What is Functional Medicine Testing?
Its common for new clients to comes to see me and they tell me they don’t need labs because their GP has run bloodwork and everything was “normal”. I want to bang my head on the table when I look at blood test trends on a new patient and realize a doc has watched their values creep towards the top of a reference range year by year, yet because it hasn't crossed the threshold, they never even had a call back. This is like saying “You’re still OK, come back when you have diabetes, hypothyroid or cancer.”
At N=1, our goal is prevention and health optimization so when we work with clients we always debrief on test results no matter how “normal” they seem at first glance!
While it’s important for most of us to have standard blood work run at least twice a year, we need to appreciate the strengths and weaknesses of standard labs. If we are to take a proactive approach to our health we must also understand how to assess where we are and where we want to be.
Think of your body as an ocean. Things are constantly changing, levels of hormones fluctuate throughout the day, blood sugar rises and falls, liver enzymes will peak and wane following ingestion of things like alcohol and inflammatory markers follow circadian rhythms.
When we do a blood draw we are looking at the body's chemistry at one moment in time. It’s a snapshot of what is going on. While this is very useful, we need to be careful not to make generalizations. For example, we need to know what time of the day a test was run and what happened that day or previous days to best interpret results. Testosterone needs to be measured before 8am, and for women LH/FSH needs to be drawn at a certain day of the month. This is why it’s very important to have a blood draw for specific markers at the correct time/day, to make results valid. We also need to understand reference ranges.
Lab test results are not meaningful without a comparison to reference values, or the “normal values.” By comparing your results to “population averages” you can get a sense of how you compare to others in your province or state. Unfortunately “healthy” in conventional medicine translates simply to “absence of an overt disease state”. As reference ranges are simply an average chunk of the bell curve of everyone who has been to the lab, as the population gets sicker, reference ranges get wider and less useful.
That’s why I like to refer to standard reference ranges as “pathological reference ranges” and differentiate them from the “functional or optimal reference ranges” we use at N=1 when reviewing bloodwork. The pathological reference range is helpful in diagnosing disease, whereas the functional range is used to assess risk of disease before it develops. The main difference between the functional and pathological reference range is usually the deviation between acceptable low and high numbers. For instance, the optimal range for TSH (thyroid stimulating hormone) is about 0.5-2 mlU/l. The pathological or “normal” range is 0.5-4mlU/l. Levels outside of the pathological range may indicate frank hypothyroidism, levels outside of the optimal range suggest someone is on the way to developing problems with their thyroid. As hypothyroidism can take years to develop by assessing people in the functional range we often can make changes early to address thyroid function and prevent the progression to hypothyroid.
The aim of functional medicine lab testing is to prevent illness before it occurs through assessing patters of imbalance that may progress to chronic disease states without intervention. Functional laboratory testing and evaluation is a critical component in allowing us a deeper and more comprehensive understanding of how the body is functioning. It allows us to create highly targeted personalised therapeutic or health optimization strategies. The more data we have about our starting point the easier it is for us to prioritise the steps on our journey to thriving.
Functional laboratory testing may include blood, stool, urine, saliva or hair samples to provide information about a variety of body systems and can help to identify:
Digestive, absorptive, and metabolic dysfunction
Toxic exposures and issues with our ability to remove substances from the body
Inflammation, and potential allergic responses and triggers
Imbalances in neurotransmitter metabolites and amino acid precursors
Hormonal imbalances—adrenal and thyroid and sex hormones
Sex hormone breakdown pathway issues
Nutritional deficiencies
Mitochondrial dysfunction
Gut function and disturbances of the gut microbiome
Genetic susceptibilities such as methylation (MTHFR) and detoxification issues
Knowledge is power, so we always use a combination of standard blood work, viewed through the lens of “functional reference ranges” combined with functional lab testing that looks deeper at the functioning of the body.
If you are interested in functional testing or having your blood work interpreted with an understanding of functional vs pathological ranges, i invite you to book a complimentary Biohacker Discovery call today.