Claire

Thanks Buddy, I will check it out. By the way, I think virtually all of the regulars here agree with Jeff on the importance of avoiding artificial ingredients--most if not all of us are fairly meticulous about it. I signed up for Feingold myself after reading Jeff's posts. I also shop Whole Foods for this reason. Claire

Hi Susanna, Sorry for your little guy--remember my son has 20 food allergies--many of the same things, but to corn not soy, and to peanuts. Can he have yogurt? When my son tested sensitive to milk, they said he could have yogurt on a rotated basis. Stoneyfield farms makes a great frozen yogurt with no corn syrup. A number of parents say their kids react to corn syrup--even without corn allergies. I would eliminate it initially, then after a couple of months add it back and see if there is a reaction. My son and I are both allergic to corn syrup, but I admit, we still have catsup and BBQ sauce at restaurants on occasion (though Heinz organic doesn't have it). I just got a cookbook. They all supposedly have wheat/gluten-free, milk-free, egg-free and even lots of yeast and corn-free recipes. The AiA Gluten and Dairy Free $18.86 1 $18.86 Dark chocolate candy--no milk Pancakes--I customized from another recipe. Pamela's Pancakes have a TERRIFIC mix (we can't have the corn though) 1 C brown rice flour 1/2 C tapioca flour 1/4 potato starch (or corn starch?) ½ t baking soda 2 T baking powder (aluminum free) This has corn in it. I make a corn-free one 2-3 T lt olive oil or Safflower oil or Canola oil 1/4 cup goat milk protein powder, depending on how much protein you want. I use Gotein (rice protein powder would work) 1/2 dropper Stevia (optional) 1+ C Water--to taste, depending on thickness desired mix well and drop into pan and brown on both sides, etc... I wrote a long note on this topic--to Bean I think. Can't find it though. Claire ps Fruit smoothie with goat/rice protein powders are great also.

Hi Phyl, I have never observed this myself, but I have read about yeast on the skin. By the way, tea tree oil applied topically is a wonderful antifungal--I believe double blind studies show it is affective for athletes foot. It wouldn't help with excema, but it should help if it is fungal in origin. Zinc (orally) is helpful for excema--and by the way, it is an antifungal too! So something to consider, as it would apply either way--yeast or excema Yeast overgrowth can make kids susceptible to excema so they are intertwined in any case. Sorry for your frustrations with the yeast issue. This is part of the reason why I am looking into MT promotion and going to the outreach clinic. Sorry, but I forgot, does your son have food sensitivities? My doctor said they can cause gastroint. inflammation and make a great place for yeast to grow. Glad your son is still doing well. Claire

Good luck with Ivan! Claire

BN123 In addition to what Chemar suggested, please think hard as to whether you ate something in the last few days that might be a trigger. Something you weren't eating the week before.

Hi Holly, My son had excema for well over a year Then we discovered he had a wheat allergy. Chemar has hit on two important things to look into. If you have elevated metals, or yeast, they can contribute to other allergies. I read that 80% of childhood excema (rashes) were cause by food allergies. The most common ones are wheat, milk, peanuts, soy and I forget the last one. You can run blood tests for IgG sensitivities, or you can do an elimination diet. We did this and found many food allergies. In his case, wheat, corn, milk, peanuts and eggs were big ones. Wetook away wheat, and most of it cleared up. Then we took away corn and he was down to half a patch that stayed for months. Then we added zinc (to a whole host of other vitamins including fish oil and probiotics), and the last of his excema is now gone. Excema is just one indicator of metabolic issues or reactions. In my opinion, and the opinion of many here, so are tics. Sure the tendency may be there genetically, but environmental 'assaults' contribute. For my son, the elimination of computers and TV (never gameboy) completely eliminated his tics. For others, it is artificial colors. As Chemar says, watch for triggers when they are worse. As for your mistakes, we have ALL made them. Almost everyone here feels guilty for something that we did out of ignorance with our child. You are not alone. More importantly, on this board we believe we CAN make a difference. There is a lot you can do, please read the threads for ideas--or go to the doctor list that Chemar suggested. THe literature on TS makes it seem inevitable and without help, but we have found differently. Every single one of the regulars who has been posting for 9 months or so and tried different things (methodically) has seen substantial improvement. Others are just beginning their journeys. It will take a lot of time and effort though--that's why most of us have a specialist guiding us. Not a mainstream neurologist, but MDs and naturopaths who look to heal metabolic issues. Clearly your son has some with the excema--in fact, that has been a huge indicator to me of my son's healing. Here is the doctor's link. Be sure to ask questions before making an appointment. http://www.latitudes.org/forums/index.php?...p?showtopic=565 Claire

