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  • Food allergies, food intolerance and food sensitivities...what's the difference?

    Many of us are aware of and may even know someone that has a negative reaction to food. Maybe it’s your best friend that has to avoid shellfish or a family member that avoids peanuts. In these situations, these are most likely food allergies and can be quite severe leading to hives, wheezing and even anaphylaxis. Maybe you experience gas, bloating or diarrhea after consuming dairy – classic food intolerance. But have you ever given thought to food causing symptoms like: Headaches/Migraines Joint or muscle pain/stiffness Sinus congestion, pain or post nasal drip Fatigue, anxiety, depression Other GI symptoms such as heartburn, abdominal pain or nausea Skin issues like rashes, eczema or psoriasis These can be classic symptoms of food sensitivity. So how do you know if you have a food allergy, intolerance or sensitivity? While many people (including some healthcare practitioners) tend to lump allergy, sensitivity and intolerance all together there are very specific differences between all three. Food Allergy Also known as a Type 1 hypersensitivity reaction is the attack that is launched by IgE antibodies, which cause mast cells in your tissues to “degranulate” (break apart) and release histamine and other chemicals that cause the traditional symptoms of allergy. Reactions or symptoms typically occur within a short period of time (sometimes just minutes) of eating the offending food and can range from hives and itching to swelling of the face, tongue or lips, abdominal pain, nausea, vomiting diarrhea, dizziness, wheezing, nasal congestion or life-threatening anaphylaxis. The top 8 Food Allergens are: 1. Peanuts 2. Shellfish (such a crab, lobster, shrimp) 3. Fish (such as bass, flounder, cod) 4. Eggs 5. Tree nuts (such as almonds, cashews, walnuts) 6. Cow’s milk 7. Soy 8. Wheat Food Intolerance Intolerance does not involve the immune system at all. Food intolerance is much more common than allergies or sensitivities and occur when the body lacks the correct enzyme to break down a food/food component. An example of this would be lactose intolerance, which is very common and is caused by the body’s reduced or absent production of the enzyme lactase which is what breaks down the sugar in milk called lactose. When there isn’t enough lactase, lactose remains undigested and passes into the large intestine which creates an osmotic effect increasing fluid into the large bowel and results in pain, gas and diarrhea. It’s also possible to be intolerant to other sugars in foods like fructose (fruit sugar) but is less common. A person can also be histamine intolerant (meaning the body is unable to break down histamine in foods) or amine intolerance (in aged foods). Food intolerances are treated by avoiding the food that you have trouble digesting, taking digestive enzymes with meals or consuming products that already contain the necessary enzymes (like Lactaid products which are enriched with lactase). Food Sensitivity Food sensitivities do involve the immune system but they do NOT involve IgE antibodies and unlike allergies, sensitivity reactions are often delayed by up to 72 hours after ingestion (crazy right? I mean how is anyone supposed to determine what may be bothering them from three days ago? More on this in a bit). There are two different types of sensitivity reactions that can occur (in a nutshell): Type 3 hypersensitivity reaction which occurs when IgG and/or IgM antibodies (which are different than the IgE involved with true allergies) attach to offending food antigens in the bloodstream and form immune complexes. Once these immune complexes reach and attach to tissue, your immune system gets signaled that an invader is present and white blood cells go to the area and release “chemical mediators” in an attempt to destroy the immune complex. These mediators can lead to inflammation and damage in the tissue which is what leads to symptoms (because they are really meant to be fighting infection). Type 4 Hypersensitivity doesn’t involve any antibodies but instead T cells decide that the food antigen is a threat; which stimulates the white blood cells to release the mediators previously mentioned that leads to inflammation, pain and other symptoms. Since food sensitivities are not mediated by IgE antibodies and mast cells, traditional allergy testing will not work for identifying them. How do food sensitivities get identified then? The most accurate way to identify food sensitivities currently is with MRT (Mediator Release Test). This blood test measures your body’s inflammatory response to food no matter what pathway triggered them (IgG, IgM, T-cells etc.) so that you can know what foods are or are not contributing to your food sensitivity symptoms. With that being said, having the test results and not knowing how to apply them is only going to be so effective. Many times, practitioners that do some type of food sensitivity testing (whether MRT or IgG only), will typically tell you to avoid your reactive foods BUT by taking that approach, there most likely is still offending foods in your diet. There is NO way to test every food out there…… The BEST way to be tested for food sensitivities is to work with a Certified LEAP Therapist (CLT). CLT’s are certified in food sensitivities, the MRT test and the therapeutic diet using test results known as LEAP (which is what produces the best results quickly!). To find a CLT, you can search near you on Healthprofs or depending upon your states licensure and telehealth laws, you may be able to work remotely with a CLT (like me!). Wondering if your symptoms might be related to food sensitivities? Let's chat! Get started by scheduling an initial visit. Photo Courtesy of Oxford BioMedical Technologies

  • How Long Does Gluten Stay in Your System After You Stop Eating It?

