GASTROINTESTINAL TESTING
PRACTITIONER MANUAL
2
NutriPATH Pty. Ltd.
18a Harker Street, Burwood, VIC, 3125, Australia
Phone: 1300 688 522 (Australia)
+613 9880 2900 (International)
Fax: +613 9880 2999
Web: www.nutripath.com.au
V1.2
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Contents
Health Starts in the Gut....................................................................................................................5
Assessments of GI Function ........................................................................................................5
Options in GI Testing ...................................................................................................................5
FOOD SENSITIVITIES .........................................................................................................................6
Tests for Food Sensitivies.................................................................................................................6
IgE.................................................................................................................................................6
IgG ................................................................................................................................................7
IgA ................................................................................................................................................7
IgG / IgE / IgA Allergy Panels ..................................................................................................8
Combination Panels..............................................................................................................13
ALCAT (Antigen Leukocyte Cellular Antibody Test)..................................................................14
ALCAT Food Cartridge Panels...............................................................................................15
ALCAT Additives, Environmental chemicals, Antibiotics & Moulds Panels ........................16
ALCAT Herbs Panels..............................................................................................................17
ALCAT Combination Panels ..................................................................................................18
Measuring Gut Health....................................................................................................................19
COMPREHENSIVE DIGESTIVE STOOL ANALYSIS (CDSA) ................................................................19
CDSA Panels...............................................................................................................................20
CDSA Levels Comparison Chart.................................................................................................21
INTERPRETATION GUIDELINES FOR CDSA ................................................................................23
4
INDIVIDUAL GASTROINTESTINAL TESTS ........................................................................................28
Calprotectin ...............................................................................................................................28
Helicobacter pylori ....................................................................................................................28
M2 Pyruvate Kinase...................................................................................................................29
Pancreatic Elastase....................................................................................................................29
Transglutaminase ......................................................................................................................29
Clostridium difficile....................................................................................................................30
Gastrin........................................................................................................................................30
Faecal Occult Blood ...................................................................................................................30
Organic Acids ‐ Intestinal Dysbiosis ..........................................................................................31
LIVER DETOXIFICATION PROFILE...............................................................................................31
INTERPRETATIVE GUIDELINE FOR LIVER DETOX..................................................................32
Intestinal Permeability ..............................................................................................................35
Candida Antibodies ...................................................................................................................35
COELIAC PROFILES.....................................................................................................................36
HLA‐DQ TESTING and ‘Serologic Equivalent’.......................................................................36
Secretor Status ..........................................................................................................................38
Secretory IgA .............................................................................................................................38
5
Health Starts in the Gut
The cornerstones to good health are the ability to digest and absorb nutrients from food
effectively. When your gut function is poor, you can experience symptoms associated with
digestive, absorption, metabolic and excretion disorders which can be uncomfortable and
debilitating.
The impact on general health and wellbeing can be detrimental if the gastrointestinal system is
out of balance.
Gastrointestinal (GI) health incorporates optimization of:
Diet
Digestion
Absorption
Metabolism
Excretion
Immune reserve
Microbiota
Eradication of gastrointestinal infections
Liver function
Assessments of GI Function
Metabolic and functional assessments of GUT health allow the practitioner to determine the
underlying cause of dysfunction throughout the entire gastrointestinal tract.
The journey of food translating to energy as ATP starts in the food we eat.
Options in GI Testing
Diet ‐ You are what you Eat!
Food allergies, intolerances or sensitivities are the underlying cause of many disease states,
especially irritable bowel syndrome, fatigue, constipation, diarrhoea, skin conditions, weight
gain, mouth ulcers, chronic tonsillitis and other chronic immune dysfunction conditions.
6
FOOD SENSITIVITIES
Food sensitivity, or food intolerance, is becoming increasingly prevalent in today’s society
predominantly as we eat foods that are adulterated; our agricultural processes are deviating
from traditional organic farming, or become super bug resistant. It is common practice to hear
of gluten or dairy intolerance or allergic to foods.
Many people are unaware that they may be sensitive or allergic to one or more foods because
their reactions are masked by other symptoms, or take some time to appear.
Tests for Food Sensitivities
IgE IgE antibodies are found primarily in mucous secretions. An IgE reaction occurs about the time
immediately after exposure to the allergen; food or inhalant. This type of reaction is referred
to as a Type I immediate hypersensitivity reaction. In serum IgE is present in very low
concentrations and elevated in atopic diseases such as allergic asthma, hay fever and atopic
dermatitis. IgE antibodies that are specific for the allergen bind onto immune cells called mast
cells and basophils. The allergen latches onto the mast cell‐bound IgE antibodies in a cross‐
linking manner. This initiates the release of histamine and other inflammatory mediators from
these cells. The allergic IgE response is comprised of not only an immediate event but in many
cases a late event as well. The early phase reaction usually occurs within 15 minutes of
exposure to the allergen. The late phase reaction may then occur 4‐6 hours later and persist
for days with increased oedema and inflammation.
Allergy Panel ‐ IgE Asian Foods 96 Asian foods 3201
Allergy Panel ‐ IgE General Foods 96 General (Western) foods 3202
Allergy Panel ‐ IgE Inhalants 64 Inhalants 3203
Allergy Panel ‐ IgE Vegetarian Foods 95 Vegetarian foods 3204
7
IgG Food sensitivities can cause a wide range of symptoms and disorders. The foods that cause
these delayed reactions are often hard to diagnose because of the time between consumption
and the physical reaction. The IgG food allergy test offers a useful tool for detecting the foods
causing this response. The results are patient specific and provide an easy, precise and
effective starting point for dietary manipulation. Representing approximately 75% of serum
immunoglobulins in humans, IgG is the most abundant antibody found in the circulation and is
found in all body fluids. IgG molecules are synthesised and secreted by plasma B cells. IgG
antibodies are very important in fighting bacterial and viral infections.
Allergy Panel ‐ IgG Asian Foods 96 Asian foods 3205
Allergy Panel ‐ IgG General Foods 96 General (Western) foods 3206
Allergy Panel ‐ IgG Herbs & Spices 48 Herbs & Spices 3207
Allergy Panel ‐ IgG Inhalants 16 Inhalants 3208
Allergy Panel ‐ IgG Vegetarian Foods 95 Vegetarian foods 3209
IgA Immunoglobulin A (IgA) is an antibody that plays a critical role in mucosal immunity. More IgA
is produced in mucosal linings than all other types of antibody combined; between three and
five grams are secreted into the intestinal lumen each day. This accumulates up to 15% of the
total immunoglobulin produced in the entire body.
