Tag Archives: digestive analysis

Functional Medicine Lab Testing

Believe it or not, most doctors don’t order nearly enough testing.  The human body is extremely complex, consisting of many different systems that interact in an intricate web, with every system influencing all of the others.  All of the different major physiological functions have special relationships with each other and all affect each other.  This is all well and good, as long as your body is humming along pleasantly, with everything working the way it should.

I might boldly venture to say that there is not a single person on this planet who fits that description.  Instead, stress, environmental toxins, food and environmental allergies, lack of proper nutrition, lack of exercise, dysbiosis, hormone fluctuations, infections, and even genetics, all throw a monkey wrench into this smooth interaction between all of your body systems.

And that’s where the domino effect starts.  Before you know it, a problem in one area becomes a problem in multiple areas; pretty soon everything seems to have gone haywire.

This is why comprehensive testing is important.  Since this level of testing is unfamiliar to most people, I thought it might be helpful to outline some of the lab testing most commonly run by a good Functional Medicine practitioner.  (Notice I said “a good Functional Medicine practitioner”!  Not all are created equal.)

Conventional blood testing – this usually includes a blood cell count, a metabolic panel, a lipid panel, a basic thyroid panel, and a few other miscellaneous tests, such as iron and/or B12 and others.

Adrenal stress testing – this often includes several readings of cortisol (the adrenal stress hormone) and DHEA (another important adrenal hormone).  There are several variations of this panel; depending on which type I order, it may also include screening for anti-gliadin antibodies, progesterone, or other male/female hormones.

Digestive analysis – this assesses your digestion and absorption, and often includes screenings for harmful microbes such as yeasts, parasites, and opportunistic bacteria that can interfere with intestinal function.  There are many varieties of this test available as well; some may include pancreatic function while others include stomach acid levels.  Some tests only screen for antibodies to a known pathogen such as candida or giardia, whereas others analyze the DNA of the microbes and compare it against a comprehensive database of microbes known to cause problems in humans.

Liver detoxification – unfortunately, the liver enzymes commonly tested for in a routine blood test don’t tell the whole story.  In fact, your liver can be in pretty rough shape and those tests will still be well within the normal range.  They don’t even start to show a problem until a liver issue is very advanced.  The good news is, there are much more efficient tests that assess liver function.  They do this by measuring levels of end-products of liver metabolism.  This gives a much more accurate picture of how the liver is functioning now, rather than waiting until advanced stages of damage and dysfunction have set in.

Heavy metal and nutrient mineral screenings – surprisingly, hair analysis is NOT the most accurate method of checking for the presence of heavy metals.  This is because hair analysis depends on proper excretion of heavy metals and some people tend to retain heavy metals inside their bodies instead of excreting them.  Luckily, there are several other methods of testing.  Some versions of this test only check for heavy metals, while other versions also evaluate the more beneficial nutrient minerals such as molybdenum and zinc to assess mineral levels.  These tests are much more accurate and reliable than blood-test versions of these minerals because the body will actually sacrifice tissue levels of nutrients to keep the blood levels constant.

Immune system panels – we can use several different tests to check various functions of your immune system.  One such test gives us clues regarding whether your immune system is fighting a foreign invader, or your own body.  Another test tells us whether your immune system is balanced (which is extremely important!) or whether one side has gotten a little overzealous and out of hand.

Thyroid test panels – to test TSH alone is never enough.  That’s like being blindfolded and trying to get an idea of what an entire elephant looks like by simply touching its trunk.  The trunk is what it is, but it does not tell you very much about the rest of the body.  I view the TSH test the same way; it is important, but it does not give the whole picture and testing TSH alone falls very short of good testing.  Thyroid test panels vary, but they can include the thyroid hormones themselves, how much of those hormones are being taken up by your body, the level of thyroid hormone transport protein lives in your blood, or even whether or not your body has started to attack your thyroid gland (i.e. the presence of thyroid antibodies).

Nutrients (Vitamins and Minerals) – there is a huge variety of different nutrient test panels available.  Some assess fat-soluble vitamins (A, E, D, and K), while others check water-soluble vitamin (B-complex, Vitamin C) levels.  Some evaluate minerals, like we talked about above.  Some measure other nutrients such as CoQ10 and/or glutathione.

Food allergy/sensitivity testing – here again, there is a variety of testing available.  In fact, there are several different types of reactions to problem foods.  One type is an immediate reaction involving histamine; another type is a delayed reaction that does more damage in the long run, but it is less obvious at first.  Several different companies test for several different types of reactions, and may include a wide variety of different panels or groups of foods.  In fact, some tests also include environmental irritants such as pollens, molds, and others.

Male/Female hormone panels – these tests look at the levels of various forms of estrogen and testosterone.  Some even include progesterone.  Most tests involve a “snapshot” of the present levels, while another test measures a female’s monthly cycle over the entire duration of the cycle!

Note 1: This list is by no means complete!  Functional Medicine doctors literally have thousands of individual tests at our disposal, which means we can explore lots of possible avenues and get to the root of the problem.

Note 2: truth be told, I order testing based on what I believe the patient needs.  Some people may need more testing, while others need less.  Some may need a particular test, while others may not.  I don’t order every one of these lab tests for every patient, but I do order every test I feel is necessary for that particular person so that I have all of the information I need to help them heal.

