Testing procedures for specific complaints

COMPLETE MICROBIOME MAPPING

What is a Complete Microbiome Mapping and What Tests does it include?

Complete Microbiome Testing is the most comprehensive digestive function test I have come across.  It is the first comprehensive stool analysis to include an FDA-approved DNA/PCR assay for GI pathogens performed on stool.  The pathogen targets include bacteria, parasites and another first for the market, viruses!  The new Complete Microbiome Mapping gives practitioners quantitative information about Giardia, Clostridium difficile, Salmonella, Candida and many more.

INCLUDED…

GIT FUNCTIONAL MARKERS

Calprotectin

Pancreatic Elastase

Faecal Secretory IgA

Faecal Zonulin

Faecal B-Glucuronidase

Steatocrit

anti-Gliadin IgA

PARASITES AND WORMS

Cryptosporidium

Entamoeba histolytica

Giardia lambila

Blastocystis hominis

Dientamoeba fragilis

Endolimax nana

Entamoeba coli

Pentatrichomonas hominis

WORMS

Ancylostoma duodenale, Roundworm

Ascaris lumbricoides, Roundworm

Necator americanus, Hookworm

Trichuris trichina, Whipworm

Taenia pesiez Tapeworm

Enterobius vermicularis, Pinworm

OPPORTUNISTIC BACTERIA/OVERGROWTH

Bacillus species

Enterococcus faecalis

Enteroccus faecium

Morganella species

Pseudomonas species

Pseudomonas aeruginosa

Staphloccus species

Staphloccus aureus

Streptoccus species

Methanobacteriaceae

POTENTIAL AUTOIMMUNE TRIGGERS

Citrobacter species

Citrobacter freundii

Klebsiella species

Klebsiella pheumoniae

Prevotella copri

Proteus species

Proteus mirabillis

Fusobacterium species

FUNGI AND YEAST

Candida species

Candida albicans

Geotrichum species

Microsporidium species

Rhodotorula species

BACTERIAL PATHOGENS

Aeromonas species

Ca,pylobacter

C. difficile, Toxin A

C. difficile, Toxin B

Enterohemorrhagic E.coli

E.coli 0157

Enteroinasive E coli/Shigella

Enterotoxigenic E. coli LT/ST

Shiga-Like Toxin E. coli Stx1

Shiga-Like Toxin E. coli Stx2

Salmonella

Vibrio cholerae

Listeria monocytogenes

Yersinia enteroclitica

Helicobacter Pylori

VIRAL PATHOGENS

Adenovirus 40/41

Noravirus G1/11

Bocavirus

NORMAL BACTERAIL GUT FLORA

Bacteroides fragilis

Bifidobacterium species

Enteroccus species

Escherichia species

Lactobacillus species

Clostridium species

Enterobacter species

Akkermansia mucinphilla

Faecalibacterium praunitzii

SHORT CHAIN FATTY ACIDS

Short Chain Fatty Acis, Beneficial

Butyrate

Acetate

Propinate

Valerate

 

Additional Testing

Gut dysbiosis has been linked to a number of metabolic disorders, the following panels may be useful:

  1. Cardiovascular Panel
  2. Mental Health Panel
  3. Thyroid Panel
  • 1’5 anhydroglucitol (glycaemic control)
  • hsCRP (systemic inflammation)
  • Cholesterol
  • Triglycerides
  • HDL/LDL (Lipid levels)
  • ApoA1/ApoB (lipoproteins)
  • Homocysteine (marker of folate, B6 and B12 deficiency)
  • Urate
  • Omega 3 index (marker of optimum omega 3 intake)

The greatest risk factor for cardiovascular disease is excess weight. Obese individuals can develop impaired glucose tolerance leading to advanced glycation end products (AGEs). AGE is thought to increase the activation of the inflammatory process and formation of atherosclerosis. The test 1’5 anhydroglucitol is a marker of glucose variability as seen in impaired glucose tolerance and diabetes.

A high-fat diet and a perturbed circulating lipid content has been linked with many diseases. We test not only lipids, but the apolipoprotein attached to the HDL and LDL particles. The ApoA1/APOB ratio has been shown to be a better indicator of cardiovascular disease risk than just the HDL/LDL ratio.

