Do I work with nutrition and functional medicine tests? Very much so. Do I insist on it? Not at all.
We have a much more sophisticated range of nutrition and functional medicine tests available to us from reliable and respectable labs, compared to when I first started practising nutrition. Much of my CPD (continued professional development) in recent years has focussed on learning more about them and how to make the best use of them. The whole point of a personally tailored approach is to find out as much information as possible about an individual, so I can adapt my diet, supplement and lifestyle advice specifically to them. Testing can add whole new layers of information.
I may therefore recommend you have one or more tests to provide more information to work from. They can provide invaluable insights and point us in useful directions when interpreted in the context of a thorough case history. The case history is always paramount, however. A test will look close-up at a very specific part of you, but won’t show you the whole picture, and can even throw up some pesky red herrings. I’m there to look at the whole picture for you, and help you make sense of it all.
Do you have to test?
Testing is always optional, however. While some tests can be relatively low cost – or even free from your GP – other tests can be a few hundred pounds. If you’re getting more than one done, this can soon add up. So you need to weigh up their affordability against their usefulness.
There may be other reasons why you’re reluctant to test. If you’re scared of needles, please let me know, as there are some great tests that don’t need any blood.
If you choose not to go down the testing route, I can still work with you, as I still have your detailed case history, as well as review sessions to stay up-to-date with what’s going on with you.
How to test?
If you do decide to have some testing done, I will let you know which you can order for yourself, and which I will need to order for you. Most of them are kits that the laboratory send to you with full instructions on how to do them and how to send them back. Sometimes it’s really simple, but with some tests it does take a little planning! For example, a cortisol saliva test needs several saliva samples over the course of a day, so you need to plan a day where that’s possible, and book the courier to come and collect them at the right time.
Some blood tests need just a couple of drops – or sometimes a few gentle squeezes – of blood from your finger. Others need a proper blood draw from your arm, so you’ll need a phlebotomist to help you with this. I can help point you in the right direction here, and let you know if you need a phlebotomist who can centrifuge your blood sample.
There are some urine tests that need freezing and others that need drying, and stool tests will need a little poo – but your kit will come with all the equipment you need for this.
Unless instructed otherwise, try and eat as close to your usual diet as possible, and follow your usual lifestyle patterns, in the run up to and on the day of your test.
The results can take a couple of days, or more often 2-3 weeks, depending on the test. We can schedule your next appointment to coincide with the results.
This is something I will discuss with you so you know you’re getting the tests that are most appropriate and useful. Here are examples of some of the more frequent tests I recommend, but there are many more we could consider.
Vitamin D tests
This is one your GP may be happy to do for free as a blood draw, perhaps as part of a broader blood panel. There are also private blood spot/ finger prick tests that start at about £35. Where possible, I do recommend people test at least a couple of times a year to make sure their intake levels are correct – especially as the amount we can make from the sun changes so much with the seasons.
Vitamin D is not just for bone strength, it’s also essential for your digestion, metabolism, cell growth and development, immune function and more. Note that ideas of what constitutes a healthy result vary!
Again, your GP may offer you a thyroid blood test for free. This will usually give you 1 or 2 markers for thyroid health. There are private tests – usually for less than £100 – that can provide you with even more information.
Your thyroid regulates metabolism, and can affect your energy levels, weight, heart rate, digestion, and pretty much everything.
This is the 24-hour saliva test mentioned above, and it gives us an idea of your body’s pattern of cortisol release. Ideally, there’s a gentle curve reflecting cortisol’s activity as an intricate part of your own circadian rhythms. Stress, exercise and other factors can have an impact here, that we can look to support with diet and lifestyle.
This is a dried urine test that looks at levels of oestrogen, progesterone, testosterone, cortisol and their metabolites, plus a select few organic acid markers (see below). Because of its focus on their metabolites, it helps us to build up a picture of your liver’s ability to process certain hormones and toxins. You can also get a DUTCH test that includes a cortisol saliva test and/or a fatty acids test.
Fatty acids tests
This is a bloodspot test that looks at a number of different kinds of omega 3, 6 and 9 fatty acids, as well as saturated fats, transfats and more. These can give me an indication of how well you are able to resolve inflammation and make healthy tissue, and whether your balance of fatty acids seems beneficial to your cardiovascular, cognitive and general health.
Organic acids tests
This looks at dozens of metabolites in your urine. These can help me assess how well things like your mitochondria (energy powerhouses) are functioning, as well as your requirement for various vitamins, minerals, amino acids and antioxidants.
There are various stool tests that inspect your poo closely for bacteria, viruses, yeasts and parasites, alongside gut health markers such as zonulin and sIgA. These have become more sophisticated and detailed over the years, and can provide invaluable insights into your immune system function as well as your digestive health.
Food sensitivity tests
I have been quite sceptical about food sensitivity tests in the past as the results always seemed so hit and miss. There are, however, one or two new food sensitivity tests that seem more precise and intelligent in their analysis, and so far I have been impressed with the results they are providing. You can do this via a bloodspot test at home.
Nutrigenomics (DNA) tests
These are not the type of test that tell you where your ancestors lived, or the sort your consultant may be ordering for you, but instead a snapshot of many different functional genes, and which variation of them you have. From this, we can get some clues about how well you may (or may not be) making certain protein structures that have specific functions in your body. Some may impact, for example, how well you might break down oestrogen, or coffee, or dopamine. Others might be involved in how you use vitamin D, or B12, or iron. We’re finding out more and more about them every day, but we’re at the stage where this kind of test can be useful, rather than just interesting.
It’s important to remember that this test is showing us the hand of cards you were dealt when you were conceived, not the game you are playing right now. All sorts of things can influence your actual game – i.e. whether or not your gene variations are impacting you in any way right now. So a Nutrigenomics test is best used in conjunction with other tests, or as a guide to help us see what other tests might be useful.
There are various additional blood panels that can give us information about your red blood cells, white blood cells, some (but not all) nutrients, inflammation markers, hormone levels and more. These often require a blood draw, and sometimes the blood sample needs to be centrifuged.
There are many more, but this hopefully gives you an idea of what’s possible and what it all entails. So if you’d like to delve a little deeper, I can discuss with you which tests might be useful for you, and then talk you through the results in the context of what’s going on with your health and wellbeing right now, as well as your medical history. Similarly if you’ve already had tests done, send them over when we have our initial consultation so I can factor them in.