    Gluten is one of the most common food allergens that people are exposed to on a regular basis. For some, it's just an inconvenience; for others, it can be life-threatening. If you want to see symptom relief, how long does gluten stay in your system? You may be wondering: if you're going gluten-free or have already done so, how long does gluten stay in your system after you stop eating it? It's important to know how long gluten stays in your body and what you should do about it. This article will help answer that question and more! Photo Credit: Polina Rytova on Unsplash Real quick: what is gluten? Gluten is a protein that naturally occurs in wheat, barley and rye. In people with celiac disease it can cause serious damage to the small intestine if consumed. For this reason, many people who have been diagnosed with this condition must go on a gluten-free diet for life. This means avoiding foods that contain gluten: wheat (ALL forms including spelt, Eikhorn etc.), rye, barley and anything made from those grains...which is a lot, once you really start looking at labels. If you don't have a reaction to gluten, there is no reason to avoid it. Protein digestion Gluten is an example of just one of the many proteins found in our food. And whether we’re talking about beans, eggs or gluten, digestion of proteins follows the same steps and timeline. Proteins are enormous molecules that are made up of amino acids. Our body does the hard work of taking proteins apart into their individual parts so that they’re small enough to be absorbed in the small intestine. The timing varies from one person to another, but in general, the digestion of proteins doesn’t take any longer than a day or two ( 1 ). So while non-expert bloggers are quick to claim that gluten will “remain in your system” for weeks or even months, it simply isn’t true. What is true, however, is that the inflammation reaction to gluten can last for a very long time. Let’s talk about that fine print, now. Photo credit: Wesual Click on Unsplash. Lasting reactions to gluten Your body having an overreaction to gluten – such as gluten intolerance – can last for a while, even if the protein is completely out of your system. This varies by person, but can last for weeks or even months. This all depends on the degree to which your gut has been affected by the gluten, how thoroughly you’re able to remove all gluten from your diet as well as how well you’re nourishing your body with the right nutrients to be able to optimize recovery. Who needs to avoid gluten? There are a lot of people who need to avoid gluten, and how long they have to stay away from it will depend on how severe their reaction is. For some with milder symptoms or less-severe conditions like dermatitis herpetiformis (which causes skin problems), avoiding eating gluten for just three days can help clear up the issue. If you have a diagnosis of any of the following conditions, you may need to avoid gluten for a time (long enough to reduce inflammation and heal leaky gut) or you may need to avoid gluten for life. And while it can seem like food allergies and intolerances are the same thing, they actually aren’t. More on that here: Food allergies, food intolerance and food sensitivities...what's the difference? What are the symptoms of gluten intolerance? If you're having a negative reaction to gluten, what does that look like or feel like? It can be remarkably different from one person to the next. Allergy If you're having a gluten allergy (which is quite rare and not to be confused with a wheat allergy) or celiac disease, you'll experience an immune response in your small intestine ( 2 ). Symptoms of wheat allergy are like that to a peanut allergy: Itchy mouth, lips or throat Difficulty breathing Headaches Cramps, diarrhea Celiac disease Celiac disease is an autoimmune condition in which the body self-destructs and attacks its own living tissue. In this case, the immune system attacks the cells of the digestive system, causing damage. The damage can accumulate over time (and takes a while to heal, once the person has an accurate diagnosis and is able to fully eliminate gluten from his or her diet.) Celiac disease symptoms can include ( 3 ): Diarrhea and belly pain Unintended weight loss Nutritional deficiencies Brain fog Fatigue And the last known reaction to gluten? Gluten intolerance, otherwise known as gluten sensitivity. Gluten intolerance If you're having a gluten intolerance the symptoms will involve how food makes you feel or how it affects other parts of your body like how well you sleep. Some people who are intolerant to gluten report issues with their digestion, just not quite as quickly as with an allergy ( 4 ). Symptoms may include: Bloating, belly pain, diarrhea Headache and brain fog Fatigue Joint pain Anemia Depression You may have noticed that some of the symptoms overlap. So, how do you know which condition you have related to gluten, if