Purity Labs - Non-Invasive Tests

Letter From the CEO of Purity Laboratories

As the head of an innovative laboratory, I want to share my enthusiasm about the bright future of lab services available directly to consumers. In recent years, more and more people have been managing their health through direct-to-consumer lab testing services. We know how crucial precise and dependable results are for your well-being, which is why our lab is a frontrunner in delivering top-notch direct-to-consumer lab services.

Our advanced lab facilities, cutting-edge technology, and highly skilled team enable us to provide a broad selection of tests and services tailored to each customer's needs. One of our specialties with DTC tests are the innovative saliva tests for hormones and other essential health markers. We have CLIA certification in 49 states to serve customers nationwide.

As the direct-to-consumer lab sector continues to expand and develop, we are committed to being at the cutting edge of innovation and supplying our customers with the most advanced and accurate testing services out there. We believe that everyone has the right to high-quality health information, and we pledge to make that a reality for all our customers.

Thank you for considering our lab for your direct-to-consumer testing needs, including our specialized saliva tests for hormones and other crucial health markers. We are excited to serve you and provide you with the most precise and reliable results possible.

Sincerely,

David Humphrey, JD

Purity Laboratories, CEO

Title: Direct-to-Consumer Lab Tests: A Significant Opportunity in the Future of Healthcare

Title: Direct-to-Consumer Lab Tests: Benefitting Consumers and Businesses

Alike in the Future of Healthcare

Executive Summary:

Purity Laboratories™ is part of the direct-to-consumer (DTC) lab testing market, which is set to grow significantly in the coming years. DTC lab tests offer numerous advantages over traditional lab testing methods for consumers and businesses alike. This report showcases the potential of DTC lab tests, growth factors, and opportunities for businesses in this evolving market.

Introduction:

DTC lab testing is a segment within the larger healthcare industry that allows people to access medical tests directly, without requiring a physician's referral. This shift in healthcare delivery empowers individuals to proactively manage their health and offers a more convenient and cost-effective

alternative to traditional lab testing methods. The global DTC lab testing market is anticipated to experience substantial growth in the coming years, driven by increased consumer demand, technological advancements, and a favorable regulatory environment.

Market Overview:

In 2021, the global DTC lab testing market was valued at approximately $2 billion. With a projected compound annual growth rate (CAGR) of 37% over the next decade, this market is expected to reach $32 billion in revenue. This rapid growth is fueled by factors such as an aging population, increasing prevalence of chronic diseases, and a rising focus on preventive healthcare. As the market expands, various segments like genetic testing, blood testing, and allergy testing are expected to experience significant growth, offering diverse opportunities for businesses.

Growth Drivers:

1. Technological Advancements: The adoption of new technologies, such as digital health platforms, telemedicine, and mobile applications, is revolutionizing the healthcare industry. Innovations in testing technologies, like microfluidics and next-generation sequencing, have led to faster, more accurate, and more affordable testing options for consumers.

2. Increased Consumer Demand: The growing emphasis on personalized medicine and health-conscious lifestyles has fueled consumer demand

Growth in Digital Direct to Consumer lab testing

for DTC lab tests. People are now more proactive in managing their health, seeking information, and opting for preventive measures to minimize the risk of chronic diseases.

3. Regulatory Landscape: As regulatory agencies recognize the potential benefits of DTC lab testing, they are gradually easing restrictions and creating a more favorable environment for the growth of this market. This shift in regulations is expected to further accelerate market expansion.

Business Opportunities:

1. Early-stage Companies: Purity Laboratories™, as an early-stage DTC lab testing company, offers an opportunity to capitalize on the rapid growth of this market.

2. Market Leaders: Established DTC lab testing companies with a strong market presence and a proven track record of success provide stable business opportunities. These market leaders are well-positioned to expand their market share and capitalize on the growth of the industry.

3. Vertical Integration: As the DTC lab testing market matures, vertical integration opportunities may arise. Companies that can provide endto-end solutions, including testing services, digital platforms, and analytics, could be attractive business prospects.

4. Strategic Partnerships: Collaborations between DTC lab testing companies and healthcare providers or pharmaceutical companies can create synergies, expand distribution channels, and enhance product offerings.

5. Conclusion: The direct-to-consumer lab testing market represents a significant and rapidly growing segment within the healthcare industry.

With numerous growth drivers and a favorable regulatory landscape, this market presents substantial opportunities for businesses looking to benefit from the future of healthcare. By strategically engaging with early-stage companies, market leaders, vertical integration opportunities, and companies forming strategic partnerships, businesses can position themselves to reap the rewards of this burgeoning market.

As the DTC lab testing market continues to flourish, it will not only transform the way individuals manage their health but also create significant value for businesses that recognize the potential of this innovative sector. Embrace this disruptive healthcare trend and capitalize on the immense growth potential of the direct-to-consumer lab testing market by making informed and strategic business decisions. As the market evolves, businesses that seize these opportunities early will be well-positioned to benefit from the transformative impact of DTC lab tests on the healthcare industry.

In summary, the direct-to-consumer lab testing market offers a chance to be part of a healthcare revolution that prioritizes patient empowerment, preventive care, and personalized medicine. As more consumers embrace this approach to healthcare management, the market is set to experience substantial growth. By understanding and leveraging the opportunities within this market, businesses can contribute to improving healthcare accessibility and consumer choice while also benefiting from the expansion of this promising sector.

Saliva-Based DTC Testing: Purity Laboratories™ Embraces Saliva as the Safest and Easiest Method for Testing

Purity Laboratories™ specializes in the rapid adoption of saliva-based testing for direct-to-consumer lab services. The use of saliva for DTC testing is gaining momentum due to its numerous advantages over traditional bloodbased tests. This section highlights the bright future of saliva-based testing, its advantages, and relevant sources that support these claims.

Sources and References:

1. BCC Research (2021). Direct-to-Consumer Genetic Testing: Global Markets. Retrieved from https://www.bccresearch.com/market-research/biotechnology/direct-to-consumer-genetictesting-report.html

2. Grand View Research (2020). Direct-to-Consumer Laboratory Testing Market Size, Share & Trends Analysis Report. Retrieved from https://www.grandviewresearch.com/industryanalysis/direct-to-consumer-laboratory-testing-market

3. Mordor Intelligence (2021). Direct-to-Consumer (DTC) Testing Market - Growth, Trends, COVID-19 Impact, and Forecasts (2021 - 2026). Retrieved from https://www.mordorintelligence.com/industry-reports/direct-to-consumer-dtc-testing-market

4. Research and Markets (2021). Direct-to-Consumer (DTC) Genetic Testing Market: Global Industry Analysis, Trends, Market Size, and Forecasts up to 2027. Retrieved from https://www.researchandmarkets.com/reports/5316084/direct-to-consumer-dtc-genetictesting-market

5. Statista (2021). Direct-to-consumer laboratory testing services market size worldwide from 2019

Advantages of Saliva-Based DTC Testing:

Saliva-Based DTC Testing: An Ideal Option for Children, Especially Those with Special Needs

Saliva-based DTC testing offers a unique advantage in its suitability for use with children, particularly those with special needs. This section highlights the benefits of saliva testing for younger populations and why it is an ideal choice for children with special needs.

1. Non-invasive collection: Saliva collection is a painless and non-invasive method, which makes it more appealing to consumers compared to blood tests that require needle punctures. This ease of collection encourages more people to participate in regular testing and monitor their health proactively (Source: Granger DA, et al. Salivary bioscience and research on adolescence: an integrated perspective. J Adolesc. 2012;35(4):1081-1095. doi:10.1016/j.adolescence.2012.01.005).

2. Convenient and cost-effective: Saliva-based tests can be easily conducted at home, eliminating the need for clinical visits and reducing associated costs. This convenience factor is particularly important for DTC lab testing, as it enables customers to access essential health information without disrupting their daily routines (Source: Dhiman N, et al. Saliva as a diagnostic tool for oral and systemic diseases. J Oral

Biol Craniofac Res. 2016;6(1):67-76. doi:10.1016/j.jobcr.2015.08.006).

3. Broad range of applications: Saliva-based tests can be used to measure various biomarkers, including hormones, antibodies, and genetic information. This versatility makes saliva an attractive medium for a wide range of DTC tests, catering to diverse consumer needs (Source: Nunes LAS, et al. Saliva: a tool for monitoring steroid, peptide and immune markers in sport and exercise science. J Sports Sci Med. 2011;10(3):424-437).

4. Accuracy and reliability: Recent advancements in testing technology have enabled saliva-based tests to achieve high levels of accuracy and reliability, comparable to those of traditional blood tests. This ensures that consumers receive dependable results for informed health decision-making (Source: Pfaffe T, et al. Diagnostic potential of saliva: current state and future applications. Clin Chem. 2011;57(5):675-687. doi:10.1373/clinchem.2010.153767).

Purity Laboratories™, with a focus on saliva-based DTC testing, is at the forefront of this emerging trend in healthcare. By recognizing and capitalizing on the advantages of saliva testing, the company is wellpositioned to benefit from the growing demand for convenient, non-invasive, and accurate testing options. As more consumers and businesses embrace the potential of saliva-based DTC testing, Purity Laboratories™ will continue to lead the way in shaping the future of personalized healthcare.

Advantages of Saliva-Based DTC Testing for

Especially Children with Special Needs

1. Minimizing stress and discomfort:

Blood tests can be particularly distressing for children, as they may experience anxiety or fear when faced with needles. Saliva-based tests are non-invasive and painless, reducing stress and discomfort for children during sample collection (Source: Granger DA, et al. Salivary bioscience and research on adolescence: an integrated perspective. J Adolesc. 2012;35(4):1081-1095.

doi:10.1016/j.adolescence.2012.01.005).

2. Easy and quick sample collection:

Collecting saliva samples is a simple and fast process that can be easily performed by children or their caregivers. This ease of collection

is particularly beneficial for children with special needs, who may have difficulties with more complex or time-consuming sample collection methods (Source: Dhiman N, et al. Saliva as a diagnostic tool for oral and systemic diseases. J Oral Biol Craniofac Res. 2016;6(1):67-76. doi:10.1016/j.jobcr.2015.08.006).

3. Safe and convenient testing environment:

Saliva-based DTC tests allow children, including those with special needs, to be tested in the comfort and safety of their own homes. This eliminates the need for clinical visits, which can be challenging for children with sensory sensitivities or mobility issues (Source: Nunes LAS, et al. Saliva: a tool for monitoring steroid, peptide and immune markers in sport and exercise science. J Sports Sci Med. 2011;10(3):424-437).

4. Encouraging preventive care and health monitoring:

The simplicity and convenience of saliva-based tests can facilitate more frequent health monitoring for children, including those with special needs. Regular testing can help detect health issues early, enabling prompt intervention and improving health outcomes (Source: Pfaffe T, et al. Diagnostic potential of saliva: current state and future applications. Clin Chem. 2011;57(5):675-687. doi:10.1373/clinchem.2010.153767).

By offering saliva-based DTC testing, Purity Laboratories™ is catering to the needs of children and their families, including those with special needs. The ease, comfort, and convenience of saliva testing make it an ideal option for younger populations, encouraging better health management and enabling more accessible healthcare for all children.

Projected Tests

The following are the Projected Test

This category of tests assesses diabetes risk factors including blood sugar levels and other markers of metabolic health. The test is designed to identify and monitor potential diabetes-related issues.

These tests detect the presence and levels of various toxic heavy metals in the body. The test helps assess potential health risks and guide detoxification efforts.

(STI) panels screen for common infections like HIV, syphilis, chlamydia, and gonorrhea. The test facilitates early detection and treatment of STIs.

4.

Food sensitivity tests measure immunoglobulin levels in response to specific foods. The test helps individuals identify potential food intolerances or sensitivities.

1. Diabetes Test:

2. Heavy Metals Urine:

3. STI Panel: Sexually transmitted disease

Food Sensitivity:

5. Hepatitis B and Hepatitis C:

These tests diagnose, monitor, and manage the viral infections that primarily affect the liver. Left untreated, both Hepatitis B and Hepatitis C can lead to chronic liver disease, cirrhosis, and liver cancer.

6. Herpes:

Herpes tests diagnose the viral infection caused by herpes simplex viruses. The test differentiates between the two types and guides appropriate management.

7. Vitamin Sufficiency:

These tests evaluate levels of essential vitamins and minerals in the body to identify deficiencies and guide supplementation for optimal health.

8. Stress and Sleep:

These tests measure cortisol and melatonin levels to provide valuable insights into an individual's stress response and sleep-wake cycle. Analyzing cortisol levels helps identify stress-related issues, while evaluating melatonin levels helps detect sleep disorders and evaluate sleep quality.

9. Men's Hormone Testing:

These tests diagnose hormonal imbalances, assess reproductive health, identify potential underlying health conditions, and guide appropriate treatment plans for male hormones like testosterone.

10. Women's Hormone Testing:

These tests assess reproductive health, diagnose hormonal imbalances, identify underlying health conditions, and guide appropriate treatment plans for female hormones.

11. Inflammation:

These tests measure markers like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) to detect and monitor inflammation in the body.

12. Sports Fitness and Performance

Cortisol, DHEA, Testosterone, and hs-CRP

Note – Drug Testing with Saliva or Urine is Included in the plans but after the Wellness program is established.

Diabetes Tests Things Tested For

1. HbA1c Diabetes

Hba1c, or A1c, measures your average blood sugar levels over the past 3 months. This test is used to diagnose prediabetes and diabetes and helps those with diabetes manage their condition.

Diabetes Health

In 2018, the United States saw 34.2 million individuals affected by Type 1 or Type 2 diabetes, with an estimated 88 million adults aged 18 and older suffering from prediabetes [1]. The prevalence of diabetes has been on a steady upward trajectory, with projections suggesting that over 54.9 million Americans will be impacted by the condition by 2030 [2]. With the rise in diagnosis rates, diabetes is becoming

a significant concern not only for those living with the chronic illness but also for their employers.

Lacking appropriate screening and management, diabetes can result in emotional and physical hardships. Employee health and wellness are vital to the success of a company, making it essential for employers to investigate the most effective ways to support their employees and enable them to lead healthier, longer lives. By implementing a successful diabetes screening strategy, employers can optimize employee health and productivity.

Our at-home healthcare and wellness solutions aim to improve access to preventive care and enhance the overall health of the workforce.

Diabetes Affects Employers

Diabetes affects individuals in their day-to-day lives, including in the workplace. Although diabetes may not generally impact an individual's ability to perform specific job duties, improper management of the condition can have negative consequences on employee well-being and productivity. For some, diabetes may result in missed workdays or an inability to work fulltime, while others may experience distressing symptoms or complications due to fluctuating blood sugar levels.

