In this episode, Dr. Eric Osansky breaks down the role of functional medicine testing for those dealing with Graves’ disease, Hashimoto’s, and other thyroid conditions. While conventional lab work can help diagnose thyroid disorders, it often falls short in uncovering the root causes behind autoimmunity. Dr. Eric shares his clinical perspective on how deeper testing can help identify underlying triggers and imbalances.
Throughout the episode, he walks through the most commonly recommended tests, including adrenal panels, hormone testing, gut health assessments, and environmental toxin evaluations. He explains when each test may be helpful, the limitations of certain testing methods, and why more testing isn’t always better. Dr. Eric also addresses controversial topics like leaky gut testing, food sensitivity panels, and the balance between testing and foundational lifestyle changes.
If you want a clearer, more balanced understanding of functional medicine testing for thyroid conditions—and how to approach it without overwhelm—you’ll get a lot out of this episode.
Click Here [1] to listen to it on the Save My Thyroid podcast
Dr. Eric Osansky:
Today, we’re going to talk about functional medicine testing for Graves’ and Hashimoto’s.
Blood tests are important. I recommend comprehensive blood testing to pretty much everybody I work with. If you have Graves’ or Hashimoto’s or even a non-autoimmune thyroid condition, doing a blood test alone isn’t enough if you want to find the underlying cause.
If you’re interested in more about blood testing specifically, I would recommend listening to episode #43, where I discuss 10 blood tests I commonly recommend to my thyroid patients. You could check that out by visiting SaveMyThyroid.com/43.
This information about functional medicine testing applies to both those with Graves’ or Hashimoto’s, or if you have the antibodies for both. Even if you have a non-autoimmune thyroid condition such as multinodular goiter or subclinical hyperthyroidism, this information will apply to you. Even with those conditions, you still want to do things to find the underlying cause of the problem.
Let’s talk more about the limits of conventional testing. Conventional testing is typically used to diagnose health conditions. That’s why you go to a medical doctor. Typically, they do some thyroid testing. Maybe if you just go to a primary care doctor, they will run TSH. Maybe they will do a T4, sometimes a full thyroid panel, but rarely. They will usually do the basics.
That’s how you find out that you have a problem, usually through your primary care doctor. Then you might be referred to an endocrinologist to have more comprehensive testing done. Even in this case, it’s not that comprehensive.
When I dealt with Graves’, I went to a primary care doctor. I had a TSH and T4 done. I think it was free T4. They determined I had hyperthyroidism. Eventually, I went to an endocrinologist, who did a little bit more testing, including antibodies, TSIs. That was positive. I was diagnosed with Graves’.
I had other tests, like comprehensive metabolic panel, CBC withdifferential. These blood tests usually are used as part of the diagnosis process. Also to see if there are any underlying problems, like elevated liver enzymes or anemia when it comes to a CBC.
These tests aren’t telling you why autoimmunity is happening in those with Graves’ and Hashimoto’s. If you have a nonautoimmune thyroid condition, these tests aren’t telling you the underlying causes of these conditions either.
There are exceptions. For example, you could do a blood test for EBV. Most medical doctors won’t do this. If you go to a primary caredoctor, they won’t test you for EBV. EBV could be a trigger for Graves’ and Hashimoto’s.
Even in this case, if someone does an EBV panel, there are four markers associated with EBV. If it seems like someone has an active EBV infection, there is a time and place for treating EBV. There are usually other underlying imbalances. Most people who have EBV as a result. It’s more of an immune problem than a virus problem. You still want to do things to find and remove triggers and heal the gut. Most immune system cells are in the gut. It’s really difficult to fix what you don’t identify.
That said, there are other practitioners who don’t test. I had Dr. Evan Hirsch on the podcast. He doesn’t do any testing. As far as functional medicine testing, he just puts people on protocols. Most functional medicine practitioners I know do testing. Some do more testing than others. I’ll talk more about that. Rarely do you come across someone who does not do testing.