Buddy, Please do publish the link for Puritan's supply--we all spend a lot of $$ on vitamins. I was calling NEEDS, and they were 25% off and I was impressed. I would like to compare prices. Thanks, Claire

mommy2111 Never hesitate to post your opinion, whether or now it agrees with a few or many of us. Some experts think there may be an underlying viral element that adds to waxing and waning --at least for a subgroup of those with tics. Others think there is an unexplained waxing and waning. As I am sure you know, I think for many it is often triggers not identified. In any case, we are all figuring this out, and I have never seen anyone in this group criticize anyone for disagreeing with them. Claire

Hi efgh, He had 1-2 capsules a day, and his yeast went up during that window. It could have been something else to raise the yeast, but still... If I tried to give him 2-3 capsules, he would get nauseous. And he doesn't know which capsules are which, so there was no bias. It gave me shortness of breath--whether that is a reaction to the die-off I don't know, but I quit. We may be more sensitive due to low antioxidants. Capryllic acid is a popular supplement for yeast, but you do need diet change. We both did have diet change--still had carbs, but no treats--for months. I just started the Threelac for myself today. 1 packet a day and I will build up if possible. I will let you all know how it goes. I don't have direct yeast symptoms--tough to tell change. It likely affects food allergies though. And I believe that fungus can raise cholesterol. In a couple of months I am due for a check--it will be interesting to see how this goes. Later this winter I plan to take the Great Plains OAT test again. I still flunk the spit test, and badly. Claire

Hi Jennifer, I was so impressed with Heather's success and the lack of the need for diet change, that I asked our DAN doctor about Threelac. He read the literature and said he saw no harm in trying it. There was a Japanese study that showed threelac was helpful for allergies, which is an indirect, but promising indicator. So I bought it--but realized unfortunately that my son is allergic to brewer's yeast (very unusual), which I then found out it contains, so unfortunately he never went through the process--we stopped after 2 days. We are doing nystatin now, and we will see. I actually had more hope with the threelac, since capryllic acid and nystatin are similar and capryllic acid didn't work for us. Heather did the oxygen water with it. We still do this. My doctor saw no harm, but he didn't believe in it either. Claire

Why is taking Nystatin a problem? Is it a capsule? Our doctor gives it in liquid form and it tastes delicious. I have been searching the internet for our family for power bars that are gluten-free and dairy-free. Some use almond butter, not soy. My son is allergic to it, but I don't think your daughter is. I will try them once a week, since he is supposed to rotate some things once a week now. If she is taking antibiotics, our DAN doctor says to give a probiotic 2 hours after the antibiotics to replace the intestinal flora, especially if yeast is an issue. I suspect your daughter is doing this? I am glad you are seeing some improvement. It is tough to replace the foods, we are still struggling ourselves after many months. Claire

