Functional medical testing can greatly aid practitioners in developing an individualized treatment plan.
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 mitigate potential 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.
“Conventional medical tests are designed to diagnose particular diseases, while functional medical 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.
Tony Hoffman, CEO of Diagnostic Solutions Laboratory headquartered in Georgia, said he has seen a tremendous increase in the number of practitioners who want to use functional medicine testing.
Both Amy Pieczarka, director of nutrition services, PreviMedica, a sister company of Cell Science Systems based in Florida, and Daniel Hanson, vice president of DHA Laboratory, headquartered in Illinois, said that functional medical tests are essential for allowing practitioners to develop targeted protocols for their patients.
The main purpose of this type of testing, added Joy Stephenson-Laws, JD, president and founder of the nonprofit national health organization Proactive Health Labs, is to anticipate and prevent diseases before symptoms even manifest.
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 that not all are covered by all insurance plans.
Ideally, conventional and functional testing should work in tandem. “Practitioners must look at every piece in the puzzle. Clinical findings and lab tests are equally important and should both be used in the equation of finding the right treatment for a patient,” said Pratt-Hyatt.
Dr. Evans noted that functional tests are increasingly being used not just by natural practitioners but by medical doctors who seek to get a complete picture of their patients’ health. “Functional medicine is becoming increasingly well-known and demanded by the general public, and more and more physicians are being trained in functional medicine,” he said.
That is important, because everyone from the practitioner to the clinician to the lab plays a pivotal role in improving outcomes, Hoffman pointed out. “Practitioners looking to find the underlying causes of illness need cutting edge testing. From autoimmune disease, to anxiety, our testing can reveal root causes of illnesses with unknown etiology. And, once discovered, the path to symptom resolution and wellness can begin,” he said.
Pieczarka said that conventional blood tests should be interpreted via a functional approach, as it helps identify early trends toward dysfunction before full blown manifestation of a disease occurs and is useful as it “…it uses tighter, more optimal target ranges that reflect optimal physiology, rather than standard ‘normal’ reference ranges, which are based on statistics and represent broad ‘average’ populations,” she said, adding, “Appropriate interventions can be implemented to prevent disease and minimize medication prescriptions.”
One advantage to the tests on the market is that patients may administer some of them at home on their own, send their results to a lab and provide their practitioners with the results.
Even for those tests done at home, though, patients should be sure to share the results with their doctors, who should “…utilize the results within a comprehensive assessment and apply the findings appropriately in individualized treatment protocols,” said Pieczarka.
Availability of Tests on the Market
The general public wants to be armed with as much beneficial information as possible. Little to no risk factors exist for patients who opt for most functional medical tests, as most are noninvasive.
There are more tests than ever available on the market. At least when it comes to gut health, the increase of tests could be a side effect of the Microbiome Project implemented by the National Institutes of Health in 2007, suggested Hoffman. “About 70 percent of our immune system resides in the gut, and [as] a result, it can affect things not commonly associated with the gut—such as autoimmune disease, hormone imbalance and mood disorders,” he said.
As of 2015, his company, Diagnostic Solutions, has offered GI-MAP which uses advanced qPCR technology to identify pathogens, parasites, and more through DNA, information that other culture-based tests might miss. “It shows a quantitative measure of the found pathogen so practitioners can see how prolific an infection is. Diagnostic specificity is essential to finding out what’s going in in the patient’s gut. It is the most comprehensive stool test available in the field of functional medicine,” said Hoffman. He added that even in the absence of digestive complaints, this test can be useful because many answers are found in the gut. He explained that practitioners, who can give this test to patients for at-home stool collection, have used this test to help patients with autoimmune disorders such as fibromyalgia and even to help patients clear up acne.
Other tests by Diagnostic Solutions include an H. pylori biopsy panel that gastroenterologists can perform during a regular colonoscopy to identify the H. pylori parasite. The company launched its most recent test in early 2019, the GenomicInsight panel, which allows practitioners to look at how unique genetic alterations in DNA impact key areas of health. “GenomicInsight allows practitioners to tailor treatments to a patient’s predisposition for disease through lifestyle changes. Our testing options offer practitioners a unique window into patient health. Armed with the information provided, treatment can be personalized and targeted more precisely,” explained Hoffman. Patients can administer this cheek swab test at home or it can be done by a practitioner.
KBMO offers food sensitivity testing called the FIT test and was developed to identify foods that cause inflammation in the body. “Because inflammation is the root cause of so many illnesses that we have in our society today, it’s very important if we’re talking about root cause to reduce inflammation. Complex chronic disease is caused by inflammation, and conventional medicine understands that. However, it has yet to fully understand the role that food can play in causing or eliminating or reducing inflammation in the body. So if we eat foods that are predominantly anti-inflammatory, that can be very good, and if we eat foods that create inflammation, that can drive complex chronic disease,” said Dr. Evans. A finger prick test, the FIT test tests the IgG (immunoglobulin) and complement systems to ascertain food sensitivities; it can also be done as part of a regular blood draw. Currently, it is only available in the practitioner market rather than direct-to-consumers.
Because of the link between inflammation and symptoms, the test is ideal for patients with such complaints as fatigue or joint aches or diabetes but also for people who have or wish to prevent heart disease and cancer, as well as for those who wish to lose weight, he said. “Everybody should know the foods that cause inflammation for them.”
