Tests that complement one another together

Did you know that Precision Point Diagnostics offers two separate test bundles? These bundles offer a way to receive a discount for mutually complementary testing and get results in tandem.  The first bundles together our P88 Dietary Antigen Test with our Advanced Intestinal Barrier Assessment.  The second bundle, the Precision Core 4 Bundle, extends this philosophy by combining the P88 DAT, the AIBA, the Advanced Oxidative Stress Test, and the Advanced Adrenal Stress Test. Both bundles are found on our current price sheet and requisitions, and both bundles are eligible for either cash or insurance billing (see price sheet and insurance information for further details).

So, why order the P88/AIBA bundle together? Aside from the price discount, these two tests can provide information together to further your understanding of the state of a patient’s immunological response and assess the state of their gut at the same time. The P88 DAT assesses the response to 88 common foods, chosen for their representation of common diets, and is designed to capture wide arrays of other foods through cross-reactivity within food families. Four separate reactions for each food are assessed: IgE (food allergies), IgG (food sensitivities), IgG4 (tolerances to individual food allergies), and C3d (complement, a marker that can assess the potential for a complement cascade from an individual food, intensifying the inflammatory impact from that food). This test can isolate triggers that the patient can miss through observation because reactions from food sensitivities can take up to 72 hours to manifest themselves. It also provides a targeted approach to an elimination diet that can more comprehensively exclude foods that cause reactions from the diet. Symptoms from food sensitivities can vary greatly from those of food allergies and this alone could mean that a patient might mistake the headaches, fatigue, skin issues, and brain fog for something else entirely, and suffer from food triggers for years that damage the gut lining and the microbiome.

The reason that one would want to test both food triggers and assess gut condition together is to find out how much damage has been done to the lining of the intestinal wall, and to the microbiome, as well as to chart markers of inflammation. Food sensitivities, over time, can damage the tight junctions between cells in the intestinal wall, allowing toxins and bacteria into the bloodstream, and potentially causing systemic, chronic inflammation. Systemic inflammation has been linked to major health conditions. Many diseases are, in essence, inflammatory diseases. The Advanced Intestinal Barrier Assessment panel includes tests for zonulin, diamine oxidase, histamine, and LPS, as well as the diamine oxidase:histamine ratio. 

• Zonulin is a well-documented marker of intestinal tight junctions. Elevated zonulin levels can indicate intestinal permeability, and can correlate to the severity of that condition. High zonulin can be a predictor of systemic inflammation, chronic gut conditions, and autoimmune diseases.

• Diamine oxidase breaks down histamine, so measuring both diamine oxidase levels and its ratio with histamine can let the practitioner see exactly how DAO is affecting histamine levels. Since most DAO is produced in the gut, low levels of this enzyme can indicate compromised gut health. Conditions like leaky gut, inflammatory bowel disease, or other gut-related issues can reduce DAO production. Low DAO levels are also often associated with histamine intolerance, where the body cannot effectively break down histamine. Excess histamine can lead to symptoms like bloating, diarrhea, abdominal pain, and nausea. These symptoms are often associated with conditions like irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD).

• Lipopolysaccharides (LPS) are components of the outer membrane of Gram-negative bacteria. When these bacteria die, LPS can be released into the gut, potentially causing erosion of the gut wall, inflammation, and interfere with the absorption of nutrients and digestion. High LPS levels can also indicate general gut dysbiosis and an imbalanced microbiome.

Any patient who may be highly reactive on the P88, or who may have had ongoing food allergies or sensitivities would benefit from the AIBA test as well. Likewise, any patient with ongoing gut issues, including cramping, diarrhea, loose stools, gut pain, brain fog, etc for whom a gut assessment is in order would also benefit from the assessment of food allergy and sensitivity triggers that the P88 offers.

The second bundle, the Precision Core 4 bundle starts with the P88 and AIBA tests described above, and adds in the Advanced Adrenal Stress Test and the Advanced Oxidative Stress Test to give an even more complete picture of the interlinking causes of a patient’s overall health. Food allergies and sensitivities, as well as unrelated or interrelated gut issues, can cause symptoms that can be hard to pinpoint. Sometimes, a patient’s decline in health is multifactorial, and a wider range of assessments should be carried out, particularly if the patient’s symptoms are severe, far-ranging, ongoing, or have not been resolved by other interventions. In these cases, a wider battery of testing is called for. Sometimes a different condition will be masked, or even interconnected by a gut or allergy/sensitivity issue. In addition to the gut and trigger assessments, an evaluation of the adrenals and oxidative stress can both unmask other causes of similar symptoms and assess the state of damage so far done to the body. All of this is necessary for pinpointing treatments and effecting better outcomes.

