Tag Archives: immune system

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.

How do I choose the right probiotic?

A reader writes…

“How do you go about selecting the right probiotic?  I’ve heard such conflicting information.  Some say that probiotics are useless, because you’re born with what you have and there’s no way to replenish.  What are your thoughts?”

My first thought is, who on earth is telling people there’s no way to replenish good intestinal bacteria?  Whoever it is, he or she is gravely misinformed on several counts.  First, we’re not actually born with any gut bacteria; we acquire it early on–first during a regular vaginal birth and next during breastfeeding.  (Those who did neither missed out on these opportunities and may not have adequate levels of good bacteria if they didn’t acquire it from other places.)

Next, it’s important to understand that our normal gut flora (beneficial or “good” bacteria) are constantly under attack.  These attacks come from anywhere: stress, processed foods, alcohol, tap water, soil, other animals, medications (especially antibiotics and antacids), other people, and lack of stomach acid, just to scratch the surface.

Why do we need these bacteria in the first place?  They carry out an extensive array of extremely important functions.  They help fight some major disease-causing bacteria; in fact, they help form most of our immune system!  They turn vitamins into their active forms so that our body can use them.  They help you absorb nutrients, including fats, carbohydrates, protein, vitamins, minerals, and others.  There’s even a growing body of evidence that suggests these bacteria may play a role in lowering cholesterol.

So, when we don’t have enough of these bacteria, the above benefits start to evaporate; the immune system becomes weak, other “bad” bacteria (as well as yeasts, fungi, and parasites) can become opportunistic and “install” themselves, you can become seriously deficient in multiple important nutrients, and if the recent studies are correct, your cholesterol may elevate.  Does any of this sound familiar?  It should.  Why?  Because most people are indeed missing much of the good bacteria they need.

So, we turn to probiotic supplements.  I would love to sit down with someone who doesn’t believe probiotics do any good and show them the before-and-after digestive analysis tests of my patients (with names protected, of course), and show them the growth of the colonies of good bacteria between the initial test and the subsequent follow-up.  The numbers of good bacteria do improve.  This is how I know the probiotics are working.

So how does one choose a good probiotic?  There are quite a few choices out there and unfortunately, not all probiotics are created equal.  The supplement industry is largely left to police itself without a lot of regulation, which has both advantages and disadvantages.  The bad news is, there are some that don’t do squat.  The good news is, there are many that are quite effective, and these companies are free to innovate and develop superior products, which many of them have done.

So how do we separate the “men from the boys”, so to speak?  There are two fundamental qualities to look for in a probiotic: a variety of species, and high, potent doses.

At your local health food store, most of the products contain anywhere from 3 to 5 species or so.  This is okay, but it’s not quite enough.  This is because your intestinal tract is essentially a small ecosystem.  There are literally billions, even trillions of different types of bacteria happily co-existing together, each of them occupying space and keeping each other in check, ultimately creating a delicate balance.  Supplementing with a 3-species formula won’t do much.  (Most formulas available only through healthcare professionals typically have much higher quality and potency than those available to the public at health food stores and other places.) The most diverse higher-quality* formulas we have found so far (and thus, the ones we use) contain 12 different species.  While that doesn’t sound like much of an improvement in the grand scheme of things, it seems to work quite well, each additional species having a compound effect.

Next, let’s talk potency.  Potency is measured in colony-forming units, or CFUs.  One CFU, theoretically, goes on to start its own entire colony.  It’s mind-bending to consider how many billions of microorganisms there are in just a teaspoon of probiotic powder.  The storebought brands tend toward lower dosages, somewhere around 5 to 35 billion CFUs.  The highest dose medical grade supplements we found (and incidentally, the ones we use) contain 100 billion CFUs…in a single quarter teaspoon.

And last but not least, as with all supplements, it’s important to avoid supplements that contain (or come from a factory that uses) gluten fillers (wheat germ, wheat flour, wheat proteins, food starches, etc), yeast, soy, egg, milk, corn, shellfish, and MSG, just to name a few.  This is because many (if not most) people actually have immunological hypersensitivites to various common foods, in which the body’s immune system perceives that food as a toxin and launches an attack against it, creating lots of inflammation and chronic, mysterious health problems.  Many storebought supplement companies may be contaminated with these common allergens, but most medical grade supplements specifically state that they are free of all of these substances.

Since our ability to maintain good bacteria balance declines with stress, age, and lifestyle, it’s good to take a high-quality probiotic as part of a maintenance regimen.  This is especially true after finishing a round of antibiotic treatment, such as that for an infection.

*There are other formulas that may contain up to 14 different species, but these are not potent enough to be considered medical food/medical grade supplements, which have the highest quality and potency.

In health,
~Dr. L. Sweeney
Functional Medicine, Functional Endocrinology, and Functional Immunology
San Antonio Family Alternative Medicine

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