Allergy Panel ‐ IgA General Foods 96 General (Western) foods 3197
Allergy Panel ‐ IgA Asian Foods 96 Asian foods 3198
Allergy Panel ‐ IgA Inhalants 16 Inhalants 3199
Allergy Panel ‐ IgA Vegetarian Foods 95 Vegetarian foods 3200
8
IgG / IgE / IgA Allergy Panels
96 GENERAL Food Panel
Dairy* Fruits Grains/Legumes/Nuts
Casein Apple Almond
Cheese, Cheddar Apricot Amaranth
Cheese, Cottage Banana Barley
Cheese, Mozzarella Blueberry Bean, Kidney
Milk Cranberry Bean, Lima
Milk, Goat Grape Bean, Pinto
Whey Grapefruit Bean, Soy
Yogurt Lemon Bean, String
*Bovine‐derived Orange Buckwheat
unless specified Papaya Coconut
Vegetables Peach Corn
Avocado Pear Gliadin, Wheat
Beet Pineapple Gluten, Wheat
Broccoli Plum Hazelnut
Cabbage Raspberry Lentil
Carrot Strawberry Oat
Cauliflower Meat/Fowl Pea, Green
Celery Beef Peanut
Cucumber Chicken Pecan
Garlic Egg White, Chicken Rice, White
Lettuce Egg Whole, Duck Rye
Mushroom Egg Yolk, Chicken Sesame Seed
Olive Lamb Spelt
Onion Pork Sunflower Seed
Pepper, Green Bell Turkey Walnut, English
Potato, Sweet Miscellaneous Wheat, Whole
Potato, White Cocoa Bean Fish/Crustacea/Mollusc
Pumpkin Coffee Bean Clam
Radish Honey, Bee Cod
Spinach Sugar Cane Crab
Squash, Zucchini Yeast, Baker’s Halibut
Tomato Yeast, Brewer’s Lobster
Red Snapper
Salmon
Scallop
Shrimp
Sole
Tuna
9
96 VEGETARIAN Food Panel Dairy* Fruits Grains/Legumes/Nuts
Casein Apple Almond
Cheese, Cheddar Apricot Amaranth
Cheese, Cottage Banana Barley
Cheese, Mozzarella Blueberry Bean, Kidney
Milk Cantaloupe Bean, Lima
Milk, Goat Cherry Bean, Pinto
Whey Cranberry Bean, Soy
Yogurt Grape Bean, String
*Bovine‐derived Grapefruit Buckwheat
unless specified Lemon Cashew Nut
Vegetables Orange Coconut
Artichoke Papaya Corn
Avocado Peach Flaxseed
Bean Sprout Pear Gliadin, Wheat
Bean, Navy Pineapple Gluten, Wheat
Beet Plum Hazelnut
Broccoli Raspberry Lentil
Cabbage Strawberry Oat
Carrot Watermelon Pea, Green
Cauliflower Miscellaneous Peanut
Celery Cocoa Bean Pecan
Cucumber Coffee Bean Pistachio
Eggplant Honey, Bee Rice, Brown
Garlic Pepper, Black Rice, White
Kamut Pepper, Chilli Rye
Lettuce Sugar Cane Sesame Seed
Millet Yeast, Baker’s Spelt
Mushroom Yeast, Brewer’s Sunflower Seed
Olive Egg Walnut, English
Onion Egg White, Chicken Wheat, Whole
Pepper, Green Bell Egg Whole, Duck
Potato, Sweet Egg Yolk, Chicken
Potato, White
Pumpkin
Quinoa
Radish
Spinach
Squash, Zucchini
Tomato
10
96 ASIAN Food Panel
Dairy* Fruits Grains/Legumes/Nuts
Casein Apple Almond
Milk Banana Bean, Kidney
Whey Cantaloupe Bean, Red
Yogurt Cherry Bean, Soy
*Bovine‐derived Coconut Cashew Nut
unless specified Grape Corn
Vegetables Grapefruit Gluten, Wheat
Bamboo Shoot Guava Job’s Tears
Bitter Gourd Honeydew Mung Bean
Broccoli Kiwi Oat
Cabbage Lemon Peanut
Carrot Lian Woo Rice, White
Cauliflower Mango Sesame Seed
Celery Orange Sunflower Seed
Cucumber Papaya Walnut, English
Eggplant Peach Spices
Garlic Pineapple Curry Powder
Kelp Strawberry Ginger
Leek Watermelon Mustard
Lettuce Meat/Fowl Pepper, Black
Mushroom Beef Pepper, Cayenne
Olive Chicken Vanilla Bean
Onion Duck Woo‐hsiang Powder
Pepper, Green Bell Egg Whole, Chicken Fish/Seafood
Potato, Sweet Egg Whole, Duck Abalone
Potato, White Goose Clam
Radish Lamb Cod
Spinach Pork Crab
Taro Miscellaneous Cuttlefish
Tomato Cocoa Bean Lobster
Vegetable Sponge Coffee Bean Oyster
Water Spinach Honey, Bee Salmon
Tea, Woo‐long Sea Bass
Yeast, Baker’s Sea Perch
Yeast, Brewer’s Shrimp
Tuna
11
IgG / IgA 16 Allergen INHALANTS
Grass Indoor Moulds
Bahia Cat Dander Alternaria tenuis
Bermuda Cockroach, German Aspergillus fumigatus
Brome, Smooth Dog Dander Cladosporium herbarum
Johnson Dust Mite Mix Penicillium notatum
Rye, Perennial House Dust
Sweet Vernal
Timothy
IgE – 64 Indoor & Outdoor Allergen INHALANTS Trees Grass Indoor
Acacia Bahia Cat Dander
Alder, White Bermuda Cockroach, German
Ash, White Brome, Smooth Dog Dander
Beech, American Johnson Dust Mite Mix
Birch, White Meadow Fescue House Dust
Box Elder Rye, Perennial Moulds
California Pepper Sweet Vernal Alternaria tenuis
Cedar, Mountain Timothy Aspergillus fumigatus
Cottonwood mix Weeds Cladosporium herbarum
Cypress, Arizona Dog Fennel Penicillium notatum
Elm Mix Firebush
Eucalyptus Iodine Bush
Hazelnut, American Lamb’s Quarters
Hickory, White Marsh Elder, Rough
Maple, Red Mugwort, Common
Mesquite Nettle
Mulberry, Red Pigweed, Rough
Mulberry, White Plantain, English
Oak, Arizona Poverty Weed
Oak, Black Rabbit Bush
Oak, White Ragweed, Short
Palm, Queen Russian Thistle
Pecan Sagebrush, Common
Pine Mix Saltbush, Annual
Pine, White Sorrel, Sheep
Sweet Gum
Sycamore, Eastern
Sycamore, Western
Walnut, Black
Walnut, English
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48 HERBS & SPICES Panel
Spices Herbs
Allspice
Basil
Bay Leaf
Cinnamon
Clove
Cumin Seed
Curry Powder
Dill
Fennel
Ginger
Horseradish
Marjoram
Mustard
Nutmeg
Oregano
Paprika
Parsley
Pepper, Black
Pepper, Cayenne
Peppermint
Rosemary
Sage
Thyme
Vanilla Bean
Aloe Vera
Ashwaganda
Astragalus
Bilberry
Black Cohosh
Chamomile
Dandelion
Dong Quai
Echinacea
Ginseng, Siberian
Goldenseal
Grape Seed
Gymnema
Licorice
Milk Thistle
Psyllium
Rose Hip
Saw Palmetto
Spirulina
St. John’s Wort
Tea, Green
Uva‐Ursi
Valerian
Wild Yam
13
Combination Panels Often, a patient may present with an IgG and an IgE response to a suspected offending food.
