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Advanced Lab Tests_Final

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>> Hey, it's great to see you again. A question that we get all the time is, "Which tests can my clients take to see if they have any imbalances?" This is a great question because as we stress throughout the course, it's so important for your clients to be properly assessed for a particular condition or imbalance rather than guessing or playing doctor. So in this lecture, we'll be talking about six of the more advanced lab tests that may be helpful for your clients to seek out. These tests help identify hormonal imbalances, thyroid issues, small bowel overgrowth, food sensitivities, and toxic burden, issues that pop up all the time but must be better understood. There are a few different ways that these tests can be performed, so we'll also be talking about the different methods of testing. Keep in mind throughout this lecture and in your practice that as a Health Coach, it's not up to you to diagnose your clients. This includes ordering tests for them, interpreting their lab results or creating a treatment based on their results. The intention for discussing these labs is for educational purposes so that you can work with your clients to help them get in the right direction and be familiar with the information they may bring to you. Knowing, for example, that your client has elevated thyroid levels will give you a better idea of how better to support them than if you didn't know that, but this information and your subsequent support doesn't replace a doctor's medical advice and treatment. You'll have many clients who are sick of bouncing from doctor to doctor and are frustrated with conventional medicine, but this doesn't make it acceptable for you as a Health Coach to step into a role that isn't yours. Always work in conjunction with their practitioner. Please be mindful that the rules and regulations for what kind of advanced health and wellness guidance Health Coaches can provide varies by state and country. Follow your local scope of practice guidelines. Previously, we discussed considering optimal levels for test rather than the normal range which may not necessarily imply good health. All lab tests are springboard to get you to the next step in creating a plan for better health with your client in conjunction with their primary healthcare provider. We'll be covering the following tests in this lecture. Basic hormone tests, the full thyroid panel, the Adrenal Stress Index, mineral and heavy metal testing, small-intestinal bacterial overgrowth, and food sensitivities, including celiac and gluten sensitivity. Let's get started with an overview of basic hormone testing, particularly the different methods of testing that are available. It's a good idea for any client to have a sense of their hormone levels. Given the complexity of the hormone system in the body, there are many possible ways that the hormone levels can be abnormal. Four main methods exist for your clients to test their hormone levels, blood testing, saliva testing, urine samples, and Dried Urine Testing for Comprehensive Hormones or DUTCH. There are pros and cons to each of these tests, and each type of test has its own set of optimal levels. We've included a handout in this module called optimal levels for laboratory values that can be used for reference if needed, so don't worry about memorizing this information. A basic hormone panel tests for the levels of the following hormones, estrogens, including estradiol, progesterone, androgens, including testosterone and DHEA, and cortisol. Many panels will add additional tests, but these are the basics. With these tests, it's possible to identify abnormalities of both the adrenal system and the reproductive system. The DUTCH test, which we'll talk about in just a few minutes, is a comprehensive test that includes much more information in this. The blood hormone tests also called serum hormone tests are the tests that most commonly performed. These require little effort on the part of the patient but provided limited data. The blood test is like a snapshot of a person's hormones taken once. Serum hormone tests are best for testing the thyroid, LH, FSH, prolactin, fasting insulin, and sex hormone-binding globulin. However, they don't do a great job at testing these sex hormones because these tests can easily differentiate between free and bound hormone levels. This means that it's less accurate compared to other methods. Saliva tests are somewhat more comprehensive and they're available without a doctor's prescription. For many years, saliva was a method preferred by functional medicine practitioners for testing reproductive and adrenal hormones. Saliva tests are noninvasive and don't require the client to go to a laboratory to run the tests because it can be done from home and mailed in. These also allow for multiple collections, which as we mentioned, provides a more accurate big picture. However, there are limitations of saliva testing. First, it can only be done for the steroid hormones such as cortisol and the sex hormones. It does not work for testing the thyroid, for example. Also, many restrictions must be followed in order to collect an accurate and adequate sample. There are restrictions