McCall McPherson for Thyroid Nation Community

When it comes to thyroid treatment nothing is more important than proper lab testing.

  • The Why:

    Hi, my name is McCall McPherson, as the founder of Modern Thyroid Clinic and Chief Hope-Giver at Thyroid Nation, I truly believe objective and measurable data is the key and number one necessity to help me give my patients get their life back. Without it, thyroid diagnosis and treatment is a guessing game, and as a thyroid expert, over the years I’ve found that thyroid absolutely must be done with objectivity, precision, diligence and with a tad bit of finesse.

    The When:

    It cannot be stressed enough how vital it is to get your labs at the start of your thyroid journey and to test and retest every three months until your thyroid medicine and function is completely stabilized. After which I recommend testing annually to make sure it stays within an adequate range. Of course, if you feel as though your thyroid has suddenly shifted, I always recommend getting labs and following up with your doctor early.

    For more information in what your thyroid labs mean, read below….

    Thankfully, obtaining these kinds of labs even without an endocrinologist or primary care doctor willing to order them is no longer a struggle.  You can now order all of these labs yourself without having to go to your doctor first.  This is a cash-based model that allows you to save money and bypass the hassles and expense of using insurance.

  • The What:

    TSH: There are numerous tests that are necessary for a true thyroid workup.  The most commonly ordered thyroid lab test is TSH, or thyroid stimulating hormone. This is absolutely not enough to gauge your thyroid status. It really just tells us how much work your body is doing in order to get your output hormones, it doesn’t at all tell us what your output hormones actually are.

    Free T4: After your thyroid is stimulated by TSH, it secretes a hormone called free T4 which is your inactive hormone, that then must be converted and activated before it takes effect. The analogy I use for free T4 is crude oil. You have to make it into gasoline before it’s useful.

    Free T3:  The real-difference maker in your quality of life, mood, metabolism, sex drive, and all those other pesky thyroid symptoms, is a hormone called free T3 This is what I refer to as your gasoline hormone and is the end step when free T4 is properly activated.

    Reverse T3: Lastly there is an in Inhibitory hormone called reverse T3, which blocks the absorption of your gasoline hormone, free T3. This is the hormone left out of most lab orders, and truly it is absolutely necessary, especially for patients on Levothyroxine, Synthroid, Tirosent or any other T4 based medication.

    Antibodies: To rule out and screen for Hashimoto’s disease, the autoimmune disease associated with hypothyroidism, TPO antibodies and thyroglobulin antibodies are necessary.

STEP ONE:  Gauging your current thyroid status.

We appreciate how complex your thyroid is so getting real and accurate information is essential.

STEP TWO: Knowing what to do the day of your labs.

You can get a copy of our quick guide on How to Take Your Thyroid Medication Before Your Labs HERE because it is VITAL that it’s done properly. Again, we are all about the nuances of your thyroid function because THEY MATTER and part of that is an accurate read of how well your medication is working (or isn’t working).

STEP THREE: Knowing how to interpret your lab values.

Again, we want to pull away the curtain and give you all the necessary information we can to help you get your life back. That’s why Thyroid Nation’s Chief-Hope-Giver, thyroid expert and Founder of Modern Thyroid Clinic, McCall McPherson PA-C, has created a FREE thyroid lab guide for you download HERE so you can better understand your lab values.

You can find more out about optimal ranges at www.thyroidnation.com/gift. Here you can download our “Thyroid Lab Guide, What labs you need and what they mean.”

After your thyroid has been stabilized, you can then move to obtaining labs every year so long as you continue to feel good.

In the presence of Hashimoto’s, I always recommend additional testing of antibodies every three months along with regular thyroid labs.

In addition to hypothyroidism, my patients often suffer from hormone dysfunction. For this reason I frequently also order hormone labs on my patients. These include estradiol, progesterone, estriol, FSH, LH, DHEA-Sulfate, testosterone, and sex hormone binding globulin. You can pick and choose individual labs all here. This is a very accurate way of giving us a well rounded picture of hormonal status. One important note, in premenopausal women this is often done on day 21 of their cycle (day 1 is the first day of the period) in order to obtain really good and accurate information. In postmenopausal women, testing can be done anytime.

Feel free to look around and determine any other labs, individual or packaged, that may provide the information you need to help you get your life back.

GET A FREE COPY OF MCCALL MCPHERSON’S AND THYROID NATION’S THYROID LAB GUIDE SO YOU’LL KNOW HOW TO LOOK AT YOUR LABS.

Ordering Your Labs is an Easy 3-Step Process!!!!

Save up to 50-80% off advanced biomarker testing by ordering direct. You will save even more as a physician visit is not required.

1. Order Testing Online

Easy online ordering – select from recommended panels and individual tests. No physician visit is required.

2. Local Blood Draw

Visit a local draw station with no appointment necessary. Choose from over 4,000 draw stations throughout the country.

3. View Results Online

Results are available in as soon as 48 hours. Your lab report will provide valuable insights and help you better understand and optimize your personal health.

1. Order Testing Online

Easy online ordering – select from recommended panels and individual tests. No physician visit is required.

2. Local Blood Draw

Visit a local draw station with no appointment necessary. Choose from over 4,000 draw stations throughout the country.

3. View Results Online

Results are available in as soon as 48 hours. Your lab report will provide valuable insights and help you better understand and optimize your personal health.

Direct lab testing now available in 46 States! Locate a draw station in your state (New Jersey, New York, Maryland, and Rhode Island excluded).

Thyroid Nation - Let's Get This (Thyroid) Party Started

These labs serve as a baseline of your thyroid function and critical nutrient needs. When you are trying to optimize your thyroid medication you must get labs about every three months and adjust medication every 3 1/2 months. This goes on until your labs are just right, and within an extremely narrow and optimal range.

Thyroid Stimulating • Hormone (TSH) • Free T4 • Free T3 • Reverse T3 • Thyroid peroxidase  • (TPO) antibodies  • Antithyrogloblin antibody

$250.00

Thyroid Nation - Let's Get This (Thyroid) Party Started. Nutrient Panel Add-On

My key nutrients for optimal thyroid function are included in this panel. This panel is an optional add on for any draw or you may select individual nutrients in the custom configurator below under the nutrient tab.

Ferritin • RBC Magnesium • Selenium • Vitamin D • Vitamin B12 • Zinc 

$199.00

Thyroid Nation - Pump up the (Thyroid) Volume

This is the bare minimum you need to know how your medication is working and what needs adjusting. This must be done at the 8 week mark after any medication changes. (That means the last medication change, not when you started making medication changes, the details matter!).

