Table of Contents Table of Contents 4 Educational Resources 5 Payment Options 7 Getting Started With Our Lab Services 8 Frequently Asked Questions 9 Testimonials 10 Tests 11 Organic Acids Test (OAT) 12 Sample Test 13 Report Analysis 14 IgG Food Allergy Test w/ Candida 15 Sample Report 16 Metals Tests 17 Gluten / Casein Peptides Test 19 IgE Food and Inhalant Allergy Tests 20 Hormone Panels 21 Amino Acids Tests 22 Vitamin D Test 23 Advanced Cholesterol Profile 24 Immune Deficiency Profile 25 Comprehensive Stool Analysis 26 Copper / Zinc Profile 27 Comprehensive Fatty Acids Test 28 GPL-3 29 GPL-4 30 OAT + IgG Food Allergy Test w/ Candida Combo 31 Comprehensive Test Panels 32 Comprehensive Autism Panel 32 Comprehensive AD(H)D Panel 32 Comprehensive Mental Health Panel 32 Comprehensive Wellness Panel 32 The Great Plains Laboratory, Inc. 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) 341-6207call: | (913) www.GPL4U.com 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 11 Our Mission William Shaw, Ph.D., is board certified in the fields of clinical chemistry and toxicology by the American Board Our mission is to improve health of Clinical Chemistry. Before he founded The Great Plains treatment outcomes for chronic Laboratory, Dr. Shaw worked for the Centers for Disease illnesses by providing the most Control and Prevention, Children’s Mercy Hospital, University accurate, reliable, and comprehensive of Missouri at Kansas City School of Medicine, and Smith biomedical analyses available - using Kline Laboratories. He is the author of “Biological Treatments for Autism and the latest technology and proven PDD,” originally published in 1998 and “Autism: Beyond the Basics,” published in 2009. He is also a frequent speaker at conferences worldwide. techniques – and by providing education to patients, families, and Dr. Shaw is the stepfather of a child with autism and has helped thousands of health care practitioners.” 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. 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: Customer Service: Billing / Insurance: 8 a.m. to 5 p.m. Central time USA Toll Free: 800-288-0383 Direct Line: 913-754-0459 1400 (2 p.m.) to 2300 (11 p.m.) Local: 913-341-8949 [email protected] Coordinated Universal Time (UTC) Fax: 913-341-6207 General Inquiries: 1 [email protected] www.GPL4U.com Our laboratory offers comprehensive evaluation panels that provide Table of Contents physicians with the right tools for a more effective, individualized treatment. We are equipped with state-of-the-art instrumentation. Our Educational Resources...... 1 superior technology allows us to develop more unique tests than regular Other Resources...... 2 commercial laboratories, while adhering to the strictest quality control Payment Options...... 3 and quality assurance guidelines of regulatory agencies. Getting Started With Our Lab Services...... 4 Authorization Lab Certifications Order a Test Kit Specimen Collection CLIA Shipping The Great Plains Laboratory is fully certified under the federally mandated Results Clinical Laboratory Improvement Amendments (CLIA). All referral laboratories Cancellation Policy used by The Great Plains Laboratory are also CLIA certified. Frequently Asked Questions...... 5 CAP Testimonials ...... 6 The Great Plains Laboratory voluntarily participates in all proficiency Tests programs offered by the College of American Pathologists (CAP). The CAP is the world’s largest association composed exclusively of board-certified Organic Acids Test (OAT)...... 8 pathologists and pathologists-in-training and is the worldwide leader IgG Food Allergy Test w/ Candida...... 11 in laboratory quality assurance. In this program, our laboratory must Metals Tests...... 13 constantly demonstrate our ability to successfully identify and quantify unknown specimens. Gluten / Casein Peptides Test...... 15 IgE Food and Inhalant Allergy Tests...... 16 Internal Quality Control Hormone Panels...... 17 Amino Acids Tests...... 18 In addition to inspections by the state and participation in external proficiency testing programs of the CAP, GPL also has a strong internal Vitamin D Test...... 19 quality control program. We have a dedicated staff of scientific professionals Advanced Cholesterol Profile...... 20 whose focus is to monitor the effectiveness of our tests and to ensure the quality and integrity of all laboratory methods. Portions of quality Immune Deficiency Profile...... 21 control samples are analyzed with every test batch to ensure laboratory Comprehensive Stool Analysis...... 22 quality. Patient samples are also frequently split to make sure that different Copper / Zinc Profile...... 23 technologists perform similar work. Comprehensive Fatty Acids Test...... 24 Food and Drug Administration (FDA) GPL3...... 25 GPL4...... 26 Approvals OAT + IgG Food Allergy Test w/ Candida Combo.. 27 The FDA regulates companies that sell instruments and reagents to clinical OAT + Amino Acids Urine Test Combo...... 27 testing laboratories. The Great Plains Laboratory uses many FDA-approved Comprehensive Test Panels...... 28 instruments and reagents. In some cases, there are no commercially Comprehensive Autism Panel available instruments or reagents. Such tests, termed “home brew” tests, are regulated by the CLIA regulatory agencies. The FDA does not directly Comprehensive Mental Health Panel regulate clinical laboratories. Other Available Test Panels: Comprehensive AD(H)D Panel Comprehensive Wellness Panel
International Support: Customer service support is available in multiple languages: Spanish, German, French, Portuguese, Italian, Japanese, and Chinese Direct Line: 913-754-0461 2 call: (913) 341-8949 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 Annual Physician Educational Workshops provide practitioners with the opportunity to learn more about the latest research and the clinical significance of tests and treatments. We provide useful tools for practitioners to understand the various influences that complicate metabolic pathways and explain the connection in our test results. Using the latest research on specific compounds and metabolites, we bring new insight to the disease process. The practitioner will gain an understanding of the clinical significance of biomedical testing and a clear comprehension of the appropriate treatment. We are the primary sponsor of the 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.
1 www.GPL4U.com BioMed Today Email Newsletter Other Resources 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 IMMH Clinician Registry and Resources events, discussions, tips, recent news, and other resources. Sign up A Clinician Registry is available through www.IMMH.org. The for our email updates for information on new and updated tests, registry provides patients with a list of medical professionals who conferences, and webinars. Don’t miss out on all that GPL has to can assess and treat Mental Health disorders based on an integrative offer! Visit www.GPL4U.com and click Email Signup. medical approach. Integrative medicine for mental health is a whole body approach utilizing multiple fields of medicine and nutritional Physician Referral Database sciences. The goal is to help patients regain mental wellness through the use of individualized metabolic testing, nutritional therapies, We are happy to recommend the names of experienced medical dietary interventions, along with traditional medical treatments, practitioners to patients and parents who need help getting including medications and psychotherapy. The IMMH Clinician testing or treatment. In areas where there is not a medical Registry eligibility is exclusive to practitioners who have attended practitioner nearby, we can recommend the medical practitioners an IMMH Conference. who provide long-distance phone consultations. The medical practitioners we recommend are familiar with our tests and are Find more about the IMMH Clinician Registry and upcoming events qualified to help patients with recommendations, authorizations, on the IMMH website. This website contains other resources such and treatment options. as research articles, webinars, blog posts, and other useful tools for integrative practitioners. Online Test Orders Nutritional Supplements Physicians can order our test kits online through ResultsPlus. This online portal also allows the physician to update account and New Beginnings Nutritionals provides specialized, high-quality billing information, send test kits directly to patients, and access nutritional supplements for adults and children on the autistic the most up-to-date testing information. Find out more on our spectrum and other chronic health issues. They offer professional- website under For Clinicians. quality products that contain pharmaceutical grade ingredients whenever possible and do not contain harmful or allergenic Many of the tests we offer are also available through MyMedLab. ingredients. Support for special dietary needs is available through This is an online test ordering system that provides patients with a wide variety of supplements that provide help for, digestion, everything they need to test through The Great Plains Laboratory, absorption, nutrient deficiencies, detoxification, immune including a medical practitioner’s signature and a professional dysfunction, and yeast and bacteria overgrowth. blood draw. To learn more about MyMedLab, visit our website or go to https://greatplains.mymedlab.com. 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 a clear comprehension of the appropriate treatment.
2 • • • • • • • • ,. • 4' call: (913) 341-8949 Payment Options Getting Started With Our Lab Services
Blue Cross and Blue Shield Insurance Plans Not Filed The Great Plains Laboratory is contracted with several Blue Cross We cannot bill State-Run Medicaid Programs, Humana, Aetna, and Blue Shield (BCBS) PPO plans.* Acceptable plans are recognized or HMOs (check the website for HMO exceptions). If the patient in one of two ways: the member’s BCBS insurance card will display subscribes to any of these insurance plans, the patient must pay in a suitcase logo on the front with the letters PPO inside or will have full by check or credit card. 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 Self Pay plans.* We offer a prompt-pay discount by paying in full at the time of *See the insurance section on our website for exceptions to the testing. We accept checks and all major credit cards including: Visa, BCBS in-network program. MasterCard, Discover, American Express, JCB, and Diners Club. We will send a statement of services for you to file with your Tricare insurance company. We are a participating provider with Tricare in every region of the United States. Patients should include a copy of the front and back PayPal of the insurance card and the member’s Social Security number. GPL accepts payments made through PayPal. Signing up for a PayPal account only takes a few minutes and is an alternative to *See the insurance section on our website for exceptions to the using checks, credit cards, or wire transfers to pay for your testing. Tricare program. If you choose to send payment via PayPal, you must complete the Medicare “Email to recipient” section within paypal when sending money. Please include the patient’s name, date of birth, and billing address GPL is contracted with Medicare, and many of our tests are covered so we can match your payment with the correct account. Send by Medicare. See the Advance Beneficiary Notice (ABN) for a list of PayPal payments to [email protected]. 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 Insurance Coverage Verification Guide of the patient’s Medicare card be sent with the specimen. We provide an Insurance Coverage Verification Guide. This helpful tool includes an insurance overview that patients can use to determine If the patient is enrolled in a Medicare Advantage Plan, then we eligibility, restrictions, and requirements. By calling your insurance require a copy of the front and back of the patient’s Medicare provider, you can verify your coverage and gather information to Advantage Card. The Medicare Advantage Card is not the same as determine any out-of-pocket expenses. a Medicare card. Please contact our Billing Department with any questions concerning coverage. For the Insurance Coverage Verification Guide, visit Pricing and Payment Options on our website, or contact Customer Service. Out-of-Network Insurance Plans The Great Plains Laboratory is considered “out-of-network” with Method of Payment some Blue Cross Blue Shield plans, United Healthcare, and Cigna. Payment information must be received by the time the specimen The laboratory will file out-of-network insurance on behalf of the arrives at our laboratory for the specimen to be processed. patient, provided the patient includes a 20% out-of-network For questions, please contact the Billing Department at prepayment along with the insurance information on the Test 913-754-0459 or [email protected]. 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.
3 0 www.GPL4U.com • Getting Started With Our Lab Services
Authorization Shipping Our laboratory requires an authorization from a medical Shipping in the United States is free. Patients within the United practitioner on all tests performed in the United States. States will not need to pay FedEx when sending samples to our Authorization is not required for patients who reside outside the laboratory. After collecting the sample, please call 1-800-463-3339 United States. We do not provide testing for any patient or medical (1-800-GoFedEx) for pick up. Remember to mention you have an practitioner who resides or practices in New York. overnight FedEx billable stamp return.
We will gladly refer patients to medical practitioners who use The Great International Plains Laboratory tests. These practitioners are more likely to provide authorization or treatment based upon results. 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 Order a Test Kit need to provide the laboratory with a method of payment upon Test kits can be ordered online, by phone, by fax, or by a medical ordering their test kit. We include a prepaid FedEx International practitioner. The kits are usually mailed directly to the patient and Priority Service bag in our international test kits. The charges for will include everything the patient needs to collect and submit the inbound shipping are applied to the patient’s account once the specimen. We do not require patients to have the practitioner’s specimen has been received by our laboratory. We have distributors authorization before ordering a test kit. However, a prescription or in many countries that can provide our test kits to patients at a signed requisition must be returned with the specimen or sent to reduced cost. Please contact International Support at 913-754-0461 our lab directly by the practitioner. to find out if there is a distributor in your country. A kit order must be signed by a practitioner to be considered authorized. Practitioners can submit signed kit requests to our lab Results via fax or through our Online Test Requisition Form. A completed Results are sent out according to the parameters established copy of the Online Test Requisition Form will be included in the by the practitioner on the New Client Form. Our laboratory will patient test kits for convenience. Faxed authorizations will be kept automatically mail a copy of results to the patient. The patient can on file at the lab to be matched with patient specimen upon arrival. also request that the laboratory send out results via secure email No payment is necessary to order a test kit within the United or secure fax after they are completed. Customer Service will make States. Test kits ordered from within the United States will include every attempt to accommodate the patient’s request for results. a Test Requisition Form; payment, insurance, and privacy forms; In some cases, the patients will have to obtain results from their instructions; specimen collection components; and a pre-paid medical practitioner. FedEx overnight clinical pack.
International Cancellation Policy The Great Plains Laboratory must be notified by the medical Payment is required for kits ordered from outside the United States. practitioner, patient, or parent/guardian to cancel a test. These test kits will include a Test Requisition Form, payment form, Cancellations will be honored if requested within 24 hours of instructions, commercial invoice, specimen collection components, receipt of the sample by the laboratory. Because testing processes and a pre-paid international FedEx priority clinical pack. begin within 24 hours, requests for cancellation beyond this time will not be honored. Specimen Collection 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.