You can do a lot through diet and lifestyle. Taking general supplements. Usually, you won’t remove your triggers just by doing that. I do recommend some functional medicine testing. Some of it is based on the health history I conduct. Some of it are tests I commonly recommend.
The first test I will talk about is adrenal testing. Not every practitioner recommends adrenal testing. When I say “practitioner,” I’m talking about natural health care practitioners. If you go to your regular primary care doctor/endocrinologist, they might run a morning cortisol, but they won’t do a full adrenal panel.
Adrenal testing is important because everyone deals with stress. Chronic stress is a factor with a lot of people. I know it was when I dealt with Graves’. By working with so many people over the years, since 2009, I have been working with people with thyroid and autoimmune thyroid conditions. When they fill out their health history, most people are putting stress down as being a factor. Even when they don’t put it down, I’m questioning if it’s really a factor. Maybe it’s not a factor now, but was it a factor when they developed their condition? You want to be aware of the impact stress has on your health.
In my case, I was aware. I was just a little bit in denial. I thought I was doing a good job of managing my stress, even though I wasn’t doing anything to manage stress.
Adrenal testing is a good idea because going back to my Graves’ journey, if I didn’t get an adrenal saliva test, I wouldn’t have realized how bad my adrenals looked, and I wouldn’t have put in the effort to block out time for stress management.
I recommend adrenal testing, whether it’s a saliva test like I did, or in some cases, dried urine testing. Saliva testing measures the cortisol levels throughout the day. Cortisol follows what’s called a circadian rhythm. It should be at the highest levels in the morning and the lowest levels at the end of the day.
Some people have that pattern, but a lot of people don’t. My cortisol levels were in the tank. First two cortisol levels were extremely low. On the other hand, some people have elevated cortisol levels at night or later in the day that might prevent them from falling asleep or sleeping throughout the night.
Saliva testing is great because you can collect it from home. Some tests look at other markers, like the adrenal stress index test looks at not only cortisol but DHEA, which most saliva panels do. This also looks at 17 hydroxy progesterone, secretory IgA, and gliadin.
Dried urine testing, such as the DUTCH test, also looks at the circadian rhythm of cortisol as well as the metabolism of cortisol. If someone has hyperthyroidism, you will typically have increased cortisol metabolism because you have increased cortisol clearance. If someone has hypothyroidism, they will have decreased metabolites, decreased cortisol clearance.
If someone wants to just focus on adrenals, I think it’s fine to look at an adrenal saliva test and not do a DUTCH test. The advantage of the DUTCH test is it also looks at the sex hormones.
Let’s go ahead and talk about sex hormone testing. You can do testing in the blood, looking at the hormones: progesterone, estrogen, testosterone. If you’re a cycling woman, the timing is important. You want to make sure to do it in luteal phase, the second half of the cycle.
Same thing with dried urine testing. If you do what’s called the DUTCH Complete, then the timing is important. On the other hand, the advantage of dried urine testing, and even some saliva panels, is you could do cycling hormone panels. You could collect the sample, whether it’s a saliva sample or dried urine sample different times throughout the cycle.
With the cycling hormone panel, you can look at them throughout the cycle. If someone has a 28-day cycle, you would collect a saliva or dried urine sample every few days, so you could see the patterns. You could see what estrogen and testosterone look like in the second half of the cycle.
DUTCH has other advantages. The big thing is looking at the hormone metabolites, especially estrogen metabolites. A lot of people have problems with estrogen metabolism, which could lead to thyroid nodules, uterine fibroids. It could be a factor with endometriosis. If someone is having some of those issues, they might want to consider doing a DUTCH test. Not always.
I work with people who have thyroid nodules and recommend an adrenal saliva test. It really depends on the situation. If someone has a history of breast cancer, it doesn’t even have to be a personal history, but a family history, where maybe a sibling or their mother had breast cancer. Especially if it was estrogen dependent breast cancer, it’s probably a good idea to do a test such as the DUTCH test and see if you have problems with estrogen metabolism. If you do, you could fix that.