any? How do you know if you have gluten intolerance? While there is currently no one specific test available to determine gluten intolerance/sensitivity, if you have been tested for celiac and are negative then you can give the removal of gluten a try and see if you feel better. One thing to keep in mind though, is that gluten containing foods (such as wheat, rye and barley) are also high in the FODMAP fructan so it might be the FODMAP and not the gluten that is causing an issue. Sometimes determining if there is a gluten intolerance requires looking at the big picture and working with a clinician that can help put the pieces of the puzzle together. For example, I use MRT testing, a blood test, to see how my clients are reacting to gluten-containing grains and other potential food offenders. I also use GI MAP to help identify if gluten may be an issue since it looks at markers such as zonulin and anti-gliadin IgA. While intestinal biopsy is an option for testing to see if you have celiac disease, it isn’t an accurate measure for gluten sensitivity . Those with gluten sensitivity don’t have the same measurable damage to their intestine as those with celiac ( 5 ). ( P.S. This is why gluten sensitivity was considered to be a fake syndrome for so long - the usual testing wasn’t able to detect anything wrong. Turns out we just needed a different tool to be able to test for the different condition.) How do you know if you have celiac? There are three ways to test for celiac disease. Do an intestinal biopsy to note the damage to your intestine Do blood testing to look for the antibody to gluten Genetic testing If you are suspicious that you have one of the above three reactions to gluten, should you just stop eating it? Should I just stop eating gluten? No! Let me be crystal clear here: if you suspect that you have celiac disease, do NOT stop eating gluten before doing testing. The blood testing measures a reaction to gluten. If you’re not eating gluten, we cannot measure the reaction. This creates a “false-negative” test result. The test says that you do not have a reaction to gluten, but it isn’t actually true. And without the reaction to gluten, you also will not be able to see the damage done with a biopsy (Or the biopsy will be skipped based on the false-negative reaction from the blood testing). If you have celiac disease, it's critical that doctors know how much damage your intestines have already sustained. [1] [2] [3] When gluten enters the digestive system and starts its trip through the small intestine, a person with undamaged intestines might only experience mild bloating or discomfort at worst from eating too many noodles. Will Going Gluten Free Help My IBS? A GI Dietitian Explains. Photo Credit: Jose Aragones on Unsplash What if I have already stopped eating gluten? Because the blood testing looks for markers that your immune system is responding to gluten , you won’t be able to measure them if you’ve been avoiding gluten for a while. This means you cannot accurately test for a reaction to gluten without eating gluten. Before you can do testing, you’ll need to eat gluten. I know that this can feel scary, but it is the only way to get accurate results. The recommended gluten intake will range from 1-2 servings per day for 2-8 weeks before testing ( 6 ). Bread is usually one of the easiest ways to incorporate gluten into the diet before testing. For my clients, especially if you’re eating gluten for the first time in a while, I recommend eating spelt bread, or even spelt sourdough bread. Spelt contains gluten but tends to be a bit better tolerated. I’m stopping gluten: how long will it stay in my system? The gluten proteins themselves are only physically in your body for a day or two. Normal digestion is fast and efficient. However, if you’re having an immune reaction to gluten, the inflammatory response to having eaten gluten can stick around for a while. Especially if your gut is damaged during the process, causing a leaky gut. You need to heal your leaky gut before you see the most complete remission of your symptoms. Unfortunately, that isn’t a fast process either, but I can help make it as efficient as possible for you. How Long Does It Take to Heal a Leaky Gut? Key takeaways: how long does gluten stay in your system If you suspect that you’re having a reaction to gluten, keep eating it long enough to do thorough testing. While the treatment – avoiding gluten – may be the same, there is no reason to avoid gluten unless you’re 100% sure it is causing your symptoms. If you’re ready to see remission from your digestive health issues, reach out! Get started by scheduling an initial visit. Discover the Low FODMAP Diet :  Your Gut's New Best Friend! Learn how the Low FODMAP Fix Diet can help you identify  food triggers, manage symptoms, and regain control of your digestive health. Take the FIRST   step towards a happier gut with the Low FODMAP Fix!

