Dr. Boggess (Medical Director)
Dr. Tony Boggess is a Physical Medicine and Rehabilitation (PM&R) physician, speaker, and writer who specializes in Nutritional and... read more
Biomedical Labs & Diagnostics
Many diagnostic strategies are available at NBW Medical Center to help guide clinical decisions, explain vague symptoms, and to reveal pre-illness and disease states. These tests are usually covered by health insurance with a written doctors prescription and they come from the most innovative, well respected laboratories in the country.
In addition to conventional medical tests, we provide a full line of functional medicine tests including: home and in-office nutritional blood and urine testing; saliva assay kits for stress hormones and neurotransmitters; comprehensive 3-day stool analysis; vitamin, mineral, amino acid, and oxidative stress test kits; food sensitivity evaluation tools; genetic tests and many others (see details below).
Standard Blood and Urine Tests
Our starting blood work includes the same standard labs ordered by most conventional physicians: blood sugar, electrolytes, liver function, thyroid function, kidney function, immune system markers, iron studies, hormones, and other standard markers. However, we also look at specific markers of methylation, fatty acid status, oxidative stress and inflammation, cholesterol absorption and synthesis, and numerous, higher level evaluations of the thyroid, adrenal, and the immune-autoimmune parameters.
All commercial insurance, including Medicare ($35.00)
Gluten, Food and Chemical Sensitivity Testing (ALCAT)
Helps identify “subclinical” sensitivities. Provides a guide to elimination diets and environmental strategies.
At NBW Medical Center we use a variety of test to evaluate for chemical sensitivity, food allergies, and intolerances. One such test, measures muscle response and variable pulse rate using applied kinesiology techniques. We also use convenient blood tests to evaluate for food and environmental sensitivities, and look indirectly at metabolic markers to assist in diagnosing chemical sensitivities.
Of special note: Standard allergy tests, such as skin testing do not assess for delayed type reactions to foods and chemicals. They measure only release of histamine or the presence of allergen specific IgE molecules. Delayed reactions to foods and chemicals are NOT IgE mediated. So these test do not detect them. Likewise, IgG or delayed mediated testing does not reveal true “allergies.” The two are distinct and different from each other.
ALCAT does not currently accept insurance, all cost will be out of pocket.
Comprehensive Digestive Stool Analysis
Provides a comprehensive, noninvasive diagnostic evaluation of the GI system looking at gut ecology, potential pathogens such as opportunistic bacteria, invasive yeast, and parasites, assesses metabolic markers, quantifies inflammation and ability to digest and absorb nutrients. The test is a 3-day home stool collection and 3-week culture evaluation.
GI Effects Stool Profile
Schedule A: (all commercial insurances with the exception of: Aetna, Humana, Principal, Kaiser, Tufts, BCBS North Carolina, BCBS Federal): $149.00
Schedule B: (the following commercial insurances: Aetna, Humana, Principal, Kaiser, Tufts, BCBS North Carolina, BCBS Federal): $256
Cash pay/Medicaid : ($523)
GI Effects Stool Profile
Schedule B: (the following commercial insurances: Aetna, Humana, Principal, Kaiser, Tufts, BCBS North Carolina, BCBS Federal): $580
Intestinal Permeability/Absorption Tests
The GI system is the rate limiting step to convert food into products the body needs in order to be healthy, detox, and achieve optimal function. It also functions as a barrier to potential toxins, bacteria, yeast, parasites, food antigens and large or partially digested molecules. A number of clinical conditions result from either increased or decreased permeability and we use this and other intestinal assessments to look for the root cause of “dis-ease.”
Cash Price: $98.00
Small Bowel Bacterial Overgrowth Breath Test
Analyzes the fermentation products of bacteria in the small intestine. When first-line protective factors such as acid and enzyme are down regulated, normal populations of bacteria can become excessive in the upper GI tract and cause immune hyper-reactivity, intestinal permeability, nutritional deficiencies, and a host of other digestive problems associated with irritable bowel, mood problems, fatigue, yeast overgrowth and exposure to toxic bacterial byproducts.
Doctors Data Stool with Parasitology
Gastrointestinal complaints are among the most common in medical care. This comprehensive profile helps pinpoint the causes of gastrointestinal symptoms and chronic systemic conditions, and measures key markers of digestion, absorption and inflammation.
Using insurance (all except for Medicaid): $0 at the time of submission, if insurance does not cover then the patient will get billed and be responsible for paying up to $542.00
Single Nucleotide Polymorphism (SNP) Genetic Testing
What are Nutrigenomics?
The study of nutrients as it relates to gene expression. This test focuses on identifying and utilizing the molecular-level interaction between nutrients and the individual’s genome. Nutrigenomics has alternatively been described by the influence of genetic variation on nutrients. It does this by correlating gene abnormalities (or SNPs) with a nutrient’s absorption, metabolism, elimination or biological effects. By doing so, nutrigenomics aims to develop a way to optimize nutrition with respect to an individual’s genotype. For our purposes it is the heart of our Precision Medicine approach.
For everyone, do not accept insurance: ($259.00: $199.00-for the 23andme kit + $50.00-translation and administrative fee)
How is testing performed?
Currently, we are using a Q-tip cell collection (cheek swab, blood spot, or saliva test to collect DNA samples. A typical report is 42 pages and it takes approximately 7 weeks to get the results.