If you wish to talk privately, please register and send a private message rather than an email (you don't have to actually post on the board to do this). I don't have a yahoo email, only one connected to my business and for privacy reasons for my son, I prefer private messages to email. Since you wrote me privately, I won't post your info, but just answer your question on vitamins. It sounds like you have already taken some great first steps, and even though they haven't shown results yet, I would stick with them until you try the other things--sometimes (in fact usually), it requires a combination of things. The vitamin levels vary from child to child. We got a spectracell test done and customized the program. I don't usually post vitamin plans, so here is my disclaimer--like Chemar gives for hers: I am not a doctor and recommend that you go through a doctor on this list to come up with the best supplement plan for your son and have him monitored. The needs vary from child to child. Chemars son is older and thus heavier and thus I noticed his dosages are higher. http://www.latitudes.org/forums/index.php?...p?showtopic=565 For the tics, I still recommend trying no screens (TV/computer/gameboy) for a week. It is your and his decision, but when they are actually interfering and causing discomfort, it may be worth the trial. It might provide relief while you look at other methods. For 80 pounds, the vitamin levels depend on it he has pyroluria, then you need more zinc and B6. So I encourage you to do the at-home urine test--no doctor's signature required, you can order the test if you just give them your doctor's name. If you do this, please give no vitamins for 3 days prior to the test: Direct Healthcare access 847-222-9546 I have read that this is fine for long term, but you need to reach your own conclusions. Here are some of the vitamins and brands I like--but I am not tied to brands. We only do capsule--easier to swallow. Good to compare with Chemar's list--though this isn't for OCD at all, so we may have differences. -- Nordic Naturals Pro-EPA Fish oil (not flax oil, boys don't derive the Omega 3's from it as well). This has a 5:1 EPA to DHA ratio, which I read is ideal (2 caps) --Borage oil (more GLA than Primrose oil, but primrose oil is fine) --Klaire Probiotics (with bifidis, acidophilis and bulgaris) --Solaray Calcium Citrate with Vitamin D. 500 mg (2 caps of 125 each) --Cardiovascular research Magnesium Taurate 250 mg (2 caps of 125 each) --Manganese? --B6100 mg --P5P 50 mg --Chromium Citrate --Iron (alt days--not with other minerals like Calcium) --Twin Labs B complex (B1-Thiamine, B2 riboflavin, B3 niacinamide, B5 pantothenic acid, folate, Biotin, B12) 1 cap (2 is one adult dose) --Deluxe Scavengers Antioxidants(must be ordered through a doctor --L-Glutathione 100 mg --Zinc 25 or Zinc picolinate 25 (I read zinc is best at bedtime) Long term use of vitamins merits testing to see if they create other deficiencies We also do: 1. gluten-free, casein-free, no corn, 2. no artificial additives/colors/preservatives/flavors. 3. Way reduced sugar, though small desserts weekly. 4. Screen viewing on LCD monitor only--and 'no flicker' games. My son has no tics at all and hasn't for 10 months. However, he only tic'd from the CRT screens, so this is not a fair comment in some ways. This problem is not resolved yet. He also had other vitamin deficiencies which we were treating (all but magnesium and glutathione have been corrected), high mercury and elevated yeast, as did others here. The mercury is much better, the yeast is in progress. Claire

Hi efgh, I am so glad that your son is doing so well! I hope you are feeling better also. We have this one. We got the 15" because we wanted it smaller (for less impact) and it is cheaper. This is a computer monitor with built-in TV tuner and the cheapest I found. One thing with the LCD monitors for TV. They have an external brightness control, which for some reason needs to be low for normal TV (we like it low anyway to minimize the light--it doesn't affect the picture). But for DVD dark movies, e.g. Batman...you need to turn the brightness up--as long as you do this, the picture is fine. , Our Price: $449.99 There is a $30 rebate right now, so $419 total. http://www.bestbuy.com/site/olspage.jsp?id...41&type=product Samsung SyncMaster 15" Multifunction TFT-LCD Monitor - Silver Model: 510MP Image is everything, and with MagicBright technology and a built-in TV tuner, this versatile monitor knows it. So let it work — or play — for you. 15" screen (15" viewable) 0.297mm pixel pitch Built-in TV tuner, stereo speakers and power supply Claire

Hi Jennifer, We used zinc picolinate (better aborbed) plus zinc citrate. He takes 1 tab of each daily. Thanks for the screens update--this is very interesting. My fingers are crossed that you find something that works on the LCD screen. Claire

Great to hear about today Heather! Really really great. More and more I think what others think of as waxing and waning is really exposure to triggers or short-term deficiencies that haven't been identified. I am looking forward to your thread on 'what worked for my son', so that other newcomers will see it when they scan here. Even if you just cut and pasted these last couple of posts as a placeholder and then edited them to your high standards later... Claire

bn123 What Chemar gave you for calcium is the daily recommended dosage of calcium for adults (nothing to do with tics), and this site is pretty conservative: http://healthinfo.healthgate.com/GetConten...&chunkiid=21612 Requirements/Sources Although there are some variations between recommendations issued by different groups, the official U.S. and Canadian recommendations for daily intake of calcium are as follows: Children 1–3 years, 500 mg 4–8 years, 800 mg Males and females 9–18 years, 1,300 mg 19–50 years, 1,000 mg 51 years and older, 1,200 mg Pregnant women 1,000 mg (1,300 mg if under 19 years old) Nursing women 1,000 mg (1,300 mg if under 19 years old) ----- If that dosage concerns you, just start with 500 mg/250 mg. If you are giving that much zinc, the literature I read said to check for induced copper deficiencies later. But don't add copper otherwise--usually bad for tic syndromes. Claire

