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Guide to Pathology tests

Conditions Chart

This reference guide may be useful in some clinical situations. The suggested investigations are neither comprehensive nor are they applicable in all circumstances. Tests should be selected upon consideration of the patient’s clinical history, signs, symptoms and previous test results.

For further information, please contact our pathologists, senior scientists or refer to The Royal Collage of Pathologists of Australia manual at www.rcpamanual.edu.au

 

Acne

 
CDSA Important to determine if there is malabsorption or dysbiosis, which may influence the expression of skin symptoms such as acne
FLDP Impaired liver detoxification can result in increased elimination of toxins via the skin
IP Altered intestinal permeability (leaky gut) allows toxins to enter the blood and may cause or exacerbate skin conditions including acne
BHP/FHP

Monitoring testosterone status is an important factor in treatment of acne. High testosterone levels may indicate increased levels of dihydrotestosterone, which can cause the increased sebum and keratin production seen in acne

IgG Food sensitivities can increase intestinal permeability and gut dysbiosis which will both contribute to acne 
VA Vitamins A, C, E and B6 are important in maintaining skin health; there may be deficiencies of any of these vitamins in cases of acne
HMA Acne is associated with an excess of Cu and deficiencies of Zn, Cr, Se.  Zn is particularly important in skin health as zinc deficiency results in increased conversion of testosterone to dihydrotestosterone increasing sebum and keratin production

Adrenal Exhaustion

AHP Altered levels of Cortisol and DHEA-S are indicative of acute and/or chronic stress which can  result in adrenal exhaustion and immune supression
FLDP Adrenal exhaustion may be the result of increased toxic load and compromised liver function
sIgA Given the role of stress in adrenal exhaustion, it may also be relevant to investigate Secretory IgA levels which are sensitive to stress. Early detection of altered sIgA may help to protect the gut from infection associated with reduced levels.
VA Adrenal exhaustion may be related to vitamin deficiency. Vitamin C and the B group vitamins, particularly B5 and B6 support adrenal function and the stress response
MA Mineral deficiency may also play a key role in adrenal exhaustion. Magnesium is the major mineral associated with exhaustion, and minerals such as calcium, zinc and iron are also worth investigating

AIDS

 
CDSA Diarrhoea, poor digestion and malabsorption are common in AIDS sufferers
FLDP Efficient Phase  I and II liver detoxification is critical to proper metabolism of hormones, and clearance of drugs, toxins and free radicals
IP Intestinal permeability is common in AIDS patients. This results in increased levels of toxins and other chemicals into the blood, as well as poor absorption of nutrients
TAS Assessment of antioxidant status in AIDS patients is important as increased levels of free radical activity is common and may cause secondary tissue damage
sIgA Secretory IgA is the first line of defence for the immune system and provides a major line of defence against pathogens in the gut and respiratroy tract
HMA Toxic metal accumulation will deplete essential minerals and compromise immune function
AHP Low levels of Cortisol and DHEA-S will compromise immune function
BHP/FHP Low testosterone levels are common in both male and female AIDS patients which may contribute to fatigue and loss of muscle mass

Alcohol Overindulgence/Alcoholism

FLDP Compromised Phase I and II liver detoxification is common leading to increased levels of free radicals which may cause secondary tissue damage/inflammation
CDSA Disturbance of intestinal microflora can lead to malabsorption of macronutrients and vitamins 
IP Excess alcohol increases intestinal permeability allowing toxins to enter the bloodstream
TAS Poor detoxification can cause oxidative stress and cell damage, hence it is important to assess total antioxidant status
AA Alcoholics develop problems with amino acid metabolism causing imbalances (e.g. low levels of the serotonin precursor tryptophan which leads to depression and sleeping problems)
VA Increased loss of the water soluble B vitamins and vitamin C can cause deficiencies. Deficiency of the fat soluble Vitamin A is also common due to impaired absorption. Folic acid deficiency is very common in alcoholics
HMA Increased loss of minerals (e.g. Mg, Zn) and impaired absorption (e.g. Zn) can lead to chronic deficiencies
NTx Alcohol dependency may be associated with increased risk of osteoporosis, particularly in females

Allergies

 
IgG Food sensitivity may underlie a number of allergic/atopic conditions including eczema, asthma, hayfever and migraine
IP Altered intestinal permeability will contribute to increased antigenic load
CDSA Poor digestion, gut dysbiosis and malabsorption will all increase antigenic load in the body
sIgA Maintaining sufficient production of sIgA is essential to support host defence mechanisms in the gut and protect gut-barrier function to reduce the incidence/likelihood of allergic reactions
FLDP Poor liver function wil contribute to increased antigenic load and sensitivity to dietary and environmental chemicals

Alopecia

 
BHP/AHP High levels of testosterone may indicate high levels of dihydrotestosterone (DHT), which is responsible for male pattern baldness (especially with Zn deficiency). Another factor may be elevated cortisol levels as a result of prolonged stress
CDSA Optimal GIT function is important for maintenance of adequate levels of  essential nutrients, which may be compromised by poor digestion, malabsorption, and dysbiosis.
FLDP Impaired liver detoxification and hence increased levels of toxins and inefficient hormone metabolism may lead to hair loss
IP Altered intestinal permeability may permit increased absorption of toxic metals 
THP Low levels of free T3 (the active thyroid hormone) may be a cause of hair loss
HMA Hair loss may be affected by the ratio of Cu to Zn. Low levels of Zn give rise to increased conversion of testosterone to DHT and also allows increased absorption of Cu, of which high levels are associated with hair loss
TM High serum and urine levels of toxic metals (Hg, Cd, and As) are associated with hair loss
AA Hair loss can be a consequence of l-lysine deficiency

Alzheimer's

 
CDSA Optimal GIT function is important for maintenance of adequate levels of  essential nutrients, which may be compromised by poor digestion, malabsorption, and dysbiosis
FLDP Impaired Phase I and II liver clearance of toxic metals may contribute to cognitive dysfunction
IP Altered intestinal permeability may permit increased absorption of toxic metals 
BHP Oestrogen imbalance in post-menopausal women may influence cognitive and memory function
HMA Provides assessment of long term levels of toxic metals in tissues, e.g. high levels of Cu can lead to low levels of zinc and reduced cognitive function and memory loss
CHEL Toxic metal accumulation (particularly Al, Hg and Pb) is shown to be relevant in the development of Alzheimer's.Chelation analysis provides information on urinary clearance and efficacy of chelation therapy
EFA The proper levels and balance of n-3/n-6 essential fatty acids are required for normal cognitive function
AA Amino acid imbalances (e.g. glutamic acid deficiencies) can cause symptoms such as memory loss
VA Deficiencies of vitamins B6, B12 and folic acid may cause elevated levels of homocysteine and are related to cognitive dysfunction
TM Provides assessment of recent exposure to toxic metals
TAS Low antioxidant status will allow increased free radical damage to neurons

Amenorrhoea

FHP/BHP It is important to assess the balance of oestradiol, progesterone, testosterone, and DHEA throughout the cycle. Also, melatonin is a marker of severe hypothalamic amenorrhea
THP It is important to assess levels of thyroid hormones as sex hormone metabolism may be linked to thyroid function 
FLDP Efficient Phase I and II liver detoxification is critical for proper metabolism of hormones
NTx Cross-linked N-telopeptide is a marker of calcium resorption and hence ultimate risk of osteoporosis, which may be a result of an oestrogen deficiency
EFA Athletic amenorrhoea is commonly related to poor nutrition, particularly essential fatty acid deficiencies
AA Low protein intake (or poor protein combining) will result in amino acid imbalances that may contribute to amenorrhoea

Anaemia

 
CDSA Assessment of gastrointestinal function is important as malabsorption (e.g. due to low stomach acidity) is a common cause of anaemia
3DP It is important to screen for parasites, such as Blastocystis hominis, which uses Fe as a nutrient source
IP High intestinal permeability wil contribute to poor absorption of iron, folic acid and vitamin B12
HMA Cu deficiency may reduce Fe absorption and retention. Absorption of toxic metals (e.g. Cd) may be increased with low levels of Fe 
VA Deficiencies of the vitamins B12 and Folic acid may cause macrocytic anaemia, and vitamin C deficiency may be associated with poor Fe absorption
FLDP Compromised liver function will inhibit absorption of crucial minerals such as iron and B group vitamins

