Over the last decade, through my own personal health journey and now as founder / CEO of Rupa Health, I've experienced the power that functional and integrative medicine can have to drastically improve a person's well-being. Core to this experience is working closely with a highly trained practitioner who can order and interpret specialty lab testing - including stool testing, hormone testing, metabolic testing, and more.
At Rupa Health, we’re passionate about empowering practitioners to bring this kind of care to more people. After helping hundreds of practitioners grow their practices and running a virtual clinic of our own at Rupa Health, these are the lab tests we have most often seen ordered for patients.
1. GI Effects® or GI-MAP
Patient Price: $500 - $600
Companies: Genova (GI Effects®), Diagnostic Solutions (GI-MAP)
By far, the most commonly ordered test we see is a comprehensive stool test, usually ordered after the first visit with a functional or integrative practitioner. The most popular stool tests we see practitioners ordering are GI Effects® and GI-MAP. These tests are so popular with providers because the gut plays an essential role in functional medicine methodology.
These tests look at many biomarkers, including those for:
- Digestion and absorption levels
- Inflammation levels
- Presence of parasites and worms
- The gut microbiome breakdown
- Bacteria including h. Pylori, Campylobacter, Clostridium difficile
What’s interesting is that we often see providers ordering one of these tests even if patients aren’t directly complaining of GI symptoms. In one provider’s words, “I order this for every single one of my patients, because it helps me understand what’s going on in the body from a root cause perspective - looking at the gut can give unique insight into overall health.” Stool testing has exploded recently with the growth of research around the gut microbiome and its increasingly understood role in overall health.
2. DUTCH Plus
Type: Dried Urine & Saliva
Patient Price: $500
Company: Precision Analytical
The DUTCH Plus (Dried Urine Test for Comprehensive Hormones) is the most comprehensive hormone panel by Precision Analytical, a diagnostic company specializing in hormones. It’s worth noting that nearly every provider we work with has an account with Precision Analytical!
The DUTCH Plus is for both men and women. It looks at the production of sex hormones and their metabolites, as well as the patterns and distributions of each, giving providers a visual result of the hormone pathways in a person’s body. Precision Analytical offers a whole suite of hormone tests; however, the DUTCH Plus is the most comprehensive. We see providers shifting from other hormonal tests to this one at an increasing rate. The DUTCH Plus’s stronghold comes from the addition of Cortisol Awakening Response (CAR) measurements, which brings in biomarkers from another key piece of the hypothalamic-pituitary-adrenal axis (HPA axis).
Similar to the stool test, the DUTCH Plus is on our list because rather than just checking for a “green flag” or “red flag” for a specific biomarker, it is a comprehensive view into how a person’s hormones are working together. These type of comprehensive tests help providers understand what’s actually going on in the body and paints a picture rather than assigning “good” or “bad” levels in isolation.
3. Organic Acids Test (OAT)
Patient Price: $300 - $400
Companies: Great Plains, Genova Diagnostics
An organic acids test, often referred to as an OAT, is a foundational functional medicine test that is a “metabolic snapshot of a patient’s overall health.” It is commonly ordered for many patients and is recommended as a baseline test after the initial appointment, especially if the patient is dealing with mood disorders, fatigue, digestive complaints, or weight issues.
An OAT looks at organic acids in urine produced in a patient’s metabolism and often includes markers that evaluate intestinal yeast and bacteria. This test is offered by many different labs; the most popular at Rupa Health are the Organic Acids Test (OAT) from The Great Plains Laboratory and the Organix® Profile from Genova Diagnostics. In addition to the markers above, The Great Plains Laboratory's OAT also includes markers for vitamin and mineral levels, oxidative stress, neurotransmitter levels, and is the only OAT to include markers for oxalates, which are highly correlated with many chronic illnesses.
4. SIBO Breath Test
Patient Price: $200 - $300
Companies: Genova, BioHealth, Aerodiagnostics, & more
Many patients come to functional medicine after 3+ years of seeking treatment and being seen by 7+ providers (primary care, specialists, other alternative medicine providers, etc.) without any answers. If a SIBO test hasn’t already been ordered by a conventional doctor, it’s one of the first tests ordered if patients are experiencing GI symptoms that might be SIBO-related.
Small Intestinal Bacterial Overgrowth (SIBO) occurs when bacteria enter the small intestine, which is normally sterile, and begin to colonize. It can cause a variety of common gastrointestinal symptoms. By measuring the release of hydrogen and methane in the breath, this test evaluates the presence of SIBO.
Click here for a list of SIBO tests currently offered by Rupa Health.
5. IgG Food Sensitivity Panel
Patient Price: $200 - $900, depending on breadth of panel
Companies: Cyrex, Genova, Vibrant America
The validity of IgG food sensitivity testing is hotly debated; however, we see almost every practitioner ordering some form of this test. Unlike the other tests on this list, many times this test is ordered because of patient demand. The rise of direct-to-consumer food sensitivity testing from companies like Everlywell has opened patients’ eyes to IgG testing.
Nearly every lab company offers some version of IgG food sensitivity testing. We’ve heard from lab companies that they need to offer this testing “in order to compete” in the market. The methodology for processing these tests differs by lab and the sample type can vary from an at-home blood spot to a full in-lab blood draw.
One of the most highly respected labs dedicated to these types of tests is Cyrex Laboratories. We see providers ordering different Cyrex arrays for their patients depending on their specific food complaints. Often, a gluten-sensitivity is the first array ordered.
Note: This is not a food allergy test. See more about the differences between food allergies and sensitivities here.