Thyroid Stimulating • Hormone (TSH) • Free T4 • Free T3 • Reverse T3

$179.00

Thyroid Nation - This Is How We Do It (Thyroid Style)

Once you’re stable, this is the (minimally) annual lab panel you need to see if you continue to be in good thyroid standing (maintenance mode).  

Thyroid Stimulating • Hormone (TSH) • Free T4 • Free T3 • Reverse T3 • Thyroid peroxidase • (TPO) Antibodies • Thyroglobulin Antibodies

$250.00

View our extensive test offering, learn more about individual tests, or add additional tests to enhance your selected panel.

Available Test

1. Cholesterol & Heart Health
2. Exposure Testing
3. Fat Hormones
4. Female Sex Hormones
5. Food Tolerance
6. General Health Screening
7. Genetic Testing
8. Inflammatory Markers
9. Male Sex Hormones
10. Nutrients
11. Stress Hormones
12. Sugar Metabolism and Diabetes Screening
13. Thyroid Hormones
Total Price:
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Test Description

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Reasons to check it:

"Cholesterol was first measured as a blood test in 1934 but it wasn't until 1969 when we were able to measure HDL, triglycerides, and come up with a calculation for LDL. It was shortly after this that we began to use thefasting lipid panel in clinical practice. It has been adopted widely and is used to make therapeutic decisions." - Dr. Alan Hopkins

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"The most accurate results of this test are obtained if you fast for 10-12 hours and avoid alcohol the day before the test.

Blood vessel disease is caused by progressive cholesterol-laden plaques building up in the arteries of the body, which leads to segmental blockages.  These blockages most frequently occur in the arteries of the heart, the brain, and the lower extremities. Once present in one part of the body, it is known that other arteries will build up plaque and blockages as well.  

Heart attacks and strokes are the two most common and dangerous problems that can result from these blockages.  Heart attacks occur when there is a build-up of cholesterol and plaque (atherosclerosis) inside the arteries that supply blood to the heart.  Strokes occur when this build-up is inside the arteries that supply blood to the brain." - Dr. Alan Hopkins

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"The most dangerous particle when it comes to heart disease and thrombotic stroke is genetically-determined, meaning your family gave it you.  Insurance companies have traditionally refused to pay to have it tested so most of the millions of people who have it are unaware.  It is called “Lp little a or Lp(a).

Lp(a) is a lipoprotein that is similar to LDL. It is very small, dense and dangerous. Like LDL, it contains an apo B molecule and a cholesterol rich lipid core. However, unlike LDL, Lp(a) has a unique sugar protein on its surface which makes it much more likely to cause blood clotting." - Dr. Alan Hopkins

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If you have risk factors for heart disease or are concerned about your vascular health, this test can provide essential information to help guide your treatment and lifestyle choices.

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If you’re concerned about oxidative stress or kidney function, this test can provide valuable insights into your overall health and guide necessary interventions.

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Reasons to check it:

If you're concerned about your heart health or have a family history of cardiovascular disease, this test can provide essential information to guide your management strategies.

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Reasons to check it:

If you're at risk for heart disease or concerned about inflammation, this test can provide valuable insights into your cardiovascular health, helping to inform your healthcare decisions.

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If you have risk factors for heart disease, this test can provide crucial insights into your LDL oxidation status, helping you and your healthcare provider make informed decisions about your heart health.

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Test Name:
Arsenic
Reasons to check it:

If you have concerns about environmental exposure or symptoms related to arsenic toxicity, this test can provide valuable insights for guiding necessary changes and interventions.

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Test Name:
Lead
Reasons to check it:

"Have you been exposed to lead in cosmetics, pain, and urban living? Contamination of our food and water supply has occurred and lead has been shown to leach out of our pipes and directly into our water supply." - Dr. Alan Hopkins

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Test Name:
Mercury
Reasons to check it:

"The most common cause of mercury toxicity in the human bloodstream is exposure to methylmercury, which is predominantly found in fish and shellfish. Methylmercury accumulates in the food chain, particularly in predatory fish such as shark, swordfish, king mackerel, and tilefish. People consume methylmercury when they eat these types of fish and seafood.

Another significant source of mercury exposure, though less common, is through dental amalgam fillings, which release small amounts of mercury vapor that can be inhaled and absorbed into the bloodstream." - Dr. Alan Hopkins

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If you’re experiencing symptoms related to mold exposure or have a family history of allergies, this test can provide valuable insights to guide your health management strategies.

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RBC Copper
Reasons to check it:

If you’re experiencing symptoms of copper deficiency or excess, this test can provide essential insights to guide your health management strategies.

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If you're concerned about environmental exposure to heavy metals, this bundle provides essential insights to guide your health management and reduce risks.

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Test Name:
Adiponectin
Reasons to check it:

"Adiponectin is produced and secreted by fat cells,heart cells, cells that line blood vessels, and pancreatic beta cells. Adiponectin production is significantly decreased with high blood sugar and even isolated insulin resistance. Obese individuals (BMI>30) have been observed to have significantly lower levels of adiponectin, than non-obese subjects. Adiponectin has direct insulin-sensitizing, anti-inflammatory, and anti-atherogenic properties, such as stimulation of nitric oxide production from the vascular endothelium. The normal range of circulating adiponectin is between 2.0-16.6 ng/mL. Low levels of adiponectin are associated with a 60% increased riskfor diabetes." - Dr. Alan Hopkins

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Test Name:
Leptin
Reasons to check it:

"Leptin is an adipokine secreted from adipose tissue. Leptin sends a signal to the hypothalamus in the brain to regulate appetite and energy expenditure. Leptin deficiency results in excessive eating and decreased energy expenditure, leading to obesity. In contrast, elevated levels of leptin can represent leptin resistance, which also paradoxically leads excessive eating and decreased energy expenditure. Elevated levels of leptin have been associated with insulin resistance, metabolic syndrome, obesity, hyperlipidemia, hypertension, diabetes, and may be an independent risk factor for coronary artery disease. Many of these associations are thought to be due to leptin's pro-inflammatory signaling." - Dr. Alan Hopkins

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Test Name:
Estradiol
Reasons to check it:

"There are 3 primary forms of estrogen in the body and each of these estrogens are metabolized uniquely.  E2 or estradiol is the most potent of the estrogens and this is what we measure in your blood stream.  Estradiol levels fluctuate dramatically at two points in a woman’s life. The first is in and around the time of puberty and adolescence and the second is around the time of menopause.