Anorexia

 
FHP/BHP Delayed menarche or prolonged amenorrhea is common in anorexic females. The balance of adrenal (increased cortisol) and sex hormones (low oestradiol) may be disturbed and nocturnal melatonin levels elevated
CDSA Optimal gastrointestinal function is important to ensure levels of essential nutrients (e.g. Zn) are not compromised by poor digestion, malabsorption, or dysbiosis. Healthy intestinal microflora contributes to immunity
FLDP Decreased glutathione synthesis in patients with anorexia nervosa may cause impaired trans-sulfuration in Phase II detoxification, hence reduced capacity to detoxify electrophilic metabolites and reactive oxygen species. Conversely, reduced liver function may be a cause of appetite loss
IP It is important to assess gastrointestinal mucosal integrity in cases of anorexia, as there is reduced nutrient supply to the cells, leading to mucosal atrophy and hence increased permeability to bacteria and endotoxins
HMA Zn deficiency is common in anorexia. Levels of other nutrient minerals may also be low due to malnutriton 
3DP Loss of appetite may be a symptom of an infestation by intestinal parasites (e.g. Dientamoeba fragilis, Blastocystis hominis)
NTx Anorexia nervosa increases the risk of osteoporosis

Anxiety

 
AHP Anxiety is commonly stress-related, the impact of which can be assessed by measuring the levels of Cortisol and DHEA-S over a 24 hour period
MEL Reduced melatonin levels are also associated with anxiety, and can be related to Mg deficiency
BHP/FHP Sex hormone imbalance is common in conditions of anxiety and stress, e.g. progesterone has anxiolytic properties, whereas oestradiol has anxiogenic effects. 
FLDP Compromised Phase I and II liver detoxification may contribute to anxiety, as the liver plays a critical role in the metabolism of hormones and clearance of toxins
IP Stress and anxiety may cause increased intestinal permeability, which may lead to increased levels of toxins in the blood
rT3 During times of increased stress, higher levels of reverse T3 (rT3) are produced, resulting in reduced conversion of T4 to T3
VA The B group vitamins are essential for nervous system function. Deficiencies of these, particularly B5 and B6 are common in anxiety
HMA Anxiety may be caused by mineral deficiencies, particularly Mg, and elevated levels of toxic metals such as Hg, Cd and Pb
AA Deficiency of certain amino acids (e.g. tryptophan, glutamine, tyrosine etc.) may result in altered neurotransmitter function which will contribute to anxiety
THP Anxiety may be exacerbated by reduced levels of active thyroid hormones, such as free T3

Asthma

 
IgG IgG food sensitivity testing can identify foods which may be causing asthma symptoms 
CDSA The GIT is the first line of defence against food antigens, so optimal gastrointestinal function is important in reducing the likelihood of food sensitivities which may contribute to asthma symptoms. Healthy intestinal microflora also make an important contribution to GIT barrier properties and immunity
FLDP Impaired liver detoxification may result in a higher antigenic load and the increased production of free radicals and tissue damage, which may contribute to the symptoms of asthma
IP Altered intestinal permeability (which may be related to food sensitivities) allows antigens and other molecules to enter the blood stream, which may trigger asthma
EFA A high ratio of n-6:n-3 fatty acids may contribute to asthma due to the balance between pro-inflammatory and anti-inflammatory mediators
HMA Deficiencies in the minerals Zn, Se, and Cu, which are cofactors in antioxidant mechanisms (e.g. Se and glutathione peroxidase) and elevated Na may contribute to asthma symptoms

Atherosclerosis

TAS Oxidised LDL cholesterol is a major component of atherosclerotic plaque. Determining total antioxidant status is crucial in preventing oxidative damage
CoQ10 Coenzyme Q10 may help to prevent Atherosclerosis (by preventing the oxidation of LDL Cholesterol)
EFA Excessive Arachidonic Acid may increase the risk of atherosclerosis due to its role as a precursor to Prostaglandin E2 and Thromboxane A2 synthesis. This can be countered by the presence of greater levels of n-3 EFAs. An EFA analysis provides important information on EFA ratios
AA Homocysteine is a significant independent risk factor in the development of atherosclerosis
FLDP The liver plays an important role in fat metabolism. Compromised liver function will impair this and also contribute to greater free radical generation and subsequent tissue damage
CHEL Toxic metal accumulation will contribute to the oxidation of LDL cholesterol. Chelation analysis provides information on the urinary clearance of toxic metals and monitors effectiveness of chelation therapy

Attention Deficit/ 

Hyperactivity Disorder (ADHD) 

 
IgG Sensitivities to certain foods may influence behaviour
IP Increased intestinal permeability will result in increased absorption of xenobiotics and toxic metals (e.g. Pb) which may contribute to symptoms
EFA Deficiencies of both n-3 and n-6 essential fatty acids are associated with ADD and hyperactivity in children
AA Symptoms may be caused by deficiencies of amino acids, such as the neurotransmitter precursors tyrosine and tryptophan
HMA Assesses long term CNS effects of toxic metal (Pb) accumulation and deficiencies of nutritional elements (including Mg, Ca, K), which also affect CNS function
TM Pb toxicity is related to CNS effects. A blood analysis for toxic metals is ideally used in acute situations to determine the level of recent exposure and toxicity
VA Deficiencies of vitamins, such as B1, B3, B6, and C, can contribute to cognitive dysfunction

Autism

 
IgG Food sensitivities are common in cases of autism
IP Increased intestinal permeability will result in increased absorption of xenobiotics and toxic metals (e.g. Pb) which may contribute to symptoms
CDSA Dysbiosis is often found in autism patients. Digestive enzyme production is often also compromised which may be responsible for nutritional deficiencies associated with autism
EFA Abnormal fat metabolism is common in autism resulting in essential fatty acid deficiencies, with a higher than normal n-6:n-3 ratio
AA Amino acid deficiencies are common, e.g. methionine (important in toxic metal metabolism). These deficiencies can be exacerbated by restricted diets, so it is important to check their levels (e.g. neurotransmitter precursors, tyrosine and tryptophan)
TM High levels of toxic metals are seen in autism 
HMA Hair mineral analysis can be used to assess long term nutrient deficiencies and toxic metal accumulation which may contribute to impaired neuronal development ( a potential consequence of defective metallothionein metabolism and regulation of toxic metals)
FLDP Impaired liver detoxification will contribute to increased sensitivity to many chemicals which may trigger symptoms

Biliary Cirrhosis

FLDP Much of the liver damage associated with cirrhosis is caused by free radicals from lipid peroxidation and oxidative stress as a result of glutathione depletion in the liver. Ensuring adequate Phase I and Phase II liver detoxification and support is therefore essential
TAS Antioxidants are necessary to reduce the oxidative damage seen in biliary cirrhosis
AA Arginine, taurine and the branched chain amino acids may all be useful in supporting liver detoxification and the management of biliary cirrhosis
MA Patients with biliary cirrhosis are found to have deficiencies in Mg, Se and Zn
EFA An EFA Profile is useful for determining imbalances that may be contributing to inflammation

Bipolar Disorder 

AHP The impact of stress and consequent changes in Cortisol and DHEA-S levels are an important consideration in the management of bipolar disorder
BHP/FHP Hormonal imbalances, particularly in women,may contribute to manic episodes in bipolar disorder
FLDP Poor liver detoxification and increased antigenic load will exacerbate this condition
THP Hypothyroidism may be an important underlying factor in bipolar disorder
TM The accumulation of toxic metals may further contribute to symptoms of bipolar disorder
MA Magnesium deficiency is common in bipolar patients

Bone Fractures

NTx Cross-linked N-telopeptide (NTx) is an indicator of bone resorption, high levels can indicate reduced bone mineral density
FHP The correct balance of testosterone and oestrogens are essential to maintaining bone mineral density
2 & 16 An increased ratio of 2- and 16-oestrogen metabolites may indicate osteoporosis risk in females due to oestrogen deficiency
HMA Elevated levels of Cd interferes with Ca uptake and vitamin D metabolism
AA Deficiencies of amino acids such as proline, lysine and cysteine will reduce bone strength and integrity
EFA EFAs are required for the collagen matrix supporting bone

Bowel Cancer 

CDSA Chronic constipation, gut dysbiosis and deficiency of short chain fatty acids such as butyrate for the colonic epithelium are all associated with an increased risk for bowel cancer
FLDP Impaired Phase I and II liver detoxification will increase the potential for oxidative damage and also contribute to poor fat metabolism associated with bowel cancer
IP Altered intestinal permeability results in increased absorption of toxins and reduced absorption of minerals
TAS Bowel cancer may be associated with the cellular damage caused by reactive oxygen species
sIgA Maintaining an adequate daily production of Secretory IgA is essential to mucosal immunity and the proliferation of protective microflora 
IgG Chronic food sensitivity and related GIT damage and inflammation may be a contributing factor to bowel cancer and an important treatment consideration

