Before we talk about the various types of tests you can do to help get to the root cause of your gut issues, I want to start with a caveat:
I believe that lab tests are overused by many practitioners, often time simply leaving a hole in your wallet!
I see so many clients in my clinics who have spent thousands of dollars on various stool and lab tests (with previous practitioners), but got very little out of it, in terms of helping them feel better.
However, this doesn’t mean that there isn’t a time and place for testing… so let’s talk about it!
First of all, here are a few good rules to remember when it comes to lab testing:
1- START WITH DIET
There is no point doing expensive lab tests if you haven’t done any diet changes.
Many of my clients have already done a lot of improvement in their diet, but they haven’t always done the right changes.
A good practitioner will help you identify the best diet for YOU, depending on your story and symptoms. Start there!
2- WILL IT CHANGE YOUR APPROACH?
This is probably the most important point: Is the test going to change your approach? Is it going to add information that you cannot get otherwise, that will allow you to choose the most effective treatment, diet, supplements, etc
Is it necessary or are symptoms enough to guide you?
Although I agree with the ‘test don’t guess’ approach, I believe that how the person feels is just as important as an actual test results.
Many tests have false negative (this is especially true for parasites) and false positive, so it’s important to remember this as well, and not rely entirely on a ‘number on a piece of paper’ to decide on the correct course of action.
3- CHOOSE THE RIGHT TEST FOR YOU
Not everybody should invest in the same tests. Here again, my approach is to get to know my clients and take a thorough history… this will help select the tests that will truly help to figure out the root cause.
So, bearing this in mind, here are some tests you should consider doing, if you are feeling stuck and looking for the next step.
LACTULOSE BREATH TEST
I use this test a lot in my clinic.
What is it:
It is used to detect an overgrowth of bacteria in your small intestine (aka SIBO). I talk about SIBO in my FREE Fix Your Gut mini-course.
After doing a preparation diet for 24 hours, you will drink a solution of lactulose (a type of sugar that is fermented by bacteria in your gut). You will then blow in a tube every 20 minutes for 3 hours. The lab will then analyse the amount of hydrogen and methane in your breath. If you produce too much of either of those gases, it indicates that you have small intestinal bacterial overgrowth (SIBO).
To learn more about SIBO, go here.
It can be done at home, which is super convenient.
Direct patient order available, see below for lab recommendations.
Both a positive and negative result is useful and will potentially change the treatment approach.
It is out of pocket (not covered by medicare) and costs about $200.
False-positive and negative can happen.
Recommended labs offering direct patient order:
This one is a stool test that is used to learn more about your microbiome (aka gut bacteria).
There are various similar tests available, but at this point in time, I find the ubiome explorer to be the best value in terms of cost and information given.
Reasonably inexpensive (around AUS120)
Can be used to assess improvement after diet changes, which can be motivating.
Gives a good picture of the health of the microbiome.
Can give very useful information about which foods might be more important to eat or avoid, depending on the type of bacteria present or absent.
Although the information can be really useful, we are still restricted by the lack of information available about how to interpret the results… more research is needed!
The turn around can be very slow, ranging from 4 to 8 weeks to get results.
PCR STOOL TEST
Another stool test, but this one is used to detect parasites and pathogenic bacteria.
Uses DNA instead of the traditional culturing method to detect bacteria and parasites, which is more sensitive and reliable.
Inexpensive and can often be done through your GP (covered by medicare).
There is a lot of debate about the detection of parasites and whether or not they are always problematic and require treatment.
False-negatives are common, so multiple tests are sometimes necessary to completely rule out the presence of parasites. Doing the 3-day test (collecting stool over 3 days) can be useful for this reason.
This test is especially useful to detect gut infections. It uses a novel DNA technique (qPCR) to detect a comprehensive list of bacteria (both pathogenic and commensal), viruses, fungi, and parasites. If you suspect a gut infection, this is the test for you.
- Currently one of the most comprehensive test for gut infections
- Includes fecal markers like pancreatic elastase (indicator for digestive enzymes) and calprotectin. Not as comprehensive in this regard as some of the other CDSA on the market (see below), but still offers very valuable information.
- Includes testing for H.Pylori virulence factor
- Gives information about quantity, not simply a positive or negative results, which can be useful for the practitioner to decide or the need to treat or not.
- Fairly pricey at around $360 (Australian dollars) but well worth the cost for the right candidate.
- Not the best test to get information about the microbiome (see ubiome for that)
A CDSA is a very comprehensive stool test.
Various labs offer this test, the most popular being:
- GI Effects (Genova Dx)
- Comprehensive Stool Analysis (Doctor’s Data)
It combines a large number of tests that evaluate the function of the gastrointestinal tract. The analysis investigates digestion, metabolism, absorption and metabolic markers, pancreatic function, the balance of beneficial bacteria and the presence of pathological bacteria, yeast and parasites.
The most comprehensive stool test
Includes information about dysbiosis/ balance of gut bacteria (similar to ubiome).
Biomarkers indicating levels of digestive and absorptive functions, as well as potential issues with gut inflammation and immunology
Includes PCR to identify parasites
Can include detection of H.Pylori
Faster turn around than ubiome
Very expensive (up to $650)
FOOD SENSITIVITY TEST
A lot of people ask me about food sensitivity test.
To tell you the truth, I do not use it much. I have found that learning to listen to your own body, and doing an elimination diet, is much more effective and will be more helpful in the long term. Your body knows best 😉
In my Happy Gut Program, I usually start by taking people through an elimination diet (I provide a 4-week Meal Plan for that).
You can also buy the 4-Week Meal Plan here if you are keen to try that on your own.
Can be useful for people struggling to figure out which foods are causing symptoms.
Can be very expensive.
Sensitivities can change depending on what you are eating.
If you have a leaky gut, the list can be overwhelming, leaving you with very little to eat if you try to avoid everything you are ‘sensitive’ to.
False-positive and negative are possible.
Does not allow people to get in tune with their body as much as doing an elimination diet does.
OTHER USEFUL TESTS
DUTCH TEST OR SALIVA HORMONE TEST
Many people with long-standing gut issues end up with adrenal issues and hormonal imbalances. Testing hormones (cortisol and sex hormones) can give valuable information for people with fatigue, PMS, fertility issues and other symptoms of hormonal imbalances.
I recommend that everybody get tested for thyroid issues as it is very commonly associated with gut issues. This can be done at your GPs. However, I recommend asking to get a full panel, including TSH (the standard test) as well as free t3 and t4 and thyroid antibodies.
ORGANIC ACID TEST (OAT)
This test gives a metabolic ‘snapshot’ of a person’s overall health. It is useful to do when it seems like nothing is working and you don’t know what to do anymore to keep progressing towards better health. I do not recommend doing this test before you have tried other interventions (diet, nutrition, supplements, etc).
It includes markers for vitamin and mineral levels, oxidative stress, inflammation and neurotransmitter levels (to assess mood issues), as well an indication of yeast and bacterial overgrowth.
It is the most accurate test for yeast overgrowth.
Most of those tests need to be ordered by health practitioners, although some labs offer direct orders from patients. However, please note that you will get the best value for your money if your test is interpreted by someone who has experience reading them, and knows what to do with the results.
So if you would like some help with testing (deciding which tests are best for you, ordering the test, interpreting the test and choosing the best course of action depending on the results) book a consultation with me. Or if you are looking to truly get to the root of your health issues with a very comprehensive program, read more below.
Do you want to get to the root cause of your gut issues?
My Happy Gut Program, which includes 1:1 coaching, lab testing and analysis, and so much more, might be what you’ve been looking for.