PATIENT PROVIDER · Buffalo milk L 1 L 4 Buttermilk L 6 L 6 Butternut Squash L 3 L 3 Cane sugar L 2...
Transcript of PATIENT PROVIDER · Buffalo milk L 1 L 4 Buttermilk L 6 L 6 Butternut Squash L 3 L 3 Cane sugar L 2...
MK-0017-20 Page 1 of 5
PATIENT PROVIDER
The comments in this report are meant only for potential risk mitigation.Please consult your physician for medication, treatment or life style management.
Vibrant America | 1021 Howard Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www.vibrant-america.com
Final Report Date: 10-28-2019 20:38 Specimen Collected: 11-30-2015
Accession ID: 1512010000 Specimen Received: 12-01-2015 00:00
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
Name: PATIENT TESTNAMEDate of Birth: 1961-01-20Gender: MaleAge: 58Height: 5'9'' Weight: 160 lbsTelephone #: [email protected] Address: 1021 HOWARD AVENUE SUITE BCity: SAN CARLOSState: CA Zip #: 94070Fasting: FASTING No. of hours: 12.0
Practice Name: Vibrant IT4 PracticeProvider Name: Vibrant IT4, MD (999999)Street Address: 999999 PRACTICE STREET AVECity: SAN CARLOSState: CAZip #: 94404Telephone #: 666-666-6662Fax #: 111-222-0000
For doctor's reference
High Risk Moderate N/ASUMMARY 1-3 L Low - Not Ordered
DIETARY ANTIGENALLERGEN SENSITIVITIES
IgE IgG IgAAcorn Squash L 7 L 10Agave 13 L 8Alaska pollock L 4 L 6Almond L 1 L 5Amaranth L 2 L 2Anchovy L 5 25Anise L 9 L 7Apple L 5 L 9Apricot L 1 23Arrowroot L 6 L 9Artichoke L 9 L 2Arugula L 7 L 1Asparagus L 6 L 9Avocado L 6 L 8Bamboo shoots L 2 27Banana L 6 L 2Barley L 9 L 6Bay leaf 22 L 10Beef L 1 29Beet root L 6 L 1Beta-Casein L 3 L 6Black Beans L 5 L 8Black Walnut L 5 L 1Black pepper L 6 L 6Black tea L 8 28Black-eye Peas L 6 L 1Blackberry L 8 L 9Blue mussel L 8 L 4Blueberry L 1 L 2Brazilnut L 4 L 5Broad bean L 7 27Broccoli L 5 25Brown Rice L 6 L 8Buckwheat L 4 L 9
DIETARY ANTIGENALLERGEN SENSITIVITIES
IgE IgG IgABuffalo milk L 1 L 4Buttermilk L 6 L 6Butternut Squash L 3 L 3Cane sugar L 2 L 1Cantaloupe L 2 L 6Capers L 8 L 6Caraway L 2 L 5Carp L 3 L 7Carrot L 3 L 6Cashews L 8 L 9Casomorphin L 7 L 4Cassava L 6 L 9Catfish L 9 L 3Cauliflower L 6 L 6Cayenne pepper L 9 L 7Celery L 2 L 10Chard L 7 L 4Cheddar cheese L 3 L 10Cherry L 4 L 7Chia L 7 L 6Chicken L 5 L 5Chickpea L 5 L 1Cilantro L 10 L 8Cinnamon L 9 L 6Clam L 6 L 2Cocoa 29 L 2Coconut 25 L 7Codfish L 4 L 6Coffee L 3 22Common thyme L 8 L 2Coriander seed L 5 L 4Corn L 1 21Cous Cous L 8 L 4Cow's Milk L 7 21
MK-0017-20 Page 2 of 5
Vibrant America | 1021 Howard Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www.vibrant-america.com
PROVIDERPATIENTNAME: PATIENT TESTNAME
DATE OF BIRTH: 01/20/1961 AGE: 58
HEIGHT: 5'9'' WEIGHT: 160 lbs
PHONE NUMBER: [email protected]
ADDRESS: 1021 HOWARD AVENUE SUITE B, SAN CARLOS, CA- 94070.
