Labrix Saliva Hormone Testing

"Effects of the Phytoestrogen Genistein on Bone Metabolism in Osteopenic Postmenopausal Women: A Randomized Trial."

noreply@blogger.com (Labrix Clinical Services) — Tue, 30 Sep 2008 16:31:00 +0000

FAQ Genistein

Q: What is Genistein?

A: Genistein (or aglycone genistein) is an isoflavone phytoestrogen that is abundant in certain fermented soy products (i.e. natto, miso, tempeh), and has been shown to increase bone mineral density in osteopenic postmenopausal women.

Q: Have any studies been done on genistein?

A: A study was recently published in the journal The Annals of Internal Medicine. University Hospital in Messina, Italy conducted a randomized placebo-controlled trial of 389 women aged 49 to 67 to examine the effects of 2 years' treatment with genistein on bone mineral density and bone metabolism in postmenopausal women with osteopenia. Researchers concluded that genistein increased bone mineral density at the femoral neck and lumbar spine at 24 months.

Q: How much Genistein did these women take?

A: The Messina study concluded that 54 mg genistein per day, taken in divided doses irregardless of meals, increased bone mineral density in postmenopausal osteopenic women.

Q: I eat soy. Can I get enough genistein from my diet?

A: The amount of genistein (54 mg/day) administered in this study cannot be easily obtained by a mere change of diet. Given the low amounts of aglycone genistein in most soy foods as well as supplements and low consumption of fermented soy products in the western diet, it would be extremely difficult to obtain 54 mg/day of purified genistein from food sources. Moreover, soy, soy supplements and soy food products also typically contain high levels of diadzein, which may antagonize the effects of genistein on bone. For instance, individuals would need to consume over 1 kg of the highest genistein containing foods (i.e. about 4 kg of tofu or 9 kg of soymilk) to achieve the amount of genistein aglycone (54 mg/day) administered in this study.

Q: I take estrogen HRT to help with bone mineral density. Would genistein benefit me?

A: HRT treatment of osteopenia is associated with increased risk for breast, endometrial and ovarian cancer, cardiovascular disease, and stroke. However, as a natural selective estrogen receptor (ER) modulator, genestein may positively regulate bone cell metabolism without the harmful estrogenic activity in the breast and uterus. Genistein produces effects on osteoblasts that inhibit osteoclastic activity, promotes osteoblast survival and causes direct stimulation on the anabolic effects of osteoblasts.

Q: Can I give genestein to my patients with osteoporosis?

A: Future studies in osteoporotic women are warranted to determine whether genistein also significantly decreases fracture risk in this group.

Q: Is genistein contraindicated for any patient population?

A: Genistein is not intended for pediatric patients or for pregnant or nursing women because it has not been tested in these groups. Moreover, because no studies have been done in these populations, as a precaution, aglycone genistein is contraindicated for patients with a history of cancer of the breast or reproductive organs.

©Labrix ETL/LF 2008

Article Synopsis:"Effects of the Phytoestrogen Genistein on Bone Metabolism in Osteopenic Postmenopausal Women: A Randomized Trial." Ann Intern Med, 2007; 146(12):839-47. 45456 (9/2008).

Conclusion: In 389 osteopenic postmenopausal women genistein at 54 mg/d in divided doses irregardless of meals increased BMD at the femoral neck and lumbar spine at 24 months.

Bone mineral density (BMD) is reduced with the onset of menopause. HRT has been the hallmark treatment of osteopenia for many years, but it is associated with an increased risk of breast, endometrial, and ovarian cancer, cardiovascular disease, and stroke. Phytoestrogens, present in soy products, carry lower risk for such adverse effects and are used by many women to maintain BMD. Genistein (aglycone genistein), an isoflavone phytoestrogen that is abundant in certain fermented soy products (natto, miso, tempeh), has been shown in postmenopausal women to increase BMD at the lumbar spine and femoral neck with no adverse effects.

A recent study conducted at the University Hospital in Messina, Italy set out to explore the effects of genistein. This was a randomized placebo-controlled trial of 389 women aged 49 to 67 to examine the effects of 2 years' treatment with genistein on BMD and bone metabolism in postmenopausal women with osteopenia. Researchers concluded that genistein increased bone mineral density at the femoral neck and lumbar spine at 24 months.

Included were 389 women aged 49 to 67 years who had been postmenopausal for at least 12 months and were in good general health. Excluded were women with systemic diseases, those using hormone therapy or steroids, smokers, those with family history of estrogen-dependent cancer, and those with BMD at the femoral neck greater than 0.795 g/cm2 corresponding to a T score of -1.0 SD (i.e. osteoporosis).

After 4 weeks of stabilization with a low-soy, reduced-fat diet, women were assigned to receive either 54 mg/day of genistein in 2 tablets or identical placebo. Both genistein and placebo tablets contained calcium carbonate (500 mg) and vitamin D (400 IU). All participants were counseled to eat a reduced fat diet. The intake of soy, legumes, or other supplements was prohibited.

The primary outcome was BMD at the anteroposterior lumbar spine and femoral neck at 12 and 24 months. Secondary outcomes were serum levels of bone-specific alkaline phosphatase
and insulin-like growth factor I, and urinary excretion of pyridinoline and deoxypyridinoline. Data on adverse events including changes in endometrial thickness were also collected.

After 24 months, Mean BMD at the femoral neck increased from 0.667 g/cm2 at baseline to 0.683 g/cm2 at 1 year and 0.702 g/cm2 at 2 years in genistein recipients. Mean BMD decreased from baseline to years 1 and 2 in placebo recipients. Similarly, mean lumbar spine BMD during 2 years increased in the genistein group and decreased in the placebo group. Genistein statistically significantly decreased urinary excretion of pyridinoline and deoxypyridinoline, increased levels of bone-specific alkaline phosphatase and insulin-like growth factor I, and did not change endometrial thickness compared with placebo. Biochemical and liver function did not change
with time. At 2 years, genistein use was associated with reduction in the mean number of hot flashes per day vs placebo (1.7 vs 3.9 per day). More genistein recipients than placebo recipients experienced gastrointestinal side effects (19% vs. 8%; P = 0.002) and discontinued participating in the study.

Conclusion: Twenty-four months of treatment with genistein has positive effects on BMD in osteopenic postmenopausal women.

©Labrix ETL/LF 2008

The Proper Collection of a Saliva Specimen

noreply@blogger.com (Labrix Clinical Services) — Mon, 11 Aug 2008 20:10:00 +0000

Like any laboratory test, the proper collection of a saliva specimen is vital to an accurate result. It is important for you as a provider to clearly understand the instructions enclosed in each kit so you can educate your patients or clients to ensure the best sample is submitted. The following are some frequently asked questions regarding the saliva collection instructions:

Q. Why are facial lotions or creams prohibited during collection?
A. Many "anti-aging/wrinkle" creams contain the very hormones that we test. It is easy to contaminate a specimen by direct contact with the straw or tube or by absorption into the body, thus altering the results to an inaccurate higher level.

Q. Why do all four tubes need to be submitted if only one test is ordered?
A. For the testing of Estradiol, DHEA, Progesterone, and Testosterone, we take an equal amount of specimen from each tube and transfer it into a 5th tube, the pool, which is used for testing. This process ensures a more accurate overall average of the hormone level, compensating for the natural daily peaks and troughs of these analytes. If only one tube is collected at a random time of day, there is no way to know if the result reflects one of those daily fluctuations and is accurate. For Cortisol, however, we want to catch those ups and downs, (the expected diurnal pattern) and test each tube individually.

Q. Why is there a difference in the instructions for sublingual and topical hormone use?
A. Sublingual hormones are detected in saliva for a longer period than topical hormones. If these instructions are not followed, a true therapeutic level will not be reflected.

Q. Why should cycling women collect their sample only on days 19-21 of their cycle?
A. These days should reflect the luteal phase, which is the ideal time to measure both progesterone (which should be at its peak) and estradiol in order to calculate the most accurate ratio between the two.

Q. Is it necessary to complete the symptom questionnaire on the back of the test requisition?
A. While not required, we ask that patients fill out this section so that the doctor interpreting the test results takes symptoms into consideration as well as laboratory numbers. The same thing applies to the section of the requisition where we request information on hormones the patient is taking. Please instruct your patients that we only need information about hormones, not vitamins or any other supplements.

Q. The instructions say not to eat at least one hour before collection. Does eating interfere with test results?
A. The ingestion of food is not the issue; it is the creation of as "clean" a specimen as possible. Food can create a more viscous or "junky" specimen and any particles can interfere with the testing process. While there are laboratory procedures to eliminate as much of this type of interference as possible, it is best to submit a sample taken when food residue is not in the mouth.

Understanding the importance of collecting a good sample is the first step to achieving the accurate and reliable results that have helped us set the standard for salivary testing!

Labrix Billing and Operational Procedures

noreply@blogger.com (Labrix Clinical Services) — Mon, 11 Aug 2008 19:52:00 +0000

By now you should have a pretty good idea of how to administer a test kit, access and interpret results, and provide a general treatment protocol. Now comes the business side of building a successful saliva testing program into your already successful practice. In this newsletter we have identified a number of frequently asked questions related to the business of saliva testing with Labrix.

