Why is a Comprehensive Metabolic Blood Chemistry panel included in the FNHP?

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1. PATHOPHYSIOLOGY OF METABOLIC SYNDROME

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Why is a Comprehensive Metabolic Blood Chemistry panel included in the FNHP? (A cornerstone of my approach is test, don t guess. Identifying the underlying patterns contributing to poor health is the key to a successful and lasting outcome. If there is dysregulated blood sugar, sub-optimal thyroid function (which can only be uncovered from comprehensive testing) or poor oxygen delivery to tissues no treatment plan will work nor is there any value in suggesting advanced functional testing profiles such as comprehensive stool analysis if the fundamental biochemistry is failing or sub-optimally malfunctioning. A comprehensive blood chemistry panel (comprehensive being the optimal word) is the single most efficient and effective tool for evaluating your biochemistry and therefore health as it screens for a wide range of conditions, including several types of anemia; indications of gut, viral and bacterial infections; insulin resistance and hypoglycemia; liver and kidney issues; and thyroid and adrenal problems. But, many of these functions listed here can only be illuminated when interpreting the results, as it is in functional medicine, within a patterns analysis model, Such a model recognizes that the bodily systems i.e. digestive, immune, endocrine, cardiovascular are not separated silos but interconnected through our biochemistry of hormones, neurotransmitters enzymes and chemical reactions that occur 24-7 and have a causative effect upon each other. A comprehensive metabolic blood chemistry test is a snapshot in time of the culmination of all these reactions, and therefore can tell an overall story of where to dig deeper, if interpreted in this way. A patterns analysis goes far beyond the concept of ideal ranges for individual markers i.e.: - your total cholesterol is high this needs to be lowered or everything on you blood test is in-range, nothing is wrong. As markers begin to shift away from range and symptoms start to occur, a picture begins to emerge. The training of understanding blood chemistry from a view of patterns analysis, identifies more subtle physiological imbalances or highlights system/s moving away from homeostasis and towards sub-optimal function, that present as multiple symptoms. Thus looking for patterns of function better explains or provides more targeted reasoning as to why a marker is raised and or what systems are involved. Returning to the high cholesterol marker as an example to demonstrate this here: In terms of why the total cholesterol is high, we must analyse not only the total cholesterol, we must also pay attention to: the LDL/HDL ratio, the triglycerides, glucose, inflammatory markers (such as CRP), electrolyte activity, liver-related markers, adrenal-related markers, thyroid functions and GI inflammatory markers. All of these pathways can play into why cholesterol can be raised. By reviewing these markers and categories, we can form a more truly integrated impression that seeks to understand what is taking place within the many complex layers of the body.)

1) CBC with Differential: Functional Blood Chemistry & Metabolic Markers 2) Iron & Inflammation Iron Total Iron binding capacity % Saturation Ferritin Hs C-Reactive protein ESR 3) Glucose, fat/lipid metabolism liver and renal function Sodium Potassium Chloride Bicarbonate Protein total Urea Globulin Creatinine Phosphate Bilirubin glucose, insulin & HbA1c to best determine & define insulin resistance and or blood sugar dysregulation Alkaline phosphatase AST ALT CK LDH Gamma- GT Albumin Calcium Uric acid Total cholesterol HDL and LDL Triglycerides

4) Thyroid profile TSH/FT4/TT3/FT3/Reverse T3/ Thyroid-antibodies (TPO & TG)/T3uptake Thyroid function is often compromised due to on-going stress, trauma, infection, yo-yo dieting, toxins and low-calorie diets. To assess overall metabolic function a full panel must be run as included here. 5) Homocysteine Cardiovascular marker & can be an indicator of B12/folate re-cycling issues. 6) Vitamin D Over the past decade there has been a dramatic increase in the understanding of the many biological actions that result from vitamin D acting through its daughter steroid hormone, 1α, 25-dihydroxyvitamin D3 [1α, 25(OH) 2D3].In other words Vitamin D does more than support bone health. Evidence has accumulated that beside intestine and bone, there are five additional physiological systems where the Vitamin D Receptor with 1α, 25(OH) 2D generates biological responses. These include the: 1. Immune system (both the innate and adaptive), 2. Pancreas and metabolic homeostasis, 3. Heart-cardiovascular, 4. Muscle and brain systems 5. Control of the cell cycle, and thus of the disease process of cancer 7) Magnesium, B12 and Folate 8) Hormone Health Progesterone Testosterone Sex Hormone Binding Globulin (SHBG) DHEA-S (DS) Estradiol

Value of this panel is 385. This is paid directly to the laboratory by completing the requisition form within the kit that is dispatched to you on booking your FNHP. The balance of your Functional Nutritional Health Package is paid at the close of your case review appointment. How is this blood test run: 1) Blood is taken prior to your initial functional consultation with Tanya and results e-mailed directly to her for analysis. Full explanation of your results are provided at your consultation and integrated into your treatment plan together with your health history. A kit is sent to your home, you can then either attend one of the phlebotomy services listed below by appointment or If none of the locations below are convenient, a local GP, Private Laboratory or hospital may provide this service for an additional charge. Please note however that some of the markers have specific requirements such as centrifuging and freezing: please check with the phlebotomy centre if not one listed here they have this facility before attending. 2) The test kit must be taken to the chosen Clinic. Please ensure all paperwork within the kit is completed including payment details. 3) Once your sample has been taken, please send the kit with samples directly to the laboratory in the envelope provided. 4) All locations will charge a fee for the service, approximately 30. The London Clinic - Out-patients 5 Devonshire Place, London, W1G 6HL Tel: 020 7034 6330 The phlebotomy service is available at the following times (excluding public holidays): Monday - Thursday: 8.30am to 6.30pm Friday: 8.30am - 11am. It is not necessary to book an appointment. Transport The nearest underground stations are: Regents Park, Great Portland Street and Baker Street.

Express Medical Clinic 117A Harley Street London W1G 6AT Tel. 020 7499 1991 A walk in service is available at the following times: 9.00am - 8.00pm Monday to Thursday (excluding public holidays) 9.00am - 11.00am Friday Other times may be available by appointment. Transport The nearest underground stations are: Regents Park, Great Portland Street and Baker Street. Independent Nursing Services 19 Devonshire Street London, W1G 7AH Tel. 020 7580 9442 A walk in service is available at the following times: 9.00am - 5.00pm Monday to Thursday (excluding public holidays) 9.00am - 11.00am Friday Fountain Therapies 4 Fountain Mews High Street Handcross, Haywards Heath East Sussex RH17 6BH Tel. 020 7580 9442 Service available by appointment 9am 2pm Monday Wednesday. NUFFIELD Hospitals Nationally by appointment.