We are all used to getting a blood test when we are not feeling well. But bloodwork alone can paint the whole picture of what is causing your condition or issues you may be having. A condition can have many causes or underlying triggers or deficiencies. That’s why it is important to get to the root cause or causes of the problem. We use a variety of certified labs and different types of testing such as saliva, urine, stool, hair, and of course, blood.
Our goal is to use the appropriate testing to get a baseline of where you started and then down the road, we retest to prove what we are doing is working to bring the body’s chemistry closer to the normal functional range. We can get results for our clients because each care plan is customized to the individual. The care plans are personalized based on results from very specific and cutting-edge diagnostic testing. Our motto is, “Test! Don’t guess”. Review other tests down below.
Note, however, that the type of testing that may be recommended for each client is also customized and recommended by the doctor after a thorough case history and exam.
If you have any questions about our diagnostic testing, email us at info@imo.com or call the office at (330) 644-5488.
The Adrenal Rhythm & Its Importance
The human adrenal glands do not secrete steroid hormones at a constant level throughout the day. The hormones are released in a cycle, with the highest value in the morning and the lowest value at night when functioning properly. This 24-hour cycle is called the circadian rhythm and is depicted below in Figure 1.
An abnormal adrenal rhythm can influence many functions of the body, some of which are described below.
Energy Production
Abnormal adrenal function can alter the ability of cells to produce energy for the activities of daily life. People who have a hard time rising in the morning, or who suffer from low energy throughout the day, often have abnormal adrenal rhythms and poor blood sugar regulation.
The maintenance of a stable blood sugar level depends on food choice, lifestyle, adrenal function, and insulin activity. The Adrenal Stress Index™ panel measures stress hormones and insulin, to help ferret out the causes of fatigue, cravings, and obesity.
Muscle and Joint Function
Abnormal adrenal rhythms are known to compromise tissue healing. Reduced tissue repair and increased tissue breakdown can lead to muscle and joint wasting with chronic pain.
Bone Health
The adrenal rhythm determines how well we build bone. If the night and morning cortisol levels are elevated, our bones do not rebuild well, and we are more prone to osteoporosis. Stress is the enemy of the bones. In postmenopausal women, the effect of stress worsens due to female hormone imbalances.
Immune Health
Various immune cells (white blood cells) cycle in and out of the spleen and bone marrow. The immune system trafficking follows the cortisol cycle. If the cycle is disrupted, especially at night, then the immune system is adversely affected.
Short-term and long-term stress is known to suppress the immune response in the lungs, throat, urinary tract, and intestines. With a reduction in the surface antibody (called secretory IgA), the resistance to infection is reduced and allergic reactions are believed to increase.
Sleep Quality
The ability to enter REM sleep cycles and experience regenerative sleep is interrupted by high cortisol values at night and in the morning. Chronic lack of REM sleep can reduce a person’s mental vitality, vigor, and induce depression.
Skin Regeneration
Human skin regenerates mostly during the night. With higher night cortisol values, less skin regeneration takes place. Therefore, a normal cortisol rhythm is essential for optimal skin health.
Thyroid Function
The level of cortisol at the cell level controls thyroid hormone production. Often, hypothyroid symptoms such as fatigue and low body temperature are due to an adrenal maladaptation.
Grain Intolerance and Stress Response
Approximately 12-18% of the U.S. population suffers from a genetic intolerance to grains, such as wheat, rye, or barley contained in cereals, bread, and pasta. A high incidence occurs in people with Celtic, Nordic, non-Caucasian, and Mediterranean ethnicity. The gut becomes inflamed within 30 minutes after consuming grains, and this can lead to an adrenal stress response, increased cortisol, and reduced DHEA.
Chronic Fatigue Syndrome (CFS)
A common HPA axis defect in CFS is impaired corticotrophin release. As a result, low cortisol and eventual adrenal atrophy may be observed. Depleted adrenals with flat rhythms are often seen on the ASI™ panel. Simultaneous use of several therapies can help improve the debilitating effects of CFS.
Glycemic Dysregulation
Chronic hypoglycemia can impair normal adrenal function by repetitive overstimulation of cortisol production. Recurring exposure to high cortisol will impair insulin activity and invariably lead to insulin resistance and beta-cell exhaustion (diabetes). The ASI™ panel investigates the insulin-cortisol relationship under real-life conditions to allow targeted and meaningful interventions. This panel is useful in the following clinical situations: rapid weight gain and obesity, deranged blood lipids, sugar blues, early diabetes, and associated emotional disturbances.