With the increasing diagnosis rates and associated costs, diabetes has become one of the most expensive diseases for employers in the United States. The American Diabetes Association (ADA) estimates that the overall costs of diagnosed diabetes rose from $245 billion in 2012 to $327 billion in 2017 [3]. Of the $327 million in costs, $237 billion were attributed to direct medical expenses, whereas $90 billion were a result of indirect costs stemming from productivity losses. Indirect workplace costs include an estimated $3.3 billion loss due to increased absenteeism, $26.9 billion from

reduced productivity among employed individuals, and $37.5 billion from disease-related disability causing an inability to work.

Proper screening is a critical component for the successful identification and management of prediabetes and diabetes. Without adequate screening, people might remain uninformed about their health status. In 2018, out of the 34.2 million Americans diagnosed with diabetes, approximately 7.3 million were undiagnosed [4]. Early diagnosis allows those with prediabetes to make appropriate lifestyle changes and those with diabetes to receive timely treatment.

Health Risks if Diabetes Untreated

If left untreated, diabetes can cause damage to the heart, kidneys, nerves, eyes, and blood vessels. Fortunately, with the right ongoing treatment and support, managing the condition and reducing the risk of long-term complications is possible. Workplace health promotion efforts, such as diabetes screening, can positively impact productivity and costs while also boosting employee morale, retention, and overall company culture.

How Purity Laboratories can support employers in extending diabetes screening:

Employers play a pivotal role in enhancing preventive care for their employees. By providing diabetes screening, employers can identify employees with prediabetes or assist those with diabetes in managing their condition more effectively. Emphasizing employee health and wellness can help minimize negative outcomes related to diabetes, including work absences, productivity losses, and frequent healthcare visits.

Purity Laboratories offers user-friendly and precise diabetes testing that employees can utilize from the comfort of their homes. Our home Diabetes Test enables individuals to assess their risk of diabetes (prediabetes) or evaluate their diabetes management. The test measures the percentage of hemoglobin A1c in the blood, which consists of red blood cells with glucose attached. An A1c level between 5.7-6.4% suggests prediabetes, while an A1c level above 6

References:

1. https://wonder.cdc.gov/ucd-icd10.html

2. https://www.cdc.gov/heartdisease/facts.htm

3. https://www.amgenemployerresources.com/cardiovascular-toolkit.html

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7609459/

5. https://www.cdc.gov/workplacehealthpromotion/initiatives/resourcecenter/pdf/WHRC-Calling-All-Employers-Heart-Disease-Stroke-Infographic508.pdf

Heavy Metals

Things Tested For

The Heavy Metals Test is a valuable diagnostic tool for assessing exposure to toxic metals and identifying mineral deficiencies in the body. By analyzing urine samples, this test offers essential information that can help practitioners diagnose physiological disorders associated with imbalances in essential and toxic element metabolism.

A heavy metals test typically checks for a broad range of metals, many of which are potentially toxic to humans.

The metals will include those that are the most concerning to human health including Lead, Cadmium. Mercury, and Arsenic

It's important to note that some of these metals, like calcium, magnesium, and zinc, are essential to human health in trace amounts. Heavy metals tests are typically used to detect and monitor excessive levels of these

metals in the human body, which may result from environmental exposure, diet, or other sources.

Why Test for Heavy Metals as a Health Screening

Health Risks:

Heavy metals can accumulate in the body over time, leading to a variety of health problems. For example, lead exposure can cause cognitive impairment and developmental delays in children, while mercury exposure can cause neurological problems and kidney damage.

One study found that blood lead levels above 5 micrograms per deciliter (µg/dL) can cause significant health problems, including decreased IQ and behavioral problems in children (CDC, 2012). Similarly, exposure to mercury at levels above 1 µg/L can cause adverse health effects (WHO, 2011).

Lab testing can identify the presence of heavy metals in the body and enable individuals to take steps to reduce their exposure. For example, chelation therapy can be used to remove heavy metals from the body (ATSDR, 2019).

Environmental Contamination:

Heavy metals can enter the environment through various sources, such as industrial waste, agricultural runoff, and atmospheric deposition. These metals can accumulate in soil, water, and air, posing a risk to human health as well as the health of plants and animals.

Lab testing can identify the presence of heavy metals in the environment and enable the implementation of appropriate remediation measures. For example, soil testing can determine if heavy metal concentrations exceed regulatory limits, and if so, remediation techniques such as soil amendments can be used to reduce exposure (EPA, 2018).

Regulatory Compliance:

Many industries are subject to regulations regarding heavy metal content. For example, the Food and Drug Administration (FDA) has established limits for heavy metals in certain foods, such as lead in candy and arsenic in apple juice (FDA, 2022).

Lab testing can ensure that these industries are in compliance with regulations and avoid legal penalties. For example, a study of heavy metal content in herbal supplements found that some products contained lead, mercury, and arsenic above acceptable levels (Gardner et al., 2013). This led to regulatory action by the FDA to remove these products from the market.

Sexually Transmitted Infection Things Testing For

The following are the STIs are the standard testing done by physicians or hospitals.

These conditions are important to screen for because they are common sexually transmitted infections (STIs) that can have serious health consequences if left untreated. Regular screening can help detect these infections early, prevent their spread, and ensure timely treatment. Here are some reasons why it's essential to screen for each of these STIs:

Chlamydia:

Most common bacterial STI, often asymptomatic.

Can cause pelvic inflammatory Infection (PID), infertility, and ectopic pregnancy in women if left untreated.

Increases the risk of acquiring or transmitting HIV.

Gonorrhea:

Common bacterial STI, often asymptomatic or presents with mild symptoms.

Can lead to PID, infertility, and ectopic pregnancy in women, and epididymitis in men, which can cause infertility.

Increases the risk of acquiring or transmitting HIV.

Trichomoniasis:

Most common curable STI caused by a protozoan parasite.

Can cause inflammation, discomfort, and increase the risk of acquiring or transmitting other STIs, including HIV.

Pregnant women with trichomoniasis are at higher risk of premature birth and low birth weight infants.

HIV:

Human immunodeficiency virus attacks the immune system, leading to acquired immunodeficiency syndrome (AIDS) if left untreated.

Early diagnosis and treatment can significantly improve life expectancy and quality of life.

Reduces the risk of transmission to others through sexual contact, sharing needles, or from mother to child during pregnancy, childbirth, or breastfeeding.

Syphilis:

Bacterial infection that can cause long-term complications or death if not treated.

Progresses through stages (primary, secondary, latent, and tertiary) with varying symptoms, making early detection crucial.

Pregnant women with syphilis can transmit the infection to their unborn child, leading to congenital syphilis, which can cause severe health problems or death.

Screening for these STIs is vital for both individual and public health. Early detection and treatment can prevent serious health complications, reduce the spread of infections, and contribute to better sexual health for everyone.

A Larger Panel, we Add:

Mycoplasma genitalium:

• Mycoplasma genitalium is a sexually transmitted infection (STI) that can cause genitourinary issues, such as urethritis and cervicitis.

• Symptoms may include pain during urination, genital discharge, and pelvic pain. However, many cases can be asymptomatic, increasing the risk of transmission and complications.

Ureaplasma:

• Ureaplasma is a genus of bacter ia that can cause sexually transmitted infections in the urogenital tract.

• The most common species associated with STIs are Ureaplasma urealyticum and Ureaplasma parvum.

• Infections can lead to urethritis, pelvic inflammatory disease, and even infertility. Symptoms may be mild or absent, making it crucial to screen for these bacteria in sexually active individuals.

Why STI Testing Matters: Protecting Your Health and Others

One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects.

In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a

committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action.

Sexually Transmitted Infections (STIs), also known as sexually transmitted infections (STIs), affect millions of people worldwide. The World Health Organization reports over 1 million new STIs every day (1). Regular STI testing is essential for stopping the spread of infections, lowering health risks, and ensuring good sexual health.

Why STI Testing is Important

1. Detecting and Treating Infections Early –

a. Many STIs, like chlamydia, gonorrhea, and syphilis, don't always cause noticeable symptoms (2). People might unknowingly spread infections to their partners. Regular STI testing allows for early detection and treatment, preventing long-term health issue

Avoiding Serious Health Problems

b. Untreated STIs can lead to severe health complications such as infertility, pelvic inflammatory disease, chronic pain, and a higher risk of HIV transmission (3).

c. If left untreated, syphilis can harm the nervous system, heart, and other organs (4).

d. Pregnant women with untreated STIs may experience complications like premature birth, low birth weight, and infections in their newborns (5).

Stopping the Spread of Infections

e. Routine STI testing helps identify and treat infected individuals, who can then take steps to protect their partners.

f. This is particularly crucial for preventing the spread of HIV, which requires lifelong management and impacts a person's quality of life.

Encouraging Sexual Health and Awareness

g. STI testing promotes open communication about sexual health between partners and creates a culture of responsibility and awareness.

h. By understanding the importance of testing, people can make informed decisions about their sexual health, recognize the risks associated with certain behaviors, and take precautions to avoid STI transmission.

Effective STI Prevention Programs

i. Broad STI testing can offer valuable data for public health experts, allowing them to monitor infection prevalence in communities, pinpoint high-risk groups, and improve prevention efforts. This ultimately helps reduce the overall burden of STIs on individuals and healthcare systems.

Conclusion

STI testing plays a crucial role in maintaining sexual health and preventing the spread of infections. By raising awareness, promoting open communication, and making testing accessible, we can lessen the negative impact of STIs and ensure a healthier future for all.

Sources:

1. World Health Organization. (2019). Sexually transmitted infections (STIs). Retrieved from https://www.who.int/news-room/fact-sheets/detail/sexuallytransmitted-infections-(stis)

2. Centers for Disease Control and Prevention. (2019). Chlamydia - CDC Fact Sheet. Retrieved from https://www.cdc.gov/STI/chlamydia/STIfactchlamydia.htm

3. Ibid.

4. Centers for Disease Control and Prevention. (2017). Syphilis - CDC Fact Sheet. Retrieved from https://www.cdc.gov/STI/syphilis/STIfact-syphilis.htm

5. Centers for Disease Control and Prevention. (2019). STIs during Pregnancy - CDC Fact Sheet. Retrieved from https://www.cdc.gov/STI/pregnancy/STIfact-pregnancy.htm

Food Sensitivity

Things Testing For

Screening for food sensitivities helps identify triggers, prevent symptoms, and improve overall health and well-being by allowing individuals to create personalized diets tailored to their unique needs.

The following are standard Food Sensitivities done by doctors and hospitals

An IgG (Immunoglobulin G) food sensitivity test is used to identify potential food sensitivities by measuring the IgG antibody levels in response to specific foods. Common foods tested for in an IgG screening include:

1. Dairy products: cow's milk, cheese, yogurt, and casein.

2. Gluten-containing grains: wheat, barley, and rye.

3. Non-gluten grains: corn, rice, and oats.

4. Eggs: both egg white and egg yolk.

5. Soy and soy products.

6. Nuts and seeds: almonds, peanuts, walnuts, cashews, sunflower seeds, and sesame seeds.

7. Fish and shellfish: salmon, tuna, shrimp, and crab.

8. Fruits: strawberries, bananas, oranges, an d apples.

9. Vegetables: tomatoes, potatoes, peppers, and onions.

Legumes: beans, lentils, and peas.

Meats: beef, chicken, pork, and lamb.

What are the benefits?

Understanding and managing food sensitivities can lead to significant improvements in overall health and wellbeing. Here are some benefits of addressing food sensitivities, supported by scientific research: Improved digestion:

a. Identifying and eliminating or reducing the intake of foods that cause sensitivity can lead to better digestion

b. Food sensitivities can result in various gastrointestinal symptoms, such as bloating, gas, diarrhea, or constipation (Turner & Campbell, 2017) 1 . By addressing these sensitivities, individuals may experience relief from these symptoms and improved digestive health.

Increased energy:

c. Food sensitivities may cause fatigue and low energy levels (Bohn et al., 2013) 2 . By addressing these sensitivities, individuals may experience increased energy levels and improved overall health.

Better mental clarity:

d. Some people with food sensitivities report experiencing brain fog, difficulty concentrating, or mood swings (Mitchell et al., 2011) 3 .

e. Eliminating or reducing the consumption of triggering foods can lead to improved mental clarity and emotional well-being.

Reduced inflammation:

f. Food sensitivities can contribute to chronic inflammation in the body. Research has shown that addressing food sensitivities can help reduce inflammation and improve related health conditions, such as irritable bowel syndrome (IBS) and other gastrointestinal disorders (Catassi et al., 2017) 4 .

Healthier skin:

g. Food sensitivities can contribute to various skin issues, such as acne, eczema, or rashes. Studies have shown that identifying and managing food sensitivities can lead to healthier, clearer skin (Katta & Desai, 2014) 5 .

Personalized diet:

h. Identifying food sensitivities helps individuals create a personalized diet tailored to their unique needs.

i. This can lead to better overall health and a more enjoyable eating experience (Korovessis et al., 2019)[^6^].

Footnotes

1. Turner, J. R., & Campbell, J. A. (2017). Food sensitivity in patients with gastrointestinal symptoms. Current Gastroenterology Reports, 19(12), 62.

2. Bohn, L., Storsrud, S., Liljebo, T., Collin, L., Lindfors, P., Tornblom, H., & Simren, M. (2013). Diet low in FODMAPs reduces symptoms of irritable bowel syndrome as well as traditional dietary advice: a randomized controlled trial. Gastroenterology, 145(5), 961-967.

3. Mitchell, N., Hewitt, C. E., Jayakody, S., Islam, M., Adamson, J., Watt, I., & Torgerson, D. J. (2011). Randomised controlled trial of food elimination diet based on IgG antibodies for the prevention of migraine like headaches. Nutrition Journal, 10(1), 85.

4. Catassi, C., Alaedini, A., Bojarski, C., Bonaz, B., Bouma, G., Carroccio, A., ... & Leffler, D. A. (2017). The overlapping area of non-celiac gluten sensitivity (NCGS) and wheat-sensitive irritable bowel syndrome (IBS): an update. Nutrients, 9(11), 1268.

5. Katta, R., & Desai, S. P. (2014). Diet and dermatology

Here is a list of peer-reviewed studies on food-specific IgG testing

1. Uhde M, Caio G, De Giorgio R, Green PH, Volta U, Alaedini A. Subclass Profile of IgG Antibody Response to Gluten Differentiates Non-Celiac Gluten Sensitivity from Celiac Disease. Gastroenterology. 2020; S0016-5085(20)34992-1. doi: 10.1053/j.gastro.2020.07.032.

