Manual

OPTIMAL HEALTH
LABORATORIES
GUIDELINES AND INSTRUCTIONS

FOR PROCESSING PATIENTS IN
CONJUNCTION WITH THE
OPTIMAL HEALTH PROGRAMS
FOR MEN AND WOMEN
VERSION 20081222
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Contact Information
Address
Optimal Health Laboratories
3521 Oak Lawn Avenue
Suite 123
Dallas, Texas 75219
Website
www.oh-labs.com
Phone Numbers
1-877-216-8004
Monday thru Friday
9AM – 6PM CST
General Fax
1-888-353-0876
Fax Medical Records to

1-888-370-4670
Email Medical Records to

medical@oh-labs.com
Personal Representative
Name:
Phone:
Fax:
Email:
Website Login
Username:
Password:
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Table of Contents
Program Options for Men................................................................................................................................. 7
Program Options for Women ........................................................................................................................... 9
Preferred Referral Program ............................................................................................................................ 11
Protocol for Men ............................................................................................................................................ 13

Testosterone Therapy.................................................................................................................................. 13
Secretagogue Therapy ................................................................................................................................. 14
Thyroid Therapy........................................................................................................................................... 16
DHEA Therapy .............................................................................................................................................. 17
Nutritional Supplementation....................................................................................................................... 18
New Patient Evaluation................................................................................................................................ 19
Follow-Up Patient Evaluation ...................................................................................................................... 19
Blood Analysis .............................................................................................................................................. 20
Blood Sample Collection/Requisition Form................................................................................................. 20
Diagnosis and Plan ....................................................................................................................................... 21
Instructions for Processing Men

Step 1: New Patient Evaluation Form for Men, page 1 of 6 ..................................................................... 23
Step 2: Initial Evaluation Requisition Form............................................................................................... 29
Step 3: Prescription Form for Men – Level 1 ............................................................................................ 31
Step 4: Follow-Up Evaluation for Men...................................................................................................... 35
Step 5: Follow-Up Requisition Form – Level 1 .......................................................................................... 37
Protocol for Women....................................................................................................................................... 41

Testosterone Therapy.................................................................................................................................. 41
Progesterone Therapy ................................................................................................................................. 42
Estrogen Therapy ......................................................................................................................................... 44
Thyroid Therapy........................................................................................................................................... 45
Secretagogue Therapy (Growth Hormone, IGF-1)....................................................................................... 47
DHEA Therapy .............................................................................................................................................. 48
Nutritional Supplementation....................................................................................................................... 49
Follow-Up Patient Evaluation ...................................................................................................................... 51
Blood Analysis .............................................................................................................................................. 51
Blood Sample Collection/Requisition Form................................................................................................. 51
Diagnosis and Plan ....................................................................................................................................... 52
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Instructions for Processing Women
Step 1: New Patient Evaluation Form for Women, page 1 of 6................................................................ 55
Step 2: Initial Evaluation Requisition Form............................................................................................... 61
Step 3: Prescription Form for Women – Level 1....................................................................................... 63
Step 4: Follow-Up Evaluation for Women ................................................................................................ 67
Sample Marketing Materials ......................................................................................................................... 73

Brochure Samples ........................................................................................................................................ 73
Postcard Mailer Samples ............................................................................................................................. 77
Point of Sale with Brochure Samples........................................................................................................... 81
Email Template ............................................................................................................................................ 85
Program Menus ........................................................................................................................................... 87
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Program Options for Men
Optimal Health Evaluation for Men
Patient price $375, one time fee
Patient price w/o blood analysis: $215*, one time fee
*physician must arrange alternative blood testing that meets “basic requirement” below
Physician price $155, one time fee
Physician receives $200 administrative fee

Includes: physical exam, medical history review and blood analysis
Blood tests
DHEA Sulfate - CPT 82627* Estradiol - CPT 82670
Free Testosterone - CPT 84402* Total Testosterone - CPT 84403
IGF-1 - CPT 84305 Insulin - CPT 83525
Total Cholesterol CPT 82465 Triglycerides CPT 84478
HDL Cholesterol CPT 83718 PSA - CPT 84153*
T3 Free - CPT 84481* T4 Free - CPT 84439
TSH - CPT 84443
*basic requirement
For patients currently undergoing hormone optimization therapy and/or receiving blood testing similar
to those listed above, the physician may decide, at his or her sole discretion, to forego the Optimal
Health Evaluation and enroll the patient into one of the programs listed below.
Program for Men - Level 1

Patient price: $295 every 4 weeks
Patient price w/o blood analysis: $245* every 4 weeks
Physician price: $185 ($145 w/o blood analysis) every 4 weeks
Physician receives $50 administrative fee every 4 weeks

Includes: follow-up examination, long-term care, blood analysis and products
Blood tests
DHEA Sulfate - CPT 82627* Free Testosterone - CPT 84402*
Total Testosterone - CPT 84403 PSA - CPT 84153*
*basic requirement
Products
Optimus™ Gel for Men (testosterone 10-20% and DHEA 2.5%)

Patient price w/o blood analysis: $335 every 4 weeks
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Blood tests
DHEA Sulfate - CPT 82627* Free Testosterone - CPT 84402*
Total Testosterone - CPT 84403 PSA - CPT 84153*
IGF-1 - CPT 84305
*basic requirement
Products
Growth hormone secretagogue

Patient price $495 every 4 weeks
Physician price $315 ($235 w/o blood analysis) every 4 weeks

Blood tests
DHEA Sulfate - CPT 82627* Estradiol - CPT 82670
HDL Cholesterol CPT 83718 PSA - CPT 84153*
TSH - CPT 84443
*basic requirement
Products
Armour thyroid
Saw palmetto, antioxidants and supplements
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Program Options for Women
Optimal Health Evaluation for Women
Patient price $375, one time fee
Patient price w/o blood analysis: $215*, one time fee
Physician price $155, one time fee
Physician receives $200 administrative fee

Includes: physical exam, medical history review and blood analysis
Blood tests
DHEA Sulfate - CPT 82627* Estradiol - CPT 82670*
HDL Cholesterol CPT 83718 Progesterone - CPT 84144*
TSH - CPT 84443
*basic requirement
Health Evaluation and enroll the patient into one of the programs listed below.
Program for Women - Level 1


Blood tests
Estradiol - CPT 82670* Progesterone - CPT 84144*
TSH - CPT 84443
*basic requirement
Products
Optima™ Gel for Women (progesterone and estradiol)
Armour thyroid
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Patient price w/o blood analysis: $335 every 4 weeks

Blood tests
Estradiol - CPT 82670* Progesterone - CPT 84144*
TSH - CPT 84443 IGF-1 - CPT 84305
*basic requirement
Products
Optima™ Gel for Women (progesterone and estradiol)
Armour thyroid

Patient price $495 every 4 weeks
Physician price $315 ($235 w/o blood analysis) every 4 weeks

Blood tests
DHEA Sulfate - CPT 82627* Estradiol - CPT 82670*
HDL Cholesterol CPT 83718 Progesterone - CPT 84144*
TSH - CPT 84443
*basic requirement
Products
Optima™ Gel for Women (progesterone, estradiol, testosterone and DHEA)
Armour thyroid
Saw palmetto, antioxidants and supplements
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Preferred Referral Program
Referring Other Healthcare Providers
Commissions are paid to members for referring qualified healthcare professionals to the Optimal
Health Community. The commissions are paid in relation to the number of patients a given healthcare
provider has under his or her care. To encourage members to refer qualified healthcare professionals,
commissions are paid on referrals of referrals of referrals.
Level A
Commissions paid for direct referrals, or personal referrals, are as follows:
Program Level 1: $9 per patient per 4 week period
Example: Refer five healthcare professionals to the community. Each has 60 patients, 20 purchasing
program level 1, 20 purchasing program level 2 and 20 purchasing program level 3.
Level A commissions would be calculated as follows:

