When the check engine light comes on in your car you know exactly what to do. You call up your mechanic and schedule a checkup as soon as they can get you in. After performing a few diagnostics, a competent mechanic can quickly diagnose and fix the problem and get you back on the road again.
What about when your “check engine light” comes on? The nagging symptoms that you experience from time to time (or daily) are your body’s check engine light. Symptoms are how your body lets you know there’s an issue and, although they may be uncomfortable and unwanted, they are a blessing. Without this easy warning system, you would have no way of knowing that you are heading down the road to a bigger problem. Sometimes the problem is obvious: like the pain from a sprained muscle, fatigue from not getting enough sleep, or a headache from having one too many drinks. However, oftentimes the problem is less obvious. You don’t feel quite right, but you just can’t identify why. Possibly you don’t have the energy you would like or you’ve developed a skin condition that just won’t go away. Maybe your joints hurt for no apparent reason or you’re constantly bloated or constipated. Perhaps your memory is just not as sharp as it once was. It’s easy to dismiss these (and other) vague symptoms as no big deal or assume they are normal for your age, but doing so is like ignoring the check engine light on your dashboard. Eventually, the problem will worsen and lead to an even bigger and more expensive problem.
This is a good analogy, and one that I use often with my functional medicine patients, but there is one big difference between cars and living biological systems like us. When a car breaks down, the fix is generally straightforward: replace a spark plug, repair the transmission, or remove a nail from the tire. One problem, one fix. Living systems, on the other hand, are much more complex and interconnected. When one system (like the gut) is off, this often leads to inflammation in other systems (like nervous or musculoskeletal system). In this case, treating the nervous system with an antidepressant or the musculoskeletal system with a pain medication may help dull the symptoms, but does not address the underlying root cause. If this continues, the real problem (the gut) never gets addressed and more systems (circulatory, hormonal, skin, etc…) become symptomatic.
As a functional medicine practitioner, my job is to act like a detective and find the underlying mechanisms that are impacting my patients. There are many potential tools at my disposal, but there are 4 tests that can provide the best look “under the hood,” uncovering the imbalances responsible for each person’s unique health situation.
Unfortunately, in most instances, these tests are not covered by insurance companies and, therefore, are not ordered but most physicians. Just because a valuable test is not covered by insurance is no reason to discount the test altogether, especially if it can yield critical information to help you regain your health. The specific tests I’ll be discussing are outside the scope of most conventionally trained physicians. They require spending quality time with each patient justifying their value and then interpreting the results. Most conventional doctors just don’t have that much time to spend their patients. If you prioritize your health and want real solutions, I would recommend working with a functional medicine practitioner who has experience running these tests and is well-versed in interpreting the results from a holistic point of view.
1. Comprehensive Digestive Stool Analysis (CDSA)
Over 2,000 years ago Hippocrates, the father of medicine, said all disease begins in the gut. Today, research is proving that Hippocrates knew what he was talking about! Imbalances in gut function have been implicated in a wide range of diseases including diabetes, obesity, autoimmune diseases, neurodegenerative conditions (ADD, Autism, dementia, and Alzheimers) depression, acne, infertility, and chronic fatigue syndrome, just to name a few. What makes matters worse, a staggering number of people with gut disfunction don’t have any digestive complains at all. This is one reason why I find this test so valuable. If a patient can see for themselves that they do, in fact, have an imbalance in their gut, they are more apt to make the necessary changes to correct the imbalances found.
The CDSA test is a non-invasive stool test that measures multiple aspects of gut health. The first measurement I look at is the microbiome, or the balance of friendly bacteria and unfriendly bacteria, yeast or parasites. Too many of these unfriendly pathogens cause toxins to dump into the blood stream. Once in the blood, these toxins can travel around and cause inflammation literally anywhere in the body. Not enough good bacteria can lead to deficiencies in critical nutrients and neurotransmitters that affect our mood and metabolism. Next, I’ll look at digestive markers. Undigested food particles in the stool could indicate the need for specific digestive enzymes. Then I’ll look for the specific inflammatory markers that can help determine if the gut is “leaky” or if inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), ulcerative colitis or Crohn’s disease are present. Finally, I’ll look at secretory IgA (sIgA) levels. Abnormal sIgA levels indicate that the gut’s immune system is compromised either from a chronic infection or food sensitivity.
Once the underlying root cause of dysfunction is properly identified, better targeted and more effective treatment plans can be recommended. I can’t stress enough how important it is to address underlying gut disorders if you truly want to see your health improve!