2. Fritscher-Ravens A, Pflaum T, Mösinger M, et al. Many Patients With Irritable Bowel Syndrome Have Atypical Food Allergies Not Associated With Immunoglobulin E. Gastroenterology. 2019;157(1):109-118.

3. Atkinson W, Sheldon TA, Shaath N, Whorwell PJ. Food elimination based on IgG antibodies in irritable bowel syndrome: a randomized controlled trial. Gut. 2004;51(10):1459-1464. doi: 10.1136/gut.2003.037697.

4. Zar S, Benson M, Kumar D. Food-specific Serum IgG4 and IgE titers to common food antigens in Irritable Bowel Syndrome. Am J Gastroenterol. 2005;100(7):1550-1557. doi: 10.1111/j.1572-0241.2005.41348.x.

5. Zuo XL, Li YQ, Li WJ, Guo YT, Lu XF, et al. Alterations of food antigen-specific serum immunoglobulins G and E antibodies in patients with irritable bowel syndrome and functional dyspepsia. Clin Exper Allergy. 2007;37:823-830. doi: 10.1111/j.1365-2222.2007.02727.x.

6. Aydinlar EI, Dikmen PY, Tiftikci A, Saruc M, Aksu M, et al. IgG-based elimination diet in migraine plus irritable bowel syndrome. Headache. 2013;53(3):514-525. doi: 10.1111/j.15264610.2012.02296.x.

7. Sub Lee H, Jae Lee K. Alterations of food-specific serum IgG4 titers to common food antigens in patients with Irritable Bowel Syndrome. J Neurogastroenterol Motility. 2017;23(4):578-584. doi: 10.5056/jnm17054.

8. Cai C, Shen J, Zhao D, Qiao Y, Xu A, et al. Serological investigation of food specific immunoglobulin G antibodies in patients with inflammatory bowel diseases. PLoS ONE. 2014;9(11):1-8. doi: 10.1371/journal.pone.0112154. [includes Crohn’s and Ulcerative colitis]

9. Xie Y, Zhou G, Xu Y, He B, Wang Y, Ma R, et al. Effects of Diet Based on IgG Elimination Combined with Probiotics on Migraine Plus Irritable Bowel Syndrome. J Pain Res. 2019;7890461. doi: 10.1155/2019/7890461.

10. Drisko J, Bischoff B, Hall M, McCallum R. Treating Irritable Bowel Syndrome with a food elimination diet followed by food challenge and probiotics. J Am Coll Nutr. 2006;25(6):514522. doi: 10.1080/07315724.2006.10719567.

11. Gunasekeera V, Mendall MA, Chan D, Kumar D. Treatment of Crohn’s Disease with an IgG4Guided Exclusion Diet: A Randomized Control Trial. Dig Dis Sci. 2016;61(4):1148-1157. doi: 10.1007/s10620-015-3987-z.

12. Rajendran N, Kumar D. Food-specific IgG4-guided exclusion diets improve symptoms in Crohn’s disease: a pilot study. Colorectal disease. 2011;13(9):1009-1013.

13. Wang G, Ren J, Li G, Hu Q, Gu G, Ren H. The utility of food antigen test in the diagnosis of Crohn’s disease and remission maintenance after exclusive enteral nutrition. Clinics and Research in Hepatology and Gastroenterology. 2018;42(2):145-152. doi: 10.1016/j.clinre.2017.09.002.

14. Bentz S, Hausmann M, Piberger H, Kellermeier S, Paul S, et al. Clinical relevance of IgG antibodies against food antigens in Crohn’s disease: a double-blind crossover diet intervention study. Digestion. 2010;81(4):252-264. doi: 10.1159/000264649.

15. Jian L, Anqi H, Gang L, Litian W, Yanyan X, et al. Food exclusion based on IgG antibodies alleviates symptoms in ulcerative colitis. Inflammatory Bowel Diseases. 2018; 24(9):19181925. doi: 10.1093/ibd/izy110.

16. Alpay K, Ertas M, Orhan EK, Üstay DK, Lieners C, Baykan B. Diet restriction in migraine, based on IgG against foods: a clinical double-blind, randomized, crossover trial. Cephalalgia. 2010;30(7):829-837. doi: 10.1177/0333102410361404.

Effect of Food Sensitivities on the Body

Hepatitis B and Hepatitis C

In the United States, the prevalence and impact of Hepatitis B (HBV) and Hepatitis C (HCV) in the workplace are significant concerns for employers.

Prevalence:

According to the Centers for Disease Control and Prevention (CDC), an estimated 862,000 people are living with chronic Hepatitis B, and around 2.4 million people have chronic Hepatitis C in the United States (CDC, 2021) 1 . While the overall prevalence of these infections has declined in recent years, certain populations and workplace settings continue to face a higher risk of exposure and transmission (Wasley, Kruszon-Moran, Kuhnert, & Simard, 2010) 2 .

Workplace Prevalence:

Certain occupations and industries have a higher prevalence of HBV and HCV infections, particularly those involving exposure to blood or other potentially infectious materials (OPIM). These high-risk occupations include healthcare workers, first responders, and workers in settings such as correctional facilities, waste management, and laboratories (Beltrami, Williams, Shapiro, & Chamberland, 2000) 3 .

Dangers in the Workplace:

Chronic liver disease: Employees with chronic HBV or HCV infections may experience fatigue, reduced cognitive function, and other symptoms that can impact their job performance and productivity (Younossi, Henry, & Bush, 2014) 4 .

1. Workplace transmission: In high-risk settings, the transmission of HBV and HCV through needlesticks, sharps injuries, or contact with contaminated blood or OPIM is a significant concern. Employers must ensure proper safety protocols and training to minimize the risk of workplace transmission (De Carli et al., 2003)[^5^].

2. Absenteeism: Employees with chronic HBV or HCV infections may require time off for medical appointments, treatment, or hospitalizations, impacting productivity and workforce availability (Diel et al., 2017)[^6^].

3. Stigma and discrimination: Employees living with HBV or HCV may face stigma and discrimination in the workplace due to misconceptions about the transmission and severity of these infections. This can lead to a hostile work environment and reduced job satisfaction, impacting employee retention and morale (Zickmund et al., 2003)[^7^].

By understanding the prevalence and dangers of Hepatitis B and C in the United States and implementing appropriate measures to address these issues, employers can create a safer and more inclusive work environment for all employees.

Early detection and treatment of Hepatitis B (HBV) and Hepatitis C (HCV) are crucial for improving patient outcomes and preventing the progression of liver disease.

Hepatitis B:

For individuals with chronic HBV, early detection allows for timely intervention and management, which can help prevent complications such as liver cirrhosis, liver failure, or hepatocellular carcinoma (liver cancer) (Terrault et al., 2018)1. Effective antiviral medications, such as nucleos(t)ide analogues, can suppress viral replication and decrease the risk of liverrelated complications (Marcellin et al., 2013)2. In some cases, the treatment can lead to a functional cure, defined as sustained loss of Hepatitis B surface antigen (HBsAg) and undetectable viral DNA (Terrault et al., 2018) 1 .

Hepatitis C:

The landscape of HCV treatment has undergone a significant transformation with the advent of direct-acting antivirals (DAAs), which have revolutionized the management of the disease. Early detection and treatment with DAAs have shown to be highly effective, with cure rates exceeding 90% in most patient populations (Falade-Nwulia et al., 2017) 3 . Achieving a sustained virologic response (SVR), which indicates successful treatment, reduces the risk of liver cirrhosis, liver failure, hepatocellular carcinoma, and overall mortality (van der Meer et al., 2012) 4 .

In Summary

Early detection of HBV and HCV infections allows for timely and effective treatment, significantly improving patient outcomes, and reducing the risk of liver-related complications. Employers who facilitate screening and early diagnosis can potentially improve the health and well-being of their employees while also minimizing the impact of these infections in the workplace.

Footnotes

1. Centers for Disease Control and Prevention (CDC). (2021). Viral Hepatitis Surveillance - United States, 2019. Retrieved from https://www.cdc.gov/hepatitis/statistics/2019surveillance/index.htm ↩

2. Wasley, A., Kruszon-Moran, D., Kuhnert, W., & Simard, E. P. (2010). The prevalence of hepatitis B virus infection in the United States in the era of vaccination. Journal of Infectious Diseases, 202(2), 192-201. ↩

3. Beltrami, E. M., Williams, I. T., Shapiro, C. N., & Chamberland, M. E. (2000). Risk and management of blood-borne infections in health care workers. Clinical Microbiology Reviews, 13(3), 385-407. ↩

4. Younossi, Z. M., Henry, L., & Bush, H. (2014). Clinical and economic burden of chronic liver diseases in the USA. Journal of Viral Hepatitis, 21(11), 750 ↩

5. Terrault, N. A., Lok, A. S. F., McMahon, B. J., Chang, K. M., Hwang, J. P., Jonas, M. M., ... & Vargas, H. E. (2018). Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology, 67(4), 1560-1599. ↩ ↩ 2

6. Marcellin, P., Gane, E., Buti, M., Afdhal, N., Sievert, W., Jacobson, I. M., ... & Dinh, P. (2013). Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study. The Lancet, 381(9865), 468-475. ↩

7. Falade-Nwulia, O., Suarez-Cuervo, C., Nelson, D. R., Fried, M. W., Segal, J. B., & Sulkowski, M. S. (2017). Oral direct-acting agent therapy for hepatitis C virus infection: a systematic review. Annals of internal medicine, 166(9), 637-648. ↩

8. van der Meer, A. J., Veldt, B. J., Feld, J. J., Wedemeyer, H., Dufour, J. F., Lammert, F., ... & Manns, M. P. (2012). Association between sustained virological response and all-cause mortality among patients with chronic hepatitis C and advanced hepatic fibrosis. Jama, 308(24), 2584-2593. ↩

9. Terrault, N. A., Lok, A. S. F., McMahon, B. J., Chang, K. M., Hwang, J. P., Jonas, M. M., ... & Vargas, H. E. (2018). Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology, 67(4), 1560-1599. ↩ ↩ 2

10. Marcellin, P., Gane, E., Buti, M., Afdhal, N., Sievert, W., Jacobson, I. M., ... & Dinh, P. (2013). Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study. The Lancet, 381(9865), 468-475. ↩

11. Falade-Nwulia, O., Suarez-Cuervo, C., Nelson, D. R., Fried, M. W., Segal, J. B., & Sulkowski, M. S. (2017). Oral direct-acting agent therapy for hepatitis C virus infection: a systematic review. Annals of internal medicine, 166(9), 637-648. ↩

Herpes Test

The Prevalence and Dangers of Herpes in the US: Why Screening Matters

Introduction

Herpes is a common yet often misunderstood viral infection that affects millions of people in the United States. With two primary types, herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2), this infection can cause a range of health issues and concerns. In this article, we will explore the prevalence and dangers of herpes in the US, and explain the importance of getting screened for this common infection.

Prevalence of Herpes in the United States

According to the Centers for Disease Control and Prevention (CDC), herpes is one of the most common sexually transmitted infections (STIs) in the United States. It is estimated that nearly half of the adult population has HSV-1, often associated with oral herpes or cold sores, while around 12% of adults aged 14 to 49 have HSV-2, which is more commonly linked to genital

herpes. However, it is essential to note that both types of the virus can cause oral and genital infections.

Dangers of Herpes

While herpes is often considered a benign infection, it can lead to several health complications and risks, including:

1. Physical discomfort: Herpes outbreaks can cause painful sores, itching, and burning sensations, leading to significant physical discomfort and emotional distress.

2. Psychological impact: A herpes diagnosis can result in feelings of shame, guilt, and anxiety, impacting an individual's mental health and personal relationships.

3. Increased risk of other STIs: Having genital herpes can increase the risk of acquiring other STIs, including HIV.

4. Neonatal herpes: If a pregnant woman has genital herpes, the virus can be transmitted to the newborn during delivery, which can lead to severe complications and even death.

5. Herpes encephalitis: Although rare, herpes can cause encephalitis, a potentially life-threatening inflammation of the brain.

The Importance of Screening

Due to the possible dangers associated with herpes, regular screening is crucial for several reasons:

1. Early detection: Many individuals with herpes are unaware of their infection because they may not exhibit symptoms or have mild

symptoms that go unnoticed. Early detection allows for proper management and treatment, reducing the risk of complications.

2. Reducing transmission: Knowledge of one's herpes status can help prevent transmission to partners. Using barrier methods, such as condoms, and taking antiviral medications can reduce the risk of spreading the virus.

3. Pregnancy management: Pregnant women should be screened for herpes to minimize the risk of neonatal herpes. If a pregnant woman has genital herpes, precautions can be taken during delivery to reduce the risk of transmission to the baby.

4. Emotional support and coping strategies: Being aware of one's herpes status can facilitate access to emotional support and resources, helping individuals to better cope with the psychological impact of the infection.

Conclusion

Herpes is a prevalent infection in the United States, and despite its often asymptomatic nature, it can pose significant dangers to affected individuals and their partners. Regular screening for herpes is crucial for early detection, management, and prevention of complications. By promoting awareness and encouraging screening, we can work together to reduce the impact of herpes and improve the well-being of individuals and communities across the nation.

References:

(1) Centers for Disease Control and Prevention. (2020). Genital Herpes - CDC Fact Sheet. Retrieved from https://www.cdc.gov/STI/herpes/STIfact-herpes.htm

(2) Gupta, R., Warren, T., & Wald, A. (2007). Genital herpes. The Lancet, 370(9605), 2103-2110.

https://doi.org/10.1016/S0140-6736(07)61908-4

(3) Banez, G. A. (2010). Psychological and psychosexual aspects of genital herpes. In S. P. S. S. Tan (Ed.), Practical Guide to Genital Herpes: Diagnosis, Treatment, and Prevention (pp. 33-40). CRC Press.

