Tag Archives: hormone

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.

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Natural Weight Loss Alternatives: Part 1

One of the most common questions people ask is, “how do I lose weight?”  Indeed, most of us are carrying around a few extra pounds.  If you are, you’re not alone; two-thirds of the population is now officially overweight.

There is good news and bad news.  The good news is, the problem can usually be solved.  The bad news is, it’s not a simple answer.  If it were, we wouldn’t all be struggling like we do!

Weight gain is a symptom of an underlying problem, and as with any healthcare dilemma, it’s extremely important to get to the bottom of what’s causing the extra weight to accumulate.  There are lots of causes of extra weight gain, too many to explore completely in one article, but I will touch on the most common causes and perhaps write a continuation in the future.

Cause #1: Low Thyroid Function – your thyroid gland makes thyroid hormone, which is a biochemical gas pedal for your cells.  It tells your cells how fast their metabolism should be.  It keeps you going, but also eases back on the throttle when necessary so that you don’t burn out. If your cells aren’t getting enough thyroid hormone, their metabolic activity slows down.  When this happens, your cells don’t burn fuel (blood sugar, oxygen, etc) like they should and the extra fuel gets stored in the fat cells.

Now, consider this: there are literally 22 different causes that fit into 7 different categories of thyroid dysfunction.  And it may not even be an actual problem with the thyroid gland at all!  The real culprit may be coming from any one of several other body systems, and the thyroid gland could be the victim, not the suspect.  This is why it’s extremely important to have a *complete* thyroid function panel done, and to have it interpreted correctly.  There are two problems that most people encounter; one is, most conventionally-trained doctors will only run TSH and maybe T4 or if you’re lucky, they’ll add T3 Uptake. The second problem is, the lab results aren’t interpreted in a way that evaluate for proper function, so many conventional doctors miss an underlying thyroid problem.

Cause #2:  Overactive Adrenal glands – your adrenal glands are small triangular-shaped glands that sit on top of your kidneys.  Their main function is to help us deal with stress.  They produce and release cortisol, our “stress hormone” whose job it is to raise blood sugar and heart rate so that we have more energy to handle the stress we face.

The catch is this: we’re only designed to handle immediate stressors that quickly pass.  If we’re under too much stress for too long, our bodies pay the price.  If cortisol levels are consistently too high, they will promote weight gain, especially around the lower abdomen and hips.  If the problem worsens, a person’s face can become rounder and slightly more pale.  It is important to have your cortisol hormone levels checked.  The best test for this is actually not a blood test; it’s a saliva test.  The cortisol found in saliva is the amount of active hormone readily available for your body to use, so it’s a more relevant test.

Cause #3: Liver Congestion – the liver is a large organ under the right side of your rib cage that basically acts as a garbage disposal or water treatment plant.  It has more than 500 jobs, and detoxification is at the top of the list.  Every toxic chemical we breathe, eat, or drink (air pollution, food additives), and every metabolic waste product from all your cells passes through the liver to be cleansed and converted to a less- or non-toxic substance.  The result is that the wastes go to the kidneys and the circulating blood is clean.

If your liver gets bogged down with too many toxins (poor diet, polluted area, or excess hormones), then it creates a traffic jam and all the toxins waiting in line to be detoxified start to back up.  As a defense mechanism, your body will try to pick the safest spot to store the excess toxins, where they will do the least amount of damage.  That would be (drumroll, please): the fat cells.  There are excellent tests that evaluate true liver detoxification function that go much further beyond the basic blood tests your conventional doctor is familiar with.  The functional tests are usually part of a much larger panel designed to evaluate a wide variety of body functions.

Please see Part 2 for more!

What Functional Medicine is NOT, Part 1:

The term Functional Medicine has become a buzzword.  This is only a natural phenomenon; several practitioners have built lucrative Functional Medicine practices that are becoming well-known and receiving a lot of attention.  Practiced correctly, it truly is the next wave of medicine, or at least we can only hope.  Naturally, many practitioners want to catch the wave and “cash in”.

The only problem is, many practitioners who say they are practicing Functional Medicine aren’t really doing so.  They have attempted to bend the term to fit their practice, without really adapting or changing anything they were doing.

When practitioners use one term to mean several different things, the public gets confused.  So, since we already know what Functional Medicine is, I thought I’d ease the above situation by spelling out what Functional Medicine is NOT.

Truth #1: Functional Medicine is not bioidentical hormones.  In fact, bioidentical hormones are not even utilized in genuine Functional Medicine, because exogenous hormones (i.e. hormones that the body itself did not make, that come from the outside of the body) is, by definition, an allopathic treatment.  (That’s not to say that you don’t need them or they won’t do some good.  It simply means that someone who claims to be a Functional Medicine practitioner simply because they give you Armour instead of Synthroid to jumpstart your thyroid is full of baloney.)

