Labs & Testing

A comprehensive laboratory workup begins with the basics. Dr. Galina starts with markers that you should test during a standard yearly check up (if you have not yet done so already with your PCP); these include CBC, CMP, Lipid Panel, Insulin, A1C, CRP, TSH, Vitamin D, and Vitamin B12. Although very important, these markers are just skimming the surface. Based on your concerns and presentation, Dr. Galina may also order additional markers for a more comprehensive work up for thyroid, autoimmunity, inflammation, hormones, and a variety of nutrients.

If your insurance is in-network with Quest Diagnostics, we are able to order blood work through your insurance.  Coverage is never guaranteed and you should check with your insurance. If you do not have insurance or it does not offer you coverage for Quest, Dr. Galina is partnered with a private company called Ulta Labs that provides discounted cash pricing for lab work that is actually fulfilled at Quest locations.

Precision Analytical offers a variety of hormone profiles for the needs of both women and men going through various stages of hormone imbalance and the associated diagnoses and challenges.

DUTCH Complete: a urine test that offers comprehensive assessment of sex and adrenal hormones and their metabolites. It also includes the daily, free cortisol pattern, organic acids, melatonin, and more.

DUTCH Adrenal: a urine test that provides free cortisol patterns that parallel saliva with the addition of metabolite measurements for an improved marker for total cortisol production. Also measures DHEA.

DUTCH Cycle Mapping: maps the progesterone and estrogen pattern throughout the menstrual cycle. It provides the full picture of a woman’s cycle to answer important questions for patients with month-long symptoms, infertility, and PCOS. Nine targeted estrogen and progesterone measurements are taken throughout the cycle to characterize the follicular, ovulatory, and luteal phases.

The Adrenocortex Stress Profile by Genova Diagnostics provides an assessment of the Hypothalamic-Pituitary-Adrenal (HPA) axis using carefully timed salivary samples of the hormones cortisol and DHEA. Salivary testing is an easy, non-invasive option to measure unbound, biologically active parent hormone levels. The report offers an easy-to-interpret graphic which plots the results of the natural diurnal rhythm.

Four salivary samples measured throughout the day give insight into the natural circadian diurnal cortisol rhythm, and help clinicians address specific daily stressors. DHEA is measured once in the 7:00 AM – 9:00 AM sample and a ratio of DHEA to cortisol is calculated to provide insight into anabolic/catabolic balance.

Daily hassles, chronic pain, blood sugar dysregulation, work stressors, and poor relationship quality can alter the HPA axis. Imbalances in adrenal hormones can have a wide range of negative consequences that can adversely impact a patient’s overall quality of life. The symptoms of HPA axis dysfunction can be vague and are highly variable but may include: fatigue, insomnia, weight gain, depression, GI complaints, and chronic pain. HPA axis dysfunction is associated with many conditions including: hypertension, cardiovascular disease, gastrointestinal and immune dysregulation, diabetes and metabolic syndrome, depression, chronic fatigue, persistent pain, neurodegenerative disease, and cognitive decline.

Adrenocortex Stress Profile testing can reveal these HPA axis imbalances and provide direction for clinical intervention with targeted therapeutic treatments such as nutrient support and/or adaptogens, stress management, behavioral modification and lifestyle interventions.

Metabolomix+ by Genova Diagnostics is A Non-Invasive Personalized Nutritional Assessment. It is a unique combination of nutritional tests that provides an analysis of key nutritional biomarkers. A first morning void (FMV) urine collection, with optional add-ons that include blood spot and buccal samples for a heavy metals profile, fatty acid assessment, and genomic markers, the Metabolomix+ nutritional test is a non-invasive, patient-friendly way to assess the functional need for antioxidants, B-vitamins, minerals, digestive support, fatty acids, amino acids and more. 

Insights gained from the Metabolomix+ nutritional test allows clinicians to target nutritional therapies to meet the precise needs of the patients. Common clinical indications for testing include:
– Mood Disorders
– Mitochondrial Dysfunction
– Fatigue
– Chronic Stress
– Inflammation

Several diseases are associated with abnormal organic acid, amino acid, and fatty acid levels such as depression, anxiety, cardiovascular disease, neurocognitive decline, diabetes, cancer, anorexia, and many others.

