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Thanks for joining us for episode 85 of The Ancestral RD podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.
Specialized testing offered by alternative healthcare laboratories is a common method of diagnosis and treatment intervention. But a recent event has many wondering, just how reliable or necessary are these tests?
In response to the recent news story of the settlement between the Wisconsin government and Pharmasan Labs, Inc., today we shine a spotlight on the use of independent lab testing services by many alternative healthcare practitioners and patients.
As we share our insight into the case and talk about the conflict of interest involved with labs that offer both testing and treatment solutions, we’ll be discussing ways practitioners and patients can protect themselves and make informed decisions to provide and receive the best care. You’ll be empowered to be a knowledgeable, active participant in your healthcare!
Here’s what Laura and Kelsey will be discussing in this episode:
- Discussion of the case between the Wisconsin government and Pharmasan Labs, Inc. and NeuroScience, Inc.
- Why practitioners and patients should take caution with labs that perform tests and also recommend or sell supplements to treat abnormal results
- Why lab companies offering the testing and solution to results can be appealing to some practitioners
- The problem of over-relying on test results without considering symptoms to make health interventions
- Why it’s crucial to be working with a trusted healthcare practitioner to order testing and choose supplements to address results
- The importance of asking your healthcare practitioner questions and being an active part of the decision making process
- The value of second opinions
- The limitations of the usefulness of testing in developing a meaningful treatment protocol
- This episode is sponsored by Pure Indian Foods
- Nutritional Supplement Provider and CEO Plead Guilty & Agree to Pay Over $6.1 Million to Resolve False Claims Act Allegations
Kelsey: Hi everyone. Welcome to episode 85 of The Ancestral Rds. I’m Kelsey Kinney and with me as always is Laura Schoenfeld.
Laura: Hey everybody.
Kelsey: How’s it going, Laura?
Laura: Good, just trying to hopefully finish and launch my new website, new brand this week. It’s been a couple of long months before, or I guess since I’ve been working on it. I was hoping to have launched it over the summer, but with meeting my fiancé and now being in the throes of wedding planning I’ve just been totally sidetracked.
But I was interviewed on “The Paleo Women Podcast” a couple days ago and I think by the time we publish this podcast, theirs will have published as well. It was funny because before I got on the call Noelle Tarr was asking me, what website do you want to share with our listeners? And I’m like , you know what, if I tell them that it’s my new site and that gives me two weeks to really get it done and get it live, then that would be nice little deadline for me because I’ve been really bad about following my own deadlines recently.
Kelsey: Mm hmm.
Laura: It’s like if somebody else has a deadline for me, I’m good. But if it’s my own deadline, I make excuses for pushing it back a lot. I was like you know what, just whatever. I’m going to say it’s my new site and I’ll get it done and have it ready for when that episode comes out. Since that episode as of this podcast publication is supposed to be live, that means, I think, my new site will be live by the time this one goes live.
I’m switching over from The “Ancestralize Me” brand to just my name, which at first I had been trying to think of a different brand. It’s not that I’m not into ancestral health and ancestral nutrition anymore, it’s just I didn’t really like being pigeon holed by that name.
Kelsey: Mm hmm.
Laura: I like to talk about things that aren’t really related to ancestral health, so I decide to just branch out. I couldn’t really think of anything creative for an actual brand name, so I decided to just go with my name and I guess build name recognition for that.
Kelsey: Mm hmm.
Laura: Which ironically I made this decision I think back in January of this year and that was before I met my fiancé, so I’m like I guess I’m sticking with my maiden name because I’m not rebranding again with my married name.
Kelsey: Forget it.
Laura: Yeah. I mean a part of me wishes I had known because I might have considered changing to my married name, but the other part of me actually is happy to not have my personal life always intersect with my professional life.
Kelsey: Mm hmm.
Laura: I feel like a lot of people already recognize my last name. I’m sure as you’re experiencing, changing your name when people already know you as a different name can be a little hard.
Kelsey: Yeah, I agree with that. So far it’s a little even confusing for me never mind everybody else. I’m like trying to keep it straight and remember that that’s my new name. For me, most of that decision was just like I want to keep it simple. Just having the same name across everything seemed easier. I still think that way, it’s just that transition I think that’s a little difficult.
Laura: Mm hmm.
Kelsey: Also when I kind of like told friends, and family, and business friends, and everybody, they kind of were like Kelsey Kinney just sounds more fun, like you should just go with that. I was like okay, fine.
