Have you hit a dead-end with your doc? 

Maybe you’ve heard the dreaded 5 words…  “all your labs are normal”.

If you’re tired of the limitations of conventional Western medicine and seeking a more comprehensive and personalized approach to your health, you’ve come to the right place.

In this blog, we will explore some of the tests I commonly use and how they can help you achieve optimal health and wellness.  Whether you are struggling with a chronic illness or simply looking to optimize your health, this blog will give you a better understanding of f

THE DIFFERENCE

First, let’s talk about the difference between Functional Medicine and your standard Western medicine tests. Our focus in Functional Medicine is identifying and addressing the underlying root causes of health issues, rather than merely treating symptoms. 

unctional medicine tests.

 

1. SPECIALIZED TESTING

In functional medicine, testing plays a pivotal role in unraveling the complexities of your health. Unlike traditional Western medicine, it goes beyond basic assessments and dives deep into your unique biology, lifestyle, and environment. Rarely do I have a patient that comes back with all their labs being normal. We almost always discover something that needs attention and improvement.  In the rare case everything does show up normal and they are experiencing symptoms, it means we just haven’t looked in the right place yet. 

While your doctor runs routine check-ups and barebones basic bloodwork, functional medicine testing takes it up a notch. We use comprehensive bloodwork, gut and stool tests, hormone assessments, and specialized tests like SIBO and food sensitivity testing. These powerful tools give us a wealth of information, revealing imbalances, deficiencies, toxicities, hidden infections, and other factors that might be contributing to your health issues.

We also use stricter parameters for what is considered healthy, aiming for optimal physiological functioning rather than relying on ‘normal’ ranges. Western medicine uses lab ranges that are based on the average American and we can all agree that the average American is not healthy. That’s why you can feel like crap but still have all your labs come back normal. 

 

2. PERSONALIZED PROTOCOLS

It’s often not just one thing that led to your current health situation. It’s a combination of your habits, diet, and lifestyle that have contributed to how you feel every day. In Functional Medicine, we dig deep into these factors and examine how they impact your health on a foundational level. By using test results, we can identify areas where we can make changes to your habits, incorporate supplements, and adjust your diet to improve your overall well-being.

This holistic understanding of your health helps us create personalized treatment plans that target the specific root causes affecting you. Our goal is to bring about long-lasting results and enhance your overall wellness. We’re here to support you on your journey towards better health and make a positive impact on your well-being.

Now that you know some of the differences between the Western and Functional Medicine approach, let’s talk about the tests that I frequently use to get down to the root of my patient’s health issues.

1. COMPREHENSIVE BLOODWORK

I run a comprehensive bloodwork panel for all of my patients. This gives us information on how your body is working at a foundational level and can be incredibly illuminating when we test for the right things.

Unlike the limited testing done during a routine doctor’s checkup, the tests we order include a wide range of markers that are often overlooked. We go into much greater depth compared to what a typical doctor tests for, which is why your previous bloodwork is usually not very helpful. There’s just too many missing puzzle pieces to get a good idea of what’s going on.

Conventional bloodwork looks something like this:

    • Complete Blood Count
      • Red/white blood cells
      • Hemoglobin
      • Hematocrit
      • Platelets

Etc… 

    • Basic Metabolic Panel 
      • Glucose
      • Electrolytes (sodium, potassium, calcium)
      • Liver function (AST, ALT, bilirubin)
      • Protein
      • Kidney function (BUN, creatinine)
    • Cholesterol Panel

And maybe:

    • Basic thyroid (TSH, T4)
    • Iron

In addition to the above, we also do….

a) FULL THYROID PANEL

Your regular doctor typically runs thyroid tests like TSH and maybe T4 to assess your thyroid function. However, relying solely on these markers can be unreliable and insufficient. TSH levels fluctuate significantly throughout the day, so a single snapshot may capture a low, high, or normal level without reflecting the overall average. Using a single marker like TSH alone cannot provide a definitive diagnosis. To get a clearer picture, it’s essential to analyze multiple markers and observe patterns.

In functional medicine, we go beyond TSH and T4 and test for other crucial thyroid hormones like T3, T3 uptake, thyroid antibodies (TPO + TGA), reverse T3, and free T3 and T4. This comprehensive testing is vital for identifying thyroid imbalances that can affect your metabolism, energy levels, and overall well-being. It helps us pinpoint the specific organ (pituitary, thyroid, hypothalamus) involved in the chain of events related to your endocrine hormones. Optimal thyroid function relies on harmonious communication between these three organs, and by only testing TSH, we are assessing the interaction between the thyroid and pituitary gland, not the thyroid’s actual function.

While many doctors wait until your markers are out-of-range and require medication, in functional medicine, we monitor any high or low levels closely. We provide dietary and supplement recommendations to support optimal thyroid function naturally and prevent the need for medication. By addressing imbalances early on, we aim to maintain thyroid health and promote overall well-being.