around eating, drinking, gum chewing, lipstick use, and tooth brushing that must be observed to get a usable specimen. Tooth brushing in particular can interfere with obtaining a good sample for up to an hour. Lastly, these tests are highly affected by topical and oral hormone usage which appears to disproportionately raise saliva levels. Clients who are on prescribed hormone supplements should not use these tests. Now let's move on to urine testing. This method hasn't been used extensively by practitioners in the past because it requires a 24-hour collection of urine to complete the test. This can be pretty inconvenient for patients. To help identify the diurnal pattern of cortisol, it's possible to collect individual urine tests several times for day but the information that's provided isn't very specific. The urine test also allows individual hormone metabolites to be measured. This is helpful with evaluating fertility and abnormal menstrual cycles. The downside of urine tests is that results can be skewed by hydration level, particularly dehydration as well as by liver and kidney disease. The Dried Urine Test for Comprehensive Hormones or DUTCH is a newer player on the laboratory front. This test allows for individual collection of urine samples without the inconvenience of multiple jars. To take a dried urine test, a pad that's provided is soaked in the person's urine and then allowed to dry according to the instructions provided in the kit. The DUTCH complete test can be used by both men and women. It collects a very large amount of data. It covers the basics of the sex and adrenal hormone tests, as well as additional tests for all the sex hormone metabolites and melatonin. The comprehensive nature of this test is a major advantage of the DUTCH test. It combines the advantages of serum, saliva, and urine testing all in one. The cycled collection allows the practitioner to evaluate hormonal patterns easily. However, it's an expensive test, and the results report is complicated, making interpretation potentially difficult. This can be problematic because clients shouldn't be guessing at the results, nor should you be interpreting them. Now that we've discussed the four different types of basic hormone tests, blood, saliva, urine, and dried urine, let's move on to discuss some other tests that capture a data that the basic hormone tests don't. You may have noticed one of our key players of the endocrine system is not mentioned in the basic hormone tests. The thyroid requires its own specific blood test that is best administered by a doctor or a lab. For clients who are having symptoms of thyroid disease but haven't been fully tested, levels for the following may be checked. Thyroid stimulating hormone, thyroid peroxidase antibodies or TPO, thyroglobulin antibodies or TG, free T3, and free T4. The thyroid stimulating hormone or TSH test measures the hormone that's released from the pituitary, signaling the thyroid to produce more thyroid hormone. Recommended functional medicine levels are 0.2 to 2.0 international units per milliliter, whereas the normal Western medicine range is 0.5 to 4.0 international units per milliliter. Levels of TSH can vary throughout the day and even from day to day, so the results of one test may not mean that all is right with the thyroid. For this reason, it's a good idea for your clients to get their TSH level tested more than once. Ideally, this should be done on different days and at different times. It's also important to look at the other labs in the thyroid panel because they all play a role in how the thyroid functions. The thyroid peroxidase antibody or TPO test is used to help diagnose Hashimoto's autoimmune thyroiditis, which as you know is the most common type of hypothyroidism. Ninety-five percent of people with Hashimoto's will have a positive TPO test. The optimal level is less than 15 international units per milliliter. Thyroglobulin antibody or TG may be positive in people with Graves' disease which is an autoimmune hyperthyroidism. However, it can also be positive in people with Hashimoto's thyroiditis as well. The optimal level for the TG is less than 1 international unit per milliliter. Free T3 measures the functional thyroid hormone level in the body. The optimal range is 3 to 4 picograms per milliliter. Early on in Hashimoto's, this level will often be normal. As the disease advances, the T3 may get lower, whereas high T3 levels are indicative of Graves' disease. Free T4 is the nonfunctional version of the thyroid hormone in the body. The optimal range is 6 to 12 milligrams per deciliter. Low free T4 is seen in Hashimoto's thyroiditis, although not usually until the disease has progressed. This is a similar pattern to what's seen with free T3. Many practitioners also include a reverse T3 test. Reverse T3 is a breakdown product of T4, but it is an inactive hormone. Tests that measure T3 can't distinguish between T3 and reverse T3 unless a special test is run, specifically for reverse T3. Reverse T3 is normally a very small part of the thyroid hormones. However, it can become significant in cases of chronic or acute illness, significant stress, or when ferritin levels are low. The Adrenal Stress Index or ASI is a trademark test that measures four cortisol tests, also called a 4-spot cortisol. DHEA, DHEA-S, 17-hydroxyprogesterone, fasting and non-fasting insulin, total salivary secretory, IgA or SIgA, gliadin antibodies for grain intolerance. This is a standardized test that is frequently ordered by functional medicine practitioners. The ASI assesses for adrenal dysfunction, blood sugar management, and food intolerances. The total salivary secretory IgA is a special test that may show food intolerance when the level is low. It's a sign of poor immunity in the digestive tract. In rare cases, the level is high which can be a sign of an ongoing infection or acute information in the GI tract. The 4-spot cortisol tests measures cortisol at for schedule times of the day to uncover an individual's pattern. Recall the cortisol is a key player in HPA axis dysfunction. 