Unexplained Medical Condition 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 and will often recommend further testing as needed. Our clinic does request some testing that is and not commonly performed in more "mainstream" medical clinics. 24-hour heavy metal testing with provoking agent, neurotransmitter analysis, food sensitivity testing, comprehensive stool testing and Candida antigen testing are commonly recommended by our medical staff. Some of these are discussed in detail in the links in this section.
What to Expect on Your First Visit:
First office visits typically last 45-60 minutes. Your doctor 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 doctors. Specialty laboratory testing may be recommended. Most clients are offered an initial protocol consisting of nutritional supplementation, dietary and life style recommendations.
First Visit: Blood Test
To assess and identify kidney, liver, blood sugar and other key factors such as blood cholesterols. The results are explained to the patient, giving him/her a fuller understanding of the blood chemistry, so that they may take control.
Patients are 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 8pm 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 clinic, and separate arrangements will be made.
First Visit: Urine Analysis
To establish exactly how the kidneys are functioning. Patients are 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 hours fasting period prior to the appointment.
A recommended timetable is that the first urine of the day should be excluded, than all subsequent urine for the next 24 hours collected in clean plastic containers. (If collection starts at 8am, this process must be followed until 8am the following day.) Eg. Appointment 10am Friday, fasting commences Thursday 8pm. Urine collection starts Wednesday 8am. until Thursday 8am.
Containers should be clearly labeled with the patient's names and brought to the clinic at the time of their appointment.
First Visit: Resting ECG for Doctors Report
The electrocardiograph (ECG) determines the condition of the heart and measures its actions and the pulse.
The doctor in charge reports any findings in his medical notes.
Specific Unexplained Medical Condition Testing:
Comprehensive Metabolic Panel
What is a Comprehensive Metabolic Panel (CMP)?
A comprehensive metabolic panel is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This panel measures the blood levels of sodium, potassium, calcium, chloride, carbon dioxide, glucose, blood urea nitrogen, creatinine, protein, albumin, bilirubin, and liver enzymes. A CMP evalueates your liver, kidneys, blood proteins, blood sugar, organ functions.
Indications and Contraindications:
The Comprehensive Metabolic Panel is ordered as a part of a routine medical examination. Your doctor may order a comprehensive metabolic panel as part of a regular health examination. Your doctor may use this test to check on a medical condition, such as high blood pressure, or to help diagnose a medical condition, such as diabetes.
How do you prepare for the complete cholesterol testing?
The patient is required to fast for 9 to 12 hours and only water may be taken leading up to the test. This is to obtain a more accurate result. Coffee, tea, and other beverages such as alcohol or pop soda should be avoided within 24 hours before the testing. If you are taking contraceptive pills, the doctor may advise you to stop taking drugs a few days before the test as this may affect the test results.
How does it feel? How long will it take?
The CMP is a painless procedure that usually lasts for a few minutes, about three minutes or less. Some patients may feel a slight stinging pain while the needle is being inserted to draw blood. After the test, a small amount of throbbing might occur on the needle site.
Expected effects after the test:
Normally, there are no major effects after the test. In most cases, patients may feel a little sore and slight bleeding may occur on the needle site. Bruising or swelling may occur.
Special instructions after the test:
After drawing blood, cover the needle site with a pressure wrap or a bandage. Because patients fast leading up to the test, it is recommended to bring a light snack to eat after the test in case you become hungry. You may return to your normal activities and regular diet after the test.
Results:
|
Test |
Normal Findings |
Implications |
Ammonia |
Adults- 15-56 µg/dl; Children- 36-85 µg/dl |
Increased levels of ammonia indicate the following conditions: Liver disease, cirrhosis, GI Hemorrhage, renal disease |
Bilirubin |
Total- 0.3-1.0 mg/dl |
Bilirubin elevations indicate: Jaundice, congestive heart failure, hemolytic anemias, hemorrhagic pulmonary tracts |
Blood Urea Nitrogen (BUN) |
Adults- 6-20 mg/dL; Elderly (>60 yrs)- 8-26 mg/dL; Children- 5-18 mg/dL |
Increased BUN levels indicate the following: impaired renal function, chronic renal disease, urinary tract obstruction, GI tract hemorrhage, diabetes mellitus
Decrease BUN levels indicate: liver failure, malnutrition, celiac disease, acromegaly |
Albumin |
Adult- 3.5-4.8 g/dL; Children- 2.9-5.5 g/dL |
Increased albumin indicates dehydration
Decreased albumin indicate: Acute and chronic inflammation and infections, cirrhosis, liver disease, nephritic syndrome, crohn's disease, burns, heart failure, thyroid disease |
Sodium |
Adult- 136–145 mEq/L; Children- 138–145 mEq/L |
Increased levels indicate: dehydration caused by severe vomiting or diarrhea, Cushing's syndrome, kidney disease or injury, diabetic ketoacidosis, diabetes insipidus, (hyperaldosteronism).
