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Functional Lab Tests For The Digestive System

Functional lab tests help show the root cause of digestive symptoms. These are non-invasive tests that use either stool or saliva samples.

There are several companies offering such testing. This page reviews the tests I have found most helpful with clients.

Diagnostechs GI panel

Diagnostechs GI Health Panel is invaluable for giving clinically relevant information, in a cost effective manner.
The following are the more important markers on their GI Health Panel.

Inflammation

  • Intestinal Lysozyme: marker of colonic inflammation
  • Alpha Anti-chymotrypsin: marker of GI inflammation including in the small intestine
  • Calprotectin: inflammatory marker which can help to differentiate inflammatory bowel disease (Chron’s or Ulcerative Colitis) from other GI system disorders.

Sometimes people have no digestive symptoms, but elevated inflammatory markers. The inflammation may be there and cause other symptoms, such as autoimmune disease or frequent allergies.
However, there are no direct digestive symptoms.
Othertimes, people may have severe GI symptoms, but low inflammatory markers.

Some people have pathogens, or allergies that cause symptoms, but their inflammatory markers are low. You can not assume there is inflammation based upon symptoms alone.

Secretory IgA

Secretory IgA is the immune system’s first line of defense. It is secreted acrross the whole length of the digestive tract.
Its job is to bind to pathogens and alert the rest of the immune system to pathogens.

  • Low total secretory IgA: supressed immunity. Oftern related to stress.
  • Elevated total IgA: increased immune system activity, usually in response to a pathogen.

Specific IgA tests

Besides testing for total IgA levels, it can also be tested against specific foods or pathogens. This helps to show hidden food allergies or parasites.

Available IgA food markers
  • Gliadin (wheat)
  • Corn
  • Soy
  • Egg
  • Cassein (dairy)
IgA tests for parasites

Looking at a stool sample for parasites commonly gives false negative.
Tests for IgA against specific parasites helps to lower the chance of false negatives.
In fact, over years of running this test, I‘ve seen many more times parastites found on IgA tests, then microscopic exam.

  • Blastocystis hominis: estimated 2.6% of US population infected. About 50 to 80% of those infected will present with symptoms, and often diagnosed with “Irritable Bowel Syndrome.”
  • Entamoeba coli: estimated 4.2% of US population infected.
  • Toxoplasma gondi: estimated 40 to 50% of US population infected. Causes multiple symptoms including brain cysts leading to behavioral disorders, muscle cysts, depression, insomnia and reduced stress tolerance.
  • Entamoeba histolytica: causes episodic diarrhea or perianal itch causing colon ulceration. May be locally invasive, causing liver and lung abscesses.
  • Trichinella spiralis: tissue worm, causing abdominal cramping, nausea, diarrhea and muscle soreness and pain leading to fibromyalgia, edema of the upper eye lids or fever.
  • Ascaris lumricoides: roundworm. The most common worm infection in the world. Causes nutritional deficiencies, reduced liver and pancreas function, intestinal colic, diarrhea, dyspepsia and spasmodic cough.
  • H. pylori: common cause of stomach symptoms (they test for this using saliva IgG)

Bacterial and yeast culture

A stool culture for bacteria and yeast can quantify amounts of certain dysbiotic organisms such as candida, Klebsiella, E. coli, Streptococcus and more.

Microscopic Exam

Parasitse may still be found on microscopic exam. For comprehensive testing doing both, looking under the microscope and IgA is best.

FilmArray PCR Gastrointestinal Panel

This is a different lab test avaiable through biofiredx and is more specific for pathogenic bacteria and a few parasites.

PCR stands for polymerase chain reaction. This test looks for strands of DNA to identify specific pathogens. Sometime when there is a need to identify specific pathogens, this is the best way to do it.