(4) Wald, A., & Link, K. (2002). Risk of human immunodeficiency virus infection in herpes simplex virus type 2-seropositive persons: a meta-analysis. The Journal of Infectious Diseases, 185(1), 45-52. https://doi.org/10.1086/338231

(5) Brown, Z. A., Benedetti, J., Ashley, R., Burchett, S., Selke, S., Berry, S., Vontver, L. A., & Corey, L. (1991). Neonatal herpes simplex virus infection in relation to asymptomatic maternal infection at the time of labor. The New England Journal of Medicine, 324(18), 1247-1252. https://doi.org/10.1056/NEJM199105023241804

(6) Whitley, R. J., & Gnann, J. W. (2002). Viral encephalitis: familiar infections and emerging pathogens. The Lancet, 359(9305), 507-513. https://doi.org/10.1016/S0140-6736(02)07680-6

(7) LeFevre, M. L., & U.S. Preventive Services Task Force. (2014). Screening for asymptomatic herpes simplex virus infection: U.S. Preventive Services Task Force reaffirmation recommendation statement. Annals of Internal Medicine, 161(12), 879-885. https://doi.org/10.7326/M14-2424

(8) Martin, E. T., Krantz, E., Gottlieb, S. L., Magaret, A. S., Langenberg, A., Stanberry, L., Kamb, M., & Wald, A. (2009). A pooled analysis of the effect of condoms in preventing HSV-2 acquisition. Archives of Internal Medicine, 169(13), 1233-1240. https://doi.org/10.1001/archinternmed.2009.177

(9) American College of Obstetricians and Gynecologists. (2007). ACOG Practice Bulletin No. 82: Management of herpes in pregnancy. Obstetrics and Gynecology, 109(6), 1489-1498.

https://doi.org/10.1097/01.AOG.0000263929.33222.5c

(10) Fergusson, D. M., Horwood, L. J., & Lynskey, M. T. (1997). The effects of unemployment on psychiatric illness during young adulthood. Psychological Medicine, 27(2), 371-381.

https://doi.org/10.1017/S0033291796004387

Vitamin Sufficiency

What we need to Test For?

Lab tests for vitamins and minerals can be helpful in assessing the status of these nutrients in the body. Here are some reasons why testing for these specific vitamins may be recommended:

Folate: Folate is a B vitamin that is essential for DNA synthesis and cell division. Low levels of folate can lead to anemia, birth defects, and an increased risk of certain cancers. A lab test for folate can help determine if a person is getting enough of this nutrient.

Choline: Choline is a nutrient that is important for brain function, liver health, and muscle movement. Low levels of choline can lead to liver damage, muscle weakness, and cognitive impairment. A lab test for choline can help determine if a person is getting enough of this nutrient.

Iron: Iron is an essential mineral that is important for the production of hemoglobin, which carries oxygen in the blood. Low levels of iron can lead to anemia, fatigue, and other health problems. A lab test for iron can help determine if a person has a deficiency or excess of this nutrient.

Omega 3s: Omega-3 fatty acids are essential fats that are important for brain function, heart health, and other physiological processes. Low levels of omega-3s can lead to cognitive impairment, depression, and an increased risk of heart disease. A lab test for omega-3s can help determine if a person is getting enough of these nutrients.

Vitamin B12: Vitamin B12 is essential for nerve function, DNA synthesis, and red blood cell production. Low levels of B12 can lead to anemia, fatigue, and neurological problems. A lab test for B12 can help determine if a person has a deficiency or insufficiency of this nutrient.

Vitamin E: Vitamin E is an antioxidant that is important for immune function and cell signaling. Low levels of vitamin E can lead to neurological problems, muscle weakness, and other health problems. A lab test for vitamin E can help determine if a person is getting enough of this nutrient.

Taking a vitamin sufficiency lab test can be helpful in determining if you have any vitamin deficiencies or if you are taking too much of any particular vitamin. Some reasons why someone may choose to take a vitamin sufficiency lab test include:

1. Identifying Nutrient Deficiencies: A vitamin sufficiency test can help identify if you have any nutrient deficiencies, which can lead to a wide range of health issues. For example, a deficiency in vitamin D can cause weak bones, while a deficiency in vitamin B12 can cause anemia and nerve damage.

2. Personalized Supplement Plan: A vitamin sufficiency test can help you create a personalized supplement plan that is tailored to your individual needs. This can help ensure that you are taking the right vitamins in the right amounts.

3. Prevention of Health Issues: A vitamin sufficiency test can help prevent future health issues by identifying any deficiencies early on. This can give you the opportunity to correct the deficiency through diet or supplements before it leads to more serious health issues.

4. Improved Energy and Mood: Many vitamins play a role in energy production and mood regulation. If you have a deficiency in any of these vitamins, you may experience fatigue and low mood. By identifying and correcting any deficiencies, you may be able to improve your energy levels and mood.

5. Monitoring Vitamin Levels: If you are taking supplements or have a medical condition that affects your vitamin levels, it can be helpful to monitor your vitamin levels regularly to ensure that you are not taking too much of any particular vitamin.

Overall, a vitamin sufficiency lab test can be a useful tool for anyone who wants to optimize their health and well-being

Vitamin D Testing

What Test For

The most accurate way to test for vitamin D levels in the body is through a blood test called the 25-hydroxyvitamin D test (also known as the 25(OH)D test). This test measures the amount of vitamin D in the blood and is considered the most reliable indicator of vitamin D status.

The 25-hydroxyvitamin D test is performed using a liquid chromatographytandem mass spectrometry (LC-MS/MS)

Why Test for Vitamin D

Vitamin D is essential for maintaining overall health and preventing various health issues. Special needs children, pregnant women, and people of color are especially susceptible to Vitamin D deficiency and should take measures to ensure sufficient levels. Vitamin D testing is advised for individuals at risk of deficiency, and treatment may involve dietary modifications, supplementation, and increased sunlight exposure.

Benefits of Vitamin D

Regular Vitamin D testing is beneficial for several reasons. First, Vitamin D deficiency is a widespread global health concern, and testing can identify individuals who may be at risk. Second, Vitamin D deficiency often presents without symptoms, leaving individuals unaware of their low levels. Lastly, testing allows healthcare providers to determine suitable treatment options, such as dietary changes or supplementation.

Prevalence of Vitamin D

The prevalence of Vitamin D deficiency and insufficiency is relatively high in the United States. A study published in the Journal of Clinical Endocrinology and Metabolism found that approximately 42% of American adults were deficient in Vitamin D, while another 39% were classified as Vitamin D insufficient. These findings indicate that a majority of the American population may not be getting enough Vitamin D.

Benefits for Special Needs Children:

Children with special needs might be at a higher risk of Vitamin D deficiency due to factors like limited sunlight exposure, dietary restrictions, and medication use. Vitamin D is particularly vital for children with developmental disabilities, as it can promote healthy bone growth and prevent conditions such as osteoporosis.

Benefits for Pregnant Women:

Vitamin D is essential for pregnant women, as it plays a significant role in the development of the fetus's bones and teeth. It can also help prevent conditions like preeclampsia and gestational diabetes. Research suggests

that Vitamin D deficiency during pregnancy may increase the risk of complications like preterm birth and low birth weight.

Benefits for People of Color:

People of color have been found to have lower levels of Vitamin D compared to other races due to their darker skin, which requires more sunlight exposure to produce the same amount of Vitamin D as lighter skin. Vitamin D deficiency in people of color has been linked to an increased risk of chronic diseases like hypertension, diabetes, and certain cancers.

Vitamin D and COVID-19 Protection:

Research has suggested that Vitamin D may play a protective role against COVID-19. A meta-analysis of observational studies found that low levels of Vitamin D were associated with an increased risk of COVID-19 infection, hospitalization, and mortality. Another study found that Vitamin D supplementation was associated with a lower risk of testing positive for COVID-19 among asymptomatic individuals.

One proposed mechanism for Vitamin D's protective effect against COVID-19 is its role in regulating the immune system. Vitamin D can modulate the immune response, including the production of cytokines, which are small proteins involved in the inflammatory response. The dysregulation of cytokines, known as cytokine storms, has been associated with severe COVID-19 disease. Vitamin D may help reduce the risk of cytokine storms by regulating the production of inflammatory cytokines.

Vitamin D and Cytokine Storm

Prevention: Cytokine storms are characterized by an excessive and uncontrolled release of cytokines, leading to widespread inflammation and tissue damage. Cytokine storms have been associated with severe COVID-19 disease and are believed to contribute to disease progression and mortality.

Several studies have suggested that Vitamin D may help prevent cytokine storms in COVID-19 patients. A study of hospitalized COVID-19 patients found that those with higher levels of Vitamin D had lower levels of inflammatory cytokines and a lower risk of adverse outcomes. Another study found that Vitamin D supplementation reduced the levels of proinflammatory cytokines and improved clinical outcomes in COVID-19 patients.

The mechanism by which Vitamin D prevents cytokine storms in COVID-19 patients is not fully understood, but it is believed to involve the regulation of the immune response. Vitamin D can modulate the production of cytokines, including pro-inflammatory cytokines, and may help reduce the risk of an excessive cytokine response.

Benefits of Screening Employees for Vitamin D Deficiency:

1. Improved overall health: Screening employees for Vitamin D deficiency can lead to improved overall health by identifying and addressing deficiencies early. Adequate Vitamin D levels contribute to better bone health, a reduced risk of certain cancers, and improved immune system function.

2. Reduced sick leave and absenteeism: Ensuring employees have sufficient Vitamin D levels can lead to a decrease in sick leave and absenteeism. Research has shown that Vitamin D supplementation can reduce the risk of respiratory infections, which are a common cause of missed workdays.

3. Increased productivity: Adequate Vitamin D levels have been associated with improved mood and mental health, which can translate into increased productivity at work. Employees with sufficient Vitamin D levels may experience fewer symptoms of depression and anxiety, allowing them to be more focused and efficient in their job duties.

4. Improved safety: Screening employees for Vitamin D deficiency can also contribute to a safer work environment. Vitamin D plays a role in muscle function, and employees with adequate levels may have better balance and a lower risk of falls and injuries.

Screening employees for Vitamin D deficiency can provide numerous benefits, including improved overall health, reduced sick leave and absenteeism, increased productivity, and improved safety. By identifying and addressing Vitamin D deficiencies in the workplace, employers can promote a healthier and more productive work environment.

Conclusion:

Vitamin D plays a crucial role in maintaining overall health, including immune system function and bone health. The scientific evidence suggests that Vitamin D may play a protective role against COVID-19 and reduce the risk of cytokine storms in COVID-19 patients. Vitamin D testing and supplementation may be beneficial in preventing and treating respiratory infections, including COVID-19, and reducing the risk of adverse outcomes.

Sources for this article:

1. Forrest KY, Stuhldreher WL. Prevalence and correlates of vitamin D deficiency in US adults. Nutr Res. 2011;31(1):48-54.

2. Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266-81.

3. Lappe J, Cullen D, Haynatzki G, Recker R, Ahlf R, Thompson K. Calcium and vitamin D supplementation decreases incidence of stress fractures in female navy recruits. J Bone Miner Res. 2008;23(5):741-9.

4. Autier P, Boniol M, Pizot C, Mullie P. Vitamin D status and ill health: a systematic review. Lancet Diabetes Endocrinol. 2014;2(1):76-89.

5. Grant WB, Lahore H, McDonnell SL, et al. Evidence that Vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths. Nutrients. 2020;12(4):E988.

6. Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017;356:i6583.

7. Jorde R, Sneve M, Figenschau Y, Svartberg J, Waterloo K. Effects of Vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial. J Intern Med. 2008;264(6):599-609.

8. Penckofer S, Kouba J, Byrn M, Ferrans CE. Vitamin D and depression: where is all the sunshine? Issues Ment Health Nurs. 2010;31(6):385-93.

9. Holick MF. Sunlight and Vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004;80(6 Suppl):1678S-88S.

10. Bischoff-Ferrari HA, Dawson-Hughes B, Willett WC, et al. Effect of Vitamin D on falls: a metaanalysis. JAMA. 2004;291(16):1999-2006.

11. Shuler FD, Wingate MK, Moore GH, et al. Sports health benefits of Vitamin D. Sports Health.

Sleep and Stress Tests

Cortisol is a hormone that plays a vital role in the body's stress response. Testing cortisol levels typically involves a blood test, saliva test, or urine test. Each method has its advantages and limitations, and the choice of test depends on the specific situation and the preference of the healthcare provider or individual.

Why Measure Melatonin for Sleep Disorders

Melatonin is a hormone that plays a crucial role in regulating the sleep-wake cycle. Measuring melatonin levels can provide valuable insights into sleep issues for several reasons, as supported by scientific literature:

1. Sleep-wake cycle regulation: Melatonin is involved in regulating the body's circadian rhythm, which governs the sleepwake cycle. Abnormal melatonin production can lead to disruptions in this cycle and cause sleep problems (Arendt, 2005). Reference: Arendt, J. (2005). Melatonin: Characteristics, concerns, and prospects. Journal of Biological Rhythms, 20(4), 291-303.

2. Sleep disorders: Some sleep disorders, such as delayed sleep phase syndrome (DSPS) or advanced sleep phase syndrome (ASPS), are associated with altered melatonin production and release patterns.

Assessing melatonin levels can help diagnose these sleep disorders (Lewy, 2007). Reference: Lewy, A. J. (2007). Melatonin and human chronobiology. Cold Spring Harbor Symposia on Quantitative Biology, 72, 623-636.

3. Shift work and jet lag: Shift work and jet lag can disrupt the body's internal clock and affect melatonin production, leading to sleep issues. Measuring melatonin levels can provide insights into how these factors are affecting the sleep-wake cycle and help in developing appropriate strategies to address the disruptions (Sack, 2010). Reference: Sack, R. L. (2010). Clinical practice. Jet lag. New England Journal of Medicine, 362(5), 440-447.

4. Sleep quality: Low melatonin levels may be associated with poor sleep quality or difficulty falling asleep. By measuring melatonin levels, individuals and healthcare professionals can identify potential issues with sleep onset and quality (Herxheimer & Petrie, 2002). Reference: Herxheimer, A., & Petrie, K. J. (2002). Melatonin for the prevention and treatment of jet lag. Cochrane Database of Systematic Reviews, (2), CD001520.

5. Aging and sleep: Melatonin production tends to decrease with age, which can contribute to sleep disturbances in older adults. Measuring melatonin levels can help identify age-related changes in sleep patterns and inform appropriate interventions to promote healthy sleep in older individuals (Pandi-Perumal et al., 2005). Reference: Pandi-Perumal, S. R., Zisapel, N., Srinivasan, V., & Cardinali, D. P. (2005). Melatonin and sleep in aging population. Experimental Gerontology, 40(12), 911-925.

By assessing melatonin levels, healthcare professionals can identify potential sleep issues, diagnose sleep disorders, and inform appropriate interventions to improve sleep quality. If you suspect you have low melatonin levels and

are experiencing sleep issues, consult with a healthcare professional to ensure proper evaluation and management.

