I've started doing more functional testing in my practice in the past year and have found it to be incredibly useful. I like the information that I get from these tests because it helps me to see the big picture and plan out an effective treatment.
Functional tests are a little different from conventional lab tests in that they tell you how well your body systems are working. They show whether systems involved in your digestion, liver detox, cellular energy, macronutrient metabolism or hormonal systems are working well or need some support. Often, the "normal" ranges are narrower than conventional labs because the point of functional and naturopathic medicine is to prevent problems before they become a major health issue.
I recognize that functional testing can be a big investment upfront. I only recommend the tests that I think will provide the information that we need. Overall, I think they're a good investment because of the wealth of information they provide. We can take this information and get to work on what your body actually needs rather than what we think needs to be done. I've found that doing these tests gets you feeling better faster and you don't waste time or money trying out treatments that may not work.
I understand that testing may be outside of some people's budgets so I wanted to go into the top 2 tests that I think are most worth the money and also discuss a 3rd one that I think is great in certain circumstances, especially for women.
This post is not sponsored and I'm not specifically advocating for these companies and their tests. These are just the ones I'm familiar with, ones other colleagues recommend, and ones I've used in my own practice.
#1 Comprehensive Stool Analysis (CSA): GI-MAP by Diagnostic Solutions
There's a saying in naturopathic medicine to always "treat the gut." The gut is where so much happens that affects your entire body. It's home to much of our immune system, is where hormones are metabolized, where nutrients are absorbed, how we eliminate toxins and where the all important microbiome lives. There's so much going on here that when it's out of wack, the whole body can be too.
Often times, if you can heal the gut, everything else falls into place. Having a healthy gut can have downstream effects on your hormones, periods, mood, skin, pain levels and sleep quality. It's a foundational system to other body systems. This is why I think one of the most useful tests is a comprehensive stool test. There are many that you can do but I use Diagnostic Solutions GI-MAP because of the truly comprehensive panel that they do. Another company that offers a similar test is called Doctor's Data with their comprehensive stool analysis with parasitology and a panel called the GI 360.
What's Tested on the GI-MAP?
Pathogens - bacterial, parasites, viruses (EBV, CMV), worms
Helicobacter pylori (H. pylori) - can be responsible for indigestion, low stomach acid, ulcers, nausea, vomiting, bloating, or early satiety (fullness after a relatively small meal)
Gut flora - both normal and others including ones called Firmicutes and Bacteroidetes that are associated with weight gain, insulin sensitivity, blood sugar imbalance, and inflammation. They also include opportunistic gut flora that may become elevated if there are infections or dysbiosis. These can cause symptoms like diarrhea or constipation and may lead to triggering autoimmune responses.
Fungi and yeast - Candida and others
Intestinal health markers - this is probably one of my favorite aspects of this test because it tells us a lot about how well your digestion is working. It tells us about liver detoxification, pancreatic function, fat absorption and the presence of blood. It tests for an immune protein called secretory IgA that can signal if your immunity is depressed or overactive. They also include a marker found in inflammatory bowel disease (IBD) called calprotectin, that can help distinguish between irritable bowel syndrome (IBS) and IBD. The last marker in this section is called zonulin and this is a marker of leaky gut.
Who Can Benefit From Getting This Test?
I think most people could benefit from the information on this test but especially if you have any of the following:
Irritable bowel syndrome (IBS)
Inflammatory bowel disease (IBD) - Crohn's or ulcerative colitis
Autoimmune diseases - Hashimoto's thyroid disease, Celiac disease, rheumatoid arthritis, lupus, etc.
Small intestine bacterial overgrowth (SIBO)
Skin issues - eczema, psoriasis, acne, rash, hives
General symptoms like bloating, diarrhea, constipation
PMS or menstrual issues
Mental health issues like anxiety, depression, brain fog or difficulty concentrating
Chronic yeast infections
Suspected reactivation or history of infections like Epstein-Barr virus (EBV), parasites, Candida or H. pylori
Difficulty losing weight
Insomnia
So as you can see, there's a lot of information on this test. I look to see if there are any infections we need to clear up, if probiotics are needed to balance dysbiosis, if you could benefit from digestive enzymes, if you need a course of immune support to build up that secretory IgA and if we need to work on "healing and sealing" leaky gut.
If you'd like to learn more visit their site: https://www.diagnosticsolutionslab.com/ or Doctors Data at https://www.doctorsdata.com/
#2 Food Sensitivity Testing: US Biotek
The second test that I find to be very useful is a food sensitivity test. I think this and the CSA actually go hand-in-hand because for some people eating foods that your body is sensitive to can cause a lot of inflammation and leaky gut. Taking out certain foods in an elimination diet is part of the gut healing process. If you don't do this part, you'll never really get the gut to heal.
I use the US Biotek 96 or 144 food panel. It's a blood test that patients can just go down to the local lab and get drawn. Then you ship it in their pre-paid mailer and we get results in about 2 weeks.
What's Tested on This Panel?
I like this panel because they test for a wide array of foods. Whether you do the 96, 144 or 208 food panel, each one includes these categories and they just add more foods in each category.