Below is an example of Cytochrome P450 (Phase 1 liver detoxification). -/- means no abnormal gene, +/- means a abnormal copy inherited from mother OR father, +/+ means an abnormal copy inherited from mother AND father.
Amino Acid Analysis
Uses urine or blood spot to evaluate for deficiencies associated with nutritional problems, fatigue, metabolic impairments, general pain, mood and sleep issues, anxiety, and much more.
Schedule A (all commercial insurances with the exception of: Aetna, Humana, Principal, Kaiser, Tufts, BCBS North Carolina, BCBS Federal): $149.00
FMV – Essential and Metabolic Fatty Acid Analysis
Assists with identifying imbalances and/or deficiencies associated with conditions like dysbiosis, cardiovascular disease, hyperactivity, autoimmune phenomena, depression, and many other symptoms/problems.
Schedule A (all commercial insurances with the exception of: Aetna, Humana, Principal, Kaiser, Tufts, BCBS North Carolina, BCBS Federal) ($149)
Cash pay/Medicaid: ($523)
Intercellular Nutritional Assessment
Standard diagnostic tests evaluate the blood which may or may not represent the total picture. More advanced protocols look at the level of organic acids, fatty acids, amino acids, vitamins, minerals, and antioxidants in the cell itself via culture methods of white blood cells giving invaluable insight to the life and nutritional status of the cell itself.
Hormone & Neurotransmitter Testing
Hormonal Health Assessments
Used to find ways to alleviate symptoms associated with Fatigue, Sugar Cravings, PMS, Perimenopause, Lost Libido, Polycystic Ovary Syndrome, Dysmenorrhea, Impotence, Sexual Dysfunctions, Depression, and Declining cognitive function, and Osteoporosis in both Men and Women.
All commercial insurance, including Medicare: ($250)
Cash pay/Medicaid: ($250)
Saliva samples are used to test a wide spectrum of hormone and neurotransmitter levels in pediatric and adult patients. Examples of hormones tested include progesterone, testosterone, DHEA, cortisol, melatonin, thyroid and several others. Neurotransmitter testing can be very helpful when evaluating mood disorders, anxiety, ADD, insomnia, phobias, et cetera.
Flex 5 Saliva Test
With all commercial insurance: ($95.00)
This form of testing is a new way of assessing neurochemistry in a more dynamic and reliable way. The primary value of this type of testing is that the system is put under what’s called “competitive inhibition”, this means the testing occurs after amino acid therapy has started. According to Dr. Hinz research, this is the most reliable way to determine the real state of proper balance between the brains inhibitory and stimulatory neurochemistry. This form of testing is reserved for patients who are in significant need of amino acid therapy / neurochemistry rehab and it is often a process that is reserved for later on in the clinical process.
For more information please read through the DBS Catalog.
Toxicity and Oxidative Stress Analysis
Toxic Element Analysis
Helps identify potential toxic burdens and nutrient imbalances that may play a role in symptoms associated with chronic fatigue, “brain-fog,” depression, hyperactivity (children), autism (children), stress, thyroid problems and many other functional symptoms and conditions.
Oxidative Stress Profile
Measures oxidative stress at the cellular level associated with may symptoms such as fatigue, chemical sensitivity, mood problems, hyperactivity, and autism spectrum disorders. In addition, the profile provides an indirect measure of the consequences of toxic exposures, medications, trauma, radiation, etc.
Cellular Energy Profile
Reveals metabolic distress and mitochondrial physiology potentially associated with generalized muscle pain, fatigue, cold intolerance, toxic exposure, nutrient imbalances, digestive dysfunction and many other factors.
In-Home Sleep Diagnostics
Description: In-home sleep diagnostics are an increasingly popular and convenient way to diagnose sleep apnea or other forms of disordered sleep NOT associated with brainwave abnormalities or restless leg syndrome (which require in-lab testing). The reason this approach is becoming the new standard for insurance, doctors, and patients is that it is considered more of a “true test” of sleep, in a comfortable and familiar setting, assessing multiple nights in a row. The units are portable, easy to use, and the test is self administered which also make is more cost effective ($1200-1600 vs in-lab testing, which ranges from $1800-3200). We use an in-home sleep diagnostic company that bills all commercial insurance, including Medicare. While they will bill to insurance what is customary and reasonable, they do not “balance bill” patients, regardless of deductibles and or denials from insurance. So the out-of-pocket expense is capped at $375, and is sometimes as low as $185 for commercial insurance, and never more than $87 for Medicare patients.
The test evaluates oxygen saturation, respiratory excursion, and uses a recorded microphone to evaluate for abnormal palatal noises, and will detect all subtle and obvious apnea events. By way of calculation and analysis it will also distinguish the difference between central (brain mediated) mechanisms versus obstructive mechanisms. One of its most important utilities for our patient base is that it will detect clinically relevant oxygen deprivation while sleeping, which tends to be a key component to a lot of our patients symptoms and functional problems such as fatigue, hormone abnormalities, depression, anxiety, low and high blood pressure, and various forms of pain sensitives, myofascial pain, headaches and a long list of other potential associations.
All commercial insurance: $185-375
Cash pay / Medicaid: $350-475
Bone Resorption Test
This urine test measures bone turnover accurately and inexpensively. A non-invasive indicator and guide for managements of early osteoporosis and disease prevention.
Ordered as needed based on individual need and medical assessment.