ACCESSION ID: 1512010000
SPECIMEN COLLECTION TIME: 11-30-2015
SPECIMEN RECEIVED TIME: 12-01-2015 00:00
FINAL REPORT TIME: 10-28-2019 20:38
FASTING: FASTING NO. OF HOURS: 12.0
PRACTICE NAME: Vibrant IT4 Practice
PROVIDER NAME: Vibrant IT4, MD (999999)
ADDRESS: 999999 PRACTICE STREET AVE, SAN CARLOS, CA- 94404.
TELEPHONE: 666-666-6662
For doctor's reference
High Risk Moderate N/ASUMMARY 2-3 L Low - Not Ordered
DIETARY ANTIGENALLERGEN SENSITIVITIES
IgE IgG IgACrab L 4 L 10Cranberry 28 L 2Crayfish L 6 L 6Cucumber L 10 L 3Cumin L 5 L 2Curry powder L 5 L 5Dill L 6 L 9Duck meat L 5 23Eel L 2 L 5Egg White L 2 26Egg Yolk 26 L 10Eggplant L 7 L 9Endive L 7 L 5English Walnut L 5 L 8Espresso L 7 L 6Fig 25 L 2Flax seed L 3 26Flounder L 8 L 9Garlic L 4 27Ginger L 1 L 2Goat's Milk L 6 27Goose meat L 5 L 3Grape L 4 L 3Grapefruit L 4 L 9Grapevine snail L 10 L 4Green Bean L 10 L 5Green Peas L 9 L 8Green Pepper L 3 L 4Green Tea L 2 L 8Green cabbage L 2 L 5Green onion/Scallions L 3 L 4Guava 23 L 1Habanero pepper L 4 L 5Halibut L 10 L 10Hazelnut 23 L 10
DIETARY ANTIGENALLERGEN SENSITIVITIES
IgE IgG IgAHemp L 2 L 8Honeydew melon L 2 L 5Hops L 2 L 2Hot paprika powder L 7 L 1Jalapeno pepper L 3 L 4Kale L 9 L 10Kefir L 3 28Kidney Bean L 7 L 10Kiwi fruit L 4 L 9Lake Trout L 9 L 1Lamb L 4 L 8Leek L 6 L 4Lemon L 10 20Lemon grass L 9 L 3Lentils L 9 L 7Lima Bean L 6 L 6Litchi L 3 21Lobster L 8 L 9Macadamia Nut L 4 L 1Mackerel L 2 L 8Malt L 10 L 7Mandarin L 10 28Mango 30 L 4Molasses 27 L 7Mung beans 19 24Mustard L 3 L 2Navy Bean L 3 L 4Nutmeg L 9 L 5Oats 25 L 5Octopus L 5 L 4Olive L 9 25Oolong tea L 4 L 9Orange L 1 L 5Oregano L 3 27Oyster L 6 L 3
MK-0017-20 Page 3 of 5
Vibrant America | 1021 Howard Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www.vibrant-america.com
FULL NAME: PATIENT TESTNAME ACCESSION ID: 1512010000 DATE OF SERVICE: 11-30-2015
High Risk Moderate N/ASUMMARY 3-3 L Low - Not Ordered
DIETARY ANTIGENALLERGEN SENSITIVITIES
IgE IgG IgAPacific squid L 4 L 10Papaya L 3 L 1Parsley L 10 L 7Parsnip L 8 L 3Peach L 3 L 6Peanut L 1 24Pear L 7 L 2Pecan L 1 L 3Perch L 8 L 9Pine nut L 3 L 8Pineapple L 10 L 2Pinto Beans L 5 L 6Pistachio nut 20 L 3Plum L 6 L 1Poppy seed L 3 L 5Pork L 10 L 3Portabella Mushroom 27 L 5Purple Potato L 8 L 8Rabbit L 1 L 8Rape seed L 9 L 2Raspberry L 1 L 10Romaine lettuce L 1 L 4Rosemary L 2 L 2Rye L 4 L 9Salmon 29 L 1Sardine L 9 L 5Savoy cabbage 28 L 6Scallops L 4 L 9Sea bass 11 L 4Seaweed(Kelp) L 9 L 3Sesame L 8 L 8Shallots L 10 L 4Sheep's milk L 10 19Shiitake mushroom L 4 L 4Shrimp 30 L 1
DIETARY ANTIGENALLERGEN SENSITIVITIES
IgE IgG IgASole L 8 L 1Soybean L 6 22Spaghetti Squash L 2 L 2Spinach L 3 L 1Squid L 1 23Strawberry L 8 L 7Sunflower seed 24 L 6Sweet Potato L 9 L 9Sweet chestnut L 10 L 7Tapioca L 10 L 6Taro Root L 4 L 4Tempeh L 9 27Tiger nut L 10 L 3Tofu L 9 L 9Tomato L 5 L 4Tuna L 5 L 7Turkey L 9 L 6Turmeric L 1 L 8Turnip L 5 L 10Vanilla Bean L 2 L 8Veal 28 L 1Vegan Cheese L 2 17Vine leaf L 7 30Watermelon L 2 L 8Whey Protein L 1 28White Potato 23 L 6White mushrooms L 5 L 8White onion L 3 L 5White radish L 5 L 7Woo-hsiang powder L 5 L 6Yeast L 1 28Yellow squash L 4 L 1Yoghurt L 2 20Zucchini L 9 L 7
