inc. ergy Test measures the relative presence of IgG antibodiesPhysician: to specific food proteins. The patient’s serum Requisition #: 273466 otein extracts from each of the different foods. If food-specific occurs between the antigen 07/30/2012 Patient Name: Date ofbinding Collection: atient’s IgG serum antibodies, a symptomatic reaction to that food is possible. A food elimination diet d based on results of this test and improvement of symptoms can be monitored.
G antibodies to Candida, a genus of yeast, have been found in patients who scored high on a arding symptoms of yeast overgrowth, like sugar cravings which can improve with antifungal therapy. In , IgA or IgM antibodies to Candida did not correlate with questionnaire scores. IgG antibodies to due to past infections and therefore do not indicate a current infection. However, Candida antibodies 7.4 H mmune disease. Candida antibodies react with virtually all human organs, including the brain. In one 2.3 with pituitary malfunction had Candida antibodies that also reacted to a human pituitary protein. Candida vated in Crohn’s disease, cystic fibrosis, and cancer. Individuals with cancer and elevated IgG 3.3 H dida died on average one year sooner than individuals with the same type of cancer and normal ntibodies to Candida. A wide range of disorders have been linked to Candida including depression, yroid disorders, autism, multiple sclerosis, vulvodynia. Use of antibiotics, oral contraceptives, 0.29 d anti-inflammatory steroids greatly increase susceptibility to Candida. Overgrowth of Candida may also ses of food allergies.
63 148 Crohn’s disease, celiac Saccharomyces cerevisiae are prevalent in inflammatory bowel disease, cet’s disease, while not usually elevated in ulcerative colitis. High amounts of antibodies to either erevisiae or Candida albicans may also cross-react with other Candida species or Saccharomyces als with high amounts of antibodies to Candida albicans or 4.3 Saccharomyces cerevisiae might react poorly s boulardii probiotic supplements because of this8.2cross-reactivity. 1.9
antibodies to wheat, gluten, rye, or barley are common in celiac disease. However, most people with tibodies do not have celiac disease, but may still benefit from exclusion of these foods from the diet. The est with blood serum can confirm celiac disease. To determine if enough serum is available, contact The ratory, Inc. (test is not available for bloodspot samples). The Celiac Disease Test should be done prior of a gluten-free diet to avoid false negative results. For more information on the Celiac Disease Test, reat Plains Laboratory website, www.gpl4u.com <http://www.gpl4u.com>.
call: (913) 341-8949
10
Comprehensive IgG Food Allergy T
IgG Food Allergy Test w/ Candida
Nuts and Seeds
General Description
Recommendations
Elevated levels of IgG (Immunoglobulin G) antibodies are associated with a wide variety of illnesses. Symptoms ranging from headache and nausea to seizure and hyperactivity may occur hours or even days after the offending food has been ingested. The degree and severity of symptoms vary due to the individual’s genetic makeup. The complete elimination of IgG positive foods may result in important improvements in symptoms of irritable bowel syndrome, autism, AD(H)D, cystic fibrosis, rheumatoid arthritis, and epilepsy, as demonstrated in numerous clinical studies. The 94 foods tested increase the identification of various offending foods.
Vegetables Depending on test results, follow-up may include: Asparagus ■ Elimination of offending foods Avocado ■ Immune system support Broccoli ■ Gut restoration Beet ■ Implementation of a food rotation diet (included in report) Cabbage ■ Supplementation Carrot
The standard IgG Food Allergy Test includes the foods most common in Western diets, while the IgG Asian Food Allergy panel is designed for individuals who commonly eat Asian cuisine. Asian foods tested include mango, sunflower seeds, miso (soybean paste), green tea, and a variety of seafood. This test replaces some vegetables in the general IgG Food Allergy Test with more common Asian vegetables, such as the shiitake mushroom, and adds a new “spices” food category. The Asian panel also analyzes twice as many seafood items than the general test, ranging from oysters and clams to Pacific saury.
*See IgE section on page 21 for more details. Lettuce
Clinical Usefulness
IgG Food Allergy Test + IgE Food Allergy Cane SugarEssential Test (12): 3 mL of
■ ■ ■ ■ ■ ■ ■
Walnut
Celery
When ordering an IgG Food Allergy Test in serum, patients have Eggplant the option of adding our IgE Food Allergy Essential Test (12)* for a Garlic discounted price. Green Pepper Onion
Specimen Requirements Potato PumpkinSST or in a royal blue-topped Serum: 1 mL of serum in a gold-topped Radish no-additive tube. Spinach - or Sweet Potato
Dried Blood Spot (DBS): Five full circles of blood on the protein saver Tomato card. Miscellaneous - or Candida Albicans serum in a gold-topped SST or inCocoa a royal blue-topped no-additive tube.
Promote non-invasive, food-based therapy Eliminate allergy triggers Reduce the burden on the immune system Reduce gut inflammation Reduce food cravings Improve assimilation of nutrients Reduce food mediated behaviors
Coffee
CPT Codes
Honey Mushroom
86001*93 86628 86671*2 Yeast, Bakers * No Medicare Coverage Yeast, Brewers * *For add-on IgE Food Allergy Essential Test (12): 86003*12 *Saccharomyces cerevisiae Not Significant Low Moderate High
Analyte List (93 Foods) ■ ■ ■ ■ ■ ■
■ ■ ■ ■ ■ ■
■
11
Continue
Sunflower
Almond Apple Apricot Asparagus Avocado Baker's Yeast (Saccharomyces cerevisiae) Banana Barley Beef Beet Blueberry Brewer's Yeast (Saccharomyces cerevisiae) Broccoli
www.GPL4U.com
■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■
Buckwheat Succinic Cabbage Candida albicans Cane Sugar Carrot Cashews Casein Celery Cheese Chicken Cocoa Coconut Cod fish Coffee Corn Crab
■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■
Cranberry Eggplant Egg White Egg Yolk Flax Garbanzo Beans Garlic Gliadin Goat's Milk Cheese Grape Grapefruit Green Bean Green Pepper Halibut Hazelnut Honey Kidney Bean
■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■
Lamb Lemon Lentil Lettuce Lima bean Lobster Milk Millet Orotic Oat Onion Orange Papaya Pea Peach Peanut Pear
■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■
1.00-1.99 2.00-3.49 3.50-4.99 >=5
Pecan ■ Spinach Testing performed by The Great Plains Laboratory, Inc Pineapple ■ Strawberry the performance characteristics of this test. This test h Pinto Bean ■ Sunflower Pistachio ■ Sweet Potato Plum (Prune) ■ Tomato Pork ■ Tuna Potato ■ Turkey Pumpkin ■ Wheat Gluten Radish ■ Walnut Rice ■ Watermelon Rye ■ Wheat Salmon ■ Whey Sardine ■ Yogurt Sesame Shrimp Sorghum Soybean
gy Test + C. albicans, S. cerevisiae (94)
ntinued 1.67 1.62
Reactivity Summary High
Egg White
Egg Yolk
Candida Albicans
1.98
Milk
Yeast, Bakers *
Yeast, Brewers *
1.92
Whey
Yogurt
Casein
2.50 RequisitionCheese #: 2.01 Requisition #:Lemon Patient Name: 2.16 Moderate Patient Name: Patient Age:Cranberry 2.44
Beef
Goat Cheese
Strawberry
Sorghum
Wheat
Mozzarella Cheese
Patient Age: Wheat Gluten 4.28 Sex: Grapefruit 2.26 Sex:
Celery
Kidney Bean
Time of Collection: Time of Collection:
Lettuce
Gliadin
Rye
Millet
Print Date: Print Date:
Garlic
3.92
PhysicianName: Name: Physician DateofofCollection: Collection: Date
Peanut Barley Com 2.24 prehen sive IgG Foo d Allergy TestCorn + C. albicans, S. cerevisiae (94) Cocoa Comprehensive IgG Food Allergy Test + C. albicans, S. cerevisiae (94) 4.07
2.84
Low
Pinto Bean Nuts 2.37 and Seeds
Sunfl Dairy 2.04 ower Waln Casein 2.38 ut
Green Bean
Lamb
Buckwheat
Honey
Mushroom
Chicken
Salmon
Vegetables Onion Cheese 2.17 Watermelon AspaCheese Goat 1.59 ragus
Tomato Apple
1.62 Pistachio
7.05
Pear
Banana
Radish
Eggplant
Turkey
Green Pepper
Flax
Cabbage
Cashews
Oat2.44
Pecan Carrot
Carro Legumes - Beans and Peas 3.57 t Celer Garbanzo Bean 1.98y Eggp Green Bean 3.13lant
1.67
Sesame 7.15
5.91 1.98 Broccoli 9.39 1.92 Cane Sugar 4.65 2.50 Potato 8.13 2.01 Orange 7.27 Spinach 2.16
Pineapple Avocado Milk 2.69 Blueberry Broccoli Cheese Mozzarella
Beet Whey 12.84 Cabb Yogurt 2.43 age
Continued
Grape
Pumpkin
Garli Kidney 3.06c Bean Gree 8.62n Pepper Lentil Lettu 8.40ce Lima Bean Onio Pea n Potat Pintoo Bean Pump kin Soybean Radis Fruith
1.96 Beet 4.28 3.34 2.26 4.19 3.92 1.28 2.24 1.22 4.07 1.36 2.84 3.46 2.37 1.69 2.04
2.38 2.60 2.17 Swee t Potato Apricot 1.81 1.59 Toma to Banana 2.39 2.69 Misc ellaneous Blueberry 2.45 ory, Inc., Lenexa, Kansas. The Great Plains Laboratory has developed and determined ida Albic s test has notCand been evaluated by the U.S. Food and Drug Administration. ans Coconut 1.96 12.84 Cane Sugar Cranberry 4.90 2.43 Coco a Grape 2.06 3.57 Coffe e Grapefruit 4.16 1.98 Hone y Lemon 5.40 3.13 Mush room Orange 2.25 3.06 Yeas t, Bake rs * Papaya 1.78 8.62 Yeas t, Brewers * Peach 1.67 8.40 *Sacc Pearharomyces cerevisiae 2.60 Spina Apple ch
Not Significant Pineapple Low (Prune) Plum Moderate Strawberry High Watermelon
1.00-1.99 2.00-3.49 3.50-4.99 >=5
3.24
Corn
3.60
HighGliadin
3.95
Egg White
Egg Yolk
Milk
Yeast, Bakers *
Millet Oat
Candida Albicans
3.84
Yeast, Brewers *
2.11
Whey
Yogurt
Cheese
Casein
Beef
1.70
Lemon
Strawberry
Goat Cheese
3.88
Sorghum
5.09
Wheat
Mozzarella Cheese
Rice Rye
Sorghum
Moderate
Wheat Gluten
Cranberry
Wheat Whea t
Celery
fruit Cod Fish Garlic
Lettuce
Gliadin
Rye
Millet
Barley
Corn
Gluten
Fish Grape
Crab Peanu t
Halibut Cocoa Low
Kidney Bean
Lobster
PintoSalmon Bean
Green Bean
Lamb
Honey
Chick en Shrimp
Mushroom
Salmon
Sesame
Water melon Meat/Fowl
4.72 1.79 0.99 1.85 1.49
Buckw Sardine heat Onion Tuna
4.34
Tomato
Pistachio
Apple
Pear
2.89 1.30 0.99 1.98
PineaBeef pple
Pecan
BluebChicken erry
Broccoli
Carrot
Banan a White Egg EggplEgg ant Yolk
Cane Sugar
Radish
Potato
13.63
Turkey
Green Pepper
Orange
12.91
Lamb
Flax
Cabbage
Spinach
3.25
Pork
Cashews
Grape
Oat
1.68
Turkey
Pumpkin
Beet
2.26
6.39 3.05
Nuts and Seeds Almond
1.86
Cashews
2.12
Flax
2.18
2.59
Hazelnut
1.45
1.69
Peanut
3.77
5.33
Pecan
2.56
2.66
Pistachio
2.66
Sesame
2.85
Grains Barley
Buckwheat
Reactivity Summary
3.61
Testing performed by The Great Plains Labor atory, Inc., Inc., Testing performed by The Great Plains Laboratory, Lenexa, Kansas. Plains Laboratory has developed and determined Lenex a, Kansa s. The The GreatGreat Plains Laboratory has developed and determ the performance characteristics of this ined This This test has the performance characteristics of test. this test. test not hasbeen not been evaluated byU.S. the U.S. and Drug Administration. evalua ted by the FoodFood and Drug Administration.
