This extensive profile covers over 150 biomarkers, each carefully explained and addressed in the following tests: GPL4 DBS GPL4 Serum ■ ■ ■ ■ Organic Acids Test - 74 markers IgG Food Allergy Test - 93 markers plus Candida Metals RBC Test - 18 markers Phospholipase A2 Activity Test - 1 marker ■ ■ ■ ■ - or - Organic Acids Test - 74 markers IgG Food Allergy Test - 93 markers plus Candida Metals Hair Test - 39 markers Phospholipase A2 Activity Test - 1 marker General Description CPT Codes - DBS The GPL4 panel provides a comprehensive assessment of an individual’s metabolism and is targeted to find any irregularities that are directly related to numerous conditions. This panel provides a comprehensive assessment of the individual’s metabolism to assess microbial dysbiosis, and also provides vitamin levels and indicators of possible genetic problems. Included in the panel: Organic Acids Test, IgG Food Allergy Test, Red Blood Cell Metals or Metals Hair (your choice), and Phospholipase A2 Activity Test. With the GPL4 panel, a no blood draw option is also available. 82108 82131 82300 82507 82525 82570 83018*28 83150 83497 83605 83655 83735 83785 83825 83885 83921*63 83945 84100 84207 84210 84255 84585 84591 84630 84999 86001*93 86628 86671*2 No Medicare Coverage CPT Codes - Serum Specimen Requirements 82131 82175 82300 82310 82495 82507 82525 82570 83015 83018*4 83150 83497 83605 83655 83735 83785 83825 83921*63 83945 84100 84132 84207 84210 84255 84585 84591 84630 84999 86001*93 86628 86671*2 No Medicare Coverage Urine: 10mL of first morning urine before food or drink. Patient must avoid apples, grapes (including raisins), pears, cranberries, and their juices 24 hours prior to specimen collection. GPL4 Serum: GPL4 DBS: Serum: 2 mL of serum in a gold-topped SST or royal blue-topped no-additive tube. Hair: 1 gram of hair Red Blood Cell: 4mL of packed cells in a royal blue topped potassium RDTA tube. Dried Blood Spot (DBS): Two protein saver cards filled with five full circles of blood. LAB#: PATIENT: ID: SEX: AGE: µ Requisition #: 273466 Patient Name: Patient Age: 4 Patient Sex: F Date of Collection: 07/30/2012 Time of Collection: 08:00 AM Print Date: 08/02/2012 Requisition #: Physician Name: Patient Name: Date of Collection: Patient Age: Time of Collection: Sex: Print Date: Reference Range Patient Value (mmol/mol creatinine) Comprehensive IgG Food Allergy Test + C. albicans, S. cerevisiae (94) Reference Population - Females Under Age 13 Intestinal Microbial Overgrowth Dairy Yeast and Fungal Markers 1 2 ≤ Citramalic ≤ 5-Hydroxymethyl-2-furoic 5.3 3.1 30 3.1 7.4 3 3-Oxoglutaric ≤ 0.52 0.50 4 Furan-2,5-dicarboxylic ≤ 22 8.6 5 Furancarbonylglycine ≤ 3.6 6 Tartaric ≤ 3.9 0.07 H H 7.4 0.50 7 Arabinose ≤ 56 8 Carboxycitric ≤ 34 1.3 9 Tricarballylic ≤ 0.86 0.08 9.0 242 2-Hydroxyphenylacetic ≤ 1.1 0.45 4-Hydroxyphenylacetic ≤ 30 16 242 1.3 12 4-Hydroxybenzoic 0.09 - 2.0 13 4-Hydroxyhippuric ≤ 14 Hippuric ≤ 15 3-Indoleacetic ≤ 11 16 Succinic ≤ 15 2.0 15 15 377 377 6.1 H 6.1 39 17 HPHPA (Clostridia Marker) ≤ 227 148 18 4-Cresol (C. difficile) ≤ 76 63 19 DHPPA (Beneficial Bacteria) ≤ 0.73 0.29 3.84 2.11 Potassium mEq/L 79 515 Copper 0.60 0.52- 0.89 39 63 42 Requisition #: Cadmium 0.001 Lead 0.017 2.26 Mercury 0.001 Almond 1.86 Thallium < 0.0001 < 0.0005 Cashews 2.12 Wheat Green Bean 3.34 Fish Kidney Bean 4.19 Cod Fish 4.72 1.79 Lentil 1.28 Crab 0.99 Lima Bean 1.22 Halibut 1.85 Pea 1.36 Pinto Bean 3.46 1.69 2.60 Lobster Salmon Sardine Shrimp Tuna Apricot 1.81 Meat/Fowl Banana 2.39 Beef 1.49 2.89 1.30 13.63 Egg Yolk 12.91 4.90 2.06 3.05 Lamb 3.25 Pork 1.68 Lemon 5.40 Turkey Orange 2.25 Nuts and Seeds Pear 2.60 Flax 2.18 Pineapple 2.59 Hazelnut 1.45 1.69 Peanut 0.0006 Selenium 0.22 Boron 0.023 Vanadium 0.0002 Molybdenum < 0.0005 Arsenic 5.33 Pecan 2.56 2.66 Pistachio 2.66 Sesame 2.85 RESULT µg/g 0.004 97.5 3.61 ©DOCTOR’S DATA, INC. th µ Methodology: µg/g = ppm ADDRESS: 3755 Illinois Avenue, St. Charles, IL 60174-2420 Patient Age: 26 Sex: F Date of Collection: 1/16/2015 Time of Collection: 08:00 AM Print Date: 1/23/2015 Mean .5 Units Per Creatinine Patient Value Phospholipase A2 Normal Elevated 1.500 .1 .5 1 5 Secreted Phospholipase A2 (sPLA2) has been implicated in many diseases because of its role in inflammation and host defense. sPLA2 is found