General Billing Issues

What billing options are available through Labrix?

I. Direct Collection: Receive the wholesale price and collect payment from your patient directly.

II. Labrix Collection: We will collect the fees for testing and bill insurance if applicable; please contact Labrix for retail and insurance rates.

Please Note: You will need to choose Option I or Option II. A combination of the two options is not available at this time.

Do my patients have to pay up front for this testing?
No, when you elect to have Labrix collect, and your patients want their insurance billed first, we will do so (except for Blue Cross, which we require payment in advance). We will then bill your patients for the remaining balance should there be one.

Does insurance cover this?
If a person's policy covers hormone testing, then our FDA-approved testing will be covered under their insurance.

Can I do direct collections for some patients and have Labrix bill insurance for others?
You will need to choose to be a direct collections vendor (wholesale price, you collect testing fees) OR a Labrix collections vendor (we collect for testing as stated above).

Does Insurance billing affect my results turn-around-time?
Absolutely not! You will receive results guaranteed in 3-5 business days with either option. This is a standard part of Labrix's commitment to customer service.

How often does Labrix bill my account?
For Option 1, Direct Collections, Labrix will bill you the first week of the following month, for all test completed the prior month.

Will I receive an itemized invoice with what patients Labrix is billing for?
Yes! You will always be mailed a copy of your bill and an itemized list of patients tested for the specific month, as well as the date and what was tested.

What happens if Labrix normally charges my credit card, and instead I receive an invoice stating I owe?
Most likely your credit card did not authorize the charge due to expired credit card, not sufficient funds, canceled card, etc...Please be sure to contact the Lab with updated payment information to ensure finance charges are not applied.

Is it legal to mark up testing?
This depends on the state in which you do business. Please refer to your states rules and statutes.

What is the most common retail pricing for testing?
Please contact Labrix for suggested retail pricing.

Insurance Questions

Will Labrix bill insurance for my patients?
Labrix will bill Medicare for any of your applicable patients, however you must choose Option 2: Labrix Collections, in order for Labrix to bill private insurance.

What forms are required to bill insurance?
Please call the Lab and we can provide the appropriate forms. These are required to file insurance claims.

Are there different pricing schedules for insurance billing?
When Labrix bills insurance the patient is responsible for any amounts not paid by the insurance company (an exception is with Medicare: patient is not responsible for remaining balance unless the claim was denied by Medicare. In that case they will be responsible for the full amount).

Will the patient receive the reimbursement or will the Lab?
Most insurance companies will reimburse the Lab, however BlueCross BlueShield sends the check to the patient. Please be sure to notify these patients that the amount should be submitted in advance (with the specimen), or their sample will not be processed.

What if the patient has insurance questions?
If you have signed up for Option 2: Labrix Collections, the patient can call our office for insurance questions.

Operation Issues

Does Labrix provide the private labeling of test kits and reports?
For customers with significant monthly kit volumes and the desire to apply their brand to all elements of the testing process (kits, requisition forms, reports, etc...) Labrix offers a private label program. Call us for more information.

What are the most common profiles that are ordered through Labrix?
The most common profile ordered at Labrix is the Basic Hormone Panel (5-hormones). This includes Progesterone, Testosterone, DHEA and the AM Cortisol. This is a great baseline for starting a hormone monitoring program. You can always call within 30 days of the Lab receiving the sample to order the additional Cortisols for testing if needed.

How do we order more kits?
Simply call the Lab at 877-656-9596 and let us know how many kits you need.

Who pays for shipping?
Labrix pays for all ground shipping, however if you need the kits faster then ground, we will simply invoice you for the difference.

What if we want to guarantee quicker shipping to the Lab?
Labrix has an arrangement with UPS for guaranteed 5-business day delivery. Call the Lab to learn more about this shipping option and the additional cost.

Does Labrix offer assistance in building a world class saliva testing program?
Of course! We are always very excited to help our customers build a state of the art program into their practice. Call Labrix to discuss your needs and objectives.

Does Labrix offer a Drop Ship Program?
If you require individual shipping of kits to your patients directly, Labrix offers a simple drop ship program. Call the Lab for more details.

Does Labrix work with customers outside of the USA?
Labrix has customers all over the world. Are you interested in doing business outside of the US or know an international health care provider looking for excellent saliva testing service? Call the Lab today to learn more about our International Programs.

Does Labrix work directly with patients?
Labrix prides itself on the fact that we work with and therefore do not compete with the health care provider. We refer all questions and inquiries back to the health care provider (unless it is a billing/insurance question under Option 2: Labrix Collection program).

Bioidentical Hormones Supplementation Guidelines

noreply@blogger.com (Labrix Clinical Services) — Mon, 11 Aug 2008 19:32:00 +0000

These guidelines are provided based upon 26+ years of combined
experience balancing women and men's sex hormones.

INTRODUCTION: We have found the dosages, intervals and applications to be excellent starting points once a need for supplementation has been established clinically and through laboratory validation.

Please note that these are starting dosages, which need to be monitored through laboratory and clinical follow-up. We routinely test saliva for baseline hormone levels prior to initiating supplementation with repeat laboratory testing and clinical follow-up at 2 months intervals until hormones are balanced; then yearly thereafter.

PROGESTERONE

Pre-menopause interested in conception: USP Progesterone 20-30mg in a trans-dermal base (e.g. Vanpen) applied day 15 thru 28 of the menstrual cycle. Rotate application daily to the "thin" region of the body: inner wrist, behind knees, upper inner arm or upper chest. Dose may be given qd or split into bid application as preferred by provider and patient. An example script: P4 25mg/ml, #30, Sig: ½ml bid or 1ml qd (day 15 thru 20). You may want to give 2 refills, which will take the patient up to the 2 month retest interval.

Pre-menopause NOT interested in conception: USP Progesterone 20-30mg in a trans-dermal base (e.g. Vanpen) applied day 7 thru 28 of the menstrual cycle. In other words, this means apply on days not menstruating. Rotate application daily to a "thin" region of the body: inner wrist, behind knees, upper inner arm or upper chest. An example script: P4 25mg/ml, #30, Sig: ½ml bid or 1ml qd(day 7 thru 28). You may want to give 2 refills, which will take the patient up to the 2 month retest interval.

Post-menopause: USP Progesterone 20-30mg in a trans-dermal base(e.g. Vanpen) applied daily. Some providers prefer to cycle dosage, e.g., 3 weeks on and 1 week off. Rotate application daily to a "thin" region of the body: inner wrist, behind knees, upper inner arm or upper chest. Example scripts: P4 25mg/ml, #30, Sig: ½ ml bid or qd or alternatively: Sig: ½ ml bid or 1ml qd (3 wks on, 1wk off). You may want to give 2 refills, which will take the patient up to the 2 month retest interval.

Andropause (Men): USP Progesterone 5 to 10 mg in a trans-dermal base (e.g. Vanpen) applied daily. Rotate application daily to a "thin" region of the body: inner wrist, behind knees, upper inner arm or upper chest. Example script: P4 10mg/ml, #30, Sig: ½ml qd.You may want to give 2 refills, which will take the patient up to the 2 month retest interval.

BI-ESTROGEN (BIEST)

Pre-menopause interested in conception: USP Estriol(E3) and estradiol(E2) combination: 1mg (E3:E2;4:1) in a trans-dermal base (e.g. Vanpen) applied day 1 thru 13 of the menstrual cycle. Rotate application daily to the "thin" region of the body: inner wrist, behind knees, upper inner arm or upper chest. Dose may be given qd or split into bid application as preferred by provider and patient. An example script: Biest 1mg (E3:E2;4:1)/ml, #30, Sig: ½ml bid or 1ml qd (day 1 thru 13). You may want to give 2 refills, which will take the patient up to the 2 month retest interval.

Pre-menopause NOT interested in conception: USP Estriol(E3) and estradiol(E2) combination: 1mg (E3:E2;4:1) in a trans-dermal base (e.g. Vanpen) applied day 1 thru 25 of the menstrual cycle. Rotate application daily to the "thin" region of the body: inner wrist, behind knees, upper inner arm or upper chest. Dose may be given qd or split into bid application as preferred by provider and patient. An example script: Biest 1mg (E3:E2;4:1)/ml, #30, Sig: ½ml bid or 1ml qd (day 1 thru 25). You may want to give 2 refills, which will take the patient up to the 2 month retest interval.

Post-menopause: USP Estriol(E3) and estradiol(E2) combination: 1mg (E3:E2;4:1) in a trans-dermal base (e.g. Vanpen) applied daily. Some providers prefer to cycle dosage, e.g., 3 weeks on and weeks off. Rotate application daily to a "thin" region of the body: inner wrist, behind knees, upper inner arm or upper chest. Example scripts: Biest 1mg (E3:E2;4:1), #30, Sig: ½ml bid or 1ml gd or alternatively: Sig: ½ml bid or 1ml gd (3 wks on, 1wk off). You may want to give 2 refills, which will take the patient up to the 2 month retest interval.

