Getting Started with Functional Lab Testing

Well, hello everybody, and welcome to our free webinar. I am Dr. Dan Kalish, and I am here today to talk about getting started with functional lab testing. And I want to thank Genova Diagnostics for helping to partner with us, uh, at the Kalish Institute on this class. And this is ground zero in a functional medicine practice: is how did you get started with functional lab testing? So we're going to take an hour and just talk about this. If you need a break, hit the pause button. This is all going to be recorded. You can come back and listen to it later. We'll send out links to the recordings because there's a lot of information in here, and I wanted to pack it all in so you guys can get started with ordering functional medicine lab testing. Because there's a lot of emotional, psychological, financial hurdles to making this happen. And it's my sort of central premise for my entire career, which is like, 31 years now, that you will be successful if you order the right tests and you learn how to interpret them. You will be successful in functional medicine. And your programs are really going to only be as effective as the lab data that you have. So this is a really important step. This is not like an optional kind of thing.

So we'll do a little introduction to what's happening at the Kalish Institute first. You can snap a shot of that QR code, or, you know, hold your phone up to there, and you will see all the amazing things that we have created for you. But as a webinar registrant, you will receive a free master class and extra special VIP access to our exclusive boot camp series that we built just for you guys, for this particular audience. And so you'll get an email on all of this tomorrow. You can take a little snapshot of the QR code there right now if you're anxious to take a look at it. And I designed a couple of extra courses to go along with, or sort of partner with, this course that are also free and that are also done in partnership with Genova. So super excited about that. And I will show you, uh, in a few minutes, maybe just a little bit about what we've built because there's quite a few courses that we put together for you guys.

Okay, so those of you that are brand new to all this and to me, I am Dan Kalish. I'm the founder of The Kalish Institute. I've trained over 7,000 practitioners in since 2006. We started this training program. And the focus has always been on what are the tools that a practitioner needs to be successful in practice? Business tools, clinical lab interpretation tools. We work a lot with patient communication skills development, all the things that are required. All the things that were sort of gifted to me by my teachers and my mentors, I'm trying to pass on to the next generation of practitioners. I've also done a bunch of projects throughout the years. I spent a year doing a research study with the Mayo Clinic on the Kalish Method, which was published back in 2016. I've worked a lot with different lab directors. Currently working with Richard Lord, who's one of the original scientists that created organic acids, fatty acids, amino acids. He's the scientist who developed the GI Effects test. So he and I have worked together quite closely for 10 years now. Again, lab interpretation skills development, that's really what this is all about. I'm also in practice. I'm, if I'm certified and all that good stuff, you know, but really now my focus is more on teaching than it is on patient care.

So the purpose of this webinar is to get you to order your first set of labs. I mean, that's the first 20 to 50 labs, let's say. So if you've already ordered one lab, you know, that's great. But let's get you up to like around 50. Once you hit 50, you'll never turn around. You'll just, you'll see the profound effectiveness of of this work and you'll just keep going. But we do find that people that order one or two labs, so they order one lab a month and they forget about it, they never get the traction they need to really get a successful practice going based on lab interpretation. And so one of the key first steps is being able to explain to patients why these labs are important. And we're going to spend a lot of time going through a model or a series of scripts or a way to explain to patients why these labs are important. Picking the right patients to do the labs with is also important, so we'll talk about that. And we want to get you to the point where you're what we call a lab whisperer, where you have every patient just magically walk out of the treatment room door, go up to your front desk and order every single lab that you suggested because they see the value and purpose of the testing. That's really the goal. And we get people to this point. This is not a magical thing. We get people to this point all the time where within a few weeks, within a month usually of practicing some of these techniques, they're getting pretty much all their patients to do all the tests. It's pretty amazing. It took me like 15 years to get to that point. We had somebody in our recent boot camp, this just happened. It was the second week of the class and I was like, "How are you guys doing?" And she was like, "Well, the last five new patients got all the tests." And I'm thinking, "Okay, like, you've been in class for two weeks, you figured this out. This is not super hard if you focus on it and you practice."

So our success here is based on your health also. So we want you to set up your Genova account. We want you to order a set of tests on yourself. And we had a boot camp again recently this year where every single case study that was presented in the class was the doctor testing themselves. And I, I realized, oh, I mean, we should just mention this, you know, that this is like a good place to start. Even if you feel great, who cares? Just test yourself and see what's going on. Everybody has things that they can work on in terms of their health. And so when I say a complete set of labs, in the way that we teach these classes and the Kalish mentorship and whatnot, that complete set of labs is an adrenal stress profile from Genova, the GI Effects test, Flagship GI test from Genova, and either a metabolomics or a Nutrival, depending on if you want to get your blood drawn or not. Okay? So metabolomics is urine. Nutrival is the metabolomics plus there's a blood draw. So it has extra markers on it. Okay? So go ahead and order at least one test on yourself. Get that rolling so you can start to get your understanding of the labs, you know, more on a personal level for your own goals that you may have in terms of your own health.