The wild swings of estrogen can cause sleeping problems, irritability, weight gain, and memory lapses among many other things.  The loss of estrogen completely can lead to night sweats, hot flashes and the movement of subcutaneous fat around the thighs and hips to be converted into belly fat around the organs." - Dr. Alan Hopkins

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"Follicle stimulating hormone (FSH) is produced by the pituitary gland and, in women, promotes ovulation and stimulates secretion of estradiol and progesterone from the ovaries.  FSH is released in short bursts (pulses) every 1 to 4 hours, and the magnitude of these bursts varies greatly throughout different phases of the menstrual cycle.  Therefore, depending on the time of your blood draw, a high level may simply reflect a burst of FSH. As ovarian production of hormone decreases or ceases, the pituitary gland receives a message to produce more FSH.  Post-menopausal women and women who have their ovaries removed will have consistently high levels of FSH. " - Dr. Alan Hopkins

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Luteinizing hormone (LH) is produced by the pituitary gland and it helps in the production of testosterone.  Some men who possess elevated levels of LH demonstrate evidence of decreased testosterone production by the testes - this is called primary hypogonadism and is rare and should result in consultation with a urologist.

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Test Name:
Progesterone
Reasons to check it:

"Progesterone levels are normally high in pre-menopausal women and become elevated during pregnancy. Levels are lower after menopause. High levels may indicate ovarian cancer or adrenal cancer, while low levels may be associated with amenorrhea (lack of menstruation), or problems with pregnancy."- Dr. Alan Hopkins

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"Women with a high testosterone level may have a condition known as polycystic ovarian syndrome (PCOS).  Women with PCOS are prone to insulin resistance and type 2 diabetes.  Women who have unexplained high testosterone should be screened for the presence of insulin resistance with a fasting insulin. They will also benefit from checking a fasting blood sugar and a hemoglobin A1c (a 3 month measurement of blood sugars) to ensure they do not have prediabetes or diabetes.

Women may also have a high testosterone level due to skin absorption of testosterone gel or cream utilized by their male partner. 

High testosterone levels in women can lead to irritability, excessive hair growth and even acne." - Dr. Alan Hopkins

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"For an accurate testosterone, it is best to measure it first thing in the morning. 

Testosterone is measured several ways: total, free and bioavailable:

Total testosterone is all testosterone in the blood. Not all testosterone is available for use; therefore, bioavailable testosterone may be measured

Bioavailable testosterone is the amount of testosterone that is loosely bound to albumin, but can detach and become available quickly

Free testosterone is the amount of testosterone in the blood that is not bound to anything and is immediately available for use

Bioavailable and free testosterone are important measurements for correctly assessing the testosterone that is available for the body to use." - Dr. Alan Hopkins

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"Luteinizing hormone (LH) and follicle stimulating hormone (FSH) are produced by the pituitary gland and, in women, they promote ovulation and stimulate secretion of estradiol and progesterone from the ovaries.  LH and FSH are released in short bursts (pulses) every 1 to 4 hours, and the magnitude of these bursts varies greatly throughout different phases of the menstrual cycle.  Therefore, depending on the time of your blood draw, a high level may simply reflect a burst of FSH or LH.  As ovarian production of hormone decreases or ceases, the pituitary gland receives a message to produce more FSH.  Post-menopausal women and women who have their ovaries removed will have consistently high levels of FSH. 

An LH/FSH ratio is helpful in the evaluation of polycystic ovarian syndrome.  In healthy premenopausal women, the ratio is about 1:1; however, women with PCOS may have a ratio of 2:1 or higher." - Dr. Alan Hopkins

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If you have concerns about menstrual irregularities, mood swings, or fertility, this bundle can provide a thorough evaluation of your hormonal balance, helping you and your healthcare provider address any issues effectively.

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"Dihydroepiandrosterone sulfate (DHEA-S) is a hormone that is manufactured in the adrenal glands of both men and women. Its levels are abnormal in various glandular conditions. DHEA-S is a weak androgen secreted primarily by the zona reticularis of the adrenal cortex. Secretion is controlled by ACTH and other pituitary factors. Physiologically, DHEA-S has many roles, including the development of pubic and axillary hair, the development and maintenance of immunocompetence, and as a possible tumor marker. Serum levels of DHEA-S are 1,000 times greater than those of DHEA. "- Dr. Alan Hopkins

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If you suspect hormonal imbalances affecting your mood, energy, or overall health, this test can provide crucial insights to guide your treatment options.

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If you're dealing with chronic stress, fatigue, or suspected adrenal issues, this test can provide deeper insights into your hormonal health and guide necessary interventions.

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If you're experiencing symptoms of hormonal imbalance or are going through menopause, this test can help provide insights into your estrone levels and guide your healthcare decisions.

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If you’re experiencing symptoms related to growth hormone deficiencies or excesses, such as fatigue or unexplained weight changes, this test can provide valuable insights into your hormonal status.

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If you’re experiencing fatigue, mood swings, or cognitive issues, this test can help clarify your pregnenolone levels and guide necessary interventions for hormonal health.

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If you’re struggling with digestive issues or unexplained symptoms, this test can provide valuable insights to guide your dietary choices and health management strategies.

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If you’re experiencing symptoms like bloating, fatigue, or digestive discomfort, this test can provide essential insights to help identify and eliminate food triggers for better health.

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"A complete blood count is a measure of the various cells within the blood. Red blood cells and hemoglobin are responsible for carrying oxygen to the body and carbon dioxide out of the body. The red blood cell count is the absolute number of red blood cells in the blood. A high level can be associated with problems with cardiovascular function, tobacco abuse, stress, high altitude or dehydration. A low count may indicate anemia, or problems with bone marrow or kidney function. 

The complete blood count or "CBC" can be very helpful to assess for the end result of serious nutrient deficiencies. In fact, one of the most common finding of severe iron deficiency is anemia.

White blood cells are part of the immune system and are responsible for fighting off infection. In terms of immune system activation, the white blood count should be within the reference range, unless, of course, there is active infection. There are several types of white blood cells, each with a specific job to do in terms of fighting off threats to the body.

Neutrophils are involved in fighting off bacterial and other infections and are elevated in tissue injury, inflammation, stress, certain metabolic conditions, metastatic cancer and in response to some medications.