TESTOSTERONE

Women: USP testosterone: 0.5 to 1.5mg in a trans-dermal base (e.g. Vanpen) applied daily. Some providers prefer to cycle dosage, e.g., 3 weeks on and weeks off. Rotate application daily to a "thin" region of the body: inner wrist, behind knees, upper inner arm or upper chest. Example scripts: Testosterone 0.5mg/ml, #30, Sig: ½ml bid or 1ml qd or alternatively: Sig: ½ml bid or 1ml qd (3 wks on, 1wk off). You may want to give 2 refills, which will take the patient up to the 2 month retest interval.

Men: USP testosterone: 10 mg in a trans-dermal base (e.g. Vanpen)applied daily. Rotate application daily to a "thin" region of the body: inner wrist, behind knees, upper inner arm or upper chest. Example scripts: Testosterone 10mg/ml, #30, Sig: ½ml bid or 1ml qd. You may want to give 2 refills, which will take the patient up to the 2 month retest interval. Note: It is important to monitor PSA and CBC levels during the treatment interval.

DHEA

Women: USP DHEA: 10mg in a trans-dermal base (e.g. Vanpen) applied daily. Rotate application daily to a "thin" region of the body: inner wrist, behind knees, upper inner arm or upper chest. Example scripts: DHEA 10mg/ml, #30, Sig: ½ml bid or 1ml qd. You may want to give 2 refills, which will take the patient up to the 2 month retest interval. Note: DHEA supplementation will often raise testosterone levels (conversion in the adrenal glands), which may alleviate the need for testosterone supplementation.

Men: USP DHEA: 10 mg in a trans-dermal base (e.g. Vanpen) applied daily. Rotate application daily to a "thin" region of the body: inner wrist, behind knees, upper inner arm or upper chest. Example scripts: DHEA 10mg/ml, #30, Sig: ½ml bid or 1ml qd. You may want to give 2 refills, which will take the patient up to the 2 month retest interval. Note: DHEA supplementation in males will NOT raise testosterone levels.

COMBINATION FORMULAS

All bio-identical hormones can be combined effectively into a single trans-dermal cream. Though while finding the correct balance, it may be advantageous to prescribe the hormones individually. Conversely, once combined into a single cream the absorption characteristics of each hormone may change slightly. Providers tend to be split evenly on which approach is best--as are we. You will have to find the approach that best suits you and your patients. The following combination examples have been found by each of us to effectively correct hormone imbalances:

Post-menopause: Biest 1mg (E3:E2;4:1), P4 25mg, DHEA 10mg, testosterone 0.5mg, #30, Sig: ½ml bid or 1ml qd or alternatively:Sig: ½ml bid or 1ml qd (3 wks on, 1wk off). You may want to give 2 refills, which will take the patient up to the 2 month retest interval.

Men: P4 5mg, testosterone 10mg, DHEA 10mg/ml, #30, Sig: ½ml bid or 1ml qd. You may want to give 2 refills, which will take the patient up to the 2 month retest interval.

Copyright 2008 Labrix Clinical Services, Inc.

Iodine FAQ’s:

noreply@blogger.com (Labrix Clinical Services) — Thu, 10 Jul 2008 21:41:00 +0000

I’ve heard that the Iodine skin test works just as well as the Iodine Spot and Load Urine test for determining whether I’m deficient in Iodine. Is that true?

No, the skin test will not accurately assess your body’s tissue stores of Iodine. The skin test will only reflect your local absorption of liquid iodine at that site. And since 88 % of the Iodine applied to the skin will evaporate you are only absorbing 12 percent of the applied iodine.

Additionally, this Iodine evaporation increases with increased ambient temperatures and decreased atmospheric pressure, so depending on whether you are in Colorado or California you may have a substantial difference in skin patch results.

It is also of note that the yellow color of iodine will disappear when reduced to iodide by the skin since iodide is white. So it is thought that this is not so much a reflection of Iodine deficiency (when the yellow color leaves) but the expected conversion to the iodide (white) form.

In conclusion, the skin test is not an effective means for evaluating iodine deficiency. Guy Abrahams MD concisely summarizes it thusly: “…the iodine patch test is not a reliable method to assess whole body insufficiency for iodine. Many factors play a role in the disappearance of the yellow color of iodine from the surface of the skin…the iodine/iodide loading test is much more accurate”.

The Bioavailability of Iodine Applied to the Skin, Guy E Abraham MD, The Original Internist June 2008

©Labrix Clinical Services ETL2008

$20.00 Off Testing Promotion with the Purchase of Slim, Sane, and Sexy

noreply@blogger.com (Labrix Clinical Services) — Thu, 03 Jul 2008 17:50:00 +0000

Labrix has teamed with Calaroga Publishing to offer $20.00 off of a Comprehensive Hormone Analysis with the purchase of EVERY Slim, Sane and Sexy book. Purchase the books at wholesale and resell them and your patients get a $20 off coupon to purchase a Labrix 8-panel Hormone Test at your location.

This means if you are selling the Labrix book at the retail price of $19.95, the book is essentially free to the customer when they then go on to purchase their Labrix 8-panel Hormone Analysis from your business. It’s a win-win for everybody! The customer is taking action and responsibility for their health, and you are providing them with the tools for which they start their BHRT journey!

Start carrying Slim, Sane, and Sexy today! To order wholesale please click here to download the wholesale pricing and order form!

The process is straightforward:.

1. The customer will provide your business with one-half of the coupon “provider” and if you chose to participate you provide them $20.00 off of their Labrix Comprehensive 8-panel saliva hormone test kit.

2. The customer will then place the other half of the coupon “lab” in the test kit when sending the samples back to Labrix. This step is important because it is what signals to the lab that you provided the customer with $20.00 off on your end. You may want to put the coupon in the kit box & explain the process.

3. We will then credit your account with $20.00 for each coupon that arrives in a test kit.

Want to sell more kits? Order Slim, Sane, Sexy at wholesale prices and resell them at your location…remember each book comes with the $20.00 off coupon!

Please Note: Whereas all books come with the coupon, you are by no means required to offer your customers the discount, even as crazy as that might be!

Wholesale Pricing and Order Form

Labrix is excited to introduce our new National Sales and Marketing Director

noreply@blogger.com (Labrix Clinical Services) — Thu, 03 Jul 2008 17:38:00 +0000

We are delighted to announce that Kate Wells has recently joined the Labrix team as our National Sales and Marketing Director. Kate has over 20 years experience in all aspects of business operations including several years' prior experience in the diagnostic hormone testing field.

From a start in retail banking marketing, through organizational development, to operations management and sales, Kate is bringing to us years of hands on experience plus a systemic approach to every element of the work within the company. Balancing a capacity to focus in on detail and ensure accuracy, with the ability and desire to see each area of the business in an interwoven broader concept Kate will add depth and breadth to marketing and sales process in our fast growing and very nimble company. She is skillful at swiftly developing process which supports and develops an organizations' capacity to serve its customers in a timely and effective way, and she is passionate about providing educational resources for providers and their patients.

As National Sales and Marketing Director Kate will be someone you meet often at conferences; she will be someone you can contact with any questions about the operation of your account; she and her department will be a resource for you and your staff as you grow your testing program. Kate brings a drive and determination to produce high quality services on a consistent basis and is ready to answer your questions and support the growth of your practice both for your patients and your bottom line.

When she manages to pull herself away from work…Kate is an active outdoors woman and, with her two teenage daughters, enjoys many activities available in the Pacific Northwest...particularly those that involve mountains and water. Kate is the first person to say that finding balance can be a challenge…but she tries to set the example at all times by laughing often, enjoying life to the full and, of course, by testing regularly!

Please join us in welcoming Kate to our team. She can be reached at 503-342-8367 ext 1367 and kate.wells@labrix.com with your questions and suggestions.

Slim, Sane, and Sexy

noreply@blogger.com (Labrix Clinical Services) — Thu, 29 May 2008 23:27:00 +0000

New Book Released on Bioidentical Hormone Replacement Therapy

Slim, Sane, and Sexy- authored by Jay H. Mead and Erin Lommen, ND

http://www.slimsaneandsexy.com

If you are looking for a safe and scientifically sound method of hormone replacement, this is the book that will answer your questions and guide you to sources for testing, treatment, and further information. While there are many books on menopause and hormones, most provide only partial or even potentially dangerous solutions. Slim, Sane, and Sexy offers safe, research-based treatments and recommendations for correcting hormone imbalances. Bioidentical hormone replacement therapy, along with wholesome lifestyle habits offers women a safe, effective alternative to conventional, or synthetic HRT. Physicians Drs. Mead and Lommen have helped thousands of women reclaim their lives using the methods outlined in this simple to follow guide for you and your physician. Add years to your life and feel better than ever—for the rest of your life!

Whatever your interest or motivation, Slim, Sane, and Sexy offers straight talk about what you’re experiencing and what you can do about it. If hormone imbalance is causing your symptoms, this natural hormone guide can put you back in the driver’s seat, allowing you to maintain healthy weight, steady emotions, and sustained energy.