Allergies/Autoimmune Disorders
More than fifty years ago, Dr. W. Jefferies (author of Safe Uses of Cortisol) discovered that patients with environmentally triggered allergies and autoimmune diseases dramatically benefited when given cortisol for other purposes. More recently, German researchers reported that disruption of the adrenal axis and cytokine relationships lead to predisposition and aggravation of autoimmune diseases. The findings of the ASI™ help identify patients with autoimmune diseases and adrenal problems who can benefit from cortisol supplements.
Depression/ADD
Several recent publications report a hyperactive HPA axis in depressed patients. Elevated midnight salivary cortisol is now considered one of the best tests for diagnosing endogenous depression. Other anomalies in cortisol rhythm usually accompany the midnight elevation. On the other hand, cortisol elevations and rhythm disruptions throughout the day are typical of attention deficit disorders (ADD). The anomalous cortisol findings in depression and ADD can be diagnosed successfully with ASI™. Subsequent interventions to rectify the time-specific cortisol elevations (during the day or night) are usually effective when applied under proper supervision.
Female Hormone Panel – The Cyclical Pacing of The Ovaries
The human ovary releases its hormones in a cyclical manner, which is referred to as the menstrual cycle. The average cycle is 26-30 days. The timing and pacing of hormone release are governed by GnRH, FSH, and LH, hormones from the hypothalamus and pituitary glands in the brain. The two major classes of ovarian hormones released during the menstrual cycle are estrogens, and progesterone, also known as the female steroid sex hormones. The major and most active estrogen released is estradiol, while the major progestogen is progesterone.
The Female Cycle Has Three Physiologic Phases:
Functions of Female Sex Hormones
Estradiol and Progesterone affect several target organs involved in successful conception and pregnancy. Additionally, these hormones maintain a number of secondary sexual characteristics, such as reduced body hair, soft skin texture, a higher voice pitch, and the possible release of certain pheromones.
Target Organs of Estrogen and Progesterone
The Uterus – Estradiol prepares the uterus for conception, produces a three-fold to five-fold increase in the thickness of its inner lining, and also promotes uterine gland development and mucus secretion. Progesterone causes swelling of the uterine lining, an increase in glycogen (a complex sugar) content, and an increase in the mucus secreted by the uterus. If conception does not occur, the uterine lining is shed, resulting in the menstrual flow.
Fallopian tubes – Sex hormones stimulate the Fallopian tubes to move the egg toward the uterus. The Fallopian tubes also secrete fluids that nourish the egg, the sperm, and ultimately the embryo when fertilization occurs.
Vagina – Estrogens promote the thickening of the vaginal lining and increase its secretions, which makes the lining more resistant to infections.
Breasts – Before puberty, the breasts grow only in proportion to the rest of the body, but under the influence of estradiol and progesterone during puberty, the breasts develop to maturity. During the menstrual cycle, excess estradiol causes breast swelling and tenderness.
Bones – In the adult female, Estradiol and Progesterone play an important role in the inhibition of osteoporosis and improve the incorporation of calcium and magnesium into bone. This is often why doctors prescribe Estrogen for menopausal women.
Kidney – Estrogens cause the body to retain sodium, which results in fluid buildup. Conversely, progesterone causes a loss of excess sodium and retained fluid. Before the period begins, there may be a relative excess of estrogen over progesterone, which commonly leads to several PMS-associated complaints.
Liver – Estradiol has stimulatory effects on liver proteins which may reduce thyroid hormone availability and increases the risk for cardiovascular disease. Estradiol also slows the process of liver detoxification of various harmful substances.
Miscellaneous – Estradiol can elevate blood sugar in certain susceptible individuals. Progesterone can increase appetite and has a general calming effect on the nervous system, especially at night.
What We Test
The Female Hormone Panel (FHP) is a simple, non-invasive test. Eleven saliva samples are collected during specified time periods throughout the menstrual cycle.
When using this panel in routine medical practice, both patients and doctors can view the profiles of estrogen and progesterone simultaneously. Diagnostic guesswork is minimized, and hormonal balance evaluation and customized treatment become a reality. In addition, we report the cycle average for testosterone and DHEA. The expanded panel also includes five FSH and LH measurements to see if brain control and stimulation of the ovaries are optimal.
Applications of The Female Hormone Panel
Detection of Luteal Phase Deficit. There are at least three luteal phase-deficit patterns that are characterized by a progesterone/estrogen imbalance. This imbalance is usually associated with PMS, infertility, fibroids, and other female hormone-related problems and can be readily detected by our panels.
Hormonal Imbalance and PMS. Many women suffer from hormonal imbalances in the estrogen-to-progesterone ratio. Our panels can define the hormonal state with exquisite accuracy which, in turn, provides specific insights for appropriate intervention to relieve hormonal imbalance and PMS-related symptoms.