Laura: Yeah, it does kind of roll of the tongue a little easier.
Kelsey: Yeah, Kelsey Marksteiner is a little rough. But I’m actually doing the same thing as you, I’m getting very close to launching my new website. I think on this podcast I had said back in probably the beginning of this year I was aiming to maybe have my new website ready before I technically got married, which was in June. Ha-Ha, that really worked out. I’m hoping to launch before the end of this year, so I’ve have a few weeks to do that, but we’ll see.
It’s really, really close, but it’s like all those little details that you kind of are like I don’t want to launch until that is finished, or whatever. That’s like where I’m at right now with it, and I’m sure the same thing happened to me that happened to you. I started this process months and months ago. I was like okay, I’m getting married, and then having this big wedding, and I just didn’t think it through. I kind of wasn’t entirely what I wanted out of the website either, which just confused the whole process and made it take a lot longer than it probably should have. It turned into a very long process. But I’m really excited about re-launching it, and I’m sure you are too.
Kelsey: At least for me, it’s sort of has reinvigorated my motivation to make my business better and really put in all the effort for this stuff because I think you can kind of get a little bit comfortable in how the business is going. For me, I’m like okay, now I’m going to really focus on branding and doing all this stuff that I kind of have just been putting off I think for the last year.
Laura: I think moral of the story is don’t try to plan a wedding and make any major business changes at the same time.
Laura: As Kelsey and I have discovered, it’s I’d say mentally impossible.
Laura: I’m sure it can be done. But for me, and I feel like for you as well, just the amount of brain space that organizing and executing a wedding takes…I think’s there’s a lot of business things that have gotten a little autopilot for me, And I’m assuming it’s the same with you where things are going well enough without really putting in a ton of extra effort into marketing or branding, that kind of thing.
Laura: I know I’ve kind of just allowed things to keep going as they’ve been going and then been focusing on getting the wedding planning stuff done. For me, I’m not getting married until June, so I still have a good six plus months of time before that happens. But I’m kind of in that stage where almost all the major decisions have been made and there’s probably going to be stuff to do a couple months before the wedding, but I’m going to get into that phase of like, alright, I’ve kind of already done all the planning I can do for now.
Kelsey: Mm hmm.
Laura: And now I just have to wait until it’s closer. That’s why I’ve kind of decided to work on business stuff in the interim. Part of it is because I need to pay for this wedding. If that’s something I have to be saving money for, then obviously having a more successful business improves the ability to do that.
Laura: But even just having a little bit of a lull of mental space between the major planning decisions and then once things get closer, the execution phase.
Kelsey: Yeah, that lull phase turned into just like oh my God, I can’t think about anything phase.
Laura: Oh really? How long did that last for you though?
Kelsey: That’s a good question. I don’t really remember. I mean it was a few months I would say. But then everybody starts asking you questions because they want to help you with your wedding too. I think you think of it as this lull period, but it’s not really.
Kelsey: Or at least that was my experience.
Laura: I sound maybe mean saying this, but that’s almost one reason I’ve not really accepted any help from people.
Kelsey: Yeah, it’s honestly not a terrible idea.
Laura: I’m sure it would be some little things here and there that people can help with, and of course I’ve included my fiancé in the major decision making. Although to be fair, a lot of it he’s just been like you do whatever you want, I’m happy to just let you make all the decisions. I’m like thanks, babe. We’ve made decisions together, but really I’ve done the bulk of the work on it.
Kelsey: Mm hmm.
Laura: In some ways, it almost makes it easier because l don’t have to consider other people’s input.
Laura: Which sounds terrible, but honestly I think I have a harder time collaborating on that kind of thing than I do just deciding, okay, this is what I want, this is my budget, and this is what we’re going to do. I’ve been trying to make as many executive decisions as possible without needing other people’s coordination.We’ll see what happens.
Laura: I’m hoping that I’ll have a couple of months, maybe January through March where I can kind of like again focus on my business and get a few projects off the ground, that kind of thing. Then I’m sure I’ll be in another phase of complete distraction. So, we’ll see. I mean that’s my hope. I need to kind of take January and February really seriously when it comes to business stuff, and then like I said, it’s kind of up in the air what’s going to happen.