call: (913) 341-8949
12
Metals Tests Hair Metals Test General Description Heavy metals toxicity, caused by increasing levels of environmental pollution and use of chemicals in industry, is a growing threat to the health and development of children. High levels of toxic metals deposited in body tissues, and subsequently the brain, may cause significant developmental and neurological damage. A Metals Hair Test is ideal for checking current exposure to toxic metals. For example, a study in Poland found a high correlation between hair and brain mercury. Hair provides important information that can assist practitioners with an early diagnosis of physiological disorders associated with aberrations in essential and toxic element metabolism. The U.S. Environmental Protection Agency stated in a recent report that “... if hair samples are properly collected and cleaned, and analyzed by the best analytic methods, using standards and blanks as required, in a clean and reliable laboratory by experienced personnel, the data are reliable” (U.S.E.P.A. 600/4-79-049). The Center for Disease Control acknowledges that hair mercury levels provide a valuable maternal and infant marker for exposure to neurotoxic methylmercury from fish.
Clinical Usefulness ■ Determine if metal toxicity is contributing to a disorder ■ Determine if a deficiency in minerals is inhibiting metabolic processes
Recommendations Depending on test results, follow-up may include: ■ ■ ■ ■ ■
Identification of the source of contamination Elimination of heavy metals from the environment Elimination of heavy metals from the body Mineral supplementation Administration of supplements that support detoxification
Specimen Requirements 1 gram of hair.
CPT Codes Hair: 82108 82300 82525 83018*28 83655 83735 83785 83825 83885 84100 84255 84630 No Medicare Coverage
13
www.GPL4U.com
The Great Plains Laboratory, Inc.
µ
< 8.0 < 0.080 < 0.020 < 0.13 < 0.15 < 1.0 < 0.40 < 0.005 < 0.010 < 0.005 < 0.060 < 0.40 < 0.20 < 0.30 < 1.0
Reportµ Analysis - Hair Metals Test 125- 370 Toxic element representation 12- 30
12- 90 of the toxic metals The greater the elevation 12- greater 40 found in the test, the the risk for 8.0- 16 damage. High accumulation of heavy metals 100- 190 0.20- 0.55 can cause or contribute to chronic illness. 0.26- 0.50 Test results will help identify the source of the 0.030- 0.10 exposure. 0.050- 0.13 0.60- 4.0
Aluminum, Antimony, Barium, 0.25- Arsenic, 1.3 Beryllium, Bismuth, Cadmium, Lead, Mercury, 0.0070.023 250 Platinum, Thallium,160Thorium, Uranium, Nickel, 0.95- 1.7 Silver, Tin, Titanium 0.16- 1.0 45500- 53000 Essential element representation 0.16- 0.80
0.0130.035 Nutritional mineral assessment in hair can 8.0- 19 identify the disruption of transport due to heavy 0.045- 0.065 metals accumulation. deficiency in 0.016-Dietary 0.18 1.0 can seriously inhibit essential minerals0.040(metals) neurotransmission and the body’s ability to eliminate harmful toxins.
Calcium, Magnesium, Sodium, Potassium, Copper, Zinc, Manganese, Chromium, Vanadium, Molybdenum, Boron, Iodine, Lithium, Phosphorus, Selenium, Strontium, Sulfur, Cobalt, Iron, Germanium, Rubidium, Zirconium; Ratios: Calcium/Magnesium, Sodium/Potassium, Zinc/ Copper, Zinc/Cadmium, Calcium/Phosphorus
V06.99
99
Metals Tests Additional Metals Tests
CPT Codes
Blood is routinely checked for metals toxicity; however, blood only reflects very acute and extreme poisoning by metals. Acute metals poisoning is rare. A chronic, low-level exposure to toxic metals, which can result in significant retention in the body, is more common. This can be associated with a vast array of adverse health effects and chronic disease. Cellular damage can occur at much lower levels than what is expressed in blood. We recommend blood only for checking levels of essential minerals and acute exposure to heavy metals.
Whole Blood: 82310 82495 82525 83018*7 83655 83735 83825 84132 84255 84285 84295 84630
Urine testing is recommended to check how well toxic metals are being eliminated after consuming a chelating (metal removing) agent. Analysis of the toxic metals concentrations in urine after the administration of a metal detoxifying agent is an objective way to evaluate the accumulation of toxic metals in body tissues. Fecal testing is recommended for the determination of actual exposure to metals as opposed to the accumulation of metals in the body. Analysis of elements in feces provides indirect information about the potential for toxic metals burden. For many toxic metals, fecal (biliary) excretion is the primary natural route of elimination from the body. Thus, the representation of metals in fecal matter is a reflection of the metals ingested in the diet or excreted into the intestine.
Specimen Requirements Whole Blood: 7 mL of whole blood drawn in a royal blue-topped potassium EDTA tube. Red Blood Cell: 4 mL of packed cells in a royal blue-topped potassium EDTA tube. Urine: 50 mL of urine. Fecal: 35 mL of stool collected in the redtopped vial (with ultra-pure water). Do not overfill the specimen. 4- 30 0.88 0.5- 10 4- 20 > 800
Red Blood Cell: 82175 82300 82310 82495 82525 83015 83018*4 83655 83735 83785 83825 84100 84132 84255 84630 Urine: 82108 82175 82300 82495 82525 82570 83018 83540 83655 83735 83785 83825 83885 84100 84133 84255 84300 84630 Fecal: 82175 82300 82525 83015 83655 83825 83885 No Medicare Coverage (for all metals tests)
Report Analysis - Additional Tests for Metals Whole Blood Essential: Calcium, Copper, Lithium, Magnesium, Manganese, Molybdenum, Selenium, Strontium, Zinc Toxic: Arsenic, Barium, Cadmium, Cobalt, Lead, Mercury, Nickel, Platinum, Silver, Thallium, Uranium
Red Blood Cell Essential: Boron, Chromium, Calcium, Copper, Iron, Magnesium, Manganese, Molybdenum, Phosphorus, Potassium, Selenium, Vanadium, Zinc Toxic: Arsenic, Cadmium, Lead, Mercury, Thallium
Urine Essential: Boron, Calcium, Chromium, Cobalt, Copper, Iron, Magnesium, Manganese, Molybdenum, Phosphorus, Potassium, Selenium, Sodium, Strontium, Sulfur, Vanadium, Zinc Toxic: Aluminum, Antimony, Arsenic, Barium, Beryllium, Bismuth, Cadmium, Cesium, Gadolinium, Lead, Mercury, Nickel, Palladium, Platinum, Tellurium, Thallium, Thorium, Tin, Tungsten, Uranium
Fecal Toxic: Antimony, Arsenic, Beryllium, Bismuth, Cadmium, Copper, Lead, Mercury, Nickel, Platinum, Thallium, Tungsten, Uranium
call: (913) 341-8949
14
Phospholipase A2 Activity Test General Description
Recommendations
Phospholipase Activity Test (PLA2) is one of the key biochemical factors produced in the inflammatory response. It is commonly found in human tissues, as well as insect and snake venom. In infections, PLA2 can break down the phospholipids in the membranes of bacteria, fungi, and parasites leading to their death. However, inflammation, like many other biological processes often has negative effects. The same phospholipase that attacks infectious agents may also attack the cell membranes of the human host, damaging or killing those cells. In addition to PLA2 causing local cell damage, it may be transported by the blood vessels to other parts of the body, causing widespread tissue damage. In normal amounts, PLA2 is involved in remodeling cell membranes and changing cell architecture.
