New England Naturopathic Health utilizes both conventional and integrative Diagnostic laboratories in order to fully assess and understand the underlying causes of seemingly-mysterious health issues. As accurate Diagnostics are so integral to the NENH approach, testing is ordered in the first patient consultation, prior to the initiation of treatment.
NENH utilizes Mercy Diagnostics for blood work and offers phlebotomy services in-office. Mercy Diagnostics, being an out-of-network lab, is able to offer a “no client bill” guarantee, meaning that you will never be financially responsible for any lab work that your insurance doesn’t cover. If you have medical insurance, Mercy will file a claim on your behalf; if you don’t have insurance, Mercy offers the lowest out-of-pocket lab costs in the state of Maine. Please note that Maine Care and Medicare do not acknowledge NDs in the state of Maine as providers and so do not cover testing ordered by Dr. Marinaro. For additional questions about Mercy’s unique billing paradigm, please contact the company directly at 1-877-514-5504.
Common labs drawn in the first visit include:
- Complete Blood Count with differential
- Comprehensive Metabolic panel
- Lipids, Cardio-reactive Protein, Hemoglobin A1c, Ferritin, Homocysteine and other markers of inflammation
- Total Vitamin D
- Comprehensive Thyroid Panel including: TSH, Free levels of T3 and T4, Reverse T3 and thyroid antibodies
- Immune system assessment of total antibody output, if indicated
- Infectious Disease Panel (as indicated from patient history and symptoms):
- Western Blot and Lyme Disease co-infections
- Viral Infection Panel
- Anti-nuclear Antibodies, to assess for auto-immune disease caused by infection
Salivary Hormone Levels, through Diagnostechs
Hormone balance is integral to human health and quality of life. Achieving appropriate hormone balance requires a baseline evaluation of hormone levels and follow-up evaluation to monitor hormone-balancing treatments. Dr. Marinaro utilizes salivary testing of hormone levels frequently, as this method provides an insight into the “free” levels of each hormone. “Free” levels of a hormone dictate the portion of the total hormone pool that is “available” to the system and therefore are much more sensitive for a functional understanding of hormone balance. Hormone testing panels include:
- Female hormone panel: Estrogen metabolites, Progesterone, Testosterone, DHEA, Cortisol levels (if necessary)
- Male hormone panel: Testosterone, DHEA, Estradiol (if necessary), Cortisol levels (if necessary)
- Adrenal Stress Index: morning, afternoon, evening and bedtime levels of cortisol, DHEA levels
Gut Microbiome Assessment, through Genova or Diagnostechs (depending on patient insurance)
Dysbiosis, or an imbalanced population of intestinal flora, is the root cause of many digestive issues, allergenic and auto-immune pathologies. A stool culture can diagnose a pathogenic overgrowth of yeast, bacteria or parasites and can also indicate the population of beneficial types of flora. This technology is also utilized to monitor the effectiveness of treatment strategies for digestive and/or inflammatory health concerns.
- Digestive enzyme levels
- An under- or over-active intestinal immune system
- Undigested nutrients in the stool
- Inflammatory markers
- Presence of occult (hidden) blood
- Stool pH balance
Food Allergy Testing, through US Biotek
NENH utilizes nutrition as a first-line treatment for reducing symptoms of inflammation. If you are not aware of which foods contribute to your symptoms, a food allergy panel to determine which foods irritate your immune system can be a good idea. The US Biotek food allergy panel checks for IgG antibodies to 96 common food allergens through a blood draw or a finger-stick. Foods that are determined to have an antibody reaction must be avoided in the short-term in order to immediately decrease inflammation and de-sensitize the immune system to them. The US Biotek food allergy panel is also an excellent assessment for “leaky gut” syndrome and to determine the extent of treatment that will be necessary for the GI tract to function normally.
Genetic Testing, through Courtagen or 23 and Me with Sterling Application
Dr Marinaro has trained extensively with Dr Ben Lynch, founder of Seeking Health Educational Institute and leading resource on how genetics can influence an individual’s tendency toward disease patterns.
Genetic testing is rapidly becoming a cornerstone of Functional Medicine and can provide insight into which body systems biochemical pathways are affected by SNPs (or genetic mutations) on an individual level. Due to the expense and time-consuming nature of this modality, it is utilized only for extremely complex adult patients and children. For already-established patients who are simply curious about their individual genetic patterns, NENH can interpret the Sterling’s Application of the raw data provided by 23 and me and provide a written summary of important SNPs.
When it comes to genetic medicine, it is important to understand that for most patients, epigenetic stressors to the system are as important, if not more so, than genetic mutations. Epigenetic stressors include:
- Poor Nutrition
- Life Stressors
- Toxic exposures including substance abuse, environmental exposures such as mold and heavy metals and poor air or drinking water quality
- Chronic Infections
Genetic testing only has value in the context of individual symptom pictures and understanding the epigenetic burden on the system. Because Dr Marinaro has to have a good clinical understanding of the patient before she can interpret genetic testing accurately, NENH does not offer interpretation of these tests in the first patient visit.
Other Functional Testing companies used by NENH include:
IGenex: comprehensive Lyme and co-infection testing through blood work
Microbiology Dx: testing of chronic bacterial and fungal sinus infections and the “biofilms” that protect the infections; samples are obtained through a swab culture of the sinuses
Great Plains Laboratory: heavy metal testing through provocated 12-hour urine collection and OATS urinary analysis of neurotransmitter metabolites for mood disorders