Ready to get started?
Simply follow these steps:
- If you request a free "pre-consultation" you will have an opportunity to speak to the doctor about your questions and concerns.
- Select a Lab Panel or Individual Test
- With any Lab Panel y ou have an option for Consultation with the doctor and a detailed Assessment with Supplements Plan.
- You will receive a requisition form to have blood drawn at a local lab.
- Urine test kit will arrive at your door for testing pyrroles.
- Your completed order will include instructions for completing History Questionnaire and next steps.
- Labs results and any Assessments will be sent to your email via a secure encyrpted email.
- The Consultation is a phone conversation with the doctor to discuss results.
- After taking supplements for 3-6 months, follow-up testing may be recommended by your doctor and ordered online.
If there are any questions post-consultation, the doctor is pretty good about responding to brief emails from time to time at no extra charge.
Consultation with Assessment and Plan
Second Opinion Physician provides the service of ordering labs, reviewing test results and client history and providing a detailed assessment and report. Dr Epstein reviews each case and makes his professional recommendation. The patient is provided with a list of supplements including target dosage and scheduling along with dietary and lifestyle considerations.
With more general health issues, following a complete consultation plus review of additional labs, it may be necessary that the patient receives a prescription from a local compounding pharmacy. Second Opinion Physician will assist in locating an integrative medicine physician in your area that is supportive of this holistic approach. If psychiatric medicine adjustments are needed, clients are encouraged to stay on their medications for six or more months of supplement therapy and follow up with their primary care provider or prescribing psychiatrist for monitoring adjustments. After this period of stabilization, patients are likely to have greater success with discontinuing one or more of their medications.
Follow Up Questions and Lab Services
Follow up inquiries are generally free. When questions extend beyond explanation of Assessment and Plan, emails or calls that require additional time are billed in 15 minute increments at $75.
Retesting, or not?
Depending on results from initial tests, we like to retest only a few labs. If initial tests are out of normal range, follow-up tests may include one or more of the following: copper, ceruloplasmin, zinc, homocysteine and vitamin D.
- Pyrroles and histamine do not typically require re-testing.
- Retesting is helpful in determining which supplements to adjust.
- Zinc, copper and ceruloplasmin are often retested when patient has trouble with low zinc or elevated free copper and/or would like to begin on MT Promoter. It is also useful when attempting to lower your medications under the supervision of your primary care provider.
- If histamine results are questionable because of taking antihistamine medicines, the test can be repeated when medications have been out of the system for 3-4 weeks.
- If your doctor suspects you may are undermethylated but result interpretation is complicated by taking histamine lowering medications, an alternate Methylation Panel may be ordered.
- For persons who have a cardiovascular or stroke risk, it is advisable to wait on addressing undermethylation until homocysteine levels are brought down to a more normal level.
- CBC is retested when replacing folates in an overmetylated person to monitor progress and ensure proper hemaglobin uptake and macrocytosis correction.