Testing for Optimal Wellness
Four Tests Lay the Foundation for An Effective Supplement Regimen
Individuals who want to make a stronger commitment to enhancing their health in 2008 as well as newcomers to the healthy aging supplement field, can dramatically improve the success of their regimen by first taking a series of tests. Beginning a supplement regimen without taking the tests mentioned below is a little like trying to navigate the streets of an unfamiliar city without a road map. I always tell my patients “Tests Don’t Guess.”
In this article, I will explain the different testing options available and how individuals can use the results to either build a new supplement program or refine an existing supplement regimen to enhance overall health.
Organic Acid Testing
One of the most underutilized tests, organic acid testing is a crucial step in determining exactly which vitamins and minerals a person’s body needs. Perhaps the reason why this test has been underutilized is simply because its relevance to personal health is not understood. Yet, it is one of the easiest ways to determine which supplements are right for each individual. It truly takes the guesswork out of creating the foundation for a personal customized supplement program. I tell my patients it provides a glimpse of their “own biochemical thumbprint.” Anyone who asks the questions “Where do I begin?” or “Now that I’m taking the basic supplements, what other nutrients do I need to improve my overall health?” will find the answers they’re looking for in the results of the organic acid testing.
We are all unique biochemical creatures. Therefore, each of us has different supplement needs. Some individuals may be deficient in vitamin E while others need extra coenzyme Q10, regardless of apparent cardiac issues or concerns. Everyone has inherent strengths and weaknesses within their personal biochemistry that determines how much of a particular nutrient—or even if that particular nutrient—will be of benefit to their bodies. Organic acid testing can help pinpoint the vitamin, mineral, and amino acid deficiencies present in each patient. The lack of proper nutritional sufficiency relative to your own “biochemical individuality” will play a pivotal role when it comes to expressing genetic strengths or weaknesses.
Organic acid tests are important for both those seeking to fine tune or increase a supplement program’s effectiveness and anyone beginning a supplement regimen. The clinical benefits seen when the body’s unique needs are addressed can be the difference between modest clinical results versus a significant metamorphosis.
Organic acids are key compounds of many biochemical pathways. Organic acid testing provides critical insights into the functioning of the Krebs cycle in the mitochondria. The Krebs cycle is comprised of nine organic acids and eight enzymes and is the main way that all dietary fuel sources—including carbohydrates, proteins, and fats—are metabolized (Figure 1). Because the Krebs cycle provides the energy required for the body to function, any disruption in its flow can be disastrous to health.
Abnormal organic acid metabolism, therefore, can indicate that an individual is deficient in a number of nutrients or is simply not using those nutrients effectively.
Supplementation of specific vitamins and nutrients can help balance altered and imbalanced metabolic pathways, but it’s impossible to know which nutrients to give which patients unless an organic acid test is completed
Organic acid tests can now be done in the convenience of your home. Easily collected urine samples are sent to an internationally recognized and nationally certified laboratory. By taking this test, you can have a better understanding of your own unique health needs.1-5
Salivary Hormone Testing
Another important way to get serious about building a supplement regimen tailored to an individual’s own needs is salivary hormone testing.
There are several ways to test hormones (saliva, serum and urine), but the state-of-the-art testing is through saliva. This is because it measures only the active portions of hormones and it is these portions that determine how a patient feels.
The five hormones monitored through saliva testing are testosterone, progesterone, estrogen (estradiol), cortisol and DHEA. As we age, levels of these hormones often become imbalanced. Using a saliva test as a blueprint for proper supplementation with these hormones can make a dramatic difference in patients’ health.
Testosterone is important for both men and women. In males, the decline in testosterone commonly referred to as andropause often begins in the early 30s and eventually hits a crescendo when symptoms are unmistakable in the 50s and 60s. A progressive decline in testosterone in men starting at age 30 is well documented with a free testosterone decline of 1 percent per year. After age 60, 25 percent of men are clinically overtly hypogonadal (low in testosterone). Overt testosterone deficiency occurs in about 24 percent of men aged 50-60 years and 40 percent in men aged 60-80.6 Yet, subclinically, low testosterone levels are likely prevalent in nearly double these very conservative estimates. Furthermore, SHBG (sex hormone binding globulin) increases with age, binding up more free testosterone.
Low testosterone levels in men are linked to low energy, decreased libido, decreased concentration, insomnia, night sweats, depression, infertility and, surprisingly, even hot flashes.
Balanced testosterone levels are important in females as well, with lower than normal levels associated with a reduced sex drive.7 Testosterone is considered the “desire hormone” due to its ability to enhance libido. Women, however, often tend to have an excess of prolactin, the “anti-desire” hormone.8 In addition, with age, and especially after menopause, testosterone levels in women decline.7
Salivary hormone tests also are used to measure levels of estradiol, one of the main forms of estrogen found in the female body. Levels of this hormone drop dramatically during perimenopause and menopause and its deficiency is associated with vaginal dryness, hot flashes, and the many other symptoms of menopause. It is also thought that when estrogen levels plummet during menopause, it increases the risk of cardiovascular disease and high cholesterol. Excessively high estrogen levels, on the other hand, have been associated with an increased risk of breast cancer.