Breast Cancer

FHP/BHP It is important to assess the balance of sex hormones, as excessive oestrogens may cause over stimulation of the breast tissue leading to cancer. Reduced levels of progesterone may also be important as it limits the effects of excess oestrogen. Hormone replacement therapy and the oral contraceptive pill may also increase the risk of breast cancer.  
2 & 16 The ratio between the oestrone metabolites should be investigated, as high levels of 16-alpha-hydroxyoestrone relative to 2-hydroxyoestrone may be associated with a higher risk of oestrogen dependant cancers
THP Assessment of thyroid hormone status is important because breast cancer may be associated with thyroid imbalance
rT3 Increased levels of reverse T3 (rT3) are produced under stress, resulting in reduced conversion of T4 to T3
FLDP Impaired Phase I and II liver detoxification may contribute to hormone imbalance associated with breast cancer
CDSA  Maintaining optimal gut function is an important consideration where hormone levels are affected
TAS Breast cancer may be associated with the cellular damage caused by reactive oxygen species
EFA The balance between n-3 and n-6 fatty acids may play a role in breast cancer, with n-3 fatty acids providing a protective effect
CoQ10 Coenzyme Q10 deficiency may be linked to breast cancer
VA Deficiencies in vitamin A and the antioxidant vitamins C and E may be associated with breast cancer
HMA A deficiency of Se (impaired activity of glutathione peroxidase) may be associated with breast cancer

Cancer

 
FLDP Impaired Phase I and II liver detoxification will increase the potential for oxidative damage associated with cancer
TAS All cancers may be associated with the cellular damage caused by reactive oxygen species
AHP The relationship between cancer and stress is well established. Investigation of the level of the major stress hormones, Cortisol and DHEA-S is therefore essential
MEL Melatonin is a powerful antioxidant
TM Toxic metal accumulation will displace essental protective minerals (eg Cd from cigarette smoke displaces Zn) and may be an important factor in the development of many cancers

Candidiasis

 
CDSA Optimal gastrointestinal function protects against dysbiosis. The CDSA screens for all yeasts including candida species
IP Altered intestinal permeability may be a consequence of a diet high in refined carbohydrate, which will also increase the likelihood of additional food sensitivities, poor nutrient absorption and increased antigenic load
sIgA Assessing the levels of sIgA is essential in Candidiasis as a high daily production will help to reduce Candida organisms and favour the proliferation of protective microflora
IgG Sensitivity to carbohdyrates and yeasts is common and may increase the likelihood of additional food sensitvities
FLDP Poor liver detoxification will result in poor clearance of yeasts, sugars and other dietary antigens which may contribute to Candidiasis. An FLDP is particularly recommended in chronic Candidiasis

Cardiovascular Disease (CVD)

TAS Antioxidants may protect against oxidative CV damage
CoQ10 Coenzyme Q10 provides antioxidant protection and may also improve vascular function and lower blood pressure
EFA The omega-3 fatty acids, Eicosapentaneoic (EPA) and docosahexaneoic acid (DHA) acids may protect against atherosclerosis, heart attack and stroke
AA Imbalances in amino acid levels may affect metabolism of carbohydrates and lipids. 
FLDP Efficient Phase I and II liver detoxification is critical to proper metabolism of hormones, drugs and xenobiotics whose accumulation may cause damage to the cardiovascular system 
VA Vitamins B6, B12, and folate are essential for homocysteine metabolism. Vitamins C & E  may provide HDL protection
BHP Normal levels of testosterone in men and oestrogen in women are important for optimal heart function. 
AHP Cortisol and DHEA-S are markers of hypertensive stress. 
MEL Melatonin may provide cardiovascular protective effects
TM Elevated levels of toxic metals can contribute to CVD (e.g. Hg, Pb, Cd)
HMA Chronic mineral deficiencies and high levels of toxic metals are associated with CVD
THP Hypothyroidism may be the underlying cause if high levels of Triglycerides are found (TG  test)?
CDSA Optimal GIT function is important so that levels of essential nutrients are not compromised nor levels of xenobiotics elevated by poor digestion, malabsorption, and dysbiosis. Assessment includes triglycerides and cholesterol
C-RP C-reactive protein is a powerful risk factor and predictor of CVD
Hom High homocysteine levels are associated with CVD
Apo Apo A-1 and Apo-B  are  predictors of coronary atherosclerosis 
Fib High levels of fibrinogen (clotting factor I) are associated with inflammation and may increase risk of CVD
TG Abnormally high triglyceride levels may indicate other conditions such as hypothyroidism, liver cirrhosis, pancreatitis, or diabetes

Coeliac Disease

CDSA Malabsorption, maldigestion, and dysbiosis are common with coeliac disease
IP Altered intestinal permeability is a consequence of the immune response to gluten, which causes impaired nutrient absorption and increased uptake of toxic metals
IgG Sensitivities to other foods (e.g. cows' milk) should also be considered
HMA Coeliac disease  results in a number of nutrient deficiencies such as Zn, Fe, Mg and Ca and may increase the risk of toxic metal accumulation
sIgA sIgA defends mucosal surfaces against pathogenic invasion and low levels will contribute to the inflammatory response in coeliac disease, particularly when there is altered intestinal permeability
Glia The presence of gliadin antibodies is a useful marker for coeliac disease
TTg The presence of tissue transglutaminase antibodies is a reliable indicator for the diagnosis of coeliac disease
Fe Plasma Iron deficiency is common in patient's with coeliac disease

Cholesterol (High/Hpercholesterolaemia)

EFA The EFA analysis is an ideal way to detect EFA deficiency. Omega 3 PUFAs in particular have a considerable influence on the synthesis and clearance of lipoproteins, especially VLDL and chylomicrons
FLDP The liver is the major regulator of plasma LDL cholesterol. Compromised liver function may contribute to the accumualtion of high cholesterol and triglycerides in the blood and may be an important underlying factor to investigate in hypercholesterolaemia
BHP High levels of testosterone and low oestrogen can promote high cholesterol
AA The Sulphur-containing amino acids, particularly methionine, cysteine and taurine are required to support liver clearance of fats and prevent the accumulation of cholesterol
TAS As the oxidation of LD cholesterol is the chief feature in heart disease, it is essential to ensure total antioxidant status is sufficient to protect against free radical species

Colitis/Ulcerative Colitis

CDSA Intestinal dysbiosis is common in colitis. Inflammation may also cause maldigestion and malabsorption
IP Altered intestinal permeability is common in Crohn's disease and damaged intestinal mucosa more permeable to antigens and toxins which contribute to inflammation
VA, MA Chronic malabsorption can lead to vitamin and mineral deficiencies
IgG Food sensitivities are common and may increase inflammation and intestinal permeability
sIgA Stress reduces Secretory IgA which is necessary to protect the gut from infection and inflammation

Constipation

CDSA A complete assessment of digestion, absorption, intestinal function and microbial flora as well as identifying pathogens is recommended 
IP Altered intestinal permeability is common in chronic constipation and damaged intestinal mucosa more permeable to antigens and toxins which may increase the load on the bowel
FLDP Constipation will create additional burden on the liver and compromised liver function in turn will contribute to constipation
IgG Food sensitivities are common and may lead to poor digestion and reduced transit time
sIgA Suffcient levels of Secretory IgA are required to protect against pathogens which may proliferate in chronic constipation
VA, MA Chronic constipation will contribute to nutrient deficiencies over time

Crohn's Disease

CDSA Intestinal dysbiosis is common in Crohn's disease. Inflammation may also cause maldigestion and malabsorption
IP Altered intestinal permeability is common in Crohn's disease and damaged intestinal mucosa is more permeable to antigens and toxins which contribute to inflammation
IgG Food sensitivities are common and may increase inflammation and intestinal permeability
sIgA Stress reduces Secretory IgA which is necessary to protect the gut from infection and inflammation
EFA Chronic inflammatory response may result from essential fatty acid deficiencies and imbalances. A high n-6:n-3 ratio may cause elevated levels of pro-inflammatory metabolites
NTx Reduced bone mineral density is common and may be caused by corticosteroid treatment and dysfunctional Ca metabolism
VA Chronic malabsorption can lead to vitamin deficiencies, particularly the B group vitamins
TAS Free radical endothelial damage may occur as a result of low antioxidant levels
MA Test for recent imbalances in critical elements (e.g. Se, Cu, Zn)
HMA Test for chronic deficiencies of critical elements (e.g.  Se, Cu, Zn, Fe)
Fe General pathology testing for Fe and Hb is imporatant, as iron deficiency anaemia is common in Crohn's disease