17-hydroxyprogesterone is a hormone that's used by the body to produce cortisol. When the level is low, it's an indication that the adrenal glands are depleted. DHEA measures help to evaluate the adrenal function. Measuring an individual's fasting and non-fasting insulin levels helps evaluate for insulin resistance, and the gliadin antibody is one way to test for gluten intolerance. Both insulin resistance and food intolerances, particularly gluten, can be early signs of adrenal dysfunction. Mineral and heavy metal testing. This type of test is recommended for clients experiencing poor blood sugar control, hair loss, skin abnormalities like acne, and depression. Heavy metal toxicity can contribute to a variety of health issues and is increasingly common due to air and water pollution and the use of inorganic pesticides. Mercury is one of the most common heavy metal exposures. Many people have had or even still have mercury fillings in their teeth which can leach out into the body over time. Mercury is also very commonly found in fish, therefore many physicians may recommend that mercury testing be done. Next, we have testing for a small-intestinal bacterial overgrowth, commonly known as SIBO for short. This is recommended for people with GI symptoms such as bloating, increased gas, and food intolerance. It can be a helpful assessment tool for people who identify themselves as having irritable bowel syndrome. Remember, a healthy gut is an important piece of the puzzle when it comes to balancing hormones, so clients with gut issues should work on resolving these issues as part of the hormone balancing protocol. The biggest inconvenience about the test is that it takes about three hours to complete and requires special mouth care and dietary instructions. Each lab performs the test using their own protocol, so clients should refer to the report for the best way to interpret their test. Finally, let's talk about food sensitivities. Many of your clients may have food sensitivities that they're not yet aware of that are contributing to their health issues. Testing for food sensitivities can be extremely helpful for identifying foods they should avoid in order to achieve hormone balance and optimal health. The ALCAT test was one of the first and is probably the best known test for food sensitivities. This is a blood test that tests for over 450 foods and chemicals. However, the ALCAT has never been verified as a valid test for food sensitivities, and the test is often not reproducible, meaning that if the same client took the test twice, they probably would get different results. A better test is the Cyrex testing panel, a blood test which uses antibodies to test for food intolerances. There are several different panels available. One of the most helpful is Array 3, which tests for gluten and wheat intolerance. Also great is the Array 4 which tests for common foods that are often consumed in place of gluten such as buckwheat, hemp, and quinoa. A comprehensive panel is the Array 10, similar to the ALCAT, this tests immunity against many different foods and herbs. Cyrex testing can only be ordered by a licensed practitioner. All right, you got all that. Let's do a recap. Lab tests that assessed for hormone imbalances, food sensitivities, and gut health issues can be very helpful tools for you and your clients to support optimal health. Depending on the type of tests, specimens may be collected by saliva, blood sample, urine, or dried urine. When clients experience symptoms that may be indicative of hormonal imbalances or gut issues, it can be a really helpful starting point to encourage them to get tested, either by a doctor, functional medical practitioner or using an at-home testing kit. As a Health Coach, it's always okay to suggest that a client visit their doctor to evaluate a possible imbalance or health issue. But remember to leave the test ordering, administration, and result interpretation to the client and/or their doctor. This will help you work from within your scope of practice wherever you are. Have you ever taken any of these tests or worked with the client who has? What happened next? Let us know in the Facebook group. I enjoyed sharing this information with you and hope you found it to be helpful. See you soon.

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Duration: 16 minutes and 16 seconds
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Posted by: ninaz on Apr 13, 2018

Advanced Lab Tests_Final

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