So now, when we're thinking about, okay, how are we going to get patients to do these tests? Like, what's really going to motivate people? Well, you have to understand why you're doing these labs, which test to order, who you want to run the tests with, that's surprisingly important. And then how are you going to convince a patient that it's worthwhile to do this? And then what are you going to do when the results come back? For when the whole, when the results come back question, we have a whole series of lab interpretation courses that I've designed for you guys, like a gazillion of them. Okay? So we're really trying to cover that base, uh, I don't know, aggressively is not the word, but, you know, uh, significantly. And here's the link that you're going to get tomorrow to the Genova educational offerings that we've put together. This is our special super secret series of courses just for you guys. So this is not on our regular website. You're going to get a link to it. You can use the QR code to view this, but these are all the educational offerings: how to build a practice, lab ordering, getting started with adrenal labs, that's interpreting labs, getting started with the GI Effects test, getting started with the metabolomics or Nutrival, getting started with female hormone labs. We built one for everything. Okay? So as you get your first five or ten labs back and you freak out a little bit, which you should, because you don't know how to interpret them yet, perhaps sign up for one of these. They're very reasonably priced. We're trying to make it fast and easy for you guys to just get things going. And I tried to do a little bit of everything. Okay? And these are all again going to be available, especially for this audience. And it's going to be really good. So you guys can start your lab ordering for a very modest fee, you can get into these interpretation classes and get your practice going. Okay? This is like a quick start program that I've designed for people who want to do the labs but are just a little deer in the headlights, a little, you know, like frozen and not sure which way to go. Today is like the initiation of this. And then here we have all these educational offerings to follow up with for you. Okay? Try to cover every imaginable base that we could.

So now, roadblocks. Why does this not happen? In some ways, I'm more interested in why this doesn't happen because when this happens, it's easy and it flows and patients are getting better and practitioners are happy and the whole thing is just clicking. But when it doesn't work, how are we going to intervene? You know? So the obvious thing is that it revolves around money. And someone's going to think that the tests are too expensive. And if that's happening, then you haven't really explained the value of the testing to the patient yet. And we want to cover off on that in a minute. It's also from the practitioner's standpoint, just kind of scary to order a test. And I know when I ordered my first test, I ordered this adrenal panel, this is like 30 years ago, and it came back and I looked at it and this, and I didn't know what to do. I didn't know how to interpret it. And I had a panic attack. And I still remember this so clearly. And I grabbed the lab report. And these days, they mail them to you, right? This is a long time ago, they mailed you. So I had to, you know, the printed lab report in my hand. And I went into Glenn's office, who is my teacher. Glenn Peter was my mentor. And I went into his office and looked at his desk and I went to the biggest desk drawer and I hid it under all the other papers. I literally hid this thing. And then I went up to the front desk and I told Marianne, who is running the office, I said, "Um, you know, Jason's lab came back, looks fine." Or something like that. And it was totally not fine. He was just stage two adrenal exhaustion case, but I didn't know how to interpret the test and I just freaked out. So I don't want you guys to be in that position. If you do get a little scared, you've ordered a test, you're not sure how to interpret it, that's why I designed all these classes so you guys can get over that initial hump of those first 10 or 20 tests and you can get into a groove where you start to really get confident in interpreting these. Confidence is the key. Okay? And I've talked to a lot of lab directors and lab sales people and all the different lab companies in our industry. If you get three tests, if you do three adrenal tests or three GI Effects or three metabolomics, boom, boom, boom, all in a row, like next Tuesday, you do three of them, you get them all back and you interpret them properly, you're going to get over that, you know, anxiety stage. And then you'll be like, "Whoa, those three people all got better. I think I'm gonna do these tests on everybody." And then you're off and running. That's where we want to get you for this first stage. Okay?

So it starts with which labs to order. And if you order a test that's the wrong test to order, then that's not going to go very well. And how are you supposed to know? You look at these catalogs and you have so many labs. If you order a super advanced test and you're not a super advanced practitioner yet, it's not going to help. If you order a mold test on somebody, that's one of the most complicated things to treat. If you order a test for mold and they have mold, what are you going to do about it? Like, it's, you'd have to study for two or three years before you can even have that patient come in, you know what I mean? So that's a complicated subject area. If you order the basic tests and you know how to interpret them well, you're going to get great results at this introductory level. You're going to get these life-changing results for patients. And then your patients are going to go, "Wow, this is amazing." And you're going to get confidence. And then you're going to build from there. And then a couple years from now, you can test for mold or Lyme disease or heavy metals or the really complicated things. But you wouldn't start in a super complicated way with any other in human endeavor, right? If you're learning how to do anything, learning how to play a musical instrument, you don't think that you're going to walk in and be able to play at the level of like, uh, you know, a full band on your first day that you're practicing guitar, right? You start simple and you build. And that's what we want to do here. The thing is that you can get results in the very beginning that are impactful. So you don't have to worry about that part. You have to trust me on that one, a little bit. But we see this every day in the mentorship class. The very, the doctor will say the same thing all the time. They'll say, "This is my first set of labs." And we'll do the interpretation thing. And then a few weeks later, they're going to say, "Bloody blah, person got better. I can't believe it. The energy is better. Their thyroid problem is gone now that this is happening." And, you know, they get that confidence when they see that the results are really coming through for their patients.

Now, if you miss ordering one of the key tests, that's also not a great experience for you or for the patient. So we want to start simple, start easy. Everybody has stress. And everybody who has a health problem, part of the problem is stress. So the adrenal stress profile, you test the HPA axis and correct it. That helps almost probably eight or nine out of ten people that you work with. That's going to make a big difference. So that's an easy one to get started with. Everybody has a microbiome. You know, not everybody has mold or Lyme disease, but everybody has a microbiome. So you kind of have to analyze the gut. And again, the gut treatments, you can learn them pretty quickly. They make a huge difference in how people feel. And it's just such an essential, you know, system for the body that a microbiome correction could help with metabolism, autoimmune problems, neurological issues, cardiovascular problems. It's, it's so broad in the effects that that's a really great sort of entry-level basic test. And then everybody is struggling these days with their metabolism, with their inflammation, with their neurotransmitter related issues. And so a metabolomics or a Nutrival, also super important to look at cellular functions. So these are, these are three basic tests: okay, adrenals, GI, and metabolomics or Nutrival.