In males, estrogen levels are important to monitor since testosterone often can be converted into excess amounts of estrogen. Estrogen also tends to decrease testosterone production, creating a vicious circle.
Progesterone is another important hormone to have tested. During premenopause and menopause, the drop in progesterone levels is associated with estrogen dominance. Even before premenopause a progesterone deficiency can cause PMS, breast tenderness, and a host of other symptoms. Furthermore, groundbreaking work by Dr. John Lee noted that prostate problems in men can be associated with low progesterone levels.9
Cortisol and DHEA are important because of their role in adrenal health. Cortisol levels that are too low or too high can be a sign that a patient is suffering from adrenal exhaustion, a common cause of fatigue, weight gain and many other health problems. Imbalanced DHEA levels also can be a sign of exhausted adrenals. Like many other hormones, DHEA, which is associated with skin elasticity, well being, and cardiovascular health, drops dramatically with age. In some cases, however, individuals with impaired adrenals can produce excessive amounts.
Salivary testing can help a patient determine which hormonal supplements are needed to counteract any detected imbalances. Progesterone cream can be used in both females and males who test low for this important hormone. BioDIM® and Extension Resveratrol can be used in males who are converting testosterone into excess estrogen. Adaptogens and special cortisol-lowering herbs known as Relora® and Sensoril™ can be used in individuals with adrenal dysfunction while DHEA supplementation can be used to replenish the body’s low supplies of this hormone. Women who have lower than normal testosterone levels can use DHEA to raise testosterone levels, since women very efficiently convert DHEA to testosterone. Many males with low testosterone find it helpful to either increase their levels pharmaceutically or use a combination of the botanicals Eurycoma longifolia jack extract, stinging nettle, and Luteolin. Finally, women with low estrogen levels can seek out bio-identical hormone replacement (BHRT).
Retesting after initiating a hormonal support regimen ensures that individuals have achieved the proper hormonal balance and that excess estrogen levels are not created as a result of therapy.
Food Allergy Testing
Clinically, one of the most important tools I use to unearth hidden factors affecting patients’ health is Food Allergy Testing. This approach ensures that individuals can understand how their daily diet may be harming their health.
Food allergens can be broken down into two categories: immediate and delayed. It is the delayed or hidden food allergens that silently erode away ones health, frequently going undetected since the response is not immediate but rather delayed up to 72 hours, long after the offending food(s) were ingested. Thus, identifying and controlling food sensitivities is essential.
Hippocrates “The Father of Western Medicine” stated in 400 BC, “May Food be your Medicine and Medicine be your Food.” The problem that I discover with my patients is that even supposedly healthy foods such as garlic, broccoli, grapes, and fish can be sources of extremely detrimental health signs and symptoms.
ELISA immunoassay testing for delayed food allergies helps identify delayed IgG immunoglobulin allergens. This technology is used worldwide and has now been applied to home test kits that can identify 96 different food reactions ranging from dairy, wheat, corn, fish, vegetables, fruits, sugar cane, numerous nuts, eggs and other commonly consumed foods. A simple fingerstick done at home, much like that done by diabetics, makes gaining insight into ones own personal delayed food allergies both affordable and convenient. Once collected, the sample is sent from the home to a CLIA (nationally licensed) laboratory. Within a couple of weeks, results are sent back directly to the patient’s home. These results indicate low, moderate or high reactions to different foods.
The food allergy test will help individuals avoid the foods they are allergic to and will produce dramatic results in improving overall health. After understanding ones food sensitivities, Digestive Enzymes, a good probiotic supplement that includes Lactobacillus GG and Lectin Lock™ can be added to a supplement regimen to compensate for those times when people are exposed to their most common food allergens.
Anyone who is on immunosuppressant drugs, such as corticosteroids, should be aware that these drugs can alter the results of food allergy testing.
Iodine Sufficiency Test
Thyroid disorders are becoming almost epidemic in this country. Hypothyroidism is one of the most common disorders I see in my patients, who often don’t realize that their weight gain, moodiness, thinning hair and other symptoms are caused by hypothyroidism.
Noted iodine expert Dr. Guy Abraham has established a link between iodine deficiency and both hypothyroidism and hyperthyroidism. Because so many dietary components—such as the bromide found in bread and baked goods and fluoride in drinking water—compete with iodine absorption, iodine deficiency has become all too common.10
A user-friendly, oral loading test can detect iodine deficiencies. Testing involves collecting urine immediately upon arising in the morning to use in what’s called a spot test. Then, 50 mg. of potassium iodide and iodine (included in the test kit) is ingested. Urine is collected throughout the day until the first urine of the next morning. The samples, including the baseline spot test, are shipped to the lab.