Hyperhomocysteinemia has been associated with an increase risk for many disorders, including vascular and neurodegenerative diseases, autoimmune disorders, birth defects, diabetes, renal disease, osteoporosis, neuropsychiatric disorders, and cancer. Elevated homocysteine could indicate folate, B6 and B12 deficiency. Polymorphisms in the methyltetrahydrofolate reductase gene have been linked with a mildly increased risk for this condition.

Urate levels have been associated with an increased risk of cardiovascular disease independent of other risk factors. Although the mechanism for this is still unclear, there is some evidence to suggest high urate levels may affect endothelial function.

Individuals with low omega 3 levels have a 10X risk of sudden cardiac death.

Additional Testing

  1. Check-up panel
  • Thyroid stimulating hormone (TSH)
  • Free T4
  • Free T3
  • Anti TPO
  • Anti TSH Receptor Abs
  • Reverse T3
  • Iodine Loading (stored iodine)

Testing Strategy

TSH, fT4, fT3 are the standard tools to identify classical hyper/hypothyroidism. Autoantibodies to the TSH receptor can inhibit or activate the thyroid resulting in abnormal (usually increased) release of T4 from the thyroid (Grave’s Disease). Autoantibodies to thyroid peroxidase, an intracellular enzyme are associated with the cell death of thyroid cells resulting in hypothyroidism. Abnormal thyroid markers without auto-antibodies development can be consistent with thyroiditis or thyroid cancer.

Reverse T3 is often increased during illness and several other stress, inflammatory related conditions. It is a tool used by some to determine the cause of non-thyroid hypothyroidism.

Urinary Iodine is useful to identify possible dietary insufficiency. Bromide is thought by some to be a possible inhibitor of thyroid function and is included in the panel. More research is needed in this area.

Additional Testing

  • Gut Health Panel
  • Cardiovascular Panel
  • Oestrogen
  • Progesterone
  • FSH
  • LH
  • Prolactin
  • Testosterone
  • DHEAS
  • ​Androstenedione
  • Omega index

Testing Strategy

In women, Oestrogen and Progesterone levels test ovarian function. Add-on testing could also include AMH, a test for ovarian reserve. See Add-On testing. Prolactin, FSH and LH are produced in the pituitary. Prolactin is primarily responsible for breast milk development.

FSH and LH are fertility-related hormones. Testing testosterone and DHEAS is to help diagnose the cause of erectile dysfunction or the inability of your partner to get pregnant (infertility); in females, to help diagnose the cause of masculine physical features (virilization), infertility, or polycystic ovary syndrome (PCOS); in children, to help determine the cause of genitals that are not clearly male or female (ambiguous genitalia) or delayed or early puberty.

Omega index is included as DHA levels are important for fertility.

Additional Testing

  1. AMH
  2. Cortisol
  • Parathyroid Hormone (PTH)
  • Corrected Calcium
  • Vitamin D
  • Procollagen Type 1 N Propeptide (P1NP) (bone formation)
  • C-terminal telopeptide of type 1 collagen (CTX) (bone reabsorption)
  • Omega 3 index

Testing Strategy

There typically are no symptoms in the early stages of bone loss and osteoporosis can go undiagnosed. Some signs and symptoms include: back pain, caused by a fractured or collapsed vertebra, loss of height over time, a stooped posture, a bone that breaks much more easily than expected.

Bone formation is regulated by PTH. Testing PTH and calcium helps to exclude hyperparathyroidism. Vitamin D is also important for calcium absorption and deficiency can predispose to osteoporosis. P1NP and CTX are markers for bone formation (osteoblasts) and bone reabsorption (osteoclasts). Ideally these two bone markers should balance out. Therapies directed at increasing bone formation should show an increase in P1NP without an increase in CTX.

The omega 3 index is included as omega 3 fatty acid intakes has been shown to protect against post- menopausal bone loss.

Additional Testing

  1. Sex Hormone Testing
  • Full blood cell count
  • Liver function
  • Lipid levels (Trigs/Chol/HDL/LDL/ APO A1/B)
  • hsCRP
  • Renal function
  • Iron studies
  • Thyroid function (TSH, fT4, fT3)
  • Glucose
  • 1’5 anhydroglucitol

Testing Strategy

The panel is designed as a screening test for major pathologies of the liver, renal, circulating blood cells, iron status, thyroid status and glucose metabolism. It is ideal for patients with non-specific symptoms or fatigue, over-weight individuals or just individuals who want to monitor their health.

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