Now, when we're starting to present this information to patients, we want to have a model so that you can explain why you want them to do this adrenal test. And I think it's the easiest one. It's the easiest test to start with from the practitioner standpoint also because there's so many different ways that people experience stress and there's so many different ways that you can tie back what that patient's experience is to why you want them to do this test. And so I look at this from a body system standpoint and there being three body systems: neuroendocrine, GI, and detox. And that we have a test for each one of these or a series of tests for each one of these. And that when we're thinking about what are the variables that really, really trigger health problems, we're thinking about it's, there's not a great diet happening, the person's stressed, they're exercising not enough, their sleep is not so great. And these problems accumulate and end up causing some kind of HPA axis or adrenal problem. So you're going to see that a lot eventually. If the adrenals collapse for long enough, you start to have immune issues and GI problems and it goes from there. But you, it's going to be rare that you have a person that's got a health complaint that's coming to see you that has perfect adrenal hormones. I mean, it happens, but not that often. And then why does this happen in the first place? So we have a model of what we want to treat: neuroendocrine, GI, and detox. And then a model of what triggers that. So death in the family, a divorce, going through your second or third child and their, you got a toddler, but now there's a baby on the, you know, in the room too, and no one's getting any sleep, overworking. That drives the stress hormones up, that weakens our immune response, we end up with GI problems down the road and detox system issues too. But we're going to want to have this model be a definition or an explanation or throwing you a structure for why we want to do the testing. And because it's usually that, you know, stress that leads the way in terms of creating these problems, it makes sense that you would start with testing the stress hormones first, just, you know, to get the correction. So you're correcting the problems in the order in which they occur for most people. With stress is a key component. And then treatments are also going to include a healing diet, stress management, proper exercise, adequate sleep, right? So you're using lifestyle changes along with the lab-based data to really make a change. So easy peasy, adrenal stress profile, great place to start. It is the easiest sort of catalyst for promoting lifestyle changes also because when you look at an adrenal lab, you're seeing a circadian rhythm. So you can talk about sleep. Cortisols, glucocorticosteroids, you can talk about blood sugar stability and diet. Cortisol is clearly involved in exercise, too much or too little exercise, right? So cortisol testing or adrenal testing allows you to talk about diet, exercise, sleep, meditation, all the different lifestyle changes can be incorporated into an adrenal program quite easily. And that's what functional medicine is, right? It's lifestyle change medicine. So 80% of what we're doing is lifestyle. The adrenal labs kind of give you the leverage to really make that argument for people to change their lifestyle. It also has this very high-level look at the given amount of depletion in a person. So I think of it as a referendum, the HPA axis testing. It's a referendum on how much stress that person's been under compared with how much rest and recovery time. You see normal adrenal labs, and there's always a reason. We had one in class yesterday, mentorship program yesterday, 9 AM class, and the adrenal test came back, adrenal stress profile from Genova, and the car was normal, the cortisol was normal, the DHEA was normal. I think one marker was a little high, but it was like almost perfect. And so I asked the student, "Okay, what's going on with this patient?" And she's like, "Well, he feels great." And I said, "Okay, that's good." So most of the people that we work with are quite seeing. So what's his history like? She said, "Well, he's a billionaire." Well, that must be nice. He's retired, he loves his life, he loves his family, and he just wants to make sure that he's going to stay healthy for the rest of his billionaire life. So you get normal labs when people don't have a lot of stress in their life and they're in a really good place. But that is not going to be present in 99% of the people that you work with. You're going to see some pretty serious problems. And for those patients, when they see the lab and they see, "Wow, my cortisol is low and my DHA is even lower," and you know, it will validate their personal experience of exhaustion or depression or insomnia. And so the lab acts as a catalyst so that the patient can get validation at an objective level, you know, with these objective measures that we're doing with the testing to show what's, you know, sort of been all in their head prior to that, which is that they've got, you know, this low cortisol problem, and now we're going to fix it, or this high cortisol problem, and now we're going to fix it.

So the treatment plans, and here's where things get a little tricky, okay? So the treatment plans are going to include lifestyle changes, diet, exercise, sleep, and meditation. Everybody knows that they should eat better, exercise more, get more sleep, and do something to relax. That's not like a secret that you and I have, just the two of us, because we're healers or something. The testing gives you leverage to explain to the person that this lab shows that their diet is not serving their blood sugar well, that cortisol is a glucocorticosteroid, and you need them to eat in a way that's going to support their hormonal health in order for them to regain their vitality and vigor. Or that their exercise program is this, or that their sleep had it right. So that the lab acts as one of our major leverage points to get people to make the lifestyle changes. And if you do a combination of a well-designed adrenal supplement program with a couple of lifestyle changes that are motivated because of the test, and because you're going to retest the person too, nobody likes to fail a test. So if they fail the first test and their stage three adrenal exhaustion, and you put them on a supplement program and tell them how you want them to eat and exercise, and then you tell them, "Well, I'm going to test you again in like three months," then people get on it and they start to do all these things that they know that they should do. And the data is super helpful for designing the supplement programs. And that's always been my passion. I love to design supplement programs and I love to give supplements to patients because they really help and they work really well. But as much as that's great, you're also going to see lifestyle changes that just get enacted because of these tests. And lifestyle is really where this is at, right?