About the Authors

Jay H. Mead MD, FASCP, is the President and Medical Director of Labrix Clinical Services, Inc a laboratory providing innovative testing for discerning practitioners. He is a leading expert in Salivary hormone and Urine iodine testing. Dr. Mead has been practicing as a clinician for over twenty years and understands the need and value of accurate, reliable laboratory testing. Dr. Mead is a board certified pathologist (AP/CP), a retired USAF Flight Surgeon and cofounder of a progressive full service complementary and alternative medical clinic. He also has board certification in blood banking and lead the Pacific Northwest Region of the American Red Cross as the Chief Medical Officer for over 10 years. Dr Mead is the co-author of the book: Slim, Sane and Sexy; Pocket Guide to Natural, Bioidentical Hormone Balancing (available May/June 2008 Calaroga Publishing).

Dr. Lommen is a licensed Naturopathic Physician and is enjoying her 19th year of clinical family practice and health optimization through anti-aging practices. She was a clinical investigator for a successful 5-year study through the NIH (National Institute of Health) on chronic disease. Dr Lommen has taught as an associate professor at NCNM (National College of Naturopathic Medicine) for 10 years. Dr Lommen is the CEO and Assoc. medical director of Labrix Clinical Services Inc. She is the co-author of the book: Slim, Sane and Sexy; Pocket Guide to Natural, Bioidentical Hormone Balancing (June 2008 Calaroga Publishing). Dr Lommen has spoken at National conferences on topics including: Adrenal Health, GI Health, Bioidentical Hormone Balancing, PCOS and Metabolic Syndrome, Depression and Chronic Fatigue Syndrome. Television interviews include both local and national stations, most notably; CNN.

The treatment modalities she employs in her practice are: bioidentical hormones, nutrition, vitamin and mineral replacement, mind/body and lifestyle counseling, botanical medicine, liver cleansing and detoxification.

Physicians: Oppose Wyeth & FDA Actions to Limit Prescribing!

noreply@blogger.com (Labrix Clinical Services) — Mon, 05 May 2008 16:58:00 +0000

Source: Patients and Professionals for Customized Care

As you may be aware, FDA made a horrible decision on January 9, 2008—choosing Wyeth’s wealth over patient health. FDA agreed to support Wyeth in their campaign to end access to compounded hormone replacement therapies—specifically by starting a crackdown on the use of estriol, which FDA is claiming to be illegal.

FDA also stated that pharmacies must stop using the term bio-identical. IACP is unequivocally opposed to FDA’s efforts to restrict the use of estriol and believes the use of the term “bio-identical” is appropriate.

Be assured that you are on the right side of this issue:

Hundreds of thousands of patients—perhaps millions—currently benefit from compounded hormone replacement therapy as prescribed by their physicians. For many of these patients, these medications have been their only source of relief and health from symptoms of menopause and perimenopause. We are not aware of any evidence, clinical or otherwise, to suggest that these women should have their therapies stripped from them.
In a press conference, FDA admitted there was not a single instance of an adverse event related to estriol that has been reported to FDA.
Estriol has a USP monograph. It is recognized by USP. For a pharmacy to compound estriol pursuant to a valid prescription is consistent with USP standards (chapters 795 and 1075), the Pharmacy Compounding Accreditation Board’s standards, and state pharmacy law. Congress specifically recognized and approved the use of active ingredients that have a USP monograph as appropriate for use in compounding.
There is currently an estriol product in phase III clinical trials for the treatment of Multiple Sclerosis. The safety data thus far has allowed the trials to continue to proceed.
Estriol has been used in Asia and Europe for years. Its use is well-supported in medical literature.
The use of the term bio-identical is an accurate descriptor of what these estrogens are. FDA-registered manufacturers use the term on their websites to describe FDA-approved estrogen and progesterone products.

From both a clinical and legal point of view, the evidence supporting our position for compounded bio-identical hormone replacement therapy as a continued option in women's health is compelling. FDA is wrong. It is in the best interest of patients to continue to receive the medications they are prescribed.

Do you want to learn more and see how you can help? Visit P2C2

Save on Dr. John Lee Books at the Dr. John Lee Institute

noreply@blogger.com (Labrix Clinical Services) — Thu, 10 Apr 2008 16:43:00 +0000

Recommended Books for sale at The Dr. John Lee Institute Official Website

All proceeds from books sold on the Dr. John Lee Institute go directly to supporting the Dr. John Lee Institute's mission and cause. Please note The Institute is a Non-Profit organization.

Save an additional 10% off when using the coupon code: labrix

Dr. John Lee's Hormone Balance Made Simple:
The Essential How-to Guide to Symptoms, Dosage, Timing, and More

Description:
This down-to-earth, easy-to-follow handbook gives women simple steps to find out if they have a hormone imbalance. Free of confusing medical terminology, yet filled with practical advice, Hormone Balance Made Simple gives clear, step-by-step guidance for a natural hormone program that's tailored to your individual needs. Now you can learn which hormones are right for you and how to deal with mood swings, hot flashes, night sweats, breast tenderness, irregular bleeding, and other distressing symptoms of menopause and premenopause. Learn how with the help of:

* Up-to-date information about symptoms and causes of hormone imbalance
* Guidance on how much to take and when to take it
* How stress, diet, exercise, sleep and exposure to toxins can affect your hormone balance

What Your Doctor May Not Tell You About Menopause (TM):
The Breakthrough Book on Natural Hormone Balance

Description:
The revolutionary book about Bioidentical Hormone Replacement Therapy. The original book on progesterone cream by John R. Lee M.D., the pioneer in the use of natural hormones, on using natural hormones, diet and exercise to treat menopause symptoms such as hot flashes, night sweats and osteoporosis. Extensively revised and updated in 2004.

What Your Doctor May Not Tell You About Breast Cancer:
How Hormone Balance Can Help Save Your Life

Description:
Another pioneering book by John R. Lee, M.D. that really gets to the bottom of why women get breast cancer and how to prevent it. It covers a wide array of topics including how HRT may trigger breast cancer, why doctors use chemo and radiation even though they don't work very well, what causes breast cancer, how to prevent it, and the remarkably preventive benefits of natural hormones-- when used properly.

What Your Doctor May Not Tell You About PREmenopause:
Premenopause, Balance Your Hormones and Your Life from Thirty to Fifty

Description:
Real solutions from John R. Lee, M.D. for PMS, fibroids, fibrocystic breasts, weight gain, fatigue, endometriosis, irregular or heavy periods, infertility, miscarriage, and other premenopausal hormone imbalance symptoms, in detail. He also covers the topics of stress, birth control pills, hysterectomy and cancer. Many case histories are included, and Dr. Hanley adds a new dimension to this book by addressing the emotional issues of premenopause symptoms as well as the use of herbs and nutritional supplements to treat symptoms.

Combo Pack:
Dr. John Lee's Hormone Balance Made Simple | What Your Doctor May Not Tell You About Menopause (TM) | What Your Doctor May Not Tell You About Breast Cancer | What Your Doctor May Not Tell You About PREmenopause

Price: $47.20 (Retail $55.53-- Save 15%)

The Monitoring of C-Reactive Protein (CRP)

noreply@blogger.com (Labrix Clinical Services) — Thu, 03 Apr 2008 21:14:00 +0000

C-reactive protein (CRP) is an acute phase protein (one whose blood concentrations increase or decrease in response to inflammation) produced by the liver.

Elevations or increases are usually of the most significance. Levels of blood CRP can markedly rise in response to widespread inflammation anywhere in the body caused by various conditions or events such as cardiovascular disease, metabolic syndrome, rheumatoid arthritis, lupus, cancer, and traumas.

There are many applications of CRP testing. It can be employed whenever sudden and serious inflammation is suspected, to evaluate known conditions, or to assess treatment of the inflammatory condition. An advantage over the ESR (erythrocyte sedimentation rate), which was historically used as an inflammation marker, is that an increase or decrease in CRP levels can be detected much sooner than changes in an ESR.

Monitoring CRP levels has been shown to be especially popular and useful for determining the risk of heart disease and evaluating cardiovascular disease that is already present. It is believed that the inflammation process contributes to this condition by damaging the plaque adhered to blood vessel walls, enabling it to break off into the bloodstream. The plaque can then lodge in the smaller vessels of the brain or heart, causing a stroke or heart attack.

Another application of CRP assessment in our patient population is monitoring and/or risk assessment of metabolic syndrome. This condition includes some, if not all of the following: high blood pressure, abdominal obesity, elevated triglycerides and LDL-C, low HDL-C, and an elevated fasting glucose. A linear correlation between a high CRP and these elements of metabolic syndrome has been established: the more signs a patient presents with, the higher the CRP.

CRP is an important part of routine screening for all patients. We have elaborated on a few of its most useful applications. Labrix offers CRP among numerous other tests on our new BloodDrop(TM) menu. Give us a call for more information.

The Monitoring of Thyroid Peroxidase (TPO)

noreply@blogger.com (Labrix Clinical Services) — Thu, 27 Mar 2008 16:09:00 +0000

Thyroid peroxidase (TPO) is an enzyme found on the thyroid gland. It has an important role in the production of thyroid hormones: it catalyzes iodination of thyroglobulin and is involved in the coupling of the iodotyrosines to form free T3 or free T4.

