Personalizing Nutrition with Nutri-IQ Testing

Introduction

In this article, we would like to address 2 emerging trends in wellness industry.

  1. Personalizing nutrition is an actively developing business niche of wellness industry1. Hence, many wellness practices embraced at least some nutrition personalization.
  2. Moving wellness practices online as a response to COVID-19 situation. Now, practitioners can see a client, talk to her, provide recommendations, and monitor her progress from their electronic devices.
    • Online presence requires good set of effective and efficient online testing tools.

To succeed with bringing a client to wellness using personalized nutrition, we need to understand her nutritional status as one of the likely causes for the complaints, before proceeding with complex, expensive and maybe futile approaches. Our goal is providing simple, correctly targeted, and easy to follow diet improvement guidelines that will increase overall success rate and raise client’s confidence. In other words, the wellness practitioner can have an easy win (better results, stellar reviews, and higher revenue) with nutritional intervention, if nutritional gaps are known.

Easier said than done… Commonly accepted way of revealing the nutritional gaps are nutritional blood panel tests. However, the planet is adjusting to COVID-19 limitations. And the reality is that nutrient blood tests still can be ordered, but they represent a major inconvenience for the clients that try to avoid hospital and lab settings for the fear of COVID-19, and unfortunately the hospitals also having different priorities now.

Blood tests for nutrients levels are not supposed to be done remotely! Thus, in today’s challenging environment many practitioners rely mostly on their guesswork to figure out potential nutritional deficiencies.

But what if we have a non-invasive nutrient test that can be performed remotely? The ideal solution would ebnable monitoring the gradual improvements for quite a long time, remotely, seamlessly, and conveniently for the client. The protocol embracing this idea is presented in this article. It is based on Nutri-IQ Nutritional Balance Testing tool. And we will show how using Nutri-IQ-based protocol in your practice will lead to up to 15% increase of your revenue, even if your customer base stays the same (we actually hint that it will grow).

But let’s talk about importance of nutritional balance first.

When the Wellness Professionals Must Worry about Nutritional Balance?

The answer is simple: preferably, BEFORE the client already tried many things with your practice and they did not work! Yes, we work for money in wellness industry. The more times a client visits our practice, the better, right? However, we do need to deliver results. The client will come only so many times, and will spend only so much, before she realizes you are failing to help, and there are so many options online! There will be a word on the social media that you failed! So, to keep your clients and attract new ones, you’d better move in the right direction from the very first appointment with the client.

Nutritional problems are multifaceted. In the article about nutritional balance 2, we already mentioned that with nutrients imbalance, the living organism enters a chain of problems that may eventually become a disease, clearly pronounced, or with sub-clinical symptoms. Despite of the fact that nutritional homeostasis is often neglected by mainstream medicine, it contributes to degenerative processes such as arthritis, cancer, cardiovascular disease and diabetes. 

Nutrient imbalances can mask themselves as diseases3. Nutritional problems also can be related to the medications your client takes 4.

We, wellness professionals, mostly deal with subclinical manifestations when our clients look for solutions her problems but cannot find any. Successful reinstatement of nutritional balance (homeostasis) via relevant testing may be a relatively easy but very effective approach which will allow your wellness practice to stand out from the competition.

Let’s consider several examples. As you see, all hypotheses need to be verified with nutrient testing!

  • Middle-aged, non-obese woman complains about brittle bones. She has sub-par diet. 
    • Her diet may be low in calcium and vitamin D, so testing and supplementation would be recommended.
    • She also may have onset of osteoporosis/osteomalacia , when testing and supplementation with calcium, vitamin D, and phosphorus are recommended.
    • She may have sub-clinical hyperthyroidism, for whatever reason, including heightened consumption of iodine. Testing and diet change are also recommended.
  • Physically active woman complains about intermittent muscle pain:
    • Selenium level testing and supplementation if deficient are feasible.
    • Clean-up of the diet is recommended.
  • Elderly client complains about COPD symptom (shortness of breath, especially during physical activity):
    • He does not think he has COPD.
    • Vitamin B12 and folate level testing and supplementation if deficient are feasible.