5 referral physicians X 20 patients at level 1 x $9 x 13 billing periods = $11,700
Total level A commissions per year = $57,200
Level B
Commissions paid for secondary referrals, or referrals of direct referrals, are as follows:
Example: The five level A referrals from above refer two healthcare professionals each. Each has 60
patients, 20 purchasing program level 1, 20 purchasing program level 2 and 20 purchasing program
level 3.
Level B commissions would be calculated as follows:

Total level B commissions per year = $54,600
Level C
Commissions paid for third referrals, or referrals of secondary referrals, are as follows:
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Example: The ten level B referrals from above refer two healthcare professionals each. Each has 60
patients, 20 purchasing program level 1, 20 purchasing program level 2 and 20 purchasing program
level 3.
Level C commissions would be calculated as follows:

20 referral physicians X 20 patients at level 1 x $2 x 13 billing periods = $10.400
Total level C commissions per year = $52,000
Total Commissions
Total annual commissions would be calculated as follows:
Level A + Level B + Level C = $163,800
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Protocol for Men
Testosterone Therapy
Produced mainly in testes in response to LH from the pituitary gland. Results in increased muscle mass,
strength, decreased body fat, increased exercise capacity, mood and memory enhancement, increased
bone density, improved cholesterol profile (increased HDL and decreased LDL), increased libido and
sexual performance. Testosterone protects against cardiovascular disease, hypertension and arthritis.
Signs/Symptoms
Reduced libido
Depression, irritability, nervous, anxious
Fatigue
Difficulty initiating and maintaining an erection
Hot flushes
Excessive emotions
Loss of interest in life, loss of initiative
Pale complexion
Decreased muscle tone and mass especially shoulders
Increased abdominal fat, flabby
Benefits
Stimulates immune system
Improves sexual vitality
Improves mood, decreases anxiety
Decreases body fat
Increases lean muscle mass
Improves memory and supports brain function through increased blood supply
Increases energy
Increases bone density
Helps with chronic fatigue
Lowers LDL cholesterol levels
Coronary artery vasodilatation
Increases fibrinolytic activity
Optimal Level of Free Testosterone

Free testosterone (CPT 84402) as opposed to total testosterone (CPT 84403) is the most important lab
as it is the free testosterone which is the active hormone. As men age, their total testosterone may
remain fairly constant while their free fraction declines due to a gradual increase in SHBG levels with
age. As a result, functionally, men become hypogonadal. Target range should be 250-350 pg/mL. Total
testosterone levels should range from 700-1,500 ng/dL.
Treatment
Cream or gel best first choice due to: avoiding first pass effect through liver, stable tissue levels,
decreased conversion to estrogen, decreased production of SHBG. Dosage: testosterone liposomal gel
or cream 10-20% (100-200 mg/mL). As blood/tissue levels rise slowly, start with bid application to
forearms, inner aspect of biceps or thighs (avoiding scrotum). Reduction of dosage to once daily dosing
may be possible once adequate tissue levels attained (generally at least one month). Skin must be
clean and dry and free of moisturizers. Spread gel over wide area and rub in well.
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Enhancing Testosterone Levels
Eat enough calories, get enough protein
Avoid alcohol, caffeine, sugar
Avoid high glycemic carbohydrates, dairy
Paleolithic diet
Avoid obesity
Avoid chronic stress
Avoid marijuana
Follow-Up
Have patient discontinue therapy morning of blood test
Digital prostate exam and PSA, annually
Problem Solver
Excess DHT (excess 5 alpha reductase activity)
Male pattern baldness, excess body hair
Saw palmetto 320 mg/day
Finasteride 1.0-2.5 mg/day
Decrease testosterone
Excess Estrogen (excess aromatase activity)

Breast enlargement, red face
Dietary - decrease alcohol, caffeine, etc
Arimidex 1 mg po twice weekly
Secretagogue Therapy
Growth hormone (GH) is the major hormone of repair and restoration in the body. GH levels peak in the
late teens – early twenties, then decline at about 1-2% each year so that by the age of 40 most adults are
technically deficient (an individual whose insulin levels were half normal would certainly be treated).
Treatment for: fatigue, adult deficiency of GH, truncal obesity, h/o head trauma, wasting syndrome.
Signs/Symptoms
Hair thinning
Cheeks, skin, sagging and/or thin
Abdominal “spare tire”
Decreased muscle mass
Difficult recovery after exercise
Anxious, worried
Erectile dysfunction
Poor sleeping (light)
Difficult wound healing
Cold intolerance
Poor appetite
Low self esteem
Benefits
One month - 6 weeks
Skin looks better, improved afternoon energy level
Improved mood, improved sexual performance
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Six weeks - 3 months
Improved exercise capacity, decreased recovery time after vigorous physical activity
Increased strength, increased cardiac contractility (positive inotropic effect)
Three months - six months

Decreased body fat, increased muscle mass
Decreased spare tire around waist
Increased bone density
Lower diastolic blood pressure
Improved cholesterol profile
Optimal Level of GH (IGF-1)

GH levels have short (30 min.) half-life in blood so it is easier to follow IGF-1 (CPT 84305) levels (12
hour half life). GH causes the liver to release IGF-1, which is the compound that stimulates the cells.
Want to see increase: elevated IGF-1 levels have been associated with increased risk of prostate cancer
only in the setting of elevated IGF-1 and low or normal IGF-BP-3. Normally, GH supplementation leads
to an increase in both IGF-1 and IGF-BP-3. The target range for IGF-1 should be 300 - 350 ng/mL.
Contraindications
Relative: active cancer or cancer within past 5 yrs. Despite common opinion there is little evidence GH
is deleterious in this setting. AIDS pts have taken it for yrs w/o increase in Kaposi's sarcoma seen.
Intuitive rebuttal: GH levels are highest in prime of life when risk of cancer is lowest, GH revives
immune system which is first line of defense against cancer. DM is not a contraindication. Watch BS
levels but DM improved by decrease in peritoneal adipose tissue.
Treatment
Secretagogue: once in morning (1 sachet) once in evening (2 sachets) or alternatively 3 sachets per
day, take away from meals, Monday thru Friday.
Enhancing GH Levels
Eat sufficient calories
Paleolithic diet
Get adequate sleep
Weight training
Avoid sugar, alcohol, marijuana
Follow-Up
If taking exogenous GH, have patient discontinue therapy 24 hours before test (patients does not need
to discontinue secretagogue)
Problem Solver
Edema, carpel tunnel syndrome
Potassium 1-3 g/day
Excess muscle development

Reduce dosage
Acne
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Avoid sweets
Excess sweating, difficulty sleeping

If taking thyroid, reduce dosage
Thyroid Therapy
Regulates temperature, metabolism and energy; controls growth, differentiation and metabolism of all
cells, increases fat metabolism, leading to weight loss and improved cholesterol levels, protects against
heart disease, prevents cognitive impairment, relieves dry skin, thin hair and nails.
Two hormones—T3 & T4. Produced as T4, converted to T3, mostly protein bound: free T3 is the active
hormone. T4 is the most abundant hormone in the blood but T3 has the greatest volume of distribution.
Both hormones decline with age–approximately 10-25% between the ages of 25 thru 75. Peripheral
conversion of T4 to T3 (mostly in the liver) is responsible for most of the T3 found in the body. Under
stress, due to aging or infection the conversion of T4 to T3 can be negatively affected. As TSH is in a
negative feedback loop with T4, some patients will have normal T4 and as a result a normal TSH—low T3
levels and are clinically hypothyroid and should be treated. Combination therapy of T4 and T3 is best due
to reasons noted above.
Signs/Symptoms
Fatigue
Cold intolerance
Depression, slow mentation
Dry skin and hair, hair loss
Headaches
Weight gain with loss of appetite
Low immunity to colds
CHF
Easy bruisability
Thick, puffy skin cool to touch
Low libido
High cholesterol/ triglycerides
Benefits
Less fatigue
Improve cold tolerance
Improve mood
Improve cognitive function
More supple skin
Improve weight loss with increase in appetite
Improve immune response
Less bruisability
Increase libido
Lower cholesterol/improve lipid profile
Reduce risk of CHF
Improve skin tone
Thicker hair
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Optimal Level of Free T3
Serum Free T3 (CPT 84481) 350-430 pg/dL. Thyroflex test is a useful objective, functional tool to
determine if thyroid hormone levels are in optimum range for each individual patient.
Contraindications
Optimal thyroid function (FT3 350 pg/dL or greater)
Cortisol deficiency (uncorrected)
Heart attack
Treatment
Armour thyroid (T3 and T4) is best tolerated, most effective, many people do not convert T4 to T3
efficiently (Wilson’s disease). Animal origin, gentle action, sustained action. Average dose 60-120 mg in
the morning on empty stomach. Starting dose 30 mg, increase every 2 weeks by 30 mg until optimal
level FT3 reached. Go slow, especially in those of frail health or with suspected cortisol deficiency.
SCHEDULE
Weeks 1 thru 2— ½ (one-half) 60 mg tablet 30 minutes before breakfast
Weeks 3 thru follow-up visit— 1 (one whole) 60 mg tablet 30 minutes before breakfast
Enhancing Thyroid Levels

