Investigations

The following tests are the ones that are most commonly ordered:

Haematology and Biochemistry panel

This is a more detailed panel than the routine test (we measure 30 biochemistry parameters and 16 haematology ones). The results are re-analysed in detail by BodyBio Inc. to derive complex and sensitive markers of your physiological state. A less technical version of the report is provided to you, which includes supplement and lifestyle recommendations and a 7-day diet. The test screens for basic things that can go wrong in metabolism (imbalance of acid to alkali, for instance, or sodium to potassium, or poor detoxing of nitrogen compounds), but the BodyBio report data-mines the result for patterns that are hard to identify with the naked eye.

Toxicology

This cutting-edge (and therefore not strictly evidence-based) set of tests looks at key sites within cells, identifies toxins if there are any, and assesses the consequent damage. It is only semi-quantitative. These are some of the main tests:

  • Lymphocyte Sensitivity Test; when the white blood cells of your immune system show a reaction to something, we know that you have been exposed to it, we can look deeper to see what harm it may be causing, and we also know that it is a burden on your immune system.
  • DNA Adducts; identifies and locates chemicals attached to specific genes, which can block or alter gene expression (epigenetic effects) and therefore protein/enzyme functions. For example, an adduct on one of the SOD genes can block manufacture of the enzyme;
  • SOD; Superoxide Dismutase is a very important antioxidant enzyme with 3 subtypes, one of which operates only in the mitochondria, the energy-producing "batteries" within every cell
  • Glutathione and Glutathione-S-transferase Profile; GST is the single most important Phase 2 hepatic detox enzyme. The panel looks at the induction (switching on) of the Glutathione-S-transferase (GST) enzyme by toxic exposures. When the toxic burden is heavy you can become depleted in glutathione, which makes detoxifying and antioxidant activity harder for every cell.

Fatty Acid Analysis

This highly detailed test is sent to the Peroxisomal Diseases Laboratory, Kennedy-Krieger Institute at Johns Hopkins University, and then re-analysed in detail by BodyBio Inc. we use them because they are the best in the world. The panel measures;

  • The level and ratios of essential fats/oils, necessary as structural components of membranes and for normal physiological and immunological function.
  • The presence of undesirable fats/oils, which may indicate toxic or infective damage. This needs careful interpretation in context with all the other panels.

Biolab nutritional tests

I have worked with Biolab for 30 years now; they offer assessments of most micronutrients – vitamins, minerals, amino acids – and if they don’t measure something it is because there is no truly reliable test. Sometimes you will know the answers already, BUT if for instance you have been taking a zinc supplement for two years it is not guaranteed that you will have a good level in your blood – you could still have too little, or even too much.

Genomic panels

I have been studying, researching and using genomic data for 12 years now, and while it does not explain everything, nor allow us to treat everything, it is a valuable additional layer of information and understanding, which can help in selecting treatment modalities. Once you have your genomics results we can provide info sheets on several key areas, and help you to understand them, alongside all your other lab results, your history and experience.

For 3 years now the lab of choice has been excellent British start-up Lifecode. Their list of panels is updated frequently, and so far includes the key areas of Methylation, Detoxification, Oestrogen Balance, Histamine, Neurotransmitters, APOE, Nutrient Core and Athletic Performance.

23andme in California do a low-cost very large analysis, but they just send you a very long list of numbers. That leaves you with a lot of data to interpret, and in response this whole area has gone open source. There are several websites out there that will interpret your results to varying degrees for varying costs. Right now I can’t specify one to you that is the best, there are too many choices.

My colleague and co-author Anne Pemberton (formerly the nurse in my York practice, but highly qualified and experienced) has a book on Nutrigenomics coming out this summer. I’m excited about that!

Allergy tests

As the person who introduced food allergy blood tests to the UK in 1982, I have to tell you that there is no rock-solid reliable test for food intolerances. The best you could say of them is that they can give you a list of prime suspects to investigate – definitely not a list of the guilty. Even the tests for classical allergy reactions have to be interpreted with caution.

There are two tests that we can rely on, both have limited applications, both measure the response of white blood cells to a limited range of metals and other chemicals:

  • The Lymphocyte Sensitivity Test
  • The MELISA test is a lymphocyte proliferation test. The panel has been expanded to look better at patients for whom vaccine components may have been triggers.

Lyme and co-infection diagnosis

In Lyme disease the “co-infections” can be just as important as the Borrelia. I have worked for several years with Armin Schwarzbach, and am now very pleased to work with his new unit, ArminLabs in Augsburg. I don’t think there is a better laboratory anywhere in the world. They use the most advanced techniques available for diagnosing and tracking these infections. We will give you two short questionnaires to complete and return, which will tell us what are the most important organisms to test for, then we can agree a test panel and price it.

There are also new strategies emerging in the treatment of Lyme disease, and we should discuss them. Long-term multiple antibiotic therapy is not the first choice.

There are two other things that we have learnt and are still learning about, and need to factor in to your care:

Biofilm

This is how infections hide from your immune system and become chronic. See separate posting about this. Trying to get rid of an infection without tackling the biofilm, with increasing doses of antibiotics for instance, can be pointless and harmful.

The only test that we believe can be relied on is from Fry Labs in the USA, but sometimes it is best to assume the presence of biofilm and treat accordingly.

Mould and Mycotoxins

The world has learnt a lot about mould and water-damaged buildings from the effects of Hurricane Sandy in 2012, which swept up the East Coast of the USA as far as New York. Thousands of people were left with chronic illness that turned out to be triggered by mould growth and the toxins that moulds produce – mycotoxins. But we can also be exposed to these in our food and drink, with sometimes devastating consequences.

We can identify mycotoxins in our tests, not perfectly but getting better all the time.