Lawsmith, Tics can worsen with age, and I remember reading somewhere that 10 was a peak. By the way, you might wish to ask your doctor whether the allergy test your son got was IgE (instant reaction) vs IgE. My son and I both tested negative to milk on the IgE test, and months later took the IgG test (delayed reaction) and were both positive. Then elimination made a big difference for both of us. The IgE test is one blood draw for 120+ foods. Or the enterolab tests for casein/gluten is just a stool test, and thus not invasive at all. Also, re no screens, IF you test this and if it ends up as an issue, then you can try an LCD monitor with TV tuner--it works well in our household. Jennifer M's son had problems with it. So you probably don't have to him him stop watching. You could record his shows the week he misses them. Also, it may not be an issue at all (as Carmon found), and if it is, you might only restrict it when he is sick and the symptoms flare up (was he watching more TV when he was sick? If so, the TV could be an additional factor in the worsening. If not, then it is probably just the illness). In other words, the test is just so that you will know. After that you can decide what to do with the information. For example, if he is screeching, he might be willing to experiment. When his tics settle to normal, neither of you may see it as a priority. No pushing this, just letting you know that it isn't as binary as it sounds. Chemar's son knows computer games are a trigger, and she let's him decide the trade-off. You are the only one that knows your child well enough to know what decision he would make. As for disrupting his life, our DAN doctor does phone visits after the first visit. If your naturopath does this, then your son hopefully can do most of these tests at home. Claire

Lawsmith, Andy and Heather have given you great input. My first and best thought is: 'this too shall pass'. I believe this because you are obviously dedicated to learning and are taking steps with a supportive professional. Additional thoughts: I am glad you are getting pyroluria checked. It goes up with illness (e.g. a virus) and symptoms would worsen as a result. Of course for some tics simply worsen with illness, and this may not be for you but it sure is an inexpensive way to find out. It would help if we knew what else your naturopath has done with your son. e.g. Have you had food allergy testing done? How do you know wheat and dairy are not issues? Did your naturopath run IgG tests or did you do an elimination diet? If it is due to your never noticing a reaction, then I would consider testing or doing an elimination diet. We never noticed any reactions to either wheat or milk, but he tested positive, and removal made a big different in his fidgetiness--and reintroduction made it obvious they were indeed issues for him. This won't help now, but for the future: If you know he is more reactive when he has a cold, then if you haven't already, consider giving him zinc lozenges (yes it needs to be lozenges) and echinacea at the FIRST sign of a cold (along with water and kicking him into bed right away). If you will search on this site for the two, you will see that double blind studies show they make a difference in the severity and length of the cold. (I think it is this site). http://healthinfo.healthgate.com/GetConten...&chunkiid=33802 This makes a difference in our house. Bronchitis used to come with every cold and then antibiotics. Now at most sniffles last a day or two. Sorry for your pain and worry for your child--we have all been there. If he still has his cold, I see nothing wrong with keeping him out the extra day. At 9 years old, a day of school isn't a big deal. The more rest and healing, the sooner this will pass. I would be very surprised if this new was permanent. Finally, if you believe in a higher power, I hope you call on Him to guide you and to give you peace. We have a thread Ronnas started, and I will bump it if I see it. Most of us feel that God really helped us through this. Certainly if your beliefs are different than this, then I hope at least you have friends with unconditional love who will give you support. And we are here too. Claire

A friend said she heard that for the children released, they made the parents in the building choose which child they would take with them. There is a lot of healing needed here. http://www.cnn.com/2004/WORLD/europe/09/04...hool/index.html North Ossetia government spokesman Lev Dzugayev told CNN that 323 hostages, including 156 children, died in the siege in the southern town of Beslan. n addition, 26 hostage-takers -- including 10 people from Arab countries -- and at least 10 Russian special forces were killed. The two-day standoff ended Friday after Russian forces stormed the school amid explosions and intense gunfire. More than 700 people were wounded, officials said. Dzugayev said Saturday evening that 448 people were still in hospitals in the region, including 248 children. Among the total hospitalized, 69 were in serious condition. Dzugayev said most of those who died were killed when a bomb exploded in the school gymnasium where hostages were being held, collapsing the roof and starting a fire.

