9 Functional Medicine Lab Tests Chiropractors Should Be Ordering for Patients

Dr. Shawn Greenan, DACM, CFMP®
9 Functional Medicine Lab Tests Chiropractors Should Be Ordering for Patients

About 22 million Americans visit chiropractors annually, and research supports that musculoskeletal adjustments help reduce systemic inflammation overall (1).

But there are those tricky patients, the ones who just don't get better with traditional physical adjustments.

Your patients come in weekly, participate in at-home exercises, and try to reduce consumption of inflammatory foods, but the chronic inflammation and pain always seems to come back.

Maybe the answer to their challenges goes deeper.

Many chiropractors are starting to add functional medicine labs into their tool belts. Functional medicine labs help chiros understand what is going on at the cellular level so they can get to the root cause of chronic illness.

Here's a list of the top functional medicine lab tests that chiropractors order on Rupa for their patients. Sign up with the form below to start ordering these labs for your patients.


Ruling Out Inflammation

Inflammation is a component of almost every disease and degenerative process we know of. When inflammation becomes systemic, your patients will start showing signs of chronic pain, lowered immunity, possible weight gain, and fatigue.  

GI Map + Zonulin

Because of its comprehensive analysis of gut health, the GI-MAP is an ideal test for patients with autoimmune diseases, chronic inflammation, IBS/IBD, brain fog, acne, psoriasis, mood disorders, diabetes, and weight loss issues. It’s also a great test option to use preventively during annual lab work to access a patient’s overall gut health.

The GI-MAP is analyzed from a single stool sample that measures SigA and Anti-gliadin SIgA for immunity, calprotectin for inflammation, and various bacteria, parasites, viruses, fungi/yeast, antibiotic resistance genes, and several intestinal health markers.
‍A complete list of biomarkers can be found here.

Zonulin is a protein that modulates the permeability of tight junctions between cells of the wall of the digestive tract is used to help diagnose leaky gut. This marker can be ordered as an add-on to the GI-MAP.

Food Sensitivities

Do you have patients with unexplained weight gain, fatigue, joint pain, digestive upset, or maybe even a challenging case of eczema that they can’t get rid of? These conditions might be coming from food sensitivities! Even more common than food allergies, food intolerances are estimated to affect up to 20 percent of the population in industrialized countries(2).

Food sensitivities are abnormal responses to a food component triggered by the immune system in the form of immunoglobulins (IgE, IgG, IgA), representing either an immediate or delayed response. Chronic consumption of foods triggering an IgG response can lead to leaky gut syndrome allowing toxins to enter the bloodstream and cause chronic inflammation. Gluten Sensitivity, in particular, has been shown to cause joint and muscle pain, as well as numbness in the legs and arms (3).

Vitamin D

Vitamin D deficiency is a global public health issue. About 1 billion people worldwide have vitamin D deficiency, while 50% of the population has vitamin D insufficiency (4). Increasing numbers of studies have established that vitamin D insufficiency contributes to a number of diseases, including autoimmune disease, arthritis, headaches, and chronic musculoskeletal pain (5).

Ruling Out Hormone Imbalance

Hormone tests are some of the most commonly ordered functional medicine lab tests by Chiropractors through Rupa Health. Millions of patients suffer from hormonal imbalances, which can lead to more severe problems if misdiagnosed. Identifying the root cause of chronic health issues is certainly correctable, but only if properly identified.


Thyroid hormones affect multiple organ systems, so the symptoms of hypothyroidism are wide-ranging and diverse. Some common musculoskeletal and neurological symptoms associated with hypothyroid can include fatigue, weakness, balance issues, and pin and needle sensations (6). Hyperthyroidism, on the other hand, can have symptoms more commonly associated with anxiety, hand tremors, osteoporosis, and muscle weakness (7).

Functional medicine practitioners typically start assessing thyroid health by ordering TSH, Free T4, Free T3, and Reverse T3.


Dried Urine Test for Comprehensive Hormones (DUTCH) testing is the usual go-to for testing cortisol and sex hormones. Individuals suffering from insomnia, sexual dysfunction, depression, anxiety, weight gain, or irregular menstrual cycles can benefit from hormone testing. While some of these symptoms do not overlap with typical musculoskeletal complaints, it’s still important to consider testing for these hormones based off patients’ intakes. Remember hormonal imbalances can lead to more severe problems if left untreated.

Ruling Out Toxins

The environment we live in has become a source of inflammation and poor health. We are exposed to toxins, heavy metals, and molds daily, and our internal filters are having a hard time keeping up.  

Rupa Health offers a comprehensive menu of tests aimed at detecting exposures to various environmental pollutants and microorganisms, which can impair healthy cellular function, decrease immune regulation, and lead to chronic inflammatory diseases.

Organic Acids

Organic acids are chemical compounds excreted in the urine of mammals that can accurately identify conditions associated with genetic disorders, nutrient deficiencies, intestinal dysbiosis, and toxicity from diet and prescription drugs.

Several diseases are associated with abnormal organic acid levels, such as chronic inflammation, depression, anxiety, cardiovascular disease, neurocognitive decline, diabetes, and cancer.

Organic Acid Testing (OAT)can aid advanced providers in detecting imbalances, toxicity, and inflammation in chronically or acutely ill patients and can indicate the functional need for specific nutrients, diet modification, antioxidant protection, and detoxification.


Molds produce mycotoxins, and their presence in the human body can lead to autoimmune disease, cancer, fatigue, joint pain, lowered immunity, chronic headaches, and skin disorders, to name a few.  Mycotoxins are a big problem for human health because crop and food storage conditions can provide a good medium for growth of the fungi leading to toxin production. Mycotoxin symptoms are often general or vague, and therefore, may be overlooked during clinical assessments (8). Individuals most at risk for mycotoxin exposure include those who live or work in older buildings, those who live in humid environments, and those with impaired immune responses or higher levels of oxidative stress (9).

Environmental Toxins

Environmental toxins, technically called toxicants, are substances produced endogenously from the human body. When absorbed, inhaled, or ingested, can cause acute or chronic toxic overload. Environmental toxins are cancer-causing chemicals and endocrine disruptors, both human-made and naturally occurring. Patients exposed to environmental toxins may show symptoms of chronic fatigue and weakness, loss of balance, dizziness, and headaches.

Heavy Metals

Heavy metal toxicity affects over 1 million individuals annually. Heavy metals are present in all regions of the United States and can accumulate in air, soil, and groundwater.

Heavy metal toxicity symptoms can include neurological disorders, osteoporosis due to reduced bone mineral density, GI disorders, and lowered immunity (10).


If your patient isn’t getting better, it may be time to look at what’s going on at the cellular level. Toxins, disrupted hormones, and GI distress can all mimic musculoskeletal and neurological disorders. Adding in functional medicine lab tests alongside chiropractic care can give you and your patients a competitive edge on their healing journey. The above lists gives you some insight on commonly used functional medicine labs ordered by Chiropractors through Rupa Health. If you have patients with other health concerns and are wanting to learn more, feel free to sign up for our free live classes, check out our magazine, or reach out to one of our amazing onboarding managers.

We are here to help you, anytime, on your functional medicine journey!

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Dr. Shawn Greenan, DACM, CFMP®
Acupuncture Physician Certified Functional Medicine Practitioner®
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