SIBO (Small Intestinal Bacterial Overgrowth) Breath Test by Genova Diagnostics uncovers the cause of unexplained abdominal symptoms. This non-invasive test captures exhaled hydrogen (H2) and methane (CH4) gases following patient ingestion of a lactulose solution to evaluate bacterial overgrowth of the small intestine. 

SIBO is a common clinical condition and can develop in a variety of patient populations. Symptoms of SIBO are non-specific, encompassing abdominal pain/distention, diarrhea, and flatulence.

Conditions commonly associated with SIBO include:
– IBS
– IBD
– Celiac Disease
– Diabetes
– Fibromyalgia
– Rosacea
– Parkinson’s Disease
– Obesity

Risk factors for development of SIBO include structural/anatomic issues, motility disorders, organ system dysfunction, elderly age and various medications (recurrent antibiotics, PPIs) that alter the gut microflora populations.

Symptomatic patients with any underlying conditions or risk factors warrant assessment for SIBO.

Intestinal Permeability Assessment by Genova Diagnostics is a powerful noninvasive gastrointestinal test assessment of small intestinal absorption and barrier function in the bowel. The small intestine uniquely functions as a digestive/absorptive organ for nutrients as well as a powerful immune and mechanical barrier against excessive absorption of bacteria, food antigens, and other macromolecules. Both malabsorption and increased intestinal permeability (“leaky gut”) are associated with chronic gastrointestinal imbalances as well as many systemic disorders.

Increased intestinal permeability (leaky gut) of the small intestine can:

– Increase the number of foreign compounds entering the bloodstream
– Allow bacterial antigens capable of cross-reacting with host tissue to enter the bloodstream, leading to auto-immune processes
– Enhance the uptake of toxic compounds that can overwhelm the hepatic detoxification system and lead to an overly sensitized immune system

Leaky gut has been observed in a range of disorders such as:

– Inflammatory Bowel Disease (IBD)
– Food allergy
– Inflammatory joint disease
– Chronic dermatologic conditions

Studies have demonstrated that the increased intestinal permeability observed in patients with ankylosing spondylitis, rheumatoid arthritis, and vasculitis may be an important factor in the pathogenesis of these disorders.

Decreased permeability, on the other hand, appears as a fundamental cause of malabsorption, subsequent malnutrition, and failure to thrive. In certain disease states of the small intestine, such as gluten-sensitive enteropathy, permeability to large molecules may increase while permeability to small molecules decreases – a result of damage to the microvilli. As a result, nutrients become even less available to assist in the detoxification of antigens flooding the system.

Possible causes of increased intestinal permeability (leaky gut) include:

– Intestinal infection
– Ingestion of allergenic foods or toxic chemicals
– Deficient secretory IgA
– Trauma and endotoxemia
– NSAIDs

The Intestinal Permeability Assessment directly measures the ability of two non-metabolized sugar molecules to permeate the intestinal mucosa. The patient drinks a pre-measured amount of lactulose and mannitol. The degree of intestinal permeability or malabsorption is reflected in the levels of the two sugars recovered in a urine sample collected over the next 6 hours. 

The GI-MAP stool test by Diagnostic Solutions Laboratory is unique in the field of comprehensive stool testing. It relies exclusively on quantitative polymerase chain reaction (qPCR) technology to detect parasites, bacteria, fungi, and more, by targeting the specific DNA of the organisms tested.

Overwhelmingly, research indicates that gut health impacts overall health. The gut microbiome, in particular, plays a critical role in mediating the effects of diet and other factors on health, including digestive, immune, metabolic and neuroendocrine functions. Assessing GI heath with the proper tools can help practitioners get to the root cause of chronic illness.

The GI-MAP’s accuracy and reliability allows practitioners to create personalized treatment protocols to address gut dysfunction based on which infections are urgent, which areas of the gut are already optimized, and which areas should be addressed after an infection is resolved. Additionally, the quantification offers a remarkable ability to see how treatment modalities are working because a retest after treatment can show whether a pathogen has resolved, dysbiosis has improved, and more.

Almost every patient can benefit from a GI-MAP gut health assessment. Some patients are looking to achieve optimal health, while other patients have been chronically ill and frustrated without a diagnosis for years.