For example, a patient exhibiting signs and symptoms of bloating and gastrointestinal
discomfort with bread may not reflect an IgG response as one would expect, bit may be
reflected in an IgE panel.
It is therefore recommended to perform IgG and IgE testing together (cost effective option).
Allergy Panel ‐ IgE & IgG Asian Foods 96 Asian foods 3210
Allergy Panel ‐ IgE & IgG General Foods 96 General (Western) foods 3211
Allergy Panel ‐ IgG & IgA General Foods 96 General (Western) foods 3217
Allergy Panel ‐ IgG General or Asian Foods
AND 15 Vegetables
96 General (Western or Asian) foods, 15 Vegetables
3213
Allergy Panel ‐ IgG General or Asian Foods
AND 16 Inhalants
96 General (Western or Asian) foods, 16 Inhalants
3214
Allergy Panel ‐ IgE & IgG General Foods
AND 64 IgE & IgG Inhalants
96 General (Western or Asian) foods, 64 Inhalants
3215
A tissue transglutaminase (tTG) IgA and/or IgG test is used as part of an evaluation for certain
autoimmune conditions, most notably celiac disease. Celiac disease blood tests measure the
amount of particular auto antibodies in the blood. Tests that detect the IgA class
(immunoglobulin A) and IgG class (immunoglobulin G) of the auto antibodies are available, but
the types that measure IgA are more specific and are used almost exclusively.
Allergy Panel ‐ IgG General or Asian Foods
(96 Foods) AND Coeliac Antibody Panel
96 General (Western or Asian) foods
AND Transglutaminase IgA, Gliadin
IgG, Gliadin IgA
3216
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ALCAT (Antigen Leukocyte Cellular Antibody Test)
The ALCAT test is a simple blood test that can be used to identify food and other factors that
induce innate immune system activation. It measures changes in size and volume of white
blood cells in response to ex vivo challenges with foods, chemicals and other environmental
stimuli. The ALCAT test is not an allergy or IgE test.
The advantage of the ALCAT involves the identification of specific foods that are triggering
an inflammatory cascade. The identification of these specific foods works synergistically with
the thesis that gut health is one of the primary and crucial organs responsible for chronic
inflammatory states, whereby the aetiology of the vast majority of chronic inflammatory or
autoimmune conditions can be traced back through a series of mechanisms to delayed food
hypersensitivity via impaired intestinal permeability (so called ‘leaky gut’).
A significant advantage of this system is that it uses whole blood which contains all of the
immune factors, cells and serum proteins that might be involved in an adverse reaction to a
foods, chemicals and moulds. Regardless of the pathways that may underlie an adverse
reaction to an analyte, i.e. immune or non‐immune, the final common pathway may involve
release of chemical mediators. These substances such as histamine and cytokines will alter
the activity of the white blood cells which is detectable using the ALCAT® technique. In
addition, the ALCAT® test will theoretically detect changes in the innate immune system
(phagocytic white blood cells) and any cytotoxic effects of a tested analyte.
ALCAT Intolerance Test ‐ 50 Foods 50 Foods (Select 1 x cartridge ‐ A, B, C or D)
3301
ALCAT Intolerance Test ‐ 100 Foods 100 Foods (Select 2 x cartridges from A, B, C or D)
3302
ALCAT Intolerance Test ‐ 150 Foods 150 Foods (Select 3 x cartridges from A, B, C or D)
3303
ALCAT Intolerance Test ‐ 200 Foods 200 Foods (All 4 cartridges A, B, C & D) 3304
15
ALCAT Food Cartridge Panels A variety of options are available for testing foods with an ALCAT test. Foods that are
highlighted tend to be the most offending foods today.
The practitioner has the option of choosing the most efficacious and cost effective panel to
suit the patient.
Foods Cartridge A Apple, Barley, Beef, Broccoli, Baker's Yeast, Banana, Black pepper, Brown/White rice, Butternut squash, Cabbage, Cantaloupe, Casein, Cane sugar, Carrot, Corn, Cow's milk, Cauliflower, Chicken, Cinnamon, Cocoa, Cottonseed, Egg white, Egg yolk, Fructose, Garlic, Gluten/Gliadin, Grape, Green pea, Lamb, Iceberg lettuce, Lemon, Mustard, Oat, Onion, Orange, Peanut, Pear, Pork, Shrimp, Soybean, Sweet potato, Tomato, Tuna, Turkey, Squash (yellow), Strawberry, String bean, Vanilla, Wheat, White potato.
Foods Cartridge B Almond, Asparagus, Avocado, Basil, Bell peppers (Capsicum), Blueberry, Brewer's Yeast, Brussels sprouts, Candida albicans, Carob, Cashew, Celery, Cherry, Clam, Coconut, Codfish, Coffee, Crab, Cranberry, Cucumber, Eggplant, Ginger, Goat's milk, Grapefruit, Halibut, Honey, Hops, Lime, Lobster, Millet, Mushroom, Olive, Oregano, Parsley, Peach, Pecan, Pineapple, Pinto bean, Plum, Psyllium, Rye, Salmon, Scallop, Sesame, Snapper (red), Sole, Spinach, Tea, Watermelon, Whey.
Foods Cartridge C Amaranth, Apricot, Artichoke, Bay leaf, Black Beans, Blackberry, Black‐eyed pea, Buckwheat, Caraway, Cayenne pepper, Chickpea, Clove, Cumin, Date, Dill, Duck, Fig, Flaxseed, Haddock, Hazelnut, Honeydew melon, Kidney bean, Kiwi, Lentil bean, Lima bean, Malt, Mango, Navy bean, Nutmeg, Oyster, Papaya, Paprika, Peppermint, Pistachio, Pumpkin, Radish, Raspberry, Red Beet/Beet Sugar, Safflower, Sage, Sardine/Herring, Sea Bass, Sunflower, Tapioca, Thyme, Trout, Turnip, Veal, Walnut, Tilapia.
Foods Cartridge D Acorn Squash, Anchovy, Blackcurrant, Bok choy, Brazil nut, Buffalo, Canola Oil, Cardamom, Catfish, Chamomile, Chicken liver, Chilli pepper, Coriander, Endive, Fava bean, Fennel seed, Flounder, Jalapeno pepper, Kale, Kelp, Leaf lettuce, Leek, Licorice, Macadamia nut, Mackerel, Mahi Mahi, Maple sugar, Mung bean, Mussel, Nectarine, Okra, Parsnip, Pine nut, Pomegranate, Portobello mushroom, Quinoa, Romaine lettuce, Rosemary, Saffron, Scallions, Sorghum, Spelt, Squid, Swiss chard (Silverbeet), Swordfish, Turmeric, Venison, Wild rice, Watercress, Zucchini.