The following pathogens can be identified on this test:

BACTERIA:
  • Campylobacter (jejuni, coli, and upsaliensis)
  • Clostridium difficile (toxin A/B)
  • Plesiomonas shigelloides
  • Salmonella
  • Yersinia enterocolitica
  • Vibrio (parahaemolyticus, vulnificus, and cholerae)
  • Vibrio cholerae
DIARRHEAGENIC E. COLI/SHIGELLA
  • Enteroaggregative E. coli (EAEC)
  • Enteropathogenic E. coli (EPEC)
  • Enterotoxigenic E. coli (ETEC) lt/st
  • Shiga-like toxin-producing E. coli (STEC) stx1/stx2
  • E. coli O157
  • Shigella/Enteroinvasive E. coli (EIEC)
PARASITES:
  • Cryptosporidium
  • Cyclospora cayetanensis
  • Entamoeba histolytica
  • Giardia lamblia
VIRUSES:
  • Adenovirus F40/41
  • Astrovirus
  • Norovirus GI/GII
  • Rotavirus A
  • Sapovirus (I, II, IV, and V)

Who may benefit from a functional digestive system test?

Since digestion effects just about every other part of the body, there are many conditions where functional tests for the digestive symptoms may be helpful. The following are a few of the most common examples:

  • Anyone with chronic digestive issues such as cramps, bloating, chronic constipation or diarrhea, IBD, IBS
  • Conditions of inflammation such as autoimmune disease, sleep apnea, or multiple food allergies
  • Unexplained fatigue
  • Chronic Candida or other yeast infection that does not easily resolve
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Naturopathic Treatment of PCOS

What is PCOS?

Polycystic Ovarian Syndrome (PCOS) may be diagnosed when two of the following symptoms are present:
  • Irregular menstrual cycle
  • Elevated androgens (the hormones DHEA, testosterone, androstenedione and DHT)
  • Polycystic ovaries (seen on ultrasound)
It is common for the diagnosis to be based upon an ultrasound. This is not enough. PCOS is not the only cause of ovarian cysts.

Conventional treatment

Common medications for PCOS include:
  • Metformin for blood sugar control
  • Medications for elevated cholesterol and lipids
  • Birth control pills to “regulate” the cycle
  • Medication for excess androgens (Spironolactone)

What causes PCOS?

Conventionally there is no single known cause. PCOS is not one thing. It is a set of symptoms which commonly happen together for various reasons. However, we know of many contributory factors. These includes:
  • Insulin resistance
  • Body weight
  • Stress
  • Withdrawal from birth control pills
  • Poor nutrition
  • Environmental toxicity.
Each time I start with a complete history individualized assessment and treat the client (not the disease). I do not wish to box everyone into a few categories. What I list below are simply the more common factors causing PCOS. Since PCOS is a syndrome and not a distinct disease, this may not apply to everyone.

Elevated blood sugar and insulin resistance

High blood sugar is a well-known trigger for PCOS. In natural health we know how to treat this as it’s a condition of lifestyle and diet. Often I see people who have blood sugar issues despite eating a good, low-carb diet. This is frustrating. Doctors tell women to balance blood sugar, they do, and then still have PCOS. Elevated blood sugar and insulin reistance is not always a factor. In these situations I look for other factors that raise blood sugar. These include:
  • Specific nutritional deficiencies
  • Other endocrine issues (thyroid, adrenals)
  • Liver function and underlining toxicity

Chronic inflammation

The most common lab tests for inflammation includes:
  • CBC with differential
  • ESR (SED rate)
  • C-reactive protein
There are many possible causes of inflammation. Some causes are a poor diet, infection, and toxicity.

Androgen Excess

This is a shift in hormone production towards testosterone and the other “male hormones.” Typical symptoms seen with this include hair loss (on head) hair growth (on face) acne and oily skin. Conventional treatment is often the prescription of spironolactone. Natural considerations are to work on:
  • Stress and adrenal function
  • Nutritional deficiencies
  • Liver and detoxification. Many environmental toxins act like estrogen in the body and contribute to PCOS. BPA is a well known example of this.  [1]

Lack of ovulation after getting off the pill

Sometime the endocrine system needs time to adjust after being on birth control pills. Herbal medicine and good nutrition can help women to get their cycle to normal.

Other causes of PCOS

The above causes do not apply to everyone. Like any other condition I start with a review of symptoms, case history, in office evaluation and then consider lab tests. This may mean testing hormones. But it often means looking at other systems such as digestion, adrenal, thyroid, immune system, or specialized labs for toxicity.

Additional Resources

Testing.com has good information on lab tests for female hormones from a functional perspective

Reference

[1] https://www.ncbi.nlm.nih.gov/pubmed/21193545