My mission with this page is that you have access to learn about different and alternative types of medical testing, various types of questions on Chronic Illness and chronic Inflammation so that you can become a team player with your doctor and start to feel better and learn how to heal. I know from experience that it can be SO frustrating when you are not feeling better, so hopefully this page sheds some light into the darkness you may be feeling right now.
I’m not feeling better and I suspect there is something else wrong. Are there any other tests I should consider?
Yes. There are a number of tests that can help you narrow down what is going on in your body. Symptoms are always attached to a root cause, and the root cause may not be what you suspect, which is why it is important to consider these tests and conditions below, and discuss these options with your Integrative Functional Doctor. The following are a lists of tests and conditions, what they are, the name of the tests and how they may benefit you:
- Bacterial Overgrowth / a.k.a. SIBO (Intestinal)
- Yeast Overgrowth / Candida (Intestinal)
- Leaky Gut
- Food Sensitivities and Food Allergy Testing
- Chemical, and Environmental Sensitivity Testing
- Parasite Testing
- Lyme Disease
- Tellogen Effluvium
- Vitamin & Mineral Deficiency Cellular Testing / Urine and Blood Work
- Cortisol, Adrenal and Hormone Testing
- Seborrheic Dermatitis
Stool Testing: When it comes to stool testing there are two lengths of time the stool can be tested for. One is a 3 day stool test while the other is a 1 day stool test. With a 3-day stool test the stool specimen is collected over a 3-day period. And the 1 day stool test is taken just once, on one day. The 3-day stool test is the best to start with especially if you are experiencing many mystery symptoms, as you will get the most accurate information over time. Often 1 day stool tests can miss hidden bacteria. Once you get an accurate diagnosis, you would repeat the stool test every 6 months to a year until you have healed. The two tests I recommend that most Integrative Functional Doctors use are:
GI FX Stool Test by Genova Diagnostics
Comprehensive Digestive Stool Analysis Test by Genova Diagnostics (CDSA)
Believe it or not the GI FX Stool Test is a more comprehensive stool test then the Comprehensive Digestive Stool Analysis test. The GI FX stool test has a better panel for identifying multiple types of good and bad bacteria. This test also does a panel which identifies 25 different bacteria strains and their DNA as opposed to the CDSA stool testing which doesn’t test as many.
The CDSA test will show different bacteria strains, yeast strains and parasites – what type and how severe but only specific strains. The panel is smaller, leaving some strains unidentified. The CDSA test also shows digestive/absorption in the gut, gut immunology, and metabolic structure. This test also shows your PH levels, and can determine how high of a dosage your probiotic should be. It also shows if you have SIBO (Small Intestine Bacterial Overgrowth). With the GI FX stool test it covers all the strains plus everything else that the CDSA test shows. GI FX is the better test covering more, so you uncover more of the conditions you have. Better results. Once you get results from your doctor, your doctor will advise treatment either through western medicine, holistic medicine or both. In this instance, if you are put on Difulcan for Candida healing know that the brand and Teva Generic are both gluten-free and safe for Celiacs. If you are put on Xifaxan only brand is available and it is suitable for Celiacs. After 6 months it is standard to get your stool re-tested, and so forth until healed. Diet also plays a major role in this type of healing. Following either the Candida diet, the Low FODMAP diet or a Whole 30 diet which is a more strict version of the Paleo diet to helps healing process.
SIBO Breath Test (Small Intestinal Bacteria Overgrowth): – This tests for bacteria overgrowth in the small intestine by testing your breath after following a special diet and then fasting for 12 hours. This is a test where you go into your doctor’s office and breath into a series of tubes over the course of 2-3 hours every 20 minutes. The lab then tests the breath to get the results to see if there is an overgrowth of bacteria. Treatment is always advised by your doctor. If this test is negative, it means you don’t have SIBO, but may have a bacterial overgrowth in the colon, which would require one of the above tests. Commonwealth Lab has closed. This was the lab that conducted this test. The other option for this test is BioHealth. However this lab doesn’t participate in insurance plans but can be submitted for partial reimbursement. The cost of this test is under $150.00.
