Trouble with Exatest people

Anybody care to comment on their experiences with getting an Exatest? Has it been a hassle? Seems that they (IC Diagnostics) are not eager to help me. I kind of have to push them to get them to send me a kit. My Doctors don't know anything about it, but several of them will write a script for it.

At www.exatest.com, in the LH column click on:

Order a specimen collection kit which opens to:

PATIENT order options

Fill out the form, click Submit Form

Tell your doctor to expect the Exatest specimen collection kit.in the mail.

Your experience is real; I will gladly share my current experience.

I have for the past four years had annual Exatest scrapings performed at my primary care physicians office with an all around favorable experience with Intracellular Diagnostics. Approximately two months ago as I approached the date of my annual physical, my doctor contacted Intracellular requesting the replenishing of Exatest kits which he maintains at his practice. A couple weeks following his request he realized there was yet to be a response. A second communication from him to Intracellular was made, and as the first, no response and no kits were received. I became personally involved by making phone calls to Intracellular and found that with the exception of two calls, they all went to a voicemail, and those calls were not returned. Of the two phone calls which were taken, the first was with a lady which I believe to have been Mrs. Silver, wife to the company founder, Dr Silver. I received from her, explanations to the cause for having been unresponsive to my doctors requests, which, to me, were lacking and less than an accurate portrayal of the problems they were experiencing. It came across as an attempt at damage control but was lacking in both conviction and an understanding of customer satisfaction. I was assured a kit would be forwarded to my primary care doctor. Another couple weeks passed and no kit was received by my doctor. He then notified me that he had made a third request to Intracellular Diagnostics.

It was at that time that I again phoned Intracellular and by chance the call was taken by Dr Silver himself. I communicated to him my frustration with the lack of response my doctor was experiencing and inquired if the company was a going concern. Though Dr. Silver's time is in the research arena rather than daily lab processing, as we spoke I found him in no way to be defensive or deflect the frustration which he must have sensed by my tone. His explanation, without detail, was that they recently had several key employees up and leave at one time. The void during rehire and training has caused a short term backlog and difficulties for them. He assured me the business was stable; it was a short term setback to daily continuity. He committed that he would ensure my doctor would immediately get the response which he deserved and that a kit would be in the mail right away. He asked for all of the key information such as name, mailing address, phone number, etc., to ensure they had it right at their end.

Two days later my doctor e-mailed to notify me that he had received the kit, and in addition, had received a personal phone call from Intracellular apologizing for the inconvenience he had been subjected to. On June 8th we did the scraping at the doctors office, and it was placed into the mail for return to Intracellular that same day. Today is June 20th and I have not heard from my doctor to notify me that he is in receipt of the lab results. I will be placing a phone call to Intracellular early in the week to have them confirm whether results have been returned to my doctor or not.

I am at loss as to what to really think regarding the problems with Intracellular Diagnostics which we are experiencing. During my phone conversation with Dr. Silver, I found him to remain calm and come across sincere. Yet it is reasonable to wonder just what is it that would cause key employees to up and depart, leaving an organization in such turmoil.

Larry - Thanks for those current details.

Several afibbers I know had received kits without delays in sending or receiving results not long ago, so obviously, this is a relatively recent situation. Hopefully, they are still going to be operational once they settle the personnel issue which, as you comment, seems odd.

Jackie

I've had the test done 4 times previously, and maybe it's in part because I asked the Kits be sent directly to me, and they don't normally do that, but I always felt a bit put off by them, it's a $500 test, seems like they would want the business. I usually talked with some lady by the name of Katy or Karen, something starting with a K.

Anybody know if another company does the same thing? I don't have a good feeling about this one.

Unless something changed, re: the cost... Exatest says to check with your insurance, as many providers cover it and so does Medicare. (mine were covered by MC).

If you pay out of pocket, you have to assure them you will not try to submit to insurance anyway, and then the fee is $275.00... or at least it was less than 6 months ago.

The kits can be ordered by a doctor and sent to the office. Some individuals have had kits sent directly to their homes without the doctor's Rx. It's easy to collect the buccal scrapings at home via tongue blade so there isn't a need to have the doctor's office do it.

However, if there is an organizational or financial problem with Intracellular Diagnostics, who knows what to think.

They are the only ones doing that test, unfortunately.

Jackie

Anti-fib

I had asked my Holistic doctor, Dr. Brownstein, about the Exatest a few years ago and he told me that he found the test to be un-reliable, he does the RBC test for magnesim. So, that is the test that I get, I don't fool around with these kits, sounds to me a little shaky.

Liz

The magnesium level within erythrocytes (RBCs) does not relate to the magnesium level within cardiomyocytes (heart muscle cells) or neurons

That doesn't make sense.