Lymphocytes identify foreign substances in the body and produce antibodies against them. Monocytes are increased in response to infection, particularly infection with viral or parasitic agents. They can also be increased in response to chronic infection, inflammatory bowel disease, leukemia and certain cancers.

Eosinophils are typically involved with allergies and parasitic infections. Basophil levels can be elevated in conditions involving inflammation and allergic reactions.

Platelets are involved in the process of blood clotting. When a blood vessel is damaged, platelets clump together and help to initiate clotting. Abnormal platelet counts are found in a number of blood-related and autoimmune diseases."- Dr. Alan Hopkins

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"Our bodies have an enormous capability to filter toxins. Two of the major organs in our bodies that accomplish this task are the kidney and liver. They are so important that we cannot live without them.

Kidney and liver function are most comprehensively evaluated with blood tests that measure the levels of serum biomarkers that are regulated or synthesized by these essential organs. In many cases, specific biomarkers are associated with the cause of impaired function." - Dr. Alan Hopkins

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If you're preparing for surgery, considering pregnancy, or want to know your blood type, this test is essential for ensuring safe medical procedures and understanding your health better.

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Test Name:
Calcium
Reasons to check it:

"Calcium is a mineral that is important for normal growth of bones and teeth as well as proper functioning of nerves and muscles.  Most of our body’s calcium is stored in bones, but it is also found in our muscle cells and blood.  Calcium is important for muscle contraction.  It is essential for normal heart rhythm.

Elevated levels of calcium may be due to excess intake of calcium supplementation, certain medications or even cancer." - Dr. Alan Hopkins

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"Celiac disease is caused by an immune response to gluten in genetically sensitive individuals. The diagnosis is largely based on a biopsy of the small intestine, but serologic tests also help support a diagnosis and may assist identification of patients who may require biopsy." - Dr. Alan Hopkins

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Test Name:
GGT
Reasons to check it:

If you have risk factors for liver disease or are experiencing symptoms like jaundice or abdominal pain, this test can provide valuable insights into your liver health and guide your management strategies.

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Test Name:
LDH Total
Reasons to check it:

If you’re experiencing unexplained symptoms or have concerns about tissue damage, this test can provide crucial insights to guide your healthcare decisions.

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"Lyme disease is caused by a bacterium borrelia burgdorferi and is transmitted by ticks. A screening test with high sensitivity is used as the first step in the CDC recommended algorithm. Immunoblot testing qualitatively examines, with high specificity, antibodies in a patient's specimen. Immunoblot testing is appropriate for confirming a detected screening result." - Dr. Alan Hopkins

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If you're experiencing symptoms like bone pain or fatigue, this test can provide crucial insights into your phosphate status, guiding your dietary choices and supplementation.

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Test Name:
Urinalysis
Reasons to check it:

If you're experiencing symptoms like frequent urination, pain during urination, or changes in urine color, this test can help identify underlying health issues and guide your treatment options.

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"A complete blood count is a measure of the various cells within the blood. Red blood cells and hemoglobin are responsible for carrying oxygen to the body and carbon dioxide out of the body. The red blood cell count is the absolute number of red blood cells in the blood. A high level can be associated with problems with cardiovascular function, tobacco abuse, stress, high altitude or dehydration. A low count may indicate anemia, or problems with bone marrow or kidney function. 

The complete blood count or "CBC" can be very helpful to assess for the end result of serious nutrient deficiencies. In fact, one of the most common finding of severe iron deficiency is anemia.

White blood cells are part of the immune system and are responsible for fighting off infection. In terms of immune system activation, the white blood count should be within the reference range, unless, of course, there is active infection. There are several types of white blood cells, each with a specific job to do in terms of fighting off threats to the body.

Neutrophils are involved in fighting off bacterial and other infections and are elevated in tissue injury, inflammation, stress, certain metabolic conditions, metastatic cancer and in response to some medications.

Lymphocytes identify foreign substances in the body and produce antibodies against them. Monocytes are increased in response to infection, particularly infection with viral or parasitic agents. They can also be increased in response to chronic infection, inflammatory bowel disease, leukemia and certain cancers.

Eosinophils are typically involved with allergies and parasitic infections. Basophil levels can be elevated in conditions involving inflammation and allergic reactions.

Platelets are involved in the process of blood clotting. When a blood vessel is damaged, platelets clump together and help to initiate clotting. Abnormal platelet counts are found in a number of blood-related and autoimmune diseases.

ADVANCED BIOMARKERS: BUN, Creatinine, eGFR

Your kidneys are vital organs that filter waste and water from your bloodstream and excrete them as urine. They also help to regulate our body's electrolytes including sodium, potassium, chloride, and bicarbonate. Creatinine and urea (blood urea nitrogen or BUN) are two waste products that your kidneys filter out and excrete in the urine.  When the kidneys are not functioning optimally, levels of BUN and creatinine can build up causing elevated levels of these biomarkers. eGFR stands for estimated glomerular filtration rate and is a mathematical calculation that takes into account muscle mass to "estimate" proper kidney function. If the eGFR is less than 60 ml/min then this is an indication of significant diminished function that needs to be further evaluated. Ideally, we like to see eGFR >100 ml/min.

People with mild or even moderate diminished kidney function typically do not experience symptoms; therefore, kidney biomarker evaluation may be the only indication that the kidneys are not functioning well. 

ADVANCED BIOMARKERS: AST, ALT, ALP, TBili

The liver performs over 500 vital functions. Some of the most important functions include its role in carbohydrate and protein metabolism, production of blood clotting factors, storage of vitamins and minerals, the formation and secretion of bile, and the breakdown of potentially harmful substances like alcohol, certain medications, and other toxins.

Biomarkers that reflect liver function are used to detect disease or damage to the liver or bile ducts. Bile ducts are small drainpipes that carry bile (a digestive fluid) from the liver to the gallbladder and from the gallbladder to the small intestine. If a duct becomes blocked, by a gallstone or tumor, waste can build up in the bile duct system and in the bloodstream. 

These liver markers can elevate with a number of conditions. One I commonly see in my practice is fatty liver. If a person has belly fat, this same fat can deposit in the liver and damage liver cells. Damage to liver cells can be picked up with these biomarkers.  Other common reasons for liver enzyme elevation are alcoholism and certain medications - statins, and sometimes, high dose niacin and long term use of NSAIDS (think motrin, ibuprofen). Liver enzymes can also elevate with infections, auto-immune hepatitis, and liver cancer.