Paleolithic diet
Food sources rich in iodine (seafood, kelp)
Follow-Up
Problem Solver
Signs of overdose
Anxious, jittery, tachycardia, trouble sleeping, losing weight excessively fast, excess hunger and/or
thirst, speaking, thinking too quickly
Stop therapy for two days, resume with dosage reduced by ¼ to ½ tablet
DHEA Therapy
Produced in the adrenal cortex and brain. Precursor to testosterone, estrogen, progesterone. Levels tend
to be low in cases of obesity, cancer, heart disease, diabetes, immune deficiencies and elderly.
Signs/Symptoms
Reduced axillary and/or pubic hair
Dry eyes/skin
Fatigue
Mild depression
Optimal Level of DHEA Sulfate

DHEA-Sulfate (CPT 82627) should range between 450-600 ug/dL
Benefits
Page 17
Improves mood
Decreases body fat
Improves memory
Increases energy
Lower LDL cholesterol levels
Treatment
Cream or gel best first choice due to: avoiding first pass effect through liver, stable tissue levels
Dosage: DHEA liposomal gel or cream 2.5% (25 mg/mL)
Enhancing DHEA Levels

Avoid alcohol, caffeine, sugar
Avoid high glycemic carbohydrates, dairy
Paleolithic diet
Avoid obesity
Avoid marijuana
Follow-Up
Problem Solver
Excess DHEA
Oily hair, skin, acne, male pattern baldness
Stop DHEA for 4 days, resume at half previous amount
Avoid excess sugars and carbohydrates, alcohol, caffeine
Correct cortisol deficiency if suspected
Nutritional Supplementation
Supplement 1
Grape Seed Extract, Grape Skin Extract, Green Tea Extract, Coastal White Pine Extract, Bilberry, Alpha
Tocotrienol, Gamma Tocotrienol, Carotinoids, Co Enzyme Q6-10. Standardized Levels: Grape Seed:
total flavonols 85%; Grape Skin: total polyphenols 20%; Green Tea: total polyphenols 53%.
Supplement 2
Vitamin A 5000 IU, Vitamin C 60 mg, Vitamin D 400 IU , Vitamin E 30 IU, Vitamin K 50 mcg, Thiamin 105
mg, Riboflavin 1.7 mg, Niacin 20 mg, Vitamin B-6 2 mg, Folic Acid 400 mcg, Vitamin B-12 6 mcg, Biotin
30 mcg, Pantothenic acid 10 mg, Calcium 225 mg, Phosphorus 114 mg, Iodine 150 mc, Magnesium 100
mg, Zinc 15 mg, Selenium 20 mcg, Copper 2 mg, Manganese 2 mg, Chromium 120 mcg, Molybdenum
75 mcg, Chloride 72 mcg, Potassium 80 mg, Silica 2 mg, Boron 150 mcg, Tin 10 mcg, Vanadium 10 mcg,
Nickel 5 mcg, ORAC blend 540 mg, (grape seed extract, dried apple juice concentrate, dried orange
juice concentrate, dried pineapple concentrate, dried peach concentrate, dried broccoli concentrate,
dried cauliflower concentrate, dried spinach concentrate, dried carrot concentrate)
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Supplement 3
Saw palmetto 320 mg per day
New Patient Evaluation

“New Patient Evaluation Form for Men” available online at www.oh-labs.com/forms.html)
Health Evaluation and enroll the patient.
Physical Assessment
Vital Signs Biometrics
Height (inches) Forced Vital Capacity (liters)*
Weight (pounds) Body Fat (percent)*
Heart Rate (beats/min.)
Respirations (breaths/min.)
Blood Pressure
(systolic/diastolic)
*Future data collection
Subjective Assessment
Psychiatric: alcohol or drug abuse, depression
Neurological: epilepsy, cerebrovascular accident
Earns/Nose/Throat
Cardiovascular: hypertension, myocardial infarction, angina
Respiratory: asthma, COPD
Gastrointestinal: peptic ulcer, bowel disease
Hepatic: hepatitis, hepatic impairment, gallbladder disease
Genitourinary: renal impairment
Endocrine: diabetes, thyroid disease
Musculoskeletal: rheumatoid arthritis, osteoarthritis
Dermatological
Hematological
Objective Assessment
HEENT
Neck
Chest
COR
Abdomen
Extremities
Neurological
Rectal Exam
Follow-Up Patient Evaluation

“Follow-Up Evaluation Form for Men” available online at www.oh-labs.com/forms.html)
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The follow-up evaluation is to be performed between weeks 4-6, week 12 and every 12 weeks
thereafter during the course of the patient’s program. Our standard of care suggests all patients come
to your office for each follow-up evaluation in order to monitor vitals signs, biometrics (future) and to
evaluate the need for any modifications to the patient’s product regimen as outlined in the “Problem
Solver” section for each respective therapy. Should your patient desire to perform the week 4-6 follow-
up evaluation over the phone, you are required to supply the necessary requisition form (listed below)
and either direct the patient to the nearest blood collection facility to have their blood drawn, perform
the blood draw onsite or arrange for alternative testing equivalent to those listed below.
Physical Assessment
Blood Pressure
Follow-up and short form review of symptoms
Follow-up and short from physical exam
Blood Analysis
Initial Follow-Up Follow-Up Follow-Up
Evaluation Level 1 Level 2 Level 3
DHEA Sulfate - CPT 82627 X X X X
Estradiol - CPT 82670 O O
Free Testosterone - CPT 84402 X X X X
Total Testosterone - CPT 84403 O O O O
IGF-1 - CPT 84305 O O O
Insulin - CPT 83525 O O
Total Cholesterol CPT 82465 O O
Triglycerides CPT 84478 O O
HDL Cholesterol CPT 83718 O O
PSA - CPT 84153 X X X X
T3 Free - CPT 84481 X X
T4 Free - CPT 84439 O O
TSH - CPT 84443 O O
*”X” basic requirement, “O” optional
Blood Sample Collection/Requisition Form

If using our Quest Diagnostics requisition form, the protocol is as follows:
NOTE: The information below with illustrated examples is listed in steps 2 and 5 for men.
Include copy of requisition form with all patient evaluation forms

Enter Patient’s Name| Date of Birth | Sex | Social Security No. | Phone Number
Enter Date | Time sample was collected (if drawn onsite)
Check “Fasting” or “Non Fasting” (if drawn onsite)
Under Ordering Physician, enter your Name, UPIN/NPI, Phone Number, and Fax Number or your Quest
Account Number
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Select appropriate blood tests:
Initial Evaluation: CP 316050, 839 IGF-1 and 5363 PSA
Follow-Up, Level 1: 5363 PSA Total, 402 DHEA Sulfate, 36170 Testosterone Free & Total
Follow-Up, Level 2: 839 IGF-1, 5363 PSA Total, 402 DHEA Sulfate, 36170 Testosterone Free & Total
Follow-Up, Level 3: CP 316050, 839 IGF-1 and 5363 PSA
Specimen requirements:
Initial Evaluation: 2 spun tiger tops, serum from 1 spun red top (no gel), 1 mL frozen serum
Follow-Up, Level 1: 1 spun tiger top, serum from 1 spun red top (no gel)
Follow-Up, Level 2: 1 spun tiger tops, serum from 1 spun red top (no gel), 1 mL frozen serum
Diagnosis and Plan