So now, there's a sequence here. And when you get good at this, you can do all three of these tests at the same time, for sure. So again, with the students that we work with, they're doing adrenal, GI, and metabolomics testing on all new patients. That's the ultimate level. But if you're not there yet, and that seems a little overwhelming, then you want to do it in stages, okay? In little bitty stages. Um, and by the way, I forgot to mention, we'll cover questions at the end. So we'll have plenty of time for questions at the end. Okay? So, um, so type your questions into the little typing inbox thing there and I'll cover them at the end. Okay? And, um, but if you're not there and you don't feel comfortable yet getting people to do all three tests, it usually works better to either do the adrenals first, or if they have a lot of GI symptoms, maybe do the GI testing first. Okay? Um, the problem with doing it that way is that you're going to lose a little bit of your leverage on the lifestyle change part, which is pretty important. So I would usually suggest for most of you, even if there's a GI case in front of you, to suggest that they do the adrenal testing first, maybe with the GI test. And then for your more enthusiastic patients, you can add in the metabolomics. And don't do a test on a patient until you've done it on yourself. So if you haven't done a metabolomics yet on yourself, just grab one on yourself, do that real quick, sign up for one of our interpretation classes, and we'll kind of get you through that. Okay?

Now, if the patient has obvious GI symptoms, it should be pretty easy for you to order a GI Effects on them because they're gonna, that's why they're coming to see you. So you just have to explain a little bit about the test. And this would be an exception to the rule. So if their main complaints are GI, and you just want to start with a GI FX test, I think that's totally legit. And you can just throw the whole "adrenals first" thing out the window for this particular situation. For patients with main complaints of GI symptoms, right? And so that would be gas, bloating, diarrhea, constipation, heartburn, reflux, food allergies, nausea, all those things. Um, one of the things when we're selecting patients to do the testing with is you don't want to test really hard patients. So testing somebody who has had blood in their stool every day for years, has diagnosed as having ulcerative colitis but it's not managed well, or they have Crohn's disease, it was in remission but now it's flaring up since they got COVID, or some, just don't get into the super complicated cases right away. It's just common sense. You know, start with more lightweight GI cases and you'll get results faster, you'll get your confidence up, and, and you'll be able to figure out things a little easier that way. What most practitioners do is they order the most complicated tests on the most complicated patients in the very beginning. And of course, it's, it's harder, you know, to handle that. It's a little more overwhelming for people to do it that way. I like to show people a sample GI FX lab report and explain to them, if we're going to talk about, you know, getting them to do a GI FX test, that this test is going to test for or look at three areas of your GI health. We're going to look for the microbiome and how well that's functioning. We're going to analyze the microbiome, the commensal bacteria. We're going to do a whole series of tests on this lab for functional GI organ issues. That's going to be things like your stomach and your gallbladder and your pancreas and your gut immune response, gut inflammation, leaky gut, all these different things are covered. So where you have a nice scan for functional GI organ issues, not for pathology. This is not a test to look for disease processes. Quite the opposite. We're looking for functional problems that occur before a disease would take place in the first place. And there is also a component of the test that is a pathogen screen for GI infections. So when I explain to GI FX test, try to keep it really simple. Just say, "Hey, we're going to analyze your microbiome, your GI organs, and there's a screening tool on here for a whole series of markers that screen for GI infections." You could say all that in like 20 seconds. And if the patient starts to ask more questions, I guess you can get into more detail. But, you know, simple is sometimes better. And I know when I was first, I can just, I just flashed on this moment in Glenn's office, you know, where I was ordering a test. This is in my first year of practice. And I was explaining cytochrome P450 pathways to this person. And then I remember just seeing her eyes kind of glaze over. And I realized, "Oh, she's not even a little bit interested in this." And I couldn't understand that because I had just come back from a Jeffrey Bland seminar and I was so into like phase one, phase two liver detox. And I wanted this patient to be into it. And then I realized, "Oh, maybe just because I think this is fascinating, it doesn't necessarily mean that the patients care about it." And so I started to shift my explanations about the labs to talk about the things that really matter to the patient. But to also have these 20-second, one or two-minute maximum length explanations of the more sciency part of the testing. But super short. And I'm now at the GI testing, I always just say, "Hey, we're going to analyze your commensal bacteria called the microbiome. We're looking at GI organ function here. And where it's a pathogen screen. And we should be able to get to some of the root cause issues that are really kind of dragging your digestion down if we do this test." Okay? So keep it simple.

Now, the tendency again is to run the hardest test on the hardest patients because everyone looks around in their practice and thinks about the people they haven't helped yet. And they want obviously to use these new things they're learning to help the people that haven't helped yet. But we want to kind of rein that in a little bit. Now, if you want to order a metabolomics test, and maybe you've already got an adrenal and a GI test on a patient, and you're like, "Hey, I want to do some new testing here." Then the metabolomics or Nutrival, you want to break it down by condition generally, okay? So the conditions that we can look at here would be depression, anxiety, sleep problems, fatigue, ADD, ADHD, memory issues. That would be all the brain-related issues, mitochondria, detoxification capacity, and GI. Now, the metabolomics test is really complex. And it's many pages of data. And it's a little overwhelming. And I found it very difficult to explain to patients too. Too much about the polyphenol markers for GI metabolites on that test. I think that's a little over most patients' pay grades in terms of trying to explain it. It's also kind of hard to explain detoxification pathways. As much as I'm enthusiastic about them, I think it's easier for patients to relate to either brain symptoms or mitochondrial symptoms. So I would kind of keep the explanation to to these two categories. But if the patient has any of these symptoms: fatigue, depression, anxiety, sleep problems, ADD, ADHD, memory issues, or anything else that's related to the brain, you can let them know, "Hey, this metabolomics test is a great screening tool. It looks at neuroinflammation and it looks at the metabolites or breakdown products of the main neurotransmitters. So we get a good idea of neurotransmission, how your brain is communicating signals, and we'll see if the brain is inflamed at all, which is a common problem." So that covers probably a third of your patients right there, right? If you want them to do the metabolomics. And then on the mitochondrial side, which is test CS excels at because it looks so in such depth at the mitochondria and metabolism in general. So that would be patients with insulin resistance, pre-diabetes, diabetes, anything cardiovascular, atherosclerosis, could be a history of high blood pressure, high cholesterol, high triglycerides, problems with your liver, fatty liver, fatigue, could be a thyroid issue, could be metabolic on the thyroid side. So anyone that has a hint of a metabolic problem, you can explain the metabolomics test in regards to how it analyzes mitochondrial function and let them know that you're going to see the early warning signs for all these different conditions. It's not a screening tool to see if they're about to have a heart attack. It's not a screening tool to figure out what medication they need. It's a screening tool to see how their cells are working. And if their cells are working poorly, there's all kinds of things you can do from nutritional treatments that really can make a huge difference. So I think those are the two easiest ways to explain Nutrivals or metabolomics testing: talking about brain-related symptoms or mitochondrial symptoms.