Laura: But I felt like this was a good time to really just get the website out there because I’ve been preparing for it, and creating stuff for it, and writing articles for it, and that kind of thing. I’m just like, alright, I just need to pull the trigger at this point. I don’t need to be having it be perfect before I put it out into the world
Laura: I think that’s a big reason I tend to procrastinate is I want everything exactly the way it’s supposed to be.
Kelsey: Of course, yeah.
Laura: At the end of the day I had to be just like, alright, it’s ready, just do it.
Kelsey: Yeah. My thought process around it at this point is like okay, I’ll probably change some pictures on here down the road. I’ll kind of change little things about it, but the general skeleton is what I’m going for.
Kelsey: Just got to put it out there.
Kelsey: It’s really exciting and I can’t wait to see your full new website. I’m sure it looks great and I guess people can look for yours, well they’ll be able to see it by the time this comes out.
Laura: I believe so. I don’t want to guarantee this, but I think the way my designer and I are doing it is that my old website is going to redirect to the new one. I’m hoping that it’ll be a redirection that individual articles get redirected. That’s what I’m hoping.
Laura: We’ll see. That’s possibly more complicated than just having the site go to the homepage, but that’s the goal is to make it so that anytime you go to AncestralizeMe.com it’ll get redirected. But if you guys want to check out my new website and hold me accountable to this launch date that I just committed to, the website is LauraSchoenfeldRD.com.
Which is funny that’s another reason that I was contemplating going with my upcoming married last name because LauraSchoenfeld.com is not available as a URL. For some reason somebody owns it without having any website on it. I was like, man, my new married name is available, maybe I should change it. I’m like no, I’ll just stick with what I’ve been doing.
Kelsey: Yeah, I know. I luckily was able to get mine, which is funny because there’s actually some actress, I mean she’s not like a big actress that anybody would know really, but when I search my name, she comes up as the most prominent person. I was like, yes, she hasn’t gotten this URL yet.
Kelsey: I scored the URL. Mine is KelseyKinney.com and I’m not going to commit to a date yet, you guys. But hopefully it’s coming soon.
Laura: I’m going to make you at some point.
Kelsey: I know. With that, let’s jump into our topic for today. But before we do, here’s a word from our sponsor:
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Kelsey: Alrighty. Today we don’t have a question per se, but we wanted to talk about something that happened in the news recently that has been just an interesting topic to talk about and we thought it was important that we discuss it on the podcast because it brings up some things that Laura and I think about all the time with regards people and dealing with their health issues that I think doesn’t get talked about a lot. Laura, do you want to kind of intro us into this news topic?
Laura: It’s funny because we call it a news topic, but I don’t know if anyone was really aware of it.
Kelsey: Paying attention to it? Yeah.
Laura: Yeah. And we’re going to link to the article in the show notes, but the press release came out on October 14th of this year, and I don’t think I was exposed to this until the end of November.
Laura: It was definitely at least a month or so after this actually happened that I even saw it. The only reason why I saw it was because somebody had posted in I think an alternative nutrition group.
Kelsey: Yeah, like one of the Facebook groups.
Laura: Yeah, something like that.
Kelsey: I saw it there too.
Laura: I might have not have even seen it unless somebody else had posted it. It’s not like this is some big news story that people would be aware of. But basically what happened was that the Wisconsin government reached a 6.1 million dollar settlement with a popular alternative health company called Pharmasan Labs. They have a brother company called NeuroScience Inc. People might have seen either the Pharmasan Labs that runs a lot of different types of testing, primarily the testing that we’re going to talk about is the Neurotransmitter urine test. NueorScience Inc. is a company that makes a lot of supplements.
These are supplements that a lot of practitioners work with. I know I’ve seen few of them that are super popular that we can talk about in a little bit. But it’s not like this is some unknown company that is the subject of this little lawsuit, it’s actually quite a large and popular company. They reached a settlement because the Wisconsin government was accusing them of violating laboratory testing requirements and also manipulating testing data. They actually pled guilty to this accusation, which I thought was kind of interesting.
Laura: In the article they talk about how the owner of the company actually said that they intentionally did this stuff, which I guess that’s criminal activity. But in the lawsuit it was found that they intentionally violated the requirements of something called the CLIA program, which stands for the Clinical Laboratory Improvement Amendment Program. This is a government run program that basically certifies independent laboratories for laboratory testing. It’s administered by The Center For Medicare and Medicaid Services which is a part of the US Department For Health And Human Services.