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ALCAT Additives, Environmental chemicals, Antibiotics & Moulds Panels
ALCAT Intolerance Test ‐ CHEM20
20 Food Additives / Chemicals (FSANZ code number)
Yellow 5 (Tartrazine 102), Yellow 6 (110), Red 1, Red 40 (129), Blue 1 (132), Blue 2 (133), Green 3 (143), Sorbic acid (200), Benzoic acid (210), Sodium sulphite (221), Potassium nitrite (249), BHA (320), BHT (321), MSG (621), Polysorbate 80 (433), Aspartame (951), Saccharine (954), Sucralose (955), Xylitol (967), Erythritol (968)
3305
ALCAT Intolerance Test ‐ CHEM30
20 Food Additives / Chemicals & 10 Environmental Chemicals
20 Food Additives/Chemicals AND 10 Environmental Chemicals: Ammonium Chloride, Benzene, Chlorine, Glycophosphate, Fluoride, Formaldehyde, Deltamethrin, Orris Root, Phenol, Toluene
3306
ALCAT Intolerance Test ‐ CHEM50
20 Food Additives / Chemicals, 10 Environ. Chemicals & 20 Antibiotics /Anti‐Inflammatories
20 Food Additives and Food Chemicals, 10 Environ. Chemicals AND 20 Antibiotics/Antinflammatories: Amoxicillin, Ampicillin, Acetaminophen, Naproxen, Cephalosporin, Gentamicin, Aspirin, Clinorol, Neomycin, Nystatin, Diflunisal, Ibuprofen, Penicillin, Streptomycin, Penicillamine, Piroxicam, Sulfamethoxazole, Tetracycline, Indocin, Voltaren
3307
ALCAT Intolerance Test ‐ Moulds
20 Inhalants / common Moulds
Alternaria, Aspergillus, Botrytis, Candida albican, Cephalosporium, Clado herbarum, Curvularia, Epicoccum nigrum, Fusarium oxysporum, Helminthosporium, Hormodendrum, Monilia sitophila, Mucor racemosus, Penicillium, Phoma herbarum, Pullularia, Rhizopus nigricans, Rhodotorula rubra, Spondylocladium, Trichoderma
3308
17
ALCAT Herbs Panels
ALCAT Intolerance Test ‐ Herbs General
50 functional foods used in dietary supplements
Acai Berry, Agave, Aloe Vera, Ashwagandha, Astragalus, Barley Grass, Bee Pollen, Bilberry, Black Walnut, Cascara, Chlorella, Dandelion, Echinacea, Elderberry, Essiac, Feverfew, Ginkgo Biloba, Goji Berry, Goldenseal, Grape Seed Ext., Guarana Seed, Gymnema, Hawthorn, Huperzine, Kava Kava, Lutein, Lo Han, Maitake, Mangosteen, Milk Thistle, Mullein, Noni Berry, Pau D'arco, Pine Bark, Red Clover Seed, Red Yeast, Reishi, Resveratrol, Rhodiola, Rooibos, Schizandra, Senna, Spirulina, Stevia Leaf, St Johns, Valerian, Vinpocetine, Wheatgrass, Wormwood, Yellow Dock
3309
ALCAT Intolerance Test ‐ Herbs Female
50 functional foods used in dietary/herbal supplements for women
Arnica, Black Cohosh, Blessed Thistle, Blue Cohosh, Boswellia, Buchu Leaf, Buplerum, Chaparral Root, Chasteberry, Cramp Bark, Dong Quai, Evening Primrose, False Unicorn, Fo‐Ti Root, Gotu Kola, Horse Chestnut, Horsetail, Irish Moss, Juniper Berry, Korean Ginseng, Lavender, Lemon Balm, Maca Root, Marshmallow Root, Mistletoe, Motherwort, Myrrh, Partridge Berry, Pennyroyal, Peony Root, Red Clover Flower, Red Raspberry Leaf, Rehmannia Root, Sarsaparilla, Siberian Ginseng, Skull Cap, Slippery Elm, Uva Ursi, White Willow Bark, Wild Yam Root, Nettle Leaf, Calendula, Alfalfa Leaf, Cat's Claw, Lobelia, Damiana, Yarrow, Yerbe Mate, Burdock, Butcher's Broom
3310
ALCAT Intolerance Test ‐ Herbs Male
40 functional foods used in dietary/herbal supplements for men
Alfalfa, American Ginseng, Burdock, Butcher's Broom, Calendula, Cat's Claw, Catuaba, Chaparral, Chondroitin, Cnidium Monnier, Damiana, Dong Quai, Fo‐Ti Root, Glucosamine, Gotu Kola, Horny Goat Weed, Juniper Berry, Korean Ginseng, Lobelia, Lycopene, Maca Root, Mistletoe, Mucuna pruriens, Muira puama, Myrrh, Nettle Leaf, Pumpkin Seed, Pygeum Bark, Rehmannia, Sarsaparilla, Saw Palmetto, Siberian Ginseng, Skull Cap, Stinging Nettle Root, Tribulus territories, Uva Ursi, Velvet Deer Antler, Yarrow, Yerbe Mate, Bohme Bark
3311
18
ALCAT Combination Panels
ALCAT Intolerance Test, Paediatric Profile
50 Foods AND 20 Food Additives/Chemicals 3312
ALCAT Intolerance Test, Comprehensive Profile 6
100 Foods AND 20 Food Additives/Chemicals 3313
ALCAT Intolerance Test, Comprehensive Profile 5
100 Foods, 20 Food Additives/Chemicals, 10 Environmental Chemicals AND 20 Inhalants/Moulds
3314
ALCAT Intolerance Test, Comprehensive Profile 4
150 Foods AND 20 Food Additives/Chemicals 3315
ALCAT Intolerance Test, Comprehensive Profile 3
150 Foods, 20 Food Additives/Chemicals, 10 Environmental Chemicals AND 20 Inhalants/Moulds
3316
ALCAT Intolerance Test, Comprehensive Profile 2
200 Foods AND 20 Food Additives/Chemicals 3317
ALCAT Intolerance Test, Comprehensive Profile 1
200 Foods, 20 Food Additives/Chemicals, 10 Environ. chemicals AND 20 Inhalants/Moulds
3318
ALCAT Intolerance Test, Comprehensive Profile, Platinum
200 Foods, 20 Food Additives/Chemicals, 10 Environ. chemicals, 20 Moulds, 20 Antibiotics / Anti‐Inflammatories AND 50 Herbs ‐ General
3319
19
Measuring Gut Health
A healthy digestive system absorbs the required nutrients from food and rids the body of
waste and harmful substances.
The microorganisms in your digestive system, such as bacteria, yeast and moulds make up a
unique ecological environment. It is important for this environment to be balanced in order
for the gut to function, process and absorb nutrients effectively.
COMPREHENSIVE DIGESTIVE STOOL ANALYSIS (CDSA)
The Comprehensive Digestive Stool Analysis (CDSA) is an advanced non‐invasive diagnostic
tool for assessing gastrointestinal function. As the CDSA combines a large number of tests
that evaluate the function of the gastrointestinal tract, a comprehensive picture of a patients
gut health can be obtained. The analysis investigates digestion + metabolism + pancreatic
function + the balance of beneficial bacteria + presence of pathological bacteria,
yeast and parasites.
