Premis: The 'command and control' mechanism of the body is accomplished through the hard-wired system, or way of nerves, and the 'wireless' system, of by way of hormones & chemo-transmitters.

In order to maintain or restore health, the hormonal system must remain in 'balance.'

I. Hormone Testing:

Generally, we like to get our hormone levels drawn between 7 am and 8 am. Many of the hormones fluctuate widely during the day, and peak levels are in the early morning hours. It makes sense, then, to check them when they peak, thereby permitting consistent results from which an intelligent clinical decision can be made. Blood levels are more reproducible than are levels derived from saliva, and insurance (including Medicare) covers blood testing.

Saliva testing, at this time, is not FDA approved, and is therefore not a covered expense. Having performed concurrent saliva and blood testing in a number of patients, I have not found the saliva levels to be nearly as useful as the blood levels, and for this reason, I prefer the blood studies over saliva studies.

The hormone levels that are most valuable to my evaluation include: cortisol (am), total testosterone, total estrogen, estradiol, progesterone, DHEAs, pregnenolone, T-3, T-4, & TSH.

Because of the problems that we frequently see with "Euthyroid-Sick Syndrome," which is a common presentation of mis-diagnosed auto-immune thyroid disease, we obtain anti-thyroglobulin and thyroid peroxidase (TPO) levels.

Undiagnosed auto-immune thyroid disease is extremely common, and commonly presents as 'fibromyalgia,' 'chronic fatigue syndrome,' 'syndrome X,' and "low metabolism." The first indicator is low resting body temperature. That is, temperatures that rarely, if ever, reach 99 deg F.

Nutrient testing is accomplished through blood assay.

1. Blood is drawn at the lab or physician's office.
2. Tubes are shipped by FedEx to the FIA lab, in Texas.
3. White Cell culture is accomplished over a 2-3 week period, and results are forwarded to the physician's office.
4. Micronutrient deficiencies are identified, and an intelligent and cost-effective replacement is begun.
5. Without knowing what is missing, how can you intelligently replace it?
6. The SpectraCell analysis is currently covered by Medicare, and most (if not all) insurance carriers.

The test is re-performed 6 months, or so, after initiation of treatment. Testing on an annual or bi-annual basis is probably a good idea.

II. FIA Testing for Nutritional Deficiencies:

FUNCTIONAL INTRACELLULAR ANALYSIS (FIA™) PROFILES- SpectraCell's FIA™ is a clinically effective diagnostic tool for the prevention and management of chronic disease conditions. There is overwhelming evidence confirming that nutrient deficiencies have been shown to suppress immune function contributing to chronic disease processes including cardiovascular disease, diabetes, arthritis and alzheimer's disease.

Intracellular Function of Essential Nutrients

Nutrient deficiencies may be induced by a variety of conditions. With a functional deficiency, a nutrient may be present, but it may not be properly activated, it may not be appropriately localized, or it may not have sufficient cofactors to function at a normal level of activity. Underlying reasons for a functional nutrient deficiency include inefficiencies or deficiencies in the following:

• absorption by the gastrointestinal tract - intracellular activation
• transport to the appropriate tissue - storage
• transport through the cell membrane - concentration or activity of cofactors
• presence of intracellular inhibitors - tissues with increased metabolic needs

Thus, a functional deficiency includes anything that may reduce the concentration or the efficacy of a nutrient. No matter what the underlying cause, the result will be a defect in the biochemical pathways that depend upon the optimal function of that nutrient. A deficient or defective pathway may operate at a sub-optimal level for many months or even years before a clinical symptom may become apparent.

Because SpectraCell's FIA™ evaluates the function of a nutrient rather than just the concentration present in blood or tissue, the clinical consequences of any of the problems listed above will be more likely to be detected by SpectraCell's FIA™, than by conventional serum concentration measurements.

The nutrient testing that we prefer is described, below:

David S. Klein, MD, FACA, FACPM, FACMIMS
Director, Pain Center of Orlando
www.suffernomore.com

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