4 call: (913) 341-8949 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 an updated copy of your insurance card be sent with your sample. of the United States. It is recommended, but not obligatory, for residents of other countries. An approved medical practitioner How do I find out if my insurance will cover could be any of those listed in the following question. your tests? Coverage is determined by a number of factors, including the What type of medical practitioners can type of procedure, the medical diagnosis, and the insurance policy authorize tests? guidelines. We encourage patients to call their insurance company to The Great Plains Laboratory recognizes Medical Doctors find out if tests may be covered. An Insurance Coverage Verification (MD), Osteopathic Doctors (DO), Chiropractic Physicians (DC), Guide is available on our website to help determine coverage. Naturopathic Physicians (ND), Doctors of Philosophy in Psychology, It is helpful to provide CPT and ICD-9 codes to the insurance Biochemistry, Toxicology, and Nursing (PhD), Doctors of Oriental company when calling for pre-approval. The CPT codes are provided Medicine (DOM), Licensed Acupuncturist (Lac), Physicians by the laboratory and are located on the page associated with the Assistants (PA), Nurse Practitioners (ARNP), Nurse Midwives (CNM), test in this Information Guide and also on our website. The ICD-9 Certified Nutritionists (CCN), and Registered Dietitians (RD). It is the codes are provided by the practitioner. practitioner’s responsibility to work within the rules and guidelines of the state in which they practice. Can I test my child who is not potty-trained? Yes, we provide pediatric collection tape-on bags to collect the How do I find a doctor familiar with GPL’s urine from infants or children who are not potty-trained. Please testing? request the pediatric collection bags when ordering tests through We have a national database of over 3,000 medical practitioners. Customer Service or online. Please call Customer Service at 1-800-288-0383 to locate a medical practitioner in your area. Authorization does not have to come from Can I perform multiple urine tests using one your primary care physician; any licensed health professional can specimen? order testing in your state. Yes, you can perform many of the urine tests with one urine sample. Each test has a specific volume requirement. The urine collection Where can I go to get blood drawn? container holds about 70 mL. You will need a special collection jug We are contracted with national phlebotomy services which can to perform the timed and 24-hour urine tests, which require at least provide blood draw services for our testing. In addition, many 40 mLs of urine 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 blood- More Frequently asked Questions draw facilities in your area. Patients are responsible for any fees are available on our website. Please associated with a blood draw. Additionally, phlebotomy services can be arranged either at home or an agreed upon site for an contact customer service if you have added fee. More details regarding blood collection can be found any other questions not listed: on our website under the for patients section. [email protected] | 913-341-8949 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.
5 www.GPL4U.com Testimonials
“Great Plains Laboratory provides me with information which has “I am very happy with the IgG test results from Great Plains. I always not only changed the lives of my patients and their families for the say that without this valuable test, I would not be in practice. It has better but enables me to link otherwise puzzling symptoms with helped so many of my patients! Recently, I had a patient with the most correctable causes far more completely than other labs I have used. It severe case of eczema I had ever seen in my practice. We did the Great has been extremely interesting and just plain FUN to see patients with Plains IgG testing [and] we saw he was sensitive to the usual gluten, “chronic” illnesses improve dramatically or even recover as a result of dairy and eggs, and promptly removed these foods. Beef had also using information from Great Plains. The reports are easy to read and come up very elevated, but I had initially ignored that result, thinking arrive in a timely manner. Helpful, friendly technical support is readily that beef is a rather ‘benign’ food. Finally once we removed beef, the available when needed. The clinician training courses the Great Plains eczema cleared completely! So if it were not for this testing, this child Lab provides are invaluable too; these are a great way to learn about would still be suffering.” the science behind the tests, the pathology and treatments, as well as – Elaine H., MS, RN, APN to meet the people you’ll be dealing with at the lab.” – Deborah Nash, MD “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 “Your lab has a very appropriate name that suits its mission: ‘Great.’ breakthrough! He is in a more receptive mood, with better eye I would like to thank you for the excellent consultation I received contact, language, etc.! Thank you for helping my son to feel better and friendly and knowledgeable customer service assistance. It is and his body to work more efficiently! We look forward to taking your especially nice for the clients to receive the service in their native test again and seeing where he stands in a few months. ” languages! I consider your laboratory not regular, but special, and it’s – Parents of a child with autism in Burlingame, CA great to have these non-traditional tests available.” – Anna “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 “I would like to thank you from my heart for the way you’ve helped detection of organic acids and morphine peptides in urine and now our kids — especially Dr. William Shaw. May God bless him and all of they are improving greatly with the results you have recommended.” you and give you a thousand years to live for continuing to help our – Pediatrician from Barcelona, Spain kids to leave this cloudy road of autism and related disorders. Again, a thousand thanks!” – Mother of a girl with autism in Venezuela “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 “I just want to express my sincerest gratitude for your research and it is not often that I come across companies/individuals that compel commitment to helping people. If it were not for your work, I honestly me to send a thank you note such as this. Customer Service followed believe that my son would not be talking, socializing, nor making the through on every commitment; was prompt, knowledgeable, friendly; remarkable progress that he has been making in the past five months and bottom line helped me solve my issues. I didn’t get double talk or since starting the GFCF diet.” company policy talk – the representative took the time to listen to me – Email to The Great Plains Laboratory 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 “We have noticed ... much improvement in hyperactivity, more ourselves without the generous and knowledgeable service you, Dr. eye contact, increased vocalization, better sleep pattern, better Shaw, and all the staff at GPL provide. We are eternally grateful for concentration, and decrease of compulsive behaviors, and self injury. your support in the amazing and continuing progress our son, Eli, has The positive impact of your findings on our son’s life and our family achieved in the past 3 years -- ever since we first had him tested by cannot be described in words.” GPL (and your help with his GFCF diet). Thank you.” – A.E., father of a child with autism in Paramus, NJ – Email from a father regarding his child
6 call: (913) 341-8949 Tests
Organic Acids Test (OAT)
IgG Food Allergy Test w/ Candida
Metals Tests
Gluten / Casein Peptides Test
IgE Food and Inhalant Allergy Tests
Hormone Panels
Amino Acids Tests
Vitamin D Test
Advanced Cholesterol Profile
Immune Deficiency Profile
Comprehensive Stool Analysis
Copper / Zinc 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 A ■■Prealbumin Test – Serum ■■Streptococcus Antibodies Profile – Serum ■■Uric Acid Test (24 hr. or Random) – Urine ■■Yeast Culture w/ Sensitivity Test – Stool ■■Zinc Test – Serum Providing Comprehensive Nutritional Analysis 7 www.GPL4U.com and Individualized Treatment Options Organic Acids Test (OAT)
General Description Recommendations The Organic Acids Test (OAT) provides information about the body’s Depending on test results, follow-up may include: biochemical balance by measuring metabolic byproducts in urine. ■■Dietary modification The 74 metabolites, including creatinine, detected in the OAT can ■■Probiotic supplementation indicate vitamin and hormone metabolism, energy cycle function, ■■Nutritional supplementation intestinal wall integrity, neurotransmitter metabolites, and muscle ■■Oral anti-fungal or anti-bacterial medications function. Specimens from individuals with a chronic illness, allergic condition, or neurological disorder often have one or more ■■Antioxidant therapy abnormal organic acids. Some organic compounds are produced ■■Initiation of detoxification protocols by an overgrowth of gastrointestinal yeast or bacterial species ■■Follow-up genetic testing due to impaired immune function, exposure to broad-spectrum antibiotics, or high consumption of simple carbohydrates. Specimen Requirements The OAT reliably detects the overgrowth of yeast and bacteria 10 mL of first-morning urine before food or drink. Patient must species commonly missed by conventional culture methods. avoid apples, grapes (including raisins), pears, cranberries, and their These organisms and their metabolites can produce or magnify juices 24 hours prior to specimen collection. symptoms of many medical conditions. Identification of yeast or bacterial overgrowth paired with successful treatment increases the CPT Codes chance of recovery. 82131 82507 82570 83150 83497 83605 83921*63 83945 84207 The Organic Acids Test report includes: 84210 84585 84591 markers of nutritional deficiency, intestinal dysbiosis, oxalate metabolism, detoxification, bone disorders, amino acid, neurotransmitter, ketone, and fatty acid metabolism. The Microbial Organic Acids Test report includes: markers of Microbial Organic Acids Test dysbiosis, inflammation, beneficial and harmful bacteria, Clostridia, (21 components, including creatinine) This test is included Candida, and other yeast and fungal species. in the Organic Acids Test and primarily shows metabolites produced by yeast and bacteria. Additional indicators of Clinical Usefulness yeast and bacterial metablism are also included. ■■Understand vitamin and hormone metabolism The Microbial Organic Acids Test (MOAT) is ideal for follow- ■■Determine capacity to generate energy up to the OAT and may be recommended by practitioners ■■Evaluate intestinal wall integrity looking for a specific abnormality, monitoring certain ■■Assess performance of the central nervous system microbial balances, or assessing treatment efficacy. We ■■Evaluate muscle function strongly recommend the OAT as the initial screening test. ■■Reveal excessive levels of gastrointestinal (GI) yeast ■■Reveal excessive levels of GI bacteria Specimen Requirements ■■Detect nutritional or antioxidant deficiencies 10 mL of first-morning urine before food or drink. Patient ■Determine problems in fatty acid metabolism ■ must avoid apples, grapes (including raisins), pears, ■■Identify oxalate imbalances 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)-3- hydroxypropionic (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.
8 call: (913) 341-8949 r The Great Plains Laboratory, Inc. = William Shaw, Ph.D., Director 11813 West 77th Street, Lenexa, KS 66214 (913) 341-8949 Fax (913) 341-6207
Requisition #: 273466 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
Organic Acids Test - Nutritional and Metabolic Profile
Metabolic Markers in Urine Reference Range Patient Reference Population - Females Under Age 13 (mmol/mol creatinine) Value
Intestinal Microbial Overgrowth
Yeast and Fungal Markers 1 Citramalic ≤ 5.3 3.1 ■ 3.1 The Great Plains Laboratory, Inc. 2 5-Hydroxymethyl-2-furoic ≤ 30 7.4 7.4 Requisition #: 273466 Physician:
3 3-Oxoglutaric ≤ 0.52 0.50 Patient Name:0.50 Date of Collection: 07/30/2012 O Metabolic Markers in Urine Reference Range Patient Reference Population - Females Under Age 13 4 Furan-2,5-dicarboxylic ≤ 22 8.6 8.6 (mmol/mol creatinine) Value O Ketone and Fatty Acid Oxidation 5 Furancarbonylglycine ≤ 3.6 0.07 0.07
41 3-Hydroxybutyric ≤ 4.1 2.4 2.4 6 Tartaric ≤ 3.9 H 9.0 O9.0 42 Acetoacetic ≤ 10 1.2 1.2
7 Arabinose ≤ 56 H 242 242 43 4-Hydroxybutyric ≤ 3.4 0.55 0.55