Tip: If you have known liver disease or kidney disease or are taking blood pressure medication or potassium supplements, it is recommended you follow these biomarkers every 3-4 months. If you consistently indulge in alcohol, or routinely take over the counter non-steroidal anti-inflammatories (NSAIDS) for pain, high dose niacin or statins, you should also cautiously monitor your liver function.

ADVANCED BIOMARKERS: Albumin, Total Protein, Globulin

The liver makes and stores protein. A good way to check the overall health of the liver is to see if the liver proteins are normal. If these numbers are very low, there may be malnutrition or liver damage. It is common to see low protein levels in alcoholics or in people who have long-standing liver disease.

Total protein is made of two principal biomarkers - albumin and globulin. Albumin usually is 60% of all of the total protein, leaving about 40% to globulin.

Elevated albumin is uncommon but can be seen with hemoconcentration (look for high hemoglobin and hematocrit). Low albumin levels are much more common. This usually results from decreased production due to liver disease or acute inflammation! That is right, albumin is a NEGATIVE inflammatory marker, meaning with inflammation albumin levels will sometimes go down!

Malnutrition and maldigestion can also result in lower albumin levels. Addison's disease and protein nephropathy (kidney disease) are less common causes of lower levels of albumin due to albumin wasting in the urine (they pee out too much protein.)

As I stated earlier, about 40% of all total protein is made up of globulins. Ever heard of immunoglobulins? That's right our immune system proteins are included in this measurement.

High levels of globulin (with a normal albumin) can be seen commonly in chronic inflammation, infection, and some cancers (plasma cell, lymphomas, multiple myelomas). Other less common elevations of globulin (with normal albumin) occur with parasites, immune-mediated diseases, and pregnancy."- Dr. Alan Hopkins

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If you're concerned about your bone health or experiencing symptoms related to mineral imbalances, this bundle provides essential insights to guide your health management strategies.

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Test Name:
Apo E4
Reasons to check it:

If you have a family history of Alzheimer’s disease or cognitive decline, this test can provide crucial insights to guide your health management and preventive strategies.

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If you're concerned about your folate levels or have a family history of related health issues, this test can provide valuable insights for guiding your health management strategies.

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If you're experiencing symptoms like fatigue, joint pain, or skin issues, this test can help identify potential autoimmune conditions and guide your healthcare decisions.

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Test Name:
CK
Reasons to check it:

"Creatinine Kinase (CK) is released from damaged or inflamed muscle cells.  Exercise and muscle trauma (contact sports, traffic accidents, intramuscular injections, surgery, convulsions, wasp or bee stings, and burns) and certain medications can elevate serum creatine kinase values. About 60% of hypothyroid subjects show an average elevation of CK activity 5-fold over the upper reference limit. 

Elevated CK levels in the hundreds (300-500’s) range are common in people who exercise while levels >1000 may indicate an autoimmune attack on your muscles (called inflammatory myositis).  Patients who have very high elevations of CK may suffer from constant muscle pain." - Dr. Alan Hopkins

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Test Name:
ESR
Reasons to check it:

"The ESR test measures how quickly erythrocytes (red blood cells) settle at the bottom of a test tube containing a blood sample. A faster-than-normal rate may indicate inflammation in the body. Here’s how it fits into clinical practice:


: ESR can be elevated in both inflammatory and neoplastic (cancerous) diseases, but it is not specific enough to differentiate between them on its own. It can suggest the presence of an underlying condition that might need further investigation, but additional specific tests are required for diagnosis.


: ESR is often used to assess the severity of inflammation and to monitor the effectiveness of treatment in inflammatory diseases, such as rheumatoid arthritis, polymyalgia rheumatica, and systemic lupus erythematosus. However, it is not a direct index of disease severity as its levels can be influenced by other factors such as age, anemia, and pregnancy." - Dr. Alan Hopkins

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"The discovery of the biomarker called CRP has revolutionized our ability to characterize the inflammatory disease state of the cardiovascular system. CRP is a critical component of the immune system, a complex set of proteins that our bodies make in response to acute infections, trauma and metabolic disturbance.

CRP elevation demonstrates that its presence alone can indicate significant vascular aging, even in the absence of the usual lipid disorders that are commonly seen. CRP elevations between 2-10 are concerning for chronic cardiometabolic disease, while CRP’s above 10 may indicate autoimmune disease, acute infection, or even cancer." - Dr. Alan Hopkins

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Test Name:
Homocysteine
Reasons to check it:

"Homocysteine is an amino acid that, at high levels, seems to be a risk factor for cardiovascular disease.  

There is also evidence suggesting that people with elevated homocysteine levels have twice the normal risk of developing Alzheimer’s Disease. High levels can be seen in people who have low levels of folic acid (vitamin B9) and vitamin B12.

Blood levels of homocysteine tend to be highest in people who eat a lot of animal protein and consume few fruits and leafy vegetables, which provide the folic acid and other B vitamins that help the body rid itself of homocysteine." - Dr. Alan Hopkins

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Test Name:
Uric acid
Reasons to check it:

"Some individuals who possess elevated uric acid levels are at an increased risk of developing gout (a form of arthritis that occurs when too much uric acid builds up in the joint spaces).  Gout can cause swollen, red, hot and stiff joints.  Commonly, gout first becomes evident in the proximal joint of the big toe; however, it can also attack ankles, heels, knees, wrists, fingers, and elbows.   People who take medications to control their uric acid level should have levels within the reference range.  Elevated uric acid levels should be discussed with a physician." - Dr. Alan Hopkins

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If you're looking to optimize your heart health and overall wellness, this bundle provides essential insights to guide your lifestyle and treatment decisions.

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"High estradiol in men is always abnormal.  The most common cause is an enzyme 5' aromatase in belly fat that converts male testosterone into estrogen. When I see it elevated, we focus on targeted belly fat weight loss and may use a medication called arimidex to lower the estradiol." - Dr. Alan Hopkins

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"Follicle stimulating hormone (FSH) is a hormone that is produced by the pituitary gland and stimulates the testicles to produce testosterone. It is part the male hormone highway.

In young men, the speed limit down this highway is 100mph. There is no problem with the signals (FSH)reaching the target (the testicles) and testosterone levels are quite high. As men age, this signal begins to markedly diminish and FSH levels will drop. When we evaluate men for low testosterone, this is the most common pattern we see - low FSH and low testosterone. We call this secondary hypogonadism." - Dr. Alan Hopkins

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If you have irregular menstrual cycles, fertility concerns, or symptoms of hormonal imbalance, this test can provide valuable insights into your LH levels and guide your reproductive health decisions.

