“Functional testing works to find the underlying cause of disease and not just treat the symptoms but true prevention”
Conventional medical testing, such as blood pressure, cholesterol levels, glucose levels and other routine blood work is an important component of any patient’s annual doctor visit. But with newer technologies and an increased desire for patients to obtain genetic information to help prevent future problems and engage in preventative care, practitioners are able to offer their patients greater options than routine blood work. From food sensitivity to gut microbiome testing and more, functional medical testing provides practitioners with a more complete picture of a patient’s overall health, giving them a better understanding of disease etiology.
Treat The Cause
“Conventional medical tests are designed to diagnose particular diseases, while functional tests are designed to identify areas of the body that are not at optimal function, and that can help to identify the root cause of a particular disease,” said Dr. Joel Evans, medical director at KBMO, a medical diagnostics company based in Massachusetts.
“Functional medicine works to find the underlying cause of disease and not just treat the symptoms,” echoed Matthew Pratt-Hyatt, PhD, associate laboratory director with the Great Plains Laboratory headquartered in Kansas.
Interpreting Functional Testing
Many agree that functional testing can be interpreted independently as well as alongside conventional medical testing. “While conventional medical testing is important, many of the traditional medicine tests don’t get to the core of a patient’s medical issues. By doing both types of testing you can get to the patients issue faster and come up with a more specific plan to really get to the cause of the problem,” said Dr. Liz Cruz with Partners in Digestive Health, a gastroenterology office in Arizona. She said that she offers them to every patient, most of whom choose to do the tests at home rather than in the office, though she noted most are not covered by insurance plans.
I run a lot of lab tests for my patients, and one of the main reasons is that specific lab tests can pinpoint specific problem areas. The results help guide my treatment recommendations in a major way. Each person’s health situation, genetics, and biochemistry are unique, and these labs, above the general blood and urine profile, can effectively show the cause of a patients symptoms.
Here are the functional tests I most often run to help identify the underlying cause of my patients concerns.
1. A 24-hour adrenal stress index (ASI Test)
Dysfunction in the adrenal glands can be at the root of a wide variety of symptoms related to fatigue, anxiety, depression, blood sugar imbalances, brain fog, weight gain, irritability, decreased sex drive, and trouble sleeping. The reason is that the adrenal glands release several hormones, including your body’s main stress hormone (called cortisol), through a complex web of communication between your brain and adrenal glands, known as the HPA-axis. Adrenal fatigue occurs when there is an imbalance in cortisol due to miscommunication in the HPA-axis. This causes cortisol to be low when it should be high, high when it should be low, always low, or always high.
Each one of these cortisol imbalances can result in different vague or even severe uncomfortable symptoms. Since your hormones play a large role in the rest of your health, this imbalance can throw off other hormones, as well, which contribute to the long list of symptoms that can be caused by adrenal fatigue. The 24-hour adrenal stress index is a saliva test that tracks your cortisol levels throughout the day, resulting in a general assessment of the functioning of your HPA axis.
2. A full thyroid panel
If the adrenal glands affect many parts of your system, the thyroid glands affect even more. Every cell in your body needs thyroid hormones to function, but unfortunately, thyroid dysfunction can be hard to nail down. Many underlying thyroid problems don’t show up on standard labs because conventional medical doctors typically only run TSH and sometimes T4. A full thyroid panel is a blood test that looks at TSH and T4 but also at T3 uptake, total T3, free T4, free T3, reverse T3, and thyroid antibodies, to give you the most accurate picture of your thyroid health and rule out possible iodine imbalances or autoimmune problems.
Functional testing also has a narrower reference range when reading lab test results. That means that what a conventional doctor might deem as normal after surveying labs might well be considered abnormal to a functional doctor. This can explain why you may be experiencing symptoms of thyroid dysfunction, like fatigue, weight gain, dry skin, hair loss, and depression, even though your doctor told you that you do not have a thyroid problem.