The RBC test is to measure intracellular magnesium. The easiest cell to get at is the red cell, hence this test.

Liz



Edited 2 time(s). Last edit at 06/21/2015 11:10PM by Elizabeth.

Post script to my comments above:
I received a phone call today from IntraCellular Diagnostics notifying me that results of the ExaTest which they had received from my primary care doctor on June 10th were forwarded to my doctor on June 16th. I came away from the phone conversation with an understanding that work for them is almost back to normal and the back log is now considerably less.

Anti-Fib, hope you now find better results with them.

Liz:

The Mg level in the blood cells in the blood stream is different than the level in Heart Muscle cells. That is my understanding of the reasoning involved in doing the Exatest.

The fact that it's not widely used by Dr's though lends credence to your opinion.

Thanks, Larry for posting that news.

AntiAfib... Medicare covers Exatest and if were bogus or suspect, I doubt it would be accepted.

Consider also that If ExaTest is reliable enough for NASA's astronauts' critical monitoring in space flight, it ought to be reliable enough for the average afib patient. It's also used during cardiac surgery to monitor and help keep magnesium levels adequate to prevent heart attacks during the procedure.

The complication in general medical practice is that the majority of physicians don't understand why it's so accurate and often haven't even heard about it. Those opinions don't mean it isn't reliable.

The head of Intracellular Diagnostics, BURTON B. SILVER, is a Ph.D., FACN. Professor of Physiology & Biophysics.

As I recall, the life of a RBC is about 120 days. The writings on evaluating magnesium levels from RBCs indicate that when cells are toward the end life, they are found to be lower in magnesium than new RBCs... or words to that effect. So the accuracy of RBC magnesium would most likely be a random collection of new, middle aged and nearly expired RBCs. There would be no way to select only new RBCs for Mg testing.

Whereas, the sublingual epithelial cell magnesium correlates well with atrial tissue magnesium according to Intracellular Diagnostics as stated in their published study in Circulation….1995;92:2190-2197, doi:10.1161/01.CIR.92.8.2190

Noninvasive Measurement of Tissue Magnesium and Correlation With Cardiac Levels
• Mark C.P. Haigney, Burton Silver, Emmanuel Tanglao,Howard S. Silverman, J. Donald Hill, Edward Shapiro, Gary Gerstenblith, and Steven P. Schulman

Tissue levels is what we’re interested in since it directly affects heart function.

Jackie

Elizabeth,

What I wrote does indeed make sense. In fact, with knowledge it becomes obvious. The two cell types, red blood cell and heart muscle cell, have the word cell in common but little else. Their functions are vastly different, as are their magnesium levels. It is an unfortunate error for physicians, thus patients, to assume that intracellular red blood cell means the same as intracellular heart muscle cell..It's also unfortunate if readers of this forum make the error, it's focus being heart muscle cell functioning.

The bottom line is if your RBC indicates that one is low in Mag., why do you need to get the exacta test, I suppose if your magnesium is in the normal range, in the RBC test then do you want to verify it with the exacta test, why do you think that all of this testing is necessary, most of us take as much magnesium as is possible, so if you can't take anymore mag. what is the point?

Liz

LIZ:

I am reading that the RBC test is not always accurate. ??? If it is reliable, then your logic makes sense in that if you test low on the RBC test, then the more advanced Exatest is unecessary. Alot of us are taking as much Mg as we can the easy way, but how many are doing the more exotic methods, like Mg Oil rub downs, Mg baths or Mg IV pushes?

Anti-Afib... It's more than just a measure of magnesium. The Exatest also measures the IC levels of the other electrolytes… and then compares the ratios …and those ratios are often very key observations… ie, high calcium and low magnesium…. and high sodium, low potassium… either or both can support Afib.

Remember that when IC magnesium is low, then the critical mineral/electrolyte potassium can’t work as it should and potassium stabilizes electrical conduction. Low IC potassium equates to PACs and PVCs since the refractory period is shortened when potassium is low. However, as we know… just adding potassium when Mg is deficient will make it worse instead of improve.

Thus the whole IC picture is obviously important.

Using various methods to optimize magnesium has been reported frequently. The IM or or IV delivery of Mg can be difficult since access to practitioners doing it vary by state and location... which is unfortunate, because it's highly effective. But...that doesn't address the optimizing of potassium once the Mg is repleted and they both work together.
Dietary intake of sodium is also an important factor since so many people don't cook at home using whole foods.