The Advanced Adrenal Stress Test uses saliva to measure the 24-hour cortisol cycle by sampling at four points during this period and measures DHEA (dehydroepiandrosterone), and secretory IgA (sIgA). Cortisol is the body’s main stress hormone and helps regulate blood pressure, metabolism of fats and carbohydrates, anti-inflammatory response, blood sugar level, and immune response. sIgA (secretory immunoglobulin A) antibodies are critical for the proper function of your immune system and gastrointestinal tract, making up 80-90% of the immune system. This is the body’s first line of defense against invading pathogens and toxins. Levels of sIgA can provide insight into how stress is affecting your immune system. DHEA (dehydroepiandrosterone) is the most abundant circulating steroid in the body and is best known as a metabolic intermediate for the production of androgens and estrogens. DHEA production is measured alongside cortisol production. Unfavorable ratios of DHEA to cortisol have been linked to depression, anxiety, and other psycho-emotional disorders. The interrelationship between stress, the gut, and inflammation makes this test essential to puzzle out the interlinking issues between them. Running an advanced AST at the same time as the P88 helps to distinguish between food triggers and stress triggers, or can draw a correlation between them.

The Precision Core 4 also includes our Advanced Oxidative Stress Test, which assesses total glutathione, reduced glutathione, F2-isoprostane, and 8-OH-2deoxyguanosine from whole blood and urine specimens. Taken together, these markers paint a picture of the levels of oxidative stress in the patient. 

• Glutathione is the most abundant intracellular antioxidant and is critical for defending the cell against oxidative stress. GSH neutralizes free radicals and conjugates toxins for removal from the body, thereby protecting cells from oxidative stress and toxic xenobiotics.Total glutathione includes both reduced and oxidized glutathione levels. Glutathione is constantly undergoing oxidation and reduction and therefore exists in two forms, reduced and oxidized. The reduced form of glutathione is the radical scavenger (or antioxidant). Oxidized glutathione is the “used up” form of glutathione. Oxidized glutathione has contributed its antioxidant potential and then must be recycled to the reduced form of glutathione to be useful once again. Total glutathione levels can indicate the body’s total reserves of glutathione for removing harmful free radicals and toxins. The test measures both total glutathione and %reduced glutathione.

• F2-isoprostane can cause vasoconstriction in the kidneys, lungs, liver, bronchi, blood and lymph vessels, uterus, and gastrointestinal tract. F2-isoprostanes are associated with increased perception of pain and F2-isoprostane has been suggested as an indicator of cardiovascular disease among other conditions. Urinary F2-isoprostane is the gold standard marker of lipid peroxidation in biological specimens and has been described as a “reliable approach to assess oxidative stress.”

• 8-OHdG (8-hydroxy-2’-deoxyguanosine) is an oxidized base that has been identified and removed from the DNA, and excreted in the urine. It is the most studied marker of oxidative damage to DNA. DNA damage is a normal part of life, but chronic elevation can be a concern because it signals increased oxidative damage. While 8-OHdG is not a diagnostic marker of cancer, it has been widely used as a marker of oxidative stress, and degenerative diseases, and is considered a risk factor for certain cancers. Oxidative stress as evidenced by high 8-OHdG has been found in depression, fatigue, diabetes, extreme exercise, neurodegenerative disease, toxicity, and other conditions. High urinary 8-OHdG was found in patients with major depression and chronic fatigue syndrome. DNA damage has been shown to be involved in the pathogenesis of Alzheimer’s disease. High 8-OHdG was detected in the cerebrospinal fluid of patients with Alzheimer’s and is correlated with the duration of illness.

Environmental stresses, such as chemical toxins, endocrine disruptors, heavy metals, and infectious agents can cause oxidative damage. Detoxification of the body is additionally supported with an anti-inflammatory diet free of allergens such as gluten, dairy, eggs, caffeine, nicotine, artificial sugars and flavors, and stimulants, or any other foods that the patient is found to be sensitive or allergic to from the P88 DAT test. Gastrointestinal tract testing, (intestinal permeability, stool testing, food sensitivities) is also advised.  In a patient with chronic oxidative stress, gastrointestinal infection or inflammation may be the underlying cause. The Precision Core 4 can help the practitioner get to the interconnected roots of conditions.