Seven different CDSA panels are available through NutriPATH which evaluate the following
areas of gastrointestinal function:
Digestion & metabolism
Pancreatic function
Gluten sensitivity
Inflammation – Inflammatory Bowel Disease versus Irritable Bowel Syndrome
H. pylori, Gastritis, peptic ulcers and gastric cancer markers
Colorectal cancer markers
Beneficial & potentially pathogenic bacteria
Yeast & parasites
20
CDSA Panels
CDSA Level 1 Macroscopic & Microscopic Description, Beneficial & Bacteria,
Yeasts, Parasites (visual detection)
2003
CDSA Level 2
Macroscopic & Microscopic Description; Digestive, Absorption &
Metabolic Markers; Beneficial & Other Bacteria; Yeasts; Parasites
(visual detection)
2004
CDSA Level 3
Macroscopic & Microscopic Description; Digestive, Absorption &
Metabolic Markers; Beneficial & Other Bacteria; Yeasts; Parasites
(visual detection) & Sensitivities
2005
CDSA Level 3+
Macroscopic & Microscopic Description; Digestive, Absorption &
Metabolic Markers; Inflammation Markers; Tumour/Ulcer
Markers; Beneficial & Other Bacteria; Yeasts; Parasites (visual
detection) & Sensitivities
2006
CDSA Level 4
Macroscopic & Microscopic Description; Digestive, Absorption &
Metabolic Markers; Beneficial & Other Bacteria; Yeasts; Parasites
(visual & chemical EIA detection) & Sensitivities
2007
CDSA Level 4+
Macroscopic & Microscopic Description; Digestive, Absorption &
Metabolic Markers; Inflammation Markers; Tumour/Ulcer
Markers; Beneficial & Other Bacteria; Yeasts; Parasites (visual &
chemical EIA detection) & Sensitivities
2008
CDSA Level 5
Macroscopic & Microscopic Description; Beneficial & Other
Bacteria; Yeasts; Parasites (visual & chemical EIA detection) &
Sensitivities
2009
21
CDSA Levels Comparison Chart
MARKERS CDSA
Level 1
CDSA
Level 2
CDSA
Level 3
CDSA
Level 3+
CDSA
Level 4
CDSA
Level 4+
CDSA
Level 5
MACROSCOPY Stool colour & form Mucous / Blood
MICROSCOPY RBC, WBC, Food remnants, Fat globules, Starch
DIGESTIVE MARKERS Chemotropism SCFA, putrefactive Meat fibre Vegetable fibres Pancreatic elastase 1**
ABSORPTION MARKERS Triglycerides (stool) Long chain fatty acids Cholesterol (stool) Phospholipids
METABOLIC MARKERS Beneficial SCFAs, pH, Butyrate, Acetate, b‐Glucuronidase, Propionate
INFLAMMATION MARKERS Transglutaminase IgA** Eosinophil Protein X Calprotectin **
TUMOUR/ULCER MARKERS M2 Pyruvate kinase** H. pylori antigen **
Beneficial BACTERIA Bifidobacteria, Lactobacilli E. coli, Enterococci Other: Klebsiella Pseudomonas Campylobacter Citrobacter Yersinia
22
CDSA Comparison Chart (contd.)
MARKERS CDSA
Level 1
CDSA
Level 2
CDSA
Level 3
CDSA
Level 3+
CDSA
Level 4
CDSA
Level 4+
CDSA
Level 5
YEASTS / FUNGAL
Candida albicans
Other yeasts
PARASITOLOGY
Cryptosporidium
Giardia lamblia
Entamoeba histolytica
Blastocystis hominis
Other parasites
Cryptosporidium EIA
Giardia lamblia EIA
Entamoeba EIA
SENSITIVITIES
Penicillin
Ampicillin
Erythromycin
Tetracyline
Sulphonamides
Trimethoprim
Ciprofloxacin
Gentamycin
Ticarcillin
Tobramycin
Augmentin
Cephalexin
23
INTERPRETATION GUIDELINES FOR CDSA CDSA MARKER INCREASED
LEVELS DECREASED /
NORMAL LEVELS
MACROSCOPY
Stool colour Other colours may indicate abnormal GIT conditions.
Brown is normal.
Stool form (See Bristol Stool chart) Variations may indicate abnormal GIT conditions.
Formed stool is normal.
Mucous May indicate presence of infection, inflammation or malignancy.
Blood May indicate possible GIT ulcer. INVESTIGATE or REFER.
MICROSCOPY
RBCs May indicate presence of infection, inflammation or haemorrhage.
WBCs May indicate presence of infection or inflammation.
Food remnants May indicate maldigestion.
Fat globules May indicate fat maldigestion.
Starch May indicate carbohydrate maldigestion.
DIGESTION
Chymotrypsin May indicate protein maldigestion due to pancreatic insufficiency.
SCFAs, Putrefactive Produced with anaerobic bacteria, ferment undigested protein.
May indicate protein maldigestion.
Meat fibres May indicate maldigestion from gastric hypoacidity or diminished pancreatic output.
24
Vegetable fibres May indicate maldigestion from gastric hypoacidity or diminished pancreatic output.
Pancreatic elastase **
Used to assess pancreatic exocrine function. Levels decline with age.
Not affected by enzyme therapy.
May indicate poor absorption; pancreatitis
May indicate increased absorption; pancreatic insufficiency; hypochlorhydria
ABSORPTION
Triglycerides, stool May indicate lipid maldigestion; hypochlorhydria; pancreatic insufficiency; bile salts insufficiency.
Long chain fatty acids May indicate inadequate lipid absorption.
Cholesterol, stool May indicate inadequate absorption.
Phospholipids May indicate inadequate absorption.
METABOLISM
SCFAs, Beneficial May indicate bacterial overgrowth.
May indicate inadequate normal bowel flora; lack of prebiotics and/or probiotics.
Butyrate Butyrate is a major metabolite in colonic lumen arising from bacterial fermentation of dietary fibre and is a mediator of the colonic inflammatory response.
Predominant SCFA and preferred fuel for colonocytes.
Associated with carbohydrate intolerance and diarrhoea.
May indicate inadequate colonic function.
May indicate constipation or increased risk of inflammatory bowel disease.
‐Glucuronidase May indicate poor Phase II detoxification processes.
25
pH Imbalances will influence SCFA production. Affected by gut biome.
May indicate dysbiosis; low SCFAs, low prebiotics; slow transit time, constipation; hypochlorhydria
May indicate dysbiosis; bacterial overgrowth, elevated SCFAs; carbohydrate maldigestion, pancreatic insufficiency; fast transit time, diarrhoea
Acetate May indicate inadequate colonic function.
Propionate May indicate inadequate colonic function.
INFLAMMATION
Transglutaminase IgA **
Tissue transglutaminase is the most specific test for Coeliac disease.
May indicate gluten sensitivity. Confirm with blood Transglutaminase IgA, Gliadin IgA & IgG [2002] and anti‐Endomysial antibodies.
Coeliac tendency can be determined by HLA‐DQB1 molecular analysis [2019] or blood HLA‐DQ2 & HLA‐DQ8.
Eosinophil protein X
Calprotectin ** Protein in neutrophilic granulocytes and indicator of bowel inflammation.
May indicate IBD, infection, inflammation.
May indicate milk or multiple food allergies.
May indicate IBS.
TUMOUR / ULCER
M2 Pyruvate kinase **
Key regulator of tumour metabolism.