3. Gut permeability labs
All health begins in the gut—that famous saying attributed to Hippocrates, the founder of modern medicine, has a lot of truth to it. Research is finally starting to show that many chronic and autoimmune diseases can be connected to gastrointestinal problems. When your gut lining is damaged due to stress, poor diet, medications, and other triggers, it can cause undigested food particles and bacterial endotoxins to pass into the bloodstream, leading to a cascade of chronic inflammation that can pop up all over the body, leading to a wide variety of symptoms. This is commonly known as leaky gut syndrome. You can figure out if this is happening to you (and might be a cause of your symptoms) with a gut permeability lab test. This test checks for:
- Zonulin and occludin: These two proteins control how permeable the gut is by regulating the tightness of the “mesh” that lines the intestines. If the test finds antibodies in your blood to these proteins, that is a biomarker indicating that the intestinal tight junctions have been compromised.
- Actomyosin antibodies: These antibodies should also not be in your blood unless the the gut lining has been damaged.
- Lipopolysaccharides LPS: These bacterial endotoxins are supposed to stay in your gut. If they are in your blood, it could mean there was enough loosening of the intestinal junctions in the gut lining to let them pass.
4. Sex hormone labs
All of us, men and women alike, need balanced levels of estrogen, progesterone, and testosterone to maintain optimal health. The ratios are a little different in each of us, but all the sex hormones are players and when they get out of balance (either too much or too little of any of them), this can lead to many seemingly diverse symptoms, including weight gain, anxiety, depression, erectile dysfunction, mood problems, low sex drive, infertility, acne, and more. A female salivary panel as well as blood and saliva testosterone and DHEA panels look for ratios of these hormones.
5. Inflammation labs
That sprained ankle swells up because of inflammation, but there is another kind of inflammation that is far less obvious and far more insidious. Chronic, systemic inflammation is a factor in almost every health problem we face today. Whether a cause or a symptom or both, inflammation is certainly a culprit in autoimmune conditions, cancer, heart disease, brain fog, fatigue, and even weight gain. Even though a certain amount of inflammation is healthy to fight off infections, viruses, and injuries, inflammation becomes a problem when it doesn’t go away after the threat is gone and continues to perpetuate throughout the body, like an out-of-control wildfire.
A blood test can detect markers of inflammation in the body. As with other tests, the functional medicine reference range to determine what lab results are normal or abnormal are stricter than conventional reference ranges, so you can know sooner that inflammation is becoming a problem for you. that followed by conventional doctors). The inflammation labs I like to run for the most complete picture of chronic inflammation test for:
- CRP: C-reactive protein is an inflammatory protein and is tested alongside another pro-inflammatory protein, IL-6.
- Homocysteine: This inflammatory amino acid has been implicated in brain problems, heart disease, and autoimmune conditions.
- Ferritin: This is a measure of stored iron levels in the body. That may not seem relevant to inflammation, but ferritin it is considered an acute phase reactant—in other words, it is a sign of inflammation when the level is higher than usual.
6. Genetic testing
There is one aspect of health that is predetermined, but even though you may not be able to change it, you can do a whole lot to influence how your body responds. I’m talking about your DNA, which can affect many aspects of your health. Specifically, certain genetic mutations can make you more susceptible to certain nutrient imbalances, drug reactions, and other health problems. 23andMe and other specialized genetic lab tests will lay out all of your possible genetic weaknesses for your functional medicine practitioner to interpret. This can help you intervene, balancing risk factors with natural medicines and lifestyle changes.
There are nine critical genes I take into consideration most often in my patients, but one of the main dysfunctions I look for is a methylation impairment. Methylation is a complex process that acts like your body’s biochemical superhighway. This process assists in keeping your gut, brain, hormones, and detox pathways healthy and fully functioning. Methylation happens a billion times every single second, so if it isn’t working well, it can greatly affect your overall health. Certain genetic mutations can impede certain methylation pathways, with a ripple effect of symptoms and problems. Attack the deficiency, excess, or imbalance at the source and you can prevent trouble down the line.
Keep in mind that this is a general list. Each person is unique, so the specific combination of labs I run may be different based on your the assessment of your particular health case, dietary habits, health history, and previous lab work. However, these labs can create a foundation of knowledge on which you can build as you work towards sustainable health and meaningful health restoration healing that lasts.
If you want to learn more about your own health case please check out the Build A Better You nutritional assessment of your lifestyle, diet and functional lab tests here! Or call Kathy or Kristyl at 503.631.4184 and schedule an evaluation today.