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Detoxification Testing Overview

In order to gauge your current state of health, our clinic will often request copies of your last two years of medical testing. We will often recommend further testing as needed. Our clinic does request some testing that is not commonly performed in more traditional medical clinics. Neurotransmitter analysis, 24-hour heavy metal testing with provoking agent, food sensitivity testing, comprehensive stool testing, and Candida antigen testing are commonly recommended by our medical staff. 

What to Expect on Your First Visit

The initial office visit typically lasts 45-60 minutes. Your physician will review your intake form with you and gather a detailed medical history. A partial physical exam is usually performed and medical records are often requested from your primary care physician and/or other physicians. Specialty laboratory testing may be recommended. Most clients are offered an initial protocol consisting of nutritional supplementation, and dietary and life style recommendations.

First Visit: Blood Test

The blood test assesses and identifies any issues with your kidneys, liver, and blood sugar, as well as other key factors such as blood cholesterols. The results are explained to you so that you will have a fuller understanding of your blood chemistry and be able to take control.

You will be required to fast for 14 hours before the test. Water may be drunk freely, but not tea, coffee, juices or other beverages. Appointments are normally arranged for mid-morning so that food and drink can be consumed up to 8 p.m. the previous evening. On the day of the appointment any prescribed medication should be taken with water as normal.

Patients are recommended to bring food to eat after the blood sample has been taken. Diabetics should advise the medical center and separate arrangements will be made.

First Visit: Urine Analysis

A urine analysis establishes exactly how the kidneys are functioning. You will be required to collect urine over a period of 24 hours. This should be as near the date of the blood test as possible, but must not include the 14 hour fasting period prior to the appointment. For example, if your appointment is at 10 a.m. Friday, urine collection should start Wednesday, 8 a.m. and continue until Thursday, 8 a.m. Fasting commences Thursday at 8 p.m. and continues until after your appointment on Friday, 10 a.m.

The first urine of the day should be excluded. All subsequent urine for the next 24 hours should be collected in clean plastic containers. Avoid contaminating the sample by urinating before defecating, and by not putting any foreign objects (i.e. toilet paper) in the container. The specimen should be kept refrigerated during the 24 hour collection period. Containers should be clearly labeled with your name and brought to the clinic at the time of your appointment. You are encouraged to drink fluids during the 24 hours.

First Visit: Resting ECG for Physician's Report

The electrocardiograph (ECG) determines the condition of the heart and measures its actions and the pulse.

The physician in charge reports any findings in his/her medical notes.

Specific Detoxification Testing

Life in the twenty-first century has challenged our ability to eliminate toxicity from our bodies.

Tap water, drugs, industrial chemicals, environmental pollutants, food additives, food adulteration, and mineral depletion of the soil are all saboteurs of good health. Your present state of health is a product of the toxins you have taken into your mind, body, and spirit over many years of exposure, and as a result of decisions you have made.

Urine Analysis (Urinalysis)

A urine analysis is a series of tests that screens and evaluates the urine sample for abnormalities, presence of various compounds (protein, glucose, ketones), and checks the kidney and metabolic processes. The urinalysis also involves tests that assess the color, appearance, odor, and pH of the urine, and checks for the presence of blood.

Indications and Contraindications

A urinalysis is part of a routine medical examination. It is especially done in patients who are pregnant, who are experiencing abdominal pains, frequent urination, symptoms of dysuria (difficult or painful urination), hematuria (blood in the urine), diabetes, chronic renal failure, urinary tract infections, and other metabolic diseases.

Preparation for a Urinalysis

There is no special diet or preparation before testing. However, let your physician know if you are taking medications as some drugs can alter urinalysis results.

How Does it Feel? How Long Does it Take?

Collection of a urine sample for urinalysis is simple and will not cause you any discomfort. You will be given a container to collect three to four ounces of urine. This will only take a few minutes.

Expected Effects After the Test

There are no risks or side effects after this test.

Special Instructions After the Test

Practice good hygiene when collecting your urine sample. Wash your hands with soap and water before and after collecting the sample.

Interpretation of Results

Normal Findings

Test	Normal level/range	Interpretation
Appearance	Clear	Cloudiness may indicate presence of pus, or bacteria.
Color	Amber yellow	Red or brown urine indicates blood in the urine (bleeding from kidneys). Green may indicate infection.
Odor	Aromatic	Strong smell of acetone indicates diabetic ketoacidosis. Foul odor indicates presence of UTI.
pH	4.6-8.0	Abnormal pH may indicate a urinary or kidney disorder, disease, or infection. Increased levels indicate a urinary tract infection (UTI). Decreased levels indicate diabetes.
Protein	0-8 mg/dl, 50-80 mg/24 (at rest), <250 mg/24 hr (during exercise)	Increased levels indicate renal disease, lupus (an autoimmune disease), heavy metal poisoning, and kidney disease.
Specific gravity	1.005-1.030	Low values indicate renal disease, over hydration, and diabetes insipidus (a lack of the antidiuretic hormone vasopressin). High levels indicate dehydration, diarrhea, and decreased renal blood flow.
Leukocyte esterase	Negative	Detection of leukocyte esterase indicates possible urinary tract infection.
Nitrites	None	Detection of nitrites indicates possible urinary tract infection.
Ketones	None	Detection indicates anorexia, hyperthyroidism, diabetes, aspirin ingestion.
Bilirubin	None	Detection indicates gallstones, liver cancer, tumor, inflammation.
Urobilinogen	0.01-1.0 Ehrlich units/ml	Increased levels indicate hemolytic anemia, pernicious anemia, hematoma, ecchymosis. Decreased levels indicate cholestasis, biliary obstruction.
Crystals	None	Detection indicates renal stone formation, urinary tract infection.
Casts	None	Detection indicates UTI, pyelonephritis, acute tubular necrosis, chronic lead poisoning, mercury poisoning, heavy metal poisoning, eclampsia.
Glucose	None	Detection and increased level of glucose indicates kidney damage, diabetes, pregnancy.
WBC	0-4 per low power field	Increased WBC indicates bacterial infection.
RBC	≤ 2	Increased RBC indicates primary renal disease, cystitis, prostatitis, bladder trauma.
RBC casts	None	Increased RBC cast indicates systemic lupus erythematosus, vasculitis, subacute bacterial endocarditis.