That’s the thing about these tests. The reason we want to test for these is not only to detect the problem, but this way, we have a baseline. If you choose to retest in the future, you could do so.
Getting back to the saliva test that I did when I dealt with Graves’, my cortisol was in the tank, my DHEA was low, my secretory IgA was low, and a few months later, I did a retest, just to see. I was doing a lot to improve my adrenals, but I had no idea if they would look better. I did another saliva test. Sure enough, cortisol looked better, DHEA looked better, 17 hydroxy progesterone looked better. However, my secretory IgA was low and hadn’t improved. I worked on improving that, and a few months later, I did another secretory IgA panel. With the saliva panel, you could test that separately if you want. That thankfully did improve.
Same thing with the DUTCH test. If someone does a DUTCH test, let’s say the adrenals, if they do a DUTCH complete, and the adrenals are not looking great. If someone has low cortisol or DHEA, and they have problems with estrogen metabolism, the 4 hydroxy estrogen metabolite is elevated, which is the- I hate calling it the bad estrogen metabolite as it’s not really good or bad, but you don’t want high levels of 4 hydroxy. You want more of the 2 hydroxy. If the 4 hydroxy is more dominant, that could be problematic.
You could test that. You could do an initial test. If someone has those problems, a number of months later, after you make some modifications, you could do a retest and see if the diet and supplement modifications you made help to improve the test. If it did, great. Now you know. If not, then maybe you need to make some tweaks.
Maybe it’s improved, but just like my situation, where the saliva test looks a lot better but not perfect, I made some adjustments. In my case, with secretory IgA, I made some dietary adjustments. That did seem to help.
Let’s switch gears and talk about gastrointestinal (GI) testing. If you have Graves’ or Hashimoto’s, you might already know that you can’t have a healthy immune system without having a healthy gut. Most of the immune system cells are located in the GI tract.
I can’t say I recommend gut testing for everybody, but I have recommended over the years a lot of comprehensive stool panels and other types of tests, like SIBO testing. It depends on the person.
I do give people a choice. If someone works with me, maybe I just think that they need comprehensive blood testing, saliva testing. I like hair mineral analysis testing, too. Maybe I start off with those. I might give them the option of doing comprehensive stool testing, and they may or may not choose it.
Even though you can’t always go by symptoms, if someone has a lot of GI/digestive symptoms, I do recommend some type of digestive test. Unless food is the culprit, meaning that sometimes, if someone is not eating a great diet, maybe change your diet, which I will recommend. See if that resolves the GI symptoms.
It does depend on the person. I do like comprehensive stool panels. I have done a lot of GI Maps. I have done GI Effects. There are others I’ve done. Typically, they are not just looking at good or commensal bacteria but opportunistic and pathogenic bacteria. Opportunistic means that it’s normally in your GI tract, in the large intestine, but you don’t want it to get out of hand.
Sometimes, you’ll see things like streptococcus, staphylococcus, elevated klebsiella, pseudomonas. Sometimes, these could be pathogenic. Others like H-pylori, which has some controversy, but it can be a potential trigger for Graves’ and Hashimoto’s. if I see H-pylori, I will recommend a natural protocol.
Controversy with parasites as well in some cases. I’ve had people on the podcast who say that not all parasites are bad. You don’t always want to treat for parasites. There are people who treat everybody for parasites.
Stool testing is not perfect. You need to keep that in mind, especially when it comes to parasites. That is one justification for treating everybody with parasites. You can’t 100% rely on stool testing. That being said, it’s not perfect.
Usually when I’m doing a stool test, it’s not just for parasites. We are looking for other things, too. If it picks up a parasite, at least we have an answer. Let’s say someone tests positive for Blastocystis hominis. I have had some on the podcast, Dr. Jason Hawrelak, Dr. Nirala Jacobi, who don’t recommend always treating Blastocystis hominis. If I see it, I will recommend a treatment for it. Again, it will be more of a natural protocol. This way, if we treat it, a few months later, if you want to, you can retest.