Now, another way you can explain that test too, if you're really into it, and this is one of my favorite tests, so you should have a good set of scripts around this, is what if the patient has, you know, they're taking care of their parent, their parent has some kind of cognitive decline, some kind of dementia. Maybe the patient's in their 40s or 50s, their parents in their 70s or 80s, and not doing very well, and they're worried about this. You can say, "Well, let's look at your neuroinflammation that's on this test." If they have their best friend just had a heart attack, or they know that their dad died when he was 48 and now they're turning 49, they're a little worried about heart disease and they have concerns around that. Diabetes in the family. We just had a patient the other day, I think she's like four or five family members that are diabetic, and she's already pre-diabetic, even though she eats really well. And that's this, "Let's look at your insulin resistance problems. Let's look at your cell metabolism and see what we can fix." Maybe it's a patient that had breast cancer 10 years ago and doesn't want to get cancer again, or someone whose parent had colon cancer and they're really concerned about it and they want to do something proactive to prevent the problem. You can look at oxidative stress with these. You can look at environmental toxin exposure. I mean, it's a pretty profound test. It covers a lot of preventive screening tools that you can action on with supplement programs. Okay? I also like to use the metabolomics for super healthy people. Like our billionaire guy that we just talked about. "Hey, if you notice, if you're super healthy, you just want to stay that way, maybe you're taking a whole bunch of supplements, maybe you're not." This is a great test because I've had so many patients who are pretty healthy and they're taking like literally 20 different supplements. And when we get them off of everything for a week, we do the test, and then we find out what they actually need. And that is just a, what do you call it, that's an eye-opening and wonderful experience for a patient to actually have a test-guided personalized supplement program rather than reading some magazine and adding in all these, you know, products randomly. Okay? I also use the metabolomics and the adrenal and GI testing as a yearly check-in screening test. And you can do some amazing things with these labs if you want to personalize your programs. Okay? So anyways, adrenal testing, GI FX, and metabolomics, trying to give you some ideas around scripting so you can start to explain these tests to patients and get people going.

Right now, I'm kind of changing gears here for a second. I'm going to take a sip of water to just define the break here. And again, type in your questions. We'll answer questions at the end. All right. Uh, why is selling labs a critical step? And it took me a few years to understand this. However, there is a sort of trajectory upon which the patient launches themselves when they order a lab, and it's entirely predictable. Most people that get the labs are going to come back and start a supplement program. It doesn't make any sense to pay for a lab and then not come back, you know? And it doesn't make any sense to pay for a lab, see that something's wrong, and then not fix it. So you're pretty assured when they buy the lab that they're going to come back and they're going to do the supplement program that you recommend. That's the whole point of doing the test. The more that they are focused on the testing, and the more they've invested their own money in the testing, the more likely they're going to follow your lifestyle change advice. And that's really what gets people better. So if you've got this combination of things happening, a few labs coming in, a really big incentive for them to follow the lifestyle change, like for example, if they run a metabolomics and their liver detox pathways are screwed up, and you tell them, "You just have to stop the alcohol." And they're like, "Really?" "Yeah, well, you can't. It doesn't make any sense to do a liver detox program and drink alcohol every day. So just getting off the booze for three or four months is going to help people." And the same with the adrenal labs. If you run an adrenal lab and you see their cortisol levels are really high at night, you can say, "Look, we just need to do like five minutes, just two minutes, two minutes, two minutes of breathing exercises right before you go to bed every night. Two minutes, that's all I need." You know? And so now all of a sudden, they're doing this breathing exercise, it's totally relaxing to lower their cortisol at night. But that's the lifestyle change that's really pushing things along. And the more that they invest in the lab testing, the more likely they're going to get better.

If you don't have the labs, then you're just stuck telling people what to do. And in my experience, human beings don't respond really well to just being told what to do. It's just not a nice experience for someone to boss you around. But when you see a test and something's wrong, like if I tell the patient, "Look, you got to meditate every day, right, when you go to bed for five minutes because you're stressed out of your mind and you just look like a crazy person to me," you know, they're not going to listen to you. But you're like, "Hey, your cortisol is really high at night." "Oh my gosh, we got to lower that." "Oh, how do we do that?" "Well, let's have you do some breathing exercises every night to lower your cortisol." It's not my personal opinion as a practitioner. I'm not directing them or bossing them around. I'm just interpreting the lab and telling them what makes sense based on the lab. So big, big difference there.

This is one of my original teachers, Dr. Bill Timmons. He is no longer with us. Uh, he died quite a few years ago. But he used to say this like every day. And I spent eight years with Bill getting trained. "The effectiveness of your clinical program is ultimately dependent on the depth and accuracy of the available lab data." I can just see him saying that over and over. I must have not really listened very carefully because he said that like over and over and over. But what he was trying to say was that, "Dan, like, you got to do more labs. You can't just like wing it here, you know? You're gonna have clinical results that are a direct correlation or a direct outcome of having ordered a test and knowing how to interpret it. And the more data that you have and the better you can interpret it, the better your program is going to be."