8 Carboxycitric ≤ 34 1.3 1.3 44 Ethylmalonic ≤ 4.6 3.8 3.8 O id= 45 Methylsuccinic ≤ 4.3 H 4.4 4.4 9 Tricarballylic ≤ 0.86 0.08 0.08 —<> 46 Adipic ≤ 9.7 5.5 5.5 Malabsorption and Bacterial Markers The Great Plains Laboratory, Inc. 47 Suberic ≤ 9.5 4.1 4.1 10 2-Hydroxyphenylacetic ≤ 1.1Requisition #: 0.45 273466 0.45 Physician: O 48 Sebacic ≤ 0.37 0.08 0.08 Patient Name: Date of Collection: 07/30/2012 11 4-Hydroxyphenylacetic ≤ 30 16 16 Metabolic Markers in Urine Reference Range PatientO Reference PopulationNutritional - FemalesMarkers Under Age 13 (mmol/mol creatinine) Value 12 4-Hydroxybenzoic 0.09 - 2.0 2.0 Vitamin B122.0 Indicators of Detoxification 49 Methylmalonic ä ≤ 6.2 3.0 3.0 13 4-Hydroxyhippuric ≤ 27 15 15 57 Pyroglutamic 7.0 - 63 52O 52 Vitamin B6
14 Hippuric ≤ 71758 Orotic 377 ≤ 0.88 0.36377 50 0.36Pyridoxic (B6) ≤ 59 2.7 2.7 O 59 2-Hydroxyhippuric ≤ 1.2 H 3.2 Vitamin B5 3.2 15 3-Indoleacetic ≤ 11 6.1 6.1 51 Pantothenic (B5) ≤ 26 13 13 Amino Acid Metabolites 16 Succinic ≤ 15 H 39 39Vitamin B2 (Riboflavin)
60 2-Hydroxyisovaleric ≤ 1.2 0.63 52 Glutaric0.63 ä ≤ 1.1 0.35 0.35 17 HPHPA (Clostridia Marker) ≤ 227 148 148 61 2-Oxoisovaleric 0.03 - 2.4 L 0 0.00 Vitamin C
18 ≤ 76 63 53 Ascorbic 10 - 200 L 0.82 4-Cresol (C. difficile) 62 3-Methyl-2-oxovaleric ≤ 1.1 0 0.00 63 0.82
Vitamin Q10 (CoQ10) 19 DHPPA (Beneficial Bacteria) ≤ 0.7363 2-Hydroxyisocaproic0.29 ≤ 0.70 0.07 0.07 0.29 54 3-Hydroxy-3-methylglutaric ä ≤ 101 55 55 64 2-Oxoisocaproic ≤ 0.54 0.05 I 00.05 I Glutathione Precursor and Chelating Agent 65 2-Oxo-4-methiolbutyric ≤ 0.30 0.03 0.03 Testing performed by The Great Plains Laboratory, Inc., Lenexa, Kansas. The Great Plains Laboratory has developed and determined the 0 55 N-Acetylcysteine (NAC) ≤ 0.41 0.09 0.09
performance characteristics of this test. This test has not been evaluated66 Mandelic by the U.S. FDA; the FDA does not currently≤ 0.28 regulatH 0.38e such testing. 0.38 I 0Biotin (Vitamin H)
67 Phenyllactic ≤ 0.27 0.11 56 0.11Methylcitric ä ≤ 5.5 4.9 4.9 9 www.GPL4U.com 68 Phenylpyruvic 0.45 - 2.3 L 0.12 0.12 Organic Acids Test - Nutritional and Metabolic Profile Page 1 of 9 ä A high value for this marker may indicate a deficiency of this vitamin. 69 Homogentisic ≤ 0.51 0.06 0.06
70 4-Hydroxyphenyllactic 0.04 - 1.1 0.59 0.59
71 N-Acetylaspartic ≤ 8.1 2.8 2.8
72 Malonic ≤ 12 1.7 1.7
73 3-Methylglutaric 0.07 - 0.95 H 1.6 1.6
74 3-Hydroxyglutaric ≤ 11 H 18 18
Organic Acids Test - Nutritional and Metabolic Profile Page 3 of 9 75 3-Methylglutaconic ≤ 6.4 1.7 1.7
Bone Metabolites
76 Phosphoric 1 000 - 7 300 2 761 2761
Organic Acids Test - Nutritional and Metabolic Profile Page 4 of 9 Organic Acids Test (OAT) ...continued
Report Analysis Vitamin indicators: Abnormalities involving B , B , B , B , CoQ10, Glycolysis: Elevations may result from infection, exercise, or 12 6 5 2 absorbic acid, biotin, and ascorbic acid are measured. B vitamin deficiency. Very high levels may result from genetic metabolic disorders. Amino acids: High elevations are associated with possible genetic errors in metabolism. These markers are deaminated by-products Krebs cycle: Abnormalities may result from nutrient deficiencies, of amino acids themselves. Low levels do not indicate inadequate microbial overgrowth, or glutathione (GSH) synthesis deficiency. protein intake. 2-oxoglutaric: Regeneration of amino acids to remove excess Slight elevations of valeric acid analogs may indicate a greater ammonia may result in low levels. requirement for thiamine (B1). Neurotransmitters: Metabolites of dopamine, norepinephrine, 3-Methylglutaric or 3-methylglutaconic Acid: Elevated adrenaline, and serotonin are measured. Abnormalities may result levels indicate reduced capacity to metabolize leucine. Small from stress or poor detoxification, toxic metal exposure, and rarely, elevations may accompany impairment of mitochondrial specific tumors. Low levels may be associated with mood disorders function. or depression. 3-Hydroxyglutaric Acid: Elevations indicate deficiency in the Pyrimidines: Slight elevations may occur from folic acid deficiency. enzyme involved in the breakdown of lysine hydroxylysine Significant elevations can indicate possible genetic disorders. and tryptophan. Fatty acids: Elevations can result from ketogenic diets or fasting, Phosphate: Low phosphate is primarily associated with vitamin D intake of medium-chain triglycerides, carnitine deficiency, diabetes, deficiency. Individuals consuming a low grain diet may have lower The Great Plains Laboratory,or genetic disorders. Inc. phosphoric acid compared to those on a conventional “Western Requisition #: 273466 Toxic indicators: AbnormalitiesPhysician: can result from a deficiency of Diet.” More rarely, hypoparathyroidism may be involved. Patient Name: glutathione, poor ammonia detoxification,Date of Collection: or the ingestion07/30/2012 of Metabolic Markers in Urine aspartame,Reference Range or salicylates.Patient Reference Population - Females Under Age 13 (mmol/mol creatinine) Value Ketone and Fatty Acid Oxidation A booklet explaining the complete clinical significance of each metabolite 41 3-Hydroxybutyric ≤ 4.1 2.4 2.4
42 Acetoacetic ≤ 10 1.2 1.2 included in the Organic Acids Test is 1—<>
43 4-Hydroxybutyric ≤ 3.4 0.55 0.55 freely available to all physicians. NC: 44 Ethylmalonic ≤ 4.6 3.8 3.8 m<> 45 Methylsuccinic ≤ 4.3 H 4.4 4.4 —<>
46 Adipic ≤ 9.7 5.5 5.5 The Clinical Significance The Great Plains Laboratory, Inc. The Great Plains Laboratory, Inc. 47 Suberic ≤ 9.5 4.1 4.1 Requisition #: 273466 Physician: Requisition #: 273466 Physician: of the Organic Acids Test Patient Name: Date of Collection: 07/30/2012 48 Sebacic ≤ 0.37 0.08 0.08 the Patient Name: Date of Collection: 07/30/2012 °Tank Arias snaeshcrt of what is Test OM offers an accurate metabolic ryoing on in the brxly Neurotransmitter Metabolism Markers not offering Metabolic Markers in Urine Reference Range Patient Reference PopulationNutritional - FemalesMarkers Under Age 13 Yeastthe most and completebacteria, and accurate evaluation of intestinal it.1150 prqvides in (mmol/mol creatinine) fOrmation on Value oxalateneurotransmitters nutritional markers, glutathiorveimportzrd Vitamin B12 metabolism, and much mom The test offers urinary metabolite us markets that can be very 74 Indicators of Detoxification useful 49 Methylmalonic ä ≤ 6.2 3.0 3.0 discovering underlying ca uses of chronic illness. for
Patientsand physicians moon that treating Yeast dna bacterial 57 Pyroglutamic 7.0 - 63 52 52 abnormalities rechiCeSfbri9ue, Vitamin B6 7.4H improves sleep normalizes bowelincreases function, alertness and energy, hyperactivity and abdominal and radix% 58 Orotic ≤ 0.88 0.36 50 0.36Pyridoxic (B6) ≤ 59 2.72.3 2.7 pain.
3.3 H Oginahil 59 2-Hydroxyhippuric ≤ 1.2 H 3.2 Vitamin B5 3.2 SHIAA
51 Pantothenic (B5) ≤ 26 13 13
Amino Acid Metabolites „..,,,,,,,onosne CIIPPA :lad " firallaligia . .41,11111M1 Vitamin B2 (Riboflavin) "Agroiriai.iT 0.29 \I :1 60 2-Hydroxyisovaleric ≤ 1.2 0.63 pargirn ."... Tyrosi ne ;11;;I'rZat 52 Glutaric0.63 ä ≤ 1.1 0.35 Om. 0.35 I 61 2-Oxoisovaleric 0.03 - 2.4 L 0 0.00 Vitamin C
63 narerg 1-1P1-1.. 148 53 Ascorbic 10 - 200 L 0.82 62 3-Methyl-2-oxovaleric ≤ 1.1 0 0.00 0.82
!Coro sc,rine 63 ≤ 0.70 0.07 Vitamin Q10 (CoQ10) CIOPSii.fift 2-Hydroxyisocaproic 0.07 Hyde:wefts. er, ..-- The OATassists fn evaluating: 4.3 54 3-Hydroxy-3-methylglutaric ä ≤ 101 55 ViAa. " • Krebs 55 Cycle atenonnialftles 64 2-Oxoisocaproic ≤ 0.54 0.05 0.05 8.2 * Neu rotransmitter levels 1.9 Glutathione Precursor and Chelating Agent Co 'Nutritional deficlencles 65 2-Oxo-4-methiolbutyric ≤ 0.30 0.03 0.03 ntact us on the wide variety 55 N-Acetylcysteine (NAC) ≤ 0.41 0.09 0.09 emtioxIdant dendencie& • Yeast and of insurance options available! Oast-Wier 66 Mandelic ≤ 0.28 H 0.38 0.38 email: customerservice@gp14ucom • overgrowth Biotin (Vitamin H) Fatty acid metabolism Phone: {9131141-8449 Fain (913)341•6207 • Okalate levels w 67 Phenyllactic ≤ 0.27 0.11 56 0.11Methylcitric ä ≤ 5.5 4.9 4.9 w.GPL4Lf COm bible morel 10 68 Phenylpyruvic 0.45 - 2.3 L 0.12 0.12 call: (913) 341-8949 Clinical Significance of the ä A high value for this marker may indicate a deficiency of this vitamin. OrpanicArids rest 69 Homogentisic ≤ 0.51 0.06 0.06
70 4-Hydroxyphenyllactic 0.04 - 1.1 0.59 0.59 Organic Acids Test - Nutritional and Metabolic Profile Page 6 of 9
71 N-Acetylaspartic ≤ 8.1 2.8 2.8
72 Malonic ≤ 12 1.7 1.7
73 3-Methylglutaric 0.07 - 0.95 H 1.6 1.6
74 3-Hydroxyglutaric ≤ 11 H 18 18
Organic Acids Test - Nutritional and Metabolic Profile Page 3 of 9 75 3-Methylglutaconic ≤ 6.4 1.7 1.7
Bone Metabolites
76 Phosphoric 1 000 - 7 300 2 761 2761
Organic Acids Test - Nutritional and Metabolic Profile Page 4 of 9
Requisition #: Physician Name:
Patient Name: Date of Collection:
Patient Age: Time of Collection:
Sex: Print Date:
Comprehensive IgG Food Allergy Test + C. albicans, S. cerevisiae (94)
Nuts and Seeds Continued Sunflower 1.67 Reactivity Summary Walnut 1.62 High Vegetables Egg White Egg Yolk Candida Albicans Asparagus 1.98 Milk Yeast, Bakers * Yeast, Brewers * Avocado 1.92 Whey Yogurt Casein IgG Food Allergy Test w/ Candida Broccoli 2.50 Cheese Beef Goat Cheese Beet 2.01 Lemon Strawberry Sorghum
Cabbage 2.16 Moderate General Description RecommendationsCarrot 2.44 Cranberry Wheat Mozzarella Cheese Elevated levels of IgG (Immunoglobulin G) antibodies are associated Depending on test results,Celery follow-up may include: 4.28 Wheat Gluten Celery Kidney Bean with a wide variety of illnesses. Symptoms ranging from headache ■■Elimination of offendingEggplant foods 2.26 Grapefruit Lettuce Gliadin and nausea to seizure and hyperactivity may occur hours or even ■■Immune system supportGarlic 3.92 Garlic Rye Millet days after the offending food has been ingested. The degree and ■■Gut restoration Peanut Barley Corn severity of symptoms vary due to the individual’s genetic makeup. Green Pepper 2.24 ■■Implementation of a food rotation diet (included in report) Cocoa The complete elimination of IgG positive foods may result in Lettuce 4.07 ■■Supplementation important improvements in symptoms of irritable bowel syndrome, Onion 2.84 Low autism, AD(H)D, cystic fibrosis, rheumatoid arthritis, and epilepsy, Pinto Bean Green Bean Lamb Specimen RequirementsPotato 2.37 as demonstrated in numerous clinical studies. The 94 foods tested Buckwheat Honey Mushroom increase the identification of various offending foods. Serum: 1 mL of serumPumpkin in a gold-topped SST or in a royal blue-topped 2.04 Chicken Salmon Sesame no-additive tube. Radish 2.38 Onion Tomato Pistachio The standard IgG Food Allergy Test includes the foods most common Spinach - or - 2.17 in Western diets, while the IgG Asian Food Allergy panel is designed Watermelon Apple Pear Dried Blood Spot (DBS):Sweet Five Potato full circles of blood on the protein saver 1.59 for individuals who commonly eat Asian cuisine. Asian foods tested Pineapple Pecan Broccoli card. Tomato 2.69 include mango, sunflower seeds, miso (soybean paste), green tea, Blueberry Carrot Cane Sugar and a variety of seafood. This test replaces some vegetables in the Miscellaneous Banana Radish Potato general IgG Food Allergy Test with more common Asian vegetables, CPT Codes Candida Albicans 12.84 such as the shiitake mushroom, and adds a new “spices” food category. Eggplant Turkey Orange 86001*93 86628 86671*2Cane Sugar 2.43 The Asian panel also analyzes twice as many seafood items than the No Medicare Coverage Green Pepper Flax Spinach Cocoa 3.57 general test, ranging from oysters and clams to Pacific saury. Cabbage Cashews Oat Coffee 1.98 Grape Pumpkin Beet Clinical Usefulness Honey 3.13 ■■Promote non-invasive, food-based therapy Mushroom 3.06 ■■Eliminate allergy triggers Yeast, Bakers * 8.62 ■Reduce the burden on the immune system ■ Yeast, Brewers * 8.40 ■■Reduce gut inflammation *Saccharomyces cerevisiae ■■Reduce food cravings ■■Improve assimilation of nutrients Not Significant 1.00-1.99 ■■Reduce food mediated behaviors Low 2.00-3.49 Moderate 3.50-4.99 High >=5 Analyte List (93 Foods)
■■Almond ■■Buckwheat ■■Cranberry ■■Lamb ■■Pecan ■■Spinach Testing performed by The Great Plains Laboratory, Inc., Lenexa, Kansas. The Great Plains Laboratory has developed and determined ■■Apple ■■Succinic ■■Eggplant ■■Lemon ■■Pineapple ■■Strawberry the performance characteristics of this test. This test has not been evaluated by the U.S. Food and Drug Administration. ■■Apricot ■■Cabbage ■■Egg White ■■Lentil ■■Pinto Bean ■■Sunflower ■■Asparagus ■■ Candida albicans ■■Egg Yolk ■■Lettuce ■■Pistachio ■■Sweet Potato ■■Avocado ■■Cane Sugar ■■Flax ■■Lima bean ■■Plum (Prune) ■■Tomato ■■Baker's Yeast ■■Carrot ■■Garbanzo Beans ■■Lobster ■■Pork ■■Tuna (Saccharomyces ■■Cashews ■■Garlic ■■Milk ■■Potato ■■Turkey cerevisiae) ■■Casein ■■Gliadin ■■Millet ■■Pumpkin ■■Wheat Gluten ■■Banana ■■Celery ■■Goat's Milk Cheese ■■Orotic ■■Radish ■■Walnut ■■Barley ■■Cheese ■■Grape ■■Oat ■■Rice ■■Watermelon ■■Beef ■■Chicken ■■Grapefruit ■■Onion ■■Rye ■■Wheat ■■Beet ■■Cocoa ■■Green Bean ■■Orange ■■Salmon ■■Whey ■■Blueberry ■■Coconut ■■Green Pepper ■■Papaya ■■Sardine ■■Yogurt ■■Brewer's Yeast ■■Cod fish ■■Halibut ■■Pea ■■Sesame (Saccharomyces ■■Coffee ■■Hazelnut ■■Peach ■■Shrimp cerevisiae) ■■Corn ■■Honey ■■Peanut ■■Sorghum ■■Broccoli ■■Crab ■■Kidney Bean ■■Pear ■■Soybean
11 0www.GPL4U.com . . . . . . . . . . . .
