Feeling Off? These Are The Tests To Have Your Doctor Run
When we're not feeling our best—maybe we're suffering from chronic bloat, migraines, fatigue, or insomnia—it's tempting to search for that one hidden illness, dysfunction, or deficiency. The truth, however, is that every system of our body is inextricably connected to others, and health problems are almost always multifactorial—due to a number of different dysfunctions and imbalances that, over time, finally show up as various symptoms.
As a functional medicine practitioner, I run a lot of labs. They are great for pinpointing specific problem areas and help guide my treatment recommendations in a major way. And while it is important to remember that every person’s health case and biochemistry is unique—and health issues are often caused by a lot of small problems rather than one big one—talking to your doctor about testing is a great place to start.
Unfortunately, many of these test won't be covered by insurance (although you should always call and check to be sure!), and unless you have a particularly open-minded conventional medical doctor who is willing and has the time to explore these tests with you, the typical general practitioner probably won't be ordering these tests on the reg or be comfortable making them part of your treatment plan. Because of this, I'd recommend working with an integrative or functional medicine doctor who is well-versed in these labs and how to read them from a holistic perspective.
If that's not in the cards for financial or other reasons, another option would be to order the labs yourself. Companies like Thorne, EverlyWell, and Found My Fitness all have at-home tests you can purchase, administer yourself, and send in to be processed. These can also be pricey and time-intensive, but if you're feeling less-than-optimal and you've explored the standard options offered by conventional medicine without any success, they can be great options. Many of them come with a detailed description of your results or a health plan based on your results.
Whatever path you take, these are the tests I recommend looking into:
1. A 24-hour adrenal stress index
Your 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. Since your hormones play a large role in the rest of your health, this imbalance can throw off other hormones, as well—causing blood sugar imbalances, brain fog, weight gain, irritability, decreased sex drive, and trouble sleeping. The 24-hour adrenal stress index is a saliva test that looks at your HPA-axis quality by tracking your cortisol levels throughout the day.
2. A full thyroid panel
Every cell of your body needs thyroid hormones to function, and unfortunately for us, many underlying thyroid problems don't show up on standard labs because conventional medical doctors typically only run TSH and 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 autoimmune thyroid problems. Functional medicine also has a narrower reference range for what constitutes a "healthy" thyroid, which can explain why you may still be experiencing symptoms but haven't yet been diagnosed with a thyroid problem.
3. Gut permeability labs
Hippocrates was right when he said many years ago that the gut is the foundation of our entire health. 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 to all areas of the body. This is commonly known as leaky gut syndrome. A gut permeability lab test will help determine if leaky gut syndrome is a factor in your specific health case. It will check for:
- Zonulin and occludin: These two proteins control gut permeability, and antibodies could mean the intestinal tight junctions have been compromised.
- Actomyosin antibodies: These could indicate that the gut lining was damaged.
- Lipopolysaccharides LPS: These are bacterial endotoxins in your gut. If they are in your blood, it could mean there was enough destruction of the gut lining to let them pass.
4. Sex hormone labs
Both men and women need balanced levels of estrogen, progesterone, and testosterone to maintain optimal health. When these are imbalanced, either too much or too little in either sex, it can lead to weight gain, anxiety, depression, erectile dysfunction, mood problems, low sex drive, 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
Inflammation is a factor in almost every health problem we face today, including 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. A blood test can look at three different markers of inflammation in the body, according to the functional medicine reference range (which is stricter than that followed by conventional doctors). It will 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. It is considered an acute phase reactant and a sign of inflammation when high.
6. Genetic testing
Your DNA influences many aspects of your health, and certain genetic mutations can make you more susceptible to certain imbalances and health problems. 23andMe and other specialized genetic labs will lay out all of your possible genetic weaknesses for your functional medicine practitioner to interpret and help you mitigate risk factors with natural medicines and lifestyle changes. You can read about the nine 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 your body’s biochemical superhighway that assists in keeping your gut, brain, hormones, and detox pathways healthy. Methylation happens a billion times every single second, so if it isn’t working well, it can greatly affect your overall health.
It’s important to remember that since each person is unique, the specific combination of labs your practitioner runs may be different based on your doctor’s assessment of your health case, health history, and previous lab work. This is a foundation that you can build on to work toward sustainable, lasting healing.
Will Cole, IFMCP, DNM, D.C., is a leading functional medicine expert who consults people around the world via webcam and locally in Pittsburgh. He has holds a level 2 Doctor of Natural Medicine (DNM) certification. Named one of the top 50 functional and integrative doctors in the nation, Cole specializes in clinically investigating underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. He is also the host of the popular The Art Of Being Well podcast and bestselling author of Ketotarian, The Inflammation Spectrum, and the New York Times bestseller Intuitive Fasting.