Why Measure Cortisol for Stress

Cortisol is a useful biomarker for assessing stress issues due to its role in the body's stress response and its association with various physiological processes. Below are some reasons why cortisol is good to measure for stress issues, along with citations from scientific literature for further

Information:

1. Stress indicator: Cortisol levels increase in response to stress, making it a useful biomarker for assessing stress (Kudielka, Hellhammer, & Wüst, 2009). Elevated cortisol levels can indicate acute or chronic stress. Reference: Kudielka, B. M., Hellhammer, D. H., & Wüst, S. (2009). Why do we respond so differently? Reviewing determinantshuman salivary cortisol responses to challenge.

Psychoneuroendocrinology, 34(1), 2-18.

2. Diurnal rhythm: Cortisol levels follow a diurnal rhythm, peaking in the morning and declining throughout the day. Disruptions in this pattern can indicate stress-related issues or other problems (Clow, Hucklebridge, & Thorn, 2010).

Reference: Clow, A., Hucklebridge, F., & Thorn, L. (2010). The cortisol awakening response: More than a measure of HPA axis function. Neuroscience & Biobehavioral Reviews, 35(1), 97-103.

3. Chronic stress: Chronic stress can lead to persistently elevated cortisol levels, which may contribute to health problems such as cardiovascular disease, metabolic syndrome, and mental health disorders (Chrousos, 2009). Reference: Chrousos, G. P. (2009). Stress and disorders of the stress system. Nature Reviews Endocrinology, 5(7), 374-381.

4. Adrenal function: Abnormal cortisol levels can also indicate adrenal dysfunction, such as Addison's disease or Cushing's syndrome. Assessing cortisol levels can help diagnose these conditions (Nieman, 2013). Reference: Nieman, L. K. (2013). Cushing's syndrome: Update on signs, symptoms and biochemical screening. European Journal of Endocrinology, 169(5), R47-R53.

5. Effectiveness of stress-management strategies: Measuring cortisol levels can help evaluate the effectiveness of stress-management interventions in reducing stress levels (Pascoe, Thompson, & Ski, 2017). Reference: Pascoe, M. C., Thompson, D. R., & Ski, C. F. (2017). Yoga, mindfulness-based stress reduction and stress-related physiological measures: A meta-analysis. Psychoneuroendocrinology, 86, 152-168.

In summary, measuring cortisol levels can provide valuable information about an individual's stress levels, help diagnose stress-related disorders or adrenal dysfunction, and inform appropriate interventions to manage stress and improve overall health.

Why and Employer would want

Employees to be Tested for Melatonin and Cortisol

Both melatonin and cortisol play crucial roles in the regulation of sleep-wake cycles and stress response, which can have a significant impact on work performance and productivity. Here are some reasons why an employer might consider screening for these hormones:

1. Assess stress levels: Cortisol is known as the "stress hormone," and its levels tend to increase in response to stress. By measuring cortisol levels in employees, employers can get an idea of their workers' stress

levels and identify those who may be experiencing high levels of stress. This can help employers implement targeted interventions to alleviate stress and promote a healthier work environment.

2. Evaluate sleep quality: Melatonin is a hormone that regulates sleepwake cycles and plays a key role in maintaining healthy sleep patterns. By screening employees for melatonin levels, employers can identify workers who may have disrupted sleep patterns or sleep disorders. Addressing sleep issues can lead to improved well-being, productivity, and job satisfaction.

3. Boost productivity: Poor sleep and high stress levels can lead to decreased productivity, increased errors, and reduced job satisfaction. By screening for melatonin and cortisol, employers can identify workers who may benefit from interventions aimed at improving sleep and managing stress, ultimately leading to increased productivity and better overall work performance.

4. Enhance workplace safety: In jobs that require a high level of alertness and focus, such as operating heavy machinery or driving, poor sleep and increased stress can lead to safety risks. By screening for melatonin and cortisol levels, employers can identify and address sleep and stress issues, reducing the risk of accidents and promoting a safer work environment.

5. Support employee well-being: Demonstrating concern for employee health and well-being can foster a positive work environment, improve employee morale, and increase job satisfaction. Offering melatonin and cortisol screenings as part of a comprehensive employee wellness program can show that the employer cares about their workers' overall health and well-being.

It's important to note that any employer considering screening employees for melatonin and cortisol levels should do so in a voluntary and confidential

manner. Employees should be informed about the purpose of the testing, the potential benefits, and the steps taken to protect their privacy. It's also essential to provide employees with resources and support to address sleep and stress issues identified through the screening process.

Health Impact of Sleep Disorders

Sleep problems, including insufficient sleep, poor sleep quality, and sleep disorders, can have numerous adverse effects on physical, mental, and emotional health. Here are some of the dangers associated with sleep problems:

1. Impaired cognitive function: Sleep deprivation can lead to difficulties with attention, concentration, memory, problem-solving, and decisionmaking. This can negatively impact work performance, academic achievement, and daily functioning.

2. Mood disturbances: Lack of quality sleep can contribute to mood disorders, such as depression and anxiety. Sleep problems can also exacerbate existing mental health issues.

3. Weakened immune system: Poor sleep can weaken the immune system, making it harder for the body to fight off infections and recover from illness.

4. Weight gain and obesity: Sleep deprivation can affect appetiteregulating hormones, leading to increased hunger and a higher risk of weight gain and obesity.

5. Increased risk of chronic diseases: Chronic sleep problems have been linked to an increased risk of various health conditions, including cardiovascular disease, hypertension, diabetes, and stroke.

6. Impaired motor skills and reaction time: Sleep deprivation can lead to slower reaction times, reduced coordination, and diminished motor skills, increasing the risk of accidents and injuries.

7. Workplace and public safety issues: Sleep problems can lead to drowsiness, reduced alertness, and impaired decision-making, posing safety risks in various settings, including the workplace and while driving.

8. Relationship issues: Sleep problems can contribute to irritability, mood swings, and reduced patience, which can strain interpersonal relationships.

9. Lower quality of life: Chronic sleep issues can negatively impact overall well-being, leading to decreased energy levels, motivation, and life satisfaction.

10. Sleep disorders: Sleep problems can be a sign of underlying sleep disorders, such as insomnia, sleep apnea, restless legs syndrome, or narcolepsy. These disorders can have additional health risks and complications if left untreated.

It's essential to address sleep problems to improve overall health and wellbeing. Consult with a healthcare professional if you are experiencing persistent sleep issues. They can help identify the underlying causes, provide guidance on effective sleep hygiene practices, and, if necessary, recommend appropriate treatments or interventions.

Effects of Stress on Wellness

Chronic stress can have detrimental effects on both physical and mental health, leading to a variety of health problems and complications. Here are some of the dangers associated with stress:

1. Cardiovascular issues: Chronic stress can contribute to high blood pressure, increased heart rate, and inflammation in the circulatory system, increasing the risk of heart disease, heart attack, and stroke.

2. Weakened immune system: Prolonged stress can impair the immune system's ability to respond to infections and heal from injuries, making individuals more susceptible to illnesses and delaying recovery.

3. Mental health problems: Chronic stress is linked to a higher risk of developing anxiety, depression, and other mental health disorders. It can also exacerbate existing mental health issues.

4. Sleep disturbances: Stress can interfere with sleep quality and duration, leading to insomnia or other sleep disorders. Poor sleep, in turn, can further contribute to stress and negatively impact overall health.

5. Digestive problems: Stress can affect the gastrointestinal system, causing symptoms like indigestion, heartburn, nausea, and diarrhea or constipation. Chronic stress has also been linked to the development or worsening of irritable bowel syndrome (IBS) and inflammatory bowel diseases (IBD) like Crohn's disease and ulcerative colitis.

6. Weight issues: Stress can impact eating habits and metabolism, leading to weight gain or loss. It can also contribute to the development of obesity and eating disorders.

7. Skin conditions: Chronic stress can exacerbate existing skin problems, such as acne, psoriasis, eczema, and rosacea, or cause new ones to develop.

8. Reproductive issues: Stress can negatively impact the reproductive system, leading to menstrual irregularities, decreased fertility, and sexual dysfunction in both men and women.

9. Cognitive impairments: Prolonged stress can negatively affect memory, concentration, and decision-making, impacting work performance and daily functioning.

10. Increased risk of chronic conditions: Chronic stress has been linked to an increased risk of developing conditions like type 2 diabetes, chronic pain, and fibromyalgia.

11. Substance use and addiction: People experiencing chronic stress may be more likely to use alcohol, tobacco, or drugs as coping mechanisms, which can lead to addiction and additional health problems.

To mitigate the dangers of stress, it's essential to develop effective stress management strategies, such as regular exercise, mindfulness practices, social support, and proper time management. If you're experiencing chronic stress or stress-related health issues, consult a healthcare professional or mental health provider for guidance and support.

Men’s Hormone Testing

What is Tested for

These tests, Testosterone Sex Hormone Binding Globulin (SHBG) Free Androgen Index (FAI) are essential for evaluating male hormone levels and understanding overall hormonal health. The primary male hormone, testosterone, plays a significant role in various physiological processes such as muscle growth, bone density, and sexual function. Sex Hormone Binding

Globulin (SHBG) and Free Androgen Index (FAI) are also important indicators of hormonal balance in men.

1. Testosterone:

This hormone is produced primarily in the testicles and is responsible for the development of male sexual characteristics, including facial hair, deepening of the voice, and increased muscle mass. Testosterone levels can impact mood, energy, and sexual function. Measuring testosterone levels is crucial in diagnosing conditions like hypogonadism, which is characterized by low testosterone levels (1). Resource: https://www.mayoclinic.org/testsprocedures/testosterone-test/about/pac-20384616

2. Sex Hormone Binding Globulin (SHBG):

SHBG is a protein produced in the liver that binds to sex hormones, including testosterone, in the bloodstream. It helps transport hormones throughout the body and regulates the availability of free, biologically active hormones. High or low levels of SHBG can impact the amount of free testosterone available to the body, which may result in symptoms related to hormonal imbalances (2). Resource:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680715/

3. Free Androgen Index (FAI):

FAI is calculated by dividing the total testosterone level by the SHBG level and multiplying the result by 100. FAI represents the ratio of testosterone to SHBG and is an estimate of the bioavailable testosterone, which can be used by the body. Evaluating FAI can provide insights into hormonal imbalances and help identify conditions such as androgen deficiency, polycystic ovary syndrome (PCOS), and other hormonal disorders (3). Resource:

https://pubmed.ncbi.nlm.nih.gov/15955827/

By measuring testosterone, SHBG, and FAI levels, healthcare providers can gain a comprehensive understanding of a patient's hormonal health, diagnose potential hormonal imbalances, and recommend appropriate treatment plans.

Citations:

(1) Mayo Clinic. (n.d.). Testosterone Test. https://www.mayoclinic.org/tests-procedures/testosteronetest/about/pac-20384616

(2) Zang, H., & Carlström, K. (2019). Effects of treatment with an isoform-specific prolactin receptor antagonist, G129R, and testosterone replacement on sex hormone-binding globulin levels in hypogonadal men. Andrology, 7(4), 491-496.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680715/

(3) Vermeulen, A., Verdonck, L., & Kaufman, J. M. (1999). A critical evaluation of simple methods for the estimation of free testosterone in serum. The Journal of clinical endocrinology and metabolism, 84(10), 3666-3672. https://pubmed.ncbi.nlm.nih.gov/15955827/

Why Screen for Male Hormones?

5.6% of men over 30 have low testosterone and experience symptoms.

Source: J Clin Endocrinol Metab - “Prevalence of symptomatic androgen deficiency in men”

There are many factors that can contribute to low testosterone in men, including age, obesity, chronic illness, injury or infection to the testicles, medications, and genetic disorders. Symptoms of low testosterone can include reduced sex drive, erectile dysfunction, fatigue, depression, and loss of muscle mass and bone density.

Screening for hormone levels is important for men to maintain optimal health, as hormones play a vital role in various physiological functions. Regular hormone screening allows for early detection and management of hormonal imbalances and can help prevent potential health issues. Here are some reasons why men should screen for their hormones:

1. Testosterone levels:

Testosterone is the primary male sex hormone responsible for the development of male sexual characteristics, muscle mass, bone density, and the regulation of libido. A decline in testosterone levels with age can lead to fatigue, reduced libido, erectile dysfunction, depression, and loss of muscle mass. Early detection of low testosterone levels enables healthcare providers to recommend appropriate treatment plans and lifestyle changes (1).

Resource: https://www.health.harvard.edu/mens-health/is-testosterone-therapysafe-take-a-breath-before-you-take-the-plunge

2. Hormonal imbalances: Hormonal imbalances can cause a wide range of symptoms, including mood swings, irritability, sleep disturbances, and weight gain. Regular screening can help identify these imbalances and enable prompt intervention to restore balance, thus improving overall well-being (2). Resource:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3079864/

3. Prostate health: Prostate-specific antigen (PSA) is a hormone produced by the prostate gland. Elevated PSA levels can be an early indicator of prostate cancer or other prostate-related issues. Regular hormone screening, including PSA testing, can help detect potential issues early, increasing the chances of successful treatment (3). Resource:

https://www.cancer.gov/types/prostate/psa-fact-sheet

4. Metabolic health: Hormones like insulin, thyroid hormones, and cortisol play a significant role in metabolism and maintaining a healthy body weight. Hormonal imbalances can lead to metabolic disorders, such as insulin resistance, obesity, and thyroid dysfunction. Hormone screening can help identify and manage these conditions, reducing the risk of complications like heart disease and type 2 diabetes (4).

Resource: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840548/

5. Bone health: Hormones such as testosterone, parathyroid hormone (PTH), and vitamin D are important for maintaining bone health. Imbalances can lead to osteoporosis or increased risk of fractures. Regular hormone screening can help detect these imbalances and provide appropriate interventions to preserve bone health (5).