“Prescription Form for Men” available online at www.oh-labs.com/forms.html)
NOTE: The information below with illustrated examples is listed in Step 3 for men.
Free Testosterone Level (CPT 84402)

pg/mL 20-39 40-59 60-79 80-99 100-119 120-139
Testosterone, liposomal gel 20% 18% 16% 14% 12% 10%
DHEA Sulfate Level (CPT 82627)

ug/dL 25-74 75-149 150-224 225-299 300-374 375-449
DHEA, liposomal gel 2.5% 2.5% 2.5% 2.5% 2.5% 2.5%
Free T3 Level (CPT 84481)

pg/dL less than 350 less than 350 350 or greater
Armour thyroid (tablet)* 60 mg* x 30 60 mg* x 60 NA
*Schedule
Weeks 1 thru 2 – ½ 60 mg tablet 30 minutes before breakfast
Weeks 3 thru follow-up visit – 1 60 mg tablet 30 minutes before breakfast
Secretagogue
Monday thru Friday (away from meals): 1 sachet in morning, 2 sachets in evening
Monday thru Friday (away from meals): 3 sachets per day
Supplements Daily
Supplements 1, 2 and 3: one of each in morning, one of each in evening
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Step 1: New Patient Evaluation Form for Men, page 1 of 6
1. The patient must provide a valid shipping address; we cannot ship to P.O. Boxes.
2. Please ask the patient to provide a valid email address; we send important correspondence via email.
3. It's important to verify the method of payment; we accept Visa, MasterCard, Discover and American Express.
4. If the patient elects to submit their insurance, include a copy of the front and back of their insurance card. We do
not accept Medicare or Medicaid at this time.
5. The patient will be charged $375 for the Optimal Health Evaluation. Should the patient decide to enroll in the
Optimal Health Program, they will be billed every 4 weeks (see program options for details).
6. The patient must sign and date the Credit Card Authorization.
7. If the patient has provided their insurance information, they must sign and date the Insurance Authorization.
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1. The patient must sign and date the Waiver of Claims and Informed Consent.
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1. Lipid profile and blood pressure are often improved as a result of hormone optimization therapy. Risk of developing
heart disease may also be lowered.
2. In order to prescribe hormone optimization therapy, the patient must not have had cancer within the past 5 years.
3. The patient’s responses to the conditions listed help formulate whether or not the patient has symptoms consistent
with hormone deficiency.
Notes:
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1. If the patient is currently undergoing hormone optimization therapy, please prescribe according to the patient’s
current dosage level(s).
2. Emphasize the importance of avoiding recreational drugs, such as marijuana.
3. For best results, it’s essential the patient maintains an adequate caloric intake with rich sources of protein and high
glycemic carbohydrates. Make sure the patient avoids foods high in sugar, fatty or fried and consumes alcohol only
in moderation. The patient should exercise with weights 3-4 times per week.
Notes:
Page 26
1. Depression, irritability, excessive emotions and nervousness can be caused by hormonal deficiencies.
2. Take note of any discomfort experienced during urination as this can be a sign of an enlarged prostate.
Notes:
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1. Collect the patient’s vital signs. Biometrics such as force vital capacity and body fat will be future additions to the
protocol.
2. Notes:
3. Notes:
4. Include a copy of the patient’s requisition form.

5. Fax completed forms to 1-888-370-4670 (include the leading “1” or the fax will not go through). Completed forms
may also be emailed to medical@oh-labs.com.
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Step 2: Initial Evaluation Requisition Form
1. Enter the patient’s name (last, first, MI). The order is important in how it relates to the patient’s Google Health
login information. Also enters the patient’s date of birth, sex, social security number and phone number.
2. If drawing the patient’s blood onsite, enter the date the sample was collected, time and whether or not the patient
was fasting – note: the test requires a 12 hour fast.
3. Under ordering physician, enter your name, NPI or UPIN and phone number.
4. If you do not have a Quest Diagnostics account, you must select fax and enter your fax number.
5. If you have a Quest Diagnostics account, you may enter your account number and the patient’s results will be
reported according to the method chosen in your Quest Diagnostics account.
6. Select custom panel CP 316050, 839 IGF-1 and 5363 PSA, Total. Please note that we recommend sending the
patient to the nearest Quest Diagnostics facility to have their blood drawn. To find the nearest Quest Diagnostics
facility, go to www.questdiagnostics.com and click on find a location.
The specific tests above require complicated specimen preparation and transport. If you draw the patient’s blood
onsite, you must submit:
a. Submit two (2) spun tiger tops (serum separator).

b. Submit serum from one (1) spun red top (no gel).
c. Submit (1) mL frozen serum.
d. Call Quest Diagnostics and notify the representative you have a frozen specimen.
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Step 3: Prescription Form for Men – Level 1
1. Select the dosage in relation to the patient’s level of free testosterone. For instance, if the patient’s level of free-t is 44.7,
select 18%.; 1/2 mL twice daily is typical whereas 1 mL once daily is optional.
2. Select the dosage in relation to the patient’s level of DHEA-Sulfate. For instance, if the patient’s DHEA-Sulfate level is 164,
the corresponding dosage would be 2.5%.
3. NA
4. NA
5. NA
6. Please make sure to sign where applicable and select refills x5.
7. Fax completed forms to 1-888-370-4670 (make sure to include the leading “1” or the fax will not go through). Completed
forms may also be emailed to medical@oh-labs.com.
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3. NA
4. There are two options for the secretagogue, select the option most appropriate for the patient.
5. NA
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3. Select the thyroid dosage in relation to the patient’s level of Free T3. Note the schedule above – go slow.
5. Select supplements 1, 2 and 3 for the patient.
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Step 4: Follow-Up Evaluation for Men
1. If the patient’s insurance information has changed, make sure to enter the new information and include a copy of
the front and back of their insurance card.
protocol.
3. Notes:
4. Notes:
Page 35
Page 36
Step 5: Follow-Up Requisition Form – Level 1
6. Select test codes 5363 PSA Total, 402 DHEA Sulfate, 36170 Testosterone Fr & Tot. Please note that we recommend
sending the patient to the nearest Quest Diagnostics facility to have their blood drawn. To find the nearest Quest
Diagnostics facility, go to www.questdiagnostics.com and click on find a location.
a. Submit one (1) spun tiger top (serum separator).

c. Call Quest Diagnostics for specimen collection.
Page 37
6. Select test codes 839 IGF-1, 5363 PSA Total, 402 DHEA Sulfate, 36170 Testosterone Fr & Tot. Please note that we
recommend sending the patient to the nearest Quest Diagnostics facility to have their blood drawn. To find the
nearest Quest Diagnostics facility, go to www.questdiagnostics.com and click on find a location.
a. Submit one (1) spun tiger top (serum separator).

Page 38
6. Select custom panel CP 316050, 839 IGF-1 and 5363 PSA, Total. Please note that we recommend sending the
patient to the nearest Quest Diagnostics facility to have their blood drawn. To find the nearest Quest Diagnostics
facility, go to www.questdiagnostics.com and click on find a location.