May identify GIT tumours.
Investigate further.
H. pylori antigen ** May identify H. pylori infection. Confirm with urea breath test.
** These markers can be ordered as separate individual tests
26
BENEFICIAL BACTERIA
Lactobacilli, Bifidobacteria, Enterococci and E coli are normally present in the healthy gut:
Lactobacilli and Bifidobacteria, in particular, are essential for gut health because they
contribute to:
1) the inhibition of gut pathogens and carcinogens.
2) the control of intestinal pH,
3) the reduction of cholesterol,
4) the synthesis of vitamins and disaccharidase enzymes.
OTHER BACTERIA
Klebsiella, Pseudomonas, Campylobacter, Citrobacter, Yersinia
Reduced numbers of these organisms ‐ whether caused by antibiotic use, chronic
maldigestion or bacterial overgrowth – leave the intestine susceptible to colonization by
pathogens and production of carcinogens.
YEASTS
Candida albicans and other yeasts
Fungal infections are detected and reported if present.
PARASITES
Cryptosporidium, Giardia lamblia, Entamoeba histolytica, Blastocystis hominis, other parasites
ANTIBIOTIC SENSITIVITIES
If an infection is present, the offending organism is challenged against pharmaceutical
antimicrobials. The antimicrobials tested are:
Penicillin, Ampicillin, Erythromycin, Tetracycline, Sulphonamides, Trimethoprim,
Ciprofloxacin, Gentamycin, Ticarcillin, Tobramycin, Augmentin, Cephalexin.
27
PARASITOLOGY
Parasitic infections are measured in stool (visual) or by Elisa method (EIA). Elisa method of
parasite testing is more definitive and involves collection of 3 stool samples on 3 consecutive
days.
Cryptosporidium ‐ Cryptosporidiosis is a type of gastroenteritis (gastro) caused by the
parasite Cryptosporidium. Cryptosporidiosis occurs when the parasites are taken in by
mouth through eating contaminated food and water or, more commonly, from person
to person or animal to person.
Giardia ‐ Giardiasis is a form of gastroenteritis caused by the parasite Giardia lamblia.
It can lead to diarrhoea, fatigue and weight loss, although many people do not develop
any symptoms at all. Giardiasis can be spread by contaminated drinking water.
Entamoeba histolytica ‐ Entamoeba histolytica is a type of gastroenteritis. Most
infections are asymptomatic but occasionally clinically important intestinal or extra‐
intestinal disease may result.
Parasitology Profile
(Faecal) – 3 day
Cryptosporidium enzyme immunoassay EIA, Giardia lamblia EIA, Entamoeba histolytica EIA; Other parasites (visual detection)
2015
28
INDIVIDUAL GASTROINTESTINAL TESTS
Calprotectin Measurement of faecal calprotectin is a biochemical test for intestinal inflammation
including inflammatory bowel disease. Under specific clinical scenario, the test may eliminate
the need for invasive colonoscopy. It is resistant to enzymatic degradation and can be easily
measured in faeces.
The main diseases that cause an increased excretion of faecal calprotectin are infectious
colitis, Crohn’s disease, ulcerative colitis and neoplasms (cancer). Levels of faecal calprotectin
are usually normal in patients with irritable bowel syndrome (IBS).
Calprotectin (Faecal) Calprotectin – inflammation marker (IBS vs IBD) 2001
Helicobacter pylori Helicobacter pylori are a spiral‐shaped bacterium that colonizes the stomach and induces
chronic gastritis, a long‐lasting inflammation of the stomach. It infects well over 30% of the
world’s population making it one of the most common bacterial infections. The bacterium
persists the stomach for decades in most people and most individuals infected by Helicobacter
pylori will never experience clinical symptoms despite having chronic gastritis (up to 85%).
Approximately 10–20% of those colonised by Helicobacter pylori will ultimately develop gastric
and duodenal ulcers. Helicobacter pylori infection is also associated with a 1–2% lifetime risk
of stomach cancer and a less than 1% risk of gastric MALT lymphoma.
Helicobacter pylori
Antigen (Faecal)
Helicobacter pylori antigen 2010
29
M2 Pyruvate Kinase M2 Pyruvate Kinase (M2‐PK), as measured in faeces, is a tumour marker for colorectal cancer.
Though M2‐PK can be elevated in many tumour types, rather than being an organ‐
specific tumour marker, increased stool (faecal) levels can be used as an early detection of
colorectal carcinomas.
M2 Pyruvate Kinase (Faecal) M2 Pyruvate Kinase (M2PK) – tumour marker 2012
Pancreatic Elastase This test is used to diagnose certain pancreas disorders related to not producing enough
digestive enzymes and aid in diagnosis of the exocrine pancreatic function or insufficiency.
Pancreatic Elastase 1 (Faecal) Pancreatic Elastase 1 (PE1) – pancreatic insufficiency marker
2014
Transglutaminase Faecal anti‐tissue transglutaminase IgA antibodies indicate a reaction of the immune system to
the tissue transglutaminase enzyme produced by the body when gluten is ingested, leading to
an autoimmune reaction that may destroy the intestinal lining or other tissues in the body.
Transglutaminase IgA (Faecal) Transglutaminase IgA – gluten sensitivity marker
2016
30
Clostridium difficile Human infection with Clostridium difficile (CD) can take many forms. Some may have recurrent
mild to moderate diarrhoea resembling Irritable Bowel Syndrome (IBS) and may not be at all
concerned with these symptoms. Still other patients may have a condition indistinguishable
from colitis, with cramps, diarrhoea, urgency, mucus and variable amounts of blood.
[NOTE: Can only be performed on loose stool specimen]
Clostridium difficile Test Clostridium difficile 2017
Gastrin Gastrin is the main hormone that controls the release of acid in your stomach. When there is
food in the stomach, gastrin is released into the blood. As the acid level rises in your stomach
and intestines, your body normally makes less gastrin.
Gastrin Gastrin 2018
Faecal Occult Blood Faecal occult blood can be a sign of a problem in your digestive system, such as a growth, or
polyp, or cancer in the colon or rectum.
Blood may appear in conditions like:
Benign (non‐cancerous) or malignant (cancerous) growths or polyps of the colon
Haemorrhoids, anal fissures
Intestinal infections that cause inflammation
Ulcers, Ulcerative colitis, Crohn's disease
Meckel’s diverticulum, Diverticular disease
Faecal Occult Blood Faecal Occult Blood (chemical & immunological) 2020
31
Organic Acids Intestinal Dysbiosis The testing procedure measures the overflow or build‐up of intermediate organic acid
products in the urine, determining where ‘aberrations’ are occurring in metabolic pathways.
Intestinal dysbiosis markers measure microbial growth by the release of products of their
metabolism that may be absorbed and excreted in urine. Several organic acids are known to
be specific products of bacterial metabolic action on dietary polyphenols or unassimilated
amino acids or carbohydrates. Detection of abnormally elevated levels of these products is a
useful diagnostic tool for patients with gastrointestinal or toxicological symptoms.