Lyme Disease Testing:
There are some cases when the culprit can be in the form of Lyme Disease. Lyme Disease has the power to cause many of the same symptoms as other Autoimmune Diseases. It is often unsuspected, and therefore many doctor hop seeking answers. The standard lab testing for Lyme isn’t always accurate. Therefore there are two labs I recommend that do a more comprehensive Lyme test. You don’t have to go to a Lyme Disease doctor to get this test done, you can simply have your Integrative M.D. send your blood to these labs below.
IGeneX: is a reference lab out in California that specializes in research testing for Lyme Disease and associated Tick-Borne Illnesses. This lab tests for a much wider panel and can therefore detect more then a standard lab. What does this mean? It means, if you DO have Lyme Disease and it’s not caught in the standard testing, you have a better chance of it being caught by this lab’s test. This testing is not covered by insurance and it roughly costs around $500.00 out of pocket.
Stony Brook (Division of Stony Brook University School of Medicine): is another reference lab that tests for Lyme Disease and a wider range of Tick-Borne Illnesses that is here in New York. This testing IS covered by Insurance. But I prefer IGeneX.
Vitamin, Mineral Deficiency Extensive Testing:
ONE FMV – Optimal Nutrition Evaluation: This test is very different then a regular standard blood work test. The difference is, is that a standard blood test will show you the exact levels of vitamins and minerals in your blood at that moment. For example, you could have eaten a lot of sweet potatoes and carrots the day before your blood test, which could give you a false reading of your beta carotene levels. It could give you a very high result simply because of all the carrots and sweet potatoes you ate at that given time, which really isn’t accurate because your levels were only high because of what you ate at the given moment. The ONE FMV shows you your levels at a cellular level. This means that it’s showing you how the minerals and vitamins are being absorbed into your body at all times, not just at that moment. It’s a panel that shows how your body is taking nutrients in, and how your body is using them. This tests also advises a supplement schedule and recommended dosages. It gives you an amino acid profile, an antioxidant profile and a metabolic analysis markers for malabsorption, dysbiosis markers, toxin and detoxification markers and neurotransmitter metabolites to see if you are deficient. All of these test points give the doctor a sense of where your body is working and where it isn’t. It’s a comprehensive test that uses both urine and blood. This is a specific test that can be performed by Integrative M.D.’s or can be requested. This is not standard blood work.
Routine Blood Work Testing: Routine blood work panel – There are two types of routine blood work. Routine blood work from your general doctor and routine blood work from an Endocrinologist. Your general doctor will only test for so much. It is important to have an Endocrinologist or an Integrative M.D. so they can do extensive testing if you are having medical problems. Extensive testing can be anything from checking your Thyroid, to Diabetes and other Autoimmune Diseases, Chronic Illness conditions, hormone testing and a wide panel of vitamin and mineral deficiencies. It is still important to have your general doctor do your routine blood work yearly, and also see another type of doctor for more extensive blood work.
Stress, Adrenal, Cortisol and Hormone Testing:
Adrenal Saliva Test/Adrenocortex Stress Profile by Genova Diagnostics: This test is a saliva test, where you collect your saliva into a variety of tubes over the course of many hours. The saliva is then sent to a lab and tested to measure how high your Cortisol levels are over the course of a day. Your cortisol is your stress hormone. This test will show if your stress hormone is too high, too low or if it’s within range over the course of a full day. Again testing the cortisol in the blood is NOT an accurate way of testing this hormone. The saliva test is the best test for this.
NeuroScience Test by Pharmasan Labs: This test will test your Neurotransmitters and nervous (nerve) system (not to be confused with feeling nervous) and your hormones. This test is done in two ways, both saliva and urine. This test is not offered in the state of New York. This tests shows a comprehensive panel of your Cortisol levels as well as Serotonin, Histamine, Gaba, Dopamine and other Neurotransmitters. In addition this test offers customized recommendations and product information. This test will also show if your stress hormone is too high, too low or if it’s within range over the course of a full day. This test is done the same way the above test is done.