Page 39
Page 40
Protocol for Women
Testosterone Therapy
Produced in ovaries in response to LH from the pituitary gland, in the adrenal glands in response to
ACTH from the pituitary and as a result of peripheral conversion of DHEA. Daily production of
testosterone in women is approx. 20 times lower than in men. As in men, testosterone in women
results in increased muscle mass, strength, decreased body fat, increased exercise capacity, mood and
memory enhancement, increased bone density, increased libido and sexual sensitivity including
orgasm. Testosterone protects against cardiovascular disease, hypertension and arthritis.
Signs/Symptoms
Reduced libido, decreased orgasms
Depression, irritability, excessive anxiety
Fatigue
Cellulite
Excessive emotions, hysterical reactions
Loss of interest in life, lack of initiative
Pale complexion, easy bruisability
Decreased muscle tone and mass
Increased abdominal fat, flabby
Benefits
Improves mood, decreases anxiety
Decreases body fat
Improves memory and supports brain function through increased blood supply
Increases energy
Lowers LDL cholesterol levels
Coronary artery vasodilatation
Increases fibrinolytic activity
Optimal Level of Free Testosterone

Free testosterone as opposed to total testosterone is the most important lab as it is the free
testosterone which is the active hormone. As women age, their testosterone levels fall faster than men
so many are deficient by the age of 40. Free testosterone levels should range from 4-6 pg/mL. Total
testosterone levels should be greater than 35 ng/dL.
Treatment
Cream or gel best first choice due to: avoiding first pass effect through liver, stable tissue levels,
decreased production of SHBG. Dosage: testosterone liposomal gel or cream 0.2-0.5% (2-5 mg/mL).
Start with bid application to inner aspect of biceps or forearms. Skin must be clean, dry and free of
moisturizers. Spread gel over wide area and rub in well.
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Enhancing Testosterone Levels
Avoid alcohol, caffeine, sugar, high glycemic carbs, dairy, cereal fiber
Paleolithic diet
Avoid obesity
Avoid marijuana
Follow-Up
Problem Solver
Excess androgens
Acne - excess testosterone, DHEA
Reduce dosage, avoid sweets, dairy, more Paleolithic diet
Overly aggressive
Correct GH deficiency
Painful clitoral swelling or sensitivity

Excess conversion to DHT or increase in clitoris DHT receptors
Decrease dosage
Excess DHT (excess 5 alpha reductase activity)

Male pattern baldness, excess body hair
Decrease dosage
Progesterone Therapy
Produced in the ovaries in the second half of the menstrual cycle and in the adrenal glands in small
amounts.
Progestins [norethynodrel (Enovid), norethindrone (many brand names, most notably Ortho-Novum and
Ovcon) norgestimate (Ortho Tricyclen, Ortho-Cyclen), norgestrel, levonorgestrel (Alesse, Trivora-28, Plan
B), medroxyprogesterone (Provera, Depo-Provera), desogestrel, and drospirenone (Yasmin, Yasminelle,
YAZ)] are not the same as progesterone. While progestins offer some protection from uterine cancer,
they do not help protect against breast cancer and often have unwanted side effects including
thrombophlebitis, fluid retention, depression, acne, seizures, headaches, weight gain and high blood
pressure. In addition, they tend to decrease the beneficial effects of estrogens on the heart.
Roles: 1) mild diuretic - blocks aldosterone receptor; 2) converts endometrium from prolifierative to
secretory stage, limiting menstrual blood loss; 3) stimulates parasympathetic nervous system - promotes
calm mood, decreased anxiety and irritability; 4) prepare uterus for implantation of fertilized egg; and 5)
protects against osteoporosis.
Signs/Symptoms
Reddish face
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Large breasts
Swollen, tender breasts premenstrually
Premenstrual syndrome
Heavy, painful periods
Insomnia
Irritability, anxiety
Fibrocystic disease, uterine fibroids
Migraines
Benefits
Improvement in PMS symptoms of bloating, premenstrual water retention
Calmer, more even keeled mood
Natural antidepressant
Relief of insomnia
Fibrocystic, uterine fibroid shrinkage
Decreases migraines
Strengthens bones
Optimal Level of Progesterone

10-20 ng/mL on 18-21st day of cycle. For women with shorter or longer cycles, 7 days before onset of
menses. For menopausal women, blood can be drawn any day.
Contraindications
See notes regarding progestins above.
Treatment
Transdermal 2-5% (20-50 mg/mL); apply 1 mL at bedtime to inner aspect of biceps or forearms,
alternating areas of application. Skin must be clean, dry and free of creams or lotions. Apply over wide
area and rub in well. Gel should be applied in the evenings of days 15-24 unless symptoms are severe,
in which case gel should be applied on days 11-25. Menopausal women apply progesterone on days 1-
25 of the month and discontinue along with estrogens for the remainder of the month. This is done
because cycling of hormones (progesterone and estrogen) has been associated with a 50% decrease in
the risk of breast cancer.
Follow-Up
Generally, correction of clinical symptoms is most important indicator of adequate progesterone levels.
Serum levels should be checked on 18-21st day of cycle in premenopausal women or any day in
menopausal women. Generally, allow 2-3 months of treatment before follow-up testing.
Problem Solver
Continuation of symptoms
Increase dosage
Relative Estrogen Excess

Nervousness, anxiety, dysmenorrhea, menorrhagia, swollen, painful breasts, abdominal bloating,
weight gain
For symptoms worse in 1st half of cycle - decrease estrogen
For symptoms worse in 2nd half of cycle - increase progesterone
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Estrogen Therapy
Produced in the ovaries and in fat cells from the conversion of testosterone by aromatase.
Synthetic estrogens and Premarin are not the same as human estrogen. Women produce 3 forms of
estrogen: estrone, estradiol and estriol—estriol is the weakest. Premarin is conjugated (metabolized by
the liver) from horse estrogens which consist of estrone, equilin and equilenin. Estrone sulfate is
converted to estradiol by women in the liver. Equilin and equilenin, however, are foreign hormones to
women and are often responsible for side effects associated with Premarin.
Women on birth control pills can still have symptoms of estrogen/progesterone imbalance and should be
treated accordingly and, in addition, if possible and practical, switch to other form of birth control.
Signs/Symptoms
Increased body fat
Increased risk of breast and uterine cancer
Swollen, tender breasts premenstrually
Increased blood clotting
Large breasts
Premenstrual syndrome
Heavy, painful periods
Insomnia
Irritability, anxiety
Fibrocystic disease, uterine fibroids
Migraines
Decreased thyroid function
Micromastia (early onset)
Breast ptosis (late onset)
Hypo- or amenorrhea
Vaginal dryness, itching
Small, sharp wrinkles above upper lip
Benefits
Reduce or eliminate menopausal symptoms such as night sweats, hot flashes, depression, vaginal
dryness, fatigue, decreased libido
Protects against heart disease and stroke
Decreases cholesterol
Prevents or protects against Alzheimer’s
Helps prevent osteoporosis
Increases mental alertness and improves memory
Increases skin thickness (decreases fine wrinkles)
Decreases urogenital atrophy (improves vaginal epithelial thickness, elasticity, lubrication, decreases
UTI’s and urethral syndrome)
Optimal Level of Estrogen (Estradiol)

90-120 ng/mL on 18-21st day of cycle. For women with shorter or longer cycles, 7 days before onset of
menses. For menopausal women, blood can be drawn any day.
Contraindications
History of breast/uterine cancer within previous 5 years
Page 44
History of phlebitis/blood clots
Uterine fibroids or Endometriosis
Treatment
Transdermal E2 0.05-0.20% (0.5-2.0 mg/mL); apply 1 mL in the morning to inner aspect of biceps or
forearms, alternating areas of application. Skin must be clean, dry and free of creams or lotions. Apply
over wide area and rub in well. Gel should be applied in the mornings of days 10-24. Menopausal
women apply estrogen on days 1-25 of the month and discontinue along with progesterone for the
remainder of the month. This is done because cycling of hormones (estrogen and progesterone) has
been associated with a 50% decrease in the risk of breast cancer.
Follow-Up
Generally, correction of clinical symptoms is most important indicator of adequate estrogen levels. If
symptoms persist, increase dosage. Symptom improvement should occur within a few days to one
week. Serum levels should be checked on 18-21st day of cycle in premenopausal women or any day in
menopausal women. Generally, allow 2 months of treatment before follow-up testing.
Problem Solver
Continued estrogen deficiency symptoms
Underdosage or poor absorption, underproduction due to stress, aging, increased consumption due to
extreme physical exercise
Increase dosage
Verify proper application (see above)
Relative estrogen excess

Nervousness, anxiety, dysmenorrhea, menorrhagia, swollen, painful breasts, abdominal bloating,
weight gain
For symptoms worse in 1st half of cycle - decrease estrogen
For symptoms worse in 2nd half of cycle - increase progesterone
Symptoms improved occasionally or irregularly