Customized Hormone Therapy. Presently, female hormone therapy is not individualized to the needs of each woman, because current diagnostic tests do not provide sufficient data. Consequently, most women are empirically treated without regard to their individualized physiology and specific needs. The FHP, for the first time, will allow a clinician to customize therapy to each female patient.
Other Applications
The FHP can also be used to detect and monitor the following:
Advantages of The FHP
Convenience: Requires no blood draws, therefore no repeat clinic visits, and avoids the inconvenience of the 24-hour urine collection.
Economy: The fee for the 11-sample test is less than that of two blood determinations or a urine analysis for estrogen and progesterone.
Physiological accuracy: Research has demonstrated that the free hormone fraction predominates in saliva. Hormones can be found free or bound to protein. The free hormone fraction is very important because it is the bioactive fraction that most significantly influences living cells. The salivary female hormone levels correlate at 93% with the free hormones in the tissues.
One or two blood determinations or a 24-hour analysis of urine for these hormones gives only an idea of the ovaries’ hormonal productivity. The FHP provides a view of the ovarian capacity over a whole menstrual cycle.
Do You Need The FHP?
To determine if the FHP is the appropriate test for your hormone-related problems, consult with your physician or healthcare provider.
Post-Menopausal Hormone Panel
Menopausal Hormone Panel
Literally, menopause means the cessation of the monthly menstrual cycle; it signals the end of a woman’s natural childbearing years. Menopause is neither a disease nor an illness—it is a natural and usually gradual change in glandular function. It has its origins at the beginning of menses and culminates in a series of hormonal changes that result in the cessation of menstrual flow. This transition produces a variety of bodily manifestations and symptoms, due to changes in the production of hormones and the timing of their release.
The right balance of hormones is important for long-term emotional, mental, and bodily health
Various body parts undergo change and can produce one or more of the following symptoms:
Endocrine
Nervous System
Metabolic Changes
What Can You Do About It?
There are several therapeutic options that may minimize or even eliminate many of the symptoms:
Hormone levels from woman to woman can vary from 200% to 1,500%!
What Do We Test for and What Does It Tell You?
We test for male and female natural hormones. One, two, six, or eight of them, depending on your need. We utilize your saliva as a sample for measuring hormones, such as testosterone, DHEA, progesterone, estriol, estrone, and estradiol.
The brain-derived regulating hormones FSH and LH, are also measured to help assess the efficacy of control and feedback between the brain and ovaries. Measurement of FSH and LH is included in the expanded panel, the ePostM™ as well as in the ePeriM™.
Saliva hormone values reflect the tissue concentration of your hormones. Blood and serum contain the total hormone, but your tissues are only bathed with the active or effective fraction as found in saliva. Active fraction measurements are superior to blood and urine measurements both in diagnosis and treatment.
How Can We Help You?
Let us take a common example:
A woman suffers from several symptoms—migraines, hot flashes, and emotional fragility. She is having irregular periods, one every 6-8 months. Her doctor treats her with natural estrogens, but he does not do any testing to determine quantities or types of hormones that will meet her specific needs. The symptoms are under control, but her risks are increased.
Risks of treatment without actual testing of hormone levels include:
What could we have found out if we had tested her saliva hormone levels? We would have known that she has too much estrogen, not enough progesterone to balance the estrogen, low DHEA, and marginal testosterone.
But she felt good on the estrogen, many will say. Yes, however, the silent killers (cancer, blood pressure, heart disease) rarely make anyone feel bad at the start. Her best course is a new treatment plan, designed around the objective saliva hormone measurements.
Arbitrarily given hormones may deal with the symptoms while posing other serious health risks
How Do You Benefit?
There are five distinct ways that you can benefit from using the saliva tests in the Menopausal Hormone Panels™:
With salivary hormone testing, guesswork is a part of the past!
What You Can Do About Male Hormone Imbalance
Optimal health is dependent on a balance of hormones, not just a single hormone. Currently, men with low androgen hormones can benefit from hormone replacement therapy. Men with imbalances in their levels of androgen to estrogen and progesterone can also benefit from hormone supplements.
Supplemental hormones can be given by mouth, injection, skin patch, or implant. Androgen supplementation, in states of deficit, improves alertness and produces a feeling of well-being, with a reduction in abdominal fat and enhanced lean body mass.
Testosterone production in males is mainly a testicular function. The pituitary sex hormones, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) stimulate and regulate this function. Specifically, LH stimulates testosterone production in the testicles. This process is under negative feedback, meaning that testosterone levels regulate LH secretion. FSH and testosterone stimulate sperm production.
