SAMPLE. dd/mm/yyyy SAMPLE. Patient Name. Patient Date of Birth. Test Analysis. Date Completed. Disclaimer

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Patient Name SAMPLE Patient Date of Birth dd/mm/yyyy Test Analysis SAMPLE Date Completed Disclaimer

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1 Patient Name SAMPLE Patient Date of Birth dd/mm/yyyy Test Analysis SAMPLE Date Completed Disclaimer Please note we do not provide medical advice or services. If you have health disorders, medical conditions, or any condition needing medical supervision you should consult your doctor or medical professional. All products and services are provided for educational purposes and research purposes only and are not intended to be a substitute for a proper medical consultation; and the site, services, products and materials may support the relationship between you and your healthcare provider, but are not intended to replace it. They should not be used as a substitute for professional diagnosis and treatment. If you suffer from any health condition you must consult your doctor or medical professional. We do not recommend self-diagnosis or self-medication, and no information within our site or presented by us or our associates may be construed or interpreted as recommending self-diagnosis or self-medication.

PATIENT FIRST NAME : PATIENT SURNAME: DATE OF BIRTH: GENDER: ADDRESS: Comprehensive Brain Assessment Test Name Urinary Inhibitory Neurotransmitters Serotonin 5-HIAA GABA Glycine Urinary Excitatory

2 PATIENT FIRST NAME : PATIENT SURNAME: DATE OF BIRTH: GENDER: ADDRESS: Comprehensive Brain Assessment Test Name Urinary Inhibitory Neurotransmitters Serotonin 5-HIAA GABA Glycine Urinary Excitatory Neurotransmitters Glutamate Histamine PEA Dopamine DOPAC HVA Norepinephrine (pooled) Normetanephrine Epinephrine (pooled) Ratio: Norepi/Epi VMA Urinary Creatinine Result Range µg/g Cr (Optimal ) µg/g Cr (Optimal ) µg/g Cr (Optimal ) mg/g Cr (Optimal ) µg/g Cr (Optimal ) µg/g Cr (Optimal ) µg/g Cr (Optimal ) µg/g Cr (Optimal ) 2838 H µg/g Cr (Optimal ) µg/g Cr (Optimal ) µg/g Cr (Optimal ) µg/g Cr (Optimal ) 11.2 H µg/g Cr (Optimal ) 1.6 L (Optimal ) µg/g Cr (Optimal ) Creatinine (pooled) mg/ml <dl = Less than the detectable limit of the lab. N/A = Not applicable; 1 or more values used in this calculation is less than the detectable limit. Therapies Page 1 of 6

3 Name **Category Symptom None Mild Moderate Severe Burned Out Feeling Apathy Difficulty Sleeping Increased Forgetfulness Decreased Mental Sharpness Depressed Mental Fatigue Irritable Nervous Anxious Morning Fatigue Evening Fatigue Decreased Stamina Decreased Muscle Size Sore Muscles Increased Joint Pain Decreased Flexibility Neck or Back Pain Weight Gain - Breast or Hips Weight Gain - Waist Elevated Triglycerides Sugar Craving Heart Palpitations Dizzy Spells Headaches Ringing In Ears Cold Body Temperature Allergies Sensitivity To Chemicals Decreased Erections Decreased Libido Prostate Problems Decreased Urine Flow Increased Urinary Urge Hot Flashes Night Sweats Bone Loss Stress Rapid Aging High Cholesterol Swelling or Puffy Eyes/Face Slow Pulse Rate Decreased Sweating Hair Dry or Brittle Nails Breaking or Brittle Thinning Skin Infertility Problems Constipation Rapid Heartbeat Hearing Loss Goiter Hoarseness Low Blood Sugar High Blood Pressure Low Blood Pressure Numbness - Feet or Hands Oily Skin or Hair Acne Aggressive Behavior Prostate Cancer Metabolic Syndrome 14.3 Hypometabolism 14.9 High Cortisol 35.4 Low Cortisol 19.3 High Androgens (DHEA/Testosterone) 16.7 Low Androgens (DHEA/Testosterone) 25.9 Estrogen Dominance / Progesterone Deficiency 14.8 Estrogen / Progesterone Deficiency 21.4 **Category refers to the most common symptoms experienced when specific hormone types (eg estrogens, androgens, cortisol) are out of balance, i.e., either high or low. Page 4 of 6