MK-0017-20 Page 4 of 5
Vibrant America | 1021 Howard Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www.vibrant-america.com
FULL NAME: PATIENT TESTNAME ACCESSION ID: 1512010000 DATE OF SERVICE: 11-30-2015
Risk and Limitations
This test has been developed and its performance characteristics determined by Vibrant America LLC., a CLIA certified lab. These assays have not been cleared or approved by the U.S. Food and Drug Administration.
Allergen-specific IgE assays do not demonstrate absolute positive and negative predictive values for allergic disease. Clinical history must be incorporated into the diagnostic determination. Quantification of specific IgG and IgA antibodies is not FDA-recognized diagnostic indicator of allergy.
Food allergen, Inhalant, Food additives, Food Sensitivity and Food Zoomers testing is performed at Vibrant America, a CLIA certified laboratory and utilizes ISO-13485 developed technology. Vibrant America has effective procedures in place to protect against technical and operational problems. However, such problems may still occur. Examples include failure to obtain the result for a specific antigen due to circumstances beyond Vibrant’s control. Vibrant may re-test a sample in order to obtain these results but upon re-testing the results may still not be obtained. As with all medical laboratory testing, there is a small chance that the laboratory could report incorrect results. A tested individual may wish to pursue further testing to verify any results.
The information in this report is intended for educational purposes only. While every attempt has been made to provide current and accurate information, neither the author nor the publisher can be held accountable for any errors or omissions.
Vibrant Wellness makes no claims as to the diagnostic or therapeutic use of its tests or other informational materials. Vibrant Wellness reports and other information do not constitute medical advice and are not a substitute for professional medical advice. Please consult your healthcare practitioner for questions regarding test results, or before beginning any course of supplementation or dietary changes.
MK-0017-20 Page 5 of 5
Vibrant America | 1021 Howard Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www.vibrant-america.com
FULL NAME: PATIENT TESTNAME ACCESSION ID: 1512010000 DATE OF SERVICE: 11-30-2015
FOOD SENSITIVITY
Food For
Thought
1(866) [email protected]
www.vibrant-wellness.com 1360 Bayport Ave. Ste. BSan Carlos, CA 94070
PRACTICE NAME:PROVIDER NAME:ADDRESS:
Vibrant IT4 PracticeVibrant IT4, MD (999999)
999999 PRACTICE STREET AVE SANCARLOS, CA, 94404
PATIENT PROVIDER
Vibrant Wellness is pleased to present to you, Food Sensitivity Testing, to he lp yo u ma ke he althy li festyle an ddietary choices in consultation with your physicians and dietitians. It is intended to be used as a tool to encourage a general state of health and well-being.
Vibrant Food Sensitivity (Profile 1) is an array of 96 commonly consumed food antigens which offersvery specific antibody-to-antigen recognition. The panel is designed to assess an individual’s IgG and IgA sensitivity to food antigens.