Decreased levels indicate: sweating, burns, severe vomiting or diarrhea, psychogenic polydipsia, poor nutrition, underactive adrenal glands or thyroid gland, heart failure, kidney disease, cirrhosis, |
Potassium |
Adults- 3.5–5.0 mEq/L; Children- 3.4–4.7 mEq/L; Infants- 4.1–5.3 mEq/L; Newborn- 3.9–5.9 mEq/L |
Increased levels indicate: damage or injury to the kidneys, severe burns, crushing injuries, heart attack, and diabetic ketoacidosis.
Decreased levels indicate: hyperaldosteronism, severe burns, cystic fibrosis, alcoholism, Cushing's syndrome, dehydration, malnutrition, vomiting, diarrhea and certain kidney diseases, such as Bartter's syndrome. |
Creatinine |
Adult male- 0.9-1.9 mg/dL; Adult female- 0.6-1.1 mg/dL; Children- 0.5-1.0 mg/dL; BUN/creatinine ratio: 10:1 to 20:1 |
Increase levels indicate: impaired renal function, chronic nephritis, obstruction of the urinary tract, congestive heart failure, shock, hyperthyroidism, gigantism, dehydration
Decreased levels indicate: severe liver disease, inadequate dietary protein |
Calcium |
Adult- 9.0–10.5 mg/dL; Children- 7.6–10.8 mg/dL |
Increased levels indicate: hyperparathyroidism, kidney disease, tuberculosis, or cancer that has spread to the bones, eating a diet with too much vitamin D, vitamin A, or calcium, dehydration, sarcoidosis, chronic liver or kidney problems, Paget's disease, and Addison's disease.
Decreased levels indicate: hypoparathyroidism, malabsorption syndrome, bone problems, kidney disease, acute pancreatitis |
Chloride |
Adults- 98–106 mEq/L; Children- 90–110 mEq/L; Newborn- 96–106 mEq/L |
Increased levels indicate: anemia, dehydration, kidney disease
Decreased levels indicate: cushing's syndrome, diabetic ketoacidosis, heart failure, kidney failure |
Carbon Dioxide |
Adults- 23–29 mmol/L; Children- 20–28 mmol/L |
Increased levels indicate: respiratory acidosis, chronic obstructive pulmonary disease (COPD), emphysema, and pneumonia, cushing's syndrome, Conn's syndrome, and alcoholism.
Decreased levels indicate: pneumonia, cirrhosis, liver failure, or hyperventilation, diabetes, kidney or heart failure, aspirin overdose, shock, frequent diarrhea, dehydration |
Glucose |
70–99 mg/dL |
Increased levels indicate: diabetes, heart attack, stroke, Cushing's syndrome
Decreased levels indicate: insulinoma, addison's disease, hypothyroidism, cirrhosis, kidney failure, anorexia. |
The Right Diagnosis and Treatment for Unexplained Medical Conditions
Once the comprehensive review is completed for each patient, our doctors and our team of medical professionals will evaluate your diagnosis. At this point, our doctors 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 doctors will prescribe a preventative and comprehensive treatment plan that is tailored to your needs and fits into your lifestyle.
Patients Medical's Personal Approach to Unexplained Medical Conditions
Our doctors and our 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 doctors. 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.
Next Steps:
Poor health can significantly affect your life. Improve your life by changing to good health. Call our patient coordinator at 1-212-679-9667 or click on Request an Appointment to schedule an appointment with one of our doctors for evaluation and testing.
We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd & 43rd Street), Manhattan, NYC, New York, NY 10017.
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Article Last Updated: 06/26/2009