Resource: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3336669/

Citations:

(1) Harvard Health Publishing. (2021, January). Is testosterone therapy safe? Take a breath before you take the plunge. https://www.health.harvard.edu/mens-health/is-testosterone-therapy-safe-takea-breath-before-you-take-the-plunge

(2) Giordano, R., & Guaraldi, F. (2011). Hormones and cardiovascular health in men. The aging male: the official journal of the International Society for the Study of the Aging Male, 14(2), 85-93.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3079864/

(3) National Cancer Institute. (2012, April 30). Prostate-Specific Antigen (PSA) Test.

https://www.cancer.gov/types/prostate/psa-fact-sheet

(4) Kyrou, I., & Tsigos, C. (2009). Stress hormones: physiological stress and regulation of metabolism. Current opinion in pharmacology, 9(6), 787-793.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840548/

(5) Clarke, B. L., Khosla, S., & Riggs, B. L. (2012). The physiology of bone remodeling. Contemporary endocrinology: osteoporosis, 1-22. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3336669/

(6) Mayo Clinic. (2021, January 6). Male hypogonadism. https://www.mayoclinic.org/diseasesconditions/male-hypogonadism/symptoms-causes/syc-20354881

(7) Harvard Health Publishing. (2019, December). Do testosterone supplements really work?

https://www.health.harvard.edu/mens-health/do-testosterone-supplements-really-work

(8) MedlinePlus. (2022, February 15). Hormone tests. https://medlineplus.gov/lab-tests/hormonetests/

(9) Lab Tests Online. (2022, February 17). Hormones. https://labtestsonline.org/tests/hormones

(10) U.S. Food and Drug Administration. (n.d.). Home use tests. https://www.fda.gov/medicaldevices/home-use-tests

In conclusion, regular hormone screening for men is essential for maintaining overall health and preventing potential health issues related to hormonal imbalances.

(11) U.S. Food and Drug Administration. (n.d.). CLIA overview. https://www.fda.gov/medicaldevices/clinical-laboratory-improvement-amendments-clia/clia-overview

(12) U.S. Food and Drug Administration. (n.d.). CLIA certificate of waiver. https://www.fda.gov/medical-devices/clinical-laboratory-improvement-amendments-clia/cliacertificate-waiver

(13) U.S. Department of Health and Human Services. (n.d.). Clinical laboratory improvement amendments (CLIA). https://www.cms.gov/Regulations-and-Guidance/Legislation/CLIA

Women’s Hormone Testing

What is Tested for

• Follicle Stimulating Hormone (FSH),

• Luteinizing Hormone (LH),

• Prolactin and

• Estradiol

Why Specific Things are Tested For

Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), Prolactin, and Estradiol are essential hormones that play critical roles in reproductive health and function. Testing for these hormones can provide valuable information about various aspects of an individual's reproductive health, fertility, and even some non-reproductive health concerns.

1. Follicle Stimulating Hormone (FSH): FSH is a hormone produced by the pituitary gland that plays a crucial role in the development and maturation of follicles in the ovaries (in females) and the production of sperm in the testes (in males).

Benefits of FSH testing:

• Assessing fertility: Abnormal FSH levels can indicate issues with fertility, such as premature ovarian failure or polycystic ovary syndrome (PCOS) in women, and impaired sperm production in men.

• Evaluating menstrual irregularities: FSH testing can help determine the cause of irregular or absent menstrual periods.

• Diagnosing pituitary gland disorders: Abnormal FSH levels may also suggest a problem with the pituitary gland, such as a tumor or other disorder.

2. Luteinizing Hormone (LH): LH, another hormone produced by the pituitary gland, is responsible for triggering ovulation in females and stimulating testosterone production in males.

Benefits of LH testing:

• Assessing fertility: LH testing can help evaluate fertility issues, such as anovulation (absence of ovulation) in females and low testosterone levels in males.

• Diagnosing PCOS: An abnormal LH to FSH ratio may indicate the presence of PCOS, a common endocrine disorder affecting women of reproductive age.

• Monitoring ovulation: LH testing can be used to determine the most fertile time in a woman's menstrual cycle by identifying the LH surge that occurs just before ovulation.

3. Prolactin: Prolactin is a hormone produced by the pituitary gland that stimulates breast milk production after childbirth and regulates other reproductive functions.

Benefits of prolactin testing:

• Investigating menstrual irregularities: High prolactin levels can cause irregular or absent periods, making prolactin testing important for diagnosing the underlying cause.

• Evaluating galactorrhea: Prolactin testing can help determine the cause of abnormal breast milk production in individuals who are not pregnant or breastfeeding.

• Diagnosing pituitary tumors: Elevated prolactin levels may indicate the presence of a prolactinoma, a benign tumor of the pituitary gland.

4. Estradiol: Estradiol is the primary form of estrogen, a hormone involved in the development and maintenance of female reproductive tissues, bone health, and other physiological processes.

Benefits of estradiol testing:

• Assessing fertility: Abnormal estradiol levels can indicate ovarian dysfunction or other fertility-related issues.

• Evaluating menstrual problems: Estradiol testing can help diagnose the cause of irregular, heavy, or painful periods.

• Monitoring hormone therapy: Estradiol testing is useful for monitoring the effectiveness of hormone replacement therapy, particularly during menopause or for transgender patients undergoing hormone therapy.

In summary, FSH, LH, prolactin, and estradiol tests offer valuable insights into an individual's reproductive health and fertility. These tests can help diagnose various reproductive disorders, evaluate menstrual irregularities, and monitor hormone therapy. However, it is essential to consult with a healthcare professional to determine the appropriate tests and interpret the results in the context of each individual's unique situation.

References

1. Fritz, M. A., & Speroff, L. (2011). Clinical gynecologic endocrinology and infertility. Lippincott Williams & Wilkins.

• This textbook offers comprehensive coverage of endocrinology and infertility in clinical gynecology, including detailed information on hormones like FSH, LH, prolactin, and estradiol, as well as their role in reproductive health.

2. Gleicher, N., & Barad, D. H. (2007). Unexplained infertility: Does it really exist? Human Reproduction, 22(8), 2084-2087.

• This article explores the concept of unexplained infertility and discusses the potential role of hormone testing in diagnosing and managing fertility issues.

3. Lab Tests Online. (n.d.). Hormone Testing. Retrieved from https://labtestsonline.org/tests/hormone-testing

• Lab Tests Online is a resource provided by the American Association for Clinical Chemistry (AACC) that offers information about various laboratory tests, including hormone testing. It covers the purpose, methodology, and clinical utility of hormone tests like FSH, LH, prolactin, and estradiol.

4. Melmed, S., Polonsky, K. S., Larsen, P. R., & Kronenberg, H. M. (2016). Williams Textbook of Endocrinology. Elsevier Health Sciences.

• This textbook provides in-depth information about endocrine physiology, disorders, and hormone testing, including the roles of FSH, LH, prolactin, and estradiol in reproductive health and disease.

Why it is Important to Measure Hormone Levels in Women

Female hormones play crucial roles in regulating various physiological processes and maintaining overall health. Hormones such as estrogen, progesterone, folliclestimulating hormone (FSH), and luteinizing hormone (LH) are particularly important for women's health. Here are some reasons why female hormones are important and why lab screening can be beneficial:

1. Menstrual cycle regulation: Female hormones are responsible for regulating the menstrual cycle, which is essential for fertility and reproductive health. Imbalances in hormones like estrogen and progesterone can lead to irregular periods, heavy bleeding, or painful menstruation.

2. Fertility and pregnancy: Hormones such as FSH and LH regulate the maturation and release of eggs during ovulation, which is crucial for fertility. Estrogen and progesterone play critical roles in maintaining a healthy pregnancy. Hormone imbalances can cause fertility issues or complications during pregnancy.

3. Bone health: Estrogen plays a key role in maintaining bone density and preventing osteoporosis. A decrease in estrogen levels, such as during menopause, can increase the risk of bone loss and fractures.

4. Cardiovascular health: Estrogen has a protective effect on the cardiovascular system by helping to maintain healthy blood vessels and regulating cholesterol levels. Hormone imbalances can contribute to an increased risk of cardiovascular diseases.

5. Emotional well-being: Female hormones can influence mood and emotional well-being. Imbalances in hormone levels have been linked to mood disorders such as depression or anxiety, particularly during premenstrual syndrome (PMS), postpartum period, or menopause.

Lab screening for female hormones can help:

1. Identify hormonal imbalances: Hormone testing can detect imbalances that may contribute to various health issues, including menstrual irregularities, fertility problems, or mood disorders.

2. Guide treatment: Identifying hormone imbalances can inform appropriate treatment strategies, such as hormone replacement therapy or lifestyle changes, to restore hormonal balance and alleviate symptoms.

3. Monitor response to treatment: Regular hormone testing can help assess the effectiveness of treatment and make adjustments as needed to ensure optimal hormone balance.

4. Early detection: Lab screening can detect hormone imbalances before they lead to significant health issues, allowing for early intervention and prevention of complications

Citations to support the importance of female hormones and lab screening:

1. Schindler, A. E. (2006). Hormones in human reproduction. Gynecological Endocrinology, 22(4), 168-175.

2. Prior, J. C. (1998). Perimenopause: The complex endocrinology of the menopausal transition. Endocrine Reviews, 19(4), 397-428.

3. Riggs, B. L. (2000). The mechanisms of estrogen regulation of bone resorption. Journal of Clinical Investigation, 106(10), 1203-1204.

4. Mendelsohn, M. E., & Karas, R. H. (1999). The protective effects of estrogen on the cardiovascular system. New England Journal of Medicine, 340(23), 1801-1811.

5. Schmidt, P. J., Nieman, L. K., Danaceau, M. A., Adams, L. F., & Rubinow, D. R. (1998). Differential behavioral effects of gonadal steroids in women with and in those without premenstrual syndrome. New England Journal of Medicine, 338(4), 209-216.

Inflammation

What we Should Measure

1. The Inflammation tests markers C-reactive protein (CRP) to detect and monitor inflammation in the body. C-reactive protein (CRP): CRP is a protein produced by the liver in response to inflammation. When there is an inflammatory process in the body, CRP levels increase. The high-sensitivity CRP (hs-CRP) test is used to detect even small changes in CRP levels, which can be helpful in assessing cardiovascular disease risk. CRP tests can be important in detecting and monitoring conditions such as infections, autoimmune diseases, and chronic inflammatory conditions.

Why is it Important to Measure Inflammation

Measuring inflammation through lab tests is essential because inflammation is a critical factor in many health conditions and diseases. Chronic inflammation can contribute to the development and progression of various disorders. Here are some reasons why it is important to measure inflammation using lab tests:

1. Early detection: Inflammation can be an early indicator of underlying health issues. Identifying increased inflammation through lab tests can

help detect potential health problems and allow for early intervention and prevention (Libby, 2002).

2. Monitoring disease progression: Inflammation plays a crucial role in the progression of many chronic diseases, such as cardiovascular disease, diabetes, and autoimmune disorders. Measuring inflammation can help healthcare professionals monitor the disease's status and adjust treatment plans accordingly (Hansson, 2005).

3. Assessing treatment effectiveness: Monitoring inflammation levels can help evaluate the effectiveness of therapeutic interventions, such as medication or lifestyle changes, in reducing inflammation and improving overall health (Golia et al., 2014).

4. Identifying potential health risks: Elevated inflammation levels have been linked to an increased risk of developing chronic diseases, such as cancer, heart disease, and neurodegenerative disorders. Measuring inflammation can help identify individuals at risk and implement preventive measures (Balkwill & Mantovani, 2001).

Some common lab tests for measuring inflammation include:

1. C-reactive protein (CRP): CRP is a protein produced by the liver in response to inflammation. High-sensitivity CRP (hs-CRP) tests are

often used to assess the risk of cardiovascular disease (Ridker et al., 2000).

2. Erythrocyte sedimentation rate (ESR): ESR measures the rate at which red blood cells settle at the bottom of a test tube, which can be an indirect indicator of inflammation (Gabitova et al., 2015).

3. Cytokine levels: Cytokines are proteins released by cells during inflammation. Lab tests can measure the levels of pro-inflammatory cytokines, such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha), to assess inflammation (Turner et al., 2014).

It is essential to consult with a healthcare professional before undergoing any inflammatory testing to ensure proper evaluation and interpretation of the results.

References:

1. Balkwill, F., & Mantovani, A. (2001). Inflammation and cancer: back to Virchow?. The Lancet, 357(9255), 539-545.

2. Gabitova, G., Kudasheva, F., & Shakirova, A. (2015). Inflammatory markers in early diagnosis of acute appendicitis. International Journal of Inflammation, 2015.

3. Golia, E., Limongelli, G., Natale, F., Fimiani, F., Maddaloni, V., Pariggiano, I., ... & Calabrò, R. (2014). Inflammation and cardiovascular disease: from pathogenesis to therapeutic target. Current Atherosclerosis Reports, 16(9), 435.

4. Hansson, G. K. (2005). Inflammation, atherosclerosis, and coronary artery disease. New England Journal of Medicine, 352(16), 1685-1695.

5. Libby, P. (2002). Inflammation in atherosclerosis. Nature, 420(6917), 868-874.

6. Ridker, P. M., Rifai, N., Rose, L., Buring, J. E., & Cook, N. R. (2002). Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in

7. Turner, M. D., Nedjai, B., Hurst, T., & Pennington, D. J. (2014). Cytokines and chemokines: At the crossroads of cell signalling and inflammatory disease. Biochimica et Biophysica Acta (BBA)-Molecular Cell Research, 1843(11), 2563-2582.

These citations provide evidence for the importance of measuring inflammation through lab tests in detecting, monitoring, and treating various health conditions and diseases. Tracking inflammation levels can help

healthcare professionals identify potential health risks, monitor disease progression, and assess the effectiveness of treatments, ultimately promoting optimal health.

Lab Measurement

Some popular laboratories that offer direct-to-consumer sports fitness testing include:

InsideTracker:

InsideTracker offers a variety of blood tests that assess biomarkers related to sports performance, such as testosterone, cortisol, and vitamin D. The cost of tests ranges from $49 to $589.

WellnessFX:

WellnessFX offers a range of blood tests that assess biomarkers related to sports performance, such as testosterone, cortisol, and iron levels. The cost of tests ranges from $78 to $1,235.

Everlywell:

Everlywell offers a variety of at-home saliva and blood tests that assess biomarkers related to sports performance, such as cortisol, testosterone, and vitamin D. The cost of tests ranges from $49 to $399.

WHAT SHOULD WE MEASURE

Cortisol is a hormone that is released in response to stress, and can affect metabolism, blood sugar levels, and immune function. Measuring cortisol levels in athletes can provide insight into their stress levels and help identify potential risks for overtraining or injury.

DHEA (dehydroepiandrosterone) is a hormone that is involved in the production of other hormones, including testosterone and estrogen. Measuring DHEA levels in athletes can help identify hormonal imbalances that could affect performance, recovery, and overall health.

Testosterone is a hormone that is important for muscle growth, bone density, and energy levels. Measuring testosterone levels in athletes can help identify potential issues with hormonal balance that could affect athletic performance and overall health.