Basically through this CLIA Program, the CMS regulates laboratory testing performed on humans for the purposes of medical diagnosis, treatment, and prevention. It’s a pretty important program to make sure that testing and diagnostic tools are being monitored and appropriately developed. This situation is a great example of an issue where the test wasn’t actually accurate and it was being promoting as accurate. The thing that the CLIA regulation does is it basically requires that each test performed by a lab must be subjected to a process known as method validation, and that ensures that the test is reliable and that it accurately reports the results.
In this lawsuit, the founder of the company, Pharmasan Labs, admitted that he actually intentionally subjected neurotransmitter testing to a multiplication factor that altered the results of the testing without performing method validation on the multiplication factor. What that basically means is you get a certain result from this test and they added this arbitrary multiplication factor that actually would change what the results were, and I believe that that was something that would affect the results and affect the reference ranges. The main issue with what the company was doing is that they were intentionally reporting the neurotransmitter test results as either high or low based on a not properly validated reference range and they had created this narrowed reference range that had not been subjected to the method validation procedure that the CLIA requires. Then on top of that, the brother company NeuroScience Inc., they would then recommend products to patients that fell outside of this narrow and un-validated range.
Just to kind of summarize what the company was doing is they created this test, they created reference ranges for the results that were adjusted by this, I don’t know if we could call it a fake multiplication factor, but it’s a multiplication factor that they created to change the results of the test to make the test results fall outside of the reference range more often.
Kelsey: Mm hmm.
Laura: Then when patients would be outside of the reference range for a test, they would promote the use of supplements to fix that problem. It’s kind of a big deal because in these kind of testings, first of all they can be kind of expensive so you don’t want it to be inaccurate. If a test isn’t that expensive and it’s not really changing much of the treatment, then the accuracy I think is a little bit…I mean you still want testing to be accurate, but I think when a test costs several hundred dollars and then you’re on top of that adding hundreds of dollars of supplements to treat the results of the test, I think it’s even worse.
Laura: There’s some blood test people recommend that maybe aren’t super helpful, but I don’t think it’s that big of a deal, or it’s not quite as criminal in that situation.
Kelsey: Mm hmm.
Laura: This is why the company was sued and they ended up settling. And like I said, it was like a 6 million dollar settlement. Even the owner of the company I think is subject to up to a year in jail. It’s a pretty big deal for this company. One of the attorneys I think that was on the case, or at least quoted in this press release, says that “Patients and their medical practitioners make critical healthcare decisions based on the test results reported by independent laboratories and it is crucial that laboratories report their results accurately and reliably. Intentionally subjecting test results to alterations and narrowed reference ranges that have not been properly validated violate the laboratories responsibility not only to the United States, but more importantly to the public and will not be tolerated.” That’s kind of the overview of what happened in this lawsuit. Any thoughts about the lawsuit itself?
Kelsey: Yeah. I mean I think that it’s really interesting. And I think it’s kind of funny that it wasn’t a bigger deal and that it wasn’t a bigger news story. I, like you, saw this way later than when it actually happened. The fact that they pled guilty, I mean it was probably maybe a smart move on their part even if maybe they weren’t totally intentionally doing this to begin with just to get a lesser settlement or a better settlement I guess.
Laura: Actually the press release said that they admitted to intentionally doing this, so it was intentionally violating the requirements.
Laura: At least they pled guilty.
Kelsey: Right, exactly. They were pleading guilty to it. Who knows what really went on behind closed doors, but interesting that they would admit that. I think it just goes to show that you have to be really careful with this stuff. I would say I haven’t really used their supplements, which we’ll talk about in a little bit. But I was definitely aware of this company, heard of the supplements and everything. It’s not like, like you said, that it was small company or anything.
Reading this press release, I was like wow, you have to kind of think about the business side of this stuff when you’re buying these things. To me, the most interesting part of it was that this company is doing testing and then also selling supplements, so it’s not like those two things were separate whereas a lot of lab tests that you get that same company usually or a lot of the times I would say is not selling you the supplements to then treat that lab abnormality.
Kelsey: This was interesting to me in that regard in that the same company essentially is doing the testing for you and then selling you the supplements to treat it. In a way they’re really motivated to kind of give you a narrowed test result range to make it more likely that you would be outside of that so that they can convince you more easily that you need whatever supplements they’re selling. To me, that was like wow, that’s the biggest take away here.