Organic Acids ‐ Intestinal
Dysbiosis Panel (Urinary)
Indoleacetic Acid, Phenylacetic Acid,
Dihydroxyphenylproionic Acid, Succinic Acid,
Benzoic/Hippuric Acids ratio; Citramalic Acid,
Arabinose, ‐ketoglutaric Acid, Tartaric Acid
2013
LIVER DETOXIFICATION PROFILE The process of detoxification is one of the chief roles of the liver. It works to convert lipid‐
soluble xenobiotics into water soluble substances that can be excreted from the body. It does
this via a two‐step process designated phase I and phase II. Specific measurements of the
different phases of liver detoxification including phase I and phase II (glycination,
glucuronidation, sulphation and glutathionation) are obtained, guiding the design of effective
and specific therapeutic strategies which can optimise liver function. When the function of the
liver is sub‐optimal, toxins can build up and poison the body. The liver detoxification profile
evaluates the ability of an individual to process caffeine, aspirin (salicylate) and paracetamol
(acetaminophen) by assessing certain metabolites in salivary and urinary specimens.
Liver Detoxification Profile Phase I Detoxification: Caffeine Clearance; Phase II
Detoxification: Measures of Glucuronidation,
Glycination, Glutathionation & Sulphation
4010
32
INTERPRETATIVE GUIDELINE FOR LIVER DETOX
PHASE I – Caffeine clearance
Causes Treatment Considerations
HIGH Phase 1
Increased exposure to
toxins and production
of free radicals.
Exposure to P450 enzyme
inducers:
Drugs e.g. barbiturates, HRT, steroids, sulphonamides;
Environmental pollutants e.g. exhaust fumes, paint fumes, dioxin and pesticides;
Gut‐derived toxins from gut dysbiosis or leaky gut;
Others: alcohol, Cruciferous vegetables, charcoal‐broiled foods, tobacco.
Assess and remove exposure to any P450 inducing substances.
Reduce exposure to environmental toxins.
Assess and treat gut dysbiosis and/or intestinal permeability (IP).
Antioxidant supplementation e.g. acai, Se, vitamin C & E, Zn.
Botanical liver support e.g. ellagic acid, green tea, silymarin, grapefruit juice.
LOW Phase 1
Reduced activity of P450 enzymes
from exposure to pharmaceutical
medications:
Benzodiazepines
Antihistamines
Ketoconazole
H2 blockers
Green tea (catechins)
Turmeric
Vitamin B complex
Bioflavonoids
Amino acids ‐ glutathione, glycine, glutamine, cysteine
33
PHASE II Causes Treatment Considerations
LOW Glucuronidation
Reduced
acetaminophen
glucuronide recovery,
impaired
glucuronidation
detoxification.
Increased exposure to drugs and xenobiotics requiring glucuronidation
e.g. steroid hormones,
oxazepam, carbamates,
phenols, aniline.
Genetic enzyme defect e.g. Gilbert’s disease.
Medications, such as antibiotics, e.g. chloramphenicol, novobiocin.
Nutritional and metabolic causes:
Decreased energy production or reduced energy from dietary sources;
Hypothyroidism;
Insulin resistance; Vitamin K excess
Upregulation of other Phase II
pathways.
Discontinue medications which may affect glucuronidation.
Reduce xenobiotic exposure. High quality protein source. Support mitochondrial function to help improve energy production
e.g. antioxidants, coQ10,
magnesium, zinc, EFAs; aspartic
acid, iron, L‐glutamine, niacin,
vitamin B complex.
Increase Cruciferous vegetable intake.
Reduce enterohepatic re‐circulation of toxins e.g. calcium D‐glucurate.
Support other Phase II pathways.
LOW Glycination
Reduced salicyluric
acid recovery,
impaired glycination
detoxification.
Increased levels of drugs and xenobiotics requiring glycination e.g. aspirin, benzoate, phenylacetic acid, aliphatic amines.
Glycine and glycination cofactor deficiencies.
Liver disease. Genetic enzyme defect.
L‐glycine supplementation.
Supplement glycination cofactors, e.g. cysteine, magnesium, vitamin B5, B6.
Reduce benzoate exposure e.g. sodium benzoate (211).
Reduce xenobiotic exposure. Reduce salicylate exposure from cosmetics, drugs and diet.
HIGH Phase 2 pathways
Use adequate cofactor and nutrient support ‐ this will ensure that these molecules do not
become depleted and liver detoxification does not become impaired.
Phase 1: Phase 2 ratio ‐ Glycination
These two ratios reflect the relationship between Phase 1 and these two conjugation
pathways and will demonstrate whether the biochemical load from Phase 1 is high or low.
34
PHASE II Causes Treatment Considerations
LOW Glutathionation
Reduced
acetaminophen
mercapturate
recovery, impaired
glutathionation
detoxification.
Increased exposure to drugs and xenobiotics requiring glutathionation e.g. acetaminophen, penicillin, tetracycline, styrene, toxic metals, bacterial toxins.
Increased oxidative stress. Impairment of other Phase II pathways.
Genetic enzyme defects.
Enhanced bile production (increases mercapturate elimination via the bile).
Assess and remove exposure to xenobiotics.
Glutathione and glutathioine precursor and cofactor supplementation e.g. glutathione, L‐glycine, L‐glutamine, L‐methionine, N‐acetylcysteine.
Vitamin B5, B6, B12.
Botanical liver support supplementation, e.g. silymarin, artichoke, Cruciferous vegetables.
Antioxidant supplementation e.g. vitamin C & E, Zn, Se.
Support other Phase II pathways.
LOW Sulphation
Reduced
acetaminophen
sulphate recovery;
impaired sulphation
detoxification.
Increased exposure to drugs and xenobiotics requiring sulphation e.g. minoxidil, terpines, amines, phenols.
Increased oxidative stress. Impaired sulphoxidase activity.
Molybdenum or vitamin B6 excess (can inhibit sulphation).
Liver disease. Genetic enzyme defects.
Upregulation of other Phase II pathways.
Assess and remove exposure to xenobiotics.
Sulphate precursors and cofactor supplementation – e.g. glutathione, L‐methionine, N‐acetylcysteine, Zn.
Supplement inorganic sulphate (MSM) and/or Molybdenum if inadequate cysteine to sulphate conversion (sulphoxidase activity) is suspected.
Reduce dietary phenols and amines.
Phase 1:Phase 2 ratio ‐ Sulphation
Demonstrates the relationship between Phase 1 and the sulphation pathway and
demonstrates whether the biochemical load from Phase 1 is too high.
Phase 1: Phase 2 ratio ‐ Glucuronide
These two ratios reflect the relationship between Phase 1 and these two conjugation
pathways and will demonstrate whether the biochemical load from Phase 1 is high or low.
35
Intestinal Permeability Changes in intestinal permeability are associated with many health conditions including
autism, autoimmune disorders, food sensitivities and inflammatory bowel disease. This
‘leaky gut’ causes disease because the perturbed intestinal barrier allows toxic molecules to
enter the bloodstream and poison the body. Intestinal permeability can be measured using
the lactulose/mannitol test. Furthermore, the intestinal permeability test has been used to
monitor the compliance and effectiveness of a gluten‐free diet in patients with Coeliac
disease. In addition to assessing leaky gut, this test can also help diagnose malabsorption.
