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Friday, March 04, 2005

Great Plains Lab fest

Great Plains Lab is a mail-order lab that uses massspectrometry to analyze urine. The lab is a Medicare provider but does not appear to be CLIAA certified. According to the Lab Website information, organic acid testing and other mass spectrometry based urinetesting are used to diagnose attention deficit disorder, ADHD, depression, food allergies, chronicfatigue syndrome, Alzheimer's disease, autism, vitamin deficiency, dermatitis, yeast infection, just to name a few conditions on a long list.

The Lab director, William Shaw, PhD is a biochemist and not a medical doctor or pathologist. He is not a clinical specialist in the pathophysiology or treatment of medical conditions.

Mass spectrometers are mainstay equipment in larger medical pathology labs. Organic acid testing of urine is routine in the work-up for inborn errors of metabolism. There are few other established reasonsto do urine organic acid testing, especially routinely. Most of the associations made by the Website concerning the listed illnesses' with yeast infections, diet deficiencies, allergies and measured organic substances in the urine are speculative at best. There is little correlation of these relationships with established clinical practice, and the scientific literature. Most references on the Website are of books, reviews and case studies by Shaw himself.

As evidenced by sites linking to the Great Plains LabWebsite, the mainstay of business appears to be inalternative medicine that use testing results to ultimately market brand name nutritional supplements, or to establish a pathology for which an advocated alternative medicine treatment can address.

There is no compelling evidence that organic acid urine testing as advocated by Great Plains Lab is linked to most of the listed clinical conditions, that such testing is useful for the diagnosis of the disease or condition, or (most importantly) that such testing assists in making treatment decisions. Much of the site information may be based on good science that has been taken to the fringe of clinical applicability; science that is stretched and mixedwith authoritative sounding speculation in an attempt to legitimize or substantiate unneeded or even whimsical treatment.

Labs like this one provide a very essential service within alternative medicine. Those health conditions for which mainstream medicine often seems at a loss are (allegedly) quantified, measured and substantiated via a real live scientific lab test, making the malady appear legitimate, understandable and/or curable. I find myself wishing it could always be that simple. (no vested interests)
1.http://www.greatplainslaboratory.com/
2.http://www.aruplab.com/home/pediatric_testing/testing_services.jsp
3. Practice parameter: Evaluation of the child withglobal developmental delay. Report of the QualityStandards Subcommittee of the American Academy ofNeurology and The Practice Committee of the ChildNeurology Society. Neurology. 60:3 February 11, 2003 5. Practice Parameters for Allergen ImmunotherapyAAAI - V90 Number 1t January 2003 6. PubMed search "urine organic acid testing"http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed

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