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Julie McGregor, MD
Will Pendergraft, MD, PhD

5915 Farrington Road, #106
Chapel Hill, NC 27517
Telephone: (984) 999-0902

The Science of Testing on the Path to Healing

It’s often noted that healing embraces both art and science—with a practitioner’s experience, intuition, and manner forming the art, and testing providing the science in the healing process.

Dr. Pendergraft (left) and Dr. McGregor prepare specimens for testing in the Clinic’s laboratory.

When used in harmony, these two elements of medical practice hold great power to heal through the discovery of often well-masked biological defects and an understanding of the larger, whole-health picture.

Striking that balance of art and science in their practice is the mission of Dr. Julie McGregor and Dr. Will Pendergraft, physicians and co-founders of the Integrative Medical Clinic of North Carolina in Chapel Hill (IMCNC).

And they explain that although testing is an important part of their practice, they tend to focus more on the precision of the testing they order. “At IMCNC,” Dr. McGregor says, “we tend to do less of the broad-based testing you may find in a more conventional medical clinic. One of the reasons for this is that we are an insurance-based practice, so we do our very best to work within the limits of what insurance will pay for. There are definitely complex mysteries that require us to broaden the scope of our testing, and these are not always covered by insurance. But we want to at least start with tests that are.

“Our goal is to use our clinical skills, our experience, and the patient exam and history to narrow down the likely causes of illness,” she continues. “Once we have two or three likely suspects, investigative testing then becomes more useful. Often, we will even be quite certain of a diagnosis based on the patient’s history and exam, and then testing will help us confirm that diagnosis or will guide us down an even more accurate path.”

Complex Health Problems:
Viruses, Infections, Autoimmune Disorders

The doctors note that many—perhaps the majority—of their patients come to the practice with complex, challenging health issues. “Often,” says Dr. Pendergraft, “they have not even gotten a clear diagnosis of their problem—despite having completed a battery of standard tests—and have simply been told no cause for their symptoms could be found.

“What we often find in such cases is that routine testing has been insufficient, and for that reason, our standard procedures include tests for infections. We look for tick-borne illnesses, chronic viruses, and do a lot of unconventional vitamin and mineral testing,” he explains. “We also often do extensive auto-immune panels, looking for the presence of antibodies not commonly tested for in a routine physical.

“Some complaints can be tricky,” he continues. “Patients may come in with really sore joints and simply feeling generally awful. They’ve been to numerous doctors and been checked for everything. What often isn’t looked for, however, is what has been there in the past but may not be acutely present. Viruses—such as Epstein-Barr virus (EBV), Cytomegalovirus, or Herpes Simplex virus—are a good example. A virus may have been cleared by the immune system years ago, but patients with these vague symptoms of pain, headache, and fatigue will often test strongly positive for past exposure.”

“This is significant,” says Dr. McGregor, “because emerging data suggest these viruses actually integrate into our genomes, allowing them to cause damage long after the active virus itself has cleared. Basically,” she explains, “something like the Epstein-Barr virus integrates into the genetic coding and essentially hijacks our own transcriptional machinery. So, if you look at all the different autoimmune diseases, what you’ll find is that EBV has been incorporated into the genomes of those people, and years down the road starts turning around transcription factors that are pro-inflammatory. This process puts people at huge risk of developing an autoimmune syn-drome. It’s something people rarely think about, but that we see a lot of.”

A recent example of this, Dr. Pendergraft recalls, “is a patient who had been going back and forth to the ER with symptoms for which no one could find a cause; and it all started with a steroid injection in her back. So, we decided to check out her viral state—and the result was a blowout for Epstein-Barr virus. It’s likely that she got the original virus years ago and that the recent steroid injection—which is an immuno-suppressant—allowed more of that transcriptional machinery to be activated, producing her EBV symptoms.”

The Science and Art of Healing

While testing may be the science of healing, there is an art to the process as well. Testing can lead to answers, but what to test for and where to start can be a mystery all of its own, the doctors explain.

“First, patients have to talk to us,” Dr. Pendergraft says. “And we have to listen. It’s your body and your life experience, so your insights about what’s going on with you are invaluable. Thus, brainstorming with patients is critically important in our approach to testing and our working diagnoses.”

Dr. McGregor wholeheartedly agrees, adding that “another important component in this work is testing for what works and what doesn’t. Sometimes a patient will present with very complex or vague symptoms, and all our standard testing shows nothing.

“It’s clear we need to look deeper into the problem, so then the question becomes where do we dig?In these cases, it can sometimes be helpful to actually work backwards by testing potential treatments to see what works and what doesn’t. If a steroid injection helps, for example, now we know an inflammatory process is a possible or likely contributor to whatever is going on, even if our initial testing didn’t flag the prospect of systemic inflammation. With this information, the field of tests and potential diagnoses gets narrowed down.”

Dr. Pendergraft adds, “It’s also important for the patient to understand that our commitment to testing is not simply as a diagnostic tool—but is, in fact, a vital ingredient in developing and monitoring a treatment plan. In our practice, we highly value what we might call ‘collaborative testing,’ as we work with our colleagues—nutritionists, energy healers, naturopaths, and others—in developing a holistic, comprehensive treatment plan that incorporates their evaluations and expertise.”