Intestinal detectives

Little plastic pill bottles filled with a mucky, chocolate-brown substance sit on a counter, waiting to be processed at the nation’s largest lab for detecting intestinal parasites.

The parasitology lab is one of six at the Great Smokies Diagnostic Laboratory, which is tucked away on the picturesque campus of the former Highland Hospital in Asheville’ s Montford neighborhood.

And the chocolate-brown substance? You guessed it: Human feces.

By analyzing samples — including stool, urine, saliva, blood, hair or even breath — the lab gives medical professionals critical information about how their patients’ bodies are working.

“We’re asking the question, ‘Why is something wrong with you?’ as opposed to, ‘What is wrong with you?'” explains President/Chief Operating Officer Frank E. Taylor, sitting in his office in the historic Rumbough House. The ornate structure on Zillicoa Street houses several administrative offices, next door to the high-tech lab buildings.

The lab tests are part of an approach known as functional medicine. Using laboratory assessment and early intervention, functional medicine seeks to improve physiological, emotional, cognitive and physical function, according to company literature. Taylor calls functional medicine one tool in the alternative-medicine tool box.

“Certainly, we’re not a replacement for allopathic [or conventional] medicine,” says Taylor, adding, “This is a different approach, a different tool.”

You are what you digest

The belief that nutrition and digestion are important to good health is fundamental to the philosophy of the Great Smokies Diagnostic Laboratory, according to the lab’s Functional Assessment Resource Manual.

“You’ve heard the adage, ‘You are what you eat,'” says Gerry Pielack, the lab’s manager of multiplex analysis. “It’s not only ‘You are what you eat,’ but ‘You are what you digest and how you digest it.'”

Taylor, 46, bought into the lab’s philosophy when he took the company’s helm in July. He had his own battery of tests and, based on the results, made changes in his diet. (Before sitting down to the interview, in fact, Taylor downed a couple of dietary supplements with a glass of water.)

“My feeling is, when you enter something like this, you have to enter the experience,” he remarks.

The lab specializes in tests that evaluate digestion, nutrition, detoxification/oxidative stress, allergies, hormone function and cardiovascular workings. Lab employees analyze about 300,000 “kits” a year, Taylor says, each of which may require up to 20 individual tests.

The lab’s original — and still most popular — product is its comprehensive digestive stool analysis, which Pielack calls the company’s “flagship test.” It evaluates stool samples for digestion and absorption, bacterial balance and metabolism, yeast and immune status.

“This information gives someone a very great idea of how well your gut is doing,” says Taylor.

The test is designed for patients who may have irritable bowel syndrome, indigestion, malabsorption or other gastrointestinal problems.

Break it on down

Stool and other bodily samples come into the lab complex in lab kits patients get from their health-care providers, who order the kits from the lab. The patients collect their own samples and send them in.

Flags from 21 countries flap in front of the main lab building, which receives daily shipments of lab kits from practitioners in those countries via Airborne Express, the U.S. Postal Service and others. Workers open the kits, check the information provided by the senders, and enter the data into computers. The samples are then sent to one of the six labs (each has a different focus) for processing.

In the parasitology lab, workers perform a number of different tasks. One employee makes labels for the pill bottles, while others process stool samples so that slides can be made. Lab technicians sit at microscopes, examining slides for signs of intestinal worms and other parasites. The parasitology lab handled 65,696 specimens last year, according to lab officials.

In the microbiology lab down the hall, brightly colored solutions in hockey-puck-shaped containers are waiting to be examined.

“What makes us so unique and different is that we identify every single organism in the stool,” explains supervisor Trace Bates.

The tests performed in the chemistry lab are somewhat similar to what might be done in a hospital lab, but Great Smokies workers also perform other tests not available elsewhere, says supervisor Uta Levinson.

All the fecal samples must be processed before they can be examined. “That is a big challenge here, because the stool samples need to be processed and turned into clear samples,” Levinson says delicately.

But even here, a touch of whimsy is in evidence: A dream catcher, chimes and a mobile dangle from the chemistry lab’s ceiling. And those decorations are there to stay — given the potential for contamination in the lab environment, it would be unwise for the owners to take them home again, says Levinson.

Great Smokies employees may have two-year or four-year degrees, Levinson reports. Quite a few staffers are graduates of A-B Tech and UNCA. Each department also has a research scientist who works to develop cutting-edge tests, notes Pielack.

A strong, undefinable chemical smell pervades the labs. Sometimes, though, what wafts through the nostrils is all too definable.

In the microbiology lab, the bacteria being analyzed may smell like a compost pile, Pielack explains.

And, because patients are encouraged not to brush their teeth before providing saliva samples (to avoid possible contamination by blood), the result is containers of pure morning breath.

“You open the vial — ugh,” reveals Endocrinology Technician Mary Deaton.

Employees combat the smell with room deodorizers.

On the plus side, most of the labs have windows overlooking the pastoral campus.

Deaton works in the radioimmunoassay lab, where saliva samples are analyzed for male and female sex hormones, as well as for melatonin and other substances. A woman experiencing menstrual irregularities, for example, would provide 11 saliva samples over her 28-day menstrual cycle. The samples would be analyzed for their hormonal components, which could provide clues to her problem.

In the immunology lab, workers examine blood samples for signs that the patient may have allergies — to specific foods, grasses, cat dander, dust mites or other irritants.

“We have many people that have food allergies that lead to other serious complications,” Taylor says.

Another building, formerly a hospital laundry, now houses other labs performing such esoteric tests as liquid chromatography, which analyzes the amino acids present in urine. That information, Pielack explains, can provide clues about a patient’s nutritional status.

In yet another lab, industrial-strength microwave ovens reduce hair samples to a clear, yellow solution. After processing, the samples can be analyzed for nutrients such as calcium and sodium, and toxins such as arsenic, cadmium, lead and mercury.

“When it all comes down to it, this can tell you what you really are,” says Fred Boeheim, supervisor of elemental analysis.

Once the various analyses are completed, the information is compiled in color-coded reports, complete with detailed commentary, that are sent off to the patient’s medical practitioner. Reporting results to practitioners over the Internet via encrypted accounts is another cutting-edge service the company offers, notes Taylor.

The analyzed samples are kept for 30 days. After that, the biohazardous waste is sent off-site for proper disposal, he reports.

Making the problem go away

The lab’s work doesn’t necessarily end with the initial analysis, either. Once a person makes dietary or other changes, they often submit new samples, to see if it has corrected the problem.

“We’re trying to make the problem go away — not cover [it] up,” says Taylor.

Since the company works exclusively through health-care practitioners, you can’t walk up to their doors with a sack of bodily outtakes and expect an analysis. But you can request test kits through any of 7,000 medical professionals in the U.S. and 20 other countries, Taylor explains.

About 60 percent of the lab’s clients are medical doctors; the rest include naturopaths, chiropractors, osteopaths and acupuncturists.

Founded in 1986, the Great Smokies Diagnostic Laboratory is certified by the College of American Pathologists, company officials note with pride.

And, pooper-snooper jokes aside, the privately held company isn’t anything to sniff at: It has 270 employees and grosses about $30 million annually. Taylor’s goal is to boost revenues to $100 million within three years.

“The field is exploding. The whole aspect of people taking care of themselves and deciding on a different way to be treated is exploding,” he declares, promising, “We’re going to be a beneficiary of that growth.”