Weird vibes from recommended lab test
September 30, 2021 10:05 AM   Subscribe

I've been working with a psychiatric nurse practitioner for the past two years, recommended by my (very rational, intelligent) therapist. This nurse practitioner has been great - helping me find the right medications for my mental health challenges (anxiety + depression). However, she just recommended a lab test from a provider that is setting off some scammy alarm bells for me - how should I handle?

Details: Overall, my mental health needs are well-managed by medication, yay! My psychiatric NP has been great throughout the adjustment process.

But one thing has been an ongoing challenge - extreme sleepiness throughout the day. I'm working with my GP on figuring out what is causing this (pursuing iron deficiency then sleep test).

At the same time, I'm communicating with my psychiatric NP on this issue, in case it's caused by mental health medication. At our last appointment, she suggested getting a food allergy test, in case a food allergy is causing the sleepiness, which sounded like a good idea to me.

But then after our appointment, she followed up with the food allergy test lab details - I'm supposed to get a "IgG Food MAP with Candida + Yeast" test from "The Great Plains Laboratory, Inc." The first red flag was that the test includes Candida + Yeast (that's not a legit thing, is it???) and then I started googling the laboratory, which sent up a bunch of other red-flags that it's scammy, not science-based, etc.

Questions: Is this test a legit test? Is this lab a legit lab? If not, is this a dealbreaker with my nurse practitioner? I could totally have my meds handled elsewhere, but I do have a good relationship with her. Is it worth a conversation with her about my discomfort?
posted by Uncle Glendinning to Health & Fitness (11 answers total) 1 user marked this as a favorite
If it’s worth asking a bunch of internet strangers because you feel uncomfortable, it’s worth going to the source and asking her directly.
posted by blazingunicorn at 10:32 AM on September 30, 2021 [3 favorites]

It looks like the test is just testing for allergic responses to candida and yeast. Yeast is a legit allergen, so I don't think that's cause for a red flag.

But if you're uncomfortable, YES, please talk to your provider.
posted by hydra77 at 10:33 AM on September 30, 2021 [1 favorite]

Best answer: What Science Based Medicine has to say about Candida “tests and treatments” (fake illness, bogus treatments)

What SBM has to say about scammy labs (Great Plains is mentioned)

It’s weird and perplexing that your otherwise good and rational NP would suggest these. I don’t think any harm could come from asking her why she recommended the test, and why at that lab. Her answer could be illuminating for you. Like if she says, “We are only checking to see if you’re allergic to yeast, and that lab does the test the cheapest,” well okay, I’d be annoyed that I’m supporting a scammy lab with my money, but that doesn’t mean she believes in “CANDIDA CAUSES CANCER!” type woo-woo. But honestly if you get a whiff that she believes in pseudo science…I’d be pretty hesitant having someone as my health provider if they embraced pseudo science.
posted by hurdy gurdy girl at 10:40 AM on September 30, 2021 [13 favorites]

This appears to be an extremely broad food allergy test and yeast is mentioned separately because it's tested by a different lab process than the other food allergens. It does not appear to be a yeast only test. I don't know squat about this lab or this specific test outside of a general ability to google, but if you think you should be tested for food allergies that does indeed appear to be what you're being tested for.

tl;dr ask your doctor
posted by phunniemee at 10:41 AM on September 30, 2021 [1 favorite]

Specifically you might want to ask her what have been her experiences with this lab, has she ever worked with them before, how did she find out about them, and what are some other things you can try (not necessarily instead of). It's a weird time in the world in that a lot of things that are new are scams, but then that makes us think that anything new is a scam, which probably isn't true either.
posted by bleep at 10:42 AM on September 30, 2021 [1 favorite]

Best answer: IgG testing is not recommended for diagnosing food allergies and intolerances.

Here's a lengthier lay explanation of how IgG antibodies act as "memory" antibodies for foods you are regularly exposed to -- not necessarily foods that cause you problems. People end up unnecessarily eliminating a whole bunch of foods that were staples of their usual diet because their immune system can recognize broccoli as broccoli, etc.

If you're really interested in pursuing the food allergy or intolerance angle (e.g. if you have any other symptoms of food allergies or digestive issues), it may be worth asking for a referral to an allergist or a registered dietician who will have the right tools and methodologies for the job.
posted by fountainofdoubt at 11:05 AM on September 30, 2021 [14 favorites]

Best answer: I find it weird that a psychiatric NP or any mental health provider would provide advice about diagnosing food allergies.

I am a GI doctor and refer patients with food allergies to an allergist. I see a lot of patients who self diagnose with those IgG tests (you can self refer for lab tests in my country). These tests are usually promoted by providers who talk a lot about "toxins" in your body and have a very vague understanding of the actual physiology involved. They are also easy cash for the lab.

I'm obviously not your doctor but if you're concerned about a possible food allergy I suggest talking to someone who actually diagnoses allergies for a living and use your psychiatric folks for psych stuff.
posted by M. at 12:01 PM on September 30, 2021 [17 favorites]

We agreed to test my kid through that lab (to keep peace, and little boys love urine tests). When we got a candida-yeast diagnosis, I brought it to our GP who was not impressed, and felt that that lab diagnosed everyone with the same thing.

For what it’s worth, allergy blood tests always show me as having no allergies, when scratch tests, and having anaphylactic reactions show that I have a tree nut allergy.
posted by Valancy Rachel at 1:15 PM on September 30, 2021

I don't know about this specific test but my GP did a blood allergen test before referring me to an allergist, and the allergist basically said they do their own preferred testing depending on the suspected allergen (in my case a scratch test for environmental allergies) and the blood test ordered by my GP was not clinically relevant (aka a waste of money). So if your psychiatry NP suspects a food allergy then talking to an allergist seems like the next step.
posted by muddgirl at 1:18 PM on September 30, 2021 [3 favorites]

The only thing I would say is that no, a single odd recommendation is not a good reason to end a good working relationship. You may even find that she would be grateful for the information you’ve uncovered — even professionals get sucked in occasionally.
posted by Tell Me No Lies at 2:36 PM on September 30, 2021 [4 favorites]

Best answer: I work in a hospital-based Genetics Clinic. Great Plains should be avoided. Period.
posted by kuanes at 3:27 AM on October 1, 2021 [5 favorites]

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