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"If you are a man taking testosterone replacement, most physicians recommend following PSA levels to make sure you do not have any indication of a slow growing prostate cancer. It is thought that prostate cancer cells have androgen (testosterone) receptors on them and that giving a man with prostate cancer could potentially cause the cancer cells to grow more quickly." - Dr. Alan Hopkins

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"Testosterone is secreted by the testes and to a lesser degree by the adrenal glands.  It is the primary male sex hormone. Testosterone levels show a diurnal variation with the highest levels detected in the early morning and the lowest in the evening. In healthy men, testosterone levels decrease at a rate of about one percent per year as men age.  Experts estimate that approximately 20% of men have low testosterone levels by the time they are 50 years old.

Low testosterone can cause many symptoms

Libido, Erectile Dysfunction, Impotence – Libido, or sexual desire, is a complex process and can be affected by many factors including medications, depression, stress, anxiety, illness and body image to name a few.  Testosterone is the primary hormone affecting the libido and low levels are associated with decreased libido, erectile dysfunction and impotence.

Mental Functioning - Testosterone levels influence mental functioning.  In the brain, testosterone is thought to affect attention, memory, and spatial ability.  Some researchers believe there is a relationship between low testosterone levels and poor cognitive functioning and some further believe the relationship between low testosterone and decline in cognitive function may be a risk factor for Alzheimer’s disease.

Mood – Decreased testosterone has been associated with depression, anxiety, and irritability.  

Increased Abdominal Fat - Some men who have an increased BMI due to an increased amount of adipose tissue, particularly abdominal fat, have decreased level of testosterone.   

Physical Energy Level, Physical Endurance – Low testosterone levels are associated with a decrease in energy and a decrease in physical endurance. 

Bone Health - Testosterone also plays a role in maintaining strong bones.  Low testosterone levels are associated with low bone mineral density and an increased risk for osteoporosis.   

Strong Muscles - Muscle mass and strength decline with decreasing testosterone levels. " - Dr. Alan Hopkins

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"For an accurate testosterone, it is best to measure it first thing in the morning. 

Testosterone is measured several ways: total, free and bioavailable:

Total testosterone is all testosterone in the blood. Not all testosterone is available for use; therefore, bioavailable testosterone may be measured

Bioavailable testosterone is the amount of testosterone that is loosely bound to albumin, but can detach and become available quickly

Free testosterone is the amount of testosterone in the blood that is not bound to anything and is immediately available for use

Bioavailable and free testosterone are important measurements for correctly assessing the testosterone that is available for the body to use." - Dr. Alan Hopkins

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"Dihydroepiandrosterone sulfate (DHEA-S) is a hormone that is manufactured in the adrenal glands of both men and women. Its levels are abnormal in various glandular conditions. DHEA-S is a weak androgen secreted primarily by the zona reticularis of the adrenal cortex. Secretion is controlled by ACTH and other pituitary factors. Physiologically, DHEA-S has many roles, including the development of pubic and axillary hair, the development and maintenance of immunocompetence, and as a possible tumor marker. Serum levels of DHEA-S are 1,000 times greater than those of DHEA. "- Dr. Alan Hopkins

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"Want to ease the many effects of aging? Look to see if your “mother hormone” is optimal. Pregnenolone is made directly from cholesterol and it may improve libido, enhance memory and combat depression symptoms." - Dr. Alan Hopkins

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If you’re experiencing symptoms related to growth hormone deficiencies or excesses, such as fatigue or unexplained weight changes, this test can provide valuable insights into your hormonal status.

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Test Name:
CoQ10
Reasons to check it:

"Concerned about your athletic performance? An adequate amount of CoQ10 may help. CoQ10 levels tend to decrease as we age and some medications (like statins) are known to deplete the body of CoQ10. f you are over 50 or take a statin, you may be deficient in CoQ10." - Dr. Alan Hopkins

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Test Name:
Ferritin
Reasons to check it:

"Ferritin is a protein that transports iron in your body’s tissues.  Research has shown that ferritin is a very reliable indicator of the status of your body’s iron stores.  People who have very low or very high ferritin levels may have conditions that produce fatigue as a symptom. 

One of the most common reasons for a low ferritin level is due to a woman having heavy periods.  Very low levels of iron can lead to iron-deficiency anemia (the inability to make red blood cells efficiently). Supplementation with a good source of iron is easy, but be warned, supplemental iron can be hard on the stomach and constipating! 

Hemochromatosis is a condition that interferes with iron metabolism and causes a surplus of iron in the body. Serum ferritin levels will be very high. It is a genetic condition affecting1 in 200 people of Northern European descent, particularly people of British and Irish descent. One in 15 Caucasians are genetic carriers of the disease." - Dr. Alan Hopkins

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Test Name:
Magnesium
Reasons to check it:

"Magnesium is a mineral that is important for nearly all chemical processes in the body, including reactions that produce energy. Magnesium is plentiful in nuts, coffee, bananas, avocados, legumes, tea and leafy green vegetables. About half of the body's magnesium is found in bone. The other half is found inside cells of body tissues and organs.

Magnesium helps maintain normal muscle and nerve function, and keeps the bones strong. Magnesium is also needed for the heart to function normally and to help regulate blood pressure. Magnesium also helps the body control blood sugar level and helps support the body's defense (immune) system.

Magnesium deficiency is relatively common and symptoms include irritability, abnormal functioning of the nerves and muscles, heart damage and kidney damage. High levels of magnesium can also have health consequences. Symptoms of elevated magnesium include decreased muscle tone, fatigue, drowsiness and lethargy." - Dr. Alan Hopkins

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If you’re experiencing symptoms of B12 deficiency or are concerned about your nutritional intake, this test can provide essential insights for guiding necessary interventions.

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"High levels of Omega-3 fatty acids are important for good heart, brain, and joint health. Indeed, research has shown that optimal levels of Omega-3s can decrease one’s risk for heart disease, stroke, dementia, and depression. The typical American diet is low in Omega-3 fatty acids leading to chronic low blood levels in the majority of the population. Fortunately, levels can be improved via supplementation and simple dietary changes." - Dr. Alan Hopkins

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Test Name:
Selenium
Reasons to check it:

"Want to improve your thyroid hormone function? Make sure you have plenty of selenium which you can get in many natural foods like brazil nuts, sunflower seeds and eggs."- Dr. Alan Hopkins

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Test Name:
Serum Copper
Reasons to check it:

If you’re concerned about your copper levels or experiencing symptoms of deficiency or excess, this test can provide valuable insights to guide your management strategies.