Suspect Candida infection in gut– eliminate sugar, soda, milk, bread and pasta, switch to Paleolithic
diet emphasizing fresh, whole fruits and vegetables, lean protein (little or no red meat)
Thyroid Therapy
Regulates temperature, metabolism and energy; controls growth, differentiation and metabolism of all
cells, increases fat metabolism, leading to weight loss and improved cholesterol levels, protects against
heart disease, prevents cognitive impairment, relieves dry skin, thin hair and nails.
Two hormones—T3 & T4. Produced as T4, converted to T3, mostly protein bound: free T3 is the active
hormone. T4 is the most abundant hormone in the blood but T3 has the greatest volume of distribution.
Both hormones decline with age–approximately 10-25% between the ages of 25 thru 75. Peripheral
conversion of T4 to T3 (mostly in the liver) is responsible for most of the T3 found in the body. Under
stress, due to aging or infection the conversion of T4 to T3 can be negatively affected. As TSH is in a
negative feedback loop with T4, some patients will have normal T4 and as a result a normal TSH—low T3
levels and are clinically hypothyroid and should be treated. Combination therapy of T4 and T3 is best due
to reasons noted above.
Page 45
Signs/Symptoms
Fatigue
Cold intolerance
Depression, slow mentation
Dry skin and hair, hair loss
Headaches
Weight gain with loss of appetite
Low immunity to colds
CHF
Easy bruisability
Thick, puffy skin cool to touch
Low libido
Menstrual irregularities
High cholesterol/triglycerides
Benefits
Less fatigue
Improve cold tolerance
Improve mood
Improve cognitive function
More supple skin
Improve weight loss with increase in appetite
Improve immune response
Less bruisability
Increase libido
Lower cholesterol/improve lipid profile
Reduce risk of CHF
Improve skin tone
Thicker hair
Optimal Level of Free T3

Serum FT3 350-430 pg/dL. Thyroflex test is a useful objective, functional tool to determine if thyroid
hormone levels are in optimum range for each individual patient.
Contraindications
Optimal thyroid function (FT3 350 pg/dL or greater)
Cortisol deficiency (uncorrected)
Heart attack
Treatment
Armour thyroid (T3 and T4) is best tolerated, most effective, many people do not convert T4 to T3
efficiently (Wilson’s Disease). Animal origin, gentle action, sustained action. Average dose 60-120 mg in
the morning on empty stomach. Starting dose 30 mg, increase every 2 weeks by 30 mg until optimal
level FT3 reached. Go slow, especially in those of frail health or with suspected cortisol deficiency
SCHEDULE
Weeks 1 thru 2—½ (one-half) 60 mg tablet 30 minutes before breakfast
Weeks 3 thru follow-up visit—1 (one whole) 60 mg tablet 30 minutes before breakfast
Page 46
Enhancing Thyroid Levels
Paleolithic diet
Food sources rich in iodine (seafood, kelp)
Follow-Up
Problem Solver
Signs of overdose
Anxious, jittery, tachycardia, trouble sleeping, losing weight excessively fast, excess hunger and/or
thirst, speaking, thinking too quickly
Stop therapy for two days, resume with dosage reduced by ¼ to ½ tablet
Secretagogue Therapy (Growth Hormone, IGF-1)

Growth hormone (GH) is the major hormone of repair and restoration in the body. GH levels peak in
the late teens – early twenties, then decline at about 1-2% each year so that by the age of 40 most
adults are technically deficient (an individual whose insulin levels were half normal would certainly be
treated). Treatment for: fatigue, adult deficiency of GH, truncal obesity, h/o head trauma, wasting
syndrome.
Signs/Symptoms
Hair thinning
Cheeks, skin, sagging and/or thin
Abdominal “spare tire”
Decreased muscle mass
Difficult recovery after exercise
Anxious, worried
Poor sleeping (light)
Difficult wound healing
Cold intolerance
Poor appetite
Low self-esteem
Benefits
One month - 6 weeks
Skin looks better, improved afternoon energy level
Improved mood, improved sexual performance
Six weeks - 3 months

Improved exercise capacity, decreased recovery time after vigorous physical activity
Increased strength, increased cardiac contractility (positive inotropic effect)
Three months - six months

Decreased body fat, increased muscle mass
Decreased spare tire around waist
Increased bone density
Lower diastolic blood pressure
Improved cholesterol profile
Page 47
Optimal Level of Growth Hormone (IGF-1)
GH levels have short (30 min.) half-life in blood so it is easier to follow IGF-1 levels (12 hour half life).
GH causes the liver to release IGF-1, which is the compound that stimulates the cells. The target range
for IGF-1 should be 250 - 300 ng/mL.
Contraindications
Relative: active cancer or cancer within past 5 yrs. Despite common opinion there is little evidence GH
is deleterious in this setting. AIDS pts have taken it for yrs w/o increase in Kaposi's sarcoma seen.
Intuitive rebuttal: GH levels are highest in prime of life when risk of cancer is lowest, GH revives
immune system which is first line of defense against cancer. DM is not a contraindication. Watch BS
levels but DM improved by decrease in peritoneal adipose tissue.
Treatment
Secretagogue: once in morning (1 sachet) once in evening (2 sachets) or alternatively 3 sachets per
day, take away from meals, Monday thru Friday.
Enhancing GH Levels
Eat sufficient calories
Paleolithic diet
Get adequate sleep
Weight training
Avoid sugar, alcohol, marijuana
Follow-Up
If taking exogenous GH, have patient discontinue therapy 24 hours before test (patients does not need
to discontinue secretagogue)
Problem Solver
Excess GH
Edema, carpel tunnel syndrome
Potassium 1-3 g/day
Excess muscle development

Reduce dosage
Acne
Avoid sweets
Excess sweating, difficulty sleeping

If taking thyroid, reduce dosage
DHEA Therapy
Produced in the adrenal cortex and brain and ovaries. Precursor to testosterone, estrogen,
progesterone. Levels tend to be low in cases of obesity, cancer, heart disease, diabetes, immune
deficiencies and elderly.
Signs/Symptoms
Reduced axillary and/or pubic hair
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Dry eyes/skin
Fatigue
Mild depression
Benefits
Improves mood
Decreases body fat
Improves memory
Increases energy
Lower LDL cholesterol levels
Optimal Level of DHEA Sulfate

Levels should range between 280-350 ug/dL
Treatment
Cream or gel best first choice due to: avoiding first pass effect through liver, stable tissue levels.
Dosage: DHEA liposomal gel or cream 0.2-0.5% (2-5 mg/mL).
Enhancing DHEA Levels

Avoid alcohol, caffeine, sugar, high glycemic carbs, dairy
Paleolithic diet
Avoid obesity
Avoid marijuana
Follow-Up
Problem Solver
Excess DHEA
Oily hair, skin, acne, excess hair
Stop DHEA for 4 days, resume at half previous amount
Avoid excess sugars and carbohydrates, alcohol, caffeine
Correct cortisol deficiency if suspected
Nutritional Supplementation
Supplement 1
Grape Seed Extract, Grape Skin Extract, Green Tea Extract, Coastal White Pine Extract, Bilberry, Alpha
Tocotrienol, Gamma Tocotrienol, Carotinoids, Co Enzyme Q6-10. Standardized Levels: Grape Seed:
total flavonols 85%; Grape Skin: total polyphenols 20%; Green Tea: total polyphenols 53%.
Page 49
Supplement 2
Vitamin A 5000 IU, Vitamin C 60 mg, Vitamin D 400 IU , Vitamin E 30 IU, Vitamin K 50 mcg, Thiamin 105
mg, Riboflavin 1.7 mg, Niacin 20 mg, Vitamin B-6 2 mg, Folic Acid 400 mcg, Vitamin B-12 6 mcg, Biotin
30 mcg, Pantothenic acid 10 mg, Calcium 225 mg, Phosphorus 114 mg, Iodine 150 mc, Magnesium 100
mg, Zinc 15 mg, Selenium 20 mcg, Copper 2 mg, Manganese 2 mg, Chromium 120 mcg, Molybdenum
75 mcg, Chloride 72 mcg, Potassium 80 mg, Silica 2 mg, Boron 150 mcg, Tin 10 mcg, Vanadium 10 mcg,
Nickel 5 mcg, ORAC blend 540 mg, (grape seed extract, dried apple juice concentrate, dried orange
juice concentrate, dried pineapple concentrate, dried peach concentrate, dried broccoli concentrate,
dried cauliflower concentrate, dried spinach concentrate, dried carrot concentrate)
Supplement 3
Saw palmetto 320 mg per day
New Patient Evaluation