So I was in Columbus, Ohio, a bunch of years ago at, I was teaching a class, actually a GI class. And at the break, the lunch break, this doctor came up to me. And she said, "I don't know what you're doing in that mentorship class, but, you know, my junior associate who's here with me," this was the senior doctor in the clinic, "my junior associate is here with me. We call her the lab whisperer." And I was like, "What's going on with that?" And she said, "Because everybody that walks out of her clinic room buys every single lab. And none of my other associates have those kinds of results." And I was thinking, "Whoa, what is this woman doing? I gotta find out." And so I ran up because they were both the doctors were at the conference, you know, the senior one and the associate. And we had up to the associate doctor. I was like, "What's going on here, Jane?" You know? And she's like, "Oh, I'm just doing what you taught us in the class." And I realized, "Oh, okay. Well, this isn't an obvious thing. A lot of us struggle with the ideas of patient communication." Okay? And how are we gonna, like I said in the beginning, I would seriously talk to people about, I'm not making this up, I would talk to people about cytochrome P450 pathways. And like, "You got to do this test, it's going to measure your cytochrome P450 pathways." And people will glaze over because that has no, there's no value to them. They don't even understand what I was, what I meant, you know, let alone get motivated from it. So if you, to become a lab whisperer, you just need to understand what the patient's needs are and then explain how the lab is going to meet their needs. It's really that simple. And then you're going to be off and running because then you're going to be able to design the supplement programs, they're going to make the lifestyle changes. The combination of the supplements and the lifestyle changes is going to get them better. It's really that combination that's key. You can't just do one and not the other, really can't.

Again, patients complaining, "Labs too expensive." You got to explain the value of the lab in a more, you know, meaningful way, a more emotionally charged and directive way to them. Patients asking, "Why can't I just get a bunch of stuff from you like you gave all this stuff to my friend and she's better now?" That's the whole idea of the lab testing is that it's personalized. And just because Susie had a beta-oxidation problem and I gave her carnitine and she lost 10 pounds and now her marathon times are like 10 minutes faster, that doesn't mean that that's going to be what you need. We need to see what's going on with your metabolism by actually measuring it. So you want to emphasize that the tests allow you to create a personalized program that's going to be based on their genetics and based on their lifestyle, based on their being, right? So that everything is customized. Patients in general are going to buy based on emotion. And so if you explain the logic of the lab, like all the pathways, it's just not going to rock people's worlds. You have to just understand what they're feeling is wrong and then kind of motivate them to see that you can change that. And again, I see labs as a motivational tool, obviously as an analytical tool. And then we have this advantage, let's say that in our culture, everyone appreciates tests. This is an image of some Druid healing thing. I'm pretty sure when the Druids were active, a couple of thousand years ago, whenever that was, you know, that there weren't a lot of labs around. And probably if you were a Druid healer and you told Susie that you wanted to test your adrenals, Susie would say, like, "Whoa, are you from the future or who are you?" You know, they wouldn't have worked. But our culture is all about testing. We're all about labs. We're all about data. Everybody understands and values the sense of progress that we've made by being able to do all this. And so the testing just plays sort of a special role in what we're doing. Okay? And we want to get you guys all to be lab whisperers like our Columbus, Ohio mentorship student. And we want you to be at that 90 rate where 90% of the people that you talk to want to do all the labs.

So here are some key points to guide that whole process. First of all, learn what the patient's perspective is first. And then try to see things from their perspective. What are their needs? Do they care more about their sex drive, or more about losing weight, or more about their stomach problem, or more about their depression? When you're communicating, it's good every five or ten minutes to use a complex term that they don't understand, but then for the rest of the time to just speak an absolutely plain English so they can, you know, grasp what you're saying. And find out what they're interested in and make sure that you incorporate that into your explanations. Okay?

So I wanted to show, as we're winding up here, and we'll get to questions in a minute, just a few models about practice building so that you can use labs to build a specific practice, like working with new moms, or executives, or men's health, or women's health, or diabetes. You can use the labs in a longevity standpoint, from a longevity standpoint, as mentioned earlier, prevention and health maintenance model, kind of idea. You can include genetic testing. You can layer other kinds of testing in with this. You can do a chronic illness clip. All my teachers had, Dr. Timmons, he only really worked with complex chronic illness. He could do Lyme, mold, advanced cognitive decline, chronic fatigue, all that kind of stuff. But remember, that's advanced, you know? So that's not the kind of thing you want to start with on your first 20 to 50 cases. That's where we build up to complex chronic illness. Not a great starting point. Start simple, and then you can build up. Okay?

So before we get to questions, I just want to mention, you can scan that code, that'll get you access to our secret spot that I built for you guys. It's not so secret because anyone

Who listens to this is going to get a link to it, but in partnership with Genova, we've built out a free master class. And then extra special VIP access to all the boot camps that are for you guys, okay? And so for those of you getting started with lab testing, we want to offer the "how to get started" part, the "how to interpret" part, and get you through that first 10 or 20 or 50 cases so you get your confidence built up enough that you can really start to recommend these tests to just about anyone.

All right, so now let me take a moment here and go. We have a few minutes left to cover off on questions that have come in. And you can ask a question about anything. I mean, I don't know much about baseball, so don't ask me anything about baseball, but it could be a business question, a clinical question, a question about whatever you want. And then I'll pick out the ones that seem like they're really helpful here.