Jackie

Thank you for clarifying information. It has been frustrating reading comments consistently missing the mark, focusing on magnesium as a single electrolyte, considering thereby that an RBC magnesium test is equivalent to an Exatest, symptoms of knowledge deficiency requiring an infusion:

First, the word Exatest. The term Exa stands for Energy- dispersive Xray Analysis, the tag test explains itself. The 'exa' process is described in detail at [www.exatest.com]
.
Second, the notion that one can know enough by knowing one thing is another symptom of knowledge deficiency. RBC testing is reductionist to an extreme - see Reductionism [en.wikipedia.org]

Third, opposite to reductionist RBC testing, Exatest, in total, is an holistic 'systems analysis' - see Holism [en.wikipedia.org]

Fourth. In addition to quantifying 6 essential electrolytes withing 'excitable' cells, i.e. cells displaying an 'action potential', e.g. cardiac muscle cells, Exatest completes the system analysis by quantifying important ratios between them. The bottom line, literally, in the Exatest printout is the ratio between intracellular potassium (K+) and sodium (Na+) providing nearly direct insight into:
1) sodium/potassium pumps performance, [www.vivo.colostate.edu]
2) cell membrane potential (cell voltage), [en.wikipedia.org]
3) mitochondrial performance in providing ATP fuel for the sodium/potassium pumps, [en.wikipedia.org]

and much more.



Edited 1 time(s). Last edit at 06/23/2015 03:50PM by Moerk.

How about "infusing me with your great knowledge as to what kind of Doctor or Scientist you are. By the way Wikipedia is not know for their accuracy.

I will stick with my Holistic doctor, at least I know he is a doctor, Shannon knows who he is and has respect for him.

Liz

To emphasize the validity and the importance of Intracellular testing for electrolytes, specifically the action of ATP fuel for the sodium/potassium pumps which lie at the “heart” of why we emphasize testing IC, refer to CR 72 on the action of the sodium/potassium pumps and the quotes by Richard D. Moore who is an MD with a PhD in biophysics from Purdue University. He spent 40 years as a college professor and research scientist teaching and researching cellular biophysics so this isn’t random information. [www.afibbers.org]

Once there, and after reading through that Session, refer to the reference link for the visual aid video clip of this mechanism. [brookscole.cengage.com] which notes:

...."The sodium/potassium pump is a good example of active transport of molecules across a membrane. In this example, active transport is coupled to ATP hydrolysis to obtain enough free energy to transport the ions against their concentration gradient. This ion pump is an example of antiport membrane transport, where the transported molecules are pumped across the membrane in opposite directions (as opposed to synport). The sodium gradient is generated for use by cotransport systems, such as the active transport of glucose from the extracellular environment into the inside of the cell. The non-equilibrium state of the sodium gradient is essentially free energy to be used for the import of molecules against their own concentration gradient."

Here's another resource for active transport mechanisms across cell membranes... which isn't Wikipedia... it says the same thing, however. (from the Hyper-physics website) [hyperphysics.phy-astr.gsu.edu]

Note the illustration.

..."In the case of the mitochondrial membrane, the goal is to produce ATP as an energy currency for cell processes by oxidizing a food material (oxidative phosphorylation). The Complexes I, III and IV of the electron transport process pump protons against their concentration gradient. That proton potential provides the energy for ATP synthase to accomplish the ADP to ATP process of phosphorylation. "


Jackie

Elizabeth,

I am a non-credentialed life-sciences researcher. My office is a desk, chair, this computer, a brain, and a library of science texts.

Mork:

Good for you----Dr. Brownstein went to U of M and is a Holistic Physician, people come from all over for his services, I would say he is pretty much in accord with most things said here except he has told me that he did use the exacta test and found it not reliable. Science changes, it does not remain the same in all things. I believe I should be able to post certain things as well as others on here without being told I need to be infused with knowledge which may or may not be accurate.

L

Artemus Ward, a very funny man who has been dead a long time, "It ain't what ya don't know that will hurt ya, its what ya DO know that ain't so."

PeggyM

Thank you Artemus for pointing to health professionals knowing what ain’t so, thus depriving their paying customers of available care, as in the case of intra- red blood cells vs intra- muscle cells testing for magnesium, where a professional knows RBC testing is better than ‘unreliable’ Exatest which just ain’t so.

Using magical Search I traveled to the Archives and discovered a discussion, RBC vs Exatest, with Shannon and Jackie presenting for Exatest. Recommended: [www.afibbers.org]

An aside to Elizabeth. My long (24 years) self tasked life sciences studies up through cardiac physiology was always purely for knowledge, never for credentials. Credentials were only needed for a 40 year technical career.



Edited 1 time(s). Last edit at 06/26/2015 10:18AM by Moerk.