  • Is IBS a Real BS Diagnosis You Shouldn’t Settle For?

    Sound harsh? Maybe. But I say this from a place of genuine caring and the desire to help you understand what IBS really is (and isn’t). I get it, you have felt bad for so long, the symptoms that you experience are very real and have a huge impact on your life; they may cause you to miss work or not be as productive while you are there, to miss out on plans with family or friends because you are afraid to leave the house (and the comfort of your own bathroom) or you may not be as active as you once were because let’s face it who wants to get outside on a 5 mile walk, run or hike (or be in the middle of kickboxing class at the gym that you used to love) and risk having diarrhea hit? Right? You’ve gone to your doctor, you’ve have had probably what seems like an endless number of tests done and finally, you get diagnosed with IBS – irritable bowel syndrome. Yeah! There you have it, the answer you have been seeking, right? Wrong and here’s why. You see IBS while technically is a diagnosis, in reality it is a label, a description of what your symptoms are but it doesn’t tell you WHY you have the symptoms that you do (I mean think about it....WHY is your bowel irritable anyway?) That’s why I’m encouraging you to keep looking, to not accept this diagnosis as the be all, end all because if you do decide to learn to live with this label, then you are making a terrible mistake that’s bound to keep you feeling miserable. There is much more that you can do, that you can take charge of that your doctor most likely didn’t talk you about and YOU, your health is worth fighting for! So let’s talk a bit more about IBS and I will show you what I mean...... The Medical Definition of IBS The technical criteria for diagnosing IBS is set by the Rome Foundation which is “independent not-for-profit organization that provides support for activities designed to create scientific data and educational information to assist in the diagnosis and treatment of functional gastrointestinal disorders (FGIDs)” (1) New Rome IV criteria for diagnosing IBS states that (2): Recurrent abdominal pain, “should be present at least 1 day per week during the previous 3 months” and be: – Related to defecation and/or – Associated with a change in frequency of stool and/or – Associated with a change in form (appearance) of stool Criteria fulfilled for the last 3 months with symptom onset at least 6 months before diagnosis. Even though the new Rome criteria has been updated, it’s still pretty broad and it’s no surprise then how many people will fit these criteria and be diagnosed with IBS. Also, as you can see the Rome criteria describes a set of symptoms but offers no explanation for WHY does someone have abdominal pain at least 1 day per week? WHY might the pain be relieved with defecation? WHY does someone experience a change in the frequency or appearance of stool? These are questions that have to be answered in order for you to get feeling better. Why you shouldn’t settle for an IBS diagnosis A “diagnosis” is a label given to a consistent group of symptoms and then the symptoms are treated according to that label. Did you know that IBS is considered to be a diagnosis of exclusion? (3) This means that you go to your doctor with common symptoms like gas/bloating, abdominal pain, diarrhea, constipation (or both) and based upon your history, he or she will typically run a few tests to rule out more serious conditions like inflammatory bowel disease (IBD), colon cancer, celiac disease and possibly common pathogens like giardia. Once these tests come back negative, the digging stops and you are labeled with IBS. From this point, you most likely will be prescribed whatever the most common IBS medication is and sent on your way. The doctor’s work is done. But due to this approach, many times you may be receiving an IBS diagnosis and be prescribed medication too quickly. And while you may find temporary symptom relief from this approach, in reality, if the underlying cause is not addressed most likely you will eventually begin to feel like crap again, old symptoms may return, or new symptoms may arise and the cycle of trial and error begins - going back to the doctor, perhaps trying a new one, desperately trying to get relief from your symptoms. While there are pros and cons to receiving a medical diagnosis or label; IBS as a label is a particularly problematic one because it implies that you have found the problem, that there is no reason to continue to look for a specific root cause yet it provides no real guidance on what your next steps should be beyond taking the latest prescription or just living with it. Let me be clear, I am not against medication, prescription or otherwise to provide some temporary symptom relief. I get it. If taking some anti-diarrhea medicine allows you to have a life, to do fun things with friends and family, I’m all for it but please don’t stop there. Remember IBS is not a cause but rather it is a description of your symptoms and having a label for your symptoms or taking a medication that temporarily alleviates those symptoms doesn’t help you get better. For example, your symptoms may be abdominal pain, bloating and diarrhea but the underlying root cause could be food intolerances, bacterial or yeast overgrowth or malabsorption issues just to name a few. If you are unable to stop a medication without symptoms returning, then your root cause has not been identified or properly addressed. Symptoms are our bodies way of telling us something is wrong, is out of balance. When we try to only manage symptoms, and don’t look for and address the root cause for why we have them, it can have an impact on our health in the long term. Think of it like this – if you have a campfire that looks like it has been put out unless you stir it up to make sure, it’s possible that there are still embers burning below the top ash that could set off a forest fire. The same goes for only addressing your IBS symptoms and not addressing the underlying root cause that is still “burning”. Final Thoughts At the end of the day, ultimately, I don’t mind someone being told or labeled as having IBS. By receiving this diagnosis, it tells me that they have been checked for more serious conditions by a physician and that they have gut issues that require more investigative work, which is something for me to work with. What I do mind is people who are still suffering and don’t know where to turn or what to do because receiving an IBS diagnosis seems so final and there isn’t a treatment for IBS, only for the root causes for IBS. If you have received an IBS diagnosis, I would recommend finding a functional practitioner to work with that can help identify and address your specific underlying causes because there is always a reason for a symptom. If you would like to learn more about how I can help, you can get started by scheduling an initial visit. References: 1. Rome Foundation. www.theromefoundation.org 2. J Neurogastroenterol Motil. 2017 Apr; 23(2): 151–163. Published online 2017 Apr 1. doi: 10.5056/jnm16214 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5383110/ 3. Camilleri, M. (2012). Irritable bowel syndrome: how useful is the term and the “diagnosis”? Therapeutic Advances in Gastroenterology, 5(6), 381–386 Camilleri, M. (2012). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491678/ #digestive #IBS