Same thing with H-pylori. If you’re following a protocol for H-pylori, I recommend retesting to make sure it’s gone.
If you test negative for parasites, and someone is having a lot of GI issues, and you do a lot of things and nothing seems to be helping, sometimes I will treat for parasites, even if it’s negative on a stool test. You should be open-minded. I like testing, but I realize that it’s not perfect.
Same thing with yeast. Yeast, such as candida overgrowth, a lot of stool panels will test for yeast, but it’s not the best test. A lot of times, it will be negative, but it doesn’t necessarily rule out yeast overgrowth.
Stool tests look at inflammation markers like calprotectin, other markers like pancreatic elastase. Some look at short chain fatty acids like butyrate. They’re not perfect, but I think they could be really helpful in many cases. That’s my opinion on comprehensive stool tests.
Stool tests are different. If you go to a regular lab, they will usually just do a very basic stool test. It’s important to mention because someone might go to a doctor. They might go to a functional medicine practitioner, who recommends a GI Map or GI Effects. These could be expensive when paying out of pocket, hundreds of dollars.
Someone might go to a primary care doctor and request a stool panel that’s covered by insurance. The primary care doctor may or may not order a test. If you’re not having any GI symptoms, they probably won’t. Even if you’re having GI symptoms, regardless, whether you are or are not, if you order the test, it’s usually verybasic. It looks at bacteria and viruses that cause diarrhea, maybe some parasites. It’s not the same as a comprehensive stool panel.
If you’re having chronic diarrhea, it’s not a bad idea to start off with one of those tests, especially if covered by your health insurance. If it’s negative, it doesn’t mean you don’t have anything going on in the gut. It doesn’t mean you can’t potentially have a gut infection.
Even when looking at functional medicine stool panels, like GI Effects, GI Map, there are differences between the two. They both use PCR, where you don’t have to detect the parasite under a microscope. It’s looking at DNA. The GI Effects looks at PCR and microscopy, where you look at it under the microscope.
I recommend a GI Map because it’s the most comprehensive test I know for H-pylori. I know there are other tests out there, like the Gut Zoomer. These are just the two that I use the most, moreso the GI Map. GI Effects, I like, but H-pylori is an add-on. It’s not as comprehensive as a GI Map.
There is good and bad about both tests. If GI Effects ever changes their H-pylori, I would probably switch to GI Effects. It’s better with parasites because it not only looks at parasites via PCR but also through a microscope, too. Like I said, they both have pros and cons.
Still talking about gut testing. This isn’t necessarily related to a comprehensive stool panel, but organic acids testing, which is a great test. There are a number of different companies that offer organic acids testing. You could get it through a regular lab. In the U.S., LabCorps, Quest Diagnostics have them. They are very basic. They won’t be the same as going through companies like Mosaic Diagnostics, Genova Diagnostics. Thereare others that offer this.
They’re great tests for looking at yeast and fungi. The one from Mosaic Diagnostics looks at some potentially pathogenic strains of Clostridia, which could cause problems. They look at mitochondria, nutrients. It’s not just looking at things potentially related to the gut. Really good test.
I can’t say I recommend it toeverybody. I’m not one that recommends 5, 6, 7 tests to every single person. It depends on the person I’m working with, just because tests are expensive. If I think someone needs them, I will recommend them, but I won’t do soacross the board. If someone wants those tests, they can overrule me and get those tests. That’s just my approach.
Let’s talk about leaky gut testing. Every now and then, someone will ask me about doing a test for a leaky gut. I used to do a lot of leaky gut testing years ago. I used a company, Cyrex Labs, their Array #2, which is their intestinal permeability test. Most people were positive.
I stopped doing it for a few reasons. One is it’s an extra expense, a couple hundred dollars. I felt that if most people are testing positive, maybe I should just assume everybody has it.