I would caution anybody who’s doing any sort of testing from a practitioner or ordering it on their own that it’s probably a really good idea to look at what the lab recommends that you do with those results. I’d say a lot of better labs are going to say talk to a healthcare practitioner, they can recommend what would be good to help deal with this condition.
Laura: Mm hmm.
Kelsey: In this case, it sounds like it’s not what was happening. Do you know of the top of your head, Laura, if patients could order this testing themselves off of their website?
Laura: I don’t think so. I could double check, but I’m pretty sure that they require you to go through a practitioner.
Laura: Yeah, because they have a part on their website that says find a physician. Basically they’re saying you either have to request that your current provider sets up an account with the lab, or that you could find a Pharmasan Lab healthcare practitioner in your area.
Laura: It does require a practitioner to order the labs. Actually I’m wondering with the products, the NeuroScience Inc. products, I’m not sure if you can order those yourself either. I think that’s one of the weird things about this situation is that they do actually require a practitioner to be involved in both the testing and the ordering of products.
Kelsey: Right. It’s almost like they’re manipulating the practitioner to get to the consumer.
Laura: Yeah. I guess that’s possible. I think the biggest problem is that a lot of the practitioners out there that want to be doing more of like an alternative, integrative, functional medicine kind of thing, this stuff can get really complicated and being able to have a service like this where you can offer a test and then the test gives you all the recommendations, even though it wasn’t accurate, it’s very desirable to have that kind of situation going on.
I just think about for example our adrenal fatigue program where we have the DUTCH test that we recommend and then we have our supplement recommendations based on the results. But we had to create all those supplement recommendations results on our own, and come up with the exact patterns that people should be looking for, and find all the different brands that we recommended. It was a lot of work and it isn’t even foolproof. We mention in the program that there’s probably some nuances to different results that might affect how well they fit any of the patterns and that we do recommend working with someone one to one to make sure that it’s accurate and well suited. But the service of having a lab test that gives you exactly what to do with those results is very appealing even if again, it wasn’t really accurate or could have actually criminally inaccurate.
Laura: Yeah, I can definitely see why people would use this kind of program as a practitioner. But that’s I think a big reason why I try to avoid this kind of stuff.
Kelsey: Mm hmm.
Laura: Because I don’t really like the thought of a company giving, it’s almost like you said, having that conflict of interest where they have a test result and then they’re trying to sell supplements based on those test results, then of course there’s going to be some amount of motivation to get people buying the supplements. I don’t really do any of these kind of tests where they have any if this result, then this supplement type of outcome.
Kelsey: Mm hmm.
Laura: I know there’s some test results, like stool tests for example where if you have a certain overgrowth of a pathogen, they’ll give you evidence for certain antimicrobials that are effective against that pathogen, but they don’t give you an exact brand and they don’t sell you the supplement. Again, a lot of these more independent labs that do these kind of alternative tests, they not selling the solution to the test result, they’re just selling the test.
I think separating that, like you said earlier, is really important when you’re either a practitioner of if you’re a patient and you’re trying to order testing on your own, or if you’re working with a practitioner who does testing, I think it’s one of those things where you want your practitioner being the one making the decision about how to treat the test results.
Kelsey: Yeah. It didn’t even actually occur to me that there were companies like this doing stuff like that where they’re offering the testing and supplying the solution to that. In fact I knew of this company just basically as a supplement company. Granted their supplements aren’t ones I’ve used a ton with my clients, or I’ve just had clients come to me already on their supplements. I wasn’t doing the ordering of the supplements for them.
Kelsey: I guess I wasn’t going to their website where it is fairly clear that you can order testing through them too. But I don’t come across this all this often. I can’t even think of another lab that does this off the top of my head, but that is like a huge red flag to me. Whether or not their supplements are great I think is another question entirely. But the fact that there is a very, very clear conflict of interest, to me as a practitioner considering the labs that I’m going to use with my patients, I would be very turned off by that the way that they’re conducting business in that regard.
Kelsey: I think probably like you were kind of talking about before, it probably preys a little bit on health coaches and people that in some way are authorized to order testing, but maybe they just don’t have the training to kind of know that this sort of thing isn’t a great idea and be able to really evaluate the lab on their own to decide whether or not this testing is appropriate.
It’s really appealing to have that option of getting a test result that maybe you don’t know a whole lot about neurotransmitters, but you get clients saying I heard about neurotransmitter testing, is that something that you do? And you say well, this lab can offer me neurotransmitter testing, they tell me exactly what to do with the results for my clients so I can walk them through the process, and I know exactly the supplements that I want to give them.