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  • Refund Policy | Wholistic Works LLC

    Refund Policy Once scheduled, initial appointment fees are only refundable (minus credit card processing fees) if you cancel the appointment within 24 hours of making it. If you cancel your appointment after 24 hours but 72 hours before your appointment, you will receive a partial refund of $145. There are NO refunds for cancellation of appointments that occur within 72 hours of the scheduled appointment. Fees will be prorated accordingly if you have been provided with a discounted visit fee. Individual, personalized one-on-one nutritional counseling programs are subject to a 30-day refund policy (minus a non-refundable deposit that would be clearly stated on both your invoice and the program agreement). Refunds must be made in writing and submitted by the end of the business day (3:00 pm MT) on day 30 from having signed the program agreement and paying the invoice. Refund requests can be emailed to support@wholisticworks.com Group/online programs, meal plans, supplements, etc., are not subject to refunds. As stated above, Marissa Mekelburg/Wholistic Works, LLC maintains a no-refund policy for all services except initial visits and individual counseling programs. You acknowledge that no one has represented to you that refunds are available. Even if you cannot participate for any reason, you will continue to be billed according to the schedule in your Agreement until paid in full. Wholistic Works, LLC considers this policy a material inducement to entering into contracts with clients, and would not have done so unless this No Refunds Policy were included. ​ Wholistic Works, LLC support@wholisticworks.com

  • Wholistic Works LLC | Digestive Health Dietitian Nutritionist

    UNLOCK YOUR IN NER HEALER WITH T HE POWER OF FOOD Wholistic Works LLC REGAIN your Health and Vitality "WHOLE-PERSON APPROACH" to Digestive Wellness T IME to get to the root cause of your SYMPTOMS are you ... Tired of guessing what's safe to eat? Tired of food making you sick? Tired of removing food from your diet? Tired of never feeling any better? Tired of always second-guessing yourself? Tired of wondering if, "You're doing it right?" Tired of thinking, "Is this my new normal?" Ask Yourself Have a B ANDAID SOLUT ION? or Get to the bottom of the ROOT CAUSE? Would you rather ... No "Food Roulette" or "Symptoms Guessing Games" will get to the "Root Cause" of your DIGESTIVE HEALTH PROBLEMS YET , m any traditional GI doctors and nutritionists use a "CATCH-ALL-SOLUTION" hand you a pamphlet and send you on your way. SYMPTOMS DIAGNOSIS MEDS Does Not = SOLUTION SYMPTOMS are the body's way of saying something is wrong . Get This Research has demonstrated that a nutritious diet can significantly impact disease prevention, treatment, and outcome. Yet, only 1 in 4 adults prioritize their digestive health. I came to Marissa after many years of diagnoses, treatments, and protocols to fix ongoing GI issues. Marissa identified the underlying problems through scientific testing and data that other treatments did not. I worked with her for six months consistently and still stay in touch with her. I can now eat foods that for years were not available to me. NO ONE-SIZE-FITS-ALL NUTRITION PLAN IS DE SIGNED to treat you as an individual or provide the support you need to be successful GET CLEAR ON THE RIGHT NUTRITION THERAPY FOR YOU not knowing what "food is safe" or what "diet to follow" is not living start moving towards BETTER HEALTH Knowing What Nutritional Approach is Right for You and Your Diagnosis IS Life-Changing Are You Ready To Take Control Of Your Health? Nutritional Plan Tailor-Made Plan for You, Your Specific Issues, and Your Body No More Guessing Identify and Know the Triggers for Your Symptoms Symptom Free Re-discover What it's Like to Have Your Life Back Marissa took the time to explain how my diet may affect my quality of life. She walked me through the steps of determining which foods are not “gut-friendly” (for me) and was always enthusiastic and encouraging. In your corner You Need Someone Who Is Dedicated to enhancing your quality of life Sincerely in it to help you reach your goals That's Precisely why I do, what I do. "You literally changed my life. You hear it, you see it, you feel me." With 18+ years of experience, Marissa specializes in RESTORING CLIENTS' HEALTH by designing customized NUTRITION & LIFESTYLE PROGRAMS based on Functional Nutrition and the concept of "FOOD AS MEDICINE" Her Approach addresses the WHOLE PERSON and NOT just their Diagnosis. ABOUT Hi There ! Marissa Mekelburg Digestive Health Dietitian Nutritionist Gut Health Expert Our Services And Specialties Nutrition Therapy Food Sensitivites Low FODMAP Diet Functional Lab Tests Professionals Take Control of Your Digestive Health and Unlock the Path to a Healthier You! GET STARTED