There’s the triad of autoimmunity. Especially with Graves’ and Hashimoto’s patients, with the triad of autoimmunity, you have a genetic predisposition, exposure to one or more environmental triggers, and that increased intestinal permeability, which is the medical term for a leaky gut. According to that triad, if you have Graves’ or Hashimoto’s, you have a leaky gut. Most people tested positive for a leaky gut.
In addition, it’s not telling you what caused the leaky gut. I eventually stopped having people test for that and save a couple hundred dollars. They’re not perfect.
You could do other types of testing, like testing for zonulin on a stool test, like the GI Map. It’s an extra expense. The problem with zonulin is if it’s positive, you probably have a leaky gut. If it’s negative, it doesn’t rule out a leaky gut.
There are more classic tests like the lactulose mannitol test. There are different leaky gut options to determine if someone has a leaky gut. like I said, unless someone insists on doing that test, I usually don’t recommend it. I recommend taking the money and putting it toward another test instead.
As I mentioned, when I did the test, most people tested positive. If they were negative, I’d question them. Are they really negative? Should we still treat them for a leaky gut? If that was the case, if 95% of people were positive, even the 5% that were negative, I still wanted to treat the gut. What’s the purpose of doing the test?
The one benefit of doing it is to have a baseline. You could retest. That was kind of cool, where someone tests positive for a leaky gut, and then toward the end, you could always retest.
That’s also a common question. How do I know if the gut has been healed? If someone has Graves’ or Hashimoto’s, if their thyroid is normal, if their antibodies are normal, if they’re not having gut symptoms, I typically make the assumption that the gut is healed.
When I dealt with Graves’, I didn’t do any leaky gut testing. That marker, secretory IgA, I will say it’s not a specific leaky gut marker. When it’s low, it usually means there’s a leaky gut. You could look at that. That’s what I did at times. Some saliva test panels and comprehensive stool panels. If it’s low, then we usually want to do things to normalize it. I can’t say I order a specific leaky gut panel.
Next, let’s talk about environmental toxins and toxicants. These can trigger autoimmune conditions such as Graves’ and Hashimoto’s. They could also in some cases increase intestinal permeability, cause a leaky gut. Things like mycotoxins, microplastics, glyphosate can disrupt the gut microbiome. Doesn’t mean we need to test for all of these. I can’t say I go crazy withthe toxins tests because we’re exposed to so many toxins and toxicants. You can’t do all these tests.
I like to do hair mineral analysis testing. Hair testing is not a perfect test, but it looks at heavy metals. Some doctors do what’s called provoked urine testing to look at heavy metals. Urinary mycotoxins testing. There are a number of companies that do this now. I like urinary mycotoxins testing in some cases. Mosaic Diagnostics, Real Time Laboratories. There is a company, Vibrant Wellness, that has a total tox test that includes urinary mycotoxins and also other toxins such as heavy metals and different types of toxins and toxicants.
There is also a company, Cyrex Labs, which has what’s called Array #11. This is their chemical sensitivity test that looks at the immune system response to different toxins and toxicants. I don’t want to get into this here, but there is the argument, and it’s a really good one, that it’s not just about the toxin levels.
We all have a toxic burden; we’re all exposed to toxins. It’s really about how your immune system responds to these toxins. I can’t say I recommend this test to most people, but if someone is not progressing as expected, if their antibodies aren’t decreasing and normalizing over time, then it is something to consider.
It can help see if your immune system is reacting to any toxins or toxicants. There is what’s called a loss of chemical tolerance, which is a factor with different autoimmune conditions. This usually relates to the gut microbiome. We won’t completely eliminate our exposure to toxins and toxicants, but we can do things to improve the health of our gut. We spoke about leaky gut. That’s a big part of it. It goes beyond that as well.