Food Allergy and Food Sensitivity Testing:
Food Allergy Testing: There are many schools of thought on food allergy testing. Some doctors will tell you that skin testing for food allergies is most accurate, while others will say blood is more accurate. Either way, if you are reacting to something and it’s not gluten, and you are having symptoms that are affecting your immune system and your life/body, you should set up an appointment with an allergist or an Immunologist to try and get to the bottom of what is affecting you or at least rule out. Note: When you do skin testing, you must be off allergy medications for 1 week prior to testing. If you allergy testing comes back negative but you suspect you have a reaction to those foods, then Sensitivity testing would be your next move.
Food Sensitivity Testing:
If your allergy testing comes back negative but you suspect you have a reaction to those foods, then it’s time for Sensitivity testing. Sensitivity testing is different then Allergy testing. Allergy testing tests for IgE response while Food Sensitivity testing tests for an IgA and IgG response. I personally love food sensitivity testing. It really helped confirm what was going on in my body and what foods I had to eliminate so I could feel better. It’s important to know what foods these are because they can cause so many symptoms in your body that can lead to more serious conditions. Even though it’s not an allergy it is creating an allergy like response in your body. You can then re-introduce them within 6 months to a year, sometimes even longer. Food sensitivity testing will not always show ALL food sensitivities, but it will show most. If you have many then you and your doctor will want to consider a diagnosis of Leaky Gut and try and heal the gut so you can reintroduce those foods down the road.
Sensitivity testing is not an allergy. Just because you are sensitive doesn’t mean you are allergic. A sensitivity is a heightened response to particular foods and these should be treated seriously! Some sensitivities last a lifetime while others are relieved over a shorter period of time by first healing the gut and removing the food for a specific amount of time. Cells change over a 6-month period, and often time away from the food can deactivate the sensitivity and allow healing time. In some patients the sensitivity stays active for longer periods of time.
There is one sensitivity test I LOVE! And it’s from Cyrex Laboratories. It’s a ridiculously comprehensive test and even shows cross-reactive grains, foods in their raw and cooked form. The test breaks down foods into groups and then breaks them down further. An egg is tested as an egg white cooked, egg white raw, egg yolk cooked, egg yolk raw. Dairy is broken down into over 8 different proteins and they are all tested. So it’s more then just Lactose or Casein. Rice is broken down into rice cake, rice protein, wild rice cooked, white and brown rice. Nuts and seeds are broken down into raw, modified and roasted. Vegetables and fruits are broken down into raw, modified and pickled and so forth. It’s so extensive and it’s the best to really get down to the bottom of the problem. This test is not offered in the State of New York, so you would need to find a doctor outside of New York who can draw your blood and send it to the lab. You CAN be on any allergy medications while doing this test. Your test will NOT be affected. Cyrex testing tests both IgA and IgG.
There are two other sensitivity tests that others use and have found beneficial.
ALCAT and Genova Sensitivity Testing: ALCAT is more comprehensive then Genova. Genova only tests IgG. The IgE is a separate test that can be additionally added on, but is not part of the standard test. I have done Genova twice, but found that Cyrex was the absolute BEST one. Cyrex found what Genova did not.
I have never used ALCAT testing, but hear it is also a good option for testing sensitivities. The ALCAT website has a list of doctors that use this lab and can perform this test. It also has to be outside of New York. All of these options can be discussed with your Integrative M.D. I find that these tests are much easier then eliminating 100 foods at once and not knowing where to begin. This way you get your results and can act accordingly.
**All three tests do not need to be taken. Chose one. I strongly recommend Cyrex. Food sensitivity testing is considered a holistic form of testing and therefore many western doctors do not believe in this form of testing.