The Great Plains Laboratory, Inc.
William Shaw, Ph.D Director 11813 W. 77th Street, Lenexa, KS 66214 (913) 341-8949 Fax (9 I 3) 34 I -6207 Requisition #: Requisition #: PhysicianPhysician Name: Name: Patient Name: Patient Name: DateDate of of Collection: Collection: Patient Age: Time of Collection: Patient Age: Time of Collection: Sex: Print Date: Sex: Print Date: Comprehensive IgG Food Allergy Test + C. albicans, S. cerevisiae (94) Comprehensive IgG Food Allergy Test + C. albicans, S. cerevisiae (94)
Nuts and Seeds Continued DairySunflower Buckwheat 3.24 1.67 Reactivity Summary CaseinWalnut 7.15 Corn 3.60 1.62 CheeseVegetables 7.05 HighGliadin 1 3.95 Egg White GoatAsparagus Cheese 5.91 Millet Egg Yolk Candida Albicans 3.84 1.98 Milk MilkAvocado 9.39 Oat Yeast, Bakers * Yeast, Brewers * 2.11 1.92 Whey Yogurt MozzarellaBroccoli Cheese 4.65 Rice Casein 1.70 2.50 Cheese WheyBeet 8.13 Beef Goat Cheese 2.01 Rye 3.88 Lemon Strawberry YogurtCabbage 7.27 Sorghum 2.16 Sorghum 5.09 LegumesCarrot - Beans and Peas Moderate 2.44 CranberryWheat Gluten 4.34 Wheat Mozzarella Cheese CeleryGarbanzo Bean 1.96 Wheat 4.72 4.28 Wheat Gluten Celery EggplantGreen Bean 3.34 Fish Kidney Bean 2.26 Grapefruit Lettuce Gliadin GarlicKidney Bean 4.19 Cod Fish 1.79 3.92 Garlic Rye Green Pepper Millet Lentil 1.28 PeanutCrab 0.99 2.24 Barley Corn LettuceLima Bean 1.22 Halibut 1.85 4.07 Cocoa OnionPea 1.36 Lobster 1.49 2.84 Low PotatoPinto Bean 3.46 PintoSalmon Bean 2.89 2.37 Green Bean Lamb PumpkinSoybean 1.69 BuckwheatSardine 1.30 2.04 Honey Mushroom RadishFruit ChickenShrimp 0.99 2.38 Salmon Sesame SpinachApple 2.60 OnionTuna 1.98 2.17 Tomato Pistachio SweetApricot Potato 1.81 WatermelonMeat/Fowl 1.59 Apple Pear TomatoBanana 2.39 PineappleBeef Pecan 6.39 2.69 Broccoli MiscellaneousBlueberry 2.45 Blueberry Chicken Carrot Cane Sugar 3.05 CandidaCoconut Albicans 1.96 Banana 12.84 Egg White Radish Potato 13.63 CaneCranberry Sugar 4.90 Eggplant Turkey 2.43 Egg Yolk Orange 12.91 CocoaGrape 2.06 Green Pepper Flax 3.57 Lamb Spinach 3.25 CoffeeGrapefruit 4.16 Cabbage Cashews 1.98 Pork Oat 1.68 Grape HoneyLemon 5.40 Pumpkin 3.13 Turkey Beet 2.26 MushroomOrange 2.25 Nuts and Seeds 3.06 Yeast,Papaya Bakers * 1.78 Almond 1.86 8.62 Yeast,Peach Brewers * 1.67 Cashews 2.12 8.40 *Saccharomyces cerevisiae Pear 2.60 Flax 2.18 PineappleNot Significant 1.00-1.99 2.59 Hazelnut 1.45 PlumLow (Prune) 2.00-3.49 1.69 Peanut 3.77 Moderate Strawberry 3.50-4.99 5.33 Pecan 2.56 High Watermelon >=5 2.66 Pistachio 2.66 Grains Sesame 2.85 Barley 3.61
Testing performed by The Great Plains Laboratory, Inc., Lenexa, Kansas. The Great Plains Laboratory has developed and determined 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. the performance characteristics of this test. This test has not been evaluated by the U.S. Food and Drug Administration.
12 call: (913) 341-8949 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 LAM the health and development of children. High levels of toxic metals PATIENT deposited in body tissues, and subsequently the brain, may cause The Great Plains Laboratory, Inc. SEX: AGE: significant developmental and neurological damage. CLIENT#: A Metals Hair Test is ideal for checking current exposure to toxic metals. For example, a study in Poland found a high correlation TOXIC RESULT REFERENCE between hair and brain mercury. Hair provides important ELEMENTS µµµg/g RANGE 1 Aluminum 33 < 8.0 information that can assist practitioners with an early diagnosis Antimony 0.091 < 0 . OM of physiological disorders associated with aberrations in essential Arsenic 0.036 < 0.080 and toxic element metabolism. Beryllium < 0.01 < 0.020 Bismuth 0.009 < 0.13 The U.S. Environmental Protection Agency stated in a recent Cadmium 0.021 < 0.15 Lead 1.6 < 1.0 report that “... if hair samples are properly collected and cleaned, Mercury 1.6 < 0.40 and analyzed by the best analytic methods, using standards and Platinum < 0.003 < 0.005 blanks as required, in a clean and reliable laboratory by experienced Thallium < 0.001 < 0.010 Thorium < 0.001 < 0.005 personnel, the data are reliable” (U.S.E.P.A. 600/4-79-049). Uranium 0.091 < 0.060 Nickel 0.24 < 0.40 The Center for Disease Control acknowledges that hair mercury Silver 0.26 < 0.20 levels provide a valuable maternal and infant marker for exposure Tin 0.37 < 0.30 to neurotoxic methylmercury from fish. Titanium 0.92 < 1.0 Total Toxic Representation IIMMI. Clinical Usefulness Report Analysis - Hair Metals Test ELEMEli ■■Determine if metal toxicity is contributing to a disorder µµµ _ Calcium Toxic element representation 125- 370 ■■Determine if a deficiency in minerals is inhibiting metabolic Magnesium 12- 30 processes Sodium The greater the elevation 12- 90 of the toxic metals Potassium found in the test, the 12- greater 40 the risk for Copper 8.0- 16 Recommendations Zinc damage. High accumulation 100- 190 of heavy metals Manganese can cause or contribute 0.20- 0.55 to chronic illness. Depending on test results, follow-up may include: Chromium Test results will help 0.26- identify 0.50 the source of the Vanadium 0.030- 0.10 ■■Identification of the source of contamination Molybdenum exposure. 0.050- 0.13 ■■Elimination of heavy metals from the environment Boron 0.60- 4.0 Iodine Aluminum, Antimony, 0.25- Arsenic, 1.3 Beryllium, I= ■■Elimination of heavy metals from the body Lithium Bismuth, Cadmium,0.007- Lead, 0.023 Mercury, Platinum, ■■Mineral supplementation Phosphorus Thallium, Thorium, 160- Uranium, 250 Nickel, Silver, Tin, 0.95- 1.7 ■■Administration of supplements that support detoxification Selenium Strontium Titanium 0.16- 1.0 Sulfur Essential element45500- representation 53000 Specimen Requirements Barium 0.16- 0.80 Cobalt Nutritional mineral0.013- assessment 0.035 in hair can 1 gram of hair. Iron 8.0- 19 Germanium identify the disruption0.045- 0.065of transport due to heavy Rubidium metals accumulation.0.016- Dietary 0.18 deficiency in CPT Codes Zirconium essential minerals0.040- (metals) 1.0 can seriously inhibit neurotransmission and the body’s ability to ■ Hair: 82108 82300 82525 83018*28 83655 83735 83785 83825 COMMENTS 83885 84100 84255 84630 Date Collect( eliminate harmful toxins. Date Receive Calcium, Magnesium, Sodium, Potassium, 4- 30 No Medicare Coverage Date Comple 0.8- 8 Copper, Zinc, Manganese, Chromium, 0.5- 10 Methodology Vanadium, Molybdenum, Boron, Iodine, Lithium, 4- 20 Phosphorus, Selenium, Strontium, Sulfur, V06.99 > 800 The Great Barium, Cobalt, Iron, Germanium, Rubidium, 662' Zirconium; Ratios: Calcium/Magnesium, Sodium/Potassium, Zinc/Copper, Zinc/ Cadmium, Calcium/Phosphorus
13 www.GPL4U.com
Metals Tests
Additional Metals Tests CPT Codes Blood is routinely checked for metals toxicity; Whole Blood: 82310 82495 82525 83018*7 however, blood only reflects very acute and 83655 83735 83825 84132 84255 84285 extreme poisoning by metals. Acute metals 84295 84630 The Great Plains Laboratory, Inc. poisoning is rare. A chronic, low-level exposure Red Blood Cell: 82175 82300 82310 82495 to toxic metals, which can result in significant 82525 83015 83018*4 83655 83735 83785 retention in the body, is more common. This 83825 84100 84132 84255 84630 IS can be associated with a vast array of adverse PERCENTILE Urine: 82108 82175 82300 82495 82525 th 95th health effects and chronic disease. Cellular µµµ 68 damage can occur at much lower levels than 82570 83018 83540 83655 83735 83785 < 8.0 III what is expressed in blood. We recommend 83825 83885 84100 84133 84255 84300 < 0.080 I blood only for checking levels of essential 84630 < 0.020 < 0.13 minerals and acute exposure to heavy metals. Fecal: 82175 82300 82525 83015 83655 < 0.15 Urine testing is recommended to check how 83825 83885 < 1.0 < 0.40 well toxic metals are being eliminated after No Medicare Coverage (for all metals tests) < 0.005 consuming a chelating (metal removing) agent. < 0.010 Analysis of the toxic metals concentrations < 0.005 Report Analysis - Additional < 0.060 in urine after the administration of a metal < 0.40 detoxifying agent is an objective way to Tests for Metals < 0.20 ED evaluate the accumulation of toxic metals in < 0.30 < 1.0 body tissues. Whole Blood Fecal testing is recommended for the Essential: Calcium, Copper, Lithium, determination of actual exposure to metals as Magnesium, Manganese, Molybdenum, PERCENTILE 97.5th opposed to the accumulation of metals in the Selenium, Strontium, Zinc Toxic: Arsenic, µµµ 84th 125- 370 body. Analysis of elements in feces provides Barium, Cadmium, Cobalt, Lead, Mercury, 12- 30 indirect information about the potential for Nickel, Platinum, Silver, Thallium, Uranium 12- 90 12- 40 toxic metals burden. For many toxic metals, 8.0- 16 ill fecal (biliary) excretion is the primary natural Red Blood Cell 100- 190 route of elimination from the body. Thus, the 0.20- 0.55 representation of metals in fecal matter is a Essential: Boron, Chromium, Calcium, Copper, 0.26- 0.50 Iron, Magnesium, Manganese, Molybdenum, 0.030- 0.10 reflection of the metals ingested in the diet or 0.050- 0.13 excreted into the intestine. Phosphorus, Potassium, Selenium, Vanadium, 0.60- 4.0 III Zinc 0.25- 1.3 MI 0.007- 0.023 • Specimen Requirements Toxic: Arsenic, Cadmium, Lead, Mercury, 160- 250 MI Thallium 0.95- 1.7 MI Whole Blood: 7 mL of whole blood drawn in a 0.16- 1.0 11 royal blue-topped potassium EDTA tube. I=1 45500- 53000 ii Urine 0.16- 0.80 IINO Red Blood Cell: 4 mL of packed cells in a royal 0.013- 0.035 MI Essential: Boron, Calcium, Chromium, Cobalt, L blue-topped potassium EDTA tube. 8.0- 19 • Copper, Iron, Magnesium, Manganese, 0.045- 0.065 Urine: 50 mL of urine. Molybdenum, Phosphorus, Potassium, 0.016- 0.18 ■ 0.040- 1.0 Fecal: 35 mL of stool collected in the red- Selenium, Sodium, Strontium, Sulfur, topped vial (with ultra-pure water). Do not Vanadium, Zinc EXPECTED overfill the specimen. Toxic: Aluminum, Antimony, Arsenic, Barium, ELEMENTS RATIOS RANGE Ca/Mg 6.63 4- 30 Beryllium, Bismuth, Cadmium, Cesium, Ca/P 2.48 0.8- 8 Gadolinium, Lead, Mercury, Nickel, Palladium, Na/K 0.5 0.5- 10 Platinum, Tellurium, Thallium, Thorium, Tin, 4- 20 Zn/Cu 8.18 Titanium, Tungsten, Uranium V06.99 Zn/Cd > 999 > 800 14 • Tel: 913.341.8949 • Fax: 913.341.6207 Fecal Toxic: Antimony, Arsenic, Beryllium, Bismuth, Cadmium, Copper, Lead, Mercury, Nickel, Platinum, Thallium, Tungsten, Uranium
14 call: (913) 341-8949 Gluten / Casein Peptides Test
General Description Recommendations Peptides are incompletely degraded pieces of protein. The peptides Depending on test results, follow-up may include: from gluten and casein are important because they can react with ■■Restriction of gluten and casein from the diet opiate receptors in the brain, mimicking the effects of opiate drugs ■■Administration of digestive enzymes like heroin and morphine. These compounds, called neuropeptides, ■■Nutritional counseling have been shown to react with areas of the brain such as the ■■Calcium supplementation temporal lobes, which are involved in speech and auditory integration. Neuropeptides also reduce one’s ability to feel pain and influence cognitive function. Specimen Requirements 10 mL of first-morning urine before food and drink. The patient Many people with food allergies to milk and wheat also experience must discontinue soy proteins one week prior to collection of the opiate-like effect of gluten and casein neuropeptides. Others specimen (soy bean oil and soy lecithin are considered acceptable). experience this effect in the absence of milk and wheat allergies. Thus, it is wise to complete both peptide and food allergy testing. CPT Codes Clinical Usefulness 82570 83519*2 ■■ Determine whether cognitive or behavioral abnormalities may be No Medicare Coverage 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- and casein-free diet
- f The Great Plains Laboratory, Inc.