Testing, testing: Lab testing and Functional Medicine

A Revolution in Advanced Clinical Nutrition…

A segment of Clinical Nutrition began to evolve considerably–quietly–about 30 years ago.  Now, it has bloomed into a full-fledged, legitimate medical subspecialty.  We now know much more about the mechanisms behind chronic disorders than we did even 10 years ago.  We also now realize that pharmaceutical medications, while necessary at times, don’t usually offer much in terms of resolution or long-term relief/improvement for these conditions.  Irregular blood sugar, autoimmune disorders, nutrient malabsorption, gastrointestinal microbes, inefficient liver detoxification, and adrenal fatigue don’t necessarily respond all that well to medications.

Since many of these disorders mimic each other (sometimes very closely), it can be difficult to determine exactly what’s going on using symptoms alone.  This can pose a problem, because if there is any hope in making progress or getting relief, the right treatment approach must be followed.

For example, let’s say Betty has fatigue.  The first remedy that come to mind might be caffeine pills.  It sounds logical; if she’s tired, the idea of a stimulant probably appeals to her.  If she doesn’t like the concept of chemical stimulants, she might opt for a more natural route; a naturopath or herbalist may suggest Ginseng or something similar.  Functional Medicine, on the other hand, asks why she is tired, and considers all the possibilities.  Fatigue is a common symptom, with many causes – maybe her adrenal glands aren’t producing enough cortisol.  Maybe her thyroid gland isn’t producing enough T4, or maybe she has a sluggish liver or gastrointestinal tract and can’t convert inactive thyroid hormone (T4) to active thyroid hormone her body can use (T3).  Maybe she’s got a lingering virus.  Maybe her energy is being diverted toward immune system activity because she has seasonal allergies.  Maybe her blood cells aren’t carrying enough oxygen.  Maybe she’s got candidiasis (overgrowth of candida albicans, a problematic yeast); maybe she’s fighting a bacterial infection.  Maybe she she has a food intolerance (these can make people profoundly drowsy).  Or maybe she has low blood sugar.

Each of these possibilities is a completely different problem.  Ten people with fatigue may all share the same symptom, but have completely different reasons for feeling the fatigue.  If the underlying reason isn’t investigated, and the person assumes they have adrenal fatigue when really they have a low thyroid, and they begin taking herbs that boost adrenal function, then they’ve missed the thyroid issue and they fail to correct the problem…and the problem remains.  This begins to illuminate the reason why lab testing is crucial.

As I mentioned before, when most doctors order lab testing, they tend to stick only with what insurance covers.  What you may not realize is that the testing insurance will cover is bare-bones, hardly scratching the surface of what’s actually going on.  Essentially, it’s a screening tool for basic disease and that’s really about it.  The limited tests that are ordered and the way in which the results are interpreted does not do much of anything to accurately assess someone’s actual baseline health.

This is not to “bash” the medical profession at all or paint some kind of “us versus them” polarized picture that illustrates that Functional Medicine is everything while conventional medicine has no place.  Indeed, some of those basic disease screenings can be highly appropriate and unquestionably warranted.  However, those basic screenings are sorely limited in their ability to comprehensively assess someone’s genuine health, wellbeing, and quality of life.  And that is where Functional Medicine has a chance to shine…

Functional Medicine doctors will order comprehensive testing that evaluates multiple areas of body chemistry and multiple important functions that are hardly ever touched on in hospitals or regular clinics.  When we order testing a patient has never had, we find things other doctors have never found.  A good Functional Medicine practitioner will evaluate (at minimum) several areas during routine testing:

  • Nutrient metabolism
  • Cellular energy production
  • Oxygen delivery
  • Inflammation markers
  • Organ and gland functions
  • Infection screening
  • Status of certain nutrients
  • Blood sugar consistency, long and short-term
  • Intestinal microbes, beneficial and hazardous
  • Adrenal stress
  • Central Nervous System state

Another important tenet of Functional Medicine pertains to how the lab testing is interpreted.  Most doctors simply scan the lab test results, looking for anything that the lab has “flagged” as abnormal.  In order for a result to show up as abnormal, it must fall outside of the “normal” or “reference” range.  These ranges are set based on statistics.  They vary by lab and even by region.  Look around you; you’re being compared to your neighbors, your friends, family, and co-workers.  How healthy are they?  I don’t know about you, but being “normal” compared to everyone else isn’t exactly reassuring.

What Functional Medicine doctors do is look closer at the lab test results.  They are familiar with what healthy ranges look like and where a person’s body chemistry should be.  These doctors will find literally a dozen or so dysfunctional/abnormal results that labs and conventionally-practicing doctors will flat-out miss.

Many Functional Medicine doctors take yet one more step further, to analyze patterns between these abnormal results, to attempt to find a common denominator, because often, various dysfunctions are related.  It is indeed entirely possible that a person may have multiple dysfunctional processes happening at once, and it’s also possible that multiple symptoms may stem from one underlying disorder.  Functional Medicine practitioners spend a tremendous amount of time behind the scenes pouring over lab test results and conducting any necessary research.

In short, the rabbit hole that is human physiology can go far deeper than expected; Functional Medicine is the only discipline to ever rise to the challenge.