"Um, would your training like, let's see, after this is a long one here. Um, which your trade isn't?" Yes, I don't deal with insurance companies much at all, but if you contact the lab company, they can help you figure that part out.

"Do you think genetic testing is important?" Um, well, so here's a sweeping question. Is that you can combine genetic testing with these functional tests, and that's a high-level kind of advanced way to approach things. Um, these tests I'm talking about, adrenal stress tests, GI effects, and metabolomics or Nutrival, will show you what you're going to do and where the blocks are. If you want to layer the genetic testing over that, then you're going to see some of the "why's" involved as well, which is great. But you don't need to have a genetic test to see that someone has a COMT enzyme defect or MTHFR defect. You're going to see the methylation defect on the labs. So the treatments, you know, are going to vary somewhat, but you don't have to have the genetics in the beginning, at least.

"What about membrane stability?" Well, that's a pretty abstract question. And okay, so, uh, that's like super, super important. So speaking of methylation, when we methylate, I think somewhere between 50-60% of methylation is devoted to producing energy for muscles in the form of creatine. And somewhere around 20 or 30% of methylation is dedicated solely towards producing cell membranes. So it turns out that cell membranes are incredibly important. And you'll see this on all these tests in different ways. But, um, if some membranes are being damaged, you're going to usually see that there's a really high lipid peroxides, and you're going to see that the fatty acids are not doing very well. So one of the essential things for mitochondrial problems, for neurotransmission problems, for hormone-related problems, is to get some or detoxification. That's even more important, probably for detox, is to get cell membranes working properly. And that's at the cell physiology level. So you got to get fatty acids balanced, get the fat-soluble antioxidants figured out, and really stimulate the growth and repair of membranes. If you think about it, the biggest picture I think we're trying to do here is get people's bodies to heal and repair. And that's going to involve them making new stuff, right? That's like, I don't know if, uh, if anything is broken, you need to repair it. You have to kind of figure out how to build it back. And so to build things back, you have to have amino acids to build proteins, and you have to have fatty acids to build membranes, and all the things that are associated with that. That's kind of, uh, baseline repair for cells.

"Let's see. So Pamela just said, 'I just ran my first test for a new client. Is there a drop-in class to bring these two?'" Pamela, oh my God, where's I'm going to unmute Pamela. I did not set this up. Pamela is just a random person that I don't really know who she is. Pamela, can I unmute you for a second? Hang on, because she's asking this question, and let me show you the answer. Well, did that work? Pamela, I don't know who you are. Do I? Well, I've been, I did your mentorship in 2017, sort of a lawyer. I did not participate much because I was new. Oh, we're here. Look, look, look. So you said, "Is there a drop-in class?" Yeah, because I've been following you for like a lot of years, and I finally got. Look at the bottom. This is like the special thing I just built for this group. Look at this. Monthly membership, lab interpretation workshop, weekly live clinical case review. It's $199 bucks a month, and you just show up and stand in your labs. Perfect. And it doesn't require signing your life away for two years to join my mentorship class. This is my realizing, hey, there's a bunch of people out there probably like Pamela, just want to learn how to interpret labs. And there's no curriculum associated with this. This is just straight-up workshop, lab review. And then if you want the curriculum part, you can take some of the lab interpretation classes. But this is just straight-up workshop, right? This is how I learned. The works like I would take my labs, I would go down to Dr. Timmins' office, and he would tell me what to do. He didn't have like a PowerPoint that I had to watch. It was just like, "Here, what's going on with the case? Whether you're gonna do this." I mean, okay, so anyways, that is just launching. Like we just created this, like literally this week, and we're launching it in the fall, okay? It's coming up, and you're going to get a link to all that. That's in the special thing. So thanks for Pam for bringing that up. That's super cool. Random. I'm glad she said that because I forgot to mention it.

Um, so with the testing, you really generally want people to stop their supplements either three days before they test, or sometimes a week is better to. One of the major differences between Nutrival and Metabolomics. So the major difference is Metabolomics is urine sample only, and the Nutrival is urine and blood. And that the Metabolomics is less expensive because there's less markers. If you're new to this, the Metabolomics will keep you incredibly busy for your first two or three years. So I would just start with that one. If you're relatively new, the Nutrivals are, um, I was going to say they're a better test, but there's more information on them. But to somebody who's brand new, that may not be that helpful. So Metabolomics is a great starting test. And starting, to me, as a first couple years, and then Nutrivals kind of bring it up a notch. You do the blood work and you see some other markers. But believe me, Metabolomics will keep you busy for the first two or three years. So don't feel like you're cheating yourself if you're doing that test, anyway.

Okay, uh, and what, what the blood work gets you is fatty acids and amino acids in the blood. You can do amino acids in, in the urine too, but that's not so great. So the, um, the Nutrival gets you, uh, fatty acids, Omega-3s and 6s and all these others, and amino acids in the plasma. That's the main difference.

All right, let's see. Oh, for kids. So for kids, you can do, uh, the adrenal tests don't make so much sense if they're under the age of 16. But for children, the microbiome testing and the Metabolomics make a heck of a lot of sense, okay? For children.

