9 Lab Tests You Should Consider Running If You’re Feeling Off
Sometimes, health issues, such as a twisted ankle, heartburn, or a cut on your arm, are obvious. However, the problem is often less obvious, and you need lab tests to determine the best treatment plan for your elusive health conditions.
Whether it’s unexplained fatigue or chronic pain with no clear origin, a functional doctor can help you find that hidden dysfunction, deficiency, or toxin ruining your quality of life. Functional practitioners administer targeted functional lab testing to find that hidden culprit.
In my years as a functional medicine practitioner, I’ve learned that symptoms alone can’t define a person’s health. While they give us insight, everyone has a unique biochemistry that guides their health beneath the surface. Labs let us look under the surface to uncover the root cause of your unique symptoms.
With so many labs available, though, it can be overwhelming knowing where to start. Below is my guide to the most important lab tests you should get if you’re feeling off.
Functional Medicine Labs
As a functional medicine practitioner, I run many diagnostic tests for my patients because they pinpoint specific problem areas. The results tailor my treatment recommendations to each patient's unique situation.
Each person’s health situation, genetics, and biochemistry are unique, and labs can more effectively identify these than general symptom identification.
Unfortunately, most general practitioners won’t order these functional tests. They’re trained to follow standard procedures, matching sets of symptoms to particular lab tests and pharmaceuticals. You could demand more tests from a conventional GP, but most patients are uncomfortable with this.
I recommend working with an integrative, functional, or naturopathic doctor who is well-versed in the wide array of available lab tests and how to read the results from a holistic perspective. We’re encouraging, guided by science, and thorough.
9 Lab Tests I Recommend Running
This guide includes the the go-to labs I use most often in my telehealth functional medicine clinic. Below are my top 9 go-to functional labs, which I strongly recommend.
Adrenal Stress Index
The adrenal glands release several hormones, including cortisol – your body’s stress hormone – through the HPA axis. Adrenal fatigue occurs when there is a cortisol imbalance, and only functional labs can precisely identify adrenal fatigue biomarkers.
The 24-hour adrenal stress index is a saliva test that tracks your cortisol levels throughout the day, resulting in a general assessment of your HPA axis.
Help your overstressed body and mind achieve a normal state of balance using my Brain-Adrenal Balancer supplement. It aids in providing you with relief from stress, anxiety, and fatigue.
Look out for the symptoms below. Dysfunction in your adrenal glands can be at the root of a wide variety of symptoms, including:
- Fatigue
- Anxiety
- Depression
- Blood sugar imbalances
- Brain fog
- Weight gain
- Irritability
- Decreased sex drive
- Trouble sleeping
Inflammation Lab
Concerning chronic inflammation, there are a few key labs you should run. A functional blood test can detect markers of inflammation in the body.
The inflammation labs I like to run for the most complete picture of chronic inflammation test for:
- CRP: C-reactive protein is an inflammatory protein and is tested alongside another pro-inflammatory protein, IL-6. They are both linked to chronic inflammatory health problems. The optimal range is < 0.5 mg/L.
- Homocysteine: This inflammatory amino acid has been implicated in brain problems, heart disease, and autoimmune conditions. The optimal range < 7 Umol/L.
- Ferritin: This is a measure of stored iron levels in the body. Ferritin is an acute phase reactant, meaning high ferritin levels indicate inflammation. The optimal range in men: 33-236 ng/mL; in premenopausal women: 10-122 ng/mL; in postmenopausal women: 10-263 ng/mL.
Read More: How Chronic Inflammation Wrecks Your Health + What To Do About It
Inflammation is the root cause of numerous modern-day health problems, including:
- Chronic pain
- Depression
- Cardiovascular disease
- Respiratory disease
- Brain fog
- Autoimmune conditions
- Obesity
- Diabetes
- Cancer
Hormone Level Panel
Your hormones act as your body's chemical messengers, directing the function of all systems. To function optimally, men and women both need balanced sex hormones (in different amounts) and a healthy cortisol rhythm throughout the day.
Urine and saliva hormone labs can give us a complete overview of how well your hormones are functioning. Hormone testing looks at sex hormones like estrogen, progesterone, DHEA, and testosterone, as well as cortisol levels and your HPA axis function.
Hormone imbalance can lead to these diverse symptoms, including:
- Depression
- Anxiety
- Mood problems
- Gut health problems
- Weight gain
- Acne
- Erectile dysfunction
- Low sex drive
- Infertility
- Autoimmunity
Tired of feeling controlled by chronic health challenges? My Autoimmune Health Reset is your guide to getting to the root cause of your inflammation.
Gut Permeability Lab
When your gut lining is damaged (a condition called leaky gut), undigested food particles and bacterial endotoxins may pass into the bloodstream, leading to chronic disease, inflammation, autoimmunity, and a wide variety of other whole-body symptoms — not just gastrointestinal.
Determine whether you are experiencing leaky gut syndrome with a gut permeability lab test. This functional health test checks for:
- Zonulin and occludin: These two proteins control how permeable the gut is by regulating the tightness of the “mesh” that lines the intestines. If the test finds antibodies in your blood to these proteins, that is a biomarker indicating that the intestinal tight junctions have been compromised.