Cystic Fibrosis

CDSA Test for pancreatic insufficiency (pancreatic elastase). Malabsorption/maldigestion of cholesterol, long and short chain fatty acids, and triglycerides in stool is common
FLDP Impaired Phase I and II liver detoxification and reduced glutathionation may increase antigenic load 
IP Altered intestinal permeability is common in cystic fibrosis, affecting nutrient absorption and further compromising health
IgG Food sensitivities are common, exacerbating problems with malnutrition
sIgA Low levels of sIgA will result in reduced mucosal immunity
TAS Cystic fibrosis may be aggravated by the cellular damage associated with oxidative stress
EFA Essential fatty acid deficiency or imbalance (e.g. low levels of n-3 fatty acids) may cause increased inflammation due to high levels of the pro-inflammatory leukotrienes and prostaglandins
MA Zinc deficiency is common as impaired pancreatic function reduces absorption. Low selenium levels are also found in cystic fibrosis patients, with implications for reduced antioxidant activity
HMA Zinc, magnesium, and manganese deficiencies are common in cystic fibrosis. Altered intestinal permeability may also lead to elevated levels of toxic metals
VA Deficiencies of vitamins C, E, B1, B6, B12, and Folic acid are common
AA Impaired protein digestion and methionine metabolism may be responsible for reduced levels of glutathione in the lungs, and hence chronic inflammation and oxidant/antioxidant imbalance

Depression

 
AHP Imbalance of the adrenal hormones Cortisol and DHEA-S may contribute to depression
BHP/FHP Imbalance of the sex hormones may contribute to depression
THP Subclinical hypothyroidism may be a cause of depression
rT3 Increased rT3 production occurs during periods of stress
FLDP Impaired Phase I and II liver detoxification may contribute to hormone imbalance associated with depression
AA Amino acid imbalances, such as tryptophan deficiency and hence reduced levels of the neurotransmitter serotonin, may cause depression
EFA Low levels of n-3 fatty acids or high n-6:n-3 ratios are common in patients with depression
VA The B group vitamins are essential for nervous system function. Deficiencies of these, particularly B2, B3, B5 and B6 are common in depression
CDSA Depression can be caused by nutrient and vitamin deficiencies, which can result from malabsorption due to digestive problems. Poor gut function may also cause disruption of hormone levels
IP Altered intestinal permeability may permit increased absorption of toxic metals such as Pb which may contribute to depression
HMA Deficiencies of minerals involved in nerve function (e.g. Zn, Mg, Ca, K) may contribute to depression. Se deficiency may also be important to consider due to its role in thyroid function
TM Toxic metal accumulation (e.g. Hg, Pb) may contribute to depression
IgG Food sensitivities may be associated with depression
Glu & Ins Depression is common in diabetes 

Dermatitis/Eczema

IgG Food sensitivities should be investigated in all cases of dermatitis and eczema. 
EFA Imbalances in essential fatty acids can result in an excess of the pro-inflammatory metabolites, and overall deficiencies may be responsible for dry and itchy skin
CDSA Gastro-intestinal inflammation is common with eczema, as well as malabsorption, dysbiosis, and pancreatic insufficiency.  
FLDP Impaired Phase I and II liver detoxification may contribute to hormone imbalance and antigenic load which may be associated with dermatitis/eczema
IP High intestinal permeability results in impaired absorption of essential nutrients and increased absorption of antigenic compounds which may exacerbate skin problems
HMA Mineral deficiencies may also contribute to skin problems. Low levels of Zn are common in eczema patients. Zn, Mg and vitamin B6 are essential for the production of delta-6-desaturase, a critical enzyme in fatty acid metabolism
TAS The antioxidant nutrients, particularly vitamins A,C and E are essential for protecting the skin from irritants and infection as well as promoting healing and repair
BHP/FHP There is a link between low testosterone levels and loss of skin elasticity. Skin health is also compromised by low levels of oestrogens. 
AHP Levels of DHEA-S and cortisol should also be measured, as increased stress is associated with eczema and dermatitis
VA Deficiencies of vitamins A, C, and E may contribute to eczema. The B group vitamins particularly B2 and B3, are vital for skin health. Deficiencies of vitamins B6, B12, and folate may be seen in cases of seborrhoeic dermatitis  

Diabetes

 
FHP/BHP High insulin levels may decrease SHBG levels leading to increased testosterone and hormone imbalance
FLDP Optimal Phase I and Phase II liver detoxification ensures safe excretion of hormones such as insulin
IP Altered intestinal permeability will lead to increased antigenic load
VA, MA Nutrient deficiencies such as Mg, Cr, Mn and Zn may be implicated in diabetes
IgG  
CDSA Levels of pancreatic elastase are measured to assess pancreatic function
3DP  
Ins Insulin test

Diarrhoea

 
3DP Parasitic infection is a common cause of diarrhoea
IP Altered intestinal permeability will lead to increased antigenic load which may result in diarrhoea and nutrient malabsorption
CDSA A complete assessment of digestion, absorption, intestinal function and microbial flora as well as identifying pathogenic bateria and yeasts is recommended 
sIgA Low levels of secretory IgA will result in reduced mucosal immunity, poor microflora and greater likelihood of pathogenic invasion
HpSA Helicobacter pylori infection may cause diarrhoea and other symptoms of gastritis
IgG Diarrhoea is a common symptom of food sensitivity
FLDP Diarrhoea may be a symptom of  poor liver detoxification combined with increased antigenic load

Dysmenorrhoea

AHP The incidence of dysmenorrhoea is found to be strongly associated with high stress which can be assessed by measuring cortisol and DHEA-S levels
FLDP Impaired Phase I and II liver detoxification may contribute to hormone imbalance which may be associated with the symptoms of dysmenorrhoea
FLDP Impaired Phase I and II liver detoxification may contribute to hormone imbalance which may be associated with the symptoms of dysmenorrhoea
2 &16  The ratio between 2- and 16-oestrogen urinary metabolites may indicate poor metabolism of oestrogen
THP Assessment of thyroid hormone levels is important to assess whether hypothyroidism is involved in dysmenorrhoea
rT3 High levels of rT3 will inhibit the conversion of T4 to T3 (this is seen during times of increased stress)
EFA There is a complex relationship between essential fatty acid metabolites and dysmenorrhoea. The balance of anti- and pro-inflammatory mediators is not only important, but specific to each individual. 
CDSA Optimal gut function is an important consideration when hormone levels are affected
HMA Dysmenorrhoea may be related to mineral deficiencies such as Mg and Ca
VA Treatment of dysmenorrhoea with oral contraceptives may cause vitamin B6 and folic acid deficiency

Epilepsy

HMA Hair mineral analysis provides a profile of chronic toxic metal exposure and deficiencies of essential trace elements
TM Deficiencies of minerals such as Magnesium and Chromium may be linked to epilepsy
AA Amino acid imbalance will affect neurotransmitter levels, especially glutamine (precursor to GABA) and tryptophan (precursor to serotonin). Aspartic acid levels may also be elevated in epilepsy
TAS Antioxidant protection is important in protecting against cellular damage and toxic metal accumulation
IP Altered intestinal permeability may permit increased absorption of antigens and neurotoxic metals such as Pb and Hg, as well as contributing to poor absorption of essential nutrients
IgG Food sensitivity testing is recommended as a contibruting factor to epileptic symptoms

Endometriosis

FHP Assessment of the balance of sex hormones is important as excess oestrogens are involved in endometriosis.
2 & 16 Assessment of the levels of the 2- and 16- urinary oestrogen metabolites is useful in diagnosis of the impaired inactivation of oestradiol to oestrone, which is common in endometriosis
THP Thyroid hormone levels should be investigated where there is abnormal sex hormone function
rT3 High levels of rT3 will inhibit the conversion of T4 to T3 (this is seen during times of increased stress)
FLDP Efficient liver detoxification is critical to proper metabolism of hormones. 
EFA The ratio of n-6:n-3 essential fatty acids should be considered as the pro-inflammatory arachadonic acid (n-6) metabolite prostaglandin E2 increases endometrial aromatase activity, which increases levels of the active oestrogen species oestradiol. Women with endometriosis are found to have high levels of arachidonic acid and PGE2, which can be countered by the n-3 EFA, Eicosapentanoic acid
CDSA Optimal gut function is an important consideration when hormone levels are affected
TAS Oxidative stress may contribute to the inflammatory response in endometriosis
HMA Low levels of Se may be associated with endometriosis
VA Deficiencies in vitamin E may be linked to endometriosis