So Geraldine, most interest is mental health, nutrition, getting good at amino acid therapy. So if you want to deal with mental health and amino acids, you kind of have to be able to control for the adrenal and GI stuff first, because the adrenals are the gateway to fixing the GI, and the GI is how we absorb all nutrients. And there's a gut-brain connection as well. So the best way to start is with this foundational testing. Even if you want to do mental health related things, I would say an adrenal and GI panel, you should really work with those first. Because if you just go right to amino acids, you're going to get some results, but they won't be consistent because a lot of the people you're working with will have absorption problems. Like they might have H. pylori in their stomach. So the amino acid problems are all coming because their stomach, or all happening because your stomach's screwed up. Or they might have a stress component. So some of the anxiety and depression that they're experiencing is coming because the HPA axis or adrenals aren't working well. So adrenal stress is one of the leading reasons why people are depressed in the first place. Adrenal stress is one of the main reasons why people are anxious and can't sleep in the first place. And there's a wonderful professor at Stanford who is a very famous neurobiologist named Robert Sapolsky. He kind of looks like a little bit of a crazy guy. He looks like he's a Grateful Dead member, that maybe. But don't let him fool you. He's one of the super advanced neurobiology, neuroscience people. If you Google or type in Robert Sapolsky depression, you'll see a lecture online that's free from the Stanford, Stanford. There it is right there. Stanford professor here, where he's going to talk about how stress and depression are linked. And that's something I have patients listen to.

Um, let's see what it, yeah. So for lab, so this is a lab ordering, lab getting started with labs class. And we do have all these other courses too for you guys on lab interpretation, including that weekly session if you want to just be a member of that. Or you can sign up for other workshops that we have. So there's many different GI tests on the market. There's a GI Effects. Someone's asking about which is, you know, how they're different. GI Effects, GI Map, and GI 360. The GI 360 is from Doctor's Data. The GI Map is from Diagnostic Solutions Lab. And the GI Effects is from Genova. So I'm a little partial to the GI Effects because it was developed by my main teacher, um, Dr. Lord. And it has. So I'm a little biased in this, but I'll try to give you a less biased response here as much as I can. So the GI Effects has a really wonderful microbiome workup. They've been doing those for a long time. They have a lot of data to that they analyze behind the scenes to make sure that your results are really clinically helpful. It covers all the pathogens and all the GI organ related issues. So it's a very broad spectrum test. In some ways, it's probably the most accepted test in a conventional medical way. Um, the GI 360 is virtually identical, very similar concept. And then the GI Map is much more pathogen related. And the GI Map is all PCR. So they don't do the culture, they don't do the OMP, and they don't do the organ screening in the same way. It's all PCR-based for the most part.

If you can't draw blood, then just do the Metabolomics. So you can do the adrenal stress test, the GI Effects, and Metabolomics, and it's all urine, stool, and salivary samples that people do at home, okay? Yeah. So you can order labs if you don't have a medical license. You can order Genova Labs from Genova Connect. Genova Connect. You can order labs. That's a direct-to-consumer Genova service that's now offered. So the adrenal stress profile has the cortisol awakening response. So if you want the best, the, if you want the most validated, research-backed way of looking at the HPA axis, then the adrenal stress profile from Genova with the CAR, which stands for cortisol awakening response, that's the test to get. There are many other kinds of tests on the market, but the vast majority, almost all of the real research has been done with the cortisol awakening response at four points cortisol, okay? That's not to say you can't gain from these other tests, but if you want to keep it in the research world, then they're the best, probably.

"How would you add labs into a membership practice?" So if you have, like, say, a typical membership fee of $4,000 a year to be a member in a practice, you can definitely include some limited lab testing as part of what they get for that fee. Most practitioners will not do that. They'll have a set fee of three or four grand a year to be a member in the practice, and then an additional charge for lab testing that they want people to do. It's easier because the labs may vary from person to person. It's kind of hard to put the lab expense into a membership format.

Oh, so Gerald, Gerald took the mentorship program a long time ago but wants to retake it. We do have a refresher course, Gerald. So just email the office and I'll let you know about it and be happy to get you set up as a redo person. That'd be great. And let's see here.

Um, so yeah, we're going to send out a recording for sure. You guys will get a copy of the recording. So for those of you that are working with insurance-based people, or people that you just kind of maybe not struggling, it's overly dramatic word, but you're trying to figure out how to get people to pay cash for the tests. For that, I designed a whole series of classes. And let me show you here. They're not that expensive either. And they're, here, Lab Ordering Essentials. Okay, Lab Ordering Essentials. This is designed to teach you how to get people to order labs pretty easily. We priced it at like $500 bucks, $4.99, okay? And it's only a month. But at the end of this, you should be able to get people to order labs if that's where you're at, okay?

Uh, yeah. So the monthly membership, you just sign up for it. You know, I don't think, I don't know what the rules are on that. You have to ask the staff, um, but I think it's month to month. We talked about that. Let's see. I'm just scanning through the questions here. We had another couple minutes.

Oh, B vitamin question. When trying to get the right B vitamins, where can you find them? I think any of the major supplement companies have good quality B vitamins. You just need to figure out the dosing for the most part. Thiamine, riboflavin, niacin, all that stuff. I use Pure Encapsulations mostly. I use Designs for Health. I use Metagenics. I use Ortho Molecular. Cyanogen, you know. Okay.

Let's see. For those on a budget, do you order all three labs at a time? Yeah. So if the patient's on a budget, you're not super, super confident yet, just start with the adrenal test. It's not very expensive. It's like $100, $150 bucks, and that'll get you started. And then if the patient has a budget to do adrenals and GI, then have them do adrenals and GI. But it's not necessary to do all three tests in the very beginning. Just let people know they can do these other tests down the road when the money's there, you know?

Do we have courses for acupuncturists, uh, where we get continuing education credits? I don't. But we have tons of acupuncturists in the class. But, let's see. I think we've got the end of our time now. Okay, we better wrap it up. Oh, right at the hour. Okay, you guys are great. Thank you for all the questions and enthusiasm. We'll be getting you some more information on all this stuff. So check your inbox tomorrow and look forward to connecting with you soon. Okay, goodbye everyone. Uh.