- Lipopolysaccharides LPS: These bacterial endotoxins are supposed to stay in your gut. If they are in your blood, it could mean your intestinal tight junctions in the gut lining have loosened and let LPS pass into the blood.
- Actomyosin antibodies: These antibodies should not be in your blood unless the gut lining has been damaged.
Also, I typically run a stool test or a breath test to check for bacterial imbalance in your microbiome, such as small intestinal bacterial overgrowth (SIBO). The microbiome is made up of trillions of healthy bacteria, but dietary changes, stress, toxins, and other factors can throw your gut biome out of whack. A microbiome test often reveals surprising results.
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Your gut health influences many aspects of your health, including:
- Weight
- Mood
- Inflammation
- Hormones
- Brain function
- Immune system
Thyroid Panel
Every cell in your body needs thyroid hormones to function. Unfortunately, thyroid dysfunction is common, but it’s hard to detect. Many underlying thyroid problems don’t show up on standard labs because conventional medical doctors typically only run T4 and TSH testing.
A full thyroid panel is a blood test that looks at the following factors:
- Thyroid-stimulating hormone (TSH)
- Thyroxine (T4)
- Triiodothyronine (T3) uptake
- Total T3
- Free T4
- Free T3
- Reverse T3
- Thyroid antibodies, such as anti-thyroglobulin and anti-TPO antibodies, may indicate autoimmune thyroiditis
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Functional medicine also has a narrower reference range when reading lab test results. What a conventional doctor might deem normal might be considered abnormal by a functional medicine doctor.
Symptoms of thyroid dysfunction include:
- Fatigue
- Weight gain
- Dry skin
- Hair loss
- Cold or hot sensitivity
- Constipation
- Brain fog
- Depression
Genetic Testing
Even though you may not be able to change your genetics, you can take precautions to prevent health conditions and deficiencies you’re predisposed to.
Certain genetic mutations can make you more susceptible to specific nutrient imbalances, drug reactions, and other health problems. 23andMe and other functional medicine genetic testing will lay out all of your possible genetic weaknesses for your functional medicine practitioner to interpret.
The primary dysfunction I look for is a methylation impairment. Methylation is a complex process that keeps your gut, brain, hormones, and detox pathways healthy and fully functioning. Methylation happens a billion times every second, so it can significantly impact your overall health if it isn't working well. Certain genetic mutations can impede methylation pathways, with a ripple effect of health problems.
Attack the deficiency, excess, or imbalance at the source, and you can prevent trouble down the line.
Toxin Panels
Because we are exposed to toxins on a daily basis, blood and urine toxin panels are imperative to determining if environmental toxins like glyphosate and biotoxins like mold mycotoxins are present in your body.
These functional toxin labs give us insight into your lifestyle and how it affects your overall health, allowing you to make changes necessary to reduce your toxin load.
I may run a heavy metal test, sometimes combining blood work with a hair sample – or even a blood test – with urine analysis. We need to find these toxins so we can start addressing the problem at its root.
Nutrient Deficiency Labs
Your body relies on a specific ratio of nutrients in order to function properly. Blood nutrient testing looks at your levels of these nutrients:
- Vitamin D
- Vitamin C
- Vitamin A
- Vitamin B12
- Magnesium
- Iron
This functional lab test informs you what supplements you should consider and gives insight into maximizing your diet to overcome these deficiencies and get your levels back on track.
Also, I might consider food sensitivity testing to determine if eating too much of certain types of foods is causing your symptoms.
Glucose Testing
America has a sugar problem — a blood sugar problem, to be exact. With diabetes and other metabolic health problems on the rise, a glucose HbA1c blood test is critical for determining your average blood sugar levels over the course of three months.
Glucose abnormalities can cause the following symptoms:
- Inflammation
- Hormone imbalance
- Heart disease
- Weight gain
- Diabetes
- Fatigue
A functional test like this can show you if you’re trending toward any of these health problems. If so, you’ll be able to make informed choices concerning food. Or, if your blood sugar is too low, it can indicate other issues that need to be looked into.
Understanding Which Tests Are Right For You
Keep in mind that this guide is a general list. Each person is unique, so the specific combination of labs your practitioner runs may differ based on your doctor’s assessment of your particular health case, health history, and previous lab work.
Functional doctors are more likely to work with you to identify and address your unique health situation.
The labs I’ve recommended can create a foundation of knowledge on which you can build sustainable wellness and an optimal health restoration plan.
As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe.
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FAQ
Although I advise you to seek interpretation from a qualified healthcare provider, you can look up optimal functional ranges for specific biomarkers from the comfort of your couch. Interpret the results using these optimal ranges to see where your levels should be.
Routine labs are often covered by insurance, but thorough functional lab testing is frequently left off of insurance plans. Most people do pay out of pocket for these labs, but I recommend you check with your specific insurance provider just to be sure.
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BY DR. WILL COLE
Dr. Will Cole, DNM, IFMCP, DC is a leading functional medicine expert who consults people around the globe, starting one of the first functional medicine telehealth centers in the world. Named one of the top 50 functional and integrative doctors in the nation, Dr. Will Cole provides a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. He is also the host of the popular The Art of Being Well podcast and the New York Times bestselling author of Intuitive Fasting, Ketotarian, Gut Feelings, and The Inflammation Spectrum.
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