Ordering Lab Tests, Assesments and Reports
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Lab Testing, History Review, Biotype Report and Consultation for patients seeking a Walsh Approach to treating mood and behavior related issues.
Second Opinion Physician provides the service of ordering labs plus the option of receiving a Biotype Report. This includes a review of the full panel of test results plus client history. Dr Epstein reviews each case and makes his professional recommendations in the detailed report. The patient is provided with a list of supplements, adjusted for weight, existing meds and past medical history. The report includes how to schedule supplments, when to start what and what is the target dosage recommended. It also includes pertinent details about your specific biotype, according to the teachings of Dr William Walsh PhD.
Here's what to expect:
- First time patients typically start with the Comprehensive Biotype Panel plus Consultation. However it is possible to start with any of the initial tests or panels on the Lab Panels page.
- For other options see these Panels and Consultation Options.
- With any test or panel you have an option for a complete Biotype Report with $299 Consultation. If using labs from another clinic or lab company select the $399 Consultation option (the price is higher due to extra time and communication required to get proper tests and make manual EMR inputs.
- Patients who have already received a Biotype Report may wish to have a follow up lab test. If you would like to have the Biotype Report and supplement plan updated select the $199 Consultation. For patients who would like an extended 10-minute discussion with the physician for initial input on specific condition or in follow up on prior testing a no-report discussion may be scheduled with for a $99 Consultation. Consultations are not required with lab tests and it may not be necessary. If new or repeat labs are all within the normal 'functional range' a treatment protocol may not be necessary. If tested previously, and assumed accurate, it is not necessary to repeat pyrroles and histamine, since the values are pretty much unchanged throughout life - supplements will always be helpful. Labs that are recommended to repeat if abnormal on the initial tests vitamin D, high homocysteine and imbalances in copper, zinc and ceruloplasmin. CBC and Metabolic panels may also be repeated as a measure organ functioning, as they include glucose, kidney, liver, albumin, globulin, red and white blood cells.
- A pre-paid requisition form will be emailed to you for blood to be drawn at Lab Corp. An email will accompany with instructions on fasting, and use of medications and supplements prior to testing. You will also receive this link to Lab Corp to find the nearest location.
- Urine test kit will arrive at your door from DHA for testing pyrroles.
- Your completed order and follow up email will include instructions and links for completing an online, encrypted questionnaire and telemedicine consent agreement.
- Labs results and Assessment and Plan will be sent to your email via an encyrpted server.
- If you selected Consult and Report, following receipt of your Assessment, a phone conversation will be scheduled between you and our Walsh Protocol doctor to discuss results.
- After taking supplements for 3-6 months, follow-up testing may be advisable. You may order online directly or else contact us with any questions.
- Second Opinion Physician will provide a form to you for your insurance, should they be prepared to reimburse for labs ordered through Lab Corp and for the consultation. We do not accept assignment with any insurance and cannot offer to transfer billing for insurance direct reimbursement to Lab after payment has been received. So if there is a chance your insurance will pay for your tests directly with Lab Corp, please address this in advance of ordering labs. Keep in mind, we cannot provide a Diagnosis Code prior to the full evaluation with Biotype Report. Codes are typically required by insurance companies for lab reimbursements.
- Follow up visits are recommended and may vary on a case by case basis. Typically when labs are out of balance these may be re-tested after 3-6 months. This is useful when attempting to determine how well supplements have affected the blood chemistry or when considering adjusting supplement dosages.
Dr Epstein will reply to emails regarding issues that come up relative to the labs, supplements and general concerns. This is typically at no charge. If the time required becomes extended you will be notified if the service requires additional fees.
We are looking forward to working with you!
If following an evaluation it is determined that there are other non-supplement supported issues that should be addressed, Dr Epstein will assist in locating a functional medicine physician in your area that is supportive of approach. Regarding medicines being taking at the time of testing: If one or more "biotypes" are found to be out of balance, clients are encouraged to stay on their current prescription regimen for up to six months while on the supplement protocol before attempting to discontinue medications. This is important to prevent a worsening of symptoms while on supplements. Second Opinion Physician does not manage prescriptions or assist with psychiatric medicine changes. This should be done with your local primary care provider or prescribing psychiatrist to properly monitor your condition during adjustments.
Follow Up Questions and Lab Services
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.