Depending on test results, follow-up may include:
Increased levels of PLA2 have been observed in most systemic inflammatory diseases. Studies have linked an increase in PLA2 activity with multiple sclerosis, rheumatoid arthritis, Crohn’s disease, pancreatitis, ulcerative colitis, allergic disorders, atherosclerosis and cardiovascular disease, as a marker for lung, prostate, small intestine, and large intestine cancers, and as an indicator of increased susceptibility to metastases, Candida infection, asthma, autism, chronic pulmonary obstructive disorder (COPD), and sepsis.
■ Further testing to determine if inflammation may be caused by bacterial or fungal infection, food allergies, inhalant allergies, heavy metal toxicity, nutritional deficiencies, or metabolic dysfunction ■ Dietary modification to eliminate food allergens and reduce inflammation ■ Nutritional supplementation including vitamin E and the omega-3 fatty acids EPA and DHA ■ Treatment with CDP-choline (shown to inhibit PLA2’s ability to promote inflammation) ■ Antioxidant and/or detoxification therapy
Specimen Requirements 10 mL of first morning urine before food or drink.
CPT Codes 84999 No Medicare Coverage
Clinical Usefulness ■ Determine if PLA2 activity is increased ■ Reduce inflammation and burden on immune system ■ Prevent and reverse chronic disease caused by inflammation
Report Analysis
Requisition #:
Physician Name:
800348
Date of Collection:
12/30/1899
Patient Age:
43
Time of Collection:
Not Given
Sex:
M
Print Date:
2/2/2015
Patient Name:
Phospholipase A2 Test
Phospholipase A2
Mean .5
Patient Value PLA2 Activity / Creatinine
Normal
0.345 .1
15
Elevated
.5
1
Secreted Phospholipase A2 (sPLA2) has been implicated in many diseases because of its role in inflammation and host defense. sPLA2 is found in many mammalian tissues as well as insect and snake venom. sPLA2 catalyzes the release of arachidonic acid and is involved in the production of prostaglandins for inflammation. sPLA2 is present in connection with multiple diseases including rheumatoid arthritis, sepsis, psoriasis, pancreatitis, cancer, Crohn’s disease, and multiple sclerosis.
www.GPL4U.com There has been a great deal of research done by both academia and pharmaceutical companies to find chemical
inhibitors to sPLA2. However, there has also been research on more natural methods for inhibiting sPLA2 . Analysis has shown that treatment with supplements of Cytidine 5’-Diphosphocholine (CDP-choline) can limit the ability of
5
PLA2 The median value of PLA2 activity for patients is 0.5. Any ratio over 1.0 is considered high and supplementation with CDP-Choline is recommended to reduce inflammation and PLA2 levels. Patients with values over 1.0 may also want to consider other tests to determine underlying causes of inflammation and elevated PLA2 activity.
Gluten / Casein Peptides Test General Description
Recommendations
Peptides are incompletely degraded pieces of protein. The peptides from gluten and casein are important because they can react with opiate receptors in the brain, mimicking the effects of opiate drugs like heroin and morphine. These compounds, called neuropeptides, have been shown to react with areas of the brain such as the temporal lobes, which are involved in speech and auditory integration. Neuropeptides also reduce one’s ability to feel pain and influence cognitive function.
Depending on test results, follow-up may include:
Many people with food allergies to milk and wheat also experience the opiate-like effect of gluten and casein neuropeptides. Others experience this effect in the absence of milk and wheat allergies. Thus, it is wise to complete both peptide and food allergy testing.
Clinical Usefulness ■ Determine whether cognitive or behavioral abnormalities may be due to the presence of opiate peptides ■ Identify the factors that may be contributing to digestive issues ■ Determine if wheat and dairy products are properly digested ■ Predict the success of a gluten-free and casein-free diet
■ ■ ■ ■
Restriction of gluten and casein from the diet Administration of digestive enzymes Nutritional counseling Calcium supplementation
Specimen Requirements 10 mL of first-morning urine before food and drink. The patient must discontinue soy proteins one week prior to collection of specimen (soy bean oil and soy lecithin are considered acceptable).
CPT Codes 82570 83519*2 No Medicare Coverage
Report Analysis Gliadorphin (or gluteomorphin) is a peptide derived from the wheat protein gluten. Other related grains such as rye, barley, and oats also contain the sequence of amino acids found in gluten. Casomorphin is a peptide derived from the milk protein casein. Casein is one of the major proteins in the milk of all mammals, including cows, goats, and humans. The composition of casomorphin and gliadorphin are very similar. Both casomorphin and gliadorphin contain a sequence of seven amino acids, including the sequence tyrosine and proline at the N-terminus, and proline at positions 4 and 6. These incompletely digested peptides are structurally similar to the opiate receptors in the brain. Once absorbed, they can alter behavior and other physiological reactions. Individuals consuming large amounts of soy may have high values of casomorphin and gliadorphin in the urine presumably because the peptides from soy are structurally similar or identical to those in gluten and casein.
call: (913) 341-8949
16
Hormone Panels General Description
Recommendations
Hormones are essential for our overall well-being. Sex hormones and the adrenal (stress) hormones are subject to change due to age, environmental stress, and other factors. DHEA and cortisol are the main adrenal stress hormones. The primary sex hormones are the three main estrogens (Estrone, Estradiol, and Estriol) and testosterone. We frequently think of estrogen as being a female hormone and testosterone as being a male hormone, but men and women make both, plus several more that must be in balance for optimum health.
Depending on test results, follow-up may include:
An imbalance of any hormone can throw physical and mental health out of balance, causing aggravating and even serious health problems. For decades Western medicine has prescribed Hormone Replacement Therapy as a “one size fits all” approach. However, hormones are like fingerprints, and in order to achieve optimum health, people should be aware of their specific imbalances.
■ Adjustments in hormone therapy ■ Lifestyle changes ■ Symptom relief therapy
Specimen Requirements Saliva: 3/4 Saliva Tube full x4
CPT Codes Comprehensive Plus Panel: 82679 82670 82677 84144 84402 82626 82530*4 Comprehensive Panel: 82670 84144 84402 82626 82530*4 Short Comprehensive Panel:
Being able to identify a hormonal imbalance is essential to designing an effective treatment plan. If a patient is seeking bio-identical hormone replacement therapy (BHRT) or a topical hormone therapy, free hormone levels should be assessed first before proceeding with a particular therapy.
Clinical Usefulness ■ ■ ■ ■
Determine if there are hormonal imbalances Determine if there is estrogen dominance Monitor exogenous hormone therapies Assess disruption of optimum diurnal cortisol patterns
82670 84144 84402 82626 82530*2
Report Number: -SMP01
Patient Info: Amber Sample H
Provider: Labrix Clinical Services, Inc 16255 SE 130th Ave Clackamas, OR 97015 Ordering Provider:
Age:28 Gender:F Menopausal Status: amber.sample@sample.com 123 A St. Suite B Portland, OR 97123
Saliva Hormone Test
Result
Units
Estrone (E1) Estradiol (E2) Estriol (E3) EQ (E3 / (E1 + E2)) Progesterone (Pg) Ratio of Pg/E2 Testosterone
6.00 6.48 30.00
pg/ml pg/ml pg/ml
200.00
pg/ml
56.00
pg/ml
DHEA Cortisol Morning Cortisol Noon Cortisol Evening Cortisol Night
252.60 41.00 15.00 2.00 0.80
pg/ml nmol/L nmol/L nmol/L nmol/L
L
WR
H
Sample Collection Morning Noon Evening Night
Date/Time 06/25/2012 0530 06/25/2012 1130 06/25/2012 1745 06/25/2012 2200
Samples Arrived Results Reported
06/26/2012 06/28/2012
Reference Range 7.2-40.6 pre menopausal 1.5-10.8 supplementation <30.0 female, non-pregnant
127.0-446.0 pre menopausal (luteal)
6.1-49.0 female
Report Number: -S0052 106.0-300.0 female
Patient Info: Aurora Sample
5.1-40.2; optimal range: 18-35* Provider: 2.1-15.7; range: 6-12* The Greatoptimal Plains Laboratory Inc 11813 77th Street 1.8-12;West optimal range: 4-8* Lenexa, KS 66214 0.9-9.2; optimal range:USA 2-6*
Age:52 Gender:F
Hormone Interpretations: Saliva Hormone Test
Menopausal Status: Post-Menopause
Result
Units
Estrone (E1)
WR
H
Short Comprehensive Panel (for men + women): ■ DHEA ■ Cortisol (2x a day)
Cortisol Evening Cortisol Night
Notes:
■ Add 4x cortisol
Comprehensive Plus Panel (for women only):
Hormone **The Pg/E2 ratio is an optimal range established based on clinical observation. Progesterone supplementation is generally
18.0-126.0 post menopausal (500-3000 supplementation) 200-600 post menopausal (Pg supplementation)** 6.1-49.0 female (30.0-60.0 supplementation)
106.0-300.0 female 5.1-40.2; optimal range: 18-35*
1.8-12; optimal range: 4-8*
Interpretations:
required to achieve this level in men and postmenopausal women.
Notes: L=Low(below range) WR=Within Range (within range) H=High (above range) DHEA, Testosterone, Estrone and Estriol results are for investigational use only. *Apply only when all four cortisols are measured. Clinical interpreations may override these generalized optimal ref. ranges.