Allopathy is the branch of medicine that most doctors practice – they seek to eliminate symptoms by introducing a substance that changes the body’s internal chemical environment such that it can’t sustain the disease or symptoms.  For example, the standard allopathic treatment for diabetes (high blood sugar) is to introduce insulin (which lowers blood sugar).  High cholesterol is treated with statin drugs that lower cholesterol.  In the allopathic approach, little thought is given to the cause of the problem; the focus is on eliminating symptoms through biochemical manipulation.

Back to bioidentical hormones… Bioidentical hormones may indeed be beneficial and they may be necessary.  They may also indeed be superior to synthetic hormones.  I don’t disagree with that one bit.  And Functional Medicine DOES aim to balance hormones, after all.  What I DO find problematic, is when a doctor says they practice Functional Medicine because they balance hormones using bioidentical hormones.  That is NOT Functional Medicine.  The litmus test is this: do I need a prescription to obtain any of the remedies the doctor wants me to take?  If the answer is yes, than it’s not Functional Medicine.  Pure Functional Medicine can (and should) be practiced without any pharmaceutical medications.  True Functional Medicine will approach a hormone imbalance by attempting to find out what’s wrong underneath the surface, by asking the question: WHY are the hormones out of balance?

Truth #2: Functional Medicine is not HCG weight loss or any other fad diet.  HCG, whether in the form of the actual hormone or a homeopathic essence, is also allopathic.  This topic will most likely get its own post, because there’s more to say about this than is appropriate for the scope of this post.  For now, suffice it to say that HCG hormones are also allopathic and possibly harmful.  True Functional Medicine will ask: WHY is the person overweight in the first place?

Truth #3: Functional Medicine is not a quick fix.  While I’ve personally seen some miraculous results in just a few weeks using only true Functional Medicine and nothing else, it takes quite a while to normalize and regulate body chemistry, especially using non-pharmaceutical options.  Medications are meant to force the body’s chemistry to change quickly, and they are very good at what they do.  Natural medicine is very good at what it does, too, but its process is much slower.

Truth #4: Functional Medicine is not just glorified nutritional counseling.  It’s an entire lifestyle modification program.  Dietary modification and specific supplementation are indeed part of the major backbone, but there is much more to the story.  Since most of today’s chronic health problems developed from multiple genetic and environmental influences, the complete solution that delivers the best results utilizes multiple neuro-metabolic therapies based on genuine diagnostic lab test results.

What is Functional Medicine?

The short answer is, Functional Medicine is the future of medicine, if we are to get well and stay well as a society.  It’s the direction in which regular medicine should have gone.  It should be used as the primary method of treatment, especially in cases that are not acute, infectious, catastrophic, life-threatening, or other emergencies.

The long answer is, the definition of Functional Medicine largely depends on who you talk to.

  • The Institute of Functional Medicine, arguably the leader and Gold Standard of the field, describes a science-based, patient-centered form of healthcare that recognizes biochemical individuality and favors active prevention.
  • A talented colleague of mine defines Functional Medicine as a complete lifestyle-modification program that evaluates physiology using extensive diagnostic lab testing and then corrects any imbalances found by applying specific, individually unique combinations of neuro-metabolic therapies.
  • Another talented colleague of mine mentions looking at everything (hormone balance, nutrient metabolism, immune system, and a plethora of other categories) all at the same time, leaving no stone unturned

Functional Medicine really is “all that” – in terms of the explanations given above, as well as being Just That Cool.

When I explain it, Functional Medicine can take on a few different personas that all relate back to the same Big Idea.  Various descriptions are as follows…

  • A highly-advanced version of Clinical Nutrition, taken to another level as practiced by a doctor, that bases its herbal and nutritional plans on comprehensive lab testing
  • A third type of healthcare that is separate from both conventional and alternative medicine branches we’re already familiar with, that utilizes the best of both worlds
  • An emerging medical subspecialty that combines conventional testing and natural therapies
  • A logical, scientific alternative for those looking for natural or holistic healthcare, perfect for those who don’t know where to turn or who to trust.
  • A scientific-yet-holistic of looking at the functions of the body and how they are inter-connected, identifying dysfunctions in key areas using lab tests, and then correcting them with a comprehensive lifestyle modification plan.

That last one is my favorite (couldn’t you tell?)

Functional Medicine really shines with chronic, complex disorders, especially the degenerative and/or mysterious.  I can say it is definitely worth the effort, commitment, and investment!  Most Functional Medicine practitioners know firsthand; many of the best doctors got involved with the field because of their incredible experiences.

We’re a product of the choices we have made every day.  Every day we have another chance to stay on our current path or choose something different.  What are you waiting for? 🙂