In some disease states, people develop antibodies to thyroid peroxidase. These antibodies attack the thyroid gland and damage its function. Thyroid peroxidase antibodies are seen in all thyroid
autoimmune diseases, and the highest levels are most commonly seen in Hashimoto's thyroiditis. The existence of anti-TPO can be an indicator of developing thyroiditis: patients with a positive TPO antibody test may have symptoms of a thyroid imbalance, yet all other thyroid test levels may appear normal. Elevated concentrations of anti-TPO are also seen in patients with thyroid
cancer. Another useful application of TPO testing is in polycystic ovary syndrome (PCOS). Women with PCOS often have a greater occurrence of TPO antibodies; one study shows elevated TPO antibodies in 27% of women with PCOS.¹

Labrix offers many testing options to help you identify and treat patients with the conditions mentioned above. Our BloodDrop menu offers anti-TPO, which can be combined with different options in order to identify or monitor specific conditions.

The menu includes FT3, FT4, and TSH, which combined with an anti-TPO reflects thyroid function. In addition, our salivary test menu includes hormones that, combined with a serum anti-TPO, can help identify PCOS (testosterone, DHEA, estradiol, and progesterone).

We are excited to offer our new BloodDrop test menu. Give us a call for more information.

¹ "High Prevalence of Autoimmune Thyroiditis in Patients With Polycystic Ovary Syndrome". Janssen et.al Eur.Jour.Endo. (2004) 150 363-369.

Labrix Clinical Services blazes a new “curve” (path)!

noreply@blogger.com (Labrix Clinical Services) — Thu, 13 Mar 2008 15:34:00 +0000

We are changing the way Adrenal Function Testing specimens are collected:

Labrix continues its commitment to setting the standard for precision and reliability in laboratory testing. Our innovative research and development team has validated the following improvement in our services for immediate release: Only when the first morning sample is collected thirty minutes after awakening will the diurnal cortisol peak be maximally seen. You should now instruct your patients to collect their first morning sample 30 minutes upon awakening for precise adrenal evaluation. When specimens are collected before or after the thirty minute mark, the cortisol curve is substantially altered (see graph below). As practitioners, we need the most accurate assessments in order to provide the best therapeutic results. For adrenal function testing, this new information will increase that accuracy.

If applicable please call and order new saliva instructions.

Excerpt from: "Slim, Sane and Sexy; Pocket Guide to Natural Bioidentical Hormone Balancing."

noreply@blogger.com (Labrix Clinical Services) — Fri, 07 Mar 2008 04:16:00 +0000

By Jay H Mead MD and Erin Lommen ND.

Wow! The RDA in the US for iodine is 150micrograms/day, which is 1/89th of the 13.8milligrams consumed by the mainland Japanese population. And, guess what? The Japanese population has very little hypothyroidism and breast cancer compared to the US. As it turns out the US RDA was determined to be the minimal amount of iodine to prevent goiter (enlarged thyroid gland) and Cretinism (severe hypothyroidism with mental retardation) and does not take into account that every organ in body, not simply the thyroid gland, requires sufficient iodine for optimal function.

It is an urban legend that there is enough iodine in our salt. The amount of iodine in our salt is based upon the flawed RDA. In fact, until the 1980s, a slice of bread contained the iodine RDA, which helped somewhat. However, this was removed and replaced by Bromide, a goitrogen (enlarges the thyroid) that interferes with iodide utilization in the thyroid and most likely the breasts. Iodine has an anti-carcinogenic effect on the breast ("Orthoiodosupplementation: Iodine sufficiency of the whole human body." The Original Internist: 2002; 9:30-41) and is associated with fibrocystic changes (a precursor to cancer) and painful breasts. According to the WHO 15% of American women are iodine deficient and 1/3 of the world's population is iodine deficient.

So what? As with so many biological systems, optimization of function requires optimal nutrition, and iodine is a very important nutrient. A large percentage of Americans are marginally iodine sufficient, i.e. we ingest enough iodine to keep our glands from enlarging and prevent mental retardation, but not necessarily enough to minimize our risk of cancer and optimize our thyroid hormone production. It is estimated that the majority of patients taking thyroid hormone either don't need it or could reduce their dosage. And, what about the large numbers of patients, mainly female, who have symptoms of low thyroid (hypothyroidism) and are told they have "adequate" hormone levels and are given an anti-depressant. We believe this group of patients is often neglected by the conventional medical model.

The preferred test to determine iodine sufficiency is the "24hr urine loading test". A standard dose of iodine/iodide is ingested and amount passed in the urine over the next 24hrs determines sufficiency. If, for example, one passes less than 90% of the loading dose he or she is deficient and would benefit from iodine/iodide supplementation.

Iodine Fact Sheet

noreply@blogger.com (Labrix Clinical Services) — Fri, 07 Mar 2008 04:11:00 +0000

By Jay H Mead MD

GENERAL INFORMATION

Sufficient iodine is essential to good health. Although the primary function of iodine is in the production to thyroid hormones by the thyroid gland, many other organs require iodine for optimal function (1). Iodine deficiency is the associated with reduced mental performance (2,3), fibrocystic breasts disease and breast cancer (4,5,6,7,8) and is a potent antioxidant (9).

It is estimated that 15% of American women are below the World Health Organization's classification for iodine sufficiency and this is conservative estimate (10) and almost one third of the world's population lives in areas of iodine deficiency (11). The most recent trend in the US is a 50% reduction in urinary iodine excretion between the 1970 and 1990 (11).

The RDA for iodine is 150 mcg/day, which pales in comparison with the daily average intake of 13.8mg/day for the mainland Japanese population. The mainland Japanese consume on the average 89 times the US RDA and have reduced rates of many chronic diseases (1). In fact, the optimal iodine consumption level has never been determined (11); yet, the incidence of breast cancer is much lower in the Japan (12).

In 1829 Jean Lugol, a French physician, discovered a method to dissolve iodine in an aqueous solution. This is known as Lugol's solution and has been for a myriad of maladies for more than 150 years. The collective experience of clinicians over this period led to recommended daily amount of Lugol's equivalent to be 12.5-37.5 mgs, which so happens to be the recommended dosage to maintain whole body sufficiency using the recently developed iodine/iodide loading test (13).

RATIONAL FOR THIS FORMULATION

Administration of a liquid iodine/iodide solution may stain clothing, has an unpleasant taste, may cause gastric irritation and can vary in accurate delivery. Whereas in a tablet form consisting of 7.5 mg of iodide and 5.0 mg of iodine in a colloidal excipient coated with a pharmaceutical glaze is more precise and pleasant to ingest.

DOSAGE SUGGESTIONS

Dosage varies with the individual. The daily optimal dosage of one tablet (12.5mg) closely mimics the daily average consumption in Japan. Whereas, higher daily doses may be needed to correct total body insufficiency, e.g. 4 tablets (50mg) for up to 3 months.

ALLERGIC REACTIONS POSSIBLE ADVERSE EFFECTS

Anaphylactic reactions are essentially non existent according to the American Academy of Allergy Asthma and Immunology. Patients who report allergic reactions to topical preparations, seafood or contrast media are reacting to a component other than iodide (14).

Dr Abrahams clearly describes the known risk to idodide/iodine supplementation and reports that doses in the ranges suggested here that these adverse effects are extremely uncommon if not non-existent (15). Potassium iodide when used to in large doses, e.g. S.S.K.I solution for asthma ((up 4 grams (4,000mg) in a single dose)) the adverse effects were reported as 16% (16).

Potential adverse effects related to iodide include:

Thyrotoxicosis
Iodine Induced Goiter
Brassy taste
Increased Salivation
Coryza
Sneezing
Headache
Mild acneiform lesions in the seborrheic areas

REFERENCE LIST

1. Abraham, G.E., et al, Orthoiodosupplementation: Iodine sufficiency of the whole human body. The Original Internist, 2002, 9:30-41.
2. van den Briel, T. et al, Improved iodine status is associated with improved mental performance of schoolchildren in Benin. Am J Clin Nutr. 2000 Nov, 72(5):1179-85
3. van den Briel, T. et al. Mild iodine deficiency is associated with elevated hearing thresholds in chlren in Benin. Euro J Clin Nutr. 2001 55:763-768
4. Ghent W.R., et al. Iodine replacement in fibrocystic disease of the breast. Can J Surg. 1993 Oct;36(5):453-60
5. Eskin, B.A., Iodine and mammary cancer. Adv Exp Med Biol. 1977, 91:293-304.
6. Strum, J.M., Effect of iodide-deficiency on rat mammary gland. 1979 May 31; 30(2):209-20.
8. Carmen, A., et al. Is Iodine a Gatekeeper of the Integrity of the Mammary gland? Journal of Mammary Gland Biology and Neoplasia. 2005, 10(2):189-196
9. Winkler R, et al. Effect of iodide on total antioxidant status of human serum. Cell Biochem Funct. 2000 Jun; 18(2):143-6.
10. Abraham G.E., The safe and effective implementation of orthoiodosupplementation in medical practice. The Original Internist, 2004 11:17-36.
11. Dunn JT, What's Happening to Our Iodine? J Clin Endo and Metab 1998; 83(10):3368-3400
12 Toshihiko Kawamura and Tomotaka Sobue. Comparison of Breast Cancer Mortality in Five Countries: France, Italy, Japan, the UK and the USA from the WHO Mortality Database (1960-2000). Japanese Jounrnal of Clinical Oncology. 2005; 35(12):758-759.
13. Abraham, G.E., et al. The Safe and Effective Implementation of Orthoiodosupplementation In Medical Practice. The Original Internist, 2004 Mar, 11:17-36/
14. Academy Position Statement: The Risk of Severe Allergic Reactions from the Use of Potassium Iodide for Radiation Emergencies. American Academy of Allergy Asthma and Immunonology. February 24, 2004.
15. Abraham GE, et al. Optimal Levels of Iodine for Greatest Mental and Physical Health. The Original Internist, 2002; 9:5-20
16. Peacock L, Davison H. Observations on Iodide Sensitivity. Ann Allergy, 1957 Mar-Apr;15(2):158-164.

