Ordering Lab Tests, Assesments and Reports
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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, the 'Biotype 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. 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 medications for up to six months supplement therapy 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.
Here's what to expect:
- If you request a free "pre-consultation" you will have an opportunity to speak to the doctor about your questions and concerns at no charge.
- Depending on your preference there are options to select a Lab Panel or Individual Test. First time patients generally like to start with the Comprehensive Biotype Panel plus the option for Consult and Detailed Report by our Walsh Protocol Doctor. However it is possible to start with any of the initial tests or panels on the Lab Panels page.
- With any test or panel you have an option for Consultation with the doctor and a detailed Assessment with Supplements Plan. Consultations are not required and some may wish to order this after they have received lab results, should those labs appear to be relatively normal. Typically though with mood and behavior disorders we do find one or more biotype out of normal range.
- A pre-paid requisition form will be emailed to you. An email will accompany with instructions on fasting, and use of medications and supplements prior to testing. Take the form to your local Lab Corp where they will draw your blood.
- Urine test kit will arrive at your door from DHA for testing pyrroles.
- Your completed order will include instructions for completing an online, secure questionnaire.
- 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 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 they will pay for your tests directly with Lab Corp, please address this in advance of ordering labs.
- 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!
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.