Environmental Pollution

HMA Hair mineral analysis provides a profile of chronic toxic metal exposure and deficiencies of essential trace elements
TM Blood and/or urine testing for toxic metals is an important means of identifing levels of recent exposure and accumulation
PEST Xenoestrogens, such as polychlorinated biphenyls, can bind to oestrogen receptors blocking their effects
FLDP An increased burden of exogenous toxins may overload the liver's Phase I and/or Phase II detoxification capacity, leading to health problems caused by cellular damage. Impaired liver detoxification may also cause increased chemical sensitivity and lower tolerance to environmental toxins than normal
IP Environmental pollutants may cause altered intestinal permeability, causing further problems associated with dietary antigens and xenobiotics entering the system
sIgA Low levels of sIgA will result in greater likelihood of pathogenic invasion
MA A blood test to assess mineral status is important in diagnosing deficiencies which may occur due to antagonism by toxic metals
CHEL The Chelation Analysis provides information on the urinary clearance of toxic metals and minerals and is a valuable test to monitor the efficacy of chelation therapy
BHP Assessment of hormone levels is important as environmental toxins can affect hormone balance, upsetting their metabolism and regulation
CDSA Poor digestive function, including gut dysbiosis, may contribute to deficiency of nutrients such as zinc and magnesium that may protect against environmental toxicity
TAS Toxic metal accumulation may cause elevated levels of free radicals and reactive oxygen species which are likely to cause cellular damage

Exhaustion/Adrenal Exhaustion

AHP Altered levels of Cortisol and DHEA-S areindicative of acute and/or chronic stress which can  result in adrenal exhaustion and immune supression
FLDP Exhaustion may be the result of increased toxic load and compromised liver function
IP Altered intestinal permeability will contribute to exhaustion through increased absorption of antigens and toxic metals and poor absorption of essential nutrients
VA Exhaustion may be related to vitamin deficiency. Vitamin C and the B group vitamins, particularly B5 and B6 support adrenal function and the stress response
MA Mineral deficiency may also play a key role in exhaustion. Magnesium is the major mineral associated with exhaustion, and minerals such as calcium, zinc and iron are also worth investigating
AA Exhaustion can also be the result of protein deficiency and amino acid imbalance (often seen in strict vegetarians and vegans)

Fatigue (Chronic Fatigue Syndrome)

AHP Test cortisol and DHEA-S levels to assess adrenal function
FLDP Impaired liver detoxification may lead to accumulation of metabolic wastes and exogenous toxins causing fatigue
FHP/BHP  Low levels of testosterone and hormonal imbalance generally may also cause fatigue
sIgA Low levels of sIgA wil result in greater likelihood of pathogenic invasion which may contribute to fatigue
HMA Fatigue may be caused by chronic deficiencies of Mg, Zn, and high levels of toxic metals
IgG Food sensitivities can be responsible for fatigue
THP Fatigue may be due to an underactive thyroid
TAS Oxidative stress due to reduced levels of antioxidants may cause fatigue 
3DP Chronic parasitic infection, such as blastocyctis hominis, can cause fatigue 
CDSA Maldigestion, malabsorption and dysbiosis may cause nutrient deficiencies and increased antigenic load, resulting in fatigue
AA Amino acid imbalances are common, e.g. deficiencies of the neurotransmitter precursors, tryptophan and tyrosine
EFA Low levels and imbalances in essential fatty acids affect neural function and may cause fatigue
TM High levels of toxic metals, such as, Hg, Cd, Pb affect the central nervous system and may cause fatigue
MA Mg deficiency is common in chronic fatigue and Mg deficiency in red blood cells has been observed
VA Deficiencies of vitamins C, B1, B6, B12, and folate may affect central nervous system function and will contribute to fatigue 
CoQ10 Coenzyme Q10 deficiency may affect central nervous system function, resulting in fatigue

Flatulence

 
CDSA A complete assessment of digestion, absorption, pathogens, yeasts and microbial flora is recommended as a first line approach
IP High intestinal permeability will increase antigenic load which may result in flatulence along with other symptoms of digestive discomfort
FLDP Poor liver function will result in increased antigenic load and contribute to maldigestion 
sIgA Low levels of secretory IgA will reduce microbial flora and mucosal immunity, increasing the risk of pathogenic invasion that will produce symptoms such as flatulence
IgG Flatulence may be a symptom of food sensitivity
3DP Flatulence may be a symptom of underlying parasitic infection

Food Sensitivities

IgG The first step recommended is the IgG Food Sensitivity Profile to measure IgG antibodies to a panel of foods 
IP Increased intestinal permeability may be a significant contributing factor in the development and exacerbation of food sensitivities
CDSA Poor digestive function and imbalanced microflora will contribute to the development and progression of food sensitivities
FLDP Compromised liver function may contribute to food sensitivities by increasing antigenic load
3DP An underlying parasitic infection may be an important causative factor in cases of recent or sudden food sensitivity
HpSA Helicobacter pylori infection may also be worth investigating in cases of recent or sudden food sensitivity
EFA Food sensitivity may result in EFA deficiencies
VA Long term food sensitivity will inevitably result in nutrient deficiencies

Fibrocystic Breast Disease (FBD)

FHP The balance of sex hormones should be assessed as hormonal abnormalities are a common cause of FBD featuring low levels of progesterone in particular
2 & 16 Differences from the normal ratio between 2- and 16-oestrone metabolites may indicate altered oestrogenic activity
THP FBD may be associated with subclinical hypothyroidism
rT3 High levels of rT3 will inhibit the conversion of T4 to T3 (this is seen during times of increased stress)
FLDP Efficient Phase I and II liver detoxification is critical to the proper metabolism of hormones
TAS Low antioxidant status will result in increased oxidative stress and cell damage
CDSA Optimal gut function is an important consideration when hormone levels are affected

Gastritis

 
CDSA A thorough assessment of gut function, including digestion, absorption, microbial flora and the presence of pathogenic bacteria is recommended to ascertain the underlying cause/s of gastritis
HpSA Gastritis may be the result of active helicobacter pylori infection. This is important to detect and eliminate as it is a known cause of gastric ulcers
sIgA A high daily production of secretory IgA is required to protect gastric mucosa from pathogens that could give rise to gastritis
IgG Food sensitvity can be responsible for gut irritation and the symptoms of gastritis

Gastroenteritis

CDSA A thorough assessment of gut function, including digestion, absorption, microbial flora and the presence of pathogenic bacteria is recommended to ascertain the underlying cause/s of gastroenteritis
IP Altered intestinal permeability will result in increased absorption of dietary antigens and toxic metals which could be implicated in gastroenteritis
3DP Parasitic infection may be a common cause of gastroenteritis
sIgA A high daily production of secretory IgA is required to protect gastric mucosa from pathogens that could give rise to gastroenteritis

Glaucoma

 
TAS Antioxidants are essential to prevent cellular damage. Vitamins E and C may counter the toxicity of glutamic acid and vitamin C can reduce intraocular pressure
CoQ10 Coenzyme Q10 may help to prevent glaucoma and reduce further cellular damage
VA Vitamin deficiency may contribute to glaucoma, eg B1, B12
MA Mineral deficiency may contribute to glaucoma, eg Cr, Zn

Gout

 
FLDP Given the known association between alcohol and gout, an assessment of the liver's detoxification capacity is an important approach to treatment and management
IP Alcohol intake leads to altered intestinal permeability resulting in increased antigenic load that will further exacerbate symptoms of gout
EFA EFA deficiency is common, particularly omega 3 PUFA which may be of use in the management of gout
HMA Hair mineral analysis provides a profile of chronic toxic metal exposure and deficiencies of essential trace elements

Headache

 
FLDP Headaches can result from increased antigenic load due to impaired liver detoxification
BHP/FHP Headaches are often associated with the onset of the menstrual period or menopause, due to hormonal imbalance
CDSA Optimal gut function is an important consideration when hormone levels are affected. Malabsorption, maldigestion and dysbiosis may cause nutrient deficiencies and elevated levels of xenobiotics
IP Headaches can result from increased antigenic load due to altered intestinal permeability
EFA Essential fatty acid deficiencies may affect neural function and lead to inflammation. High n-6:n-3 ratios may cause elevated levels of pro-inflammatory metabolites 
AA Amino acid imbalances or deficiencies may trigger chronic headache pain (e.g. deficiencies of the neurotransmitter precursors tyrosine and tryptophan)
TM Headaches may be a symptom of neural toxicity due to exposure to toxic metals such as Al, Hg and Pb
HMA Hair analysis can detect deficiency or excess of vital minerals and toxic metals which  may be implicated in headaches. Deficiency of magnesium in particular is associated with muscular spasm which may result in headaches
IgG Food sensitivities may cause recurrent headaches