  • Rates & Insurance | Wholistic Works LLC

    Rates & Insurance We Accept These Insurance Plans ​ ​CIGNA - DIAGNOSIS CODE(S) REQUIRED UNITED HEALTHCARE - DIAGNOSIS CODE(S) REQUIRED We are NOT a provider of MEDICARE or MEDICAI D and are UNABLE to bill these insurances.​ INSURANCE VISITS - if you live in Colorado, you may be eligible for coverage Insurance typically covers 3 visits per year. ​Aspects of the Nutrition Therapy Programs that are not billable include: Functional Labs Phone check-ins 24/7 messaging support between visits Food log reviews Meal Planning LIMITATIONS on COVERAGE - check if your insurance has put any conditions in place for what they will cover. (deductible, co-pay, etc.) Gastrointestinal issues fall under the " medical " category and are generally subject to a deductible and/or co-pay. ​ ​ BILLING - your physician (or other diagnosing provider) will need to provide a diagnosis and the appropriate billing / ICD10 codes. Need assistance obtaining these codes? Download our R eferral Form (in either a PDF or DOC ) and give it to your physician's office to obtain these codes. You may also ask for your record s/chart notes (or have them faxed to us), as the codes needed to bill will often be referenced. ​ ​ CONTACT - call the phone number on the back of your insurance card to obtain detailed information on your coverage. BE INFORMED - know what your payment responsibilities are. An Insurance verification form can be filled out and submitted HERE. OUT-OF-NETWORK All OTHER Insurance Carriers - Encourage checking for out of network benefits. Refer to the insurance verification form listed above to check out-of- network benefits for specific CPT and ICD10 codes​ We can provide a superbill for you to submit to your insurance company for potential reimbursement. We also accept HSA/FSA debit cards ​​ RATES In-Network - Your insurance company's fee schedule determines the allowed rate. Once the claim is processed, we will receive an "Explanation of Benefits" as to how much (if any) of the fee is your responsibility. The card on file will be charged. ​ Rates if n ot paying with Insurance - ​ Initial Nutrition Assessment/Case Review | up to 90 min | $245 |Due at the time of scheduling appointment. Late Cancellation Fee < 48 hours notice | $100 No-Show - full session fee charged Initial (first) Appointment : $245. Follow Up Session: $165. One Time Exceptions: given for special circumstances. PAYMENT VALID credit/debit card must be on file to ensure seamless transactions and avoid any inconvenience. Credit/debit card is used to PROCESS self-pay fees, copays, deductibles, and non-covered services as communicated by your insurance provider. YES - You can keep an HSA/FSA card on file for eligible transactions. REFUNDS - Card processing fees incurred will be deducted from your refund amount. I worked with Marissa for nearly 6 months. She patiently, systematically, and with so much empathy and care helped me identify my food sensitivities and digestive issues that had been plaguing me for years. Her method is 360°, methodical, and science-based. She gave me such wonderful recipes, support, and guidance -- many times texting with me as I walked the grocery store aisles unsure about different ingredients. A truly caring and devoted practitioner. DOUBLE the Convenience DOUBLE the Options Connect with Us HAVE A QUESTION? Check the FAQ section. Still have a question? Let's CHAT. CHAT NOW SCHEDULE A CONSULT You are ready to get to the "ROOT CAUSE" of your symptoms and start feeling better. Book an initial consult with us. BOOK NOW

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