DHA Laboratory offers the Kryptopyrrole Quantitative Urine test. “It measures a protein molecule which is problematic when overproduced. This protein molecule is responsible for binding to zinc and B6 in the blood stream and eliminating it from the body before they are able to do their jobs,” said Hanson.
“The goal is to know we are providing the body with key nutrients and elements it needs to produce neurotransmitters, fight inflammation, repair DNA, and work in our body as it was intended so we continue to function as best as we are able,” he continued. “Practitioners can utilize these results to target key supplements which will improve the bodies overall function and the outcome of the patient.”
Great Plains Laboratory manufactures several urine tests designed to help practitioners ascertain the underlying causes of disease and design a personalized health plan. “We started with the Organic Acid Test (OAT) over 20 years ago, then we developed a food sensitivity test (IgG Food Allergy Test), and in just the last five years, we developed the GPL-TOX Profile for non-metal toxicant exposure, and most recently, our MycoTOX Profile for mold exposure,” said Pratt-Hyatt.
Pratt-Hyatt further explained, “The OAT is a 75-marker snapshot picture of the patient’s overall health and metabolism. It looks at gut health, neurotransmitters, glutathione status, mitochondria status, nutritional status and more. The GPL-TOX Profile assesses for exposure to more than 170 toxic chemicals, and the MycoTOX Profile measures 11 different mycotoxins from over 40 species of mold.”
The IgG Food Allergy Test is an ELISA (enzyme-linked immunosorbent assay) test, enabling patients to test for up to 90 food sensitivities. It is a serum or dried blood spot test.
All of Great Laboratory testing can be performed at home or in a medical office.
PreviMedica offers several tests, including the Alcat test, which is a leukocyte activation test that detects the innate immune system response to more than 500 substances: foods, additives, molds and botanicals. Another is the CICA, which tests for celiac, IBS and Crohn’s Array, which assesses the genetic risk for these disease as well as the serology markers to identify the likelihood of an active disease. Yet another is the Cellular Nutrition Assays, which assesses nutrient needs at the cellular levels, as well as the Methyl Detoxification Profile and the Telomere Score. Of the latter, Pieczarka said, “Telomeres are segments of DNA found at the ends of chromosomes; they protect the genetic data contained in DNA and act as a buffer during cell replication. Telomere length may be indicative of cellular aging as well as increased susceptibility to metabolic disorders and chronic disease. Practitioners are able to suggest lifestyle changes aimed at reducing inflammation to help delay telomere shortening.”
Proactive Health Labs, a national nonprofit health organization, offers a wide variety of tests to clients at their southern California health center. These include everything from nutrient tests, toxin tests, whole genome sequencing, body composition tests and the like. Stephenson-Laws said that one of the most popular is their Nutrition Test. “This is a comprehensive nutrient test which identifies whether key nutrients that the body needs to perform efficiently are present in a balanced proportion. The nutrients tested includes all the critical vitamins (e.g. A, Bs, C, D); minerals (such as copper, manganese, magnesium, zinc etc.); amino acids; probiotics; antioxidants; and fats. The test further identifies harmful minerals like lead, cadmium and mercury, which may affect the ability of the body to efficiently absorb necessary nutrients from the food we eat,” she said.
Another popular test is the pH Health Assessment, which identifies various imbalances before they develop into disease symptoms; the purpose is to measure key health indicators to gauge overall health and provide customized recommendations. And they just also added fat testing to their suite of tests.
The Future of Testing
Dr. Cruz said that more testing companies are releasing advanced testing and getting results back more quickly than ever before, a trend that should continue into the foreseeable future.
“We see test kits being produced in ways which are easier for patients to complete. Specimen transportation technology is always advancing and allowing us to offer new tests in new parts of the world. At the same time, we are always looking at ways to automate manual procedures and simplify the testing process,” said Hanson.
Most practitioners agree that the future of testing is compatible with individualized medicine—the more intricate and customized test results are, the greater the chance of personalizing treatment protocols and garnering optimal patient outcomes.
“The future of testing is in the practice of precision medicine. We started with the GI-MAP and qPCR technology to offer practitioners a way to hone in on exactly what gut health issues to focus on to achieve better outcomes for their patients. Each result is as unique as a fingerprint and can be used to influence patient health based on their genomic profile,” said Hoffman.
“I think we’re looking at genetics and what are the genes that people have that predispose them to have problems and benefit from certain foods. The gut microbiome is an area that is being explored. I think that there is even a new area of interest in the breast microbiome and we’re understanding more about the vaginal microbiome,” said Dr. Evans.
\ Stephenson-Laws added that she believes that testing will continue to become more widespread and less expensive. “I also believe that functional testing will become even more specific and specialized to better help zero in on what may be threatening the health of their clients and how to better prevent and manage disease. This benefits everyone and should be our common goal.”
Healthy Take Aways
• Functional testing should not replace conventional medical testing but should be interpreted in tandem.
• Functional testing allows practitioners to customize a treatment protocol.
• Most tests can be done at home, though practitioners should advise their patients to consult with insurance companies for any coverage questions.
For More Information:
Cell Science Systems/Previmedica, https://cellsciencesystems.com; www.previmedica.com
DHA Laboratory, www.dhalab.com
Diagnostic Solutions Laboratory, www.diagnosticsolutionslab.com
The Great Plains Laboratory, www.greatplainslaboratory.com
KBMO Diagnostics, https://kbmodiagnostics.com
Proactive Health Labs, www.phlabs.com