Before recommending any supplements or specific “therapeutic” foods though, we need to understand if this is a feasible option. The rule of thumb is that supplement is recommended if:

  • the diet is missing a specific nutrient (i.e. testing is to be conducted),
  • the body cannot absorb the nutrient from foods and supplements,
  • there are therapeutical or overall health reasons 5.

(Un)Reliability of Nutritional Blood Panels

Wellness professionals rely upon several testing methods that can be used to provide knowledge of the current state of the nutrients in the client’s body. These tests allow us to see direction to go, from the first meeting with the client. We cannot afford our success rate to be low! As we try our best to help the client, the guesswork may be detrimental to our bottom line. We want to get results! 

We usually consider nutrient blood panels as reliable. But how reliable they are? Let’s look at some publications which came up with astonishing results.

There are warnings that many types of nutrient blood tests do not produce reliable results. According to the US National Institutes of Health, vitamin A levels in plasma do not decline until vitamin A levels in the liver are almost depleted6. Evidence suggests that serum vitamin B12 concentrations might not accurately reflect intracellular concentrations7. Serum folate concentrations are sensitive to recent dietary intake8, so it might not reflect long-term status.

There is a review devoted solely to vitamin D testing 9. The same specimen was tested in 1,090 different laboratories around the world. All labs applied sufficient quality assurance methods. Different assessment methods were utilized. Most commercial pathology laboratories used an automated immunoassay, such as Diasorin liaison, to measure the 25(Oh)D concentration. More specialized laboratories used a liquid chromatography tandem mass spectrometry (lc-Ms/Ms) assay, which provides superior performance. The results were striking: there was 5 times difference in readings, and the level of 25-hydroxyvitamin D (25(OH)D) was reported from insufficient to toxic!

Another problem is that even well-advised nutritional intervention success does not happen instantly, and we need to make adjustments while monitoring and re-testing gradual improvements for quite a long time. Questionable blood test results, waiting time, and delay with nutritional intervention may increase client’s frustration. In any case, it will be months and months before identification of the root cause for the problem and our potential success (and good testimonials on the website. IF the client stays with your practice that long).

And how much the client and her insurance (if she has any) are willing to spend for further testing? To understand the margin for the tolerance and improvement opportunities, let’s consider current protocols.

Working with Wellness Practice Client

Work with a client and progress monitoring can be conceptualized as a cyclical process10:

  • Client engages with wellness professional (WP). WP conducts initial appointment as a discovery session to get acquainted with the client, hear her complaints, understand her main concerns. During this appointment:
    • WP reviews and analyzes available information.
    • WP comes up with hypotheses and suggests test(s) to reveal gaps/missing information.
    • WP requests tests and meanwhile, explains how the client can clean-up her diet and what behavioural changes are desirable.
    • WP Revenue: usually 2 hours cost.
  • Client gets the tests done (turn-around time of 4 weeks or more)
    • Lab-administered test for majority of essential nutrients, cost: $400-900.
    • At-home kits are available with cost $200/10 nutrients; for 28 essential nutrients about $600.
    • WP Revenue: adminsitaration fee ($30-50).
  • Client makes new appointment with WP:
    • WP explains test findings.
    • WP compiles client’s meal plan and suggests behavioural changes.
    • Revenue: 1 hour cost.
  • Client changes behaviour and diet, for about 3-4 weeks.
  • Client re-engages with WP:
    • WP reviews improvements.
    • WP makes changes to the nutritional suggestions.
    • WP may request another test.
    • Revenue: 1 hour cost (+ second test administration fee if client agrees).

The process will be repeated until the majority of client’s complaints are addressed via nutrition and/or lifestyle changes. If sessions are bought as a package, in a set of 5, at least 2 iterations of the outlined process will be performed with 2 tests administered, to confirm the progress. The average cost of 5 hours program is about $600, or $120 per hour.