Samples Date/Time Patient Info: **The Pg/E2 ratio is an optimal range established based on clinical observation. Progesterone supplementation is generally David Sample Morning 11/07/2005 required to achieve this0800 level in men and postmenopausal women. Gender: M Age: 46 Noon 11/07/2005 1230 Provider: Menopausal Status: Evening 11/07/2005 1820 Just Hormones None 232323 SW Hormone St. Night 11/07/2005 2350 Mesa, AZ 85215 The Great Plains Laboratory Inc | Analyzed by Labrix Clinical 87654 NE Balanced StreetServices, Inc. ADDRESS: 16255 SE 130th Avenue | Clackamas, OR 97015 Date Samples 11/10/2005 Suffern, fffern, NJ 10901
Report Number: 09-999
Saliva Hormone Test T
Result
Units
Estradiol [E2]
<1.0
pg/ml
L
Progesterone
35.9
pg/ml
Ratio of Pg/E2
35.9
T Testosterone
46.1
pg/ml
DHEA
61.3
pg/ml
X
Cortisol Morning
4.0
nmo/L
X
Cortisol Noon
4.7
nmo/L
Cortisol Evening
1.5
nmo/L
X
Cortisol Night
<0.3
nmo/L
X
WR
Date Results
11/11/2005
Reference Range (1) 1.0-3.2 post-menopausal; (2) 1.0-10.8 pre-menopausal; (3) 1.5-10.0 replacement therapy; (4) <2.5 males
X
(1) 18-51 post-menopausal; (2) 127-446 pre-menopausal-luteal; (3) 500-3000 supplementation; (4) <94 males
(1) 200-600 females; (2) 200-300 males;
X
(1) 30.1-142.5 males; (2) 4.5-49 females; (3) 30-60 therapy females; (4) 250-350 therapy males; (1) 137-336 males; (2) 106-300 females; (1) 5.1-40.2; Optimal Range: 18-35*
X
*DHEA, T Testosterone and Estriol results are for investigational use only
H
X X
(1) 2.1-15.7; Optimal Range: 6-12* (1) 1.8-12; Optimal Range: 4-8* (1) 0.9-9.2; Optimal Range: 2-6* L=Low (below reference range)
WR=Within Within Range (within reference range) W
H= High (above reference range)
* Apply only when all four cortisols are measured. Clinical interpretations may override these generalized optimal reference ranges.
The Great Plains Laboratory Inc | Analyzed by Labrix Clinical Services, Inc. ADDRESS: 16255 SE 130th Avenue | Clackamas, OR 97015
Interpretations:
Cortisol Graph 50
• The low Pg/E2 ratio is consistent with estrogen dominance, which increases the risk of prostate gland enlargement and cancer. Supplementation with topical progesterone to correct this relative
40
(nmo/L)
30
with metabolic syndrome (insulin resistance). Fasting blood sugar and insulin levels may be warranted. Boosting the testosterone level is a consideration.
20
• DHEA A level is consistent with the expected decline with age (adrenopause). The low DHEA A level may warrant supplementation for optimal well-being. Note: Supplementation with DHEA may increase testosterone and/or estradiol levels.
10
• Diurnal cortisol pattern and reported symptoms are consistent with established (Phase 3) adrenal
0
G
NIN
OR
M
ON
NO
G
IN
EN
EV
HT
NIG
ruled out.
The Great Plains Laboratory Inc | Analyzed by Labrix Clinical Services, Inc. ADDRESS: 16255 SE 130th Avenue | Clackamas, OR 97015
www.GPL4U.com
06/15/2012 06/18/2012
1.0-3.2 post menopausal (1.5-10.8 supplementation)
nmol/L nmol/L
*Apply only when all four cortisols are measured. Clinical interpreations may override these generalized optimal ref. ranges.
■ Add: Estrone, Estriol
17
Samples Arrived Results Reported
Reference Range
DHEA, Testosterone, Estrone and Estriol results are for investigational use only.
Phone: Not available
Comprehensive Panel (for men + women):
11.30
L=Low(below range) WR=Within Range (within range) H=High (above range)
Adrenal Phase:
Date/Time
pg/ml
Estrone and estradiol are within the reference ranges, however the Estrogen Quotient (EQ) is suboptimal. 1.00 (as indicated pg/ml Estradiol (E2)present in sufficient quantities Estriol is less potent than the other estrogens and when by an Estriol (E3) optimal EQ) it plays an antagonistic role, and may govern the proliferative effects of estrone andpg/ml estradiol. Although estriol level is above the reference range (likely to individual variance), estriol supplementation EQ (E3 / (E1 + do E2)) is a consideration to optimize this quotient and reduce associated upon 47.00 available pg/ml Progesterone (Pg) risks. * References request. 47.00 Ratio of Pg/E2 Progesterone to estradiol (Pg/E2) ratio and reported symptoms are consistent with estrogen dominance. 11.90 pg/ml Testosterone Supplementation with topical progesterone to correct this relative deficiency is a consideration. DHEA level is consistent with stress response or supplementation (not reported), although metabolic 78.40may be warranted. pg/ml syndrome cannot be ruled out. Serum DHEA vitamin D, fasting glucose and insulin testing 12.10 nmol/L Cortisol Morning Adrenal gland function appears reasonably adequate. Query thyroid insufficiency (perhaps related to iodine deficiency). nmol/L Cortisol Noon
Report Analysis ■ Estradiol (estrogen) ■ Progesterone ■ Testosterone
L
Sample Collection Morning Noon Evening Night
Amino Acids Tests General Description
Specimen Requirements
The Amino Acids Urine and Plasma Tests can be utilized by the medical practitioner for different purposes. Urinary amino acids are discarded by the body as excess or “waste,” while amino acids present in plasma indicate availability for building structural, transport, and storage proteins. Amino acids also play a role in neurotransmitter functioning, cholesterol and carbohydrate metabolism, and detoxification processes.
Urine: 25 mL of first-morning urine before food or drink. The patient should discontinue amino acid supplementation 24 hours prior to collection. - or -
Clinical Usefulness
CPT Codes
■ Determine the availability of essential/conditionally indispensable amino acids ■ Evaluate urea cycle metabolites ■ Assess the efficiency of B6, B12, and folate-dependent enzymes ■ Identify the level of magnesium-dependent markers ■ Measure nonessential amino acids levels ■ Evaluate protein digestion and absorption
Plasma: 7 mL of whole blood in a lavender-topped EDTA tube. Specimen must be returned within 24 hours of the collection. This test is only available in the US.
82139*1 82140 82492 84540
Recommendations Depending on test results, follow-up may include: ■ ■ ■ ■ ■ ■
Dietary modification Modification of vitamin and antioxidant intake Magnesium supplementation Probiotic supplementation Digestive enzyme supplementation Follow-up tests for metabolic syndromes
Report Analysis
The Great Plains Laboratory, Inc.
Essential/conditionally indispensable amino acids reflect dietary intake.
45- 225 5- 160 9000- 39000 µM
Nonessential amino acids reflect assimilation of proteins and usage by the body. Gastrointestinal markers determine the availability of proteins involved in the assimilation of nutrients.
µ
7- 35 35- 500 60- 230 18- 70
Magnesium-dependent markers indicate the synthesis of amino acids that require magnesium.
8- 35 12- 50 25- 75 20- 75 170- 1200
B6, B12, and folate dependent markers indicate the metabolism of amino acids that require these co-factors.
20- 57 8- 50 270- 1150
µ
Detoxification markers indicate the availability of amino acids involved with trans-sulfuration pathway. Neurological markers indicate the availability of the amino acids needed for the synthesis of neurotransmitters. Urea cycle metabolites indicate the availability of amino acids needed for ammonia detoxification.
100- 500 20- 70 50- 225 180- 530 5- 45 20- 90 400- 1800 30- 150 130- 400 1- 45
call: (913) 341-8949
18
Vitamin D Test General Description
Recommendations
Vitamin D is a generic term that includes several metabolically related sterol substances that have hormonal activity. The metabolite 25-hydroxyvitamin D is the major circulating form of vitamin D in the body and the best indicator of a patient’s status due to its long half-life (2-3 weeks). The major biologic function of vitamin D is to maintain normal blood levels of calcium and phosphorus involved in bone mineralization. Vitamin D also controls more than 1,000 genes, including those responsible for the regulation of cellular proliferation, differentiation, apoptosis, and angiogenesis. The immune-modulating effects of vitamin D are profound as evidenced by the many conditions associated with vitamin D deficiency.
Depending on test results, follow-up may include:
Clinical Usefulness ■ ■ ■ ■
Determine if dietary vitamin D is sufficient Determine if sun exposure is adequate Determine if supplementation is reaching toxic levels Assess the likelihood of malabsorption, liver disease, and nephrotic syndrome
Report Analysis Vitamin D Two forms of vitamin D (25-OH-VitD2 and 25-OH-VitD3) are measured in this analysis. Vitamin D is obtained from foods of animal origin and from ultraviolet light-stimulated conversion of 7-dehydrocholesterol in the skin. Small amounts of vitamin D are obtained from foods of plant origin. Vitamin D is used to fortify various foods and is available in over-the-counter supplements. Desirable values are 25-80 ng/mL. Mild to moderate deficiency values are 10-24 ng/mL. Values below 10 ng/mL indicate severe deficiency, and values over 80 ng/mL indicate possible toxicity.
19
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■ ■ ■ ■ ■
Addition of vitamin D supplementation Increased sun exposure Discontinuation of supplementation Dietary modifications Additional testing
Specimen Requirements Serum: 2 mL of serum in a gold-topped SST. - or Dried Blood Spot (DBS): Five full circles of dried blood on the protein saver card.
CPT Codes 82306 82542 No Medicare Coverage
Advanced Cholesterol Profile General Description
Recommendations
The concept of “good” and “bad” cholesterol depends highly on the circumstances of the individual person. Although very high blood serum cholesterol values are associated with heart disease, low values (below 160 mg/dl) are associated with increased violent behavior, suicide, depression, anxiety, bipolar disease, Parkinson’s disease, and increased mortality from cancer. Low cholesterol values are also associated with manganese deficiency, Celiac disease, hyperthyroidism, liver disease, malabsorption, and malnutrition.