Vitamin D is essential for bone health, immune function, and muscle strength. Measuring vitamin D levels in athletes can help identify potential deficiencies that could affect athletic performance and overall health, as well as guide appropriate supplementation. Low vitamin D levels have been associated with increased risk of injury in athletes.

hs-CRP levels Measuring salivary hs-CRP levels can be useful for assessing systemic inflammation in athletes, which may be related to sports fitness. Inflammation is a natural response of the body to physical activity and is necessary for muscle repair and growth.

Why is Exercise and Sports Fitness

Important

Improved cardiovascular health: Regular exercise has been shown to improve various markers of cardiovascular health, including reducing blood pressure, improving cholesterol levels, and reducing the risk of

cardiovascular disease. For example, a study published in the Journal of the American Medical Association found that among middle-aged men, those who engaged in regular physical activity had a 35% lower risk of developing cardiovascular disease than those who were inactive (1). Similarly, a study published in the journal Circulation found that regular exercise reduced blood pressure in individuals with hypertension (2).

Weight management: Exercise can help to regulate body weight by increasing energy expenditure and promoting fat loss. According to a review published in the journal Obesity Reviews, exercise can lead to modest weight loss in overweight and obese individuals, and may be more effective when combined with dietary changes (3). Additionally, regular exercise can help to build and maintain muscle mass, which can further aid in weight management.

Improved bone density: Regular weight-bearing exercise, such as running, jumping, or resistance training, has been shown to improve bone density and reduce the risk of osteoporosis. According to a review published in the Journal of Bone and Mineral Research, weight-bearing exercise has been shown to increase bone density in premenopausal women, postmenopausal women, and men (4).

Reduced risk of chronic diseases: Regular exercise has been shown to reduce the risk of chronic diseases such as type 2 diabetes, certain types of cancer, and Alzheimer's disease. For example, a study published in the journal Diabetes Care found that individuals who engaged in regular physical activity had a lower risk of developing type 2 diabetes, even after controlling for other factors such as body weight (5). Similarly, a study published in the Journal of Clinical Oncology found that regular exercise was associated with a reduced risk of certain types of cancer, including breast, colon, and endometrial cancer (6).

Improved mental health: Exercise has been shown to improve mood, reduce symptoms of anxiety and depression, and improve cognitive function. This is thought to be due to the release of endorphins during exercise, as well as its ability to reduce inflammation and improve blood flow to the brain. For example, a study published in the journal Frontiers in Psychology found that exercise was effective in reducing symptoms of depression in adults (7). Similarly, a study published in the journal Neurology found that regular exercise was associated with better cognitive function in older adults (8).

Improved sleep: Regular exercise has been shown to improve the quality and duration of sleep, which can further improve overall health and wellbeing. For example, a study published in the journal Sleep found that moderate-intensity exercise was associated with better sleep quality and longer sleep duration in middle-aged and older adults (9).

Overall, these studies suggest that regular exercise can provide numerous health benefits. However, it's important to note that the type, intensity, and duration of exercise can all play a role in determining its effects on health. Additionally, individuals should consult with a healthcare professional before starting an exercise program, especially if they have any underlying health conditions.

References:

1. Lee I-M, et al. Physical activity and coronary heart disease in men: The Harvard Alumni Health Study. JAMA. 1995; 273: 1179-1184.

2. Whelton SP, et al. Physical activity and blood pressure: A meta-analysis of randomized, controlled trials. Circulation. 2002; 116: 1265-1274.

3. Swift DL, Johannsen NM, Lavie CJ, Earnest CP, Church TS. The role of exercise and physical activity in weight loss and weight maintenance. Prog Cardiovasc Dis. 2014; 56(4):441-447.

4. Snow CM, Shaw JM, Winters KM, Witzke KA. Long-term exercise using weighted vests prevents hip bone loss in postmenopausal women. J Gerontol A Biol Sci Med Sci. 2000; 55(9): M489-491.

5. Hu G, et al. Physical activity and risk of cardiovascular disease among middle-aged and older Chinese women. Circulation. 2006; 114: 2618-2626.

6. Meyerhardt JA, et al. Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol. 2006; 24: 3527-3534.

7. Josefsson T, Lindwall M, Archer T. Physical exercise intervention in depressive disorders: A systematic review and meta-analysis. Front Psychiatry. 2014; 5: 87.

8. Middleton LE, Barnes DE, Lui LY, Yaffe K. Physical activity over the life course and its association with cognitive performance and impairment in old age. Neurology. 2010; 75: 2075-2081.

9. Kline CE, et al. Exercise improves sleep quality and quality of life in older adults with insomnia. Sleep Med. 2011; 12(10): 1018-1027.

General Review of Test Elements

Cortisol, DHEA (dehydroepiandrosterone), and testosterone are all hormones that play essential roles in the body, including influencing athletic performance, recovery, and overall fitness. By examining the levels of these hormones, researchers and sports professionals can gain insights into an individual's physical fitness and ability to perform in various sports.

Cortisol:

Cortisol is a steroid hormone produced by the adrenal glands, often referred to as the "stress hormone." It is essential for maintaining various bodily functions, including blood pressure regulation, immune response, and metabolism. However, when it comes to sports fitness, cortisol is mainly known for its catabolic effect, meaning it can break down muscle tissue and inhibit muscle growth. High cortisol levels can indicate physical stress, overtraining, or inadequate recovery.

Sources:

1. Duclos, M. (2008). A critical assessment of hormonal methods used in monitoring training status in athletes. International SportMed Journal, 9(2), 56-66.

2. Fry, A. C., & Kraemer, W. J. (1997). Resistance exercise overtraining and overreaching. Sports Medicine, 23(2), 106-129.

3. DHEA: DHEA is a steroid hormone produced by the adrenal glands that serves as a precursor to other hormones, including testosterone and estrogen. It is involved in various physiological processes, including immune function, brain health, and bone density. In sports fitness, DHEA may have anabolic effects, which can promote muscle growth and enhance physical performance. Additionally, DHEA can help counterbalance the catabolic effects of cortisol, supporting recovery and overall fitness. However, research on the relationship between DHEA and athletic performance is still limited, and more studies are needed to establish a clear connection.

4. Morales, A. J., Haubrich, R. H., Hwang, J. Y., Asakura, H., & Yen, S. S. (1998). The effect of six months treatment with a 100 mg daily dose of dehydroepiandrosterone (DHEA) on circulating sex steroids, body composition and muscle strength in age-advanced men and women. Clinical Endocrinology, 49(4), 421-432.

5. Nair, K. S., Rizza, R. A., & O'Brien, P. (2006). DHEA in elderly women and DHEA or testosterone in elderly men. New England Journal of Medicine, 355(16), 1647-1659.

DHEA

The role of dehydroepiandrosterone (DHEA) in sports fitness is not yet fully understood, and the use of DHEA as a measure of sports fitness is controversial and not widely accepted. However, some studies have suggested that DHEA levels may be related to muscle strength and endurance, as well as recovery time after exercise.

DHEA is a steroid hormone produced by the adrenal gland, and it is involved in a variety of physiological processes, including the regulation of energy metabolism, immune function, and mood. DHEA levels can be measured through blood tests or saliva tests.

Measuring DHEA levels in saliva or blood may provide information about the body's response to exercise and its ability to recover from exercise-induced stress. Some studies have suggested that higher DHEA levels may be associated with improved muscle strength and endurance, as well as reduced muscle damage and faster recovery times after exercise.

Testosterone

Testosterone: Testosterone is the primary male sex hormone, although it is also present in females in smaller amounts. Testosterone plays a crucial role in muscle mass development, bone density, fat distribution, and red blood cell production. In sports fitness, testosterone is linked to increased strength, power, and endurance, making it a significant factor in athletic performance.

Testosterone levels can also indicate an athlete's state of recovery and overall fitness. Overtraining or inadequate recovery can lead to decreased testosterone levels, which can negatively affect performance. Therefore, monitoring testosterone levels can help athletes optimize their training regimen and ensure they are adequately recovering.

hs-CRP

Measuring salivary hs-CRP levels can be useful for assessing systemic inflammation in athletes, which may be related to sports fitness. Inflammation is a natural response of the body to physical activity and is necessary for muscle repair and growth. However, excessive or chronic inflammation can have negative effects on sports performance and overall health.

Elevated hs-CRP levels in saliva can indicate an inflammatory response to exercise, and monitoring changes in hs-CRP levels over time can provide valuable information about an athlete's recovery and training status. By measuring salivary hs-CRP levels, athletes and coaches can adjust training intensity and duration to optimize performance and prevent injury. However, it's important to note that hs-CRP levels can also be affected by factors other than exercise, such as infection or chronic diseases, and interpreting hs-CRP levels should be done in the context of other measures of sports fitness, such as strength, endurance, and speed.

Overall, salivary hs-CRP measurement is a promising technique for monitoring inflammation in athletes, which can be related to sports fitness, but more research is needed to fully validate its use in sports medicine.

Conclusion

In conclusion, cortisol, DHEA, and testosterone can provide valuable information about an individual's sports fitness. By measuring and monitoring these hormones, sports professionals can assess an athlete's training status, recovery, and overall performance. High cortisol levels can indicate physical stress or overtraining, while optimal DHEA and testosterone levels can support muscle growth, recovery, and enhanced performance. However, it is essential to consider that hormone levels can be influenced by various factors, including age, sex, diet, and sleep. Therefore, monitoring these hormones should be just one aspect of a comprehensive approach to evaluating sports fitness.

To maximize performance and recovery, athletes should work with sports professionals to tailor their training programs, nutrition plans, and recovery strategies based on their individual needs and hormone profiles.

Sources:

• Vingren, J. L., Kraemer, W. J., Ratamess, N. A., Anderson, J. M., Volek, J. S., & Maresh, C. M. (2010). Testosterone physiology in resistance exercise and training. Sports Medicine, 40(12), 1037-1053.

• Hackney, A. C. (2006). Stress and the neuroendocrine system: the role of exercise as a stressor and modifier of stress. Expert Review of Endocrinology & Metabolism, 1(6), 783-792.

Additional Sources:

• Crewther, B. T., Cook, C. J., Cardinale, M., Weatherby, R. P., & Lowe, T. (2011). Two emerging concepts for elite athletes: The short-term effects of testosterone and cortisol on the neuromuscular system and the dose-response training role of these endogenous hormones. Sports Medicine, 41(2), 103-123.

• Hayes, L. D., Bickerstaff, G. F., & Baker, J. S. (2010). Interactions of cortisol, testosterone, and resistance training: influence of circadian rhythms. Chronobiology International, 27(4), 675705.

Vitamin D - Added Test to Sports Fitness

Vitamin D is not a direct measure of sports fitness, but it plays a crucial role in various physiological processes that can impact an athlete's performance, recovery, and overall health. It is a fat-soluble vitamin that is mainly produced in the skin upon exposure to sunlight and can also be obtained through dietary sources.

Some of the ways vitamin D can impact sports fitness include:

1. Bone health: Vitamin D is essential for calcium absorption, promoting healthy bone growth and maintaining bone density. Adequate vitamin D levels can help reduce the risk of stress fractures and support overall musculoskeletal health in athletes.

2. Muscle function: Vitamin D may influence muscle strength and function. Research has shown that low vitamin D levels can be associated with reduced muscle strength, particularly in the lower limbs, which can negatively impact sports performance.

3. Immune function: Vitamin D has been shown to support immune function, which can help athletes maintain their health and reduce the risk of illness that could disrupt their training or performance.

4. Inflammation and recovery: Some studies suggest that vitamin D may have an anti-inflammatory effect, which could aid in recovery after exercise and reduce the risk of injuries.

While vitamin D levels can provide insights into an athlete's overall health, it is not a direct measure of sports fitness. However, maintaining adequate vitamin D levels can contribute to optimal performance, recovery, and overall well-being in athletes. It is essential for athletes to monitor their vitamin D status, especially if they train indoors, live in regions with limited sunlight exposure, or have dietary restrictions that may affect their vitamin D intake.

To assess vitamin D levels, a blood test measuring 25-hydroxyvitamin D [25(OH)D] concentration is typically performed. Based on the results, sports professionals and healthcare providers can recommend appropriate supplementation or lifestyle adjustments to ensure athletes maintain optimal vitamin D levels.

In summary, while vitamin D itself does not directly measure sports fitness, it is an essential factor in maintaining overall health, bone strength, muscle function, and immune function in athletes. Monitoring and maintaining adequate vitamin D levels can contribute to better sports performance and recovery.

Sources:

• Owens, D. J., Allison, R., & Close, G. L. (2018). Vitamin D and the athlete: current perspectives and new challenges. Sports Medicine, 48(Suppl 1), 3-16.

• Larson-Meyer, D. E., & Willis, K. S. (2010). Vitamin D and athletes. Current Sports Medicine Reports, 9(4), 220-226.

• Cannell, J. J., Hollis, B. W., Soren

References

REFERENCES

1. Landman, A. D., Sanford, L. M., Howland, B. E., Dawes, C., & Pritchard, E. T. (1976). Testosterone in human saliva. Experientia, 32(7), 940–941. PubMed ID: https://pubmed.ncbi.nlm.nih.gov/954994/ DOI: https://doi.org/10.1007/BF02003781

2. Pujari, M., Bahirwani, S., Balaji, P., Kaul, R., Shah, B., Daryani, D., & Iqbal, S. (2012). Oral fluid nanosensor test: saliva as a diagnostic tool for oral health. Journal of the California Dental Association, 40(9), 733–736. PubMed ID : https://pubmed.ncbi.nlm.nih.gov/23097828/

3. Bellagambi, F.G., Lomonaco, T., Salvo, P., Vivaldi F., Hangouet, M., Ghimenti, S., Biagini, D., Di Francesco, F. & Fuoco, R. & Errachid, A. (2020). Saliva sampling: Methods and devices. An overview. Trends in Analytical Chemistry. Elsevier. Volume 124, March 2020, 115781

Elsevier ID:

https://www.sciencedirect.com/science/article/abs/pii/S0165993619304182?via%3Dihub DOI: https://doi.org/10.1016/j.trac.2019.115781

4. Rahman, S. A., Kayumov, L., Tchmoutina, E. A., & Shapiro, C. M. (2009). Clinical efficacy of dim light melatonin onset testing in diagnosing delayed sleep phase syndrome. Sleep medicine, 10(5), 549–555. PubMed ID: https://pubmed.ncbi.nlm.nih.gov/18725185/ DOI: https://doi.org/10.1016/j.sleep.2008.03.02

5. Chojnowska, S., Ptaszyńska-Sarosiek, I., Kępka, A., Knaś, M., & Waszkiewicz, N. (2021). Salivary Biomarkers of Stress, Anxiety and Depression. Journal of clinical medicine, 10(3), 517. PubMed ID: https://pubmed.ncbi.nlm.nih.gov/33535653/ DOI: https://doi.org/10.3390/jcm10030517

6. Lewis J. G. (2006). Steroid analysis in saliva: an overview. The Clinical biochemist. Reviews, 27(3), 139–146. PubMed ID: https://pubmed.ncbi.nlm.nih.gov/17268582/

Note – other saliva measurements for sports fitness.