Why Measure Male Hormones?
Measurements of hormones can be used in two general ways:
Baseline measurements show normal and abnormal levels of six distinct hormones. If the levels are too low, or too high or hormone ratios are outside of expected limits, an objective treatment plan can be developed for the patient. Symptoms are not a substitute for measuring hormone levels, because many symptoms may involve non-hormonal factors.
Using appropriate tests for monitoring hormone therapy is crucial in establishing the appropriate dosing regimen. This reduces the chance of undesirable side effects and maximizes beneficial effects. For example, excessive use of androgens (testosterone, androstenedione, DHEA, and testosterone derivatives) can activate subclinical prostatic tumors which are androgen-dependent. Monitoring is especially important in older males. By the age of 70, at least 50% of men have subclinical prostate cancer. These individuals are especially susceptible to growth stimulation by androgens.
The roles of the seven tested hormones are highlighted in the following descriptions of each:
DHEA – Is the precursor for both male and female hormones— and anti-stress hormone produced by the adrenal glands. Unmonitored intake can easily alter the delicate balance between male and female hormones.
Androstenedione – This is a weak (androgen) and a precursor to both male and female hormones. Unmonitored intake in men can cause excessive female hormone production with minimal male hormone production. In women, unmonitored intake usually causes excess male hormone production with body and facial hair stimulation.
Testosterone – This is the main testicular androgen and is a precursor to the highly potent dihydrotestosterone male hormone. Excessive amounts of testosterone promote hardening of the blood vessels, aggression, prostate problems, and an increase in total cholesterol.
Dihydrotestosterone (DHT) – Is made from testosterone in certain tissues. The rate of its production is controlled by the level of free active progesterone. Excess DHT causes prostate enlargement and thinning of scalp hair.
Progesterone – This is a hormone important to both men and women. It is a natural calming agent for our nervous system. It also keeps in check excessive DHT production and counterbalances the effects of excessive estrone. Unmonitored intake can lead to breast enlargement, depression, and weight gain.
Estrone – This is estrogen that both men and women produce in the fat cells. The more fat, the more estrone, which in turn promotes fat deposits. It is produced from androstenedione, and excess estrone can cause breast enlargement and contribute to prostate enlargement. In males, a certain low level of estrone is mandatory to balance the androgens.
Estradiol – This is another estrogen that is much more powerful than estrone. It is partially formed in the testes but mostly in the peripheral tissues from both the testicular and adrenal androgens.
What We Test and What It Tells You
Using a saliva sample, the regular MHP panel measures seven hormones: DHEA, androstenedione, testosterone, dihydrotestosterone, estrone, estradiol, and progesterone. The expanded panel measures these seven hormones plus FSH and LH. The hormone levels in saliva reflect the active tissue concentrations, while blood contains mostly protein-bound hormones, whose active levels can only be estimated at best. Urine contains both active hormones and numerous metabolites and can only provide a gross estimate of hormone production over time. Active fraction measurements from saliva are superior to blood and urine for use in diagnosis and treatment.
This Test is For You if You Are:
Middle-aged and experiencing any of these conditions:
Young and experiencing any of these conditions:
How Do You Benefit?
There are five distinct ways that you can benefit from using the saliva tests in the Male Hormone Panel:
Use the Male Hormone Panel to help restore well-being, vitality, and passion for life. Taking hormones without an evaluation of the actual need for specific hormones entails risks that are both serious and unnecessary. With two additional tests for LH and FSH, our expanded Male Hormone Panel can accurately identify the origin of the most common male hormone problems.
Diagnostic Stool-Based Testing
Expanded GI Panel
The Regular and Expanded Gastrointestinal Panels include comprehensive testing of two stool samples to ensure the most accurate results. We evaluate for pathogens, inflammatory markers, occult blood, and functional markers: The Gastrointestinal Health Panel provides non-invasive, early immuno- detection of parasites and sophisticated testing of inherited food intolerances like those described below.
Toxoplasma Gondii
Description: Tissue parasite
Transmission: Under-cooked meats and contaminated food consumption. Exposure to cat feces.
Method: Salivary detection of secretory IgA antibodies to Toxoplasma by ELISA.
Sensitivity: 80%
Findings: Persistent brain cysts lead to behavioral, cognitive, and memory disorders, as well as muscle cysts, depression, insomnia, and reduced stress intolerance.
Taenia Solium
Description: Pork tapeworm
Transmission: Under-cooked pork, fecal-oral (including swine-to-human).