So what do you do with food sensitivities? Depending on the severity, you either eliminate the food or foods entirely from your diet, or you religiously rotate those foods so that your body doesn’t get too used to them cause the sensitivity to escalate. Mystery symptoms can be the root to food sensitivities and can impact your health by causing additional chronic inflammation. It can be the biggest reason why you don’t feel well, why you are not getting better and why mystery symptoms are still a mystery. Symptoms can be anywhere from acne, headaches, brain fog, stomachaches, cramps, skin rashes, skin conditions, mood changes, bowel disorders, acid reflux, abdominal discomfort, mouth swelling, facial numbing, mineral and vitamin deficiencies, malabsorption and so much more call all be from food sensitivities.
Environmental Allergy Testing:
Skin testing is most effective for this type of allergy testing. This will test for molds, pet dander, trees, grass, weeds, ragweeds, Candida on the skin, roaches, feathers, mites, mugwort, and around 15 types of molds and fungus. Remember that environmental allergies may have cross-reactive allergies to specific foods. What does this mean? It means that there can be a cross-reaction between the food and the environmental allergy you are diagnosed with. Example: Ragweed allergy may give you seasonal allergic reactions to cantaloupe, honeydew, watermelon, zucchini, cucumber and bananas. Depending on which environmental allergy you have can determine possible reactions to specific foods. This doesn’t mean you will definitely have allergies to all or any of those fruits/veggies, but it means there is a possibility and can often be a mystery culprit you are unaware of. In addition, depending on the season, you may react to said food in its raw state but not in its cooked state as cooking the food desensitizes it for some patients.
Chemical Allergy Testing:
Skin testing is the best option for this type of allergy testing. And this sort of testing can confirm what chemicals you are allergic to, which can be another hidden culprit to your medical issues. Chemical allergens are found in makeup, cosmetics, shampoos, conditioners, soaps, fragrances, laundry detergent, deodorant, acne creams, lotions, scrubs, topical medication, medication and more. You can have this test performed in an Allergist’s office or if you are in New York City there is an amazing dermatologist at NYU that specializes in chemical allergy testing found in the above kinds of products. This is a skin test where patches of the allergen are put on your back and then taped to your back for 1 week without being able to shower or get that area wet. I literally lived on Benadryl for two weeks, but it was all worth it. I had allergies to things I never thought of having that were affecting my entire body and my life! And I had to eliminate most of my products and test new ones that were safe for my body.
Is it necessary to take a probiotic daily?
Yes! It is imperative!! A probiotic decreases inflammation and keeps your immune system and gut healthy. Since 80 percent of your immune system lives in your gut, it’s best that your gut remain balanced. A probiotic protects the gut and restores digestive balance. A probiotic offers optimal digestion, healthy bowels, healthy intestinal flora, overall immune function, synthesis of vitamins, minerals and nutrients, protection against travelers and a flatter tummy (less to no bloat)! A probiotic also helps reduce abdominal cramping, bloating, lactose intolerance, diarrhea, constipation, food sensitivities and other digestive problems. It helps keep your gut “healthy”. When you get sick with a cold or a stomach virus/infection the first thing to ask yourself is “Is my gut healthy?” and focus on gut health. A daily probiotic reduces inflammation in your gut which can alleviate full body inflammation and creates an environment where you don’t get sick.
What dosage of a probiotic should I take?
This depends solely on your body and your immune system and should be discussed with your doctor. The probiotic I love is by Renew Life. It’s called Ultimate Flora Probiotic 100 billion. I also like 50 billion. This is an extra care dosage. Always check with your doctor to see what dosage is best for you. This should be taken daily. This brand needs to be refrigerated and can be found in a health food store in the refrigerated section or you can order it online. **Do not take a probiotic within two hours before or after iron, ferritin or antibiotics. The iron, ferritin or antibiotic will cancel out the probiotic.
I am constipated. What kind of natural remedies can I use to relieve the discomfort?
Ah the dreaded question, but I have 3 remedies that I LOVE!