Susanna, thanks. I hope you know that my own reasons for not using a homeopath is more to do with my personal need to research everything than with any negative view on their actual qualifications or approach. By definition, I am doing 'alternative treatment' and would be the last person to judge someone else's alternative treatment! Glad you are having success with your practioner. But I thought after the strep treatment that your son was 100% better, so no further work was needed? Claire

Heather had great luck with a naturopath. Jean uses a naturopath who uses some homeopathy. To each her own, but my bias: I can't get comfortable with homeopathy because from what I have heard, they don't always tell you what is in the solutions they give. I want to know it and study it. But I am not sure that anyone here uses a homeopath to show another point of view. I would interview the naturopath over the phone--he/she could be great. Another idea: Pfeiffer has outreach clinics. Other Jennifer just signed up for one, and so did I. Perhaps call to see if they have them in your area? (e.g. they come to your town). Claire

Jennifer, There is a blood test for mercury and a hair analysis. Both require the practioner's signature. I THINK that the hair analysis can be done by someone without an actual MD, e.g. a naturopath and the blood test requires the MD signature. Neither test is perfect, apparently a tissue test is the only way to know for sure, but those are RARELY used. The children with starving brains book and the Pfeiffer clinic links say that the hair analysis can show low mercury when the child's mercury is high, simply because they are retaining it vs excreting it as they should. So anyway, our DAN doctor wanted the blood test. There are some pretty major treatments for mercury, e.g. DMSA, which are pretty controversial, even within the DAN community Our doctor (and Pfeiffer, from what I understand) prefer antioxidants--since this is the way the body would naturally detox. This is why our doctor ran the spectracell vitamin/antioxidant test. If certain antioxidants are low, then you know which ones to supplement. They are like B vitamins, some are needed for others to work right. I am very happy with this method. Our neighbor did DMSA and woke up the next day with major yeast issues (a gray tongue). This is fairly common--if the gut isn't healthy, then the DMSA just moves the mercury to the gut, since the gut can't deal with it. Even in Children with Starving Brains, she says you must stop and heal the gut (e.g. yeast first). That is why I discuss the saliva test. Heather uncovered NDF for mercury, which takes it out through the urine and avoids the gastrointestinal system. Chemar used chlorella. Claire

Hi Jennifer, Thanks so much for filling us in. Wow, that sounds normal to me, even allowing for the error, he would be so low in the borderline area. Mine was 8.5 and she said it wasn't frozen but it was still cold, so it was fine. Hmmm.... Obviously you and your doctor need to decide, but this doesn't sound like an issue to me. Unless he is under a ton of stress sometime and very symptomatic--it might be okay to check again then. My son had a 12, then later a 60+, but again, it was 2 different labs. So much for thinking that the light sensitivity would have a common underlying cause with the pyroluria...though it still could be mercury. Claire

nicky, Yes, you sound very lucky, that is great! I just pulled the tests from another post, added to it and created a new list for you. I may be biased, but I recommend the pyroluria test right away. I am sorry we didn't do this for so long. Claire