Why Test Iodine?

noreply@blogger.com (Labrix Clinical Services) — Fri, 29 Feb 2008 00:09:00 +0000

The identification and treatment of an iodine deficiency has obvious benefits. In order to determine the daily amount of essential iodine required for whole body sufficiency, an Iodine Loading Test must be performed. This test is based on the premise that the more iodine-deficient the body is, the more ingested iodine is retained, and the less is excreted in the urine.

The three basic steps of the test are as follows:

Collection of an initial urine sample before the ingestion of iodine in order to establish a baseline level.
The ingestion of iodine/iodide tablets (generally 50mg)
Collection of subsequent urine voids for the next 24 hours. The iodine in both samples is then measured and a percentage reflecting the "spill" of iodine is calculated. This simple test can prove to be profoundly useful in guiding treatment for numerous conditions including several endocrine imbalances.

Every cell in the body contains and utilizes iodine. Essential for life, iodine has many effects on the body: hormone production, nerve and muscle function, metabolism, tissue growth and repair, and cell respiration.

It has been estimated that approximately one third of the world's population is iodine deficient, and studies in the United States have suggested that the number may be even higher, with some estimates as high as 95%.¹ Iodine deficiencies can occur not only because of inadequate intake, but also due to the damaging toxins we are exposed to every day. Given the various functions of iodine in the body, it is easy to see how even a slight deficiency can cause widespread problems. An especially interesting area of study in iodine deficiency is the field of hormone balancing. Iodine is a crucial ingredient in the delicate balance of the endocrine system, and deficiencies have been implicated in conditions such as diabetes, polycystic ovarian disease (PCOS), fibrocystic breast disease, increased breast cancer risk and most commonly goiter.

More than 100 years ago, iodine was called "the universal medicine". Recent research may prove this to be true. Much promising research has been conducted on the use of iodine to treat fibrocystic breast disease, as iodine concentrates in and is secreted by the mammary glands. Normal breast architecture requires adequate iodine, and in a deficient state, the breasts and thyroid compete for available iodine. Hyperplasia may be induced in these glands. Estrogen production increases with an iodine deficiency, thus causing an increased sensitivity to estrogen by breast tissue. As early as twenty years ago The Lancet reported that iodine deficiency predisposes one to an increased risk of breast, endometrial, and ovarian cancer.² Assessing iodine levels and the imbalance of hormones is the key to lowering that risk.

A study conducted on twelve diabetics showed dramatic improvements of HA1C and blood glucose levels after supplementation with 50 mg of iodine daily, with 50% of the patients able to completely stop their diabetes medications.³ The same study author monitored five PCOS patients who, on the same iodine dosage experienced a regulation of their periods, disappearance of ovarian cysts, and control of their diabetes.

Thyroid Hormones

noreply@blogger.com (Labrix Clinical Services) — Fri, 22 Feb 2008 16:39:00 +0000

Thyroid hormones are crucial for various processes in the body at all levels: cellur growth and development, metabolic effects, and cardiovascular effects.

Even a small decline in the production of thyroid hormones can have dramatic effects on the body. Since the main purpose of thyroid hormone is to "run the body's metabolism", it is understandable that people with low thyroid hormones will have symptoms associated with a slow metabolism. Hypothyroidism is more common than you would believe...and, millions of people are currently hypothyroid and don't know it! It is estimated that 10-40% of the population are hypothyroid.¹

In hyperthyroidism, on the other hand, excess thyroid hormone causes certain physiological changes characterized by an increased or hyper-metabolism. For instance, the heart beats faster, blood moves through the circulation faster, and food is digested faster, causing an increased appetite. Increased digestion, in turn, limits the amount of nutrients that are absorbed from food, causing nutrient deficiencies. These nutrient deficiencies are responsible for a plethora of other symptoms including nervousness, anxiety, weight loss and muscle weakness.

Thyroid cells are the only cells in the body which can absorb iodine. These cells combine iodine and the amino acid tyrosine to make T3, or triiodothyronine, and T4, or thyroxine. T3 and T4 are simply iodinated amino acids. A normal thyroid gland produces about 80 percent T4 and about 20 percent T3. The remainder of T3 is produced in peripheral tissues by the deiodination of T4. T3 possesses about four times the hormone "strength" as T4 and is really the physiologically active hormone. T3 controls metabolism (conversion of oxygen and calories to energy). Every cell in the body depends upon thyroid hormones for regulation of their metabolism.

Thyroid hormones (T3 and T4) are relatively insoluble; therefore, they are transported in the plasma bound to carrier proteins. Approximately 99.9% of T3 and T4 are protein bound. Only a small amount of unbound hormones are free to enter into peripheral cells. It is important to know that tissues respond to the concentration of free hormones, not the concentration of bound hormones.

Control of the thyroid gland is regulated by thyroid releasing hormone, or TRH, occurring in the hypothalamus deep within the brain. TRH triggers the pituitary gland to release thyroid stimulating hormone, or TSH, or thyrotropin, which in turn causes the thyroid gland to produce its hormones.

Thyroid function can easily be tested by evaluating hormone levels, though results can be confusing unless the practitioner has a complete understanding of each hormone, including its origin and function. There are three thyroid hormones that are commonly tested, either alone or as part of a panel: T4, T3, and TSH. You will see choices of testing total or free T3 and T4. It is important to test free T3 and T4 (fT3 and fT4) levels in order to establish an accurate picture of thyroid function. TSH is often used as an initial screening test for thyroid function or as a tool to monitor thyroid replacement therapy. A high TSH level is indicative of thyroid gland failure, while a low level reflects an overactive thyroid. However, TSH is not a sensitive test and may not accurately reflect thyroid status and therefore, should always be ordered in combination with fT3 and fT4. Sometimes hyper/hypothyroidism is caused by autoimmune destruction of the thyroid gland. Autoimmune thyroiditis can be evaluated by measuring the antibody thyroid peroxidase (TPO) in serum.

Another important aspect of thyroid function is iodine. Without it the thyroid gland simply cannot produce adequate quantities of hormones. The names of the hormones reflect their iodine components: T3 has three iodine molecules, T4 has four. It is easy to see then, how a deficiency in iodine can result in hypothyroidism. Iodine levels can easily be tested in the urine. It has been proven that iodine replacement greatly improves, if not eliminates, symptoms of a poorly functioning thyroid gland.²

Together with our salivary hormone testing menu, Labrix now offers urine iodine testing and our Blood Drop(TM) menu, with tests that include TSH, fT3, fT4 and TPO. These may be ordered individually or as a panel. Give us a call for more information.

Low Testosterone

noreply@blogger.com (Labrix Clinical Services) — Fri, 22 Feb 2008 16:31:00 +0000

A "very exciting and potentially groundbreaking" preliminary study performed by the University of California, San Diego reported that there may be an increased risk of death for men over the age of 50 who have low testosterone. The "Rancho Bernardo Study" followed 794 relatively healthy men between the ages of 50 and 91 for eighteen years to look at the relationship between mortality and testosterone levels. The findings show a 33% higher risk of dying from any cause in men with low testosterone than those with normal or even elevated levels, regardless of age, lifestyle activities like smoking and drinking, or physical activity.

The researchers are quick to stress, however, that more research (including clinical trials) is needed to prove their findings. When the link between low testosterone and risk of dying was adjusted for the presence of metabolic syndrome and inflammatory conditions (often seen with low androgen levels), it weakened, suggesting that both can also contribute to mortality. More studies are needed to identify which is the culprit: low testosterone, metabolic syndrome, or elevated inflammatory markers. One doctor referred to it as a "chicken and the egg" question: does low testosterone cause inflammation and metabolic syndrome, or do inflammation and metabolic syndrome cause low testosterone? Drs. Mead and Lommen here at Labrix believe, based on years of treating metabolic syndrome patients with testosterone, that this is not a question, but that low testosterone is indeed the culprit.

