Straight answers, including when we’re not the right fit. Concierge & Functional Medicine FAQ

Insurance generally pays for a test only when a diagnosis code justifies it. That means many useful tests can’t be ordered until a disease has already shown up. Paying cash means Dr. Cas can order what your situation calls for, you see the price up front, and results come back faster.

No. Dr. Cas can be your primary care physician, or he can work alongside the specialists you already see.

Every membership is priced below what the same visits and labs cost à la carte, and the value tables on the memberships page show every line. HSA and FSA funds may be used for eligible services.

It varies. Many patients notice changes in energy, sleep and mood within weeks of building their foundations. Gut restoration and detox work can take up to six months. Retesting shows what’s actually changing.

No. A membership covers the visits, labs and services listed in your tier, priced below their à la carte cost. It is not health insurance.

HSA/FSA funds may be used for eligible memberships and services. Confirm eligibility with your plan administrator.

Every tier includes full functional medicine lab panels: two a year with Evoke Well, three with Evoke Optimize and four with Evoke VIP. Other specialty labs are billed separately at transparent cash prices through Vibrant America.

Services must be used within the membership year, and membership fees are non-refundable.

Soon. Join the waitlist through the consult form and you’ll hear first when enrollment opens.

Looks for the root cause instead of treating each symptom on its own. That means a deep look at your history, diet, lifestyle and environment, plus lab testing that goes well beyond a standard panel.

Yes. Dr. Castel Santana is an MD and a board-certified family physician who completed residency at the University of Maryland, and a Certified Functional Medicine Practitioner. Prescriptions are part of his toolkit when they're warranted.

Most people start with the full functional lab panel and genetic testing, both included in every membership. Gut, toxin and oxidative stress testing get added when your history or first results point that way.

Insurance generally pays for a test only when a diagnosis code justifies it. Vibrant America is cash-pay, so Dr. Cas can order what your situation calls for, and you see the price up front.

Routine labs often come back within 10 to 14 days. A full specialty baseline takes about four weeks.

Depending on the test, from blood, urine, stool, saliva or a swab, in the clinic or at home. You'll get clear instructions either way.

It looks at immune reactivity to common foods plus additives like preservatives, artificial sweeteners, emulsifiers, dyes and pesticides. It helps explain symptoms standard allergy testing misses.

No. Fatigue, brain fog, skin, joint, weight and hormone problems can have a strong gut contribution even when digestion seems fine.

No. The bigger levers are usually removing what irritates the gut, supporting digestion, feeding good bacteria with diverse fiber and repairing the gut lining.

Anyone living or working in an older or water-damaged building, with chronic fatigue, brain fog or "mystery" symptoms, or with autoimmune, hormone or gut problems that aren't resolving.

20 heavy metals (including lead, mercury, arsenic, cadmium and aluminum), 29 mycotoxins from mold, and 38 environmental chemicals like glyphosate, phthalates and bisphenols.

No. Removing exposure and opening the body's elimination pathways come first. Mobilizing stored toxins before your body can clear them can cause reactions.

A multivitamin can't tell you what you're low in, and some nutrients cause harm in excess. Your body may also not be absorbing what it gets. Testing answers both.

Gut problems, medications, stress, genetics and alcohol all affect absorption. That's why this test is often paired with gut and genetic testing.

It depends. MTHFR helps make the active form of folate. Whether a variant matters for you depends on your nutrients, homocysteine, gut health and symptoms. A genetic result alone doesn't tell the whole story.

An interactive educational tool in your patient portal that explains your labs, genetics and the reasons behind your recommendations. Genetic testing unlocks it.

No. Nutrigenomic results guide diet, supplement and lifestyle choices. They don't diagnose disease.

Making energy creates by-products often called free radicals. Oxidative stress is what happens when they overwhelm your antioxidant defenses and start damaging proteins, fats and DNA.

Not blindly. High doses can blunt helpful signaling. Evoke 5 measures first, lowers the biggest sources, then rebuilds your body's own defenses, especially glutathione.

No. It doesn't replace an autism diagnosis or the therapies that support it. It asks which modifiable stressors, like methylation bottlenecks, toxin load or dietary inflammation, might be adding to symptoms like poor sleep, GI trouble or irritability in this child.

Children and adolescents with a confirmed or strongly suspected diagnosis whose families want a time-bounded workup instead of an open-ended supplement list.

With a short, family-chosen scorecard, such as sleep, stool pattern, irritability, shared attention and energy.

Program details and investment are reviewed at the consult, before anyone enrolls.

No. The consult is where that decision gets made. Sometimes the answer is something simpler, or nothing yet.

It depends on the therapy. Common reasons to wait include active infection, pregnancy or breastfeeding, certain cancer histories, clotting problems and unstable medical conditions.

Procedures are planned after consultation and priced for your plan. Call (972) 468-9766 for pricing. Members get 5–15% off depending on their tier.

Knee osteoarthritis has the strongest evidence. A 2013 randomized trial in the Annals of Family Medicine found dextrose prolotherapy outperformed saline injections and home exercise at 52 weeks. Tendon pain and unstable joints are also treated, with more mixed evidence.

Expect an ache for one to three days; usual activity returns in a day or two. Improvement builds over weeks, so it isn't the instant quieting of cortisone.

Allergy to dextrose or lidocaine, infected skin at the site and fever are reasons not to inject. Joint replacements, inflammatory arthritis and blood thinners need careful judgment.

Two prepared umbilical-cord tissue matrix products, combined in a separate saline bag. Your physician reviews the formula, dose and timing at the consult.

It's held or declined for a history of cancer or bone marrow dysplasia, prior clotting events, immune suppression or chemotherapy, infection or fever, pregnancy or breastfeeding, sickle cell anemia, hepatitis B, advanced kidney or liver disease, or certain abnormal blood counts.

PRP depends on what your own blood supplies that day. These products are prepared to a consistent specification, with no blood draw for the product itself.

Donor plasma raises the risk of transfusion reactions and infection, and of moving someone else's inflammatory load into your body. The goal is removal, and albumin-based exchange has a long safety record.

It's a closed circuit. Your blood never contacts anyone else's. Tingling, fatigue, lightheadedness or bruising at the IV site can happen and are monitored in the chair.

No, and be wary of anyone who says so. A spaced series changes the pattern, and source control still comes first.

Anyone unstable, acutely infected, severely anemic, allergic to albumin, pregnant, or with active cancer.