in many mammalian tissues as well as insect and snake venom. sPLA2 catalyzes the release of arachidonic acid and is involved in the production of prostaglandins for inflammation. sPLA2 is present in connection with multiple diseases including rheumatoid arthritis, sepsis, psoriasis, pancreatitis, cancer, Crohn’s disease, and multiple sclerosis. PERCENTILE 4- 30 0.88 0.5- 10 4- 20 > 800 V06.99 CLIA ID NO: 14D0646470 There has been a great deal of research done by both academia and pharmaceutical companies to find chemical inhibitors to sPLA2. However, there has also been research on more natural methods for inhibiting sPLA2 . Analysis has shown that treatment with supplements of Cytidine 5’-Diphosphocholine (CDP-choline) can limit the ability of sPLA2 to promote inflammation. Studies of CDP-choline of over 11,000 volunteers and patients have shown beneficial effects for many different conditions including cerebral ischemia, traumatic brain injury, hypoxia, Alzheimer’s, Parkinson’s memory disorders, and glaucoma. CDP-choline is composed of cytidine and choline linked by a diphosphate bridge. CDP-choline is an essential intermediate of the major brain phospholipid, phosphatidylcholine. Increasing amounts of CDP-choline results in the decreased activation of sPLA2, which then results in the decreased production of arachidonic acid and inflammation. 99th SPECIMEN DATA Comments: Date Collected: Date Received: Date Completed: 3.77 Strawberry Watermelon Grains Chromium TOXIC ELEMENTS 6.39 Chicken Egg White 4.16 0.013 0.99 2.45 1.96 Grape 13.3 802 Manganese 1.98 Blueberry Coconut Grapefruit Zinc Iron th Test 1.78 1.96 5.09 4.34 84 Phospholipase A2 1.67 1.70 3.88 Sorghum Wheat Gluten Physician Name: 901000 Patient Name: PERCENTILE th 50 CDP-choline can be found at New Beginnings Nutritionals, www.NBNUS.com , or call 877-5752467. Testing performed by The Great Plains Laboratory, Inc ., Lenexa, Kansas. The Great Plains Laboratory has developed and determined the performance characteristics of this test. This test has not been evaluated by the U .S. Food and Drug Administration. V10.01 MEDICARE PROVIDER NO: 148453 Testing performed by The Great Plains Laboratory, Inc., Lenexa, Kansas. The Great Plains Laboratory has developed and determined the performance characteristics of this test. This test has not been evaluated by the U.S. Food and Drug Administration. Testing performed by The Great Plains Laboratory, Inc., Lenexa, Kansas. The Great Plains Laboratory has developed and determined the performance characteristics of this test. This test has not been evaluated by the U.S. FDA; the FDA does not currently regulate such testing. Organic Acids Test - Nutritional and Metabolic Profile Magnesium Papaya Rice Rye 7.27 Barley 0.29 17 Peach 4.65 8.13 Yogurt Plum (Prune) 148 RESULT µg/g Calcium 8- 14.5 125- 370 745- 1050 12- 30 12- 90 0.007- 0.030 12- 40 0.0003-0.0060 8.0- 16 100- 190 0.19- 0.38 0.20- 0.55 0.26- 0.50 0.01- 0.110 0.030- 0.10 0.050- 0.13 0.0001-0.0020 0.60- 4.0 0.0005-0.0020 0.25- 1.3 0.007- 0.023 160- 250 POTENTIALLY TOXIC ELEMENTS 0.95- 1.7 REFERENCE 0.16- 1.0 RANGE 95th 45500- 53000 < 0.010 0.16- 0.80 0.013- 0.035 < 0.005 8.0- 19 0.045- 0.065 < 0.090 0.016- 0.18 < 0.010 0.040- 1.0 Mozzarella Cheese Whey Cranberry 2.0 27 717 3.95 Millet Oat Soybean 16 Gliadin 5.91 9.39 Apple 0.45 3.24 3.60 Goat Cheese Fruit 0.08 Buckwheat Corn Milk Garbanzo Bean 0.07 Malabsorption and Bacterial Markers 10 7.15 7.05 Legumes - Beans and Peas 8.6 9.0 11 Casein Cheese < 8.0 Phosphorus ELEMENTS Metabolic Markers in Urine RED BLOOD CELL ELEMENTS LAB#: < 0.080 PATIENT: < 0.020 ID: < 2.0 SEX: < 0.15 AGE: < 1.0 < 0.40NUTRIENT ELEMENTS < 0.005 REFERENCE th th < 0.010 RANGE 2.5 16 8- 31 < 0.005 < 0.060 36- 64 < 0.40 < 0.20 65- 95 < 0.30 < 1.0 480- 745 Physician: Page 1 of 9 Organic Acids Test IgG Food Allergy Test Metals Hair / Metals RBC Test Phospholipase A2 Activity Recommendations Depending on test results, follow-up may include: ■ ■ ■ ■ Dietary modifications Probiotic and/or nutritional supplementation Antioxidant therapy Elimination of offending foods ■ ■ ■ ■ ■ Immune system support Gut restoration Identification of the source of contamination Elimination of heavy metals from the body and environment Mineral supplementation call: (913) 341-8949 26