2. DUTCH (Dried Urine Test for Comprehensive Hormones)
Dysfunction in your hypothalamus-pituitary-adrenal axis (HPA) is often the root cause of a variety of symptoms including weight gain, the inability to lose weight, insomnia, poor digestion, fatigue, moodiness, sugar cravings, chronic pain and inflammation, and decreased sex drive. When the body is in a state of chronic stress, dysfunction in the HPA axis can occur, resulting in abnormal patterns of cortisol release. Cortisol is the body’s primary stress hormone. The levels of cortisol in your body can be chronically too high or too low, or, too high or low at the wrong times of the day. As an example, cortisol should be lowest during the night. If cortisol is too high at night you will feel wired and suffer from insomnia. If all a doctor did was measure cortisol levels in your blood during an average blood test this pattern would almost certainly have been missed (unless your blood draw was right before you went to bed).
The DUTCH test is a noninvasive, comprehensive assessment of adrenal and sex hormones and their metabolites. This test is superior to serum and saliva testing for two reasons. First, the DUTCH test measures cortisol fluctuations throughout a 24 hour cycle by using urine samples collected at 5 specific times. Serum (blood) testing only measures cortisol once, at the time the sample was drawn. This is important because cortisol levels normally raise and fall during a 24 hour period and, like the example above, identifying abnormal ups and downs is critical to properly treat the HPA axis (adrenal glands). Second, the DUTCH test measures both free and metabolized hormones. This provides a more complete picture for better clinical outcomes. When free and metabolized cortisol differ significantly, this could indicate problems with cortisol clearance which is a hallmark of a sluggish thyroid. Neither salivary or serum testing is able to measure hormone metabolites.
As an added benefit, the DUTCH test also measures the sex hormones. Whether you’re a man or a women, knowing your levels of estrogen, progesterone and testosterone can provide your functional medicine practitioner valuable information. Weight gain, anxiety, depression, erectile dysfunction, mood problems, low sex drive, infertility, acne, and more can all be related to imbalances in your sex hormones.
3. Functional Labs
The blood tests most doctors order and the way most doctors interpret the results represents only a small fraction or what could be learned. Running standard blood panels that check the basics like blood sugar, cholesterol, and basic metabolic function do provide some value. If any results are found to be high or low, they will likely be addressed. A medication may be prescribed or some general dietary advice like “eat less fat and red meat” may be given. However, many people don’t feel well yet all their tests results come back completely normal. They are given a pat on the back, told they are doing great, and to come back in a year. This, obviously, can become very frustrating.
In functional medicine we look at lab work differently. We are trying to identify the underlying cause of our patient’s complaints, and not wait until a frank disease process shows up on the test results. We generally use a more narrow range for “normal,” and we include additional tests that provide valuable information on how the body is functioning.
One critical component functional labs measure is inflammation. When you cut your finger, you can see the inflammation. The area swells up, gets red and puffy and starts to hurt. This type of inflammation a normal and healthy, but there is another type of inflammation that is both less obvious and far more dangerous. Chronic inflammation is often referred to at the root of all disease. Conditions like fatigue, brain fog, chronic pain, depression, hormone imbalances, heard disease, autoimmune conditions and even cancer can all result from too much inflammation.
There are numerous lab tests that can suggest a problem with chronic inflammation. The tests I find most sensitive and specific for identifying inflammation include:
- CRP: C-reactive protein is a protein produced by the liver in response to CRP is a better predictor of heart disease than LDL cholesterol.
- Homocysteine: Elevated homocysteine levels have been linked to heart disease, strokes, dementia and autoimmune conditions. Nutritional deficiencies of folate, B12 and B6 can cause this inflammatory marker to increase.
- Ferritin: Ferritin is an iron containing protein. Low ferritin levels can indicate low iron levels, but high ferritin has been found to be an accurate marked for inflammatory conditions including liver disease, rheumatoid arthritis, hyperthyroid and other chronic inflammatory conditions.
4. Visual Contrast Sensitivity
Visual contrast sensitivity testing measures your ability to see details at low contrast levels and has been shown to be a reliable indicator of nerve function. Several factors can affect your ability to perceive visual contrast. These include nutritional deficiencies, the consumption of drugs or alcohol, and exposure to harmful toxins. We are exposed to a tremendous amount of toxic chemicals every single day. Some of these come from outside the body (heavy metals, pesticides, BPA, mold) and some come from inside the body (endotoxins from parasites, yeast, viruses) but all are damaging to the brain and nervous system. The ability to identify and then safely remove toxins from the body is perhaps the biggest game changer in recovering from chronic disease and getting your life back.
Please understand that this is not a complete list of helpful tests. We are all unique individuals with unique concerns. Each functional medicine practitioner may choose his or her preferred tests based on the patient’s past health history, previous treatments, and present condition. However, these labs can provide a meaningful “look under the hood” and help to build an individualized treatment plan that looks to remove the root cause and restore lasting health!
If you want to learn more about your own health case please take advantage of our free 15-minute consultation. We offer in person as well as phone and Skype consultations for people across the country and around the world.
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