Hypertension

AHP Measuring Cortisol and DHEA-S levels is recommended as stress is often a trigger factor in hypertension
FLDP Compromised liver function can lead to venous congestion which may be an exacerbating factor in hypertension
CDSA Poor digestion, slow motility, dysbiosis and chronic constipation may also contribute to venous congestion and aggravation of hypertension
TAS/CoQ10  Coenzyme Q10 may normalise blood pressure and is found to be deficient in a number of hypertensive patients.The other main antioxidants may also reduce blood pressure and protect against oxidative stress

Hyperthyroidism

THP Assessment of thyroid hormones including thyroid stimulating hormone (TSH), thyroxine (T4), and triiodothyronine (T3) to detect excess thyroid hormones. This test is also recommended to monitor treatment of hyperthyroidism
rT3 This test is recommended in conjunction with the Thyroid Hormone Profile to assess the levels of rT3, which is produced during periods of stress
AHP Measuring Cortisol and DHEA-S levels is recommended as stress may contribute to overactive thyroid 
BHP/FHP Hormonal imbalance can play a role in thyroid hormone imbalance

Hypothyroidism

THP Assessment of thyroid hormones including thyroid stimulating hormone (TSH), thyroxine (T4), and triiodothyronine (T3) to ensure sufficient production of T4 and conversion to the more potent T3. This test is also recommended to monitor the effectiveness of thyroid hormone treatment
rT3 High levels of rT3 will inhibit the conversion of T4 to T3 (this is seen during times of increased stress)
BHP/FHP Low thyroid hormone can also lead to imbalance of the sex hormones which should be investigated if symptoms are apparent in this area
FLDP Impaired Phase I and II liver detoxification may affect thyroid hormone function and should be investigated
NTx Impaired thryoid function may increase the risk of osteoporosis. This test measures the level of bone resorption as an indicator for osteoporosis
CDSA Optimal gut function is an important consideration when hormone levels are affected. Malabsorption, malnutrition and dysbiosis may contribute to deficiencies of essential nutrients required for thyroid function 
HMA Deficiencies in essential mineral nutrients may be the cause of hypothyroidism e.g. I (iodine is essential in formation of thyroid hormones), Zn and Se (essential to the conversion of T4 to T3). 

Indigestion

 
CDSA Assessment of digestive system health, including absorption, gastric pH and balance of intestinal microflora
3DP Some common symptoms (e.g. flatulence, cramps, bloating, abdominal pain) may be caused by the presence of parasites, such as Dientamoeba fragilis
HpSA Tests for Helicobacter pylori, which is implicated in gastritis and ulcers
IgG Malabsorption due to food intolerances (e.g. lactose) may be identified by IgG food sensitivity testing
IP Indigestion and related symptoms may be the result of altered intestinal permeability where dietary antigens cause intestinal inflammation

Infertility

 
BHP (Male) Assessing sex hormone levels is an important first step in determining correct hormone balance
FHP (Female) Assessing sex hormone levels is an important first step in determining correct hormone balance
FLDP Optimal liver function is important when trying to conceive to reduce free radical load and protection against liver toxins and chronic exposure to toxic metals
HMA Deficiencies in essential minerals (particularly Se and Zn) can be a major factor in infertility (particularly in men). The potential accumulation of toxic metals also needs to be assessed
TAS Antioxidants are required to prevent cellular damage due to oxidative stress. Assessing TAS is an essential part of the investigation into the causes of infertility

Insomnia

 
AHP  Assessment of Cortisol and DHEA-S levels is recommended as stress is a major cause of sleep disturbances.
MEL Melatonin levels decrease with age and low levels can result in sleep disturbances 
AA Amino acid imbalance can contribute to insomnia. Of particular importance are tryptophan, glutamine and tyrosine
EFA Omega 3 fatty acids, particularly DHA, have been shown to assist in the treatment of depression which may be an underlying cause of insomnia
FLDP Insomnia may be related to compromised liver function

Irritable Bowel Syndrome (IBS)

CDSA Irritation may be due to dysbiosis or sensitivity to foods and may result in maldigestion and malnutrition
3DP Irritation may be due to the presence of gut parasites
IP Altered intestinal permeability may occur because of irritation, allowing toxins and allergens into the system
IgG Intolerances to common foods (e.g. lactose) may cause irritation and can be identified by IgG food sensitivity testing
sIgA Stress has a major impact on the output of Secretory IgA which is needed to protect the gut mucosa from irritation and infection

Inflammatory Bowel Disease (IBD): Crohn's Disease, Ulcerative Colitis

CDSA Intestinal dysbiosis is a common cause of IBD. Inflammation may also cause maldigestion and malabsorption
3-DP Parasites or other infectious organisms may cause IBD-like symptoms and may be responsible for inflammation  
IP Damaged intestinal mucosa are more permeable to antigens and toxins, which may cause systemic problems
IgG Immune reactions due to food sensitivities are common and may increase inflammation and intestinal permeability
AA Malabsorption of amino acids leads to increased inflammatory responses and nutritional deficiencies
EFA Chronic inflammatory response may result from essential fatty acid deficiencies and imbalances, a high n-6:n-3 ratio may cause elevated levels of pro-inflammatory metabolites
NTx Reduced bone mineral density is common and may be caused by corticosteroid treatment and dysfunctional Ca metabolism
VA Chronic malabsorption (esp. Crohn's disease) can lead to vitamin deficiencies
TAS Free radical endothelial damage may occur as a result of low antioxidant levels
TE Test for recent imbalances in critical elements (e.g. Se, Cu, Zn)
HMA Test for chronic deficiencies of critical elements (e.g.  Se, Cu, Zn, Fe)
Fe General pathology testing for Fe and Hb is imporatant, as iron deficiency anaemia is common in IBD

Leukaemia

 
TAS Antioxidant status is crucial to protect immune system function and prevent opportunistic infection in leukaemia patients
MA Mineral deficiencies such as Se and Zn are seen in leukaemia patients. Se may assist in prevention and treatment
VA Vitamins that support immune system function such as A,C,D and E, are often required in larger amounts by leukaemia patients

Libido

 
BHP/FHP Hormonal imbalance can contribute to lowered libido (often seen in menopause/andropause)
AHP Measuring Cortisol and DHEA-S levels is recommended as high levels of stress can have a negative effect on libido
FLDP Poor liver detoxification can lead to headaches, nausea and fatigue which will reduce libido

Liver Dysfunction

FLDP Accurate identification of an individuals's liver detoxification profile to eliminate guesswork and assist the direction of treatment
CDSA Poor digestive function, malabsorption and dysbiosis can result in increased burden on the liver
BHP/FHP Compromised liver function can contribute to inefficient metabolism of hormones resulting in hormone imbalance

Lupus erythematosus

BHP/FHP Female sex hormones are implicated in disease pathogenesis of SLE
IP The intestinal barrier also plays an important role in the pathogenesis of autoimmune disorders in genetically susceptible people
EFA EFA status is important to assess as EFA deficiency is seen in SLE and may be an important part of the treatment strategy

Menopause

FHP It is important to assess the levels of oestrogens, progesterone and testosterone, imbalances of which may  cause chronic health problems. Testing can also be used to monitor the effects of bioidentical or natural hormone replacement therapy
2 & 16 A high ratio between 2- and 16-oestrogen metabolites may be associated with oestrogen deficiency. A low 2 - and 16 - oestrogen metabolite ratio may be associated with an increased risk of oestrogen dominant conditions such as breast cancer
AHP Stress may contribute to menopausal symptoms. Testing Cortisol and DHEA-S will assess this
THP An underactive thyroid is common in menopausal women and may contribute to symptoms such as weight gain, lethargy and increased facial hair 
rT3 High levels of rT3 will inhibit the conversion of T4 to T3 (this is seen during times of increased stress)
NTx Cross-linked N-telopeptide is a marker of calcium resorption and hence osteoporosis risk, which should be assessed as the low levels of oestrogens associated with menopause are a common cause of osteoporosis
FLDP Efficient Phase I and II liver detoxification is critical to the proper metabolism of hormones
CDSA  Optimal gut function is an important consideration when hormone levels are affected