If the body has sufficient iodine, at least 90 percent will be excreted in the urine. In iodine deficiency, however, the body will hold on to some of the iodine to compensate for the deficiency. The more iodine that remains in the body, the more a person is iodine deficient and needs to begin supplementation.
If the tests indicate an iodine deficiency, patients often begin supplementing with iodine, such as found in Iodoral®, a combination of iodide and iodine. Testing should be repeated every three to four months to monitor proper iodine doses. Working closely with your personal healthcare provider is always an important part of refining your health program.
Organic acid, salivary hormone, food allergy, and iodine sufficiency testing are the best way to build a supplement program that is specific for an individual’s needs. In my practice, I have noted dramatic improvement in the overall quality of my patients’ health after they have begun a supplement regimen based on these tests. Not using this important tool is like stumbling around in the dark when all one needs to do is turn on the flashlight that’s already in his or her hand. For individuals who want to get serious about overall wellness in 2008, taking each of these tests is a crucial step toward good health.
1. Fu X, Iga M, Kimura M, Yamaguchi S. Simplified screening for organic academia using GC/MS and dried urine filter paper: a study on neonatal mass screening. Early Human Development. 2000;58:41-55.
2. Fu X, Kimura A, Iga M, Yamaguchi S. Gas chromatographicmass spectrometric screening for organic acidemias using dried filter paper: determination of alpha-ketoacids. J Chromatography B Biomed Science Applications. 2001;758:87-94.
3. Greter J, Jacobson C. Urinary organic acids: isolation and quantification for routine metabolic screening. Clin. Chem. 1987;33:473-480.
4. Sweetman L. Organic acid analysis. Techniques in diagnostic human biochemical genetics. A laboratory manual. Wiley- Liss, New York, 1991.
5. Tanaka K, et al. Gas chromatographic method of analysis for urinary organic acids. I. retention indices of 155 metabolically important compounds. Clin. Chem. 1980;26:1839-1846.
6. Morgentaler A, Bruning CO 3rd, DeWolf WC. Occult prostate cancer in men with low serum testosterone levels. JAMA. 1996 Dec 18;276(23):1904-1906.
7. Kingsberg S, Shifren J, Wekselman K, Rodenberg C, Koochaki P, Derogatis L. Evaluation of the clinical relevance of benefits associated with transdermal testosterone treatment in postmenopausal women with hypoactive sexual desire disorder. J Sex Med. 2007 Jul;4(4 Pt 1):1001-8.
8. Hirch E. [Libido disorders] [Article in French]. Rev Med Brux. 2007 Sep;28(4):368-73.
9. Lee, J. Prostate disease and hormones. The John R. Lee, M.D. Medical Letter Feb. 2002.
10. Abraham G. Iodine: The Universal Nutrient. Vitamin Research News. October 2005.
Selective immunodeficiency, exposure to broad-spectrum antibiotics, and consumption of sugars, individually or in combination, can stimulate an overgrowth of intestinal yeast or bacteria, normally present in much lower quantities. Once any abnormalities are detected there are a variety of treatment options. Improvements that have been reported to us during and after treatment include better eye contact, improved language, less self-abusive behavior, less hyperactivity, better sleeping habits and less stimming. These organisms and their metabolites can produce or exacerbate symptoms in many conditions.
The organic acid test evaluates all of the well-defined inborn errors of metabolism that can be detected with this technology (called GC/MS) such as PKU, maple-syrup urine disease, and many others. In addition, we check for many other abnormalities such as vitamin deficiencies and abnormal metabolism of catecholamines, dopamine, and serotonin. We currently quantitate 65 substances, but also evaluate other substances that are not quantitated. Some of the other biochemical abnormalities common in autism include elevated uracil and elevated glutaric acid.
- Yeast metabolites
- Bacteria metabolites
- Nutritional deficiencies
- Antioxidant deficiencies
- Inborn errors of metabolism
- Amino acid abnormalities
- Fatty acid abnormalities
- Exposure to solvent toxins
- Deficiencies of B vitamins or vitamin C
- Indications of diabetic conditions
- Krebs cycle metabolites
- Clostridia overgrowth
- 65 important compounds
In which conditions is the test useful?
|AD(H)D||Chronic Fatigue Syndrome||Endometriosis|
The test kit is free; please see our price list for current processing charges including courier charges (for US residents) and a full report, along with professional consultation concerning test results.