There may be some insurance coverage for the requested services, but most insurance plans would limit nutritionist coverage for up to 3 hours/annually. Blood nutrient test panel would mostly be covered once a year for minority of the plan subscribers who may qualify (i.e. kidney or diabetic patients).

Given all this information, let’s summarize financial aspects of the common protocol:

  • Practitioner’s revenue: packaged program cost + 2x test administration fee = $660
  • Client pay & insurance reimbursement:
    • Insurance coverage: 3 hours ($360)
    • Client out of pocket: 2 hours ($240) and 2 tests (in average $400 + $30 administration fee per test) = $1100

If the test quality was sufficient, some positive results may be seen as early as by 3-rd appointment, 2-3 months from initial meeting. This is money very well spent! Annually, the client who trusts you may buy 2 or 3 programs addressing different aspects of her wellbeing, for duration of about 6 month, as long as she or her insurance are willing to pay.

Why Wellness Practice Would Improve Customer Satisfaction?

In general, any improvements to the described above process that warrant a higher revenue with the same or better quality of the outcomes will be desirable for the practice. And the most obvious source of revenue increase is improved customer satisfaction!

In the protocol described above, customer satisfaction will be affected by 2 factors:

  1. Getting maximum from (online) visit without physically going to a hospital or lab blood collection facility.
  2. Time and overall number of the appointments between first visit and visible results (possibility of “instant gratification”).
  3. Reduction of out-of pocket expenses with the same or better results.

These areas represent a potential for your business transformation! What if you can identify nutritional imbalances and derive directions using in-house testing, easily right at the first meeting? What if client would be paying less with this improvement of service?

Nutri-IQ In-House Testing and Revenue Increase

Yes, it is possible to get to the point where wellness practice’s revenue will GROW and the client will pay LESS! Our team did come up with the protocol that addresses major today’s customer satisfaction issues. When you use Nutri-IQ testing, major problems affecting customer satisfaction are addressed:

  • No in-person blood collection required.
  • Noticeable positive changes may start right after the very first visit reducing twice time before.
  • Out-of pocket client’s expenses for the same program are reduced up to 75% (we will provide more detailed explanations below).

Reliability of the test results will solely depend on sincerity of the client. The test is functional, i.e. it interprets what the client feels from the standpoint of nutrient imbalances, deficiencies and toxicities. There is no magic around it (well, a little bit of Artificial Intelligence does not count, does it?) The major data sources are the very respectable US National Institutes of Health and US National Academy of Medicine (NAM). Hence, the more accurate the client would answer questions about her symptoms, the better results the test produces.

So, let’s assume the client purchased 5-sessions program, for the same $600. Then, the wellness professional may follow this protocol:

  • Client engages with WP who conducts initial appointment as a discovery session. During this appointment:
    • WP reviews and analyzes available information.
    • WP performs Nutri-IQ functional test using collection of client’s symptoms and complaints, no in-person blood collection required. WP explains test findings.
    • WP devises personalized nutritional recommendations based on Nutri-IQ findings and suggestions, explains the need for diet clean-up, and suggests behavioural changes.
    • WP Revenue: 2 hours cost + test administration fee with minor increase to $40.
  • Client changes behaviour and diet, for about 3-4 weeks.
  • Client re-engages with WP, up to 3 times:
    • WP reviews improvements (100% of our clients showed significant improvements in a month or less after the very first appointment. This is a close to instant gratification as possible).
    • WP runs Nutri-IQ test again, to confirm improvements and create new recommendations, explains findings to the client, and gradually introduces behavioural changes, such as exercise program, meditation, yoga practice, etc.
    • WP may ask to post a positive review on social media – that’s a good way to start attracting new clients!
    • WP makes changes to the nutritional suggestions.
    • WP Revenue: 1 hour cost + test administration fee .

