LAB TESTS
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Clarice,
Our preference is BioHealth Laboratory – http://www.biohealthlab.com. We have used their salivary profiles for adrenal and sex hormones for years.Their #201 profile is a basic 4 cortisol and 2 averaged DHEA markers.
Their #205 profile includes information from the #201, but also evaluates for estradiol, estriol, progesterone, testosterone and melatonin.
These are both excellent profiles. However, when it comes to following sex hormone levels on people on hormone replacement therapy (HRT) saliva testing can be a bit sensitive, particularly to transdermals. In these cases looking at blood levels, i.e. estradiol, progesterone, testosterone seems to be a better option. However, it needs to be understand that even blood testing can have its drawbacks with tracking hormone levels when people are on HRT determining the clinical response of the patient is important and not just solely relying on lab markers.
Sincerely,
Dr. Woeller -
I would agree with Dr. Woeller on the issue of assessing hormone levels when someone is on HRT even with bioidenticals. Salivary testing will often come up high with transdermals especially with progesterone. The values will also depend on how long someone has been using the hormones and if they use them daily. In the blood, transdermals hardly show up at all so you can’t really judge by those values either. It is best to make a clinical assessment rather than solely relying on lab testing. That being said, we still need to assess hormone levels at least annually when someone is using HRT to at least see some consistency in the numbers.
Both salivary and blood are fine for baseline values when someone is not using an exogenous source of hormones.
Sincerely,
Dr. Tranchitella -
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Hi,
Received my first OAT results with many highlights. 24 yo ASD pt known for many years, with marked anxiety, mood lability, mild GI issues. History of cancer successfully treated with chemo, in remission for 1 year. Primary psych symptom is anxiety as he is graduating from college soon. Given many abnormal markers, what would be your stepwise treatment approach? Is currently on Wellbutrin and Propranolol. Thanks. -
Eric,
Okay. Here you go:1. #4 is slightly high. Probably mold exposure through food
2. Arabinose is mildly high too. Not likely causing the core of his issues, but worth treating.
3. All bacteria markers normal
4. Oxalate is normal. High glyceric…maybe an indicator of the need for more Vitamin B6?
5. #30 is slightly high. Indicates some mitochondrial stress.
6. HVA and VMA look normal. There is the common low 5-HIAA and high ratio of 5-HIAA/Quinolinic Acid linked to poor serotonin metabolism. For this individual, this is probably the best place to start intervening.
7. #42 and #46 are slightly high. Also, can indicate the need for mitochondrial support
8. Nutritional markers actually look pretty good. High Vitamin C is not a problem
9. #59 being high does suggest increase oxidative stress. One thing to consider is the new GPL-TOX screen from Great Plains Laboratory to assess for environmental chemical exposure.
10. #62 – just slightly high
11. Low phosphoric – he likely is low on Vitamin D. Worthwhile to check Vitamin D status, but minimally use 1000IU of D3 for every 25lbs body weight daily.I don’t see a lot on this test that is significantly a problem. Therefore, going after things from a gut standpoint that may be causing anxiety is a bit of stretch.
If you can do Nystatin I would suggest 1 tablet three times daily for 60 days. If no Nystatin, then 1 capsule of Biocidin three times daily would suffice.
I am uncertain is 5-HTP is contraindicated with Wellbutrin? If no, then 150mg twice daily may help.
Mitochondrial support can be addressed with L-Carnitine at 1000mg daily and Ubiquinol (CoQ10) at 200mg daily.
I hope this helps,
Dr. Woeller
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