Point of Care Testing

Point of care testing is useful for preliminary results.  These tests use a cup or dip card that gives results within 5 min.  The results of this type of test are preliminary results and should be confirmed. There are many interferences that can cause false positives. The possibility of false negatives is also possible, because some compounds have high cutoffs. These high cutoffs cause compounds that are present to show up as negative. Some cutoffs can be as high as 300 ng/mL which is much higher than a toxicology confirmation with cutoffs as low as 5 ng/mL.


Top Notch Health  provides accurate results using the most sophisticated equipment available. Confirmations are necessary because screening results are susceptible to false positives and false negatives.  The cut off Image result for agilent 6460

levels are high for many compounds (300 ng/mL for opiates) which can lead to false negative results.  False positives are seen with many different compounds using screening and screening results need to be confirmed. Top Notch Health recommends using screening results for preliminary testing and then preforming a confirmation on the class of compounds that are positive and the class that is prescribed.

Confirmations are done using LC-MS/MS technology.  This technology is over  99.9% accurate when the data is interpreted by a trained professional. If you have any questions about your results please reach out to us and let one of our toxicologists go over them with you.


Millions of Americans struggle with allergies.  Some severe and cause anaphylaxis some occur with the season changes and cause a runny nose or watery eyes. Either mild or severe it is an issue that can be narrowed down and managed.  A blood allergy test allows for the physician to narrow down the cause and help you and your doctor chose the best treatment option.

Allergy Blood Testing is recommended if you:

  • Currently are taking an antihistamine, steroid or antidepressant that are known to interfere with test results
  • Have poorly controlled asthma
  • Have a skin condition like eczema, dermatitis, or psoriasis
  • Have cardiac problems that need to be controlled
  • Historically have an extreme reaction to the allergen typically anaphylaxis

A blood test also allows for the physician to determine how well the current treatment is working or if you have outgrown an allergy.

Neuropathy Services

Do you get incoluclusive results from EMGs and Nerve Conduction Studies on your patients with Small Fiber Neuropathy (SNF)?  A definitive answer can be reached using Epidermal Nerve Fiber Density (ENFD) testing giving you the most accurate results before you proceed with your patient’s treatment process.  The only way to definitively  diagnose  SNF is by taking a skin biopsy and performing ENFD testing.

Top Notch Health partner Ipsum Diagnostics performs ENFD assisting physicians in the diagnosis of SNF. Ipsum Diagnostice provides all the necessary materials and interpretation necessary to provide physicians with the most accurate results.


Genetic services

Genetics Testing and Clinical Care

Genetic testing can confirm or rule out a suspected genetic condition, risk for a particular disease and  help determine a person’s chance of developing or passing on a genetic disorder.  This testing can also provide information into a patient’s ability to metabolize pharmaceuticals and aid physicians in prescribing medications.

Genetics tests can be molecular, chromosomal and biochemical techniques.  This type of testing can be done with either saliva or blood.

  • Molecular-test for genes or short lengths of DNA to identify variations or mutations that lead to a genetic disorder.
  • Chromosomal -whole or long lengths of DNA to see if there are large genetic changes, ( i.e.  additional chromosome copies), that cause a genetic condition.
  • Biochemical – tests the amount or activity level of proteins; abnormalities in either can indicate changes to the DNA that result in a genetic disorder.

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