Depending on test results, follow-up may include:
Clinical Usefulness ■ ■ ■ ■ ■ ■
Determine whether a cholesterol deficiency is present Determine if cholesterol is elevated Identify the presence of abnormalities in cholesterol transport Determine if the body is eliminating homocysteine Identify risk factors for vascular and neurological disease Assess risk of having a premature baby
Report Analysis Total cholesterol: Total cholesterol measures all types of cholesterol.
■ Dietary modification ■ Supplementation ■ Follow-up/confirmational testing
Specimen Requirements 2 mL of serum in a gold-topped SST or in a royal blue-topped noadditive tube.
CPT Codes 82172*2 82465 83090 83695 83718
The Great Plains Laboratory, Inc. William Shaw, Ph.D Director
11813 W. 77th Street, Lenexa, KS 66214
(913) 341-8949
Fax (913) 341-6207
Apolipoprotein A-I (Apo A-I): The main protein component of HDL (high density lipoprotein). Apolipoprotein B (Apo B): The main protein component of LDL (low density lipoprotein). Lipoprotein (a) (Lp (a)): Consists of two components: LDL and a glycoprotein, linked by a disulfide bridge. Homocysteine (Hcy): A sulfur-containing amino acid that can be converted to methionine by methionine synthetase or homocysteine methyltransferase. High homocysteine is a risk factor for cardiovascular diseases. Each result is reported as low, intermediate, or high according to the ranges established. Reference chart: Values are deemed significant according to the age and sex of the patient. A comprehensive chart is included with the test results.
call: (913) 341-8949
20
IgE Food and Inhalant Allergy Tests General Description Type one, or “classic,” allergy causes redness, swelling, and heat in the body as a result of the elevated blood levels of Immunoglobulin E (IgE). Contrary to popular belief, the symptoms produced by IgE can be subtle and similar to those seen in other conditions. This potential confusion makes diagnostic testing very important in recognizing the offending source. The Advanced IgE Tests increase the chance that a patient may identify numerous offending foods and/or inhalants, including Thimerosal and Candida.
Clinical Usefulness ■ ■ ■ ■ ■ ■
Promote non-invasive, food-based therapy Eliminate allergy triggers Reduce the burden on the immune system Reduce inflammation Reduce food cravings Improve assimilation of nutrients
Recommendations Depending on test results, follow-up may include: ■ ■ ■ ■ ■ ■ ■ ■
Elimination of the offending foods Elimination of the offending inhalants Immune system support Gut restoration Implementation of a rotation diet Supplementation Administration of antihistamines Use of air purifiers
Specimen Requirements IgE Food Allergy Tests: 2 mL (Essential), 5 mL (Basic), or 8 mL (Advanced) of serum in a gold-topped SST or royal blue-topped no-additive tube. The elimination of a food will reduce the ability for our laboratory to detect antibodies (allergies) to that food. IgE Inhalant Allergy Tests: 5 mL (Basic) or 8 mL (Advanced) of serum in a gold-topped SST or royal blue-topped no-additive tube.
CPT Codes IgE Food Allergy Tests: 86003*12 86003*25 86003*93 IgE Inhalant Allergy Tests: 86003*36 86003*69 IgE Allergy Advanced Combined: 86003*162 No Medicare Coverage
Report Analysis IgE Food Allergy Essential Test (12)
Almond, Beef, Chicken, Corn, Eggwhite, Milk, Orange, Peanut, Shrimp, Soybean, Tomato, Wheat
IgE Food Allergy Advanced Test (93)*
Almond, Apple, Apricot, Asparagus, Avocado, Banana, Barley, Beef, Beet, Blueberry, Broccoli, Buckwheat, Cabbage, Cane Sugar, Carrot, Casein, Cashews, Celery, Cheese, Chicken, Coconut, Cod Fish, Cocoa, Coffee, Corn, Crab, Cranberry, Eggplant, Egg White, Egg Yolk, Flax, Garbanzo Bean, Garlic, Gluten, Goat’s Milk Cheese, Grape, Grapefruit, Green Bean, Green Pepper, Halibut, Hazelnut, Honey, Kidney Bean, Lamb, Lemon, Lentil, Lettuce, Lima Bean, Lobster, Mango, Milk, Millet, Mushroom, Oat, Onion, Orange, Papaya, Pea, Peach, Peanut, Pear, Pecan, Pineapple, Pinto Bean, Pistachio, Plum, Pork, Potato, Pumpkin, Radish, Raisin, Rice, Rye, Salmon, Sardine, Sesame, Shrimp, Soybean, Spinach, Strawberry, Sunflower, Sweet Potato, Tomato, Turkey, Tuna, Walnut, Watermelon, Wheat, Whey, Yogurt, Yeast (Bakers), Yeast (Brewers), Zucchini *Analytes in bold are included in the IgE Food Allergy Basic Test (25)
IgE Inhalant Allergy Advanced Test (69)*
Acacia, Alder (Smooth), Alternaria, Amoxicillin, Ash (White), Aspergillus, Bahia Grass, Bermuda Grass, Bluegrass (Kentucky), Box Elder (Maple), Brome Grass, Candida, Cat, Cedar (Mountain), Cladosporium, Cocklebur, Cockroach, Corn (Cultivated), Cottonwood Tree, Cypress (Bald), Dockweed (Yellow), Dog, Elm (American and Fall Blooming), Ferret, Fescue (Meadow), Gerbil, Goldenrod, Hickory (White), House Dust, Iodine Bush, Johnson Grass, Lamb’s Quarters, Maple (Red), Marsh Elder (Rough), Mexican Tea, Mite (D. Farinae), Mouse, Mulberry (Red and White), Nettle, Oak (Live, White, and Red), Oats, (Cultivated), Oat Grass Tall, Pecan Tree, Penicillium, Pigweed (Spiny and Rough), Plantain (English), Poplar (White), Privet, Rabbit, Ragweed (Giant and Short), Rye (Cultivated), Rye Grass (Perennial), Salt Cedar, Salt Grass, Sheep Sorrel, Sweet Gum, Sycamore, Timothy Grass, Tree of Heaven, Walnut (Black), Western Water Hemp, Wheat (Cultivated), Willow (Black) *Analytes in bold are included in the IgE Inhalant Allergy Basic Test (36)
IgE Allergy Advanced Combined Test (162)
The IgE Allergy Advanced Combined Test is a combination of both the IgE Food Allergy Advanced Test (93) and the IgE Inhalant Allergy Advanced Test (69).
21
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Comprehensive Stool Analysis General Description The Comprehensive Stool Analysis detects the presence of pathogenic microorganisms such as yeast, parasites, and bacteria that contribute to chronic illness and neurological dysfunction. It provides helpful information about prescription and natural products effective against specific microorganism strains detected in the sample. The test also evaluates beneficial bacteria levels, intestinal immune function, overall intestinal health (occult blood, short chain fatty acids, pH, and mucus), and inflammatory markers.
Parameters for digestion and absorption Cultures for bacteria Cultures for yeast Parasite testing Sensitivity panels Inflammatory markers Stool metabolic markers Infectious pathogens
73 possible species of imbalanced and dysbiotic bacteria, 6 species of beneficial bacteria.
Yeast (mycology) culture 48 possible yeast and fungal species.
Parasite isolation
Inflammatory markers Findings can indicate whether the individual has moderate or high inflammation in the gut lining. These markers are helpful in diagnosing irritable bowel syndrome as well as transient inflammation due to acute illness.
Immunology
Recommendations
Secretory Immunoglobulin A (sIgA) is the primary antibody of the GI tract. This is the primary defense in our assimilation of food particles versus pathogens. Low levels can predispose a person to infections and bowel disease.
Depending on test results, follow-up may include: ■ ■ ■ ■ ■ ■ ■
Bacterial culture
22 possible parasites, markers of digestion and absorption. Findings can indicate if an individual has pancreatic insufficiency and provide information regarding macronutrient absorption.
Clinical Usefulness ■ ■ ■ ■ ■ ■ ■ ■
Report Analysis
Antifungal agents Antibiotic agents Antiparasitic agents Probiotics Digestive enzymes Follow-up/confirmational tests Nutritional supplements
Short chain fatty acids Short chain fatty acids result from the fermentation of dietary fiber by beneficial bacteria. These fats play an important role in the health of the GI tract as well as protecting against disease.
Intestinal health markers These markers can be elevated in infection, cancer, and colitis.
Specimen Requirements
Yeast
The sample must be collected on two separate days (at least 12 hours apart). The specimen must be received within 10 days of the first collection, but it is preferred within five days of collection. It is recommended to discontinue use of any antibiotic and antifungal products two weeks before sample collection. The patient must also discontinue digestive enzymes, antacids, iron supplements, vitamin C over 250 mg, aspirin, anti-inflammatories, and large amounts of meat 48 hours prior to the collection of the specimen.
The microscopic examination of yeast identifies the visible presence of yeast cells.