 

b) FULL IRON PANEL

We also do a complete iron panel to check your iron levels and look for conditions like iron deficiency anemia. Iron itself is not a very reliable marker so we also run ferritin, iron saturation, TIBC (total iron-binding capacity), and UIBC (unsaturated iron-binding capacity) to get a clearer picture.

We also test for B12 and folic acid to figure out the cause of any anemia and create a more specific treatment plan. It’s important not to just prescribe iron blindly, as it can sometimes make symptoms worse if that isn’t the cause of the anemia to begin with. By understanding the whole story, we can provide the right treatment and support your well-being.

 

c) INFLAMMATION MARKERS

When looking at bloodwork, it’s important to remember that no single marker can determine the presence of a disease. We need to look at different patterns of the bloodwork which is why we need to test for more markers than what is included in typical bloodwork. If one marker shows an abnormal result, we need to compare it to other related markers to establish a conclusive finding.

The term “inflammation” is quite general, so to understand the underlying causes of the inflammation, we compare inflammatory markers like homocysteine, CRP, and reverse T3 with other markers such as B12, folic acid, liver enzymes, and the results of our gut tests. 

This comprehensive approach helps us identify potential sources of inflammation. Without all the relevant markers, it’s like missing puzzle pieces, and we can’t grasp the complete picture or tell the whole story.

 

d) VITAMINS

To address common deficiencies, we also include magnesium, B12, sodium, potassium, and vitamin D testing. These vitamins play vital roles in various bodily functions, and deficiencies can have wide-ranging effects on your health. Deficiencies are very common these days and can have significant effects on overall health when out-of-range. 

While it’s easy to get into the “plug-and-play” method with Vitamin deficiencies (aka take a supplement of the deficient vitamin), it’s important to address why the deficiency is happening. The body is very smart and does things for a reason. Are we deficient because there’s an infection and it’s using up more resources to heal? Is it coming from not eating a varied diet? Is there chronic stress or alcohol use that is depleting us? 

If we don’t address the root cause of the deficiency in our treatment protocol, we are still just doing symptom management like they do in Conventional Medicine.

 

HOW TO GET THE BLOODWORK DONE

If you have a good working relationship with your doctor we can see if they will order this bloodwork for you to potentially get it covered by insurance (every insurance plan is different so there’s no guarantee what they will pay). 

To do this, we email a letter that you can give to your doctor listing the tests we’d like performed. This can be more time and effort consuming if your doctor is unable or unwilling to perform all the tests requested. Many docs feel that the tests we are doing are “overkill” or medically unnecessary so often times you have to push for it or find a new doctor who is willing to work with you. 

If you don’t have a normal doc that you work with or don’t feel like jumping through hoops in order to achieve this, we can order through my company which will be out-of-pocket, not covered by insurance and ~$450 (at the time of writing this blog).

 

2. GUT AND STOOL TESTING: 

Another test I run on nearly all of my patients is the GI Effects by Genova Diagnostics. It’s a 3 day stool (that means poop) test that you do at home and then drop off to FedEx in a pre-paid box that assesses your gut health.  

Even if you don’t have digestive issues it’s completely possible (and common) to still have issues going on with your gut. The gut is the root of all health and an imbalanced gut is commonly the source of anxiety, migraines, arthritis and chronic pain, brain fog, skin issues and much more.

The GI Effects test assess the health of your gut within a few categories:

    • Digestive Function: 
        • The test assesses the overall function of your digestive system, including the production of digestive enzymes and the breakdown of food. It helps determine if there are any issues with malabsorption or if you are properly digesting your food.
    • Gut Inflammation: 
        • The test examines the presence of inflammation in the gut lining. Inflammation can be an indication of underlying gut health issues, such as leaky gut syndrome or inflammatory bowel disease. This test does not tell us conclusively if you have either however and more specific testing would need to be done but it points us in the right direction
    • Gut Microbiome Composition: 
        • The test evaluates the composition of your gut bacteria, assessing the balance between beneficial and harmful bacteria. This is one of the most common issues I see in clinic with either too little of the “good” guys (commonly due to antibiotic use, lack of pro and prebiotics in the diet, Standard American Diet) or an overgrowth of bacteria.
    • Fungal Overgrowth: 
        • Fungal overgrowth can contribute to digestive problems and compromise overall gut health. This is often a byproduct of gut dysbiosis but can check to see if there is indeed a candida or other fungal issue so we can tailor the appropriate supplements and treatment protocols by using an anti-fungal. 
    • Metabolic Efficiency: 
      • How well your body is utilizing the nutrients from your food and converting them into energy. Poor metabolic efficiency can lead to issues like nutrient deficiencies and low energy levels.