You definitely want to do things to reduce your toxic burden. Of course, you can do that even without doing these tests. Some of these tests can be quite expensive. Usually, that’s what I do initially rather than have some people spend a lot of money on tests. I do hair testing, but that’s not just looking at heavy metals; that’s looking at things like minerals, too. Try to do as much as you can in your own home to reduce your toxic burden.
Nutrient deficiencies. Nutrients are important of course. There are a lot of important nutrients when it comes to thyroid health and autoimmune thyroid conditions. Selenium. A lot of people are deficient in iron, magnesium, Vitamin D, Vitamin B12, omega 3 fatty acids. Some of these, we can just do at regular labs, like an iron panel. We can do a 25 hydroxy Vitamin D. Some of these, we look elsewhere.
You could do blood testing, but there are other companies like Genova Diagnostics, which has a NutrEval. It’s a comprehensive test that looks at vitamins, minerals, amino acids.
Hair mineral analysis looks at minerals. Hair testing is different though. It’s not perfect, and it’s not just looking at deficiencies. Most people on a hair test will be low for iron, but I wouldn’t rely on a hair test to determine if someone has an iron deficiency. I would recommend doing a full iron panel through the blood and not relying on the hair test. Like I said, there are other companies. Even NutrEval, I forget if it looks for iron, but if it does, it doesn’t look for iron saturation or ferritin.
Food sensitivity testing. I can’t say I’m a huge fan of food sensitivity testing. I usually recommend an elimination diet, like an AIP-type diet or paleo-type diet. IgG testing is very popular here. I can’t say I never do it. Usually, it’s another test where if someone is hitting a roadblock in their recovery, I might consider doing that.
If I recommend it, I usually will recommend either mediator release testing (MRT) or Cyrex Labs’ Array #10. There are other companies, too, but you have to be careful. Some food sensitivity tests, you can get on your own. I won’t name specific names here, but they’re very inexpensive, and you get what you pay for here. If you’re spending $80-100 on a food sensitivity test, I don’t know if I would rely on it.
Quickly, iodine testing. I decided to talk about this briefly. I don’t really consider this functional medicine testing, but it’s a common question. I won’t get into iodine here as far as should you take iodine; I have other episodes where I talk about that.
I will say I am more cautious now than I was in the past when it comes to iodine. I am not anti-iodine. Iodine is an important mineral. In some cases, it can cause problems.
If I do recommend iodine testing, it’s urinary testing. There is a company, Hakala Labs, that I like. They offer a spot urine test or a 24-hour iodine loading test, which does require you to take a large dose of iodine prior to that. I am not recommending that. Many people will be fine, but other people might not be fine. I just wanted to bring it up because some people might wonder about iodine testing.
Also, I wanted to bring it up because some people will get iodine tested in the blood, which is not the best way to look at iodine. If it’s low in the blood, maybe you’re low. If it looks good in the blood, it doesn’t always rule out a deficiency.
Those are the main tests I wanted to discuss. It’s not all inclusive. There are others. Those are some of the more common ones that I recommend. I’m more on the conservative side. It does depend on the person.
When I dealt with Graves’, I just did an adrenal saliva test, I did hair mineral analysis testing, and I did a blood test. I did retest the saliva test as I mentioned. Some people do need a comprehensive stool test. Some people need organic acids tests. Some people need urinary mycotoxins tests. It really depends on the person, their health history.
Like I said, it’s ultimately up to the person. If someone has been dealing with Graves’ for a long time, and they have worked with different practitioners, maybe they have done different tests or have done a bunch of tests. If they haven’t done much testing though, then they might want to do more testing than the average person, compared to someone who is newer with Graves’. It is ultimately up to the person.
If I recommend conservative testing, and someone wants to do more comprehensive testing, I am fine with that. Of course, if I recommend comprehensive testing, and someone can only afford conservative testing, that’s fine, too.
In a perfect world, everybody would do every single test, or not every single test, but you know what I mean. If you’re paying out of pocket, that’s quite expensive. I’ve found over the years, most people don’t need to do all those tests. 2-3 tests, many people are fine with, and we can always do more testing. If someone really wants to do more testing initially, that’s perfectly fine.