It is really, really appealing especially when you have people coming to you asking for this kind of stuff. I really, like you, I see that appeal for a lot of healthcare practitioners that might want to use this kind of testing. But I would hope that for a lot of practitioners out of there, that conflict of interest is a real big red flag like it is for us.
Laura: Right. I think this company, the NeuroScience Inc. part of their company that sells supplements, I do see a lot of their products being used by different integrative and functional practitioners, either doctors, or naturopaths, that kind of thing.
Kelsey: Mm hmm.
Laura: Some of their more popular products that I’ve seen are they have a product called Calm CP and then another one called Kavinase. I see a lot of people on those.
Laura: I know that their products are effective and well used around the alternative healthcare community. I don’t order these products. I don’t have an account with this company. I know that you said you don’t either.
Laura: The only product of theirs that I’ve personally used before is a product called GABA Trex and I think it’s just a chewable form of L-Theanine. There’s nothing really even that special about it and it has very similar benefits to any other L-Theanine that I’ve ever used, so I don’t really the see product as being something outrageously special or anything like that. But I do see their products being used a lot by practitioners that are looking to improve neurotransmitter functioning.
I don’t think the products themselves are bad or that the company is creating ineffective supplements, or unsafe supplements, or anything like that. I also don’t believe that using supplements to improve neurotransmitter production or function is in itself a bad idea either. We’re not saying that you shouldn’t work on improving neurotransmitter function or that you shouldn’t take supplements that can affect neurotransmitter production.
The main point of this conversation is to understand that there are a lot of “alternative health” type companies out there that could be doing some more types of scams as this and it is hard to know who to trust sometimes. Like we were just saying, looking at what’s the company’s main source income and do they rely on the results being out of range to make money, that would probably be an important factor to consider.
Like I said, I don’t think either of us use any labs like this. Even the DUTCH test that we recommend, which is a urine test so it’s kind of similar to this urine neurotransmitter test, I don’t think the Precision Analytical Company is selling anything that would rely on test results being out of range. I mean there’s always the possibility that there’s some inaccuracies there. Honestly, with any test there’s going to be the possibility of inaccuracies so it’s impossible to create a test that has 100% accuracy. So just keep that in mind that even your typical lab test that you get done at a normal doctor’s office, there’s a risk of that being inaccurate as well.
We’re not saying a test has to be 100% perfectly accurate for it to be relevant and useful, but obviously the goal of the company should be to create the most accurate test possible and to follow the legal guidelines for that independent testing and make sure that they’re doing their best to validate their procedures, and if things come back as being inaccurate, then they need to make adjustments. That’s a good sign if a company is regularly testing their results or validating their results and making sure that it’s not financially benefiting from results being out of range.
Laura: We obviously want to give you guys a take home point for this conversation. I don’t want to just scare people out of doing any kind of testing or supplements. Remember that you need to be working with a practitioner if you’re doing any supplements based on testing. I think there’s this desire by a lot of people to kind of DIY this kind of stuff.
I know our group program that we do is technically not working one of one with a practitioner, but we are involved with our group and making sure that they are educated in how to interpret their test results, and also encouraging people to not buy supplements unless they’re very clear that it’s the accurate thing to do, and to also run those supplements by a practitioner. Ultimately we don’t really ever recommend doing this 100% solo. It’s really important to have an educated guide to help you make decisions and I definitely wouldn’t recommend any sort of test where the test company is making the recommendations for the supplementation.
Kelsey: Right, for sure.
Laura: But the other thing to remember is that this company was working with practitioners. If you are working with someone that is running tests that you’re not really sure why they are using that test, you don’t understand the methods of the test itself, or if you feel like your practitioner is over relying on certain unusual testing methods, like for example they have this single test report where they create a super complicated supplement protocol based on this single test report and it’s not necessarily based on any other tests or any other symptoms or anything like that, then don’t be afraid to question them. Ask them to explain why they’re doing what they’re doing. Ask them to talk to you about their reasoning and their understanding of what those test results mean, and how they decided to use that test, and what the research is showing that that test is valid. Even if you’re not doing these things on your own, that doesn’t mean you just hand all the decision making to a practitioner.