Let’s review financial outcomes of this protocol for full course of the program:

  • Practitioner’s revenue: packaged program cost + 4 x test administration fee = $760, that is 15% higher than without Nutri-IQ!
  • Client out-of-pocket expenses & insurance pay:
    • Insurance covers: 3 hours ($360)
    • Client out of pocket: 2 hours ($240) and 4 test administration fees ($160) = $400, that is 64% reduction of client’s out-of-pocket pay compared with a protocol using blood sample testing.

Let us re-iterate. Your revenue grew 15% (hurray!), client’s per-program out-of pocket expenses reduced by 64%, and clients reliably had seen positive results after the very first appointment, twice as fast compared to current protocols. This is what they will brag about on social media!

How to Use Nutri-IQ Testing

Nutri-IQ™ is your in-house lab you use to personalize nutrition for your clients. Our method allows to assess the state of 29 essential macro- and micro-nutrients functionally, by the nutrient action on the body. The tool does not require to draw blood or any other bodily liquid.

The assessment is qualitative. It determines if a nutrient in question is balanced, or there may be suspected imbalance (excess or deficiency), or interaction with some other nutrients. Assessment is performed based on the data which the client had identified during the discovery discussion. The tool is using supplements and symptoms as inputs.

Please note that your subscription does not limit number of clients assessements. For an average practice that runs 100 annual 5-hour programs, the cost is less than $1/program/year (yes, we give discounts, lot’s of them!)

All you need to do is to follow 5 simple steps:

  1. Input supplements your client takes
  2. Identify symptoms bothering your client (either directly or by body system)
  3. Click the button to perform Nutritional Balance Analysis with Nutri-IQ
  4. Use analysis results and our Blog to fine-tune client’s diet and supplementation
  5. Print out client hand-out and save Nutri-IQ suggestions for further use

Let us show how to apply these steps in real-life examples.

CASE STUDY #1: The client was diagnosed with Bradycardia (very slow heart rhythm) about 5 years ago. Multiple medical tests were normal, and reason for bradycardia was not identified. As a prevention measure, his doctor recommended him to avoid eating foods high in potassium (i.e. bananas). Though Bradycardia itself did not affect client’s wellbeing much and he had a good exercise tolerance, his major concern was the numbness in extremities. His doctor also recommended to take vitamin D. He visits massage and physiotherapists often. Application of those measures brought no changes to his major concern though.

The input of data into Nutri-IQ™ tool took less than a minute (are you not happy to get paid $40/minute?) When you start typing, the system provides convenient prompts so you can see what’s available in your category. Alternatively, you could choose a body system/process and pick all relevant symptoms. You also can specify the frequency of experiencing a symptom. When finished, just click on Analyze Nutritional Balance button to see results.

Nutri-IQ Artificial Intelligence engine INSTANTLY identified surprising nutrient, vitamin B5, deficient in the client’s body, suggesting easy fixes to client’s diet and supplementation.

It was observed that bradycardia sometimes is accompanied by numbness, especially when toxins enter the body 11. Though the tool did not get any inputs about potassium or bradycardia, doctor’s hypothesis of potassium toxicity was confirmed just based on client’s nutritional profile!

The recommendations can be archived for the practitioner and given to the client as a reminder.

Below is the hand-out, a tasty prescription that was provided to the client. Please note that the print-out does not contain any privacy-sensitive information about the client. This information will be used for personalization of nutrition plan for the client. Following vitamin B5 supplementation, the client was able to adjust his diet and address numbness. The numbness was gone in 4 weeks!

CASE STUDY #2: An elderly client (80 yo), female, generally healthy and physically active, with a good diet, has a slew of complaints. She does not eat red meat, but consumes lots of eggs, cooked and canned fish. She takes low-dose vitamin C before bed and vitamin D. She was diagnosed with hypothyroidism and takes a very low dose of levothyroxine. Her goal is to feel better and get rid of leg pain, and nocturia if possible.