Depending on test results, suggestions can include:
- Diet modification
- Diet supplementation, primarily with nutrients which increase the quantity of beneficial bacteria (e.g. lactobaccilli) in the GI tract
- Oral antifungal or antibacterial (anaerobic) medications
- Vitamins and Antioxidants
- Reduction of exposure to toxic chemicals
- Measures 65 important compounds for overall health
- Focuses on detecting yeast and bacteria byproducts that have been implicated in many disorders
- Requires a first morning urine sample only
- Consultation on results is included with each test from The Great Plains Laboratory
- Test with the experts – The Great Plains Laboratory holds one patent (*) on this test and two others pending.
* Certain uses of the compounds arabinose, citramalic, tartaric, 3-oxoglutaric, carboxycitric, 3,4-dihydroxyphenylpropionic acid, and 3-(3-hydroxyphenyl)-3-hydroxypropionic acid in their application to autism in the organic acid test and microbial organic acid test are protected by USA patent 5,686,311 granted November 11, 1997.
What is the organic acid test for, and how can it help?
In Dr. Shaw’s work, he noticed that people with autism and other conditions (such as attention deficit disorder and fibromyalgia) frequently had overgrowths of yeast and bacteria in the gastrointestinal tract, due to a high-sugar diet and antibiotic overuse. This led Dr. Shaw, now Director of The Great Plains laboratory, to devise a urine test to detect such disorders–an organic acid test which measures nearly 70 different biochemical compounds.
Both children and adults who have taken the test and sought appropriate treatments have enjoyed marked improvements in condition as a result.
Do I have to obtain a physician’s approval to get the urine sample tested?
Yes. A medical practitioner who is licensed to order urine testing in your state must approve the test order. Regulations vary from state to state so an approved medical practitioner could be a medical doctor (MD), osteopath (DO), nurse practitioner, chiropractor (DC) or naturopath (ND).
Why should I get the organic acid test? Why don’t I just start the antifungal treatment?
Some children with autism don’t have the yeast problem, but have an overgrowth of the Clostridia. Treating these children with an antifungal could make the bacteria problem even worse. Also, if your child has the yeast problem, it will likely require major changes in diet (for the child and the family) along with drug therapy for six months or longer. It will be very difficult to make this type of commitment if you are nor even sure if your child has the yeast problem.
Also, your child could have a yeast overgrowth with a drug-resistant yeast and if you don’t do the testing beforehand, it would be difficult to know what was happening. If the problem is severe, the yeast die-off reaction may be more severe and you may want to take additional steps to control the yeast before using antifungals. Additionally, it may be very difficult to get your doctor’s cooperation for the prescriptions and insurance reimbursement if there is no evidence that the yeast problem even exists.
How often should I get my child retested?
As a general rule, every three months is satisfactory. However, retesting should be done sooner if the child does not respond favorably by the end of one month of antifungal therapy, since the yeast or bacteria might be resistant to the drugs used for treatment.
My child is currently taking antibiotics now. Should I wait until after antibiotics treatment until I get tested?
An assumption is frequently made that if the child has a significant yeast overgrowth of the intestine while on antibiotics, the yeast overgrowth will disappear when the antibiotics are stopped.
However, this is not necessarily the case and the yeast overgrowth may even become worse–especially if the person is on a high-sugar, high carbohydrate diet. There is no evidence that the yeast overgrowth will spontaneously disappear. Furthermore, the yeast overgrowth may be suppressing the immune system, preventing your child from recovering from the infection.
The sooner the yeast problem is controlled, the sooner the vicious cycle of antibiotics and frequent infections will be broken.
Will drugs or nutritional supplements interfere in the organic acid test?
No, there is no interference from any known drug or supplement. However, if antifungal supplements or drugs are taken before the test, you will probably get a lower value for the yeast byproducts. We advise you to get the test first so that you will know what the starting point is.
I already had the urine organic acid test done earlier by another lab. Can’t I get the information from the earlier test?
No. No other laboratory routinely analyzes the same compounds as this laboratory. Most test for the inborn errors of metabolism and nothing more.
I have an HMO and they have to send the test to a certain lab. Is that OK?
No. No other laboratory routinely analyzes the same compounds as this laboratory (including Labcorp, SmithKline, or Mayo Medical laboratories).
If you do not specify our laboratory, your child’s urine will be sent to one of the large reference labs which cannot accurately evaluate your child’s condition. Most test for the inborn errors of metabolism and that’s all.
Are there any other reasons that I should choose the Great Plains Lab to do the organic acid testing?
Dr. William Shaw, Director of the Great Plains Laboratory, is a recognized expert in the identification of practical, biomedical treatments for autism (as well as many other disorders). His work and the testing procedure that he developed have helped many children and adults with autism and other conditions see dramatic improvements and experience an enhanced quality of life–all based on seeking appropriate therapies using the information gained from the test.
Dr. Shaw has also authored many books and provided other materials to help you better understand the medical treatments and how to use this information to help people with autism and other conditions.