-•• ••••1. Report Analysis WII1larn Shaw..6..T .121rector 11413164a 77th %vas Lone6a. KS 64214 (413) 341.0949 Fax (413) 341.6207
Requisition is Physician Name:
Patient Name: Date of Collection:
Patient Age: Time of Collection: Gliadorphin (or gluteomorphin) is a peptide derived from Sow Print Date: the wheat protein gluten. Other related grains such as rye, Peptides Relative barley, and oats also contain the sequence of amino acids Papacies Peptide (P) Creatinine (C) Relative Ratio Ratio ng/mi mg/di (P/C) Normal found in gluten. Casomorphin (Milk) 175.4 82 2.13 40.58
Gliadorphin (Wheat) 4.8 82 0.06 40.58 Casomorphin is a peptide derived from the milk protein
casein. Casein is one of the major proteins in the milk of all If either of the peptide results is abnormal, a gluten-free and caselbfree diet should be considered for the person who wee tested. H both peptide results are normal, further testing with IgG food allergy tests should be done mammals, including cows, goats, and humans. before adopting a diet containing gluten and/or casein. If both peptide and IgG food allergy tests are norms!, then the person can probably tolerate gluten and casein but a one-month elimination diet trial without these foods might still be useful. The composition of casomorphin and gliadorphin are very Children on gluten and/or casein free diets may have normal values of the peptides In urine. Children with high values may benefit from gluten/casein free diets and/or peptides. supplementation. Children with normal papa& similar. Both casomorphin and gliadorphin contain a sequence values may still have wheat and/or milk anemias that can be debated by allergy tests.
of seven amino acids, including the sequence tyrosine and People on e diet containing soy proteins or who areconsuming soy "milk. may also have high peptides in their urine. Soy proteins are used as emulsifier., extenders, binders and stabilizers in meat, poultry, snack foods, proline at the N-terminus, and proline at positions 4 and 6. sabage, frozen spaghetti, and whipped toppings. Textured vegetable protein (TVP) is soy based and many meat substitutes are soy-based. We have found that individuals on soy may have high values for gliadorphin and/or casomorphin presumably baccause of papacies from soy that are similar or identical 10 those in gluten or casein These incompletely digested peptides are structurally similar (Zhang Xi, Wang HY, Fu ZQ, WuX11, XuGL Bloactive small peptides from soybean protein. Ann N Y Aced Sal 1998 to the opiate receptors in the brain. Once absorbed, they can Dee 13; M. 640-5). Individusis on peptidases such as Serenade or Enzymade may have high peptide values in the urine. This does not alter behavior and other physiological reactions. mean that thees products are harmful in any way. We cannot rule out the possibility that one of the components of fhbe products could be interfering in the tests for gliadorphin and/or casomorphin.
Individuals consuming large amounts of soy may have This bat was developed and its performance characteristics determined by The Great Plains Laboratory. It has not been cleared or approved by the U.S. Food and Drug Administration.
high values of casomorphin and gliadorphin in the urine The FDA has determined that such clearance or approval is not necessary. This laboratory is certified under the Clinical Laboratory Improvement Amendments of 1988 CCUAI as qualified to perform high-complexity clinical presumably because the peptides from soy are structurally tasting. similar or identical to those in gluten and casein.
15 www.GPL4U.com IgE Food and Inhalant Allergy Tests
General Description Report Analysis 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 IgE Food Allergy Advanced Test can be subtle and similar to those seen in other conditions. This Almond, Apple, Apricot, Asparagus, Avocado, Banana, Barley, potential confusion makes diagnostic testing very important in Beef, Beet, Blueberry, Broccoli, Buckwheat, Cabbage, Cane recognizing the offending source. The Advanced IgE Tests increase Sugar, Carrot, Casein, Cashews, Celery, Cheese, Chicken, the chance that a patient may identify numerous offending foods Coconut, Cod Fish, Cocoa, Coffee, Corn, Crab, Cranberry, and/or inhalants, including Thimerosal and Candida. Eggplant, Egg White, Egg Yolk, Flax, Garbanzo Bean, Garlic, Gluten, Goat’s Milk Cheese, Grape, Grapefruit, Green Bean, Clinical Usefulness Green Pepper, Halibut, Hazelnut, Honey, Kidney Bean, Lamb, Lemon, Lentil, Lettuce, Lima Bean, Lobster, Mango, Milk, Millet, ■Promote non-invasive, food-based therapy ■ Mushroom, Oat, Onion, Orange, Papaya, Pea, Peach, Peanut, ■■Eliminate allergy triggers Pear, Pecan, Pineapple, Pinto Bean, Pistachio, Plum, Pork, ■■Reduce the burden on the immune system Potato, Pumpkin, Radish, Raisin, Rice, Rye, Salmon, Sardine, ■■Reduce inflammation Sesame, Shrimp, Soybean, Spinach, Strawberry, Sunflower, ■■Reduce food cravings Sweet Potato, Tomato, Turkey, Tuna, Walnut, Watermelon, ■■Improve assimilation of nutrients Wheat, Whey, Yogurt, Yeast (Bakers), Yeast (Brewers), Zucchini
Recommendations IgE Inhalant Allergy Advanced Test Depending on test results, follow-up may include: Acacia, Alder (Smooth), Alternaria, Ash (White), Aspergillus, Bahia Grass, Bermuda Grass, Bluegrass (Kentucky), Box ■■Elimination of the offending foods Elder (Maple), Brome Grass, Candida, Cat, Cedar (Mountain), ■■Elimination of the offending inhalants Cladosporium, Cocklebur, Cockroach, Corn (Cultivated), ■■Immune system support Cottonwood Tree, Cypress (Bald), Dockweed (Yellow), Dog, ■■Gut restoration Elm (American and Fall Blooming), Ferret, Fescue (Meadow), ■■Implementation of a rotation diet Gerbil, Goldenrod, Hickory (White), House Dust, Iodine Bush, ■■Supplementation Johnson Grass, Lamb’s Quarters, Maple (Red), Marsh Elder ■■Administration of antihistamines (Rough), Mexican Tea, Mite (D. Farinae), Mouse, Mulberry ■■Use of air purifiers (Red and White), Nettle, Oak (Live, White, and Red), Oats, (Cultivated), Oat Grass Tall, Pecan Tree, Penicillium, Pigweed Specimen Requirements (Spiny and Rough), Plantain (English), Poplar (White), Privet, IgE Food Allergy Tests: Rabbit, Ragweed (Giant and Short), Rye (Cultivated), Rye Grass 5 mL (Basic) or 8 mL (Advanced) of serum in a gold-topped SST or (Perennial), Salt Cedar, Salt Grass, Sheep Sorrel, Sweet Gum, royal blue-topped no-additive tube. The elimination of a food will Sycamore, Thimerosal, Timothy Grass, Tree of Heaven, Walnut reduce the ability for our laboratory to detect antibodies (allergies) (Black), Western Water Hemp, Wheat (Cultivated), Willow to that food. (Black) IgE Inhalant Allergy Tests: 5 mL (Basic) or 8 mL (Advanced) of serum in a gold-topped SST or * Smaller panels are also available for royal blue-topped no-additive tube. 25 foods and 36 inhalants CPT Codes IgE Food Allergy Tests: 86003*25 86003*93 IgE Inhalant Allergy Tests: 86003*36 86003*69 No Medicare Coverage
16 call: (913) 341-8949 Hormone Panels
General Description Recommendations Hormones are essential for our overall well-being. Sex hormones Depending on test results, follow-up may include: and the adrenal (stress) hormones are subject to change due to ■■Adjustments in hormone therapy age, environmental stress, and other factors. DHEA and cortisol ■■Lifestyle changes are the main adrenal stress hormones. The primary sex hormones ■■Symptom relief therapy are the three main estrogens (Estrone, Estradiol, and Estriol) and testosterone. We frequently think of estrogen as being a female Specimen Requirements hormone and testosterone as being a male hormone, but men and women make both, plus several more that must be in balance for Saliva: 3/4 Saliva Tube full x4 optimum health. CPT Codes An imbalance of any hormone can throw physical and mental Comprehensive Plus Panel: health out of balance, causing aggravating and even serious health problems. For decades Western medicine has prescribed Hormone 82679 82670 82677 84144 84402 82626 82530*4 Replacement Therapy as a “one size fits all” approach. However, Comprehensive Panel: hormones are like fingerprints, and in order to achieve optimum health, people should be aware of their specific imbalances. 82670 84144 84402 82626 82530*4 Short Comprehensive Panel: Being able to identify a hormonal imbalance is essential to designing 82670 84144 84402 82626 82530*2 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. Tire Greet Philo! rrrrrrr . Inc in..,
Report Number: Patient Info: Sample Collection Date/Time -SMP01 Amber Sample H Morning 06/25/2012 0530 Clinical Usefulness Noon 06/25/2012 1130 Provider: Age:28 Gender:F Evening 06/25/2012 1745 Labrix Clinical Services, Inc Night 06/25/2012 2200 Menopausal Status: 16255 SE 130th Ave Clackamas, OR 97015 Samples Arrived 06/26/2012 [email protected] Results Reported 06/28/2012 ■■Determine if there are hormonal imbalances Ordering Provider: 123 A St. Suite B Portland, OR 97123 ■■Determine if there is estrogen dominance Saliva Hormone Test Result Units L WR H Reference Range Estrone (E1) 6.00 pg/ml 7.2-40.6 pre menopausal Estradiol (E2) 6.48 pg/ml 1.5-10.8 supplementation ■■Monitor exogenous hormone therapies Estriol (E3) 30.00 pg/ml <30.0 female, non-pregnant EQ (E3 / (E1 + E2)) Progesterone (Pg) 200.00 pg/ml The127.0-446.0 Great pre menopausal Plains (luteal) Ratio of Pg/E2 ■■Assess disruption of optimum diurnal cortisol patterns Testosterone 56.00 pg/ml 6.1-49.0 female Report Number: Patient Info: Sample Collection Date/Time -S0052 Aurora Sample Morning DHEA 252.60 pg/ml 106.0-300.0 female Noon 41.00 nmol/L 5.1-40.2; optimal range: 18-35* Cortisol Morning Provider: Age:52 Gender:F Evening Cortisol Noon 15.00 nmol/L The2.1-15.7; Great optimal Plains range: Laboratory 6-12* Inc Night Menopausal Status: Cortisol Evening 2.00 nmol/L 118131.8-12; West optimal 77th range: Street 4-8* Post-Menopause Samples Arrived 06/15/2012 Cortisol Night 0.80 nmol/L Lenexa,0.9-9.2; optimalKS 66214 range: USA 2-6* Results Reported 06/18/2012
Hormone Interpretations: Saliva Hormone Test Result Units L WR H Reference Range
Estrone and estradiol are within the referenceEstrone ranges, (E1) however the Estrogen Quotient (EQ) is suboptimal.pg/ml Estriol is less potent than the other estrogensEstradiol and when (E2) present in sufficient quantities1.00 (as indicatedpg/ml by an 1.0-3.2 post menopausal (1.5-10.8 supplementation) optimal EQ) it plays an antagonistic role,Estriol and may (E3) govern the proliferative effects of estrone andpg/ml estradiol. Although estriol level is above the referenceEQ (E3 range / (E1 (likely + doE2)) to individual variance), estriol supplementation is a consideration to optimize this quotientProgesterone and reduce associated (Pg) risks. * References47.00 available pg/mlupon 18.0-126.0 post menopausal (500-3000 supplementation) request. Ratio of Pg/E2 47.00 200-600 post menopausal (Pg supplementation)** Progesterone to estradiol (Pg/E2) ratio and reported symptoms are consistent with estrogen dominance. Testosterone 11.90 pg/ml 6.1-49.0 female (30.0-60.0 supplementation) Supplementation with topical progesterone to correct this relative deficiency is a consideration. Report Analysis DHEA level is consistent with stress response or supplementation (not reported), although metabolic syndrome cannot be ruled out. Serum DHEAvitamin D, fasting glucose and insulin testing78.40 may be warranted.pg/ml 106.0-300.0 female Adrenal gland function appears reasonablyCortisol adequate. Morning Query thyroid insufficiency12.10 (perhaps relatednmol/L to iodine 5.1-40.2; optimal range: 18-35* deficiency). Cortisol Noon nmol/L Cortisol Evening 11.30 nmol/L 1.8-12; optimal range: 4-8* Notes: Cortisol Night nmol/L L=Low(below range) WR=Within Range (within range) H=High (above range) Adrenal Phase: DHEA, Testosterone, Estrone and Estriol results are for investigational use only. Short Comprehensive Panel (for men + women): *Apply only when all four cortisols are measured. Clinical interpreations may override these generalized optimal ref. ranges. **The Pg/E2 ratio is an optimal range established based on clinical observation. Progesterone supplementation is generally Hormone Interpretations: required to achieve this level in men and postmenopausal women. The Great Plains Notes: ■■Estradiol (estrogen) ■■DHEA L•bcrnIn, 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. Patient Info: Samples Date/Time Report Number: **The Pg/E2 ratio is an optimal range established based on clinical observation. Progesterone supplementation is generally David Sample ■■Progesterone ■■Cortisol (2x a day) 09-999 Morning required11/07/2005 to achieve this 0800 level in men and postmenopausal women. Age: 46 Gender: M Noon 11/07/2005 1230 Provider: Just Hormones Menopausal Status: Evening 11/07/2005 1820 None ■■Testosterone 232323 SW Hormone St. Night 11/07/2005 2350 Mesa, AZ 85215 The Great Plains Laboratory Inc87654 | Analyzed NE Balanced by Labrix Clinical Street Services, Inc. ADDRESS: 16255 SE 130th Avenue | Clackamas, OR 97015 Suffern, NJ 10901 Date Samples 11/10/2005 Phone: Not available Date Results 11/11/2005
Saliva Hormone Test Result Units L WR H Reference Range Comprehensive Panel (for men + women): Estradiol [E2] <1.0 pg/ml X (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 Progesterone 35.9 pg/ml X (1) 18-51 post-menopausal; (2) 127-446 pre-menopausal-luteal; (3) 500-3000 supplementation; (4) <94 males Ratio of Pg/E2 35.9 X (1) 200-600 females; (2) 200-300 males; Testosterone 46.1 pg/ml X (1) 30.1-142.5 males; (2) 4.5-49 females; (3) 30-60 therapy females; (4) 250-350 therapy males; ■■Add 4x cortisol DHEA 61.3 pg/ml X (1) 137-336 males; (2) 106-300 females; Cortisol Morning 4.0 nmo/L X (1) 5.1-40.2; Optimal Range: 18-35* Cortisol Noon 4.7 nmo/L X (1) 2.1-15.7; Optimal Range: 6-12* Cortisol Evening 1.5 nmo/L X (1) 1.8-12; Optimal Range: 4-8* Cortisol Night <0.3 nmo/L X (1) 0.9-9.2; Optimal Range: 2-6*
*DHEA, Testosterone and Estriol results are for investigational use only L=Low (below reference range) WR=Within Range (within reference range) H= High (above reference range) Comprehensive Plus Panel (for women only): * 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
Cortisol Graph Interpretations: 50 ■■Add: Estrone, Estriol • 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 dE11.11q1CaMil.1011111011.