I wanted to briefly discuss some of the biggest mistakes people make with testing. #1 is what I just mentioned: doing too many tests at once. Actually, I take that back. The biggest mistake is not doing functional medicine testing in the first place, trying to change your diet and take lots of supplements.
Another mistake would be doing too many at once, spending too much money when it’s not necessary.
In this day and age, people can order tests on their own. That’s another mistake. Not necessarily ordering tests on your own but ordering it and trying to figure it out on your own.
Using AI to try to figure it out also. I would be careful because AI is pulling from so many different sources.
Another big mistake is relying too much on the testing and ignoring the foundations. I definitely recommend diet changes, blocking out time for stress management, getting proper sleep. Sometimes, you need to do some of those tests to help, like stress and adrenals go hand in hand. Adrenal imbalances can also cause sleep issues.
That is pretty much all I want to discuss here. Again, testing is beneficial. I am so glad I did testing when I dealt with Graves’. Over the years, I have recommended functional medicine testing to pretty much everybody I work with. Not everybody chooses to get tested, but most people do. They at least get some testing done.
Like I said, I am more on the conservative side. If you really want to find and remove your triggers, testing is a good idea. Yes, you can guess, and some practitioners, like Dr. Evan Hirsch, I don’t like to say he guesses, but if you’re not testing, that’s essentially what you’re doing. I’m sure he gets great results, but I like to test and see what imbalances someone has.
If we do 2-3 tests, and let’s say only one test is showing anything, I don’t see it as a waste of those other tests. We’re ruling out information. If we’re doing a few tests, usually we’re seeing multiple triggers. It’s not like there’s only a single trigger.
When we do adrenal saliva testing, hair testing, comprehensive blood testing, usually we’re seeing a number of different things. Maybe not all of them are triggers; maybe some of them are not related to your Graves’ or Hashimoto’s or non-autoimmune thyroid condition, but you still probably want to fix it if you see something out of balance.
I will say this. I am offering here for free a Beyond Thyroid Testing Checklist. You want to do thyroid tests and comprehensive blood tests, but you also want to do more than that. If you want some of this in writing as well, just so you have a handy checklist, visit SaveMyThyroid.com/TestingChecklist.
As usual, I hope you found this information I presented to be valuable. Of course, I look forward to catching you in the next episode.
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I will expand a little bit on the episode here. Testing versus guessing. I brought up how Dr. Evan Hirsch doesn’t do functional medicine testing. There are others who don’t do functional medicine testing.
As I mentioned during the episode, most of the natural health care practitioners who I know do testing. Again, they might be like me and do more conservative testing, even though there are times when I do comprehensive testing. There are practitioners who recommend comprehensive testing for everyone. They’ll recommend five functional medicine tests. Approaches are different.
I do think that if you can afford to do testing, it’s better to test rather than guess. There is a time and place for some guesswork because the tests aren’t perfect. Even though they’re not perfect, the tests are pretty good. If they were greatly inaccurate, it would be fair to question whether or not you should do testing. I think they’re valuable.
The GI Map, for example, is not perfect with parasites, but it’s not just looking at parasites. If it was just a parasite test, I could understand maybe not doing the GI Map. It’s great for H-pylori. It’s really good for opportunistic bacteria and other markers. Again, it does pick up parasites sometimes. It’s not like it never does.
With the PCR testing, there are limitations. You can’t test all parasites with PCR testing. If it’s negative, you could have a false negative, but it’s also possible that you have parasites that aren’t present on the GI Map.
Saliva versus DUTCH testing. I spoke about this a little bit. If you’re just focusing on adrenals, I think it’s perfectly fine to do saliva testing. DUTCH also has an option to do saliva testing. It’s a dried urine test, but you could do saliva testing for adrenals with DUTCH.
If you’re looking not only to evaluate adrenals but also the sex hormones and how you’re metabolizing sex hormones, especially estrogen, it could be valuable.