Menorrhagia

FHP It is important to assess the levels of oestrogens and  progesterone throughout the cycle, as elevated/prolonged high levels of oestrogen or progesterone may be responsible for menorrhagia
2 & 16 A low ratio between 2 & 16 urinary oestrogen metabolites may be associated with pathologies of oestrogen excess (including breast cancer)
THP It is important to assess levels of thyroid hormones as subclinical hypothyroidism may underlie menorrhagia
rT3 High levels of rT3 will inhibit the conversion of T4 to T3 (this is seen during times of increased stress)
FLDP Efficient Phase II liver detoxification is critical to the proper metabolism of hormones
EFA Imbalances in essential fatty acids may cause menorrhagia. In particular high levels of the n-6 EFA, Arachadonic acid, may lead to elevated levels of pro-inflammatory metabolites, such as the 2-series prostaglandins, which may cause excessive bleeding
CDSA Optimal gut function is an important consideration when hormone levels are affected
VA Deficiencies in vitamins A, C, and E may exacerbate menorrhagia
Fe Fe deficiency due to excessive blood loss is an important consideration. Chronic Fe deficiency may also promote menorrhagia 
AA Amino acid imbalance may contribute to menorrhagia

Migraine

 
FLDP The detoxification capacity of the liver (as well as the burden it is under) is an important consideration in the cause/s of migraine
CDSA Poor digestion, malabsorption, microbial flora imbalance and the presence of pathogenic bacteria can all contribute to migraine
IgG Food sensitivity is common in migraine sufferers
IP Altered intestinal permeability will result in increased absorption of dietary antigens and toxic metals which can be implicated in migraine
HMA Hair analysis can detect deficiency or excess of vital minerals and toxic metals which  may be implicated in migraine. Deficiency of magnesium in particular is associated with muscular spasm which may contribute to migraine
CoQ10 Deficiency of CoQ10 is commonly seen in migraine sufferers
CHEL The Chelation Analysis provides information on the urinary clearance of toxic metals and minerals and is a valuable test to monitor the efficacy of chelation therapy

Nausea

 
CDSA Nausea is a common symptom of inefficient digestion, gut dysbioisis, malabsorption and maldigestion. The CDSA is the first test recommended
FLDP Nausea is a common symptom of poor liver function and toxic overload. Assessing Phase I and II liver detoxification is highly recommended, especially where high intake of alcohol, caffeine, drugs and other xenobiotics
IgG Food sensitivity can result in higher antigenic load and subsequent nausea
HpSA Nausea can be a symptom of active infection with Helicobacter pylori
3DP Nausea may be a symptom of  parasitic infection
IP Altered intestinal permeability will contribute to the other digestive causes of nausea such as high alcohol/caffeine/cigarette smoking etc

Obesity

 
BHP/FHP Hormonal imbalance can contribute to obesity
FLDP Poor liver function and inefficient detoxification can contribute to weight gain
THP An underactive thyroid (hypothyroidism) is a common cause of weight gain
rT3 Conversion of T4 to rT3 instead of T3 will contribute to thyroid imbalance
AHP Adrenal fatigue (low Cortisol/DHEA-S) will decrease metabolism and may contribute to weight gain

Osteoporosis

NTx Cross-linked N-telopeptide (NTx) is an indicator of bone resorption, high levels can indicate reduced bone mineral density
FHP The correct balance of testosterone and oestrogens are essential to maintaining bone mineral density
2 & 16 Variation from normal ratios between 2- and 16-oestrogen metabolites may indicate osteoporosis risk in females due to oestrogen deficiency
HMA Elevated levels of Cd interferes with Ca uptake and vitamin D metabolism

Otitis Media

 
IgG In children food sensitivity may be linked to chronic middle ear infection/otitis media
IP Altered intestinal permeability may be an important contributing factor to food and enviornmental sensitivities
CDSA Poor gut function may contribute to food sensitivities linked to otitis media
HMA Mineral deficiencies (eg Zinc, Chromium) and toxic metal accumulation (Lead, Mercury) may contribute to recurrent otitis media

Ovarian Cysts

The following tests should be considered for patients presenting with ovarian cysts, as the aim is always to treat holistically
FHP (AHP) It is important to assess levels of E2, P4, TT and DHEA as ovarian cysts may be associated with imblances of these hormones
2 & 16  In cases of oestrogen dominance, assessing proper oestrogen metabolism is important
FLDP Hormonal imbalances are often associated with poor Phase II liver detoxification
EFA EFA deficiency may be implicated in ovarian cyst formation

Parasitic Infection

3DP Examination of three stool specimens collected over three consecutive days for parastic infection
CDSA Comprehensive assessment of the microbiology of the gut is important to assess the impact of the parasite/s on microbial flora  
sIgA Assessing the levels of secretory IgA is important as this substance is responsible for mucosal immunity and protection against pathogenic invasion
IgG Food sensitivity can lead to mucosal irritation and loss of defence, promoting an optimal environment for parasitic infection
IP Altered intestinal permeability may also be responsible for reduced defences and increased susceptibility to parasitic infection

Pre-Menstrual Syndrome (PMS)

FHP PMS is caused by irregularities in the oestrogen to progesterone balance. High levels of oestrogens may be responsible for some of the symptoms of PMS. It is important to assess each woman's individual profile in order to match treatment to the underlying cause of the condition. 
AHP PMS is affected by stress, which can be assessed by measuring levels of cortisol and DHEA. 
FLDP Efficient Phase I and II liver detoxification is critical to proper metabolism of hormones
THP Assessment of thyroid hormone levels is important to establish a relationship to PMS
rT3 High levels of rT3 will inhibit the conversion of T4 to T3 (this is seen during times of increased stress)
EFA There is a complex relationship between essential fatty acid metabolites and the symptoms of PMS. The balance of anti- and pro-inflammatory mediators is not only important, but specific to each individual. Hence an essential fatty acid profile is needed in order to treat holistically
CDSA In our experience optimal gut function is an important consideration when hormone levels are disrupted
AA Deficiencies of tryptophan and tyrosine, and hence serotonin and dopamine, can exacerbate PMS symptoms 
VA Deficiency of vitamin B6, an essential cofactor for the conversion of  tryptophan and tyrosine into the neurotransmitters serotonin and dopamine, will contribure to PMS symptoms. The B group vitamins are also needed for effective liver detoxification
HMA Long term imbalances of Ca, Mg, and Zn may cause PMS symptoms

Prostate Enlargement/Prostatitis

BHP Assessment of the profile of sex hormones is important because benign prostatic hyperplasia/hypertrophy (BPH) may be linked with excess oestrogen levels and an increase in levels of both testosterone and it's more active form dihydrotestosterone (DHT) in the prostate gland. BPH may also be one of the causes of prostatitis 
2 & 16 Assessment of the ratio between 2- and 16-alpha-hydroxyestrone is important in BPH, as there may be a link between levels of the active 16- form and prostate enlargement
FLDP Efficient Phase I and II liver detoxification is critical to proper metabolism of hormones, being responsible for breakdown of oestrone (E1) via hydroxylation at the 2- or 16- positions
CDSA Optimal gut function is an important consideration when hormone levels are affected. Malabsorption, malnutrition, and dysbiosis may also contribute to nutrient deficiencies and toxin accumulation associated with the inflammation of prostatitis
HMA Zinc is particularly important in BPH as a deficiency may cause increased conversion of testosterone to DHT. Excesses of other minerals/toxic metals may compete with Zn for absorption
IP Intestinal permeability is common in cases of prostatitis as the resultant toxins and proinflammatory mediators entering the blood stream increases the systemic tendency towards inflammatory disorders
EFA BPH may be associated with an underlying essential fatty acid deficiency
PEST Xenoestrogens, such as polychlorinated biphenyls may alter the hormone profile, giving rise to prostate cancer. While the risk of cancer does not appear to increase with BPH, prostate enlargement may be a symptom of prostate cancer

Psoriasis

 
FLDP Efficient liver detoxification is important as food and chemical sensitivities may contribute to high levels of inflammatory mediators seen in psoriasis 
IP Altered intestinal permeability will contribute to increased sensitivity to antigens resulting in further production of inflammatory mediators 
CDSA Poor gut function will increase food and chemical sensitivities and should be ruled out as an important underlying cause
IgG Intolerances to common foods (e.g. gluten) may cause irritation and can be identified by IgG food sensitivity testing
EFA Posriatic lesions are high in proinflammatory metabolites which can be inhibited by higher levels of EPA

Radiotherapy

IP Abdominal radiation therapy may cause chronic alterations in intestinal permeability due to excess generation of free radicals and destruction of intestinal villi
sIgA Damage to the gut mucosa from radiation therapy may lead to lowered levels of sIgA and increased risk of pathogenic invasion
TAS Total antioxidant status is essential to determine given the high free radical load generated by radiation therapy
VA, MA Radiation therapy may result in significant depletion of vitamins and minerals (particularly vitamin C), essential to the repair and recovery process