“New Patient Evaluation Form for Women” available online at www.oh-labs.com/forms.html)
Health Evaluation and enroll the patient.
Physical Assessment
Blood Pressure
Psychiatric: alcohol or drug abuse, depression
Neurological: epilepsy, cerebrovascular accident
Earns/Nose/Throat
Cardiovascular: hypertension, myocardial infarction, angina
Respiratory: asthma, COPD
Gastrointestinal: peptic ulcer, bowel disease
Hepatic: hepatitis, hepatic impairment, gallbladder disease
Genitourinary: renal impairment, breast lumps, cysts, disease, pregnancies, live births, age of
menarche, age at menopause, regular or irregular flow, days of flow, last thermogram/mammogram
Endocrine: diabetes, thyroid disease
Musculoskeletal: rheumatoid arthritis, osteoarthritis
Dermatological; - Hematological
HEENT
Neck
Chest, Breasts*
Page 50
COR
Abdomen
Extremities
Neurological
Pelvic Exam
*Review results from patient’s last mammogram or thermogram
Follow-Up Patient Evaluation

“Follow-Up Evaluation Form for Women” available online at www.oh-labs.com/forms.html)
The follow-up evaluation is to be performed between weeks 4-6, week 12 and every 12 weeks thereafter
during the course of the patient’s program. Our standard of care suggests all patients come to your
office for each follow-up evaluation in order to monitor vitals signs, biometrics (future) and to evaluate
the need for any modifications to the patient’s product regimen as outlined in the “Problem Solver”
section for each respective therapy. Should your patient desire to perform the week 4-6 follow-up
evaluation over the phone, you are required to supply the necessary requisition form (listed below) and
either direct the patient to the nearest blood collection facility to have their blood drawn, perform the
blood draw onsite or arrange for alternative testing equivalent to those listed below.
Physical Assessment
Blood Pressure
Follow-up and short form review of symptoms
Follow-up and short from physical exam
Blood Analysis
Initial Follow-Up Follow-Up Follow-Up
Evaluation Level 1 Level 2 Level 3
DHEA Sulfate - CPT 82627 X X
Estradiol - CPT 82670 X X X X
Free Testosterone - CPT 84402 X X
Total Testosterone - CPT 84403 O O
IGF-1 - CPT 84305 O O O
Insulin - CPT 83525 O O
Total Cholesterol - CPT 82465 O O
Triglycerides - CPT 84478 O O
HDL Cholesterol - CPT 83718 O O
Progesterone - CPT 84144 X X X X
T3 Free - CPT 84481 X X X X
T4 Free - CPT 84439 O O O O
TSH - CPT 84443 O O O O
*”X” basic requirement, “O” optional
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Blood Sample Collection/Requisition Form
If using our Quest Diagnostics requisition form, the protocol is as follows:
NOTE: The information below with illustrated examples is listed in Steps 2 and 5 for women.
Include copy of requisition form with all patient evaluation forms

Enter Patient’s Name| Date of Birth | Sex | Social Security No. | Phone Number
Enter Date | Time sample was collected (if drawn onsite)
Check “Fasting” or “Non Fasting” (if drawn onsite)
Under Ordering Physician, enter your Name, UPIN/NPI, Phone Number, and Fax Number or your Quest
Account Number
Select appropriate blood tests:

Initial Evaluation: CP 317031 and 839 IGF-1
Follow-Up, Level 1: 4021 Estradiol, 745 Progesterone, 34429 T3 Free, 866 T4 Free, 899 TSH
Follow-Up, Level 1: 839 IGF-1, 4021 Estradiol, 745 Progesterone, 34429 T3 Free, 866 T4 Free, 899 TSH
Follow-Up, Level 3: CP 317031 and 839 IGF-1
Specimen requirements:
Initial Evaluation: 2 spun tiger tops, serum from 1 spun red top (no gel), 1 mL frozen serum
Follow-Up, Level 1: 2 spun tiger tops
Follow-Up, Level 2: 2 spun tiger tops, 1 mL frozen serum
Diagnosis and Plan

“Prescription Form for Women” available online at www.oh-labs.com/forms.html)
NOTE: The information below with illustrated examples is listed in Step 3 for women.
Premenopausal
Estradiol Level (CPT 82670)
pg/mL 1-19 20-49 50-89
Estradiol, liposomal gel 0.20% 0.10% 0.05%
Problem Solver
If symptoms of estrogen deficiency persist, increase dosage one level, i.e.: if patient was started at
0.10%, increase dosage to 0.20%.
If symptoms of progesterone deficiency are worse in 1st half of cycle, decrease estrogen dosage
one level, i.e.: started at 0.10%, decrease to 0.05%.
Premenopausal
Progesterone Level (CPT 84144)
ng/mL 0.1-3.8 3.9-7.5 7.6-11.2 11.3-14.9
Progesterone, liposomal gel 5% 4% 3% 2%
Problem Solver
If symptoms of progesterone deficiency are severe, instruct patient to apply gel days 11 - 25 as
opposed to days 15-24 of cycle.
If symptoms of progesterone deficiency are worse in 2nd half of cycle, increase progesterone
dosage one level, i.e.: started at 3%, increase dosage to 4%.
Menopausal
Page 52
Estradiol Level (CPT 82670)
pg/mL 1-19 20-49 50-89
Estradiol, liposomal gel 0.20% 0.10% 0.05%
Problem Solver
If symptoms of estrogen deficiency persist, increase dosage one level, i.e.: if patient was started at
0.10%, increase dosage to 0.20%.
Menopausal
Progesterone Level (CPT 84144)
ng/mL 0.1-3.8 3.9-7.5 7.6-11.2 11.3-14.9
Progesterone, liposomal gel 5% 4% 3% 2%
Free Testosterone Level (CPT 84402)

pg/mL 0.1-1.1 1.2-2.3 2.4-3.4 3.5-4.5
Testosterone, liposomal gel 0.5% 0.4% 0.3% 0.2%
DHEA Sulfate Level (CPT 82627)

ug/dL 10-86 87-162 163-238 239-314
DHEA, liposomal gel 0.5% 0.4% 0.3% 0.2%
Free T3 Level (CPT 84481)

pg/dL less than 350 less than 350 350 or greater
Armour thyroid (tablet)* 60 mg x 30 60 mg x 60 NA
*Schedule
Weeks 1 thru 2 – ½ 60 mg tablet 30 minutes before breakfast
Weeks 3 thru follow-up visit – 1 60 mg tablet 30 minutes before breakfast
Secretagogue
Monday thru Friday (away from meals) 1 sachet in morning, 2 sachets in evening
Monday thru Friday (away from meals) 3 sachets per day
Supplements
Supplements 1, 2 and 3: one of each in morning, one of each in evening
Page 53
Page 54
Step 1: New Patient Evaluation Form for Women, page 1 of 6
2. The patient must provide a valid shipping address; we cannot ship to P.O. Boxes.
3. Please ask the patient to provide a valid email address; we send important correspondence via email.
4. It's important to verify the method of payment; we accept Visa, MasterCard, Discover and American Express.
5. If the patient elects to submit their insurance, include a copy of the front and back of their insurance card. We do
not accept Medicare or Medicaid at this time.
6. The patient will be charged $375 for the Optimal Health Evaluation. Should the patient decide to enroll in the
Optimal Health Program, they will be billed every 4 weeks (see program options for details).
7. The patient must sign and date the Credit Card Authorization.
8. If the patient has provided their insurance information, they must sign and date the Insurance Authorization.
Page 55
1. The patient must sign and date the Waiver of Claims and Informed Consent.
Page 56
1. Lipid profile and blood pressure are often improved as a result of hormone optimization therapy. Risk of developing
heart disease may also be lowered.
2. In order to prescribe hormone optimization therapy, the patient must not have had cancer within the past 5 years.
3. The patient’s responses to the conditions listed help formulate whether or not the patient has symptoms consistent
with hormone deficiency.
4. If the patient is currently undergoing hormone optimization therapy, please prescribe according to the patient’s
current dosage level(s).
Notes:
Page 57
1. Emphasize the importance of avoiding recreational drugs, such as marijuana.

