Laboratory diagnostics

The list of parameters and values that can be measured by laboratory diagnostics is endless. "Testing everything" results in costs in the upper five-digit range. That is why targeted diagnostics make sense. This is, of course, based on the symptoms, previous illnesses, previous abnormal values, family history, etc. Even if there are no specific complaints, laboratory diagnostics can be useful.

In my practice, people often ask for a micronutrient check, i.e. a blood test to check whether there is a deficiency of vitamins or other micronutrients. If someone is already taking nutritional supplements, this can also be used to check the success of the therapy and ensure that no overdose is taking place. 
Of course, when selecting the parameters to be determined, it also plays a role how someone eats, whether there is a desire for children and fertility should be supported, whether someone suffers from symptoms such as hair loss or weight gain, in which phase of life one is, whether there are pronounced neurological symptoms or whether someone does a lot of sports.

A micronutrient basic check includes, for example, calcium, iron, potassium, copper, magnesium, manganese, molybdenum, selenium, zinc, vitamin B6, small blood count, sodium, cholesterol-corrected coenzyme Q10, ferritin, the soluble transferrin receptor, vitamin B12, folic acid, homocysteine and vitamin D. This already covers quite a bit and is basically useful for everyone. The price for this is 249€ (as of 9/2023).

If there are clustered cases of heart attack or stroke in the family, it makes sense to determine the values that are relevant to the risk of cardiovascular disease. These include erythrocyte membrane fatty acids (including omega-3 index), lipoprotein (a), cholesterol, triglycerides, VLDL, HDL, IDL, LDL 1-7 subfractions, and wrCRP, and serum zonulin. The cost of this "Micronutrient Test Pro", which also includes all the parameters of the Basic Check, is 529€ (as of 9/2023).

Even more parameters are measured in the Premium Women's Health Check. In order to be able to determine the risk of diabetes and thyroid disease, the iodine content in the urine is also measured, as well as parameters associated with metabolic syndrome: Adiponectin, CRP, proinsulin, alkaline phosphatase, bilirubin, blood glucose, cholinesterase, electrophoresis including total protein, gamma-GT, GLDH, GOT, GPT, HbA1C, LAP and serum coeruloplasmin.
This testing package also includes thyroid levels (fT3, FT4, TSH) and free and bound testosterone levels. The cost of this package is 769€ (as of 9/2023).

Of course, all values can also be determined gradually. You can start with a basic diagnosis and determine further values in case of abnormalities.

Another common question concerns food intolerances and allergies. These are two different things, and it is also important for therapy to know which pathomechanism underlies the complaints. In principle, other causes such as SIBO syndrome, intoxications or infections are also possible.

If food intolerance or allergy is suspected, a food symptom diary should first be kept, ideally for at least 2 weeks. In combination with the medical history and the examination, this is already indicative for further diagnostics.

If an allergy is suspected, the following diagnostic procedure is recommended: Initially, IgG antibodies in serum to pineapple, hen's egg, hazelnut, cow's milk, mustard seed, tomato and wheat are measured in a prescreen. In addition, total IgE and sIgE titers to various inhalant allergens can also be determined. In case of abnormal values, follow-up diagnostics are useful.
In this follow-up test, IgG antibodies to up to 267 individual foods are tested, depending on the patient's wishes and diet (cost 529€).
If the subsequent therapy concept includes intestinal rehabilitation, it is also advisable to assess the intestinal mucosa by means of calprotectin, alpha-1-antitrypsin and zonulin in the stool.

For the diagnosis of non-immunological food intolerances, the following diagnostic procedure is recommended:
Based on the dietary protocol, symptom-triggering foods are identified and a suspicion of wheat sensitivity, histamine intolerance or carbohydrate intolerance is substantiated accordingly. The latter include, for example, lactose intolerance, fructose intolerance and sorbitol intolerance. Diagnostics here depend on the particular suspicion and may include stool and blood diagnostics, as well as breath tests and genetic tests.

Depending on the cause identified, a change in diet may naturally follow. Sometimes certain foods should be avoided, in other cases the use of enzymes or medications may be indicated.