Chia Seeds : Add 2-3 tablespoons to your diet per day. Start off slow as often these little seeds can cause a laxative effect if your body isn’t used to them. They are an omega-3 essential fatty acid that are fantastic for bowel health and keeping you regular.
Flax Seeds : Grind these babies up and add up to 2 tablespoons into your diet daily. These seeds work well, but I have found that Chia Seeds are the goddess of bowel health. Regardless, both should be in your diet if you can tolerate them as they both have many benefits for your body besides bowel health. Flax is excellent for the skin, hair and nails.
Ways to add chia and flax seeds into your diet:
- Put both in a daily smoothie
- Sprinkle non-ground flax seeds or chia seeds on salads, yogurt, dessert, or any meal
- Use chia or flax eggs in baking instead of real eggs
- Make a daily chia seed pudding with plant based milk
- Make oatmeal and sprinkle it on top or mix it in
- Make overnight oats and add chia or flax
- Make quinoa porridge and add flax and chia seeds or ground
Magnesium Citrate supplements 300mg-500mg : In addition to helping your bowels function properly, this natural mineral supplement is good for muscle relaxation, and healthier sleep patterns. It is also very common for men and women to be deficient in this mineral. But you don’t need to get your blood levels tested to see if you should take this supplement. Like a probiotic, this is a supplement that should be taken daily. Magnesium is best taken 1 hour before bedtime, because it promotes muscle relaxation. There are many types of Magnesium (which are all sold OTC (over the counter) – make sure your version is gluten-free) but the one that you will want will always be Magnesium Citrate if bowel health and constipation is your issue. This particular form of Magnesium has more of a natural laxative effect and therefore promotes proper bowl function. My favorite brand of Magnesium Citrate is by Metagenics.
As for dosages of Magnesium Citrate, it is important to discuss dosage with your doctor depending on your medical issue and level of constipation. For most, the recommendation is between 300-500mg a day (pill form). Taking more will often give unpleasant side effects like diarrhea. And if this happens, no sweat, just scale back or skip a day in between to give your body a rest.
Magnesium should also be taken if you are taking vitamin D or iron/ferritin supplements as both vitamins are constipating in their own nature.
Other benefits of Magnesium Citrate are:
- Relaxes the muscles
- Helps to regulate sleep patterns
- Promotes relaxation
- Prevents damage from toxins, heavy metals and other environmental chemicals
- Promotes therapeutic benefits for migraines, aging and PMS
- Prevents muscle spasms
- Aids in proper function of the nervous system, cardiovascular and muscular systems
- Helps maintain muscles, bones, teeth and nerves
Note: You can take all three Magnesium Citrate, Flax seeds and Chia seeds per day. This is totally safe. You will just have to play around with the dosages and amounts that are right for your body.
***If you have Heart Disease or Kidney Problems, consult your doctor before taking Magnesium supplements. If you have Diverticulitis, you may have trouble with all seeds so start slowly and if it bothers you, eliminate seeds.
Telogen Effluvium: Is a form of non-scarring form Alopecia that causes the hair to shed followed by widespread hair loss after a traumatic experience. Non scarring means that the hair follicles are not permanently damaged and therefore hair has the potential to grow again. TE for some patients becomes chronic where the body and hair follicles don’t fully recover from the traumatic experience causing this condition to become chronic, and if the hair follicles are permanently damaged then life long. You can get a diagnosis for this condition by doing a scalp biopsy and determining if this is in fact the condition you have at a Dermatologist’s office or Hair Specialist, M.D.
It is common to lose up to 100-150 hairs per day. With TE, you can lose up to 400 hairs a day!
“TE occurs when a large number of hair follicles suddenly decide to take a rest at the same time. Then 3-4 months later, this formerly resting hair sheds as new hair begins to take its place. Why does a large portion of hair suddenly enter the resting phase and bring about an attack of TE? Usually a traumatic experience causes the condition. Essentially, in times of stress, the body diverts its energies to something other then growing hair. As a result, the hair goes into a resting stage until the traumatic event subsides. The problem is that after the trauma, the hair can’t just start growing again. It first has to be shed, and then you have to wait for new hair to grown in.” Hair Loss For Dummies by Robert Bernstein, M.D.