 

TESTING LOGISTICS 

This test takes about 2-3 weeks to get results back once it arrives at the lab so it’s super important to get it done ASAP once your receive it! Otherwise it can be 2+ months before we start you on your treatment plan. You will also need to avoid antibiotics, probiotics, digestive enzymes, charcoal and certain other medications prior to the test which we discuss during the initial consult. There are a lot of fine details within the instructions so it’s crucial that you read over them multiple times to avoid having to repeat the test. Nobody likes to have to play with their poop more than necessary.

3. SIBO

SIBO, or Small Intestinal Bacterial Overgrowth, is a condition characterized by the presence of an excessive number of bacteria in the small intestine. Normally, the small intestine has barely any bacteria compared to the large intestine where most of our gut bacteria reside. However, when bacteria from the large intestine migrate and colonize the small intestine, it can lead to various digestive symptoms and nutrient malabsorption.  

Common symptoms include that ‘6 month pregnant’ feeling, bloating after eating, abdominal pain, diarrhea, constipation, excessive gas, and trouble absorbing nutrients. However, these symptoms can overlap with other digestive conditions, so testing for SIBO  is incredibly important to getting an accurate diagnosis and treatment.

SIBO is generally a result of carbohydrate malabsorption which can result from not chewing your food well, too many processed foods, not enough stomach acid, constipation, alcohol consumption or other things that impair digestion.

 

TESTING LOGISTICS:

The most popular and non-invasive way to diagnose SIBO is via a breath test. You’ll drink a liquid that contains a substance like lactulose or glucose. The bacteria in your small intestine ferment these substances, creating hydrogen (H2) and methane (CH4) gases. You’ll breathe into a device at specific intervals over a 3 hour period to measure the levels of these gases. Higher levels of hydrogen or methane indicate bacterial overgrowth in the small intestine.

Prior to taking the test, you will need to follow a specific diet for 24 hours to ensure accurate results. 

NOTE: It is totally possible to have SIBO or other underlying digestive issues without experiencing ANY digestive symptoms. That’s why it’s so important that we test so we can choose an accurate treatment protocol.

 

4. GLUTEN TESTING

CYREX ‘ARRAY 3’

I fall into the camp that nearly everyone should avoid Americanized gluten. Especially while you’re on your healing journey it’s important to remove inflammatory foods from your diet to allow the body to heal. 

Gluten can have an effect on the body for up to 3 months after a single exposure (yes, even one bite)! So while we are trying to heal your gut and lower your body’s inflammation, it’s UBER important that you try to avoid it as much as possible. If you’re committed to the cause and are willing to eliminate it completely, we don’t need to spend money on testing unless you’re curious and want to know if you are reacting to gluten.

If you’re reluctant to remove gluten or don’t feel like it has an effect on you and need ‘proof’, then I recommend doing Cyrex ‘Array 3’. Just because you don’t notice any gut issues after consuming gluten doesn’t mean that it’s not affecting you. It’s known to affect the skin (acne, dermatitis, keratosis pilaris – those bumps on the back of your arms, eczema, psoriasis) as well as the brain (headaches, migraines, brain fog, depression, anxiety, mood, sleep).

Even if your regular doc has tested you for Celiac, that doesn’t rule out the possibility that you’re reacting to gluten. They only testing for 2-3 markers related to gluten while Cyrex Array 3 tests for 16 different parts that can be affecting the body.

Remember, you can’t find what you’re not looking for and if your regular doc is only looking for 2 components of the gluten molecule, then there’s a LOT that can be missed! 

 

CROSS-REACTIVE TESTING

Here’s another kicker, there are other foods that look really similar in molecular structure to gluten and can create a similar inflammatory effect — we call those cross-reactants. So even if you are actively avoiding gluten, it’s important to do this test (Cyrex Array 4) to see if you’re also reacting to:

 

    • Oats
    • Corn
    • Dairy (cow’s milk, milk chocolate, milk butyrophilin, whey protein, casein)
    • Instant Coffee
    • Millet
    • Rice
    • Yeast (brewers and bakers)

This is especially recommended for those who are avoiding gluten but are still symptomatic and I usually don’t run this test right off the bat unless you have already been doing gluten free for a while and still have symptoms OR if you are able to make the investment right off the bat. 

5. FOOD SENSITIVITY TESTING

When it comes to food sensitivity tests, I typically don’t start with them unless you have a strong curiosity about how certain foods may be affecting your body. If we decide to pursue food sensitivity testing, the only test I trust is Cyrex Array 10. I use it as a tool to track our progress in healing your gut, rather than imposing a permanent ban on the foods that show a reaction.

It’s important to understand that many foods may show up as positive on a food sensitivity test not because they are true triggers for you, but because your gut is inflamed, irritated, and reacting to multiple factors. As we work on healing your gut and immune system, you will likely become less reactive to a wide range of foods.