Method: Salivary detection of secretory IgA antibodies to tapeworm by ELISA.
Sensitivity: 86%
Findings: Abdominal discomfort; brain cysts leading to cognitive decline, headaches and seizures; skeletal muscle cysts; blurry vision.
Entamoeba Histolytica
Description: Intestinal and tissue parasite
Transmission: Fecal-oral contamination from sexual contact or other exposure.
Method: Salivary detection of secretory IgA antibodies to Entamoeba histolytica by ELISA.
Sensitivity: 80%
Findings: Episodic diarrhea or perianal itch, causing colon ulceration. May be locally invasive, causing liver and lung abscesses.
Trichinella Spiralis
Description: Tissue worm
Transmission: Wildlife contact, eating improperly processed meat or eating food contaminated with such meat.
Method: Salivary detection of secretory IgA antibodies to Trichinella by ELISA.
Sensitivity: 83%
Findings: Abdominal cramping, nausea, diarrhea and muscle soreness and pain, leading to fibromyalgia, edema of the upper eyelids, or fever.
Ascaris lumbricoides
Description: Roundworm (the most common worm infection worldwide)
Transmission: Fecal-oral; contaminated water, fruits, or vegetables.
Method: Salivary detection of secretory IgA antibodies to Ascaris lumbricoides by ELISA.
Sensitivity: 92%
Findings: Nutritional deficiencies (macro and micro), reduced liver and pancreas function, intestinal colic, diarrhea, dyspepsia, and spasmodic cough.
Note: If a patient’s test results demonstrate an infection, treatment by a medical doctor will be recommended.
Comprehensive Blood Panel
Integrated Medicine of Ohio runs a Comprehensive Wellness Blood Panel when clients start their care. As our philosophy is that we cannot develop a custom care plan without full information about our clients, our comprehensive blood panel tests more than 60 different items. The Comprehensive Wellness Blood Panel will be run at least twice; once at the beginning of care and again 2-3 months after the client has started care, to objectively show them the results of all of their hard work. Of course, because our care plans are customized to the client, additional specific tests may also be run on the same blood sample when a client’s case history warrants.
The Comprehensive Wellness Blood Panel is a fasting blood test. Clients may not have anything but water and their prescribed medications for 10-12 hours prior to testing. Most clients stop eating around 8:00 p.m. the night before the test and go to LabCorp first thing in the morning and then eat breakfast when the test is completed. Be sure to drink plenty of water the day before the test. This helps with the blood draw and will also be necessary because the Comprehensive Wellness Blood Panel also includes a urine test.
Cyrex Testing
Cyrex Labs offers state-of-the-art testing designed to test for very specific functions. Arrays are only ordered in certain circumstances. A description of each test is below. You can also click on the link for a brochure.
Array #2 – Intestinal Antigenic Permeability
This test is designed to test the state of the intestinal barrier. Click here for a brochure.
Array #3 – Wheat & Gluten Reactivity and Autoimmunity
This test is designed to help determine more about a person’s sensitivity to different parts of the wheat kernel including several aspects of gliadin, glutenin, and even the wheat germ. The test was designed because so many people found they were healthier on a gluten-free diet but tested negative with current testing at that time. The doctors involved with the lab wanted to find a way of better predicting who could benefit from a gluten-free diet. Click here for a brochure.
Array #4 – Gluten Sensitive Cross-Reactive Foods
This test is an adjunct to Array 3. Array 3 looks more specifically at wheat gluten sensitivity and Array 4 looks at other foods that gluten-sensitive people often react to. Generally, if a person is already gluten-free, we do not run Array 3 and go directly to Array 4. Test results for Array 4 are a source of excellent information. Click here for a brochure.
Array #5 – Comprehensive Autoimmune Reactivity
With Array 5, you can learn which systems are affected. Autoimmune reactions require a different treatment approach than other types of pathologies. It is easy to make autoimmune reactions even worse if you don’t know that is what you are treating. Click here for a brochure.
Array #6 – Diabetes Autoimmune Reactivity
Click here for a brochure.
Array #7 – Neurological Autoimmune Reactivity
Click here for a brochure.
Array #8 – Joint Autoimmune Reactivity
Click here for a brochure.
Arrays 6, 7, and 8 are subsets of the more complete Array 5. If your doctor only wants to check for diabetes, neurological, or joint-related autoimmune antibodies, he or she will recommend one or more of these.
Array #10 – Multiple Food Immune Reactivity Screen
Click here for a brochure.
Array #11 – Chemical Immune Reactivity Screen
Click here for a brochure.
Array #20 – Blood Brain Barrier Permeability
Click here for a brochure.
