Over the last decade, through my own personal health journey and now as founder / CEO of Rupa Health, I've experienced the power functional and integrative medicine can have to drastically improve people'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 test we have seen ordered the most for patients.
The most commonly ordered test we see is by far a comprehensive stool test - usually ordered after the first visit with a functional or integrative practitioner. The GIMap and GIEffects are the two most popular stool tests we see practitioners ordering. The gut plays an essential role in functional medicine methodology, making these tests very popular with providers. The tests look at many biomarkers, including those for:
What’s interesting is that we often see providers ordering this 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.
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 and gives a really in-depth look at hormones and their pathways.
This test looks at 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, and 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 the Cortisol Awakening response (CAR) 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.
An organic acids test, often referred to as an OAT Test, is a foundational functional medicine test that is a “metabolic snapshot of a patient’s overall health”. It’s 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.
The OAT test looks at organic acids in urine produced in a patient’s metabolism. It’s offered by many different labs, with the most popular being Great Plains Laboratory and Genova Diagnostics. The test provides an accurate evaluation of intestinal yeast and bacteria. The OAT test by Great Plains 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.
Many patients come to functional medicine after 3+ years and 7+ providers (primary care, specialists, other alternative medicine providers, etc) and no real answers yet. 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.
It’ll tell patients if they have SIBO (Small Intestinal Bacterial Overgrowth) or not.
Validity of IGG food sensitivity testing is hotly debated, however we see almost every practitioner offering some form of this. Unlike the other tests on this list, many times this is actually because of patient demand. The rise of direct to consumer food sensitivity testing from companies like Everlywell have opened patients’ eyes to this IGG tests.
Additionally, nearly every lab company offers some version of IGG food sensitivity testing, and we’ve heard from lab companies that they need to “in order to compete”. This test is important! The methodologies for processing these tests differs by labs, however 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 times, a gluten-sensitivity is the first array ordered. Sample type can vary from an at-home blood spot to a full in-lab blood draw.
Note: This is not a food allergy test. See more about the differences between food allergies and sensitivities here.