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Test Name:
Total Iron
Reasons to check it:

If you're experiencing fatigue, low libido, or mood fluctuations, this test can help identify if testosterone levels are contributing to these issues, guiding necessary lifestyle or treatment changes.

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Test Name:
Vitamin B12
Reasons to check it:

"Multiple, unrelated conditions may result in a person becoming vitamin B12 deficient, with varying degrees of vitamin B12 deficiency present in approximately 10-20% of individuals over the age of 60. 

People at risk for B12 deficiency include vegans or vegetarians who also don't eat dairy or eggs -- vitamin B12 is found only in animal products. Some individuals who develop a vitamin B12 deficiency have an underlying stomach or intestinal disorder that limits the absorption of vitamin B12 that is present in the food we eat.  The inability to absorb vitamin B12 may be due to the loss of intrinsic factor caused by atrophic gastritis.  Diseases and conditions such as celiac disease, gastric infections, gastric surgery and some medications may also affect absorption of vitamin B12."  - Dr. Alan Hopkins

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"Folic acid (folate) is a B vitamin involved in many metabolic reactions in the body, including new cell growth. Maternal folic acid intake has been shown to reduce the risk of neural tube defects. Low levels of folic acid may be related to anemia, nutritional disorders, certain seizure prevention medications, excessive alcohol consumption,  metabolic disorders. Low serum folate may increase the risk of high blood pressure in women. Folate deficiency can cause poor growth, tongue inflammation, loss of appetite, diarrhea, irritability, or forgetfulness." - Dr. Alan Hopkins

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Test Name:
Vitamin D
Reasons to check it:

"We have well established the wonderful benefits of Vitamin D.  Not only do high levels of Vitamin D protect us from certain cancers, but there are other exciting benefits of having a very high Vitamin D level.  Autoimmune diseases, like lupus, thyroid disease, bowel disorders, occur less frequently in those with plenty of Vitamin D.  There is also less depression, improved mood and better blood pressure.  It is also thought that Vitamin D improves the function of the pancreas, by making insulin more sensitive.   When insulin works better, our metabolism works better and we live longer. 

Unfortunately, most of us (>70% in the United States), are deficient in Vitamin D.  

Discovered in 1929, Vitamin D is the big bang for the buck vitamin.  The standard over the counter Vitamin D supplements come in “international units or IU’s.”  The most common dosage you will see is 1000-2000 IU.  There is a common liquid preparation that is usually 4000 IU’s. 

I like Vitamin D levels to be between 60-80 for the best results.  Most of the studies showing the benefits of Vitamin D are seen in individuals that achieve these levels of Vitamin D in their blood stream.  If you are deficient in Vitamin D, it may take you 6-9 months to adequately replace Vitamin D and get within this range.  I would recommend caution for those of you with kidney stones to avoid shooting for high levels of Vitamin D since most kidney stones come from calcium and Vitamin D may increase calcium levels." - Dr. Alan Hopkins

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Test Name:
Zinc
Reasons to check it:

"Zinc has been known to improve your immune system. This test evaluates your zinc levels since the body does not store this important mineral. Interestingly, low levels of zinc have been associated with altered taste and smell." - Dr. Alan Hopkins

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If you're concerned about nutritional deficiencies or overall health, this bundle provides essential insights to guide your dietary choices and supplementation strategies.

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Test Name:
AM Cortisol
Reasons to check it:

"Cortisol is an important steroid hormone that regulates numerous body systems including the response to infection and inflammation, blood sugar, and bone metabolism.  It is often referred to as the stress hormone because it increases blood pressure and blood sugar, and reduces the immune response.  Typically, cortisol levels vary throughout the day.  It is highest in the morning and lowest before bedtime. Birth control pills can indirectly increase cortisol levels by increasing corticotrophin-binding globulin (the carrier protein for cortisol).  Thus, if you are taking birth control pills, an elevated cortisol level may not be a health concern. The most common causes of an inappropriate low morning cortisol level may be either sleep problems or chronic stress."- Dr. Alan Hopkins

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If you're experiencing chronic stress, fatigue, or mood disturbances, this profile can provide critical insights into your adrenal health, guiding your path to better well-being.

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"Historically, we have asked people to  fast for 8-12 hours and then we obtain a fasting plasma glucose (FPG). This has been considered the standard of care to detect diabetes and evaluate carbohydrate metabolism. Any FPG over 100mg/dL is associated with increased cardiovascular disease risk, but the actual diagnosis of diabetes is made after two FPG readings of ≥126 mg/dl. FPG levels between 100-126mg/dL are considered “pre-diabetes”, and this population has been known to develop microvascular and macrovascular complications over time. Optimal levels of fasting glucose are considered 70-85mg/dl." - Dr. Alan Hopkins

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"Fasting insulin is the hormone released by your pancreas that helps remove glucose from your bloodstream and into your body’s cells where it can be used for fuel.  An insulin measurement may help determine whether a high glucose reading is the result of insufficient insulin production (as in insulin-dependent diabetes) or poor use of insulin (as in Type 2 Diabetes).  Elevated levels of insulin can indicate the beginning of Insulin Resistance Syndrome and is typically the first warning sign of potential overload of the pancreas.  

Insulin resistance leads to excess sugar in the blood stream, and over time this can lead to diabetes.  High levels of insulin increase cardiovascular risk by 1.5-2x in non-diabetics." - Dr. Alan Hopkins

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Test Name:
Hemoglobin A1c
Reasons to check it:

"Hemoglobin A1c (HbA1c) is a measurement of the percent of hemoglobin molecules bound to glucose by-products.  The HbA1c measurement reflects the average glucose level over the past 60-90 days, therefore, a high HbA1c test result reflects a high glucose level over time. As a diagnostic test, glycated hemoglobin has superiority over fasting glucose, as it can be measured in non-fasting states, has greater reproducibility, and gives a better picture of the trend of how high blood sugars are going after meals.

A Hemoglobin A1c of 5.7-6.4% is consistent with prediabetes, while an A1c equal to or greater than 6.5% is consistent with diabetes." - Dr. Alan Hopkins

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If you're at risk of diabetes or struggling with weight management, this bundle can provide critical insights into your glucose metabolism, guiding lifestyle and treatment decisions.