CPT Codes
Amoxicillin, Ampicillin, Augmentin, Ciprofloxacin, Trimethsulfa, Berberine, Black Walnut, Caprylic Acid, Cats Claw, Citrus Seed Extract, Goldenseal, Oregano, Uva Ursi
†
†
†
†
82272 82492 82656 83516 83631 83986 85549 87045 87046 † 87102 87177*2 87209*2 87328 87329 89125 89160 † No Medicare Coverage
Yeast sensitivity to: Fluconazole, Itraconazole, Ketoconazole, Nystatin, Berberine, Caprylic Acid, Goldenseal, Oregano, Tanalbit, Undecylenic Acid, Uva Ursi
Bacterial sensitivity to:
For Staphylococcus aureus: Benzypenicillin, Oxacillin, Tetracycline, Trimeth-sulfa, Vancomycin, Berberine, Black Walnut, Caprylic Acid, Cats Claw, Citrus Seed Extract, Goldenseal, Oregano, Uva Ursi
call: (913) 341-8949
22
Copper / Zinc Profile General Description
Recommendations
The Copper/Zinc Profile is an excellent way to assess immune status and the nutritional intake and/or absorption of zinc and copper. Zinc is an essential trace element required for the activity of more than 300 enzymes. It is necessary for proper functioning of the immune system and is involved in most major metabolic pathways. Zinc has an inverse relationship with copper in the body. As zinc status decreases, copper status increases, and vice versa. Adequate copper levels are essential for the growth of new blood vessels, wound healing, and recovery from heart attacks and strokes. When levels are only slightly above normal physiological amounts, copper can be toxic. Any mild abnormality or impairment of liver function can lead to copper excess.
Depending on test results, follow-up may include:
Clinical Usefulness
82390 82525 84630
■ ■ ■ ■ ■
Zinc supplementation Copper supplementation Dietary modification Molybdenum salt supplementation Administration of penicillamine to reduce copper excess
Specimen Requirements 3 mL of serum drawn into a royal blue-topped no-additive tube.
CPT Codes
■ Assessment of zinc status ■ Assessment of copper status and toxicity ■ Assessment of immune status
Immune Deficiency Profile General Description
Recommendations
Individuals with recurrent infections, otitis media, asthma, and certain genetic disorders may have an immune deficiency or imbalance contributing to their disorder. Immunodeficiency predisposes an individual to intestinal yeast overgrowth, opportunistic infection, and poor health. An overactive immune system is a major contributor to severe environmental allergies and may contribute to the development of autoimmune diseases such as rheumatoid arthritis and lupus.
Depending on test results, follow-up may include:
Clinical Usefulness ■ ■ ■ ■ ■
Assess the adequacy of immunoglobulin levels Determine whether high levels of immunoglobulin are present Assess the adequacy of zinc levels Assess the potential for allergies Determine whether the individual is at risk for infection
■ Follow-up allergy testing in those with high levels of IgG or IgE ■ Supplementation with zinc and selenium ■ Supplementation with lactoferrin and colostrum ■ IV administration of gamma globulin and IgG ■ Administration of Transfer Factor ■ Supplementation with L-Glutathione, coenzyme Q10, and N-acetylcysteine
Specimen Requirements 3 mL of serum collected in a royal blue-topped no-additive tube.
CPT Codes 82784 82785 82787*4 84630
23
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Comprehensive Fatty Acids Test General Description
Recommendations
This comprehensive test profiles mitochondrial and peroxisomal fatty acid metabolism and the patient’s nutritional status. The report includes 30 markers and total levels of saturated, monounsaturated, polyunsaturated, omega-3, and omega-6 fatty acids. Essential fats play an important role in regulating inflammation, forming cell membranes, and in the optimal function of the brain, nerves, eyes, skin, connective tissue, and blood vessels.
Depending on test results, follow-up may include:
Clinical Usefulness
Specimen Requirements
■ Monitoring treatment of essential fatty acid deficiency ■ Monitoring the response to provocative tests, such as fasting or loading tests
2 mL of serum in a gold-topped or blue-topped tube. This test requires an overnight fast, and the patient must avoid alcohol for 24 hours prior to sample collection. The sample must be immediately frozen and shipped with frozen gel pack. This test is only available in the U.S. and Canada.
■ Flaxseed oil as source of ALA from which EPA and DHA are synthesized ■ Fish oil or cod liver oil as direct sources of EPA and DHA ■ Evening primrose oil, borage oil, or black currant oil as sources of GLA if insufficiently synthesized ■ Hemp oil as source of both ALA and GLA
CPT Code 82544*30 No Medicare Coverage
Requisition #:
Physician Name:
Patient Name:
Date of Collection:
Patient Age:
Time of Collection:
Sex:
Print Date:
Comprehensive Fatty Acids Panel - Serum Common Name
Patient Result
Low
Lipid Name
Reference Range
Units
1 alpha-Linolenic Acid (ALA)
C18:3 (n-3)
20 - 120
76
umol/L
2 Eicosapentaenoic Acid (EPA)
C20:5 (n-3)
8 - 90
30
umol/L
3 Docosapentaenoic Acid (DPA)
C22:5 (n-3)
30 - 270
35
umol/L
4 Docosahexanoic Acid (DHA)
C22:6 (n-3)
30 - 160
119
umol/L
5 Linoleic Acid (LA)
C18:2 (n-6)
1600 - 3500
3181
umol/L
6 gamma-Linolenic Acid (GLA)
C18:3 (n-6)
9 - 130
32
umol/L
7 dihomo-gamma-Linolenic Acid (DGLA)
C20:3 (n-6)
60 - 220
60
umol/L
8 Arachidonic Acid (ARA)
C20:4 (n-6)
350 - 1030
648
umol/L
9 Docosapentaenoic Acid (DPA)
C22:5 (n-6)
10 - 50
5
umol/L
L
C22:4 (n-6)
10 - 40
9
umol/L
L
High
Reference Range
Omega-3 Polyunsaturated Series
Omega-6 Polyunsaturated Series
10 Docosatetraenoic Acid
Page 1 of 5
call: (913) 341-8949
24
The GPL3 profile includes the following valuable tests: ■ Organic Acids Test - 74 markers ■ IgG Food Allergy Test - 93 markers plus Candida ■ Metals Hair Test - 50 markers
General Description
CPT Codes
This panel provides a thorough assessment of the patient’s overall health regarding their metabolism, vitamin and mineral levels, food allergies, and metal toxicity. Testing for organic acids, IgG food allergies, and metals is crucial to detect any deficiencies within the body. With the GPL3 panel, no blood draw is required. Included in the GPL3 is the Organic Acids Test, IgG Food Allergy Test (Dried Blood Spot), and Metals Hair Test.
82108 82131 82300 82507 82525 82570 83018*28 83150 83497 83605 83655 83735 83785 83825 83885 83921*63 83945 84100 84207 84210 84255 84585 84591 84630 86001*93 86628 86671*2 No Medicare Coverage
Specimen Requirements Urine: 10mL of first morning urine before food or drink. Patient must avoid apples, grapes (including raisins), pears, cranberries, and their juices 24 hours prior to specimen collection. Dried Blood Spot (DBS): Five full circles of blood on the protein saver card. Hair: 1 gram of hair
Requisition #:
273466
LAB#: PATIENT: ID: SEX: AGE:
Physician:
Patient Name:
Date of Collection:
07/30/2012
Patient Age:
4
Time of Collection:
08:00 AM
Patient Sex:
F
Print Date:
08/02/2012
Metabolic Markers in Urine
Reference Range
Patient Value
(mmol/mol creatinine)
Intestinal Microbial Overgrowth
Citramalic
≤
5.3
3.1
5-Hydroxymethyl-2-furoic
≤
30
7.4
3
3-Oxoglutaric
≤
0.52
0.50
4
Furan-2,5-dicarboxylic
≤
22
8.6
5
Furancarbonylglycine
≤
3.6
0.07
6
Tartaric
≤
3.9
H
9.0
7
Arabinose
≤
56
H
242
8
Carboxycitric
≤
34
1.3
9
Tricarballylic
≤
0.86
0.08
3.1 7.4 0.50
1.1
0.45
≤
30
16
-
2.0
2.0
4-Hydroxyhippuric
≤
27
15
14
Hippuric
≤
717
377
15
3-Indoleacetic
≤
11
6.1
4-Hydroxyphenylacetic 4-Hydroxybenzoic
13
0.09
16
Succinic
≤
15
17
HPHPA (Clostridia Marker)
≤
227
18 19
4-Cresol (C. difficile) DHPPA (Beneficial Bacteria)
Print Date:
≤ ≤
76 0.73
H
0.07 9.0 242 1.3
Buckwheat 7.15
Corn
3.60
7.05
Gliadin
3.95
Goat Cheese
5.91
Millet
3.84
Milk
9.39
Oat
2.11
Mozzarella Cheese
4.65
Rice
1.70
Whey
8.13
Rye
3.88
Yogurt
7.27
Sorghum
5.09
Wheat Gluten
4.34
Wheat
4.72
Garbanzo Bean
1.96
Green Bean
3.34
0.45 16 2.0 15 377 6.1 39
148
148
63 0.29
63
Kidney Bean
4.19
Cod Fish
1.79
Lentil
1.28
Crab
0.99
Lima Bean
1.22
Halibut
1.85
Pea
1.36
Lobster
1.49
Pinto Bean
3.46
Salmon
2.89
Soybean
1.69
Sardine
1.30
2.60
Shrimp Tuna
0.99 1.98
1.81
Meat/Fowl
2.39
Beef
Blueberry
2.45
Chicken
Coconut
1.96
Egg White
13.63
Cranberry
4.90
Egg Yolk
12.91
6.39 3.05
Grape
2.06
Lamb
3.25
Grapefruit
4.16
Pork
1.68
Lemon
5.40
Turkey
2.26
Orange
2.25
Nuts and Seeds
Papaya
1.78
Almond
1.86
Peach
1.67
Cashews
2.12
Pear
2.60
Flax
2.18
Pineapple
2.59
Hazelnut
1.45
Plum (Prune)
1.69
Peanut
3.77
Strawberry
5.33
Pecan
2.56
Watermelon
2.66
Barley
Pistachio
2.66
Sesame
2.85
µ
125- 370 12- 30 12- 90 12- 40 8.0- 16 100- 190 0.20- 0.55 0.26- 0.50 0.030- 0.10 0.050- 0.13 0.60- 4.0 0.25- 1.3 0.007- 0.023 160- 250 0.95- 1.7 0.16- 1.0 45500- 53000 0.16- 0.80 0.013- 0.035 8.0- 19 0.045- 0.065 0.016- 0.18 0.040- 1.0
3.61 Testing performed by The Great Plains Laboratory, Inc., Lenexa, Kansas. The Great Plains Laboratory has developed and determined the performance characteristics of this test. This test has not been evaluated by the U.S. Food and Drug Administration.