The test works on the principle that small molecules (i.e. mannitol) are readily absorbed by
the intestinal villi, whilst larger molecules such as disaccharides (i.e. lactulose) are not. These
water soluble non‐metabolised sugar molecules after penetrating the intestinal tract are
excreted into the urine. Under normal circumstances the ratio of lactulose to mannitol in
urine is low (i.e. lactulose is not absorbed), mannitol is absorbed. When the structure of the
intestinal epithelium is jeopardised (‘leaky gut’ is present), the large sugar molecule can
permeate the mucosa and is recovered in the urine. In this situation the level of lactulose is
increased in the urine and therefore the ratio of lactulose to mannitol is high.
Intestinal Permeability Test Lactulose % recovery, Mannitol % recovery, Lactulose/Mannitol ratio
2011
Candida Antibodies A systemic candida infection may cause a diverse set of symptoms. Symptoms may include
poor concentration, premenstrual syndrome, fatigue, food sensitivities, irritable bowel, cystitis
and, muscles and joint aches. Although yeast is found in everyone’s gastrointestinal tract,
problems arise when the ratio of friendly bacteria to harmful microorganism is disturbed.
This test measures the presence of both anti‐candida IgA and IgG antibodies in a salivary
sample. The levels of the antibodies detected indicate the state of the condition, i.e. whether
there is a current candida infection (IgA) or whether there has been a past candida infection
(IgG).
Candida Antibodies (Salivary) Candida IgA & IgG Ab 3001
Candida Antibodies/Antigen
(Serum)
Candida IgG, IgA, IgM, Candida Antigen 3002
36
COELIAC PROFILES It is one of several blood tests that may be used to help diagnose coeliac disease. Tissue
transglutaminase IgA and/or IgG test is used as part of an evaluation for certain autoimmune
conditions, most notably coeliac disease.
Tissue transglutaminase is an enzyme that repairs damage in the body. People with coeliac
disease often make antibodies that attack tissue transglutaminase. They are called anti‐
tissue transglutaminase antibodies or immunoglobin A (IgA) antibodies. Therefore, a blood
test that shows higher levels of anti‐tissue transglutaminase antibodies can give indication of
possible coeliac disease or gluten sensitivity.
The test detects the genes (human leukocyte antigens or HLA) that control the immune
system’s reaction to gluten. There are several types of HLA genes within each person and it is
HLA‐DQ that is most useful in the assessment of the probability that a person may be gluten
sensitive. The reason gene testing assesses probability rather than disease itself is because
some people have the genes for gluten sensitivity but have no detectable evidence of the
immune reaction to gluten or have no symptoms.
Coeliac Profile (serum) Transglutaminase IgA , Gliadin IgG & Gliadin IgA 2002
Gluten Sensitivity Genetic Test HLA‐DQB1 Molecular Analysis 2019
Gluten/Antigenic Food Sensitivity
Faecal IgA to 4 Foods: Gliadin, Casein, Ovalbumin and Soy
2021
Expanded Antigenic Food Sensitivity
Faecal IgA to 11 Foods: Almond, Beef, Cashew, Chicken, Corn, Egg, Milk, Pork, Rice, Soy, Walnut
2022
Coeliac Antibody Panel Transglutaminase IgA, Gliadin IgG & Gliadin IgA 3003
HLADQ TESTING and ‘Serologic Equivalent’ Today HLA‐DQ gene testing is done by analysing DNA using molecular techniques. In the past,
the methods were done by analysing blood cells for the antigens produced by the genes, and
these past methods were responsible for the most commonly known nomenclature for HLA‐
DQ genes even today (using integers such as DQ2). These are called ‘serologic equivalents’ to
the specifically analysed gene material.
37
If have one gluten sensitive gene then your offspring have a 50% chance of receiving the gene
from you and one of your parents passed it to you. Having two gluten sensitive or Coeliac
genes means that both of your parents and all of your offspring will possess at least one copy
of the gene. Having two copies also means there is an even stronger predisposition to gluten
sensitivity than having one gene, and the resultant immunologic gluten sensitivity or Coeliac
Disease may be more severe.
Molecular type
Serological equivalent
Gene predisposition
0201 DQ2, subtype DQ2 COELIAC
0202 DQ2, subtype DQ2 Gluten sensitivity Slight risk for coeliac
0203 DQ2, subtype DQ2 Gluten sensitivity Rare, little known regarding predisposition to coeliac
0204 DQ2, subtype DQ2 Gluten sensitivity Rare, little known regarding predisposition to coeliac
0205 DQ2, subtype DQ2 Gluten sensitivity Rare, little known regarding predisposition to coeliac
0301 DQ3, subtype DQ7 Gluten sensitivity Predisposed to Microscopic colitis
Neurological manifestations often seen when coupled with DQ1
0302 DQ3, subtype DQ8 COELIAC
0303 DQ3, subtype DQ9 Gluten sensitivity
0304 / 0319 DQ3, subtype DQ7 Gluten sensitivity
0305 / 0310 DQ3, subtype DQ8
0306 DQ3, subtype DQ3 Gluten sensitivity
0307 / 0308 / 0309 / 0311 / 0312 / 0313 /
0314 / 0315 / 0316 / 0317 / 0318 / 0320 / 0321
No serological equivalents
Gluten sensitivity
04‐‐ DQ4, subtype DQ4 All DQ4 genes are considered low risk for gluten issues
05‐‐ DQ1, subtype DQ5 Gluten sensitivity All DQ1 genes carry high predisposition to neurological manifestations of gluten sensitivity
06‐‐ DQ1, subtype DQ6 Gluten sensitivity All DQ1 genes carry high predisposition to neurological manifestations of gluten sensitivity
38
Secretor Status The term ‘secretor’ or ‘non‐secretor’ refers to the ability of an individual to secrete ABO blood
group antigens in bodily fluids such as saliva, sweat, tears, serum and the gastrointestinal
mucus secretions. The function of ABO antigens remain an enigma, however it has recently
been suggested that blood groups and secretor status are part of innate immunity against
infectious disease. Non‐secretors have an increased risk for urinary tract infections, candida,
autoimmune disorders and heart disease.
A person who is a ‘secretor’ will secrete antigens according to their blood group, i.e. a group O
individual will secrete H antigen, a group A individual will secrete A and H antigens etc.
Obviously a ‘non‐secretor’ or weak secretor will have no or little antigen present in their bodily
fluids.
Secretor Status (Salivary) Secretor status – relative to blood type 3006
Secretory IgA Secretory IgA (sIgA) is found in high concentrations in the secretions of the gastrointestinal,
genitourinary and respiratory mucosal linings. The most recognised function of sIgA includes
its role in ‘immune exclusion’ in which it prevents viruses, bacteria and other antigens
adhering to and penetrating epithelial mucosa. SIgA may also inhibit inflammatory processes
that damage the mucosa and preliminary evidence suggests that it may play a role in
inducing an antigen specific immune response by a non‐inflammatory mechanism. A sIgA
deficiency may lower resistance to infection.
Secretory IgA (Salivary) Secretory IgA 3007