A similar study conducted last year by researchers at the University of Washington and the Veterans Administration Puget Sound Health Care System showed conclusions comparable to the Rancho Bernardo study. In their study, subjects were younger (40 and older) and in poor health, and had low testosterone levels which were associated with an 88% increased likelihood of death.

It is important to keep in mind that while hormone levels fluctuate throughout the day, these are conclusions drawn from a single daily testosterone reading, which may be misleading. This stresses the importance of collecting multiple samples in one day, in order to average the numbers and get an overall picture of hormone levels. Nonetheless, as studies and research continue to gather convincing data, it is clear that hormone testing is a vital part of routine checkups for men nearing or entering andropause and that testosterone supplementation, when warranted, may not only improve symptoms, but save lives.

Which Panel Should I Be Using for My Patients?

noreply@blogger.com (Labrix Clinical Services) — Tue, 12 Feb 2008 19:46:00 +0000

We believe the bare minimum for assessing hormonal status and endocrine function is the five hormone panel: Estrogen, Progesterone, Testosterone, DHEA and am Cortisol. When there are any sleep disruptions or high cancer risk profiles we also recommend the night Cortisol level. But in general as a basic guideline, an excellent starting place for men and women is the five hormone panel.

Below you will find the various panels offered and the associated symptoms.

Comprehensive Panel: Total: 8 Tests

E2, Pg, T, DHEA, am, noon, evening and pm Cortisol

Comprehensive Panel: This assessment is used for men and women who have many of the symptoms described below, and it combines a complete adrenal function panel in addition to an assessment of sex hormone levels. It is for compromised individuals who are having the short comprehensive and adrenal function symptoms. It is especially important to assess those mid-day Cortisol levels in individuals who are experiencing blood sugar dysregulation, hyperlipidemia, weight gain around the waist, bone loss, infertility, sensitivity to chemicals and increased joint pain.

o Achieving Optimal Wellness
o Weight gain
o Multiple chemical sensitivity
o High blood sugar and/or high lipids (cholesterol and triglycerides)
o Insomnia
o Chronic Fatigue syndrome or Fibromyalgia
o Plus Basic Panel symptoms

Short Comprehensive Panel: Total: 6 Tests

E2, Pg, T, DHEA, and am/pm Cortisol.

Short Comprehensive Panel: This assessment is used for both men and women who are having symptoms related to sex hormone deficiencies or excesses (E2, P and T) and will also render an abbreviated adrenal assessment with DHEA and am/pm Cortisol.

Women Experiencing:
o Fatigue
o Sleep disturbance
o Family history of breast cancer
o Plus Basic Panel symptoms

Men Experiencing:
o Decreased Libido
o Decreased Erection
o Decreased Stamina
o Decreased Mental Sharpness
o Decreased Muscle Size
o Tearful / Moodiness
o ElevatedTriglycerides and/or High Cholesterol

Basic Hormone Panel: Total: 5 Tests

E2, Pg, T, DHEA, and am Cortisol.

Basic Hormone Panel: This assessment is used for both men and women who are having any of the symptoms listed below (when there are any sleep disruptions or high cancer risk profiles we also recommend the night Cortisol level):

o Hot flashes
o Night sweats
o Breast tenderness
o Forgetfulness
o Irregular menstrual cycle
o Anxiety/depression
o Prostate gland problems
o Irritability
o Loss of strength / muscle
o Vaginal dryness

Adrenal Stress Panel: Total: 5 Tests

DHEA & 4 diurnal Cortisol: am, noon, evening and pm.

Adrenal Stress Panel is used when individuals are complaining of:

o Fatigue
o Weakness
o Insomnia
o Headaches
o Irritability
o Nervousness
o Sugar Cravings
o Dizzy Spells
o Decreased Stamina
o In addition, all individuals with chronic disease will have changes/compromises in their adrenal function.

Cortisol Panel: Total: 4 Tests

4 Diurnal Cortisol: am, noon, evening and pm.

The Cortisol Panel is used when individuals are complaining of the same symptoms listed above in the Adrenal Stress Panel, however may not require DHEA testing.

Abbreviated Cortisol: Total: 2 Tests

2 diurnal Cortisol: am and pm.

Estradiol: E2 Only: Total: 1 Tests

Estriol: E1 Only: Total: 1 Tests

Progesterone: Pg Only: Total: 1 Tests

Testosterone: T Only: Total: 1 Tests

DHEA: D Only: Total: 1 Tests

Of course you could also call the Lab to get advice on which panel should be utilized for a specific patient's circumstance!

Estrogen Dominance is Really Progesterone Deficiency

noreply@blogger.com (Labrix Clinical Services) — Mon, 21 Jan 2008 20:30:00 +0000

The term "Estrogen Dominance" can be confusing at times because it is less related to the amount of circulating estrogen and more related to the ratio of estrogen to progesterone in the body. Contrary to popular belief, Menopause and PMS are not the result of estrogen deficiency although estrogen levels do decline during the latter phases of a woman reproductive cycle.

More relevant is that the estrogen levels drop by approximately 40% at menopause while progesterone levels plummet by approximately 90% from premenopausal levels. It is the relative loss of progesterone that causes the majority of symptoms termed estrogen dominance. The disproportionate loss of progesterone begins in the latter stages of a woman's reproductive cycle, when the luteal phase of the menstrual cycle begins to malfunction. The malfunction is initiated when the remnant tissue of the follicle (corpus luteum), the primary source of progesterone, begins to lose its functional capacity. By about age 35, many of these follicles fail to develop creating a relative progesterone deficiency. As a result, ovulation does not always occur and progesterone levels steadily decline. It is during this period that a relative progesterone deficiency, or what has become known as Estrogen Dominance, develops.

Typical symptoms of estrogen dominance are:

Mood Swings
Irritability
Depression
Irregular Periods
Heavy Menstrual Bleeding
Hot Flashes
Vaginal Dryness
Water Retention
Weight Gain: Hips, Thighs and Abdomen
Sleep Disturbance (Insomnia, less REM sleep)
Decreased Libido
Headaches
Fatigue
Short-term Memory Loss
Lack of Concentration
Dry, Thin, Wrinkly Skin
Thinning of Scalp Hair
Increased Facial Hair
Bone Mineral Loss (Osteoporosis)
Diffuse Aches and Pain

Patients experiencing a majority of these symptoms most likely will benefit from natural hormone replacement. The most effective way to assess hormone status is to test saliva for the appropriate hormone levels. Saliva is the best method for testing "functional" tissue levels of hormones.

The Progesterone/Estradiol (Pg/E2) reference ranges are optimal ranges determined by Dr. John Lee. While they are not physiological ranges, they are optimal values for the protection of the breasts, heart and bones in women, and the prostate in men. Salivary values within these ranges have been shown by Dr. Lee to decrease both breast and prostate cellular proliferation.

Progesterone & Traumatic Brain Injury

noreply@blogger.com (Labrix Clinical Services) — Mon, 21 Jan 2008 20:30:00 +0000

As hormone replacement practitioners, we know the many benefits of progesterone therapy: mood and memory improvement, decrease in fibrocystic breast conditions, fewer hot flashes, less water retention…the list goes on. A preliminary study published in the Annals of Emergency Medicine shows promise for using the hormone progesterone in a new way: to treat traumatic brain injury (TBI). In the three year study, conducted at the department of emergency medicine at Emory University, 77 TBI patients received intravenous progesterone, while 23 received a placebo. A 50 percent reduction in the rate of death was found in the group treated with progesterone.

Progesterone is traditionally thought of as a pregnancy and/or female sex hormone, but it is also vital for brain cell health. It is a neurosteroid naturally present in small amounts in the brains of both females and males. During pregnancy, progesterone levels soar, leading researchers to hypothesize a relationship with brain development and maturation. With that in mind, study data suggests that the hormone has the ability to prevent neuronal loss, reduce brain swelling, and improve brain function in those with traumatic injuries.

Interestingly, the majority of damage (approximately 75%) suffered in TBI occurs hours and even days after the initial injury. Inflammatory and cytotoxic processes cause edema in the parenchyma and brain cells, causing further destruction. Modern medicine has yet to discover a treatment effective enough to reduce or even halt the cascade of events within the brain after injury, which is why the progesterone study is so meaningful. Extensive animal research has shown that progesterone significantly reduces cerebral edema, which in turn reduces further tissue and cell injury. The application potential for humans is obvious, which is what led Emory researchers to their study.

The study was designed to assess the safety of using progesterone for the treatment of TBI and became so promising that further clinical studies are planned. The study subjects that were given the hormone received amounts approximately three times higher than those seen during pregnancy within 11 hours of initial injury for three consecutive days. Significant improvement of functional outcome, level of disability and death rate was seen at a 30 day follow up. Another important element of the study results was the lack of adverse effects from the hormone administration: none were reported.

According to the study’s lead author, progesterone has potential in numerous situations, such as the one out of every three soldiers seen at Walter Reed Medical Center who suffered TBI, usually from improvised explosive devices. Eventually the hormone may be administered by paramedics at accident scenes, and there is promise for stroke victims and newborns affected by a traumatic birth. It is also suggested that premature senility and Alzheimer’s disease patients may benefit from progesterone as well.

