Voorbeeld invulveld Teitelbaum program:
 

Section 4 - Lab Questions

Lab Section 1

Please be sure to have your doctor review the original lab reports as well!

Please enter your results in the "Your results" section. For those tests that do not already have a "Healthy/optimal range" that we have entered in the column, enter that tests normal range for your lab in the "Healthy/optimal range" column. Only enter the number results (not the units which are letters) unless the result is reported as "Negative or positive". Except for B12, Iron, DHEA, Testosterone, and Parasites, the program can usually determine which treatments you need simply from the questions you've already answered-so do not be too concerned if you get confused in this section.
 

Question Results Healthy/Optimal Range
ESR (Sed Rate or Sedimentation Rate) 0 to 15
Free T4 (Free Thyroxine)  to 
Total T3 (Triiodothyronine)  to 
TSH (Thyroid Stimulation Hormone) 0.5 to 3.0
DHEA-S (DHEA-Sulphate)
What units are these results measured in?
 MCG/DL   uMOL/L 
 		 Males
325 - 480 mcg/DL
8.7 - 12.6 uMOL/L

Females
140 - 180 mcg/DL
3.8 - 4.6 uMOL/L
 
B12 Level (Vitamin) Over 540
Iron Percent Saturation (% Sat) Over 22%
Ferritin 40 to 200
Fe (Iron)  to 
Cortisol-only enter result if it was drawn before 10:30 AM
What units are these results measured in?
 MCG/DL   uMOL/L 
 		 6 to 24 MCG/DL

160- 642 mMOL/L
 
HgbA1C (Glycosylated Hemoglobin) 5.2-6
Free Testosterone  to 
Testosterone  to 
Parasites none
Stool for Clostridium Difficile (C. Diff or Toxin)  negative
 positive
 not taken
 		 Negative
IgE 0 to 145



 

Lab Section 2

Question Results Healthy/Optimal Range
WBC (White Blood Cells) 3500 to 7500
HCT (Hematocrit) 40 to 50
MCV (Mean Cell or Corpuscular Volume) 84 to 90
RDW (Random Distribution Width) Under 13
EOS % (Eosinophils) (as % not total)  to 
FSH Under 5
LH Under 5
Estradiol Over 100
Cholesterol  to 
Glucose (Blood Sugar)  to 
BUN (Blood Urea Nitrogen Under 25
Creat (Creatinine) Under 1.5
SGOT (AST)  to 
SGPT (ALT)  to 
NA (Sodium)  to 
K+ (Potassium)  to 
Mg (Magnesium) 1.8 to 2.4
Ca (Calcium)  to 
Uric Acid 3 to 7
Triglycerides  to 
HDL Cholesterol  to 
Somatomedin C (IGF-1) indicator of growth hormone level  to 
Lyme Test  positive
 negative
 not taken
 		 negative
PH 6.5 to 7.5
S.G. (Specific Gravity) 1.010-1.017
Red Blood Cells (RBC Under 5
Leukocytes (WBC) Under 5
Free T4 Index or Free T7 Index  to 
Anti-TPO Antibody  positive
 negative
1: 		Negative
or

 to 
Antinuclear Antibodies (FANA or ANA)  positive
 negative
1: 		Negative or 1:80 or less
Rheumatoid Factor (latex Fixation)  positive
 negative
1: 		Negative or 1:80 or less
Prolactin Under 20


If there were any other abnormal lab results, Please list them below and show ALL labs to your doctor