**UPDATE October 15, 2006. So many tests, below are some tests to start with... that DON'T require you getting a doctor signature** PHASE I. 1. -Immunolab or ElisaAct blood tests for delayed food allergies (IgG). Elisa/ACT adds chemicals,preservatives, and molds, in addition to food. Again, directlabs.com has a related test and they provide the doctor's signature over the internet. [i recommend this one because sooo many here have food sensitivities] $250 for 90 foods. 2. www.pyroluriatesting.com Pyroluria test (creates B6, zinc deficiencies which cause other problems) $45 + shipping. IMO, pyroluria is a secondary condition, showing oxidative stress. My son's was 'cured' when we treated other issues. But it is a great indicator of something going on. 3. laboratoire Philippe Auguste (email to get kit sent at contact@labbio.net) urine test for mercury and lead toxicity. Excellent test, posted by Kim. $115 plus $2.50 normal mail to France. 4. directlabs.com DoctorsData hair test for metals (mercury, lead, arsenic, aluminum, etc) [beware of false negatives, but not false positives] $90 May not be needed if you do the urine test. 5. Directlabs.com blood test for zinc, copper, calcium, lead, iron/ferritin (some of these aren't listed, you must call and ask for Laurie x204 to order some of them...not all are listed). Hmm, I think these run about $200 6. Morning spit test at home (free) in water. Stringers floating down can mean elevated yeast. We did this on our own, but doctor said he thought it was pretty good for a screen. $0 7. Enterolab for gluten/casein $100 for gluten, ($100 for casein.) This assumes that you don't do the ElisaAct 142 foods which tests for gluten/casein reaction. PHASE 2 3. Spectracell blood test for vitamin and antioxidant deficiencies Antioxidant deficiencies can highlight oxidative stress and potential metal issues. $300 if pre-paid. 7. Metametrix Organic Acid test (alternative to Great Plains OAT test for yeast, also can show low glutathione, a Key antioxidant.) $270 So the total for phase I would be ~$650 for phase I and $570 for phase 2. I would do phase 1 and see what you uncover, then think about phase 2. I bet we spent $20K on tests and doctors trying to figure this all out!! But for newcomers who don't know me, the treatments following these tests 'worked'. My son is doing great (no tics) and still has some food allergies though. I can't predict how much of a difference it will make for your child, but Chemar's son followed a treatment plan with great success (which I think is the top link on this site and definitely worth reading), and Kim, Alison, Carolyn, Jean and many others have done great with treatment plans also...all based on identifying immune issues and correcting them. Disclaimer: As with Chemar, I feel strongly that you should have a doctor guide your supplement program. However, if you cannot find a good doctor, or while you are looking for one, or trying to decide if you really *believe* that immune issues can really cause or aggravate tics, then I see no harm in getting some of these tests done to convince yourself (or not) that there are underlying immune issues. Then bring the tests to an alternative doctor for guidance. But read, read, read, and educate your own doctor. Newcomers to this board, please know that many many of us have now been finding so many common issues...just not enough to have a one size fits all solution though. That's why testing AND a doctor's direction is so important. -Claire ----------------------------- ORIGINAL POST Here is the list of tests we did. Some don't need a doctor's signature. For those having a tough time finding a doctor willing to do this, you can get started, then contact a doctor if the tests are positive. For others educating their doctors, much of this is from the DAN protocal (defeat autism now), and can help with tics also. You should be able to find phone numbers on the internet. Patient can do or order directly (no doctor signature required): 1. Direct Health Care Pyroluria test (creates B6, zinc deficiencies which cause other problems) $35 + $30 shipping 2. Spectracell blood test for vitamin deficiencies $265 if pre-paid 3. Enterolab for gluten/casein $99 for gluten/ $99 for yeast [we did this on our own] 4. Morning spit test at home (free) in water. Stringers floating down can mean elevated yeast. We did this on our own, but doctor said he thought it was pretty good for a screen. 5. Kim uncovered a mercury urine test...contact@labbio.net. I keep meaning to call them, I think no doctor's signature required. "Doctor's Tests" without Doctor's signatures www.directlabs.com, a site that Kim pointed us all to, let's you order several blood tests WITHOUT a doctor's signature, because the doctor there signs the lab slip. You take the slip to a local hospital to draw blood and send overnight (don't go on a Friday), or go to a Labcorp lab (they are national). For me, the ones I use most there (and am about to reorder) are: -DoctorsData hair test for metals (mercury, lead, etc) -Blood test for zinc, copper, calcium, lead, iron/ferritin (some of these aren't listed, you must call and ask for Laurie x204 to order some of them...not all are listed). -Blood test for glucose -They also have IgG food allergy tests. -Organic Acid test (alternative to Great Plains OAT test for yeast, also can show low glutathione, a Key antioxidant. -Also, I found out they also have an IgG food sensitivity blood test. Doctor must order--don't remember costs. -Great Smokies CDSA stool test (yeast parasites intensional inflammation, intenstinal probiotic levels, etc..) -Great Plains OAT urine test (for yeast/glutathione/casein/gluten issues...) -Great Smokies blood test for Fatty acids (Omegas, etc...) -Great Smokies blood test elemental analysis (mercury, cadmium, etcc..). Some do hair analysis for this via Doctor's data. -Immunolab blood tests for delayed food allergies (IgG). Elisa/ACT does one for all sorts of chemicals,preservatives, and molds, in addition to food. Pfeiffer clinic also has an outreach program in many cities. I think they are helpful, but they only review part of the problem. I found that I can order virtually everyone of their tests through directlabs and save a lot of $$. I don't feel that they manage patient care very well from so far away, but I like aspects of their protocol. Claire