2. Note if the patient is taking a hormonal method of birth control as this may impact hormone blood test results.
3. For best results, it’s essential the patient maintains an adequate caloric intake with rich sources of protein and high
glycemic carbohydrates. Make sure the patient avoids foods high in sugar, fatty or fried and consumes alcohol only
in moderation. The patient should exercise with weights 3-4 times per week.
Notes:
Page 58
1. Depression, irritability, excessive emotions and nervousness can be caused by hormonal deficiencies.
2. Take note of any “yes” responses to questions 1 thru 19 as they may present contraindications specific to hormone
optimization and/or require consultation with the patient’s primary physician or examination by a specialist.
Notes:
Page 59
protocol.
2. Notes:
3. Notes:

Page 60
Step 2: Initial Evaluation Requisition Form
6. Select custom panel CP 317031 and 839 IGF-1. Please note that we recommend sending the patient to the nearest
Quest Diagnostics facility to have their blood drawn. To find the nearest Quest Diagnostics facility, go to
www.questdiagnostics.com and click on find a location.
Page 61
Page 62
Step 3: Prescription Form for Women – Level 1
NOTE: If the patient is premenopausal, start at number 1 and skip 4 thru 6. If the patient is menopausal, start at number 4.
2. Select the dosage in relation to the patient’s level of estradiol. For instance, if the patient’s level of estradiol is 26, select
0.10%.
3. Select the dosage in relation to the patient’s level of progesterone. Please note the patient’s symptoms of progesterone
deficiency (moderate or severe) and select the appropriate option. For instance, if the patient’s level of progesterone is
2.1 and displays normal symptoms, select 5% days 15-24. If the patient’s level of progesterone is 10.1 and displays severe
symptoms, select 3% days 11-25.
5. Select the dosage in relation to the patient’s level of estradiol. Example: the patient’s level of estradiol is 25, select 0.10%.
6. Select the dosage in relation to the patient’s level of progesterone. Example: the patient’s level is 3.2, select 5%.
7. NA
8. NA
9. Prescribe Armour thyroid in relation to the patient’s level of FT3. Be sure to follow the schedule - slow, increase gradually.
10. NA
11. NA
Page 63
0.10%.
7. NA
8. NA
11. NA
Page 64
0.10%.
7. Select the dosage in relation to the patient’s level of free testosterone. Example: the patient’s level is 0.8, select 0.5%.
8. Select the dosage in relation to the patient’s level of DHEA sulfate. Example: the patient’s level is 60, select 0.5%.
11. Select supplements 1, 2 and 3 for the patient.
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Page 66
Step 4: Follow-Up Evaluation for Women
1. If the patient’s insurance information has changed, make sure to enter the new information and include a copy of
the front and back of their insurance card.
protocol.
3. Notes:
4. Notes:
Page 67
Page 68
6. Select test codes 4021 Estradiol, 745 Progesterone, 34429 T3 Free, 866 T4 Free and 899 TSH. Please note that we
recommend sending the patient to the nearest Quest Diagnostics facility to have their blood drawn. To find the
nearest Quest Diagnostics facility, go to www.questdiagnostics.com and click on find a location.
a. Submit two (2) spun tiger tops (serum separator)
b. Call Quest Diagnostics for specimen collection.
Page 69
6. Select test codes 839 IGF-1, 4021 Estradiol, 745 Progesterone, 34429 T3 Free, 866 T4 Free and 899 TSH. Please note
that we recommend sending the patient to the nearest Quest Diagnostics facility to have their blood drawn. To
find the nearest Quest Diagnostics facility, go to www.questdiagnostics.com and click on find a location.
b. Submit (1) mL frozen serum
c. Call Quest Diagnostics and notify the representative you have a frozen specimen
Page 70
6. Select custom panel CP 317031 and 839 IGF-1. Please note that we recommend sending the patient to the nearest
Quest Diagnostics facility to have their blood drawn. To find the nearest Quest Diagnostics facility, go to
www.questdiagnostics.com and click on find a location.
b. Submit serum from one (1) spun red top (no gel)
c. Submit (1) mL frozen serum
d. Call Quest Diagnostics and notify the representative you have a frozen specimen
Page 71
Page 72
Sample Marketing Materials
Brochure Samples
Outside – Version 1
Page 73
Page 74
Page 75
Inside
Page 76
Postcard Mailer Samples
Front – Version 1
Page 77
Front – Version 2
Page 78
Front – Version 3
Page 79
Back
Page 80
Point of Sale with Brochure Samples
Point of Sale – Version 1
Page 81
Page 82
Page 83
Page 84
Email Template
Page 85
Page 86
Program Menus
Men
Page 87
Women
Page 88

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OPTIMAL HEALTH

GUIDELINES AND INSTRUCTIONS

Fax Medical Records to

Email Medical Records to

Protocol for Men ............................................................................................................................................ 13

Instructions for Processing Men

Protocol for Women....................................................................................................................................... 41

Sample Marketing Materials ......................................................................................................................... 73

Physician price $155, one time fee

Physician receives $200 administrative fee

Program for Men - Level 1

Physician price: $185 ($145 w/o blood analysis) every 4 weeks

Physician receives $50 administrative fee every 4 weeks

Program for Men - Level 2

Physician price: $245 ($195 w/o blood analysis) every 4 weeks

Physician receives $70 administrative fee every 4 weeks

Program for Men - Level 3

Physician price $315 ($235 w/o blood analysis) every 4 weeks

Physician receives $90 administrative fee every 4 weeks

Physician price $155, one time fee

Physician receives $200 administrative fee

Program for Women - Level 1

Physician price: $185 ($145 w/o blood analysis) every 4 weeks

Physician receives $50 administrative fee every 4 weeks

Physician price: $245 ($195 w/o blood analysis) every 4 weeks

Physician receives $70 administrative fee every 4 weeks

Program for Women - Level 3

Physician price $315 ($235 w/o blood analysis) every 4 weeks

Physician receives $90 administrative fee every 4 weeks

Level A commissions would be calculated as follows:

Level B commissions would be calculated as follows:

Level C commissions would be calculated as follows:

Optimal Level of Free Testosterone

Excess Estrogen (excess aromatase activity)

Three months - six months

Optimal Level of GH (IGF-1)

Excess muscle development

Excess sweating, difficulty sleeping

Enhancing Thyroid Levels

Optimal Level of DHEA Sulfate

Enhancing DHEA Levels

New Patient Evaluation

*Future data collection

Follow-Up Patient Evaluation

*Future data collection

Blood Sample Collection/Requisition Form

Include copy of requisition form with all patient evaluation forms

Diagnosis and Plan

Free Testosterone Level (CPT 84402)

DHEA Sulfate Level (CPT 82627)

Free T3 Level (CPT 84481)

4. Include a copy of the patient’s requisition form.

a. Submit two (2) spun tiger tops (serum separator).

a. Submit one (1) spun tiger top (serum separator).

a. Submit one (1) spun tiger top (serum separator).

a. Submit two (2) spun tiger tops (serum separator).

Optimal Level of Free Testosterone

Painful clitoral swelling or sensitivity

Excess DHT (excess 5 alpha reductase activity)

Optimal Level of Progesterone

Relative Estrogen Excess

Optimal Level of Estrogen (Estradiol)

Relative estrogen excess