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 Description: All doctors rely on laboratories to perform testing.  Labs take samples and run tests to show, for example, if there are chemical imbalances which could indicate problems.  Large cities have multiple laboratory sites, and hospitals and most smaller cities also have laboratories.  But, many alternative medical practitioners use specialized laboratories, sometimes even in foreign countries.  These are the laboratories sometimes referred to as "boutique" labs.

There are a lot of reasons given for using these boutique laboratories, but none are compelling.  The reasons range from these laboratories are more focused on autism specific issues to regular laboratories don't do the specified test.

Take mercury testing as an example.  Many (if not all) laboratories can do this.  Here is a document by Jim Laidler, M.D.  He was an insider in the world of autism alternative medicine at one time, even helping form a policy statement on mercury and chelation.  He discusses the drawbacks of "mail order labs" in that document and here.  This quote is telling:

The cost of many of the mail-order labs is also a significant concern. A brief survey of some of the bigger mail-order labs revealed that they charge between $175 and $300 for a “panel” of urine metal tests, including mercury. The local hospital lab charges $35 for a urine mercury test. In most cases, the other metals included in the “panel” or of little or no use—there is no research or clinical data that connects some of these other metals to any disorder whatsoever.

If you are testing for a specific issue, say metals or allergies, consider working with specialists in those areas.  They will almost always work with laboratories close to you.  They are more likely to be cheaper and covered by insurance.  And, you will be working with a real specialst.  For metal toxicity issues, the American College of Medical Toxicologists keep a list of practitioners.

One of the lab tests that is often called for in the autism alternative medical community is for urinary porphyrins, or UPPA test.   This is one where people often send samples to France.  Yes, France.

The idea of the porphyrin test for autism comes from a few alternative medical practitioners.  It is certainly not a standard test used by toxicologists. 

It is worth reading this document by a laboratory in the United States often used by alternative medical groups.  The docuement discusses some possible issues with the UPPA test. They found that while the lab in France finds most children with autism have abnormal UPPA tests, the US laboratory finds very few.  Some of this appears to be from using reference ranges for older children and adults, instead of references for children at the same age tested.

This is given to show an example of how the teamwork of alternative medical practioners and boutique laboratories can result in expensive tests that can be completely worthless