Functional Labs: Available at Vancouver wellness studio
Our practitioners at VWS apply an integrative approach to testing and treating patients that incorporates recommendations for appropriate functional testing. The quality of testing that we offer combines the best of conventional medical diagnostics with functional medicine. Appropriate testing, combined with a thorough medical history and consideration of genetics, enables us to provide holistic treatment approaches unique to one’s present state of health. In this blog series, we will be introducing you to the functional tests that we commonly utilize to identify the underlying causes of certain conditions. This series will be broken up by organ system, such as reproductive hormones, cardiovascular, immune, and others, and will include sections where we will discuss ailments resulting from dysfunction within the system. Results of this form of testing enables patients and practitioners to better understand the root cause(s) of certain maladies and make more informed decisions when collaborating on effective treatment approaches utilizing the various integrative modalities offered at VWS, which include naturopathic therapies, functional nutrition, holistic bodywork, and Classical Chinese Medicine.
The first section we will start with is the gastrointestinal system. There is so much information that can be learned from functional testing of the GI tract! Over the past 20 years research has exploded, identifying a strong correlation between chronic and autoimmune diseases and the integrity of the intestinal barrier and diversity of the gut microbiome (i.e., the trillions microbial cells that populate the intestinal tract). There has also recently been a great deal of new research looking into the relationship between intestinal dysfunction and skin health. The gastrointestinal system is a hollow tube spanning from mouth to anus where our physical being directly mingles with our environment. No wonder the barrier defenses & physiological responses (think vomiting and/or diarrhea after food poisoning or alcohol overuse), which have evolved to protect our internal milieu from the detrimental impact of toxicants, microbes, viruses, and other environmental assaults are so imperative to support, maintain, and rejuvenate when impaired. The defensive boundary of the intestines can become damaged during prolonged elevated stress, consumption of an inflammatory diet, exposure to certain medications, and other triggers. Disruption to the intestinal barrier enables poorly digested food particles and bacterial toxins to pass into the bloodstream, activating our immune system, and causing a cascade of chronic inflammation that can manifest all over the body.
The functions of the gastrointestinal system are numerous. This organ system is responsible for taking in, breaking down, and properly absorbing nutrients from the foods and beverages we consume, while also facilitating the excretion of waste products that our body does not need (I’m talking about poop y’all!). The neuromuscular composition along this hollow tube varies and is determined by the purpose of the particular segment. All of the segments work together to move food from the mouth through the esophagus to the stomach where it mixes with digestive enzymes to facilitate liberation of smaller particles that can then be pushed through the small intestine where most of the absorption takes place, and then onto the large intestine where water is reabsorbed and waste is propelled along until it reaches the end of the line and drop point at the rectum. A variety of afflictions can impose detrimental impact and even damage to the neuromuscular function of the different segments of the gastrointestinal system, which can manifest as delayed motility (think constipation, incomplete feelings after bowel movements, and need for straining) or excessive motility characterized by feelings of urgency and looser stools. We often use a combination of breath and stool testing, combined with appropriate history-taking, to determine underlying cause of different forms of dysmotility.
Common concerns that would cause your practitioner to recommend functional GI tests include a recent change in stool habits or chronic constipation/diarrhea, abdominal pain and bloating, the sight of blood or mucus in stools, food allergies, and frequent infections associated with prolonged recovery. Our practitioners at VWS have several GI-focused functional tests that we commonly order for our patients. Each test below supplies an abundance of information allowing practitioners to create personalized treatment protocols to address gut dysfunction.
Breath Tests
Genova SIBO 3 hour breath test
This is a non-invasive test that evaluates bacterial overgrowth of the small intestine, which can be an underlying cause of episodic constipation or diarrhea, severe bloating after meals, brain fog, poor digestive enzyme production, and a consequence of delayed motility.TrioSmart breath test
This is also a non-invasive test that evaluates for bacterial overgrowth within the small and large intestine. The difference between this test and the Genova SIBO test is that the TrioSmart measures an additional gas (hydrogen sulfide) that is produced by certain bacteria within the large intestine, which can lead to looser stool, difficulty metabolizing sulfur-rich foods and supplements, and stools that can smell like rotten eggs.
Stool Tests
GI Map
This test requires a stool sample and is a comprehensive stool test that utilizes qPCR technology to detect parasites, bacteria, fungi, as well as several biomarkers of intestinal immune function.