I typically wait to conduct the Cyrex Array 10 test until we have established a solid foundation in your lifestyle and gut health during the first 3 months of your treatment protocol. Symptoms often improve during that time by implementing the necessary changes. If any issues persist after the three-month follow-up, we can consider food sensitivity testing to identify any remaining triggers.

To monitor our progress, I generally recommend retesting every three to six months. The purpose of food sensitivity tests is to gauge the healing of your gut, and ideally, we should see a reduction in the number of sensitivities over time as your gut heals. These tests should not be seen as a permanent restriction on specific foods unless they consistently show up as triggers despite the healing process.

Another note on food sensitivity: 

most of the hundreds of tests out there are not very reliable. 

These tests often give you a snapshot of your sensitivity to certain foods at a specific moment in time because they only test for IgG antibodies. Cyrex array 10 tests for both IgA and IgG antibodies. IgA antibodies are associated with immediate immune responses in the gut while the IgG helps detect more delayed immune responses that are often linked to chronic conditions like migraines, skin issues or digestive problems. 

Many food sensitivity tests for reactivity to foods in ways that you wouldn’t typically eat them, like raw potatoes or raw eggs. Cyrex ‘Array 10’ tests for both raw and cooked foods because they change in structure when heated above 118 degrees.

Array 10 tests for sensitivity to over 180 potential antigens (proteins that can trigger your immune system). These include foods, raw and/or modified; food enzymes; lectins; and artificial food additives, including meat glue, colorings, and gums. Many of which are found in processed foods that many people consume daily. 

 

 

6. DUTCH HORMONE TESTING:

The DUTCH (Dried Urine Test for Comprehensive Hormones) test is a comprehensive hormone test that assesses both stress (cortisol, cortisone) and sex hormones (melatonin, estrogen, testosterone, progesterone).  It is the current gold standard for hormone testing (aka way better than blood) and provides valuable insights into the balance and function of hormones in your body.

If you’re experiencing issues like fatigue, disrupted sleep patterns, irregular periods, absence of periods, or other hormonal imbalances, the DUTCH test may be recommended.

I generally prefer to address gut and liver health before focusing on hormones, as oftentimes imbalanced hormones are a side effect of an imbalanced gut and liver, however there are certain situations where the DUTCH test right off the bat becomes necessary. It’s also helpful to have more information straight away so if finances are not an issue then this is one that can provide valuable insight into your body’s biochemistry.

 

TESTING LOGISTICS:

You’ll collect 4-5 urine samples at specific times throughout the day, following the detailed instructions provided in the testing kit. After collecting each sample, you’ll air dry the provided strips or filter paper. Once fully dry, you’ll securely package the samples in the provided container and use the pre-paid shipping label to send them back to the laboratory. The lab analyzes the hormone levels in your urine samples and provides us with a detailed report, offering insights into your hormone balance and potential imbalances. With any of these functional medicine tests, it’s super important to read the instructions carefully to make sure we get reliable results.

 

 

7. ORGANIC ACID TESTING

The Organic Acids Test (OAT) by Great Plains Labs is an important test in functional medicine that helps us understand how your body is functioning on a deeper level. It looks at the byproducts produced during different processes in your body, which can tell us about things like nutrient levels, how well your gut is working, and even how much energy your cells are producing.

The OAT is especially helpful when we can’t find a clear explanation for your symptoms through regular tests and I use it especially in cases of mood disorders, chronic fatigue, and autoimmune diseases.

By measuring the levels of these byproducts, we can see if you have any deficiencies in important nutrients like vitamins and minerals. We can also check for signs of inflammation and oxidative stress, which can affect your overall health.

The test can also tell us if there is an overgrowth of yeast or harmful bacteria in your gut, which can cause digestive issues and make it harder for your body to absorb nutrients properly. It even gives us information about how well your cells are producing energy.

We use the OAT when we suspect that there may be underlying problems with your metabolism or when other tests haven’t given us clear answers. It helps us create a personalized plan to address any imbalances or deficiencies we find, using things like changes to your diet, specific supplements, and lifestyle adjustments.

In simple terms, the Organic Acids Test is a helpful tool that gives us a closer look at how your body is functioning and helps us figure out the best ways to improve your overall health.

To wrap it up, these are the tests that are most commonly used in my clinic. While comprehensive bloodwork and the GI Effects test are standard for all patients, the other tests are determined based on individual needs and discussed during the initial consultation. 

If you’re ready to take charge of your health and explore a holistic approach, I invite you to book your initial consultation today. 

Let’s work together to dive deeper into your health concerns and identify the most suitable tests to achieve optimal well-being. Don’t wait any longer – start your journey towards better health and vitality now!