Dairy
Fish/Seafood
Fruits
Grains
Legumes
Nuts
Meat/Poultry
Egg
Herbs/Spices
Vegetables
Candida screen
Who Can Benefit From a Food Sensitivity Panel?
The people who can benefit are much the same as the above CSA panel. Food sensitivities can cause a lot of inflammation in the gut and lead to many body-wide symptoms. I really like using this panel to guide an elimination diet so you start by taking out only what has come back elevated rather than all common food sensitivities. This can be helpful for the patient because they don't have to take out all the common food sensitivities, which can be difficult and overwhelming for some.
I also look for certain food families to be elevated like nightshades (potato, tomato, eggplant, peppers), citrus, gluten-containing grains or dairy products. If one or two are elevated then I'll usually recommend that you eliminate all the foods in that family.
You may benefit from a food sensitivity test if you have:
Any kind of digestive issue or condition - diarrhea, constipation, bloating, IBS, Crohn's disease, ulcerative colitis, SIBO
Autoimmune diseases - Hashimoto's thyroid disease, rheumatoid arthritis, lupus, etc.
Skin issues - eczema, psoriasis, acne, rash, hives
Mental health issues like anxiety, depression, brain fog or difficulty concentrating
Chronic yeast infections
Difficulty losing weight
Insomnia
If you'd like to learn more visit their site: US Biotek . Another company, Alletess does a similar panel.
If you'd like to learn more about how to do an elimination diet including a free downloadable guide, read my post How to Do an Elimination Diet to Find Out if You Have a Foods Sensitivity
Those are the top two functional tests that I recommend for most people. I think you get the most "bang for your buck" with these two and as you can see from the "who can benefit" lists, these results can help with a wide variety of conditions.
#3 Hormone Testing - DUTCH Complete by Precision Analytical
The third test that I feel is really useful is a saliva and urine hormone and cortisol test. I use the DUTCH Plus test by Precision Analytical. This test also gives us a lot of information about hormone levels including progesterone, testosterone, estrogen, DHEA, and cortisol. It tells us how you're metabolizing and eliminating them, whether your body favors harmful metabolites, and whether your body favors active or inactive forms of cortisol.
The DUTCH test gives insight into how best to support these pathways with nutrients, herbs and diet/lifestyle changes. There are so many recommendations I could make for balancing hormones and supporting the adrenals but I like running this test because it narrows down the recommendations to what your body needs. It allows me to individualize the plan to your body and how it functions.
What Is Tested in the DUTCH Plus?
This test is a urine and saliva test where you take samples throughout the day starting upon waking and ending before bed. It has to be done during the ovulatory phase of your cycle if you're premenopausal or anytime if you are in menopause. This test is nice because it can be done at home.
Progesterone
Androgens (testosterone, DHEA)
Estrogen and estrogen metabolites
Cortisol and metabolites - samples are taken during the day to get a reading of what your levels are. Cortisol should rise in the morning and slowly decrease during the day. This cortisol curve can be off in conditions like adrenal fatigue.
OATs (organic acids) - I really like that this is included in the test because these can tell us important details about detoxification, neurotransmitter metabolism, vitamins and antioxidant status, which are useful in formulating a plan to support hormones.
Melatonin
Cortisol Awakening Response - this is like a "mini stress test" that looks at how much your cortisol rises after you wake up. I use this along with the cortisol readings during the day to see if you might benefit from adrenal support.
Who Can Benefit From This Test?
women with menstrual issues - irregular or absent periods, cramping, painful periods, PMS
suspected PCOS or symptoms (facial hair, irregular periods, acne)
chronic fatigue
suspected adrenal burnout or experiencing chronic stress
sleep issues like difficulty falling or staying asleep
food cravings for sugar or salt
mental health symptoms like brain fog, anxiety, depression, irritability
difficulty losing weight
If you'd like to learn more visit their site https://dutchtest.com/
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In health,
Dr. Jamie
Summary
Functional tests are different from conventional lab tests in that they tell you how well your body systems are working such as your digestion, liver detox, cellular energy, macronutrient metabolism and hormonal systems. I recognize that functional testing can be a big investment upfront, but I think they're a good investment because of the wealth of information they provide.
The comprehensive stool analysis that I do is called the GI-MAP by Diagnostic Solutions. It tests for pathogens, normal and opportunistic gut flora, H. pylori, and a variety of intestinal health markers. You may benefit from this test if you have any kind of digestive symptoms or disease, autoimmune disease, skin issues, menstrual issues, mental health symptoms, chronic yeast infections, past or suspected reactivated infections, weight gain or sleep issues.
For a food sensitivity panel I use US Biotek's 96 or 144 food panels that test for many food groups. You may benefit from this test if you have any kind of digestive issue or disease, autoimmune disease, skin issues, mental health symptoms, chronic yeast infections, weight gain or sleep issues.
The DUTCH Plus hormone/cortisol test gives information about hormone levels including progesterone, testosterone, estrogen, DHEA, and cortisol. Those who may benefit from the DUTCH test include women with menstrual issues, PCOS, chronic fatigue, adrenal fatigue, chronic stress, sleep issues, food cravings, mental health issues or have weight gain.
This website is not intended for the purpose of providing medical advice. All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.
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