Laura: If you’re not really getting the answers from that practitioner, you can always get a second opinion from another practitioner and see if they agree with those recommendations or if they have another suggestion. Because you don’t just want to be 100% relying on someone if they’re using these kind of testing methods because the practitioner may just be misunderstanding the validity of the test or maybe they were taught how to use this test by another practitioner and they never really thought to question the accuracy or the validity.
I’m not saying that practitioners are purposefully misleading their patients at all. I’m just saying that like we said, there is this motivation to make things as simple as possible when you’re a practitioner and sometimes that means oversimplification and relying too heavily on these kind of testing and supplement protocols.
I think one of the other major things to remember is that anytime you’re relying on test results whether it’s a urine test, or a saliva test, or a blood test, or whatever kind of test you’re doing, test results shouldn’t ever be the only thing you’re looking at. You should never be making massive changes just based on a test result. If it’s something like you have low vitamin D or something and you’re going to supplement with vitamin D to bring it up, I mean that’s probably fine. But if you’re getting a test and you’re having this 15 different supplements to treat a test result and you can’t even identify either a symptom that you are looking to improve or if you’ve been on the protocol for weeks and you haven’t noticed any changes, then you really need to be considering that as well.
I think a good example is food sensitivity testing. I’ve had some clients that have done some of the less, I don’t know if I want to call them less credible or just not as well supported food sensitivity testing. I’ve seen some people get some good results from that kind of stuff, so again, it’s not necessarily 100% inaccurate. But a lot of my clients will get results saying that they’re sensitive to a certain food, but then they end up removing and reintroducing that food and there’s literally no change in their symptoms either from removing the food or reintroducing it. In that kind of situation, I would question the test result.
The same thing would go with a neurotransmitter test, if you were taking supplements to balance neurotransmitters and you weren’t seeing any progress or improvements. Or if you do a stool test and then you’re taking an antimicrobial protocol and that’s not really helping, or you never had gut symptoms in the first place, I would just be really careful if you’re not also including symptoms as being something that you’re relying on to get the right treatment recommendations.
Laura: Do you have any thoughts?
Kelsey: Well, I completely agree with that first of all. I think the practitioner piece is really key here. I agree with what you said that you really need to question if you don’t understand something. Any practitioner worth their salt should be able to answer those questions super easily. I have patients that will ask me questions about the lab tests and I try to even before they have a chance to ask a question about it really explain why I think it would be beneficial for them, what it’s going to tell us, what we do based on those results.
I think any practitioner that knows a lot about the labs that they’re using and uses them for a specific purpose, those questions should be really, really easy questions to answer. You shouldn’t feel like you are standing up to authority in any way or questioning them as a practitioner. It’s an easy question for somebody who knows what they’re doing to answer and you shouldn’t feel bad about asking it.
I think sometimes people get a little bit, what’s the word? They get a little bit worried about asking their practitioner too many questions and feeling a like they are not trusting the practitioner and that that can kind of mess with the practitioner patient relationship. But honestly, I really like when I have a patient that asks these kind of questions because it just means that their doing their due diligence too.
It sounds bad I guess to say that you really, I mean you can’t trust anybody 100% because nobody knows exactly what you’re experiencing. A practitioner is going to do their best to truly understand what’s going on with you. But at the end of the day, you know your body best and so it’s worth it to ask these kind of questions to make sure you’re going in the right direction.
There are some bad healthcare practitioners out there. As much as I hate to say it, it is true. There are people out there that don’t really know what they’re doing, or like Laura mentioned, maybe they learned a particular testing method from another practitioner, or they learned it in school and they just kind of stuck with it despite not knowing a whole lot about it. I think you need to be comfortable questioning your practitioners. You don’t have to come at it from a place of…
Kelsey: Yeah, accusation or telling them that they don’t know what they’re doing, but just from a place of learning and curiosity, and that’s always appreciated. We as practitioners definitely understand why you would ask those questions. When somebody asks questions like that, we don’t think automatically that they’re accusing us of not knowing what the heck we’re doing.
Definitely don’t be afraid to ask those questions. Like I said, a practitioner that knows what they’re doing should be able to answer them very easily. It’s not going to be a big deal and you’ll feel a lot more comfortable going through with the testing and with whatever is recommended as a solution based on the results. Definitely do that.
And second opinions are always good. I know it can be expensive to do that, but it’s your health, it is worth it if you’re not sure about something or not sure about a practitioner that you’re working with. These tests, a lot of them can really expensive, so I think it’s always worth considering if you can do something without testing. It’s always worth considering how valid the test is. You need to ask these questions. Even if you don’t fully understand how the test works, you’re practitioner should be able to explain that stuff to you.