Hi Liz,

Yes, I've meet Dr Brownstein a couple times at various BHRT conferences where he occasionally speaks as well. He is a very capable functional/holistic MD with an open mind and a wealth of experience in my view. I've read a few of his books and know of other patients of his, in addition to yourself, who have done well with his guidance.

And Liz, your hunch has merit in that your RBC or Serum Magnesium is frankly low then you are pretty well assured of his having IC mag levels in near the bottom of the barrel, as both RBC and Serum mag levels tend to trail IC Mag significantly often by years, in which serum and even RBC mag levels can still read with in their broad normal ranges while IC levels are often already well below the low end of the IC range on the Exatest.

For most of my Exatest's back in the day, I did correlating Serum Mag and RBC blood tests at the same time as the Exatest sample scraping done at the same blood lab where the serum tests were drawn and within minutes of each other. The Serum and RBC most often told pretty much the same story as one another with the RBC showing some degree of better directional info meaning leaning more low earlier than the serum test that might be say at 2.2 are what any doc would automatically consider ideal when look

I found the Exatest better correlating with my symptoms than either of the two blood tests and my blood tests were ALWAYS in the very good normal range from 2.0 to 2.4 serum mag for example while my EXAtest Magnesium during most of that time, until the last couple of tests, was always frankly low except for he one time I tested during the 5 years quite period and it was just barely above the low end of normal at 35 ..≥ most afibbers do best around 38.5 to 40.5 that latter not easy to get too although I did manage to get to 39 towards the end but it did nothing to change the breakthrough pattern or remove the need for the LAA isolation to put that flutter circuit tot sleep finally and inspire of truly heroic levels of Magnesium, Potassium ( in balance with not too high or too low levels on both Exatest and serum K which is more reliable than serum mag as far as tracking your symptoms.)

In any event, the EXAtest can indeed provide some valuable info and help guide some decision making but you are right too, at least with regard to Magnesium which is the ion that has the most solid published studies behind it at EXAtest, that I have been able to find listed on their website and in PubMed., in that if your serum levels are already low, you can pretty much dose your magnesium up to just prior to bowel tolerance and keep at it until and if you start to get bowel intolerance at teh previous dose and need to come down some.... in which case an EXAtest may well come in handy for clarifying your scenario.

Frankly while I looked at the other correlations of minerals on Exatest, the Magnesium was always most useful of the bunch for me. The Potassium was often in the middle of the range and I just got more actionable help from using the Cardymeter and dosing K base on maintain in intraday swings in serum equivalent K within a heart quiet range of no lower than 4.2 to 4.9 at the highest.

The other ions were always in a decent range both individually and in comparative pairs of analysis .. nothing to write home about of be too concerned with accept with the Magnesium and .... fill in the black with any other Electrolyte comparison where my low Mag usually skewed the ratio a bit, though it was always the Mag being out of whack that drove those not so hunky dory ionic pairs ratios.

You can definitely start reading more into those numbers than are really there at a certain point too, so its good not to get too carried away.

Plus the EXATest like nearly every other lab test and form I have used and am aware of can not infrequent throw out some outlier results.

I have an expensive habit of often doing up to three comparison lab tests at a time of given lab work I am doing from three different respectable labs from the exact same test sample be it urine, blood, saliva, what have you,.

Since they is no correlative lab to the EXAtest that I know of I just stuck with doing the serum and RBC Magnesium and serum K tests too to at least be sure they were all telling an understandable story, knowing the differences in emphasis that I would expect to see between the IC test and the serum tests.

At least twice, and perhaps 3 times, out of 10 EXAtests, I got some screwball Exatest readings. .... I even did a couple of EXAtests from the same time using two different scrapings on two different little grey discs that you apply the epithelial scrapings too and then apply the fixident liquid to the samples and sent them in and on one those twin test comparisons got a wide swing in Calcium and potassium readings. between the two samples taken moments apart.

This brings up the inherent issue of precise sample collection and proper fixation of the sample and allowing it to fully dry before sending it in and still the receptionist would often tell me of anomalies that they felt were due to testing irregularities ..etc....

The bottom line in my view, which I do very much like the EXAtest for the right person and right circumstances, if anyone is placing large bets about using it as the foundational tool for determining a cure for AFIB and the veracity of the protocol being built is based on expecting a high degree of repeatable accuracy with the EXATest with various samples tested .. well ... I suggest you might want to build in a healthy fudge factor into your equation at the very least!

Its not hard to get it to tell the same story with a little effort and a lot of care in execution of the test collection and handling, but its easy too to screw it up a bit as well and if you aren't careful then make assumptions based on some outlier stats.

This is more or less true with most all testing systems I have worked with, though some approaches, equipment used and assays are more consistent and reliable than others to be sure.

Shannon

Shannon