Biome FX
This test requires a stool sample, and the report consists of a comprehensive assessment of the microbial diversity within the large intestine that takes into account 10 different keystone species that are responsible for producing compounds that play a role in immune system balance, histamine production, hormone balance, brain function, and vitamin biosynthesis. Additionally, comprehensive analysis of 34+ pathogens, including candida, is also included. The technology utilized to assess stool samples is whole genome sequencing.
*A separate order for Elastase (a biomarker of pancreatic enzyme production) and Calprotectin (a biomarker of intestinal inflammation) can be ordered separately through Quest labs.
Doctor's Data GI 360
This test requires a stool sample and analyses the presence of pathogenic bacteria, viruses, fungi, and parasites, as well as biomarkers that provide information about efficiency of digestion, absorption, and inflammatory markers. The analysis is performed with a combination of genetic testing through multiplex PCR, MALDI-TOF (microbial fingerprinting), and microscopy.
*For those with high suspicion of parasites, we can add on a full 3-day Parasitology assessment to any Doctor’s Data testing kit since these bugs can be challenging to capture in a single stool sample.
Blood Tests
Precision Point Advanced Intestinal Barrier Assessment
This blood test provides a more direct method for examining the integrity of the gut lining by measuring the levels of several major biomarkers involved in the regulation of tight junctions between the cells lining the intestine, including zonulin, histamine and DAO, and lipopolysaccharide.
Cyrex Array 2
The Intestinal Antigenic Permeability Screen (Array 2) measures intestinal permeability to lipopolysaccharide, a bacterial cell wall component that when elevated contributes to deleterious effects on the intestinal barrier and GI is inflammation. Zonulin and occludin, proteins that play an imperative role in securing the tight junctions (aka connection) between intestinal epithelial cells, are also measures to provide an estimate of barrier damage.
IBSSure
This is a simple blood test that detects two antibodies which are indicative of bacterial-pathogen-induced motility dysfunction, which can lead to increased incidence of SIBO.
Prometheus Laboratories Crohns Monitr
This blood test measures 13 biomarkers to assess endoscopic disease activity in adults with Crohn’s disease to monitor efficacy of treatment interventions and remission status. Regardless of the location of disease within the intestines, this test evaluates multiple markers of mucosal damage and repair process to produce a quantitative Endoscopic Healing Index Score ranging from 0 to 100 to aid in distinguishing active disease from endoscopic remission.
Food Allergy Testing
US Biotek 96 General Food Panel IgG
This panel is a blood spot test that can be performed in our office that only requres one finger stick with a very small lancet for sample collection. IgG antibodies to 96 different foods and spices is generated from this analysis enabling you and your practitioner to be more precise in determining which food(s) could be causing symptoms and strategize a plan for an elimination diet.
*US Biotek offers testing for individuals that follow a culturally-specific diet including Japanese, Asian, Mexican, and vegetarian. There are panels that can assess a minimum of 96 to a maximum of 240 different foods. Different immunoglobulins can also be analysed including IgA, IgG4, and IgE.
Oxford Labs Mediator Release Testing (MRT)
This test differs from the US Biotek IgE/IgG/IgG4/IgA testing in that it indirectly analyzes whether a food or food additive tiggers the release of proinflammatory mediators by our white blood cells. Proinflammatory mediators include compounds like histamine, prostaglandins, cytokines, leukotrienes, myeloperoxidases, and other immune-stimulating compounds, which function to catalyze a chain reaction leading to increased immune cell activity, immunoglobulin production (including IgG, IgG4, IgA), and inflammation. Once the inflammation provoking foods and food-chemicals are identified, patients are provided a structured eating plan for removing these foods and incorporating best foods to support wellness. There are panels for 85, 130 and 170 different foods and food chemicals.
Quest Labs Celiac Disease Panel
Celiac disease is an immunologically mediated disease in genetically susceptible people caused by intolerance to gluten, resulting in inflammation and atrophy of GI tissue, which causes malabsorption. It is essential to test prior to the removal of gluten from the diet to obtain reliable results. If someone has already been gluten free, it’s recommended to consume the equivalent of 2 servings of gluten daily for 6 - 8 weeks prior to testing. This lab test can be ordered through Quest and is often covered by insurance. VWS has client pricing through Quest, which can substantially lower the cost of this important analysis.
If you think you may be experiencing any of the symptoms mentioned in the previous paragraphs, or if you would simply like to take a closer look at the assortment of microbes occupying the ecosystem within your GI, please consider setting up an appointment with one of our naturopathic practitioners.
We hope you enjoyed a brief synopsis of the functional testing offered to assess the status of the GI. Stay tuned for our next installment featuring the endocrine system.