Then you can also look into the labs on your own as well. Your practitioner should tell you where you’re getting your labs done and that way you can look at their website, you can call their customer support if you want any more information, you can just Google that company in general and see if there’s been any problems in the past. All of that stuff is a good idea especially when of course when you’re spending a lot of money on that testing.
Laura: Yeah. I think a lot of this is big reason why I personally don’t do a lot testing as part of my work with clients. Part of that is because of the limitations of being an RD. There’s certain things that you just can’t order, which is fine. And the other side of things is some of these tests that are super complicated and maybe not 100% validated, or there’s just questions of their utility, I don’t like to order that kind of stuff because I don’t want to first be wasting anyone’s money on testing that’s not accurate.
Kelsey: Mm hmm.
Laura: And second of all, I don’t want to be making recommendations that are based on information that isn’t either accurate or it’s….
Kelsey: Little understood at this point.
Laura: Yeah, even if it was accurate, what’s the treatment protocol for that result? And if we can’t really figure it out, then the question is okay, how useful is that information anyway? What you were saying before about a patient expecting a practitioner to be able to explain the testing that they’re recommending, yes, I definitely think…and if there’s a practitioners listening to this, if you are making recommendations for tests, then you need to be able understand and be able to describe the background of that test, what they’re testing, what the benefit is, what the results can do for the treatment.
On the flipside of that, if you have a patient coming to you that’s wanting to do a test or had another test done by a different practitioner and they want you to explain it to them, I think that’s the only time where you shouldn’t necessarily feel pressure be able explain everything. I’ve had clients bring certain test results to me that I either don’t agree with or don’t really understand what the test purpose was, and I’ll admit that to them. I’ll say I don’t really use these tests, I don’t interpret them, so I’m really sure what to do with these results. I think just being honest as a practitioner and telling people if you don’t use the test and you don’t have education in that testing modality, then it’s okay to say I don’t know what to do with this test results.
Laura: But you shouldn’t be ordering tests if that’s the situation. If there’s a test you legally are allowed to order, but you have no idea what the method is, or what the validation is, or anything like that, just be careful. Because like we were saying before, it’s really tempting to rely on these companies that offer these services because hypothetically if it was accurate, it could make our jobs a lot easier. But you are putting a lot of reliance on a company to make these decisions for you and there’s always that conflict of interest concern.
Kelsey: Yeah, exactly. I think the take home here is to be careful with the kind of tests that you are having your practitioners order for you. Sometimes these tests, even if like Laura said if they’re accurate, we just don’t know enough about what the results mean to make any sort meaningful treatment protocol based on them. That’s not just even from an individual practitioner standpoint, it’s just the testing we don’t know much about the thing that we’re testing in the first place as scientists and researchers, so we can’t really determine what to do with those results.
I think there are definitely some testing methods out there that I’m not really sure why people do them because we just don’t know a whole lot about that stuff in the first place. But there are definitely useful tests out there and I think it can be difficult as a patient to decipher between those. Like we’ve been talking about here, you need to be working with a practitioner, and you need to trust that practitioner, and you need to be able to ask question of that practitioner, and they should be able to answer them very easily and honestly, and you should be able to understand what they’re talking about. If you can’t, if there’s any red flags popping up along that path, then it might be time to either find a new practitioner or at least get a second opinion.
Laura: Definitely. Well, hopefully that’s helpful. Like we said, we didn’t want to scare people out of using any sort of functional medicine testing, or taking supplements to deal with test results or to improve neurotransmitter function. But it’s just a really good example of a situation where unfortunately financial interests got in the way of patient interest.
Laura: Just keep it on your radar when you’re doing testing and like we said, don’t be afraid to ask questions and build trust with a practitioner. Don’t just go in thinking because they have letters after their name that they know exactly what they’re doing, and don’t be afraid to a get a second opinion. Just having awareness of this I think can really help the process of getting appropriate treatment.
Laura: Anyway, hopefully you all enjoyed this topic and maybe we’ll be able to do some more hot topic type conversations like this in the future. But if you have a question that you’d like us to answer, we are collecting those as always. If you go to TheAncestralRDs.com and click the contact tab, you can submit a question there and we’ll be happy to try to answer that on another show. We will look forward to seeing you all here next week.