Testing performed by The Great Plains Laboratory, Inc., Lenexa, Kansas. The Great Plains Laboratory has developed and determined the performance characteristics of this test. This test has not been evaluated by the U.S. FDA; the FDA does not currently regulate such testing.
Organic Acids Test - Nutritional and Metabolic Profile
Apricot Banana
Grains
0.29
Fish
< 8.0 < 0.080 < 0.020 < 2.0 < 0.15 < 1.0 < 0.40 < 0.005 < 0.010 < 0.005 < 0.060 < 0.40 < 0.20 < 0.30 < 1.0
3.24
Casein
Fruit
0.08
39
µ
Cheese
Apple
≤
2-Hydroxyphenylacetic
Time of Collection:
Sex:
Legumes - Beans and Peas
8.6
Malabsorption and Bacterial Markers 10
Date of Collection:
Patient Age:
Dairy
1 2
12
Physician Name:
Patient Name:
Comprehensive IgG Food Allergy Test + C. albicans, S. cerevisiae (94)
Reference Population - Females Under Age 13
Yeast and Fungal Markers
11
Requisition #:
V06.99
4- 30 0.88 0.5- 10 4- 20 > 800
Page 1 of 9
Organic Acids Test
IgG Food Allergy Test
Metals Hair Test
Clinical Usefulness of the GPL3 & GPL4 ■ ■ ■ ■ ■ ■
25
Detect nutritional or antioxidant deficiencies Understand vitamin and hormone metabolism Assess performance or antioxidant deficiencies Reveal excessive levels of gastrointestinal (GI) yeast and bacteria Promote noninvasive, food-based therapy Reduce the burden on the immune system
www.GPL4U.com
■ Reduce gut inflammation ■ Determine if a deficiency in minerals is inhibiting metabolic processes ■ Determine if dietary vitamin D is sufficient* ■ Assess the likelihood of malabsorption, liver disease, and nephritic syndrome* * only applicable to the GPL4
This extensive profile covers over 150 biomarkers, each carefully explained and addressed in the following tests: GPL4 DBS
GPL4 Serum ■ ■ ■ ■
Organic Acids Test - 74 markers IgG Food Allergy Test - 93 markers plus Candida Metals RBC Test - 18 markers Phospholipase A2 Activity Test - 1 marker
■ ■ ■ ■
- or -
Organic Acids Test - 74 markers IgG Food Allergy Test - 93 markers plus Candida Metals Hair Test - 39 markers Phospholipase A2 Activity Test - 1 marker
General Description
CPT Codes - DBS
The GPL4 panel provides a comprehensive assessment of an individual’s metabolism and is targeted to find any irregularities that are directly related to numerous conditions. This panel provides a comprehensive assessment of the individual’s metabolism to assess microbial dysbiosis, and also provides vitamin levels and indicators of possible genetic problems. Included in the panel: Organic Acids Test, IgG Food Allergy Test, Red Blood Cell Metals or Metals Hair (your choice), and Phospholipase A2 Activity Test. With the GPL4 panel, a no blood draw option is also available.
82108 82131 82300 82507 82525 82570 83018*28 83150 83497 83605 83655 83735 83785 83825 83885 83921*63 83945 84100 84207 84210 84255 84585 84591 84630 84999 86001*93 86628 86671*2 No Medicare Coverage
CPT Codes - Serum
Specimen Requirements
82131 82175 82300 82310 82495 82507 82525 82570 83015 83018*4 83150 83497 83605 83655 83735 83785 83825 83921*63 83945 84100 84132 84207 84210 84255 84585 84591 84630 84999 86001*93 86628 86671*2 No Medicare Coverage
Urine: 10mL of first morning urine before food or drink. Patient must avoid apples, grapes (including raisins), pears, cranberries, and their juices 24 hours prior to specimen collection. GPL4 Serum:
GPL4 DBS:
Serum: 2 mL of serum in a gold-topped SST or royal blue-topped no-additive tube.
Hair: 1 gram of hair
Red Blood Cell: 4mL of packed cells in a royal blue topped potassium RDTA tube.
Dried Blood Spot (DBS): Two protein saver cards filled with five full circles of blood. LAB#: PATIENT: ID: SEX: AGE:
µ Requisition #:
273466
Patient Name: Patient Age:
4
Patient Sex:
F
Date of Collection:
07/30/2012
Time of Collection:
08:00 AM
Print Date:
08/02/2012
Requisition #:
Physician Name:
Patient Name:
Date of Collection:
Patient Age:
Time of Collection:
Sex:
Print Date:
Reference Range
Patient Value
(mmol/mol creatinine)
Comprehensive IgG Food Allergy Test + C. albicans, S. cerevisiae (94)
Reference Population - Females Under Age 13
Intestinal Microbial Overgrowth
Dairy
Yeast and Fungal Markers 1 2
≤
Citramalic
≤
5-Hydroxymethyl-2-furoic
5.3
3.1
30
3.1
7.4
3
3-Oxoglutaric
≤
0.52
0.50
4
Furan-2,5-dicarboxylic
≤
22
8.6
5
Furancarbonylglycine
≤
3.6
6
Tartaric
≤
3.9
0.07 H H
7.4 0.50
7
Arabinose
≤
56
8
Carboxycitric
≤
34
1.3
9
Tricarballylic
≤
0.86
0.08
9.0
242
2-Hydroxyphenylacetic
≤
1.1
0.45
4-Hydroxyphenylacetic
≤
30
16
242 1.3
12
4-Hydroxybenzoic
0.09
-
2.0
13
4-Hydroxyhippuric
≤
14
Hippuric
≤
15
3-Indoleacetic
≤
11
16
Succinic
≤
15
2.0
15
15
377
377
6.1 H
6.1
39
17
HPHPA (Clostridia Marker)
≤
227
148
18
4-Cresol (C. difficile)
≤
76
63
19
DHPPA (Beneficial Bacteria)
≤
0.73
0.29
3.84 2.11
Potassium mEq/L
79 515
Copper
0.60
0.52- 0.89
39
63
42
Requisition #:
Cadmium
0.001
Lead
0.017
2.26
Mercury
0.001
Almond
1.86
Thallium
< 0.0001
< 0.0005
Cashews
2.12
Wheat
Green Bean
3.34
Fish
Kidney Bean
4.19
Cod Fish
4.72 1.79
Lentil
1.28
Crab
0.99
Lima Bean
1.22
Halibut
1.85
Pea
1.36
Pinto Bean
3.46 1.69 2.60
Lobster Salmon Sardine Shrimp Tuna
Apricot
1.81
Meat/Fowl
Banana
2.39
Beef
1.49 2.89 1.30
13.63
Egg Yolk
12.91
4.90 2.06
3.05
Lamb
3.25
Pork
1.68
Lemon
5.40
Turkey
Orange
2.25
Nuts and Seeds
Pear
2.60
Flax
2.18
Pineapple
2.59
Hazelnut
1.45
1.69
Peanut
0.0006
Selenium
0.22
Boron
0.023
Vanadium
0.0002
Molybdenum
< 0.0005
Arsenic
5.33
Pecan
2.56
2.66
Pistachio
2.66
Sesame
2.85
RESULT
µg/g 0.004
97.5
3.61
©DOCTOR’S DATA, INC.
th
µ
Methodology: µg/g = ppm
ADDRESS: 3755 Illinois Avenue, St. Charles, IL 60174-2420
Patient Age:
26
Sex:
F
Date of Collection:
1/16/2015
Time of Collection:
08:00 AM
Print Date:
1/23/2015
Mean .5
Units Per Creatinine Patient Value
Phospholipase A2
Normal
Elevated
1.500 .1
.5
1
5
Secreted Phospholipase A2 (sPLA2) has been implicated in many diseases because of its role in inflammation and host defense. sPLA2 is found in many mammalian tissues as well as insect and snake venom. sPLA2 catalyzes the release of arachidonic acid and is involved in the production of prostaglandins for inflammation. sPLA2 is present in connection with multiple diseases including rheumatoid arthritis, sepsis, psoriasis, pancreatitis, cancer, Crohn’s disease, and multiple sclerosis.
PERCENTILE
4- 30 0.88 0.5- 10 4- 20 > 800
V06.99
CLIA ID NO: 14D0646470
There has been a great deal of research done by both academia and pharmaceutical companies to find chemical inhibitors to sPLA2. However, there has also been research on more natural methods for inhibiting sPLA2 . Analysis has shown that treatment with supplements of Cytidine 5’-Diphosphocholine (CDP-choline) can limit the ability of sPLA2 to promote inflammation. Studies of CDP-choline of over 11,000 volunteers and patients have shown beneficial effects for many different conditions including cerebral ischemia, traumatic brain injury, hypoxia, Alzheimer’s, Parkinson’s memory disorders, and glaucoma. CDP-choline is composed of cytidine and choline linked by a diphosphate bridge. CDP-choline is an essential intermediate of the major brain phospholipid, phosphatidylcholine. Increasing amounts of CDP-choline results in the decreased activation of sPLA2, which then results in the decreased production of arachidonic acid and inflammation.
99th
SPECIMEN DATA
Comments: Date Collected: Date Received: Date Completed:
3.77
Strawberry Watermelon
Grains
Chromium
TOXIC ELEMENTS
6.39
Chicken Egg White
4.16
0.013
0.99
2.45 1.96
Grape
13.3 802
Manganese
1.98
Blueberry Coconut
Grapefruit
Zinc Iron
th
Test
1.78
1.96
5.09 4.34
84
Phospholipase A2
1.67
1.70 3.88
Sorghum Wheat Gluten
Physician Name:
901000
Patient Name:
PERCENTILE th 50
CDP-choline can be found at New Beginnings Nutritionals, www.NBNUS.com <http://www.NBNUS.com> , or call 877-5752467.