•L.A. Imbima• cer.....sperlsd.awy.nplerm on1 IN en red. 30 with metabolic syndrome (insulin resistance). Fasting blood sugar and insulin levels may be warranted. Boosting the testosterone level is a consideration. 20
(nmo/L) • DHEA level is consistent with the expected decline with age (adrenopause). The low DHEA level may warrant supplementation for optimal well-being. Note: Supplementation with DHEA may 10 increase testosterone and/or estradiol levels.
• Diurnal cortisol pattern and reported symptoms are consistent with established (Phase 3) adrenal 0 11.....0ryize•Ink0. emeaNtArtgyrela onekricane NOON NIGHT ruled out. MORNING EVENING
The Great Plains Laboratory Inc | Analyzed by Labrix Clinical Services, Inc. ADDRESS: 16255 SE 130th Avenue | Clackamas, OR 97015 17 www.GPL4U.com Amino Acids Tests
General Description Specimen Requirements The Amino Acids Urine and Plasma Tests can be utilized by the Urine: 25 mL of first-morning urine before food or drink. The medical practitioner for different purposes. Urinary amino acids patient should discontinue amino acid supplementation prior to are discarded by the body as excess or “waste,” while amino acids collection. present in plasma indicate availability for building structural, - or - transport, and storage proteins. Amino acids also play a role in Plasma: 7 mL of whole blood in a lavender-topped EDTA tube. neurotransmitter functioning, cholesterol and carbohydrate Specimen must be returned within 24 hours of the collection. This metabolism, and detoxification processes. test is only available in the US.
Clinical Usefulness CPT Codes ■■Determine the availability of essential/conditionally 82139*1 82140 82492 84540 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 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
LABE PATIENT: The Great Plains Laboratory, Inc. SIX: Male AGE: 17 Report Analysis CLIENTS: MMMMMMMMr Essential/conditionally indispensable amino acids reflect SPECIMEN RESULT REFERENCE PE LE MARKERS 2.r ,s. S4°1 97.601 dietary intake. Creatinine 32 45- 225 in:08L ChLaraimiGlutenzle 38 5- 160 LI. Ammon:44.M 19800 9000- 39000 µM Nonessential amino acids reflect assimilation of proteins and SPECIMEN VALIDITY INDEX I.
usage by the body. ESSENTIAL / CONDITIONALLY INDISPENSABLE AMINO ACIDS ESSENTIAL RESULT REFERENCE PE so I.E AMINO ACIDS µµµm..0. RANGE Le 1e Se 97.5. Gastrointestinal markers determine the availability of Methicmine 6.6 7- 35 Lyttine 200 35- 500 proteins involved in the assimilation of nutrients. Thremine 120 60- 230 Lo Lm in 37 18- 70 IL Isoleucine 13 8- 35 Magnesium-dependent markers indicate the synthesis of Velure 10 12- 50 11.0121.minc 40 25- 75 IL amino acids that require magnesium. TOP:NM 27 20- 75 Teeine 1200 170- 1200 B , B , and folate dependent markers indicate the Cr... 66 20- 57 6 12 AGIN. 23 8- 50 Lo metabolism of amino acids that require these HislitlDe 1080 270- 1150 NONE88ENTUILAMINO ACIDS co-factors. NONESSENTIAL RESULT REFERENCE PERCENTILE AMINO ACIDS µµµ...... RANGE 2.5. ir Wrl NA 97.5. Alminc 230 100- 500 L. Detoxification markers indicate the availability of amino Pup.. 20 20- 70 Saperegim 130 50- 225 acids involved with trans-sulfuration pathway. GINLmine 250 180- 530 0190899 6.6 5- 45 Neurological markers indicate the availability of the amino Cy./ 83 20- 90 Glycke 920 400- 1800 acids needed for the synthesis of neurotransmitters. 86 30- 150 Seth. 340 130- 400 Pon. 5 1- 45 IL Urea cycle metabolites indicate the availability of amino acids needed for ammonia detoxification. The Greet Plaine Laboratory, Inc. • 11813 W. 77 Street, Lenexa KS, 66214 • Tel: 913.341.8945 • Fax: 513.341.6207
18 call: (913) 341-8949 Vitamin D Test
General Description Recommendations Vitamin D is a generic term that includes several metabolically Depending on test results, follow-up may include: related sterol substances that have hormonal activity. The ■■Addition of vitamin D supplementation metabolite 25-hydroxyvitamin D is the major circulating form of ■■Increased sun exposure vitamin D in the body and the best indicator of a patient’s status ■■Discontinuation of supplementation due to its long half-life (2-3 weeks). The major biologic function ■■Dietary modifications of vitamin D is to maintain normal blood levels of calcium and phosphorus involved in bone mineralization. Vitamin D also ■■Additional testing controls more than 1,000 genes, including those responsible for the regulation of cellular proliferation, differentiation, apoptosis, Specimen Requirements and angiogenesis. The immune-modulating effects of vitamin D Serum: 2 mL of serum in a gold-topped SST. are profound as evidenced by the many conditions associated with - or - vitamin D deficiency. Dried Blood Spot (DBS): Five full circles of dried blood on the protein Clinical Usefulness saver card. ■■Determine if dietary vitamin D is sufficient ■■Determine if sun exposure is adequate CPT Codes ■■Determine if supplementation is reaching toxic levels 82306 82542 ■■Assess the likelihood of malabsorption, liver disease, and No Medicare Coverage nephrotic syndrome
Report Analysis The Great Plains Laboratory, Inc. Vitamin D Two forms of vitamin D (25-OH-VitD2 and 25-OH-VitD3) Wiliam sna re PhiD.. Director I 18 I3West nth Street Lenexa. ff5 66214 1913) 1414949 Fax 14131341.6207 rmemitiffon osi Physic!. Nam, are measured in this analysis. Vitamin D is obtained from Pagaol Name: Dale of Coilecbon:
foods of animal origin and from ultraviolet light-stimulated Patient Age: Mete of Cofieoffon: conversion of 7-dehydrocholesterol in the skin. Small Sac ,Vint MA 4:
amounts of vitamin D are obtained from foods of plant Vitamin A 25 OH origin. Vitamin D is used to fortify various foods and is metabolic Marker Relimente Range- nufint. PAM,. Vett* - notch available in over-the-counter supplements. 25-Hydrant 02 c 4.0 25-Hydro:rt. 03 2g0 Desirable values are 25-80 ng/mL. Mild to moderate 20-Mytelimi D FOtat ID2+D0) 25 - 80 29.0 deficiency values are 10-24 ng/mL. Values below 10 ng/mL
indicate severe deficiency, and values over 80 ng/mL indicate 410 non's_ severe deficisnoy. 10-24 agrthi mild to moderate deficiervoie. possible toxicity. 25-80 agfrni optimum leveler' 81-150 motmL toxicity possibia** e1511rmfml_ toxlo levels *""*
Could be amocithed with osteornalacia or rickets May be aslotheted with inbrethed rob en ostoopoomet or SecOndery nypaNimativoidam Oblinum levels in die normal mombilion 80ntent la the lowest reported level associated wilt toxicity in paterasiantrout Mary hyperparathmoidisan who have limiest renal luntim MOM patieols with Imlay have lavals >150nollint. Patients with mnial Mime mn have very high 2.5-0M-WO teweiS senthil any SIM 0010xMly, 00 renal Oenvenntin tO the adive hannarie 1, 25-0M-VI0 i9 impaled Or sliest
These veteran. ranges represent chino& decision values that apply to Mee and barman of MI ages, rather than populatian-based reference vetoes. Populatian Magma ranges far 25-01-1-14ID vary widely depentrig on ethnic background, age, geographic location of the studied populations, and the sartiOnthseason. Population-based newel correlate goody with serum 25-OH-VW ooncontratimm that are uncoated with biologically arid Or:sally relevant OlImso C effects and are Therefore of Imbed clnicol value
19 www.GPL4U.com Advanced Cholesterol Profile
General Description Recommendations The concept of “good” and “bad” cholesterol depends highly on Depending on test results, follow-up may include: the circumstances of the individual person. Although very high ■■Dietary modification blood serum cholesterol values are associated with heart disease, ■■Supplementation low values (below 160 mg/dl) are associated with increased violent ■■Follow-up/confirmational testing behavior, suicide, depression, anxiety, bipolar disease, Parkinson’s disease, and increased mortality from cancer. Low cholesterol values Specimen Requirements are also associated with manganese deficiency, Celiac disease, hyperthyroidism, liver disease, malabsorption, and malnutrition. 2 mL of serum in a gold-topped SST or in a royal blue-topped no- additive tube. Clinical Usefulness ■■Determine whether a cholesterol deficiency is present CPT Codes ■■Determine if cholesterol is elevated 82172*2 82465 83090 83695 83718 ■■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 The Great Plains Laboratory, Inc. Total cholesterol: Total cholesterol measures all types of cholesterol. 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 Patient ID # Date Reported Patient Name Date of collection Patient age Time of collection of HDL (high density lipoprotein). Physician name Patient Sex Apolipoprotein B (Apo B): The main protein component of LDL (low density lipoprotein). Total Cholesterol Lipoprotein (a) (Lp (a)): Consists of two components: LDL Cholesterol Result mg/dL 124 and a glycoprotein, linked by a disulfide bridge. Reference Range Result 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. Reference ranges for normal people. Age -years Males Males Females Females Each result is reported as low, intermediate, or high 5 percentile 95 percentile 5 percentile 95 percentile according to the ranges established. 0-4 114 203 112 200 5-9 121 203 126 205 10-14 119 202 124 201 Reference chart: Values are deemed significant according 15-19 113 197 119 200 to the age and sex of the patient. A comprehensive chart is 20-24 124 218 122 216 25-29 133 244 128 222 included with the test results. 30-34 138 254 130 230 35-39 146 270 140 242 40-44 151 268 147 252 45-49 158 276 152 265 50-54 158 277 162 285 55-59 156 276 172 300 60-64 159 276 172 297 65-69 158 274 171 303 >70 144 265 173 280
Source: Lipid Research Clinics Population Studies Data Book, NM publication no. 80-1527
20 call: (913) 341-8949 Immune Deficiency Profile
General Description Recommendations Individuals with recurrent infections, otitis media, asthma, and Depending on test results, follow-up may include: certain genetic disorders may have an immune deficiency or ■■Follow-up allergy testing in those with high levels imbalance contributing to their disorder. Immunodeficiency of IgG or IgE predisposes an individual to intestinal yeast overgrowth, ■■Supplementation with zinc and selenium opportunistic infection, and poor health. An overactive immune ■■Supplementation with lactoferrin and colostrum system is a major contributor to severe environmental allergies ■■IV administration of gamma globulin and IgG and may contribute to the development of autoimmune diseases such as rheumatoid arthritis and lupus. ■■Administration of Transfer Factor ■■Supplementation with L-Glutathione, coenzyme Q10, and Clinical Usefulness N-acetylcysteine ■■Assess the adequacy of immunoglobulin levels Specimen Requirements ■■Determine whether high levels of immunoglobulin are present 3 mL of serum collected in a royal blue-topped no-additive tube. ■■Assess the adequacy of zinc levels ■■Assess the potential for allergies ■■Determine whether the individual is at risk for infection CPT Codes 82784 82785 82787*4 84630
Report Analysis The Great Plains Laboratory, Inc.
IgM is the first response to infection or immunization. The William Shaw, Ph.D Director 11813 W. 77th Street, Lenexa, KS 66214 (913) 341-8949 Fax (913) 341-6207 presence of high levels of IgM antibodies indicates a recent ID Number Date Reported Patient Name Date of collection infection. IgM antibodies diminish a few months after Patient Age Time of collection infection. Physician name Patient Sex
IgG antibodies are produced by the B-lymphocytes when the IMMUNE DEFICIENCY PANEL body is attacked by the same microorganism in a subsequent Immunoglobullne Reference IgG Subclasses Reference invasion. Ranges Ranges mgldl IgE triggers histaminic allergy reactions (hives, sneezing, IgG 694 667 to 1454 I9G-1 505 342 to 1150 IPA 64 L 77 to 219 I9G-2 130 100 to 455
reddened skin, etc.). IgE also protects the body from parasites. IgM 94 49 to 261 IgG-3 24 26 to 125
Elevated serum IgE is associated with a history of excessive IUhnl 190-4 7 4 to 136 IgE 225 H 2.4 to 52 allergies. Metals Ug/ml IgA protects the nasal and intestinal lining from Imo' 0.60 L 0.66 to microorganisms. Blood levels of IgA may indicate genetic
ability to produce sufficient amounts of IgA. Secretory IgA A patient with an IgE value greater than 751U/m1 la likely to have significant IgE allergies and shoukl be further evaluated to determine specific IgE allergies as well as IgG allergies.