Raynaud's Phenomenon

EFA EFA deficiency may contribute to poor circulation and sufficient levels may reduce the severity of the disease
AA Amino acids such as arginine and carnitine may be useful in treating raynaud's
VA, MA Elevated homocysteine levels have been found in Raynaud's phenomenon. This is reduced by the presence of adequate levels of B12 and folate. Assessing vitamin and mineral status is also important as deficiencies of other nutrients such as vitamin B6 and magnesium are implicated in the pathogenesis of the disease
TAS Total antioxidant status is important to assess when determining treatment for Raynaud's phenomenon

Rheumatoid Arthritis

CDSA Poor digestive function results in increased food and chemical senstivities which may contribute to the inflammatory process in RA
IP High intestinal permeability must be investigated as a potential underlying factor contributing to high antigenic load and persisitent inflammation in RA
FLDP Effcient liver detoxification is also essential in reducing food and chemical sensitivities
EFA High levels of arachidonic acid with corresponding low levels of the EFAs will contribute to the inflammation and pain seen in RA

Rosacea

 
BHP/FHP Hormonal imbalance may be a contributing factor to rosacea, particularly in menopausal women
HpSA Studies show a higher prevalence of helicobacter pylori infection in patients with rosacea, and significant reduction in severity of rosacea  after eradication of this bacteria
FLDP Efficient liver detoxification is necessary to minimise food and chemical senstivities which may contribute to inflammation in rosacea
CDSA Gut dysbiosis and inflammation commonly underly skin disorders and are a recommended investigation here

Seasonal Affective Disorder (SAD)

MEL Reduced exposure to light (particularly in winter) disrupts the circadian rhythm which may contribute to sleep disturbances and depression
AHP Eevated cortisol levels (as a result of prolonged stress) may be implicated in SAD
BHP Hormonal imbalance may contribute to seasonal affective disorder
CDSA Poor digestive function and gut dysbiosis may contribute to food sensitivities/intolerances which may exacerbate SAD
FLDP Compromised liver function will result in hormonal imbalance and food and chemical sensitivities which may aggravate SAD and impair treatment
EFA Low levels of n-3 fatty acids or high n-6:n-3 ratios are common in patients with SAD

Stress

 
AHP Altered levels of cortisol and DHEA-S are indicative of acute and/or chronic mental and/or physical stress
MEL Low levels of melatonin will contribute to stress-related symptoms such as insomnia, poor immune function, depression and anxiety
IP Prolonged stress may contribute to altered intestinal permeability, resulting in higher antigenic load and inflammation
BHP/FHP Stress can contribute to hormonal imbalance and be an important underlying cause of premenstrual syndrome and menopausal symptoms
FLDP Poor liver function can exacerbate stress-related symptoms such as irritability, anxiety, headaches and tension
sIgA It is important to assess the levels of sIgA as prolonged stress inhibits its secretion, resulting in reduced immune defence

Stroke

 
TAS Total antioxidant status is important to investigate as antioxidants such as vitamins C and E may inhibit platelet aggregation and reduce further vascular occlusion. 
EFA EFA status is another important investigation as high arachidonic acid and low levels of omega 3 EFAs contribute to increased platelet aggregation
AA Amino acid imbalance may contribute to reduced liver metabolism and accumulation of triglycerides and cholesterol 
VA, MA Certain vitamins and minerals may have beneficial effects in recovery from stroke and prevention of further vascular occlusion
HMA Hair mineral analysis identifies mineral deficiencies and toxic metal exposure which may play a role in the development of stroke and inhibit recovery
FLDP The detoxification capacity of the liver is vital to the efficient metabolism of triglycerides and cholesterol and thus the prevention of further vascular occlusion

Syndrome X

 
THP Low thyroid function is common in Syndrome X patients
rT3 rT3 production may be increased at the expense of fT3 (free T3) prodcution, as seen during periods of stress
BHP/FHP Assessment of E1, E2, P4, TT and DHEAS is critical as Syndrome X may be associated with high levels of TT and E2 in particualar
FLDP Hormonal imbalances may result from poor Phase II liver detoxification
CDSA Poor digestive function may have an impact on metabolic efficiency
IP Altered intestinal permeability may exacerbate poor digestive function 

Tinnitus

 
VA Tinnitus may be related to deficiencies in vitamins A, D and B12
MA Tinnitus may be related to deficiencies in minerals such as Manganese and Zinc
TAS Given the potential relationship of tinnitus to cardiovascular and circulatory disorders, assessment of TAS is important to determine risk
HMA Toxic metals may be implicated in tinnitus, particularly by contributing to deficiency of protective minerals such as Zinc

Thrombosis

 
FLDP Poor liver function may contribute to venous congestion and poor circulation and lymphatic drainage
EFA High levels of arachidonic acid result in increased blood viscosity and increased risk of stroke
AA Elevated homocysteine levels increase the risk of thrombosis
TAS TAS is important to assess as these nutrients protect against conditions associated with thrombosis such as heart attack and stroke
CoQ10 CoQ10 is important to assess as these nutrients protect against conditions associated with thrombosis such as heart attack and stroke

Ulcers 

 
HpSA Helicobacter pylori is the main bacteria associated with ulcer
IP Altered intestinal permeability reduces mucosal defence against antigens and pathogens which may aggravate inflammation
sIgA Low levels of secretory IgA reduce mucosal defence and affect the repair process
CDSA Poor digestion and gut dysbiosis may also contribute to inflammation and inhibit the repair process in ulcer

Urinary Tract Infections

CDSA Intestinal dysbiosis and the presence of other microbes can be detected
sIgA Lowered levels of sIgA increases susceptibility to pathogenic invasion
EFA EFA deficiency contributes to hormonal imbalance which may be an important factor in UTIs
BHP/FHP Hormonal imbalance can be an important underlying factor in the predisposition to UTIs

Uterine Fibroids

FHP Oestrogen dominance is a common cause of uterine fibroids. The full cycle Female Hormone Profile is recommended in the investigation of uterine fibroids
2 & 16 Ensuring a healthy 2-and 16- oestrogen metabolites ratio is recommended in cases of oestrogen dominance
THP Thyroid hormone imbalance may be implicated in the susceptibility to uterine fibroids
FLDP The role of the liver

Ulcerative Colitis

CDSA Intestinal dysbiosis is common in Ulcerative Colitis. Inflammation may also cause maldigestion and malabsorption
3DP  
IP Altered intestinal permeability is common in Ulcerative Colitis and damaged intestinal mucosa more permeable to antigens and toxins
IgG Food sensitivities are common and may increase inflammation and intestinal permeability
sIgA Stress reduces Secretory IgA which is necessary to protect the gut from infection and inflammation
EFA Chronic inflammatory response may result from essential fatty acid deficiencies and imbalances. A high n-6:n-3 ratio may cause elevated levels of pro-inflammatory metabolites
NTx Reduced bone mineral density is common and may be caused by corticosteroid treatment and dysfunctional Ca metabolism
VA Chronic malabsorption can lead to vitamin deficiencies
TAS Free radical endothelial damage may occur as a result of low antioxidant levels
MA Test for recent imbalances in critical elements (e.g. Se, Cu, Zn)
HMA Test for chronic deficiencies of critical elements (e.g.  Se, Cu, Zn, Fe)

Vaginitis

 
BHP/FHP Hormonal imbalance may be an important factor in vaginitis
sIgA Low levels of sIgA are associated with reduced mucosal defence and increased susceptibility to pathogenic invasion
EFA EFA status is important to determine as deficiencies may contribute to hormonal imbalance and inflammation
CDSA Incorporates mycology to detect presence of yeast species such as candida
IP Altered gut permeability increases the susceptibility to pathogenic invasion
HMA An important test to determine mineral deficiencies and toxic metal accumulation which may contribute to susceptibility to vaginitis

Weight Gain/Loss

THP  Given the role of the thyroid gland in metabolism, the Thyroid Hormone Profile is recommended as the first line of investigation in unexplained weight gain/loss
rT3 High levels of rT3 will inhibit the conversion of T4 to T3 (this is seen during times of increased stress)
AHP Adrenal fatigue (low Cortisol/DHEA-S) will decrease metabolism and may contribute to weight gain
BHP/FHP Hormonal imbalance may be a contributing factor in unexplained weight gain/loss
CDSA Poor digestive function may contribute to metabolic 
FLDP Weight gain/loss may be caused by hormonal imbalances resulting from poor Phase II liver detoxification