Testing, testing... which ones might be right for you?
As a functional medicine provider, I am passionate about finding the root cause of each patient’s illness or concerns. Sometime the causes are easy to identify with simple conventional blood work, but often a more thorough investigative approach is needed. Below is a list of commonly ordered tests in my office. Rarely would any one person need all of these tests, rather the tests ordered are tailored to the need of each patient.
Comprehensive stool testing
Type: Stool collected at home
Lab: Genova GI Effects or Diagnostic Solutions GI-MAP
Cost: These tests can be billed to insurance. Out-of-pocket expense varies by insurance plan. Cash price is about $389-460.
Gut health is foundational to all wellness. A healthy gut is required for a healthy immune system and a nourished body. I order comprehensive stool tests routinely for digestive complains but also for concerns relating to autoimmune disease, mood disorders, unexplained fatigue or even skin trouble. The stool test can give unique insight into overall health.
The tests look at many biomarkers, including those for:
Digestion and absorption levels
Inflammation levels
Presence of parasites and worms
The gut microbiome health and metabolism
Pathogenic bacteria including h. Pylori, Campylobacter or Clostridium difficile
Hormone testing
Type: Urine collected at home
Lab: Precision Analytical DUTCH Complete Test
Cost: $300-700 (Receipts can be submitted to insurance for reimbursement with certain plans.)
The DUTCH (Dried Urine Test for Comprehensive Hormones) test looks at production of sex and adrenal hormones with their metabolite. The test measures estrogen, progesterone, testosterone, DHEA, melatonin and cortisol as well markers for B12 deficiency. The test offers a visual representation of an individual’s hormone production and equally important, metabolism. The information is valuable for balancing hormones. I routinely order this test when I am concerned about menstrual irregularities, PCOS, monitoring hormone replacement, supporting peri-menopause or evaluating fatigue. The DUTCH test is a comprehensive look into how a person’s hormones are working together. The DUTCH can be run on men and women.
IGG Food Sensitivity Panel
Type: Blood test
Lab: Genova or Cyrex or Alletess or IgGExplorer
Cost: Genova testing can be billed to insurance. Out-of-pocket expense varies by insurance plan. Cash price is about $420. Cyrex, IgG Explorer and Alletess testing is not covered by insurance. Cost varies from $99-1000.
Validity of IgG food sensitivity testing is hotly debated. I often recommend completing an elimination diet as a gold standard for determining food sensitivities. However, food sensitivity testing does provided valuable hints about gut permeability and foods that should be evaluated for tolerance. There are several direct-to-consumer food sensitivity tests available on the market. The methodologies for processing these tests differs by labs, however one of the most highly respected labs dedicated to these types of tests is Cyrex Laboratories.
Comprehensive Thyroid Testing
Type: Blood test
Lab: Quest (MidAmerica Clinical Lab), LabCorp or HealthLab
Cost: These are conventional labs that are typically well covered by insurance. Out-of-pocket expense varies by insurance plan. Relish Health has relationships with conventional labs for cash-pay discount pricing for patients without insurance.
If a patient’s symptoms are suggestive of a thyroid problem I will run a comprehensive thyroid panel. Conventional medicine typically evaluates TSH alone. To better understand the nuances of thyroid health I order the following:
TSH (Thyroid Stimulating Hormone)
Free T3
Free T4
Thyroid Peroxidase Antibodies (TPOAb)
Thyroglobulin Antibodies (TgAb)
Reverse T3
Advanced Lipid Analysis And Inflammation Markers
Type: Blood test
Lab: Quest (MidAmerica Clinical Lab), LabCorp or Boston Heart Lab
Cost: These are conventional labs that are typically covered by insurance. Out-of-pocket expense varies by insurance plan. Relish Health has relationships with conventional labs for cash-pay discount pricing for patients without insurance.
Cardiovascular risk assessment has evolved beyond simply knowing lipid numbers. Testing inflammatory markers and lipoprotein particle size and number can help predict both short- and long-term cardiovascular disease (CVD) risk and progression.
Chronic, systemic inflammation is a factor in almost every health problem we face today. Whether a cause or a symptom or both, inflammation is a culprit in autoimmune conditions, cancer, heart disease, brain fog, fatigue, and even weight gain. Although a certain amount of inflammation is healthy to fight off infections and injuries, inflammation becomes a problem when it doesn’t go away after the threat is gone and continues to perpetuate throughout the body.
A blood test can detect markers of inflammation in the body. The inflammation labs I like to run include:
C-reactive protein
Homocysteine-This inflammatory amino acid has been implicated in brain problems, heart disease, and autoimmune conditions.
Ferritin- This is a measure of stored iron levels in the body. It is a sign of inflammation when the level is higher than usual.
SIBO Breath Test
Type: Breath test
Lab: Genova or Trio-Smart
Cost: Both the Genova and Trio-smart testing can be billed to insurance. Out-of-pocket expense varies by insurance plan. The cash price is about $225 for the Genova test or $319 for the Trio-smart test.
Small intestinal bacterial overgrowth (SIBO) is a condition affecting the small intestine. It occurs when bacteria that normally grow in other parts of the gut start growing in the small intestine. SIBO is a common cause of irritable bowel syndrome and symptoms often include abdominal pain, diarrhea or constipation, bloating and nutritional deficiencies. Identifying SIBO allows for specific treatment plans to be tailored to a patient’s need.
Nutritional Markers and Organic Acids Tests (OAT test)
Type: Blood and urine test
Lab: Genova or Great Plains Labs
Cost: Genova testing can be billed to insurance. Out-of-pocket expense varies by insurance plan. Cash price is about $430. Great Plains Lab cost is about $320.
An organic acids test, often referred to as an OAT Test, is a foundational functional medicine test that represents a metabolic snapshot of a patient’s overall health. It is especially helpful if a patient is dealing with mood disorders, fatigue, digestive complaints or weight issues. The test also includes markers for vitamin and mineral levels, oxidative stress and neurotransmitter levels.
Additional Tests Offered
Occasionally additional test are needed to determine the cause of illness. These may include:
Igenix Tick-borne illness testing (Can be billed to insurance; Cash price varies from $250-1000)
Great Plains Laboratory Mycotoxin testing (Cash price is about $300)
IBSmart testing (Can be billed to some insurance plans; cash price is approximately $180)
Quicksilver Scientific Heavy Metal testing (Cash price is about $285-450)
Genova Methylation Panel (Cash price is about $235)
Senesco Neurotransmitter testing (Can be billed to insurance plans; cash price is approximately $300)
23 and Me data analysis with PureGenomics.com or Promethease.com