Functional Testing Explained
There are many different medical tests to assess how the body is functioning. Conventional medicine utilises standard blood tests, urine tests, stool tests, scans, x-rays, MRIs and the like. However, while these tests are very useful, they often are more geared towards picking up pathology rather than dysfunction.
For determining how well a system is functioning, many tests fail to really give a true assessment of organ function unless there is a gross pathology. Functional testing is a whole different branch of medical testing that looks to assess function of different organs. Many of these tests give us a more in-depth look at what is going on behind the scenes. These tests can also pick up abnormalities before they are at the level of pathology, allowing preventative treatment plans to be developed.
Unfortunately in most cases these functional tests are not covered under medicare, so the patient has to pay for them privately. These can vary from as low as $50 for some tests and can be as high as $500-600. Many tests are around the $100-200 mark. Obviously, functional tests are only recommended when the results gathered from the test will give very specific information that can be used to tailor an individualised treatment plan for the patient. Many of the tests are offered as simple home test kits for collecting urine, saliva, stool and blood spots however some do need blood draws from a pathology centre.
Let’s take a look at some of the different functional tests available within a few body systems.
Digestion and Liver Function
Standard testing for digestive issues can include colonoscopy and gastroscopy – where scopes (camera like devices) are used to take a look at the inside of the colon or gut. These can pick up pathology such as polyps, colon cancer, inflammatory bowel disease and gastritis (inflammation and ulceration of the stomach or oesophagus). In some cases doctors will run a PCR test to look for bacteria and parasites in the stool such as blastocystis and giardia. While these tests are useful, there is a whole host of other things that can be tested that give us a really good insight into the digestive system. For example, knowing what levels of good bacteria are present is very important and assessing enzyme levels and short chain fatty acid levels can highlight underlying gut issues and dictate the best treatment strategy. A complete digestive stool test yields lots of information that can give a detailed look at gut function.
Breath testing for Helicobacter pylori is a standard test now for stomach ulcers and gastritis. The lactulose SIBO breath test is also a very specific functional test to more accurately assess and diagnose the underlying cause of irritable bowel symptoms such as bloating, wind and erratic stools. Food intolerance testing can show what foods might be contributing to health issues – including digestive issues, allergies, sinusitis, eczema and asthma. Leaky gut can be diagnosed based on the intestinal permeability test. A functional liver detoxification profile takes a look at how efficient the liver is at detoxing certain chemicals – which is far more useful than a standard liver function test which only measures liver enzyme levels – which tend to be elevated with inflammation of the liver and do not determine the cause. We often want to get a sense of how well the liver is functioning in a day to day sense, and the liver detox profile is the best test for that.
Hormones and Reproduction
Standard blood tests are useful for looking at hormone levels, but they tend to give a fairly broad understanding. For example, there are at least 4 different types of oestrogen that can be tested, some of which are more proliferative and linked to breast and endometrial cancers while others are more protective and less damaging. Standard blood tests just give the total oestrogen level and do not differentiate between the different types. Understanding the amounts of different hormones present will also potentially highlight issues with poor excretion of hormones and poor liver function and give specific treatment strategies to reduce risk of disease and treat specific issues such as heavy periods. Functional tests look at salivary levels as well as dried urine to give a more sensitive and detailed assessment of hormone status.
Genetic testing for underlying issues with folate metabolism (MTHFR) is also an important aspect of a fertility workup that Karen undertakes. Polymorphisms (defects) in the MTHFR genes can impair methylation and this has been linked to infertility and miscarriage along with certain cancers and mental health issues. As the methylation pathway is a nutrient dependent pathway, it is one that specific nutritional supplements can improve.
Adrenals and Thyroid
The adrenal glands modulate and support the function of every tissue, organ and gland in your body to maintain balance during stress or illness to help you heal or keep you alive. Many of the hormones produced by the adrenals are essential for good health and vitality, so if your adrenals aren’t functioning well, there can be widespread impacts. Likewise the thyroid is a highly important organ responsible for metabolism and energy in the body. Assessing full thyroid function (not just TSH levels) is important to get an accurate look at the thyroid function. Likewise, a 24 cortisol test can be a good way of assessing adrenal function, whereby salivary cortisol levels are taken 4 times during a 24 hour period to assess how the adrenal functions throughout the day. Other comprehensive dried urine hormone tests can give a lot of information about the adrenal hormones and subsequent adrenal function. For more information on adrenal health click here.
A Summary Of Functional Tests Currently Available:
- Comprehensive Stool Analysis – this test is an excellent way of for beneficial & dysbiotic bacteria, clostridium, candida & yeast, secretory IgA, Lactoferrin, White blood cells, Mucus, Pancreatic Elastase, pH & details of possible food digestion impairment of fats, pH testing etc)
- Parasite testing (Blastocystis hominis, Dientamoeba fragilis, Giardia lamblia, Cryptosporidium)
- SIBO (Small intestinal bacterial overgrowth)
- Helicobacter pylori
- MTHFR gene mutation tests
- Methylation testing (Methionine, Cysteine, homocysteine, SAMe, SAH etc.)
- Pyroluria / pyrroles test (a genetic condition linked to anxiety, depression, addictions and behavioural issues)
- Saliva Hormone Testing (Cortisol, DHEA, oestrogens -E1, E2, E3, progesterone, androgens, testosterone, melatonin)
- Thyroid Hormones (TSH, fT4, fT4, Reverse T3, Thyroid antibodies)
- Nutritional Blood Profiles (Vitamin A, B1, B2, B6, B12/Folate, Vit C, Vit D, Vit E, Co-Enzyme Q10, iron studies, magnesium, calcium, iodine, selenium, copper, manganese, zinc, glutathione, omega 3 levels, etc.)
- Urine Amino Acids profile
- Histamine testing
- Hair Mineral Analysis & Heavy Metal Toxicity Testing (mercury, lead, cadmium, arsenic, aluminium etc.)
- Environmental Pollutants & Chemical Toxicity
- Liver Detoxification Profile (Assesses Phase 1 & 2 status with chemical exposure)
- Metabolic ‘Organic acids’ Testing (36 metabolic acids that may determine causes for fatigue, depression)
- Urinary Hormone Steroid Profile (Includes testosterone, oestrogens, progesterone, Melatonin, Cortisol, DHEA adrenal hormones)
- Food Sensitivity & Allergy Profiles:
- (IgA, IgE & IgG antibodies)
- ALCAT food sensitivity test
- Both food sensitivity methods can test with accuracy the immune response of the body to up to 200 foods, herbs and spices.
- Celiac Antibody Profile and Celiac Gene Test (HLA DQ2 & HLA DQ8)
- DNA Gene Profile Testing (Smart DNA, 23 & Me)
- Intestinal Permeability testing
- Zonulin testing – for diagnosing leaky gut syndrome
If you would like to discuss the merits of a functional test for your specific health issues or as a simple preventative strategy to optimise your health and vitality, please contact Karen.