4 Name Lab Comments INHIBITORY NEUROTRANSMITTERS SEROTONIN Serotonin is within reference range. Serotonin has calming effects and contributes to the feelings of well-being. Serotonin elevates mood, decreases anxiety, appetite, and libido, improves sleep and memory, eases depression, and helps regulate body temperature. Most of serotonin in the human body is produced in the gastrointestinal tract, where it stimulates gut motility. 5-HIAA 5-hydroxyindoleacetic acid (5-HIAA) is high normal (>80th percentile). 5-HIAA is the primary metabolite of serotonin via the actions of monoamine oxidase and aldehyde dehydrogenase enzymes. Research shows that high urinary 5-HIAA levels are detected in men with hypogonadism (Shakir et al., 1996;Yu and Wolin, 2012). In a clinical setting, high 5-HIAA levels are associated with oxidative and immune stress. Treatment Considerations: Therapies to slow MAO activity with supplements like Curcumin, berberine, and many other herbs and spices or a medication MAO inhibitors may be beneficial.. GABA GABA is within the reference range. The brain's major inhibitory neurotransmitter GABA functions as the off switch in the brain. GABA is essential to limiting excitation so that input signals are balanced and not overdone. GABA prevents anxiety, improves mood, promotes sleep, lowers blood pressure, acts as a muscle relaxant, aids in formation and storage of fear memories, increases insulin secretion and decreases blood glucose levels. GLYCINE Glycine is within normal range. Glycine plays a dual role as a neurotransmitter and a building block of proteins. Glycine serves as an anti-inflammatory agent, calms aggression, improves sleep quality, regulates locomotion, stabilizes blood sugar, and modulates excitatory signals in the brain. EXCITATORY NEUROTRANSMITTERS GLUTAMATE Glutamate is low-normal (< 20th percentile). The brain's major excitatory neurotransmitter glutamate functions as the "on" switch in the brain. Glutamate regulates appetite, thinking, increases gut motility, optimizes learning, modulates memory, improves libido, and decreases sleep. Low urinary glutamate levels have been reported in patients with migraines (Ragginer et al., 2012). Clinically, lower glutamate levels may contribute to agitation, depression, chronic fatigue, lack of concentration, low energy levels, and sleep difficulties. THERAPEUTIC CONSIDERATIONS:: L-glutamine may be beneficial to restore glutamate to normal values. HISTAMINE Histamine is within reference range. Histamine plays a dual role in the body as a neurotransmitter and a modulator of the immune system. Histamine has anti-pain properties, plays a neuroprotective role in the brain, and contributes to optimal maintenance of cognition and memory. Histamine stimulates wakefulness and decreases sleep, stimulates gastric acid production, increases metabolism, suppresses appetite, and prevents weight gain. Histamine is a potent vasodilator and a pro-inflammatory agent. PEA PEA is within reference range. PEA, also known as phenethylamine, promotes energy, elevates mood, and regulates attention. PEA also contributes to aggression, serves as a biomarker for ADHD, and prolongs the signaling of dopamine, norepinephrine, and serotonin. DOPAMINE Dopamine is within reference range. Dopamine improves attention, focus, and motivation, helps with decision making, modulates movement control, promotes lactation, increases blood pressure, urine output and sodium excretion, and allows for feelings of reward and pleasure. Additionally, dopamine plays a central role in the etiology of addiction. Dopamine also serves as the parent precursor to norepinephrine and epinephrine. DOPAC DOPAC is elevated. DOPAC is the primary metabolite of dopamine formed via the actions of monoamine oxidase. Research shows that DOPAC is elevated in patients with anorexia nervosa (Van Binsbergen et al., 1991). Page 5 of 6