Interpretation of Report: The test results of antibody levels to the individual proteins are calculated bycomparing the average intensity of the individual protein antibody to that of a healthy reference population. Reference ranges have been established using 192 healthy individuals. The results are displayed as Positive, Moderate or Negative. A Positive result indicates that you have an increased IgG/IgA reaction to the food antigen with respect to the reference range. A Moderate result indicates that you have a moderate IgG/IgA reaction to the food antigen with respect to the reference range. A Negative result indicates that you have a low IgG/IgA reaction to the food antigen with respect to the reference range. Vibrant utilizes proprietary reporter based analysis which is designed to assay specific total IgG (subclasses 1, 2, 3, 4), and total IgA (subclasses 1, 2) antibodies. The classification of Positive to Moderate to Negative denotes the level of IgG and/or IgA antibodies detected.
The Vibrant Wellness platform provides tools for you to track and analyze your general wellness profile. Testing for Food Sensitivity offered by Vibrant Wellness is performed by Vibrant America LLC, a CLIA certified lab CLIA#:05D2078809. Vibrant Wellness provides and makes available this report and any related services pursuant to the Terms of Use Agreement (the "Terms") on its website at www.vibrant-wellness.com. By accessing, browsing or otherwise using the report or website or any services, you acknowledge that you have read, understood, and agree to be bound by these terms. If you do not agree to accept these terms, you shall not access, browse or use the report or website. The statements in this report have not been evaluated by the Food and Drug Administration and are only meant to be lifestyle choices for potential risk mitigation. Please consult your Physician/Dietitian for medication, treatment or life style management. This product is not intended to diagnose, treat, or cure any disease.
Please Note - It is important that you discuss any modifications to your diet, exercise and nutritional supplementation with your physician before making any changes. To schedule an appointment with Vibrant Clinical Dietitians please call: Toll-Free 866-364-0963.
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
Final Report Date: 10-28-2019 20:38 Specimen Collected: 11-30-2015
Accession ID: 1512010000 Specimen Received: 12-01-2015 00:00
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
Name: PATIENT TESTNAMEDate of Birth: 1961-01-20Gender: MaleAge: 58Height: 5'9'' Weight: 160 lbsTelephone #: [email protected] Address: 1021 HOWARD AVENUE SUITE BCity: SAN CARLOSState: CA Zip #: 94070Fasting: FASTING No. of hours: 12.0
Practice Name: Vibrant IT4 PracticeProvider Name: Vibrant IT4, MD (999999)Street Address: 999999 PRACTICE STREET AVECity: SAN CARLOSState: CAZip #: 94404Telephone #: 666-666-6662Fax #: 111-222-0000
For doctor's reference
MK-0017-20 Page 2 of 22
Positive ModerateNegative
IgG IgA IgG IgA
FishSalmon
FruitsCoconutCranberryFigGuavaMango
Gluten freegrainsOats
MeatEgg YolkVeal
MiscellaneousCocoaMolasses
NightshadesWhite Potato
Nuts (Tree)Hazelnut
SeedsSunflower seed
ShellfishShrimp
SpicesBay leaf
VegetablesSavoy cabbagePortabellaMushroom
DairyCow's MilkGoat's MilkWhey ProteinKefir
FishAnchovy
FruitsApricotOliveLitchiMandarin
Gluten freegrainsCorn
LegumesPeanutSoybeanBroad beanMung beans
MeatBeefEgg WhiteDuck meat
MiscellaneousCoffeeYeastBlack tea
MollusksSquid
SeedsFlax seed
SpicesOregano
VeganTempeh
VegetablesBroccoliGarlicBamboo shootsVine leaf
FishSea bass
LegumesMung beans
MiscellaneousAgave
Nuts (Tree)Pistachio nut
DairySheep's milkYoghurt
FruitsLemon
VeganVegan Cheese
Dairy
Beta-Casein Casomorphin Buffalo milk ButtermilkCheddar cheese
Fish
Catfish Codfish Halibut Lake TroutMackerel Perch Tuna Alaska pollock
Carp Eel Flounder SardineSole
Fruits
Apple Avocado Banana BlackberryBlueberry Cantaloupe Cherry GrapeGrapefruit Orange Peach PearPineapple Raspberry Strawberry Tomato
Watermelon Honeydewmelon Kiwi fruit Plum
Capers Papaya
Gluten containing grains
Barley Malt Rye
Gluten free alternative starches
Cassava Tapioca Tiger nut Taro RootArrowroot
Gluten free grains
Amaranth Brown Rice Buckwheat
Legumes
Kidney Bean Navy Bean Chickpea Black BeansPinto Beans Black-eye Peas Lentils
Meat
Chicken Lamb Pork TurkeyGoose meat Grapevine snail Rabbit
Miscellaneous
Hops Rosemary Vanilla Bean Cane sugarDill Lemon grass Oolong tea Parsley
Green Tea Cilantro Espresso
Mollusks
Clam Oyster Scallops Blue musselOctopus Pacific squid
Nightshades
Green Pepper Eggplant
Nuts (Tree)
Pine nut Sweet chestnut
Nuts(Tree)
Almond Black Walnut Cashews English WalnutPecan Macadamia Nut Brazilnut
Seeds
Mustard Sesame Coriander seed Poppy seedRape seed Chia Hemp
Shellfish
Crab Lobster Crayfish
Positive for IgG: Consider eliminating these foods from your diet in consultation with your physician/dietitian.Moderate for IgG: Consider rotation plan/eliminating these foods from your diet in consultation with your physician/dietitian.Positive/Moderate for IgA: Consider eliminating these foods from your diet in consultation with your physician/dietitian.