Testing performed by The Great Plains Laboratory, Inc ., Lenexa, Kansas. The Great Plains Laboratory has developed and determined the performance characteristics of this test. This test has not been evaluated by the U .S. Food and Drug Administration.
V10.01 MEDICARE PROVIDER NO: 148453
Testing performed by The Great Plains Laboratory, Inc., Lenexa, Kansas. The Great Plains Laboratory has developed and determined the performance characteristics of this test. This test has not been evaluated by the U.S. Food and Drug Administration.
Testing performed by The Great Plains Laboratory, Inc., Lenexa, Kansas. The Great Plains Laboratory has developed and determined the performance characteristics of this test. This test has not been evaluated by the U.S. FDA; the FDA does not currently regulate such testing.
Organic Acids Test - Nutritional and Metabolic Profile
Magnesium
Papaya
Rice Rye
7.27
Barley
0.29
17
Peach
4.65 8.13
Yogurt
Plum (Prune)
148
RESULT µg/g
Calcium
8- 14.5 125- 370 745- 1050 12- 30 12- 90 0.007- 0.030 12- 40 0.0003-0.0060 8.0- 16 100- 190 0.19- 0.38 0.20- 0.55 0.26- 0.50 0.01- 0.110 0.030- 0.10 0.050- 0.13 0.0001-0.0020 0.60- 4.0 0.0005-0.0020 0.25- 1.3 0.007- 0.023 160- 250 POTENTIALLY TOXIC ELEMENTS 0.95- 1.7 REFERENCE 0.16- 1.0 RANGE 95th 45500- 53000 < 0.010 0.16- 0.80 0.013- 0.035 < 0.005 8.0- 19 0.045- 0.065 < 0.090 0.016- 0.18 < 0.010 0.040- 1.0
Mozzarella Cheese Whey
Cranberry
2.0
27 717
3.95
Millet Oat
Soybean
16
Gliadin
5.91 9.39
Apple
0.45
3.24 3.60
Goat Cheese
Fruit
0.08
Buckwheat Corn
Milk
Garbanzo Bean
0.07
Malabsorption and Bacterial Markers 10
7.15 7.05
Legumes - Beans and Peas
8.6
9.0
11
Casein Cheese
< 8.0
Phosphorus
ELEMENTS
Metabolic Markers in Urine
RED BLOOD CELL ELEMENTS LAB#: < 0.080 PATIENT: < 0.020 ID: < 2.0 SEX: < 0.15 AGE: < 1.0 < 0.40NUTRIENT ELEMENTS < 0.005 REFERENCE th th < 0.010 RANGE 2.5 16 8- 31 < 0.005 < 0.060 36- 64 < 0.40 < 0.20 65- 95 < 0.30 < 1.0 480- 745
Physician:
Page 1 of 9
Organic Acids Test
IgG Food Allergy Test
Metals Hair / Metals RBC Test
Phospholipase A2 Activity
Recommendations Depending on test results, follow-up may include: ■ ■ ■ ■
Dietary modifications Probiotic and/or nutritional supplementation Antioxidant therapy Elimination of offending foods
■ ■ ■ ■ ■
Immune system support Gut restoration Identification of the source of contamination Elimination of heavy metals from the body and environment Mineral supplementation
call: (913) 341-8949
26
OAT + IgG Food Allergy Test w/ Candida Combo General Description
Recommendations
A combination of our most popular tests, the Organic Acids Test (OAT) and the IgG Food Allergy Test w/ Candida, is a powerful diagnostic tool. Together, these tests help physicians evaluate their patients’ “state of the gut” and reveal how abnormal results may be contributing to chronic health issues. This combo is an excellent value if your insurance company does not typically reimburse for the standalone IgG Food Allergy Test. Visit the Insurance Benefits section on the OAT + IgG Combo webpage for more details.
Depending on test results, follow-up may include:
Clinical Usefulness ■ The combined tests increase the likelihood of identifying significant factors impairing health. ■ Results indicate the extent of yeast and bacteria overgrowth in the GI tract and provide insight on nutritional status, Clostridia infection, and fatty acids and energy metabolism. ■ The test reveals food sensitivities, that when removed from the diet often mitigate patients’ symptoms.
■ ■ ■ ■ ■
Dietary modification Nutritional and/or probiotic supplementation Follow-up/confirmational testing Elimination of offending foods/implemention of a rotation diet Immune system support
Specimen Requirements Urine: 10 mL of first-morning urine before food or drink. Patient must avoid apples, grapes (including raisins), pears, cranberries, and their juices 24 hours prior to specimen collection. Serum: 1 mL of serum in a gold-topped SST or in a royal bluetopped no-additive tube. Dried Blood Spot (DBS): Five full circles of dried blood on the protein saver card.
CPT Codes 86001*93 86628 86671 82131 82507 82570 83150 83497 83605 83921*65 83945 84207 84210 84585 84591 No Medicare Coverage
OAT + Amino Acids Urine Test Combo General Description
Recommendations
The Great Plains Laboratory offers the OAT and Amino Acids Urine Test as a combo. The OAT and Amino Acids Test quantifies different markers for assessing GI function, detoxification capacity, and certain nutritional deficiencies. Together they provide a more in-depth evaluation of overall nutritional status and digestive sufficiency. This combo is an excellent value if your insurance company does not typically reimburse for the standalone Amino Acids Urine Test. Visit the Insurance Benefits section on the OAT + Amino Acids Combo webpage for more details.
Depending on test results, follow-up may include:
Clinical Usefulness ■ ■ ■ ■ ■ ■
27
More complete insight into overall nutritional status More complete evaluation of GI function and intestinal dysbiosis More complete assessment of detoxification capacity Indication of potential harmful genetic variations Stronger clinical assessment of complex patients Assistance in building a treatment plan
www.GPL4U.com
■ ■ ■ ■
Treatment for intestinal dysbiosis Nutritional and supplement support Detoxification Genetic testing
Specimen Requirements 35 mL of first-morning urine before food or drink. Patient must avoid apples, grapes (including raisins), pears, cranberries, and their juices 24 hours prior to specimen collection. The patient should also discontinue amino acid supplementation 24 hours prior to collection.
CPT Code 82139*1 82140 82492 84540 82131 82507 82570 83150 83497 83605 83921*65 83945 84207 84210 84585 84591
Comprehensive Test Panels How A Comprehensive Approach Will Benefit Your Health: Routine lab work often falls short of uncovering the subtle abnormalities which can have a profound effect on health. Unless properly addressed, this vicious cycle will continue to inhibit the various chemical pathways necessary for proper neurological and immune function. The resulting complications will contribute to, and may even cause, the symptoms of the patient.
A biomedical approach to treatment is a search for the underlying physiological imbalances contributing to the symptoms of a patient’s disorder. Treatments are designed to restore the body to balance and optimize function through nutritional support, diet, detoxification, and reduction of environmental influences. Laboratory testing and environmental assessments can help to identify causal factors and to focus treatment.
Comprehensive Autism Panel
Comprehensive AD(H)D Panel
Advanced Cholesterol Profile
Advanced Cholesterol Profile
Comprehensive Stool Analysis
Amino Acids Urine Test
Copper / Zinc Profile
Comprehensive Fatty Acids Test
Ferritin Test
Comprehensive Stool Analysis
Gluten / Casein Peptides Test
Copper / Zinc Profile
IgG Food Allergy Test w/ Candida
Ferritin Test
Immune Deficiency Profile
Gluten / Casein Peptides Test
Metals Hair Test
IgG Food Allergy Test w/ Candida
Streptococcus Antibodies Profile
Metals Hair Test
Vitamin D Test
Organic Acids Test
Organic Acids Test
Streptococcus Antibodies Profile Vitamin D Test
Comprehensive Mental Health Panel
Comprehensive Wellness Panel
Advanced Cholesterol Profile
Advanced Cholesterol Profile
Amino Acids Plasma Test
Amino Acids Plasma Test
Comprehensive Fatty Acids Test
Comprehensive Fatty Acids Test
Comprehensive Stool Analysis
Copper / Zinc Profile
Copper / Zinc Profile
Ferritin Test
Gluten / Casein Peptides Test
Gluten / Casein Peptides Test
IgG Food Allergy Test w/ Candida
IgG Food Allergy Test w/ Candida
Metals Hair Test
Metals Hair Test
Organic Acids Test
Organic Acids Test
Vitamin D Test
Vitamin D Test
Other Available Test Panels: ■ ■ ■ ■
Comprehensive Fibromyalgia & CFS Panel Comprehensive Tourette’s & Tics Panel Basic Wellness Panel Basic AD(H)D Panel
■ Basic Tourette’s & Tics Panel ■ Basic Fibromyalgia & CFS Panel ■ Basic Mental Health Panel
Visit us online at www.GPL4U.com for more information about comprehensive testing.
call: (913) 341-8949
28
William Shaw, Ph.D., Director | 11813 West 77th Street, Lenexa, KS 66214 | (913) 341-8949 | Fax (913) 341-6207 | www.GPL4U.com
The most accurate, reliable, and comprehensive biomedical analysis. The Great Plains Laboratory, Inc. is a world leader in providing testing for nutritional factors in chronic illnesses such as autism, fibromyalgia, and AD(H)D. We offer a variety of metabolic tests such as immune deficiency evaluations, amino acid tests, essential fatty acid tests, organic acids testing, metal toxicity, and food allergies tests. Our vision is to have no borders when it comes to improving peopleâ&#x20AC;&#x2122;s quality of life.
Rev. 10/15/2014
Information Guide