In this case, discovery session took about 30 minutes. The following symptoms were revealed:

  • Hypertension, Petechiae, Frequent urination, Goiter, Hypothyroidism, Arthralgia, Joint effusions, Bone pain, Cramps (muscle), Muscle aches, Muscle weakness, Disorientation, Neuropathy, Dry, watery, or itchy eyes; Edema, Alopecia (hair loss), Dermatitis (Seborrheic), Pruritus, Skin lesions, Sweating

Do you have any idea about what’s going on? You probably guessed about vitamin B deficiency and vitamin C timing. Let’s see what our Nutri-IQ tool found:

  • The tool provided recommendation to reduce consumption of the foods containing vitamin B1, choline (eggs!), sodium, selenium.
  • The tool also advised to supplement and/or increase consumption of good foods containing: vitamins B5 & B12, biotin, calcium, phosphorus, potassium, zinc, essential fatty acids, iodine, and manganese.

We suggested that the client moves vitamin C intake to the morning and commences supplementing with vitamin B-complex and liquid calcium with manganese. The muscle pain and nocturia were gone in 2 weeks! During the follow-up appointments, we were talking about reduction of inflammation, her immunity and help with hypothyroidism.

In conclusion of the Case Studies discussion, we recommend to keep testing results handy, in a dashboard, so you can have the progress and recommendations obtained from Nutri-IQ handy. We would be honoured if you use our template.

Conclusion

We hope you are convinced now that non-invasive test of nutritional balance can it be performed remotely. If you are just starting new practice, moving exiting practice online, or want to be more successful practitioner, Nutri-IQ Nutritional Balance Testing tool will be an invaluable in-house lab for you! Using Nutri-IQ-based protocol in your practice will lead to up to 15% increase of your revenue compared to existing practices and will bring resolution to many existing and new clients. Don’t wait, register with us!

References

  1. Rankin A, Kuznesof S, Frewer LJ, et al. Public perceptions of personalised nutrition through the lens of Social Cognitive Theory. J Health Psychol. 2017;22(10):1233-1242. doi:10.1177/1359105315624750
  2. Importance of Nutritional Balance for Human Life https://www.nutriiq.ca/wordpress/importance-of-nutritional-balance/
  3. Nutritional Imbalances Masking As a Disease https://www.nutriiq.ca/wordpress/nutritional-imbalances-masking-as-a-disease/
  4. Essential Nutrient Interactions with Medications https://www.nutriiq.ca/wordpress/essential-nutrient-interactions-with-medications/
  5. Annette Dickinson, Nicolas Boyon, Andrew Shao, Physicians and nurses use and recommend dietary supplements: report of a survey, Nutrition Journal volume 8, Article number: 29 (2009)
  6. Vitamin A: Fact Sheet for Health Professionals https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/#h3
  7. Vitamin B12: Fact Sheet for Health Professionals https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/
  8. Folate: Fact Sheet for Health Professionals https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/
  9. Robyn Lucas, Rachel Neale, What is the optimal level of vitamin D? Separating the evidence from the rhetoric, Australian Family Physician, vol.43, No.3, March 2014
  10. Committee on Diagnostic Error in Health Care; Board on Health Care Services; Institute of Medicine; The National Academies of Sciences, Engineering, and Medicine; Balogh EP, Miller BT, Ball JR, editors. Improving Diagnosis in Health Care. Washington (DC): National Academies Press (US); 2015 Dec 29. 2, The Diagnostic Process. Available from: https://www.ncbi.nlm.nih.gov/books/NBK338593/
  11. Tai-Yuan Chen, Cheng-Hong Hsieh, Deng-Fwu Hwang, Development of standardized methodology for identifying toxins in clinical samples and fish species associated with tetrodotoxin-borne poisoning incidents, Journal of Food and Drug Analysis, Volume 24, Issue 1, 2016, Pages 9-14, ISSN 1021-9498,https://doi.org/10.1016/j.jfda.2015.05.004.

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