MK-0017-20 Page 3 of 22
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
Positive ModerateNegative
IgG IgA IgG IgA
Spices
Black pepper Cinnamon Nutmeg AniseCaraway Cayenne pepper Common thyme Curry powder
Hot paprikapowder
Woo-hsiangpowder Turmeric Cumin
Jalapeno pepper Habaneropepper
Vegan
Cous Cous Tofu
Vegetables
Green cabbage Carrot Cauliflower CeleryCucumber Green Bean Green Peas Romaine lettuce
Lima Bean Whitemushrooms White onion Seaweed(Kelp)
Spinach Yellow squash Ginger Sweet PotatoAsparagus Beet root Endive Leek
Arugula Turnip White radish Artichoke
Chard Kale Shiitakemushroom Zucchini
Purple Potato Greenonion/Scallions Shallots Acorn Squash
ButternutSquash
SpaghettiSquash Parsnip
Positive for IgG: Consider eliminating these foods from your diet in consultation with your physician/dietitian.Moderate for IgG: Consider rotation plan/eliminating these foods from your diet in consultation with your physician/dietitian.Positive/Moderate for IgA: Consider eliminating these foods from your diet in consultation with your physician/dietitian.
MK-0017-20 Page 4 of 22
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
MEAT
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
The values in parentheses represent previous values tested for this Food antigen.↑: Increased sensitivity compared to previous; ↓: decreased sensitivity compared to previous; ↔: Same as previous.
MK-0017-20 Page 5 of 22
SEAFISH
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
The values in parentheses represent previous values tested for this Food antigen.↑: Increased sensitivity compared to previous; ↓: decreased sensitivity compared to previous; ↔: Same as previous.
MK-0017-20 Page 6 of 22
SEAFISH
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
The values in parentheses represent previous values tested for this Food antigen.↑: Increased sensitivity compared to previous; ↓: decreased sensitivity compared to previous; ↔: Same as previous.
MK-0017-20 Page 7 of 22
DAIRY
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
The values in parentheses represent previous values tested for this Food antigen.↑: Increased sensitivity compared to previous; ↓: decreased sensitivity compared to previous; ↔: Same as previous.
MK-0017-20 Page 8 of 22
GRAINS
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
The values in parentheses represent previous values tested for this Food antigen.↑: Increased sensitivity compared to previous; ↓: decreased sensitivity compared to previous; ↔: Same as previous.
MK-0017-20 Page 9 of 22
GRAINS
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
The values in parentheses represent previous values tested for this Food antigen.↑: Increased sensitivity compared to previous; ↓: decreased sensitivity compared to previous; ↔: Same as previous.
MK-0017-20 Page 10 of 22
Vibrant Wellness | 1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LEGUMES
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
0 10 11 20 21 30
Sensitivity Negative Moderate Positive0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
The values in parentheses represent previous values tested for this Food antigen.↑: Increased sensitivity compared to previous; ↓: decreased sensitivity compared to previous; ↔: Same as previous.
MK-0017-20 Page 11 of 22
NUTS
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
The values in parentheses represent previous values tested for this Food antigen.↑: Increased sensitivity compared to previous; ↓: decreased sensitivity compared to previous; ↔: Same as previous.
