What is Functional Medicine?

Unlike traditional allopathic medicine, which focuses on treating symptoms, a functional medicine model evaluates and treats underlying causes.  Symptoms such as weight gain, fatigue, depression, gut issues, anxiety, allergies, skin issues and brain fog are signs of imbalance in the hormonal, digestive, and detoxification systems.  These systems become dysfunctional when there is inflammation, a catabolic physiology, insulin resistance or oxidative stress, which is always a result of an underlying cause.  It’s the underlying cause or root problem we are looking to find and address.  When we start addressing root causes, we restore the body’s innate ability to heal.

Examples of root causes could be diet, blood sugar imbalance, food allergies or sensitivities, nutrient deficiencies, stress, GI infection, toxins, genetics, or sleep issues. We use a nutrition and lifestyle approach to develop a plan of care that may include dietary changes, sleep and stress management, exercise and targeted supplementation.  We are typically able to use conventional lab work you may already have to identify areas that may be out of balance. Specialized functional lab testing is not always needed, but sometimes helps provide further insight into difficult cases.

What Types of Tests Do We Do?

Hormonal System

The first body system we typically look at is the adrenal hormonal system, because cortisol, which is primarily produced here, has such wide reaching effects in the body.  When cortisol is balanced you have good energy, sleep and moods.  Balanced cortisol levels help stabilize blood sugar, mobilize and burn fat, decrease inflammation and pain, support the immune system and balance the sex hormones. The adrenals direct SIgA (Secretory Immunoglobulin A) , which is your gut’s immune response.  Because 60-75% of your immune system is located in your gut it is critical that your adrenals are functioning well to keep the gut barrier strong.  If you are prone to chronic sinus/bladder infections, UTI’s, flu, and chronic yeast, this could be a sign of imbalanced adrenal glands.   Cortisol also impacts bone growth and calcium levels and plays a role in mood and brain function, which, if imbalanced, may contribute to depression, anxiety, panic attacks, concentration and memory problems. Imbalanced adrenal hormones may cause the symptoms associated with female hormones, such as PMS, night sweats, hot flashes and even polycystic ovarian syndrome (PCOS),

We test cortisol and DHEA as well as the sex hormones with a urine test that measures how your body is handling stress.  Stressors could be emotional, dietary or a hidden stress like a GI infection you may not even know about. We can test cortisol, DHEA and sex hormone levels and then correct them with personalized nutrition, lifestyle changes and a targeted supplement program.  

GI System

The biggest stressors that break down the gut are emotional stress, dietary stress (eating things that you may be sensitive to that inflame the gut like gluten and dairy), alcohol, NSAIDS (like Motrin), aspirin, birth control pills and then hidden stressors like a gut infection.  So, in addition to adrenal testing we may do some food elimination challenges primarily with gluten and dairy (depending on your history) and then we may also do a stool test to see if there is something hidden driving inflammation in the gut.  The stool test can identify an overgrowth of yeast, parasites, bacterial infection, occult blood, and toxins that may be causing gut symptoms.   Be aware that these infections may present as other symptoms such as anxiety, depression or fatigue with no digestive symptoms at all!

Detox System

An additional test that is highly recommended is the Organic Acid test (urine test).  This gives us a lot of information about how you are detoxing (how is your liver working?), making energy and burning fat, B vitamin status, oxidative stress (are you taking in enough anti-oxidants?), brain neurotransmitters (does your brain need support?) as well as gut bacterial or yeast markers that may not have been picked up in the stool test.   I use this test for nearly all of my patients as it gives us a great deal of information and direction for treatment.

What Do These Tests Involve?

None of these types of functional medicine tests require blood. Typical test recommendations are as follows:

ADRENALS & SEX HORMONES

DUTCH test- 4 urine samples are taken at specific time periods during the day.  This involves certain dietary restrictions during the test.

GUT TESTING

GI- MAP: PCR/DNA testing, 1 stool sample. There are some supplement or medication restrictions prior to sample. 

Detox, carb and fat metabolism, energy production, anti-oxidant status, gut dysbiosis, B vitamin status, brain neurotransmitter status.

Organic Acids Test: This is a single urine sample that gives us an enormous amount of information.  This involves some limitation of fluids the day before.

OTHER TESTING

Breath Test: If Small Intestine Bacterial Overgrowth (SIBO) is suspected a breath test will be recommended.  This is a 3 hour test.  It involves drinking a specific type of sugar, either glucose or lactulose and then taking breath measurements every 20 minutes over the course of 3 hours.  There are some dietary, medication/supplementation restrictions prior to testing. 

How many tests are recommended?

Specialty, functional testing is typically not something I recommend right away, unless there is good indication for it. There is generally much clean-up work to do with diet and lifestyle first, before assessing the need for testing. We can also ascertain information from standard blood work that most patients already have from their regular M.D. Specialty functional testing is always a decision made together, as we consider where we are in the treatment process, along with the patient’s finances. Most functional testing is not covered by insurance. 

Can I Get These Tests From My Doctor?

No.  These tests are looking for functional problems rather than medical problems.  Most likely your physician will not be familiar with adrenal testing or organic acid testing.  We are looking to detect problems in the functioning of systems before the onset of disease.  

Are There Any Tests Recommended if I Just Want To Be Proactive In My Health?

Yes!  One of the best tests you can take to evaluate how healthy you are is the Organic Acids Test.  This test will help pin point any areas that may need a “tune up” such as your anti-oxidant (is my DNA getting damaged?) or detoxification status (how well am I ridding my body of toxins?) among other things.   This test can be done once a year to help maintain health and wellness.

How Long Do Test Results Take, How Do I Receive Them?

The lab companies I contract with state that it may take anywhere from 1 – 4 weeks to receive results.  However, I have found that it generally doesn’t take longer than 1-3 weeks for results to come back.  All results from testing will come directly to me. You will then be contacted to discuss the test results and recommendations.

Are These Labs Covered By My Insurance?

The functional testing we do is not typically covered by insurance.  

How Long Will It Take For Me To See Results?

As one might expect, results vary from person to person depending on several factors including: patient compliance, complexity of history, length of time with condition/illness.   Most patients understand that their symptoms won’t disappear over night when they have been dealing with them for many years.   That said, as we work on getting to the root of an illness, we also simultaneously develop treatment strategies for dealing with some of the immediate symptoms utilizing more natural therapies.