(sIgA) is measured in stool samples and may vary widely If a patient has an IgE value of less then 10 !Wm!, IgE allergies are unlikely but the patient may all depending on the conditions in the bowel. have significant IgG allergies. Patients with IgE between 10-751U/m1 may have intermediate values of IgE mediated allergies and might also have 19G allergies.
21 www.GPL4U.com Comprehensive Stool Analysis
General Description Report Analysis The Comprehensive Stool Analysis detects the presence of Bacterial culture pathogenic microorganisms such as yeast, parasites, and bacteria that contribute to chronic illness and neurological dysfunction. 73 possible species of imbalanced and dysbiotic bacteria, 6 It provides helpful information about prescription and natural species of beneficial bacteria. products effective against specific microorganism strains detected Yeast (mycology) culture in the sample. The test also evaluates beneficial bacteria levels, 48 possible yeast and fungal species. intestinal immune function, overall intestinal health (occult blood, short chain fatty acids, pH, and mucus), and inflammatory markers. Parasite isolation 22 possible parasites, markers of digestion and absorption. Clinical Usefulness Findings can indicate if an individual has pancreatic ■■Parameters for digestion and absorption insufficiency and provide information regarding macronutrient ■■Cultures for bacteria absorption. ■■Cultures for yeast Inflammatory markers ■■Parasite testing Findings can indicate whether the individual has moderate or ■■Sensitivity panels high inflammation in the gut lining. These markers are helpful ■■Inflammatory markers in diagnosing irritable bowel syndrome as well as transient ■■Stool metabolic markers inflammation due to acute illness. ■■Infectious pathogens Immunology Recommendations Secretory Immunoglobulin A (sIgA) is the primary antibody of the GI tract. This is the primary defense in our assimilation of Depending on test results, follow-up may include: food particles versus pathogens. Low levels can predispose a ■■Antifungal agents person to infections and bowel disease. ■■Antibiotic agents Short chain fatty acids ■■Antiparasitic agents Short chain fatty acids result from the fermentation of dietary ■■Probiotics fiber by beneficial bacteria. These fats play an important role in ■■Digestive enzymes the health of the GI tract as well as protecting against disease. ■■Follow-up/confirmational tests Intestinal health markers ■■Nutritional supplements 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 The microscopic examination of yeast identifies the visible hours apart). The specimen must be received within 10 days of the presence of yeast cells. first collection, but it is preferred within five days of collection. It is recommended to discontinue use of any antibiotic and antifungal Yeast sensitivity to: products two weeks before sample collection. The patient must also Fluconazole, Itraconazole, Ketoconazole, Nystatin, Berberine, discontinue digestive enzymes, antacids, iron supplements, vitamin C Caprylic Acid, Goldenseal, Oregano, Tanalbit, Undecylenic Acid, over 250 mg, aspirin, anti-inflammatories, and large amounts of meat Uva Ursi 48 hours prior to the collection of the specimen. Bacterial sensitivity to: Amoxicillin, Ampicillin, Augmentin, Ciprofloxacin, Trimeth- CPT Codes sulfa, Berberine, Black Walnut, Caprylic Acid, Cats Claw, Citrus 82272† 82492† 82656 83516† 83631 83986 85549† 87045 87046 Seed Extract, Goldenseal, Oregano, Uva Ursi † 87102 87177*2 87209*2 87328 87329 89125 89160 For Staphylococcus aureus: †No Medicare Coverage Benzypenicillin, Oxacillin, Tetracycline, Trimeth-sulfa, Vancomycin, Berberine, Black Walnut, Caprylic Acid, Cats Claw, Citrus Seed Extract, Goldenseal, Oregano, Uva Ursi
22 call: (913) 341-8949
Copper / Zinc Profile
General Description Recommendations The Copper/Zinc Profile is an excellent way to assess immune status Depending on test results, follow-up may include: and the nutritional intake and/or absorption of zinc and copper. ■■Zinc supplementation Zinc is an essential trace element required for the activity of more ■■Copper supplementation than 300 enzymes. It is necessary for proper functioning of the ■■Dietary modification immune system and is involved in most major metabolic pathways. ■■Molybdenum salt supplementation Zinc has an inverse relationship with copper in the body. As zinc status decreases, copper status increases, and vice versa. Adequate ■■Administration of penicillamine to reduce copper excess copper levels are essential for the growth of new blood vessels, wound healing, and recovery from heart attacks and strokes. When Specimen Requirements levels are only slightly above normal physiological amounts, copper 3 mL of serum drawn into a royal blue-topped no-additive tube. can be toxic. Any mild abnormality or impairment of liver function can lead to copper excess. CPT Codes Clinical Usefulness 82390 82525 84630 ■■Assessment of zinc status ■■Assessment of copper status and toxicity ■■Assessment of immune status --..'01/111 The Great Plains Laboratory, Inc.
Willurn spew, RI Dime cru 11813 Wen 7741 Scroo4Lenc..155- 44714 X9131341.8949 Fax 49131 3414207
Requisition th Physician Name: Patient Name: Date of Collection: Patient Arc Thee of Collection: Sex: Print Date: Copper Zinc Profile
Report Analysis Reference !Mental Compound Reference Range Unite Patient Value Low Normal High Zinc: General signs of zinc deficiency are sleep disturbances,
diarrhea, poor appetite, unhealthy skin, behavioral problems, CeruloplasmIn 1.5 - 4.5 umoVL 2.2 I -4 inability to heal wounds, and chronic infections. CeruloplasmIn-Copper 9.0 - 27.0 umoVL 132 I —4 'Copper Serum 12.0 - 23.0 umoin. 21.1 Copper: Even modest variations in intake and retention can *Zinc Serum 10.0 - 17.0 umoVL 13.4 NonCeruloplaemln-Copper 2.3 6.3 um°111- 7.8 H cause copper to build up to toxic levels in some sensitive 0.8 - 2.0 Ratio 1.6 CopperfZinc individuals. Low copper can cause anemia, poor immune function, poor growth, reduced skin and hair pigmentation, 'Teat. performed by Mayo Reference Laboratories, Rochester, Minnesota and poor formation of the catecholamine neurotransmitters. High nonceruloplasmin or "free" copper High nonceruloplasmin or "free" copper is associated with Wilson's disease, a genetic disease due to a defective ATPase dependent copper transport protein, Menkes steely hair Ceruloplasmin: Copper is transported through the body by disorder, autistic spectrum disorders, extrahepatic biliary atresia, copper poisoning, chronic liver disease, primary biliary cirrhosis, Aagenes syndrome, and arterioductular means of a protein called ceruloplasmin. The availability of hypoplasia syndrome. this protein in the body is used to predict the potential for toxic copper accumulation. Copper/zinc ratio: This ratio elucidates the crucial balance between the two metals.
23 www.GPL4U.com Comprehensive Fatty Acids Test
General Description Recommendations This comprehensive test profiles mitochondrial and peroxisomal Depending on test results, follow-up may include: fatty acid metabolism and the patient’s nutritional status. ■■Flaxseed oil as source of ALA from which EPA and DHA are The report includes 30 markers and total levels of saturated, synthesized monounsaturated, polyunsaturated, omega-3, and omega-6 ■■ Fish oil or cod liver oil as direct sources of EPA and DHA fatty acids. Essential fats play an important role in regulating ■■Evening primrose oil, borage oil, or black currant oil as sources of inflammation, forming cell membranes, and in the optimal function GLA if insufficiently synthesized of the brain, nerves, eyes, skin, connective tissue, and blood vessels. ■■Hemp oil as source of both ALA and GLA
Clinical Usefulness Specimen Requirements 2 mL of serum in a gold-topped or blue-topped tube. This test ■■Monitoring treatment of essential fatty acid deficiency requires an overnight fast, and the patient must avoid alcohol ■■Monitoring the response to provocative tests, such as fasting or for 24 hours prior to sample collection. The sample must be loading tests immediately frozen and shipped with frozen gel pack. This test is only available in the U.S. and Canada.
CPT Code 82544*30 No Medicare Coverage
The Great Plains Laboratory, Inc.
William Shaw, Ph an Director 11811 Weir 77(8 Saner, Lenexa, KS 66211 1912) 34 I -8919 Fax (911} 141-6207
Requisition #: Physician Name: Patient Name: Date of Collection:
Patient Age: Time of Collection: Sex: Print Date:
Comprehensive Fatty Acids Panel - Serum
Low Reference Range High Common Name Lipid Name Reference Range Patient Result Units
Omega-3 Polyunsaturated Series
1 alpha-Linolenic Acid (ALA) C18:3 (n-3) - 12020 76 umol/L
2 Eicosapentaenoic Acid (EPA) C20:5 (n-3) - 908 30 umol/L
3 Docosapentaenoic Acid (DPA) C22:5 (n-3) - 27030 35 umol/L
4 Docosahexanoic Acid (DHA) C22:6 (n-3) - 16030 119 umol/L
Omega-6 Polyunsaturated Series
5 Linoleic Acid (LA) C18:2 (n-6) 1600 - 3500 3181 umol/L
6 gamma-Linolenic Acid (GLA) C18:3 (n-6) - 1309 32 umol/L
7 dihomo-gamma-Linolenic Acid (DGLA) C20:3 (n-6) - 22060 60 umol/L
8 Arachidonic Acid (ARA) C20:4 (n-6) 350 - 1030 648 umol/L
9 Docosapentaenoic Acid (DPA) C22:5 (n-6) - 5010 5 umol/L L
10 Docosatetraenoic Acid C22:4 (n-6) - 4010 9 umol/L L
Page 1 of 5
24 call: (913) 341-8949
GPL-t 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 82108 82131 82300 82507 82525 82570 regarding to their metabolism, vitamin and mineral levels, food allergies, and 83018*28 83150 83497 83605 83655 83735 metal toxicity. Testing for organic acids, IgGs, food allergies, and metals is crucial 83785 83825 83885 83921*63 83945 84100 to detect any deficiencies within the body. With the GPL3 panel, no blood draw 84207 84210 84255 84585 84591 84630 is required. Included in the GPL3 is the Organic Acids Test, IgG Food Allergy Test 86001*93 86628 86671*2 (Dried Blood Spot), and Metals Hair Test. 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
The Great Plains Laboratory. Ono. LAB#: •••.% PATIENT: The Great Plains Laboratory, Inc. ID: SEX: Requisition #: 273466 Physician: AGE: Patient Name: Date of Collection: 07/30/2012 Patient Age: 4 Time of Collection: 08:00 AM Requisition #: Physician Name: µµµ Patient Name: Date of Collection: Patient Sex: F Print Date: 08/02/2012 < 8.0 Patient Age: Time of Collection: < 0.080 Sex: Print Date: < 0.020 < 2.0 < 0.15 Metabolic Markers in Urine Reference Range Patient Reference Population - Females Under Age 13 Comprehensive IgG Food Allergy Test + C. albicans, S. cerevisiae (94) < 1.0 (mmol/mol creatinine) Value < 0.40 Intestinal Microbial Overgrowth < 0.005 Dairy Buckwheat 3.24 < 0.010 Casein 7.15 Corn 3.60 Yeast and Fungal Markers < 0.005 Cheese 7.05 Gliadin 3.95 < 0.060
1 Citramalic ≤ 5.3 3.1 3.1 Goat Cheese 5.91 Millet 3.84 < 0.40
Milk 9.39 Oat 2.11 < 0.20 2 5-Hydroxymethyl-2-furoic ≤ 30 7.4 7.4 Mozzarella Cheese 4.65 Rice 1.70 < 0.30 Whey 8.13 Rye 3.88 < 1.0 3 3-Oxoglutaric ≤ 0.52 0.50 0.50 Yogurt 7.27 Sorghum 5.09 4 Furan-2,5-dicarboxylic ≤ 22 8.6 8.6 Legumes - Beans and Peas Wheat Gluten 4.34
Garbanzo Bean 1.96 Wheat 4.72 5 Furancarbonylglycine ≤ 3.6 0.07 0.07 Green Bean 3.34 Fish µµµ 125- 370 Kidney Bean 4.19 Cod Fish 1.79 6 Tartaric ≤ 3.9 H 9.0 9.0 12- 30 Lentil 1.28 Crab 0.99 12- 90 Lima Bean 1.22 Halibut 1.85 7 Arabinose ≤ 56 H 242 242 12- 40 Pea 1.36 Lobster 1.49 8.0- 16 8 Carboxycitric ≤ 34 1.3 1.3 Pinto Bean 3.46 Salmon 2.89 100- 190
Soybean 1.69 Sardine 1.30 0.20- 0.55
9 Tricarballylic ≤ 0.86 0.08 0.08 Fruit Shrimp 0.99 0.26- 0.50
Apple 2.60 Tuna 1.98 0.030- 0.10 Malabsorption and Bacterial Markers L Apricot 1.81 Meat/Fowl 0.050- 0.13 10 2-Hydroxyphenylacetic ≤ 1.1 0.45 0.45 Banana 2.39 Beef 6.39 0.60- 4.0
Blueberry 2.45 Chicken 3.05 0.25- 1.3 11 4-Hydroxyphenylacetic ≤ 30 16 16 0.007- 0.023 Coconut 1.96 Egg White 13.63 160- 250 Cranberry 4.90 Egg Yolk 12.91 12 4-Hydroxybenzoic 0.09 - 2.0 2.0 2.0 0.95- 1.7 Grape 2.06 Lamb 3.25 0.16- 1.0 13 4-Hydroxyhippuric ≤ 27 15 15 Grapefruit 4.16 Pork 1.68 45500- 53000
Lemon 5.40 Turkey 2.26 0.16- 0.80 14 Hippuric ≤ 717 377 377 Orange 2.25 Nuts and Seeds 0.013- 0.035 Papaya 1.78 Almond 1.86 8.0- 19 15 3-Indoleacetic ≤ 11 6.1 6.1 Peach 1.67 Cashews 2.12 0.045- 0.065 Pear 2.60 Flax 2.18 0.016- 0.18 16 Succinic ≤ 15 H 39 39 Pineapple 2.59 Hazelnut 1 1.45 0.040- 1.0 17 HPHPA (Clostridia Marker) ≤ 227 148 148 Plum (Prune) 1.69 Peanut 3.77 Strawberry 5.33 Pecan 2.56 18 4-Cresol (C. difficile) ≤ 76 63 63 Watermelon 2.66 Pistachio 2.66
Grains Sesame 2.85 4- 30 19 ≤ 0.73 0.29 DHPPA (Beneficial Bacteria) 0.29 Barley 3.61 0.8- 8 0.5- 10 Testing performed by The Great Plains Laboratory, Inc., Lenexa, Kansas. The Great Plains Laboratory has developed and determined 4- 20 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 V06.99 > 800 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 Page 1 of 9 Organic Acids Test IgG Food Allergy Test Metals Hair Test
Clinical Usefulness of the GPL3 & GPL4
■■ Detect nutritional or antioxidant deficiencies ■■ Reduce gut inflammation ■■ Understand vitamin and hormone metabolism ■■ Determine if a deficiency in minerals is inhibiting metabolic ■■ Assess performance or antioxidant deficiencies processes ■■ Reveal excessive levels of gastrointestinal (GI) yeast and bacteria ■■ Determine if dietary vitamin D is sufficient* ■■ Promote noninvasive, food-based therapy ■■ Assess the likelihood of malabsorption, liver disease, and nephritic ■■ Reduce the burden on the immune system syndrome* * only applicable to the GPL4
25 www.GPL4U.com GPL- This extensive profile covers over 150 biomarkers, each carefully explained and addressed in the following tests: GPL4 Serum GPL4 DBS ■■ Organic Acids Test - 74 markers ■■ Organic Acids Test - 74 markers ■■ IgG Food Allergy Test - 93 markers plus Candida - or - ■■ IgG Food Allergy Test - 93 markers plus Candida ■■ Metals RBC Test - 18 markers ■■ Metals Hair Test - 39 markers ■■ Vitamin D - 2 markers ■■ Vitamin D - 2 markers
General Description CPT Codes - DBS The GPL4 panel provides a comprehensive assessment of an individual’s 82108 82131 82300 82306 82507 82525 metabolism and is targeted to find any irregularities that are directly related to 82542 82570 83018*28 83150 83497 83605 numerous conditions. This Panel provides a comprehensive assessment of the 83655 83735 83785 83825 83885 83921*63 individual’s metabolism to assess microbial dysbiosis, and also provides vitamin 83945 84100 84207 84210 84255 84585 levels and indicators of possible genetic problems. Included in the panel: Organic 84591 84630 86001*93 86628 86671*2 Acids Test, IgG Food Allergy Test, Red Blood Cell Metals or Metals Hair (your choice), No Medicare Coverage and Vitamin D Test. With the GPL4 panel, a no blood draw option is also available. CPT Codes - Serum Specimen Requirements 82131 82175 82300 82306 82310 82495 Urine: 10mL of first morning urine before food or drink. Patient must avoid apples, 82507 82525 82542 82570 83015 83018*4 grapes (including raisins), pears, cranberries, and their juices 24 hours prior to 83150 83497 83605 83655 83735 83785 specimen collection. 83825 83921*63 83945 84100 84132 84207 GPL4 Serum: GPL4 DBS: 84210 84255 84585 84591 84630 86001*93 Serum: 2 mL of serum in a gold-topped Hair: 1 gram of hair 86628 86671*2 No Medicare Coverage SST or royal blue-topped no-additive Dried Blood Spot (DBS): Two protein tube. saver cards filled with five full circles of Red Blood Cell: 4mL of packed cells in a blood. royal blue topped potassium RDTA tube.