Secretory IgA versus leaky gut testing. I mentioned how in 2008, I wasn’t really familiar with leaky gut testing. It wasn’t as popular then as it is now. You could add zonulin to stool tests. Cyrex Labs wasn’t around in 2008, I don’t think. If they were, I wasn’t familiar with them.
I mentioned how I did a saliva test that looked at secretory IgA, which was depressed when I did my first saliva test. I retested a few months later, and my adrenals improved, but secretory IgA was low. Eventually, it normalized. Secretory IgA is also uncertain. Comprehensive stool panel is as well. It’s not a specific leaky gut test. Usually, if secretory IgA is low, the person will have a leaky gut.
Stool testing versus SIBO testing. I didn’t talk much about SIBO breath testing. I mentioned it briefly. When do you determine if you should do a comprehensive stool test or a SIBO breath test? If you decide to do gut testing in the first place. It’s not like I have everybody do gut testing.
If someone is having a lot of gas, bloating, with certain foods, especially higher FODMAP foods, fermented foods, higher fiber foods, then that probably is more of an indication that you should do a SIBO breath test. If you have other gastrointestinal symptoms, then maybe do a comprehensive stool test.
If you’re not having symptoms, like if someone starts out with adrenal saliva testing, hair mineral analysis, comprehensive blood testing, and they just hit a roadblock in their recovery after a few months, and we’re thinking about doing other tests, but they’re not having any GI symptoms, I would say maybe a comprehensive stool test.
Usually, with SIBO, you will have some symptoms. With H-pylori, parasites even, you won’t always have symptoms. In that case, I would probably lean more toward a comprehensive stool test, like GI Map or GI Effects.
Nutrient testing. I mentioned the NutrEval. I should mention that I don’t have most people do the NutrEval. It’s a really good test. It’s a pricey test. I usually test some nutrients through the blood. I look at hair mineral analysis for some of the minerals. I can’t say I test all of the nutrients through regular labs. Organic acids tests have limitations. It’s an option in some cases to consider.
Recently, I have recommended a little bit more frequently. Still not for everyone. Not even the majority of people who I work with at this point.
Function Health. I didn’t mention Function at all. This involves comprehensive blood testing. I wanted to bring it up here because recently, I joined Function Health. I don’t know if you’ve heard of them, but Function Health is through Dr. Mark Hindman.
For a reasonable price, you get one comprehensive blood test every year. You can get a second one that’s okay, not nearly as comprehensive as the first one although you can add to it. If you have some findings on the first one, and if those markers aren’t included on the second one, you can always add them. Depending on the tests, some of them are reasonable, and some are pricey.
I think for comprehensive blood testing, if you’re paying out of pocket, whatever you can get covered by health insurance, but if you have ahigh deductible or no health insurance or poor health insurance, where you have limited coverage.
We have decent health insurance. My wife is a teacher who works for the state, so we have health insurance. You know how the medical system works. I still went with Function Health.
I have been happy with it so far. I did my first test in December. We’ll have a follow-up test sometime in June or July.
If you join, I didn’t realize until recently they give a referral link. If you know someone who mentioned Function Health, use their referral link. Don’t use mine. If you don’t know anybody, you can get $25 off. I also get a $25 credit. SaveMyThyroid.com/FunctionHealth. If you visit that, you’ll get redirected to my referral link and get $25 off Function Health. If someone else has mentioned it to you, I would ask them, just to be fair, just to get their referral link. I’m pretty sure everybody has a referral link. It’s not just because I’m a practitioner.
Feel free to do some research before you join. I learned about Function Health through my patients. I had a few patients go through it, and they told me the price. As of recording this, it is $365. They market it at $1/day. To me, that’s affordable for everything you receive.
You can always visit their website and see what it includes. If you visit the referral link, it will take you to the website, so you can look at what tests are included.
Thanks again for tuning in! Hope you found the episode to be valuable. Look forward to catching you in the next one.