Notes

Factors such as prolonged refrigeration, presence of sperm in the urethra, consumption of foods such as carrots and beets, and some drugs can affect the appearance and odor of the urine sample.

Vaginal discharge can contaminate the urine sample and alter the results.

Post Provocation Urine Element Testing (Heavy Metal Test)

For diagnosis of the presence of certain toxic elements, post provocation testing is recommended. This involves urine collection following oral or intravenous administration of chelating or complexing agents that mobilize elements from otherwise slowly exchanging tissue pools. For example, non-provoked levels of cadmium, mercury, and lead may not be indicative of deep tissue stores and only reflect ongoing or very recent exposure.

Unprovoked urinary levels of essential elements such as magnesium, calcium, sodium, and potassium may be indicative of renal wasting conditions and provide early warning of renal dysfunction. Magnesium loading tests can also be performed using urine element testing.    Provoked urinary levels of elements that chelation agents have an affinity for can provide valuable information as to the efficacy of the provocation. Blood levels are better indicators of nutritional element status.

Indications and Contraindications

Analysis of elements in urine provides diagnostic information on potentially toxic elements such as lead, mercury, cadmium, nickel, beryllium, arsenic and aluminum. It also assesses the efficiency of renal reabsorption of essential elements such as magnesium, calcium, sodium, and potassium.

Urine element analysis is an invaluable tool for the diagnosis or confirmation of toxic element burden and monitoring of detoxification therapy.

Preparation for the Post Provocation Urine Element Testing

It is recommended to do this test early in the morning as soon as you wake up. Completely empty the bladder before doing this test. Do not eat one hour prior to the testing. You may only drink a small amount of water. Avoid taking vitamin and mineral supplements as these can alter the results.

How Does it Feel? How Long Will it Take?

The chelating agents (Captomer) may be administered orally to provoke urinary levels of elements. If administered intravenously, you may feel nothing at all from the needle while chelating agents are being given or you may feel a quick sting or pinch depending on your sensitivity to pain.

Administration of chelating agents will only last for a few minutes. However, collection of the urine sample will be done over the next 6 to 24 hours depending on your physician's recommendations.

Expected Effects After the Test

This test is painless and simple. Normally, you will not feel any side effects after the test.

Special Instructions After the Test

If chelating agents were administered intravenously, cover the needle site with a bandage and apply pressure on it for several minutes. If the site becomes swollen, place warm compresses on the area a few times a day.

For the next six hours, you may only drink 0.5-1.5 liters of water. You may only eat one hour after administration of chelating agents.

You will be given a container that will be used for collecting your urine sample over the next 6 to 24 hours. Follow the instructions given to you on how to seal and transport the urine sample. Be careful not to contaminate the urine sample.

Practice good hygiene when collecting your urine sample. Wash your hands with soap and water before and after collection.

You may resume your regular diet after completion of the urine sample collection.

Interpretation of Results

Results of the test are usually available in 10 to 12 days.

Metals	Normal levels
Arsenic	≤50 µg/L
Cobalt	0.1-2.2 µg/L
Copper	25 µg/24 h
Iron	<300 µg/dL
Lead	≤70 µ/dL
Mercury	20 µg/L
Nickel	≤500 µg/L
Silver	2.6 µg/L
Thallium	<3 µg/L

Notes

Contamination during collection of the urine sample may alter the results for heavy metals. The specimen should immediately be transported to the laboratory for accuracy or refrigerated if it cannot be processed right away.

Positive results for the heavy metal test must be confirmed by repeating the procedure.

The Right Diagnosis and Treatment for Detoxification

Once the comprehensive review is completed for each patient, our team of medical professionals will evaluate your diagnosis. At this point, our physicians will spend one on one time with you to interpret and explain your results. Together you will explore your goals and discuss your treatment plan options. These treatment plans can be implemented using multiple modalities such as medications, hormones, diet, supplements, behavior and lifestyle changes, and alternative therapies. Our physicians will prescribe a preventative and comprehensive treatment plan that is tailored to your needs and fits into your lifestyle.

Patients Medical Personal Approach to Detoxification

Our physicians and medical team at Patients Medical will regularly monitor your progress and track the effectiveness of your program, making adjustments if necessary. Our goal is to support you and advise you every step of the way.

We work in conjunction with your existing physician/s. Any gaps between specialists are filled to ensure we support your overall health and well-being. While we treat serious medical conditions such as Alzheimer's, diabetes, Parkinson's, multiple sclerosis, anxiety, depression, and heart disease, the primary objective of our staff is prevention and early detection of disease.

We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd & 43rd Street), Manhattan, New York, NY 10017.