MK-0017-20 Page 12 of 22
SEEDS
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
The values in parentheses represent previous values tested for this Food antigen.↑: Increased sensitivity compared to previous; ↓: decreased sensitivity compared to previous; ↔: Same as previous.
MK-0017-20 Page 13 of 22
VEGETABLES
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
The values in parentheses represent previous values tested for this Food antigen.↑: Increased sensitivity compared to previous; ↓: decreased sensitivity compared to previous; ↔: Same as previous.
MK-0017-20 Page 14 of 22
VEGETABLES
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
The values in parentheses represent previous values tested for this Food antigen.↑: Increased sensitivity compared to previous; ↓: decreased sensitivity compared to previous; ↔: Same as previous.
MK-0017-20 Page 15 of 22
VEGETABLES
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
The values in parentheses represent previous values tested for this Food antigen.↑: Increased sensitivity compared to previous; ↓: decreased sensitivity compared to previous; ↔: Same as previous.
MK-0017-20 Page 16 of 22
FRUITS
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
0 10 11 20 21 30
Sensitivity Negative Moderate Positive0 10 11 20 21 30
Sensitivity Negative Moderate Positive
The values in parentheses represent previous values tested for this Food antigen.↑: Increased sensitivity compared to previous; ↓: decreased sensitivity compared to previous; ↔: Same as previous.
MK-0017-20 Page 17 of 22
FRUITS
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
The values in parentheses represent previous values tested for this Food antigen.↑: Increased sensitivity compared to previous; ↓: decreased sensitivity compared to previous; ↔: Same as previous.
MK-0017-20 Page 18 of 22
MISCELLANEOUS
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
The values in parentheses represent previous values tested for this Food antigen.↑: Increased sensitivity compared to previous; ↓: decreased sensitivity compared to previous; ↔: Same as previous.
MK-0017-20 Page 19 of 22
MISCELLANEOUS
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
The values in parentheses represent previous values tested for this Food antigen.↑: Increased sensitivity compared to previous; ↓: decreased sensitivity compared to previous; ↔: Same as previous.
MK-0017-20 Page 20 of 22
MISCELLANEOUS
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
LAST NAME FIRST NAME GENDER DATE OF BIRTH ACCESSION ID DATE OF SERVICE
TESTNAME PATIENT MALE 1961-01-20 1512010000 11-30-2015
0 10 11 20 21 30
Sensitivity Negative Moderate Positive
0 10 11 20 21 30
Sensitivity
Negative Moderate
Positive
0 10 11 20 21 30
Sensitivity Negative Moderate
Positive
The values in parentheses represent previous values tested for this Food antigen.↑: Increased sensitivity compared to previous; ↓: decreased sensitivity compared to previous; ↔: Same as previous.
MK-0017-20 Page 21 of 22
RISK AND LIMITATIONS
This test has been developed and its performance characteristics determined by Vibrant America LLC., a CLIA certified lab. These assays have not been cleared or approved by the U.S. Food and Drug Administration.
Quantification of specific IgG and IgA antibodies is not an FDA- recognized diagnostic indicator of allergy.
Food Sensitivity testing is performed at Vibrant America, a CLIA certified laboratory, andutilizes ISO-13485 developed technology. Vibrant America has effective procedures in place to protect against technical and operational problems. However, such problems may still occur. Examples include failure to obtain the result for a specific antigen due to circumstances beyond Vibrant’s control. Vibrant may re-test a sample in order to obtain these results but upon re-testing the results may still not be obtained. As with all medical laboratory testing, there is a small chance that the laboratory could report incorrect results. A tested individual may wish to pursue further testing to verify any results.
The information in this report is intended for educational purposes only. While every attempt has been made to provide current and accurate information, neither the author nor the publisher can be held accountable for any errors or omissions.
Vibrant Wellness makes no claims as to the diagnostic or therapeutic use of its tests or other informational materials. Vibrant Wellness reports and other information do not constitute medical advice and are not a substitute for professional medical advice. Please consult your healthcare practitioner for questions regarding test results, or before beginning any course of supplementation or dietary changes.
1360 Bayport Ave, Ste B. San Carlos, CA 940701(866) 364-0963 | [email protected] | www. vibrant-wellness.com
MK-0017-20 Page 22 of 22