One of the most powerful tools that can be used in the clinical setting is functional lab testing. It is evidence of the sad state of our health care system that this kind of testing is not only neglected, but isn't even widely understood.
Functional testing means utilizing lab testing to do more than simply identify major diseases or conditions. For instance, during routine blood work done at most annual wellness visits, the labs drawn are these:
Comprehensive Metabolic Profile (CMP) - This tells about fasting blood sugar, electrolytes, liver enzymes, kidney function and (to some extent) liver function
Complete Blood Count (CBC) - This is a look at white and red blood cells. It is almost exclusively used to determine if someone is anemic.
Lipid Panel - This looks at a few basic types of fat found in the blood, namely cholesterol, triglycerides. It also looks at the misnamed "bad" and "good" cholesterol, LDL and HDL. Elevations of these numbers are used to justify millions of prescriptions every year, even in the absence of other health risks.
If we think of our total health as a complete circle, these three labs assess health by looking at only an extremely tiny sliver of that circle. In fact, an enormous number of imbalances that can cause significant symptoms and disease can be happening without any of the values on these three test panels showing abnormality. How frustrating is it when patients don't feel well, but are told by their doctor that "everything looks normal" on the labs.
Expanding the View
The first tier beyond these basic labs can still be run through the same conventional labs. These additional tests can tell us a great deal about extremely important contributors to health and disease. Some examples include:
Hemoglobin A1c (HbA1c) - This is most commonly tested only with known or suspected diabetics, but it is valuable for everyone. It tells us the average blood sugar over the previous 3-month period. As the HbA1c rises, it means that blood sugar is spending more time elevated. Even if it is not flagged as elevated by the lab, high HbA1c allows for the kinds of diet and lifestyle changes that prevent further elevations and the health problems it causes.
Insulin - While the conventional world usually checks blood glucose, just as important is the insulin level. In fact, a strong argument could be made that elevated insulin can be just as dangerous as high glucose. Even if glucose is normal, if insulin is elevated this has to be dealt with quickly. Again, this is prevention before the problem arises.
Homocysteine, CRP, fibrinogen - These are markers of inflammation. If elevated they can indicate substantially increased risk for heart disease, blood clots, strokes and other events. It is crucial to have a good understanding of every patient's underlying level of inflammation, because inflammation is the driver of virtually every chronic disease anyone could develop.
Lp-PLA2 and MPO - These are produced by immune cells that have invaded the walls of the arteries. Those same immune cells are responsible for building up the plaques that lead to blockage, heart attacks and strokes. Anyone with a family history of heart disease should know about elevations here so they can make the kinds of changes that reverse plaque buildup.
Testing Outside the Box
Beyond these more conventional tests, there is an enormous range of specialized testing that can provide profound insights into underlying health.
Multiple Antibody Testing - Cyrex labs can test for a wide array of antibodies against various foods (cooked and raw) and tissues of the body. In addition, there are tests to find out if antibodies to some foods are causing the immune system to attack your own body, driving autoimmune conditions. Such testing can be enormously beneficial for individuals struggling with autoimmune conditions such as arthritis, MS, thyroid disease, diabetes, Crohn's disease and many others.
Functional Digestive Testing - Genova labs offers dozens of tests that can assess various aspects of digestive function and health. Identifying which bacteria are growing in excess, and which organs (pancreas, gallbladder, large intestine, etc.) are not functioning well, is enormously helpful. In addition, testing of dozens of organic acids in the blood and urine can identify specific blocks in energy production within the body, and can even pinpoint specific nutrient deficiencies and possibly metal or chemical toxicities.
Urinary Hormone Testing - Most people think of testing hormones with a blood draw. But blood actually gives a limited picture of most hormones. Looking in the urine it is possible to test not only the total 24-hour production of the various hormones, but
more important we can see how the hormones are getting metabolized in the body. These metabolites often play a major role in both hormonal symptoms and in risks associated with those hormones.
Chemical Toxicity Testing - In a world filled with potential toxic chemicals, people exhibit enormous variation in their level of exposure, and also in their ability to safely break down and excrete these chemicals. Testing can determine accumulation of pesticides, plastics, heavy metals, organochlorines and other toxic compounds. Once identified, the appropriate therapies to get them moved safely out of the body can be developed.
These are just a few of the functional testing options that are available to patients at
Immersion Health. It is also good to know that many of these tests are covered to some extent by insurance. Our clinic can determine coverage for those interested in pursuing functional testing.
The most effective way to make use of functional testing is to schedule a visit with Dr. Nigh by calling 503-719-4806. Once he has a complete health history from you he can discuss with you the most appropriate test or tests to gain a comprehensive assessment of the factors contributing to your symptoms or underlying imbalances.
Functional testing is the way healthcare should be done for everyone. Its aim is to provide enough information to create a treatment program that actually treats the cause(s) of symptoms and diseases. If you experience either mild or severe chronic symptoms but your doctor tells you that all your labs are normal, do yourself a favor and pursue functional lab testing. It just might change your life.