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"Ever wonder how your pancreas is responding to a sugar load. This test provides detailed information. Before you are given a 75 gram dose of sugar, your fasting insulin and fasting glucose are measured. After the sugar load, the insulin and glucose are measured at one and two hours respectively. The information is used to evaluate impaired glucose tolerance." - Dr. Alan Hopkins

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Test Name:
Free T3
Reasons to check it:

"An extremelycommon cause of low energy is thyroid disease.  In fact, it is often misdiagnosed as depression. In response to brain signaling, the thyroid secretes thyroid hormone.  The active form of thyroid hormone is called free T3.  It's this hormone that has effects on every cell of the body, promoting optimal metabolism and function." - Dr. Alan Hopkins

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Test Name:
Free T4
Reasons to check it:

"The thyroid actually produces both free T4 and free T3, and the majority it produces in response to signaling from the brain is free T4.  Each cell in our body is responsible for converting the inactive free T4 into the active free T3 and it is thought that approximately 15% of the population do not convert well and have lower than expected free T3 levels." - Dr. Alan Hopkins

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"Women are five to eight times more likely than men to have thyroid problems. In fact, one woman in eight will develop a thyroid disorder during her lifetime. 

Symptoms of hyperthyroidism include fatigue, anxiety, sudden weight loss, rapid heartbeat, irritability, more frequent bowel movements, difficulty sleeping, sweating and tremors. 

Symptoms of hypothyroidism include weight gain, constipation, depression, sleepiness, memory loss, decreased sex drive and more. An extremely common cause of low energy is hypothyroidism.  In fact, it is often misdiagnosed as depression.

TSH is a good screening test for most thyroid disease.  An optimal TSH is between 0.4 to 2.  Normal TSH can range up to 4. The incidence of thyroid disease has increased in the last several decades. There is concern that the increased use of GMO’s and pesticides has contributed to thyroid disease." - Dr. Alan Hopkins

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"Autoimmune thyroid disease is characterized by the occurrence of antibodies directed against the thyroid gland, referred to as autoantibodies. 

Individuals who have thyroid autoantibodies can progress to overt hypothyroidism at a rate of 3%-5% per year. A common thyroid autoantibody seen in people with hypothyroidism is called thyroid peroxidase antibody. If your thyroid peroxidase antibody is positive you may develop the signs and symptoms of hypothyroidism which includes weight gain, loss of energy and loss of sex drive." - Dr. Alan Hopkins

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"Autoimmune thyroid disease is characterized by the occurrence of antibodies directed against the thyroid gland, referred to as autoantibodies. 

Individuals who have thyroid autoantibodies can progress to overt hypothyroidism at a rate of 3%-5% per year. A common thyroid autoantibody seen in people with hypothyroidism is called thyroid peroxidase antibody.

If your thyroglobulin antibody is positive you may develop the signs and symptoms of hypothyroidism which includes weight gain, loss of energy and loss of sex drive." - Dr. Alan Hopkins

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"Women are five to eight times more likely than men to have thyroid problems. In fact, one woman in eight will develop a thyroid disorder during her lifetime. Two important hormones, triiodothyronine (T3) and thyroxine (T4) are produced by your thyroid gland in response to a hormone called TSH, which is produced in the brain.  Too much T3 and T4 can result in a condition known as hyperthyroidism and too little T3 and T4 can result in hypothyroidism. 

Symptoms of hyperthyroidism include fatigue, anxiety, sudden weight loss, rapid heartbeat, irritability, more frequent bowel movements, difficulty sleeping, sweating and tremors. 

Symptoms of hypothyroidism include tiredness, weight gain, constipation, depression, sleepiness, memory loss, decreased sex drive and more. 

Pregnant women with undiagnosed or inadequately treated hypothyroidism have an increased risk of miscarriage, preterm delivery, and severe developmental problems in their children.

Additionally, 15% of the population has trouble converting Free T4 (the inactive form of thyroid) to Free T3 (the active form).  Oftentimes the only way to pick this up is to measure both of these hormone levels in the bloodstream.

Autoimmune thyroid disease is characterized by the occurrence of antibodies directed against the thyroid gland, referred to as autoantibodies. Individuals who have thyroid autoantibodies and an elevated level of TSH progress to overt hypothyroidism at a rate of 3%-5% per year. If one or both of your thyroid antibodies are positive, you should monitor your thyroid function at least every 6-12 months as you are at higher risk of thyroid failure." - Dr. Alan Hopkins

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"Women are five to eight times more likely than men to have thyroid problems. In fact, one woman in eight will develop a thyroid disorder during her lifetime. Two important hormones, triiodothyronine (T3) and thyroxine (T4) are produced by your thyroid gland in response to a hormone called TSH, which is produced in the brain.  Too much T3 and T4 can result in a condition known as hyperthyroidism and too little T3 and T4 can result in hypothyroidism. 

Symptoms of hyperthyroidism include fatigue, anxiety, sudden weight loss, rapid heartbeat, irritability, more frequent bowel movements, difficulty sleeping, sweating and tremors. 

Symptoms of hypothyroidism include tiredness, weight gain, constipation, depression, sleepiness, memory loss, decreased sex drive and more. 

Pregnant women with undiagnosed or inadequately treated hypothyroidism have an increased risk of miscarriage, preterm delivery, and severe developmental problems in their children.

Additionally, 15% of the population has trouble converting Free T4 (the inactive form of thyroid) to Free T3 (the active form).  Oftentimes the only way to pick this up is to measure both of these hormone levels in the bloodstream." - Dr. Alan Hopkins

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If you're experiencing fatigue, low libido, or mood fluctuations, this test can help identify if testosterone levels are contributing to these issues, guiding necessary lifestyle or treatment changes.

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Reasons to check it:

If you have dietary restrictions or symptoms of thyroid dysfunction, this test can help identify iodine imbalances that may affect your thyroid health.

Price:
Regular price $59.00
Regular price $65.00 Sale price $59.00
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Reasons to check it:

"Reverse T3 is a competitor with free T3. It binds to the same cell receptor site as free T3 but since it is not active, it doesn't do anything but prevent free T3 from working. I call it a get in the way hormone that allows the body to self-regulate. 

The problem is there are multiple conditions that fool the body into making more Reverse T3 than it should. Some of these conditions are very common including stress, illness, and even pain." - Dr. Alan Hopkins

Price:
Regular price $119.00
Regular price $129.00 Sale price $119.00
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