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Wellness and Well-being 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 Wellness and Well-being Testing:

Testing for wellness and well-being involves a series of test that evaluates the individual's physical, mental, emotional and social health.

1. 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 Comprehensive Metabolic Panel?

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. Commonly, 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	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, cystic fibrosis
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.

2. Vitamins and Minerals Testing

 

What is the Vitamins and Minerals Testing?

Vitamin tests measure the levels of certain vitamins in an individual's blood. They are generally used to aid in the diagnosis of vitamin deficiencies or in detecting toxic amounts of a vitamin in a patient's system.

Vitamin tests are used to assess the level of certain vitamins in an individual's blood so that doctors can more accurately diagnose vitamin deficiency diseases or vitamin overdoses and devise effective therapy. The vitamins that are most commonly measured by doctors are folate, vitamin B12, vitamin D, and vitamin A.

Indications and Contraindications

The Vitamins and Minerals Testing is usually done to patients who have symptoms of anemia and deficiencies of Vitamin B12 and folate. This test can also be done to evaluate an individual's nutritional status.

How do you prepare for the Vitamins and Minerals Testing?

Most vitamin tests require no preparation; however, some may require that the patient fast for at least eight hours before giving a blood sample, or stop using some medications.

 

How does it feel? How long will it take?

The blood sample is taken from a vein in your arm. An elastic band is wrapped around your upper arm. It may feel tight. You may feel nothing at all from the needle while your blood is being drawn, or you may feel a quick sting or pinch depending on your sensitivity to pain. The Vitamins and Minerals Testing may last for a few minutes.

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 also occur.

Special instructions after the test:

After drawing the blood, cover the needle site with a bandage and apply pressure on it for several minutes. If the site becomes swollen, do warm compresses few times a day. You may resume your regular diet and your daily activities after the test. However, it is recommended to avoid strenuous activities and to report persisting pain, bleeding and swelling on the needle site.

Results:

In interpreting data on plasma vitamin levels, it should also be noted that different normal ranges may exist for different age groups and genders. For example, the normal range for plasma vitamin B6 for males is 7-52 nanograms per milliliter (ng/mL) for males and 2-26 ng/mL for females.

The normal ranges for levels of certain vitamins are as follows. Please note that, by convention, the units referring to the levels of each of the vitamins may differ from each other. The units picogram/milliliter (pg/mL), nanogram/milliliter (ng/mL), and micrograms per deciliter (micrograms/dL) refer to the weight of vitamin in the specified volume. The units nanomoles/liter (nmol/L) and micromoles/liter (M/L) refer to the concentration of vitamin in the specified volume.

• Folate (folic acid): 3.1-18.0 ng/mL
• vitamin B12: 200-1100 pg/mL
• thiamin: 9-44 nmol/L
• riboflavin: 6.2-39 nmol/L
• vitamin B6: 7-52 ng/mL
• vitamin C (asorbic acid): 28-84 M/L
• vitamin A: 28-94 micrograms/dL
• vitamin D (25-hydroxy-vitamin D): 40-100ng/mL
• vitamin K: 80-1160 pg/mL

A low value of vitamin B12 and folate indicates that there is a deficiency of these vitamins in the body. Low values also detect the presence of anemia.

A high value of vitamin B12 may indicate liver dysfunction and leukemia.

Notes:

In all cases, abnormal results fall below or above the normal concentration range. However, as noted above, values that are considered to be borderline or severely abnormal can differ according to the discretion of the medical laboratory or physician

3. Neurotransmitters Test

What is the Neurotransmitters Test?

A neurotransmitters test checks for the level of neurotransmitters (Serotonin, Dopamine, Epinephrine, Norepinephrine) in the body. These neurotransmitters are required for proper brain function and suboptimal or deficient levels can cause serious health problems.

Indications and Contraindications

Neurotransmitters are made in the body from amino acids. If the body does not have a sufficient supply of the right amino acids, neurotransmitter levels can become depleted and this chemical imbalance can result in many symptoms such as:

• Depression
• Anxiety
• Insomnia
• ADD/ADHD
• Poor appetite control
• Compulsive behaviors
• Fibromyalgia
• Chronic pain
• Lowered ability to focus
• Sleep problems
• Prolonged stress

How do you prepare for a Neurotransmitters Test?

The patient is required to avoid certain foods that increase levels of neurotransmitters 2-3 days before the test. These include tea, coffee, cocoa, vanilla, chocolate, cider vinegar, soda, licorice, citrus fruits and bananas. Follow the diet restrictions that your doctor will be prescribing to you.

Avoid vigorous activities, stress, and starvation before the test.

Notify your physician if you are taking OTC or prescription medications. You may be advised to discontinue taking these drugs prior to the test.

Drugs that may affect the test include:

• Aminophylline
• Caffeine
• Chloral hydrate
• Clonidine
• Disulfiram
• Erythromycin
• Insulin
• Levodopa
• Lithium
• Methenamine
• Methyldopa
• Nicotinic acid (large doses)
• Nitroglycerin
• Quinidine
• Tetracycline
• Clonidine
• Disulfiram
• Guanethidine
• Imipramine
• MAOIs
• Phenothiazines
• Reserpine
• Salicylates

How does it feel? How long will it take?

The blood sample is taken from a vein in your arm. An elastic band is wrapped around your upper arm and it may feel tight. You will feel nothing at all from the needle while your blood is being drawn, or you may feel a quick sting or pinch depending on your sensitivity to pain. Drawing a blood sample lasts for a few minutes.

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 clean and dry bandage. If advised by the health care professional, apply pressure or warm compress on the area several times a day to minimize swelling and bruising.

Results:

Normal Findings:

Epinephrine: 20 ng/100 mL

Norepinephrine: 60 ng/100 mL

                                    Serotonin: 101-283 ng/ml

Abnormal Findings:

Low neurotransmitters levels: If neurotransmitters are low, the nerves fire ineffectively or not at all. 

Low neurotransmitter levels can result from prolonged stress, anxiety, sleep disorders, genetic predisposition, depression and diets low in the amino acids from which neurotransmitters are made. Toxic substances like heavy metals, pesticides, illicit and some prescription drugs can cause permanent damage to the nerves that make neurotransmitters.

Norepinephrine: depression

Serotonin: sleep disorders, depression, obsessive-compulsive behavior, violence, aggression, suicide, panic disorder, urinary frequency, hyperactive bladder, and urge incontinence.

GABA: anxiety

Dopamine: schizophrenia and incoherent thoughts, Parkinson's disease, and depression.

High neurotransmitters levels: If the levels of neurotransmitters are too high, nerves may fire inappropriately.

Neurotransmitters exist in a delicate balance with one another. If the levels of one neurotransmitter become too low, the balance can shift and other neurotransmitter levels can become too high.

Norepinephrine: irritability, panic attacks, fear, anxiety

Serotonin: low appetite

Dopamine: anger and aggression

The Right Diagnosis and Treatment for Wellness & Wellbeing

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 Wellness & Wellbeing

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.

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