TESTING OPTIONS FOR POSTPARTUM IMBALANCE:
All perinatal imbalance is likely to result from a combination of three factors: biological, psychological and social. This is referred to as the biopsychosocial model. In other words, Perinatal Imbalance is likely to result from a combination of factors relating to Mind, Body & Spirit:
Mind (psychological, emotional)
Body (biochemical, nutritional, hormonal, neurochemical)
Spirit (connections to society, source and self)
A Standard way evaluate women’s mental health throughout pregnancy and the postpartum period by using the Edinburgh Postnatal Depression Scale (EPDS). It's a series of 10 questions that are designed to help a new mom identify any imbalance. I find if a mom is scared she might not want others to know what she's really thinking for fear that her child will be taken away from her so it's important that she know she's got rights and that she is safe with the person doing the evaluation. Many moms prefer to fill it out themselves in the privacy of their own home.
BODY - BIOCHEMICAL IMBALANCE
Nutrients are essential for brain growth and development, as well as for good physical and mental health. According to an article written by Drs. John Neustadt, ND and Steve Pieczenik, MD, PhD, NBITC, antidepressants can be helpful but they don’t treat the underlying biochemical causes of postpartum imbalance. Antidepressants just treat symptoms. After all, no one has a deficiency in Prozac. They state that pregnancy is a tremendous stress on the body. It increases a woman’s risk for nutritional deficiencies and subsequent depression. Post-partum depression is therefore simply the manifestation of subclinical nutritional deficiencies and the spectrum of biochemical changes that can occur in pregnant women. The underlying biochemical causes of post-partum depression can be treated. NBI Testing and Consulting Corp. (NBITC, www.nbitesting.com) tests can determine deficiencies in specific amino acids, vitamins, minerals and fats that are the underlying causes of post-partum depression. Through the use of Targeted Nutrient Therapy™, customized programs are provided to clients that replenishes their deficiencies and promotes health.
BODY - HORMONAL IMBALANCE
There is a wonderful company called ZRT Laboratories which performs salivary hormone testing. Saliva samples are collected in the home and mailed directly to ZRT Laboratories. Your trained postpartum specialist (Midwife, Physicians Assistant, OB/GYN, HRT specialist, or Medical professional) will work with you to review your results. Moms are tested for estradiol, progesterone, testosterone, DHEA, and Cortisol. It is important to have all five of these hormones tested! It usually costs $150 to test estradiol, progesterone, testosterone and DHEA and $150 to test Cortisol which is tested at 4 different times in a day. Follow these steps for testing your hormones with ZRT:
Step 1: Contact your insurance company in advance to find out if saliva testing is covered under your policy, if they cover saliva testing through a non-participating provider (ZRT Lab.), and what percentage of saliva testing is covered. If your insurance is not one that ZRT will bill directly, find out if and how you can manually submit for reimbursement following testing. Gie your insurance company the following CPT codes: (Estradiol 82670), (Progesterone 84144), (Testosterone 84402), (DHEA 82627), (Cortisol AM 82530) Saliva testing is covered by several insurances, but not all insurances and not all policies ZRT does bill some insurances directly, and ZRT would need to be contacted directly to see if your insurance would be included. (Tip: assume your insurance is not going to pay for it, but hope that it will and you won't be disappointed) Medicare pays for testing 100% in most cases. If your insurance doesn't cover the entire cost of your test, you are responsible for any remaining balance.
Step 2: If billing to Insurance company, ask your postpartum specialist to write a prescription to complete saliva testing. (note: if you are not submitting to insurance you don't need a prescription). Submit your prescription from your postpartum specialist with your saliva sample. The prescription must order "Saliva Hormone Testing" and a list of the hormones to be tested on the prescription along with an ICD-9 diagnostic code (259.9 Hormone Imbalance). It should be signed and dated by the postpartum specialist with a date prior to testing.
Step 3: Your postpartum specialist will give you your ZRT kit. Fill out the patient requisition form inside the kit (female side) including the symptoms, current hormes, etc. Also include a copy of the front & back of your insurance card, and the signed ZRT Insurance Authorization form with your sample submission. Do not take any hormones or use any facial creams within 12 hours of collecting saliva.
Step 4: Collect your saliva between days 19-21 of your menstrual cycle (use the first day of your period as day one). Saliva should be collected within the first two hours of awakening. When you wake, don't eat, drink, brush your teeth or floss. Wash your hands to prevent any contamination. Rinse your mouth out twice with water to clean your mouth and begin collecting saliva in the tube(s). Tubes must be filled between half and three-fourths the way full. If you are collecting evening cortisol, collect the sample at bedtime (no food, drink, water 2-3 hours before). Label tube with name, date and time and put in plastic bag with the ZRT patient requisition form, prescription, copy of the front and back of your insurance card and the signed ZRT Insurance Authorization form. The results will be sent to you along with a copy to your postpartum specialist within 2-3 weeks from the date mailed. Following saliva testing you, your specialist and your compounding pharmacist can communicate to prepare a recommendation for your hormone replacement needs.
(NOTE: If you can't find a postpartum specialist you have the option of going to a compounding pharmacy in your area for an individual consult to review your history, symptoms and hormone levels to prepare a letter of recommendation for your physician.)
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