LAB#: PATIENT: ID: SEX: AGE: '+‘.1/ The ilreai Plain. Labe/alone. inn. T. Gr.11 P12412 µµµ RED BLOOD CELL ELEMENTS < 8.0 Requisition #: 273466 Physician: LAB#: < 0.080 PATIENT: Patient Name: Date of Collection: 07/30/2012 < 0.020 ID: Requisition #: Physician Name: Patient Age: 4 Time of Collection: 08:00 AM < 2.0 SEX: Patient Name: Date of Collection: < 0.15 AGE: Patient Sex: F Print Date: 08/02/2012 < 1.0 Patient Age: Time of Collection: < 0.40NUTRIENT ELEMENTS Sex: Print Date: RESULT REFERENCE < 0.005 PERCENTILE < 0.010 th th th th th ELEMENTS µµµg/g RANGE 2.5 16 50 84 97.5 < 0.005 17 8- 31 Metabolic Markers in Urine Reference Range Patient Reference Population - Females Under Age 13 Comprehensive IgG Food Allergy Test + C. albicans, S. cerevisiae (94) Calcium < 0.060 (mmol/mol creatinine) Value Magnesium 42 36- 64 < 0.40 < 0.20 Intestinal Microbial Overgrowth Dairy Buckwheat 3.24 Potassium mEq/L 79 65- 95 < 0.30 Casein 7.15 Corn 3.60 < 1.0 515 480- 745 Yeast and Fungal Markers Cheese 7.05 Gliadin 3.95 Phosphorus 1 Citramalic ≤ 5.3 3.1 3.1 Goat Cheese 5.91 Millet 3.84 Copper 0.60 0.52- 0.89
Milk 9.39 Oat 2.11 8- 14.5 2 5-Hydroxymethyl-2-furoic ≤ 30 7.4 7.4 Mozzarella Cheese 4.65 Rice 1.70 Zinc 13.3 µµµ 125- 370 Whey 8.13 Rye 3.88 802 745- 1050 3 3-Oxoglutaric ≤ 0.52 0.50 0.50 Iron 12- 30 Yogurt 7.27 Sorghum 5.09 0.007- 0.030 12- 90 Legumes - Beans and Peas Wheat Gluten 4.34 Manganese 0.013 4 Furan-2,5-dicarboxylic ≤ 22 8.6 8.6 12- 40 Garbanzo Bean 1.96 Wheat 4.72 0.0006 0.0003-0.0060 8.0- 16 Green Bean 3.34 Chromium 5 Furancarbonylglycine ≤ 3.6 0.07 0.07 Fish 100- 190 Kidney Bean 4.19 Cod Fish 1.79 Selenium 0.22 0.19- 0.38 0.20- 0.55 6 Tartaric ≤ 3.9 H 9.0 9.0 Lentil 1.28 Crab 0.99 0.26- 0.50 0.01- 0.110 Lima Bean 1.22 Halibut 1.85 Boron 0.023 0.030- 0.10 7 ≤ 56 H 242 Arabinose 242 Pea 1.36 0.050- 0.13 Lobster 1.49 Vanadium 0.0002 0.0001-0.0020 Pinto Bean 3.46 Salmon 2.89 0.60- 4.0 8 Carboxycitric ≤ 34 1.3 1.3 0.0005-0.0020 Soybean 1.69 Sardine 1.30 Molybdenum < 0.0005 0.25- 1.3 Fruit 0.007- 0.023 9 Tricarballylic ≤ 0.86 0.08 0.08 Shrimp 0.99 Apple 2.60 160- 250 Tuna 1.98 0.95-POTENTIALLY 1.7 TOXIC ELEMENTS Malabsorption and Bacterial Markers Apricot 1.81 Meat/Fowl TOXIC RESULT REFERENCE 0.16- 1.0 PERCENTILE Banana 2.39 th th 10 2-Hydroxyphenylacetic ≤ 1.1 0.45 0.45 Beef 6.39 ELEMENTS µµµg/g RANGE45500- 53000 95 99 Blueberry 2.45 Chicken 3.05 Arsenic 0.004 < 0.010 0.16- 0.80 11 4-Hydroxyphenylacetic ≤ 30 16 16 Coconut 1.96 Egg White 13.63 0.013- 0.035
Cranberry 4.90 Egg Yolk 12.91 Cadmium 0.001 < 0.005 8.0- 19 12 4-Hydroxybenzoic 0.09 - 2.0 2.0 2.0 Grape 2.06 Lamb 3.25 0.045- 0.065 < 0.090 Grapefruit 4.16 Lead 0.017 0.016- 0.18 Pork 1.68 13 4-Hydroxyhippuric ≤ 27 15 15 0.040- 1.0 Lemon 5.40 Turkey 2.26 Mercury 0.001 < 0.010 14 Hippuric ≤ 717 377 Orange 2.25 Nuts and Seeds 377 < 0.0005 Papaya 1.78 Almond 1.86 Thallium < 0.0001 15 3-Indoleacetic ≤ 11 6.1 6.1 Peach 1.67 Cashews 2.12
Pear 2.60 Flax 2.18 SPECIMEN DATA 4- 30
16 Succinic ≤ 15 H 39 39 Pineapple 2.59 Hazelnut 1.45 0.8- 8 CH Comments: Plum (Prune) 1.69 Peanut 3.77 0.5- 10 17 HPHPA (Clostridia Marker) ≤ 227 148 148 Date Collected: Methodology: 4- 20 Strawberry 5.33 Pecan 2.56 Date Received: µg/g = ppm V06.99 > 800 18 4-Cresol (C. difficile) ≤ 76 63 63 Watermelon 2.66 Pistachio 2.66 Date Completed: V10.01 Grains Sesame 2.85 Barley 3.61 19 DHPPA (Beneficial Bacteria) ≤ 0.73 0.29 0.29 ©DOCTOR’S DATA, INC. ADDRESS: 3755 Illinois Avenue, St. Charles, IL 60174-2420 CLIA ID NO: 14D0646470 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 Page 1 of 9
Organic Acids Test IgG Food Allergy Test Metals Hair / Metals RBC Test Vitamin D Recommendations
Depending on test results, follow-up may include: ■■Immune system support ■■Dietary modifications ■■Gut restoration ■■Probiotic and/or nutritional supplementation ■■Identification of the source of contamination ■■Antioxidant therapy ■■Elimination of heavy metals from the body and environment ■■Elimination of offending foods ■■Mineral supplementation
26 call: (913) 341-8949 OAT + IgG Food Allergy Test w/ Candida Combo
General Description Recommendations A combination of our most popular tests, the Organic Acids Test Depending on test results, follow-up may include: (OAT) and the IgG Food Allergy Test w/ Candida, is a powerful ■■Dietary modification diagnostic tool. Together, these tests help physicians evaluate ■■Nutritional and/or probiotic supplementation their patients’ “state of the gut” and reveals how abnormal results ■■Follow-up/confirmational testing may be contributing to chronic health issues. This combo is an ■■Elimination of offending foods/implemention of a rotation diet excellent value if your insurance company does not typically reimburse for the standalone IgG Food Allergy Test. Visit the ■■Immune system support Insurance Benefits section on the OAT + IgG Combo webpage for more details. Specimen Requirements Urine: 10 mL of first-morning urine before food or drink. Patient Clinical Usefulness must avoid apples, grapes (including raisins), pears, cranberries, ■■The combined tests increase the likelihood of identifying and their juices 24 hours prior to specimen collection. significant factors impairing health. Serum: 1 mL of serum in a gold-topped SST or in a royal blue- ■■Results indicate the extent of yeast and bacteria overgrowth in topped no-additive tube. the GI tract and provide insight on nutritional status, Clostridia Dried Blood Spot (DBS): Five full circles of dried blood on the infection, and fatty acids and energy metabolism. protein saver card. ■■The test reveals food sensitivities, that when removed from the diet often mitigate patients’ symptoms. 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 Depending on test results, follow-up may include: Test as a combo. The OAT and Amino Acids Test quantifies different ■■Treatment for intestinal dysbiosis markers for assessing GI function, detoxification capacity, and ■■Nutritional and supplement support certain nutritional deficiencies. Together they provide a more ■■Detoxification in-depth evaluation of overall nutritional status and digestive ■■Genetic testing 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 + Specimen Requirements Amino Acids Combo webpage for more details. 35 mL of first-morning urine before food or drink. Patient must avoid apples, grapes (including raisins), pears, cranberries, and their Clinical Usefulness juices 24 hours prior to specimen collection. The patient should also discontinue amino acid supplementation prior to collection. ■■More complete insight into overall nutritional status ■■More complete evaluation of GI function and intestinal dysbiosis ■■More complete assessment of detoxification capacity CPT Code ■■Indication of potential harmful genetic variations 82139*1 82140 82492 84540 82131 82507 82570 83150 83497 ■■Stronger clinical assessment of complex patients 83605 83921*65 83945 84207 84210 84585 84591 ■■Assistance in building a treatment plan
27 0www.GPL4U.com Comprehensive Test Panels
How A Comprehensive Approach Will Benefit Your Health: Routine lab work often falls short of uncovering the subtle A biomedical approach to treatment is a search for the underlying abnormalities which can have a profound effect on health. Unless physiological imbalances contributing to the symptoms of a properly addressed, this vicious cycle will continue to inhibit the patient’s disorder. Treatments are designed to restore the body various chemical pathways necessary for proper neurological and to balance and optimize function through nutritional support, immune function. The resulting complications will contribute to, diet, detoxification, and reduction of environmental influences. and may even cause, the symptoms of the patient. 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 ■■Basic Tourette’s & Tics Panel ■■Comprehensive Tourette’s & Tics Panel ■■Basic Fibromyalgia & CFS Panel ■■Basic Wellness Panel ■■Basic Mental Health Panel ■■Basic AD(H)D Panel Visit us online at www.GPL4U.com for more information about comprehensive testing.
28 call: (913) 341-8949 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.
rillCO 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 people’s quality of life.
"'"•/1\ The Great Plains Laboratory, Inc. Information Guide Rev. 02/17/2014