Immunoglobulin A (IgA): IgA is an antibody that plays a role in the immune system's defense against infection. Measuring IgA levels in saliva can provide information about the body's immune function, which can be affected by intense exercise.

Alpha-amylase: Alpha-amylase is an enzyme that is released in response to stress and exercise. Measuring alpha-amylase levels in saliva can provide information about the body's stress response to exercise.

DMG: In urine, DMG levels can be measured through a simple laboratory test called a DMG urine test. This test is commonly used to assess DMG levels in individuals who have suspected metabolic disorders, such as those affecting the breakdown of amino acids.

hs-CRP levels can be useful for assessing systemic inflammation in athletes, which may be related to sports fitness. Inflammation is a natural response of the body to physical activity and is necessary for muscle repair and growth. However, excessive or chronic inflammation can have negative effects on sports performance and overall health.

Elevated hs-CRP levels in saliva can indicate an inflammatory response to exercise, and monitoring changes in hs-CRP levels over time can provide valuable information about an athlete's recovery and training status. By measuring salivary hs-CRP levels, athletes and coaches can adjust training intensity and duration to optimize performance and prevent injury.

However, it's important to note that hs-CRP levels can also be affected by factors other than exercise, such as infection or chronic diseases, and interpreting hs-CRP levels should be done in the context of other measures of sports fitness, such as strength, endurance, and speed.

Overall, salivary hs-CRP measurement is a promising technique for monitoring inflammation in athletes, which can be related to sports fitness, but more research is needed to fully validate its use in sports medicine.

There are several benefits to measuring saliva as a biological sample in sports science and medicine:

1. Non-invasive: Saliva sampling is a non-invasive method of collecting biological samples, which means that it is less painful and less stressful for the individual compared to other methods such as blood sampling.

2. Convenient: Saliva sampling is easy to perform and can be done anywhere, making it a convenient method for collecting samples in sports settings.

3. Cost-effective: Saliva sampling is generally less expensive than other biological sampling methods, such as blood sampling, making it a cost-effective method for collecting samples in large-scale studies.

4. Reproducible: Saliva sampling is highly reproducible, meaning that it can produce consistent results over time, making it a reliable method for assessing changes in biomarkers related to sports performance.

5. Sensitive: Saliva samples can be highly sensitive, meaning that they can detect small changes in biomarker levels, making them a useful tool for monitoring changes in sports performance over time.

Overall, saliva sampling is a valuable method for collecting biological samples in sports science and medicine, and can provide useful information about biomarkers related to sports performance and health.

Drug Testing in Saliva

It's just Saliva. No blood. No needles.

At work or home-based saliva collection kit is all you need to send your test to the lab. We have made the process as simple as possible.

Drug testing can be performed using saliva samples. Saliva drug testing is a non-invasive and convenient method of testing for the presence of drugs in the body.

Saliva drug testing works by detecting the presence of drugs or their metabolites in saliva samples. The test typically involves collecting a small amount of saliva from the mouth using a swab or other collection device.

The sample is then tested using a variety of methods, such as enzymelinked immunosorbent assay (ELISA), gas chromatography-mass spectrometry (GC-MS), or high-performance liquid chromatography (HPLC).

Saliva drug testing can be used to detect a variety of drugs, including marijuana, cocaine, opioids, amphetamines, and benzodiazepines. The detection window for saliva drug testing varies depending on the drug being tested for and the frequency of drug use, but typically ranges from a few hours to a few days.

Advantage of Saliva Testing

Saliva drug testing has several advantages over other types of drug testing methods, such as urine or blood testing. Saliva testing is less invasive than blood testing and can be performed onsite, making it a useful tool for workplace drug testing or roadside drug testing. Additionally, saliva drug testing can detect recent drug use, as drugs and their metabolites can be detected in saliva within minutes of use.

However, there are some limitations to saliva drug testing. The detection window for some drugs may be shorter in saliva than in blood or urine, which can lead to false-negative results. Additionally, the accuracy of saliva drug testing can be affected by factors such as the collection method and the presence of food or drink in the mouth.

Overall, saliva drug testing can be a useful tool for detecting drug use in certain situations, but it should be used in conjunction with other testing methods and should be interpreted in the context of other clinical and behavioral factors.

Is drug testing in saliva approved by regulatory agencies?

Yes, drug testing in saliva is approved by regulatory agencies such as the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA).

In the United States, the FDA has cleared several saliva drug tests for use in various settings, including workplace drug testing and forensic drug testing. These tests are classified as Class II medical devices under the Federal Food, Drug, and Cosmetic Act, and are subject to regulation by the FDA.

Similarly, in Europe, the EMA has approved several saliva drug tests for use in roadside drug testing and workplace drug testing. These tests have been granted Conformité Européene (CE) marking, indicating that they meet the essential health and safety requirements set out in European Union (EU) legislation.

Saliva drug testing is also recognized by various professional organizations as a valid method of drug testing. For example, the Substance Abuse and

Mental Health Services Administration (SAMHSA) in the United States has included saliva drug testing as an approved alternative to urine testing in its Mandatory Guidelines for Federal Workplace Drug Testing Programs. Similarly, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has recommended the use of saliva drug testing for roadside drug testing.

It's important to note that the use of saliva drug testing may be subject to regulatory and legal restrictions in certain jurisdictions, and should be performed in accordance with local laws and regulations. Additionally, the accuracy of saliva drug testing can be affected by various factors, such as the collection method, the type of drug being tested, and the frequency of drug use. Therefore, it's important to use saliva drug testing in conjunction with other testing methods and to interpret the results in the context of other clinical and behavioral factors.

References and Sources

1. U.S. Food and Drug Administration. "Medical Devices." Accessed October 22, 2021. https://www.fda.gov/medical-devices .

2. European Medicines Agency. "Medical Devices." Accessed October 22, 2021. https://www.ema.europa.eu/en/human-regulatory/overview/medical-devices

3. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. "Mandatory Guidelines for Federal Workplace Drug Testing Programs." Accessed October 22, 2021. https://www.samhsa.gov/workplace/resources/drugtesting/mandatory-guidelines .

4. European Monitoring Centre for Drugs and Drug Addiction. "Drug Testing in Oral Fluid."

Accessed October 22, 2021. https://www.emcdda.europa.eu/publications/topicoverviews/drug-testing-in-oral-fluid_en

5. Vindenes, V. et al. "Oral fluid drug testing in Norway - An overview of the results from the first three years." Forensic Science International. 2014; 246: 97-106.

6. Kintz, P. "Saliva as a matrix for drug testing: physiological and pathological factors affecting interpretation." Journal of Chromatography B. 2002; 797(1-2): 267-277.

7. Huestis, M.A. et al. "Cannabinoid disposition in oral fluid after controlled smoked cannabis." Clinical Chemistry. 1996; 42(5): 757-763.

8. Lee, D. et al. "Saliva as a non-invasive specimen for detection of illicit drugs in drug treatment patients." Journal of Substance Abuse Treatment. 2004; 27(1): 59-65.

9. Cone, E.J. et al. "Oral fluid testing for drugs of abuse." Clinical Chemistry. 1997; 43(11): 1915-1933.

10. Wang, M. et al. "A liquid chromatography-tandem mass spectrometry method for the simultaneous quantification of THC, THC-COOH, CBD, and CBN in oral fluid." Journal of Analytical Toxicology. 2014; 38(7): 390-395.

Overall, these sources and citations demonstrate that drug testing in saliva is an approved and recognized method of drug testing in various settings, including workplace drug testing and forensic drug testing. However, the accuracy of saliva drug testing can be affected by various factors, and should be used in conjunction with other testing methods and interpreted in the context of other clinical and behavioral factors.

What Drugs can be Tested in Saliva with GC/MS

Gas chromatography-mass spectrometry (GC-MS) is a highly sensitive and specific analytical method that can detect and quantify a wide range of drugs and their metabolites in various biological matrices. The following is a more detailed list of drugs that can be detected using GC-MS:

1. Amphetamines: GC-MS can detect amphetamines such as amphetamine, methamphetamine, and MDMA (ecstasy).

2. Opioids: GC-MS can detect opioids such as morphine, codeine, oxycodone, fentanyl, and tramadol.

3. Cocaine and its metabolites: GC-MS can detect cocaine and its metabolites, such as benzoylecgonine, ecgonine methyl ester, and cocaethylene.

4. Cannabinoids: GC-MS can detect cannabinoids such as THC (tetrahydrocannabinol) and CBD (cannabidiol).

5. Benzodiazepines: GC-MS can detect benzodiazepines such as diazepam, alprazolam, and lorazepam.

6. Barbiturates: GC-MS can detect barbiturates such as phenobarbital, butalbital, and amobarbital..

7. Antidepressants: GC-MS can detect antidepressants such as fluoxetine, amitriptyline, and sertraline.

8. Antipsychotics: GC-MS can detect antipsychotics such as haloperidol, olanzapine, and risperidone.

9. Anticonvulsants: GC-MS can detect anticonvulsants such as carbamazepine, phenytoin, and valproic acid.

10.Stimulants: GC-MS can detect stimulants such as methylphenidate, modafinil, and ephedrine.

Executive Managers and Owners of Purity Laboratories

Zahara Kashi PhD, HCLD | Laboratory Director

Zahra Mehdizadeh Kashi, PhD, HCLD, is a board-certified molecular immunohematologist with over 33 years of experience in clinical laboratories with extensive leadership. Dr. Kashi completed her undergraduate studies in Clinical laboratory Science (CLS) at Oregon Health & Sciences University (OHSU). Dr. Kashi pursued her graduate studies by attending Portland State University (PSU), where she obtained her Masters degree in Immunology. Dr. Kashi obtained her doctorate degree in molecular immunohematology from Portland State University, and completed her doctoral thesis under the mentorship of Dr. Michael Heinrich at Oregon Health Sciences University. She also completed the Michigan Ross Executive MBA Program at the University of Michigan.

Shortly after graduation, she successfully obtained her Board certification and was appointed as the Histocompatibility Laboratory Director of the American Red Cross. It was during this tenure that she

Zahara Kashi PhD, HCLD Laboratory Director

recognized there were unmet transplant/transfusion-related needs in the Histocompatibility community. Consequently, despite the progressive advancement of responsibilities in her career with the ARC, Dr. Kashi proceeded with establishing another clinical laboratory (Kashi Clinical Laboratories) to better support cellular therapy advancements. Her goal was to offer services that provided better patient care before and after transplantation. She is currently serving as the Director and Clinical Consultant of both laboratories.

Dr. Kashi has managed a quality operation in the field of transplantation and transfusion support for over 33 years. Her main research interest is the role of histocomatibility molecules in the pathophysiology of Transfusion-Related Acute Lung injury (TRALI); she has multiple publications on the topic.

Dr. Kashi has significant expertise in clinical laboratory development, quality system auditing, GMP development, project management, regulatory compliance, strategic planning and business development. She is a highly sought clinical laboratory consultant, with dozens of peer-reviewed publications and abstracts, as well as numerous invited presentations.

Dr. Kashi is active in various regulatory agencies including the American Society of Histocompatibility & Immunogenetics (ASHI), College of American Pathologists (CAP) and American Association of Blood Banks (AABB) where she has served in many roles ranging from inspecting laboratories to serving on the Board of Directors.

In addition, Dr. Kashi has served as a clinical assistant professor in the department of pathology/CLS at Oregon Health & Science University and has held a number of other education and research positions at local universities, hospitals, and corporations.

Kulani Mahikoa | President

Kulani Mahikoa is President of Purity Laboratories, Inc. She has had successful careers both as a journalist and as an entrepreneur.

After graduating from Lewis and Clark College, she worked for the Oregonian, KATU-TV and Community Press Newspapers in Portland, Oregon.

Ms. Mahikoa also lived in Honolulu, Hawaii where she started Hawaiiana Products, that manufactured fragrances and bath products. That company was sold to General Atlantic Corporation, a major stock holder of Duty Free International.

She also founded Honolulu Premium Products, which became Maui Gold, Inc., the country's largest manufacturer of gemstone rings and also sold a range of products from country themed promotions to stuffed animals and luggage. Honolulu Premium Products won the distinction of being named one of the top companies in Hawaii by Hawaii Business magazine after only

Kulani Mahikoa | President

seven years in business and was also named by Inc. magazine to its list of 500 fastest growing companies in the nation for four consecutive years. She served as President of Maui Gold, Inc., until she and her partner-husband David Humphrey sold the company to the international conglomerate, Jardine Matheson of Hong Kong.

David Humphrey, JD | CEO

David Humphrey is a distinguished attorney and CEO with a focus on children's health, particularly special needs children. As a National Board Member of THE FORUM INSTITUTE and ACT Today!, he co-founded the Autism Treatment Network (ATN) and the physician training group, Medical Academy of Pediatric Special Needs (MAPS). Currently, he is involved in the P2i project, aimed at creating safer pregnancy protocols and promoting healthier babies.

After graduating from the University of Washington School of Law, Humphrey, a MENSA member, founded The Humphrey Corp, which became the world's largest manufacturer of promotional "Frisbees." As an environmental attorney, he founded the Public Interest Research Group (PIRGs) alongside renowned environmentalist Ralph Nader, laying the foundation for a nationwide PIRGs that significantly contributed to implementing environmental laws and protection in the US.

Humphrey has held executive positions in the Autism Society of America and the Autism Research Institute. As the former President and owner of Kirkman Group, Inc., he has led various businesses, including a pharmaceutical/nutraceutical company and Purity Laboratories, a CLIAcertified clinical and ISO 17025 environmental laboratory specializing in Mass Spectrometry (MS) and non-invasive dry fluid spot testing services.

Throughout his career, Humphrey has received numerous accolades, such as being named one of Inc. magazine's "500 Fastest Growing Companies in the Nation" and one of Oregon Business magazine's "Top 100 Companies to Work for in Oregon" and "Top 100 Green Companies." He has also been a partner and "of counsel" in several law firms in Oregon and Hawaii.

David Humphrey, JD