Some conditions that warrant testing are:

– Autoimmune diseases
– IBS/IBD
– Digestive complaints, diarrhea or constipation
– Brain fog
– Skin problems, like acne, eczema, and psoriasis
– Mood disorders, depression, and anxiety
– Diabetes and weight loss issues

The GI-MAP is also commonly used in infants and children, and can provide insight into conditions related to ADHD, autism, and digestive complaints.

Food Sensitivity test by US Biotek allows quick and easy testing of IgG and IgA reactions via blood spot or serum. Food sensitivities are recognized to be correlated with many chronic health conditions, such as IBS, eczema, fatigue, and others – but with proper identification and elimination of offending foods, many experience relief from their symptoms.

Food sensitivities are inflammatory responses of the immune system triggered by food allergens. Unlike food allergies, the symptoms of a food sensitivity often occur hours or even days after exposure, making it difficult to pinpoint the specific offending food(s). This delayed reaction is what causes the majority of the 12 million people estimated to suffer from food sensitivities unaware and blaming things like aging for their chronic symptoms.

Testing for food sensitivities streamlines the process of identifying triggering foods, providing clear evidence and guidance to begin the healing process and start improving symptoms.

Conditions & Symptoms Commonly Associated with Food Sensitivity:

– Brain Fog
– Bloating
– Weight Gain
– Mood Swings
– Joint Pain/Inflammation
– Constipation
– Diarrhea
– Bronchitis
– Crohn’s disease
– Eczema
– Migraines
– GI distress
– Stomach pain
– Acne
– ADD/ADHD
– Autism
– Sinus issues
– Depression

IgG is an antibody that can activate the pro-inflammatory complement system (complement cascade) associated with chronic inflammatory conditions. High levels of IgG overload receptors and drive the inflammatory reaction while low levels of IgG indicate tolerance. IgG testing is the most commonly performed food sensitivity testing and foods that are only high in IgG can often be safely re-introduced after a period of abstinence.

IgA is an antibody that can activate the pro-inflammatory complement system. Serum IgA levels are associated with allergies and asthma. A Serum IgA reaction to food triggers can indicate foods that are irritating the lining of the gut.

Dr. Galina recommends running both IgG and IgA components in any of the chosen panels to ensure a comprehensive assessment of potential food sensitivities. 

Food and cuisine create a beautiful foundation for cultures around the world. Depending on regionality, ethnicity, personal preferences, and more, the foods that make up an individual’s diet can vary greatly. To ensure access to food sensitivity panels that fit the diets of patients and address as many relevant antigens as possible, US BioTek has developed eight unique food panels.

– Standard Diet Panels: 96 Foods, 144 Foods, 208 Foods

– Specialized Diet Panels: 96 Asian Foods, 96 Japanese Foods, 96 Mexican Foods

– Vegetarian Diet Panels: 96 Foods, 168 Foods

Sample Collection Methods:

– The dried blood spot collection method utilizes a simple finger prick and collection card.

– The serum collection method requires a modest blood draw. 

Comprehensive Neurotransmitter Profile by Doctor’s Data is a urinary test that provides an overall assessment of the body’s ability to secrete and metabolize neurotransmitters and are representative of whole body levels. Neurotransmitters are secreted all through the body, in neurons of both the central and peripheral nervous systems. The enzymes, cofactors and precursors in neurotransmitter metabolism in general are the same in the periphery and in the central nervous system. Therefore, alterations in urinary neurotransmitter levels assessed in urine provide important clinical information, and may be associated with many symptoms including cognitive and mood concerns, diminished drive, fatigue and sleep difficulties, cravings, addictions and pain. Associations between urinary neurotransmitter levels and health conditions have been documented in scientific literature and may provide valuable insights as part of a comprehensive health assessment.

Urine Toxic Metals test by Doctor’s Data is used to evaluate exposure to potentially toxic elements / heavy metals, which disrupt the balance and health of many organ systems and biological processes.

This test is useful for those who suffer from:
– Toxic Element Exposure
– Alopecia
– Bone Density Issues
– Cardiovascular Disease
– Depression
– Dermatitis or Poor Wound Healing
– Fatigue
– Gastrointestinal Symptoms
– Hypertension
– Immune Function
– Impaired Glucose Tolerance
– Inflammation
– Kidney Function
– Nutritional Deficiencies
– Parkinson’s-like Symptoms