5 HVA HVA, a dopamine metabolite, is high-normal. Elevated HVA levels may be associated with anxiety, hyperactivity, inability to focus, mood swings, poor GI function, psychosis, and sleep disturbances. High levels of HVA can result from the use of medications such as L-dopa, methyldopa, clozapine, SSRIs, tricyclic antidepressants, or metoclopramine (Davidson, et. al. 2005; Zendron, et. al. 2004). Examples of supplements that can elevate HVA are Mucuna Pruriens (contains L-dopa) and flavonoids, such as quercetin (Weldin, et. al. 2003). HVA resulting from supplementation with plant precursors may have enhance brain function, but are rarely associated with adverse symptoms seen with high endogenous levels. Research shows that HVA is elevated in patients with anorexia nervosa (Van Binsbergen et al., 1991); lead toxicity (Tang et al., 1995); coper, cadmium and/or iron toxicity (Wu, et. al. 2017); exposure to polychlorinated biphenyls (Putschogl, et. al. 2015); functional dyspepsia (Wachowska-Kelly, et. al. 2016); candida infection (Shaw, 2017); obsessive compulsive disorder (de Groot et al., 1995); and stress (Frankenhaeuser et al., 1986). High endogenous production of HVA is rare, and may indicate the presence of a neuroendocrine tumor (Barco, 2014). TREATMENT CONSIDERATIONS: Evaluation of supplements for precursors or known triggering agents. Consider imaging if neuroendocrine symptoms are problematic and levels are likely endogenous. NOREPINEPHRINE Norepinephrine is within reference range. Norepinephrine functions both as a neurotransmitter and a hormone, participating in the body's "fight or flight" response. Norepinephrine increases alertness, focuses attention, fine-tunes vigilance, increases blood pressure, heart rate, and blood sugar, reduces digestive activity, pain, and sleep, prevents bladder emptying, and regulates body temperature. Norepinephrine is very similar in structure and physiological effects to epinephrine. The adrenal gland produces approximately 20% of the total output with 80% produced by the sympathetic nerve fibers. NORMETANEPHRINE Normetanephrine is within reference range. Normetanephrine is a norepinephrine metabolite formed via the actions of catechol-omethyl (COMT) transferase enzyme in response to stress. EPINEPHRINE Epinephrine is elevated. Epinephrine, also called adrenalin, functions both as a neurotransmitter and a hormone, participating in the body's fight or flight response. Epinephrine increases alertness, focuses attention, fine-tunes vigilance, increases blood pressure, heart rate, and blood glucose, reduces digestive activity, pain and sleep, prevents bladder emptying, and regulates body temperature. The majority of catecholamines produced by the adrenal glands is epinephrine. Research shows that urinary epinephrine levels are increased in patients with attention deficit disorder (Faraone et al., 2014), anxiety and depression (Hughes et al., 2004), bipolar disorder (Koslow et al., 1983), hyperglycemia (Troisi et al., 1991), hyperinsulemia (Troisi et al., 1991), obstructive sleep apnea (Kheirandish-Gozal et al., 2013), post-traumatic stress disorder (Yehuda et al., 1992), and stress (Holzman et al., 2009;Fujiwara et al., 2004). In rare cases, epinephrine is elevated in patients with adrenal lymphangioma, pheochromocytoma (Carr et al., 2013), and paraganglioma (Eisenhofer and Peitzsch, 2014). THERAPEUTIC CONSIDERATIONS: Testing for levels of copper and zinc may be helpful to make sure that sufficient levels of these elements are present to properly metabolize epinephrine. Adrenal adaptogens and GABA may also be helpful to calm the epinephrine response. NOREPINEPHRINE/EPINEPHRINE RATIO NE/E ratio is lower than the reference range. Norepinephrine and epinephrine function both as neurotransmitters and hormones, participating in the body's "fight or flight" response. Norepinephrine and epinephrine increase alertness, focus attention, fine-tune vigilance, increase blood pressure, heart rate, and blood sugar, reduce digestive activity, pain, and sleep, prevent bladder emptying, and regulate body temperature. Epinephrine is derived from norepinephrine via the actions of phenylethanolamine N- methyltransferase (PNMT). High concentrations of cortisol enhance the expression of PNMT, potentially contributing to higher levels of epinephrine and thus decreasing the NE/E ratio. Additionally, a low NE/E ratio can be associated with severe mental illness (Ostroff et al., 1985). VMA Vanillylmandelic acid (VMA) is within reference range. VMA is a norepinephrine and epinephrine metabolite formed via the actions of monoamine oxidase, catechol-o-methyl transferase (COMT), and aldehyde dehydrogenase. Creatinine is within range showing normal concentration of urine. Page 6 of 6

TEST REPORT # SB. Patient Name: Comprehensive Male Profile I Patient Phone Number: TEST NAME RESULTS 08/12/18 RANGE

TEST REPORT # SB. Patient Name: Comprehensive Male Profile I Patient Phone Number: TEST NAME RESULTS 08/12/18 RANGE TEST REPORT Ordering Provider: David Getuwell, MD 8605 SW Creekside Place Beaverton, OR 97008 Phone: 503-466-2445 Fax: 503-466-1636 Samples Received 08/15/2018 Report Date 08/20/2018 Samples Collected