While further clinical studies are pending, this research helps confirm what many of us already know: progesterone is a safe, effective, and beneficial hormone.

DHEA: A Commonly Overlooked Hormone

noreply@blogger.com (Labrix Clinical Services) — Mon, 21 Jan 2008 20:29:00 +0000

A commonly overlooked hormone in our testing menu is DHEA. It is an often misunderstood, yet very important part of the whole hormonal picture and is a key player in achieving hormone balance.

So what exactly is DHEA and why is it important to test?

DHEA (Dehydroepiandrosterone) is the most common steroid hormone in the body and is mainly produced by the adrenal glands, but smaller amounts are made elsewhere in the body. It is metabolized from pregnenolone and is a precursor to the sex hormones: namely testosterone, but also the estrogens. These features are why testing DHEA is a valuable part of dealing with hormone imbalance: the result will reflect how the adrenal glands are functioning, and a baseline DHEA level is important for dosing supplementation, as DHEA can raise testosterone and estrogen levels due to its precursor status. Female patients with low levels of DHEA and sex hormones having complaints of symptoms like low libido will be well served on DHEA, as they convert DHEA to testosterone more readily than men.

While DHEA is often seen in applications and discussions of anti-aging and adrenal function issues, it has also been found to be involved in many other processes in the body. Studies have shown that DHEA displays significant positive results in areas such as the regulation of insulin, cortisol and immune activities, cardiovascular protection, anti-dementia, bone stimulation, antibacterial activities, energy, and well being.

The potential promise of future applications of this hormone is leaking into the mainstream and increasing awareness, although not always with the best outcome. A simple internet search yields hundreds of sites touting the “magical" properties of DHEA, especially the feature of improving one’s feeling of well being. What they don’t say, of course, is how unwise the unmonitored use of this hormone is. As mentioned above, it can raise estrogen levels. This is not something a patient should do on their own. Someone who is feeling “blue" and has perfectly normal levels of DHEA and testosterone may start supplementing with over the counter DHEA and create a whole new set of problems by throwing their hormones out of balance. It is important to look at the whole picture when treating hormone imbalances, and DHEA is a critical part of that process.

Bioidentical Hormones: One Size Does Not Fit All!

noreply@blogger.com (Labrix Clinical Services) — Mon, 21 Jan 2008 20:29:00 +0000

The severity of problems caused by the use of synthetic hormones led to a landmark decision in 2002 by the Women’s Health Initiative (WHI), a long term health study of postmenopaual women. After discovering that instances of breast cancer, heart disease and osteoporosis increased with the use of medroxy progesterone and pregnant mare’s urine conjugated estrogens, research was halted. Bioidentical hormones were brought into the spotlight after women sought a safe alternative for synthetic hormone replacement therapy.

The difference between bioidentical and synthetic hormones starts at the molecular level. Bioidentical hormones have the same chemical structure as hormones made by the human body, and can replicate the actions of those made naturally. Side effects and risk factors are minimized when your body recognizes its own molecular structure, fills its receptor cites efficiently, and can utilize, break down, and detoxify hormones effectively. Bioidentical hormones can be tailored to match each individual’s needs by a compounding pharmacist. Synthetic hormones, on the other hand, have an altered molecular structure that the body does not recognize completely, thus their actions are not straightforward and they are not detoxified from the body as easily. Side effects are common with these types of hormones because they are foreign to the body. Synthetic hormones are prescribed as a “one size fits all", and cannot be specifically made for an individual.

The individualized approach of bioidentical hormone treatment requires a saliva hormone test. This will measure only active (free/unbound) hormone levels unlike serum tests, which reflect inactive (total/bound) levels. Measuring inactive hormone levels is not useful in assessing function or balance. When testing the sex hormones through saliva, it is also important to assess adrenal status (DHEA and diurnal cortisols). Even if the chief complaints seem to be an imbalance of the sex hormones, the adrenal and sex hormone pathways are so closely linked that an imbalance in one area will affect the function and efficiency of the other.

The state of the art delivery system for bioidentical hormones is transdermal. By applying hormone to the skin rather than ingesting it, the liver first-pass is averted, thus therapeutic levels can be reached with far less hormone. Studies have shown that measurement of transdermal hormones is best done through saliva rather than serum. Overdosing of hormone supplementation is often seen when using serum to monitor topical hormones (often 4-5 times higher than is needed).

A good starting place for assessing hormonal status is to measure estradiol, progesterone, testosterone, DHEA, and morning cortisol. Remember: cortisol has a well established 24-hour diurnal rhythm, and the time of day when this is measured will reveal unique aspects of one’s health. If there are complaints of sleep disruptions, a night cortisol should also be performed, and if there are suspected metabolic and blood sugar dysregulations, all cortisols should be tested (morning, noon, evening and night).

Bibliography 1. Peter O'leary, Peter Feddema, Katherine Chan, Mario Taranto, Margaret Smith, Sharon Evans (2000) Salivary, but not serum or urinary levels of progesterone are elevated after topical application of progesterone cream to pre-and postmenopausal women . Clinical Endocrinology 53 (5), 615–620.
2. Lee, John R. MD. Letters to the Editor Menopause. 10(4):374-377, July 2003
3. Mead, Jay H. MD. Saliva versus Serum Bibliography, Labrix Clinical Services, Inc. (2004)
4. FDA Statement on the Results of the Women's Health Initiative (8/13/2002) Women’s Health Initiative (WHI) Results Signal Need for Reassessment of Risks and Benefits of Conjugated Equine Estrogens/medroxyprogesterone Acetate (Prempro) in Postmenopausal Women.
5. Risks and benefits of estrogen plus progestin in healthy postmenopausal women. JAMA 17 July 2002; 288:321-333
6. Diurnal changes of salivary estradiol in a female during luteal phase., IBL Hamburg Germany (2004)

Male Menopause

noreply@blogger.com (Labrix Clinical Services) — Mon, 21 Jan 2008 20:29:00 +0000

Male menopause, also known as andropause, somatopause and men’pause, is most often ignored by conventional medicine yet it affects the majority of men. Declining testosterone levels are commonly seen in men beginning in the fourth decade of life. This is analogous to menopause in women when ovarian production of estrogens and progesterone begins to decline. Undetected yet equally as powerful, a male’s hormonal status changes dramatically during this time. The production of testosterone by testicles declines at exactly the same time as the amount of protein that binds testosterone (sex hormone binding globulin) increases. This may seriously lower the amount of free testosterone available to the target organs. Unless the level of free testosterone is sought and assessed, a man’s symptoms are often ignored and he is blown off as having a "mid-life crisis", or his physician diagnoses depression and an antidepressant is prescribed.

Testosterone is an important anabolic hormone in men. It plays many roles in maintaining both physical and mental health by increasing energy, preventing fatigue, maintaining normal sex drive, and increasing strength of structural tissues.

Testosterone deficiency is often associated with symptoms such as:

Night Sweats
Hot Flashes
Erectile Dysfunction
Loss of Energy
Aches and Pains
Reduced Flexibility
Low Sex Drive (libido)
Decreased Mental Acuity
Loss of Muscle Mass

Furthermore, insulin resistance and diabetes are quite often additional serious consequences associated with testosterone deficiency. Stress management, exercise, proper nutrition, dietary supplements (particularly adequate zinc and selenium), and androgen replacement therapy have all been shown to raise androgen levels in men and help counter andropause symptoms. Androgen replacement therapy should be discussed with a qualified health care provider.

Insufficient testosterone is not the only hormone imbalance that a man experiences. An excess amount of estradiol relative to progesterone is routinely discovered in the saliva during andropause, which is known to be associated with prostate gland diseases such as benign prostatic hypertrophy (BPH) and prostate gland cancer.

Labrix Saliva Hormone Testing

"Effects of the Phytoestrogen Genistein on Bone Metabolism in Osteopenic Postmenopausal Women: A Randomized Trial."

The Proper Collection of a Saliva Specimen

Labrix Billing and Operational Procedures

Bioidentical Hormones Supplementation Guidelines

Iodine FAQ’s:

$20.00 Off Testing Promotion with the Purchase of Slim, Sane, and Sexy

Labrix is excited to introduce our new National Sales and Marketing Director

Slim, Sane, and Sexy

Physicians: Oppose Wyeth & FDA Actions to Limit Prescribing!

Save on Dr. John Lee Books at the Dr. John Lee Institute

The Monitoring of C-Reactive Protein (CRP)

The Monitoring of Thyroid Peroxidase (TPO)

Labrix Clinical Services blazes a new “curve” (path)!

Excerpt from: "Slim, Sane and Sexy; Pocket Guide to Natural Bioidentical Hormone Balancing."

Iodine Fact Sheet

Why Test Iodine?

The three basic steps of the test are as follows:

Thyroid Hormones

Low Testosterone

Recommended Reading

Which Panel Should I Be Using for My Patients?

Estrogen Dominance is Really Progesterone Deficiency

Progesterone & Traumatic Brain Injury

DHEA: A Commonly Overlooked Hormone

Bioidentical Hormones: One Size Does Not Fit All!

Male Menopause