Now, when TE becomes chronic the hair follicle stages are in a constant cycle of distress and resting phases occur for a longer periods of time often overlapping and causing a chronic vicious pattern.
It’s important to know that ALL forms of chronic Illness cause a metabolic shift of nutrients to the hair follicles and may bring on TE.
TE can also caused by metabolic, hormonal stresses, certain medications, Autoimmune diseases, Thyroid complications, Celiac Disease, Lupus, Scleroderma, Alopecia Areata, Anemia or nutrient deficiencies, chemical/food allergies, and other related root conditions. Some patients experience burning and itching in the area that is shedding and find it painful, while others do not. Most often this condition comes with extreme emotional ties. It’s especially heartbreaking for a women to lose their hair or even experience massive shedding. The emotional aspect of hair loss is grand causing so much stress on top of the Alopecia itself, making mind/body practices more important then ever. Hair shedding and loss can occur at any age.
There are many western medications that can help with hair loss, but many of them lose their results when the medication is stopped. This includes but is not limited to:
- medical shampoo’s like Rogaine and Minoxidill (for men and women)
- the medication Propecia (men only) which is taken in pill form
Then there are helpful western treatments that decrease inflammation. This includes but is not limited to:
- Cortisone scalp injections (a steroid) to decrease inflammation and to get the immune system to stop attacking the hair follicles. This would be done at a Dermatologist’s office or Hair Specialist M.D.
- The Laser Comb Treatment
- Spironolactone (brand name Aldactone) – is a prescription oral diuretic (or water pill) that’s FDA-approved to treat congestive heart failure and has shown in some studies being able to treat Women’s (women ONLY) thinning hair loss by blocking the hair from falling out. It’s also used to treat severe acne. The side effects of this drug can cause massive dizziness, heat flashes and nausea to an extreme for some people. This pill should also be taken at dinner time so that the side effects don’t affect you during the daytime. Please note that this drug acts as a hormone.
What I have found most important with this condition is holistic mind/body practices to stop negative/worrisome thinking about the hair loss. Mind/body plays a huge roll in healing especially when negative thoughts, low confidence, sadness and frustration take their toll and the emotional aspect of the condition bears too much weight. Some of these practices are as follow:
- Yoga / Restorative Yoga
- Holistic remedies such as hair masks for soothing
- More sleep / Getting enough rest
- Energy Healing
- Angel Card Readings
- Tarot Card Readings
- Positive Affirmations
- Nature Walks
- Taking control of your Diet (knowing that it plays a massive role in healthy healing-Getting in more protein (especially in the morning), fitting in good healthy fats and lowering sugar intake and/or removing dairy as dairy is inflammatory)
Seborrheic Dermatitis: Is a skin condition and a form of Eczema found mainly on the scalp. It causes scaly patches and red skin mainly on the scalp. It can be chronic and difficult to manage. The symptoms are itchy scalp, burning, often flaking scalp with hair loss. Sometimes it can feel like the inflamed area has a bug crawling in it, but it’s just the hair follicles acting up. In this skin condition the hair follicles become inflamed which makes it hard for the hair to grow. Because it can be itchy, the automatic response is to scratch which adds more bacteria to the irritated area causing more hair loss. In many cases moderate to extreme hair loss accompanies this condition and can often accompany TE. It can come at any time of your life and often comes out in times of trauma or severe stress. This condition can also be associated with Yeast Overgrowth or Candida.
Diagnosis should come from a Dermatologist or a Hair Specialist Doctor, M.D.
There are many ways to manage this condition both holistically and with western medicine:
Cortisone shots in the scalp (from a Dermatologist) every few months depending on the severity to bring down the inflammation.
- Cortisone Shampoo’s – decreases inflammation, itchyines and burning – prevents build-up
- Fungus Shampoo’s – decreases inflammation, itchyines and burning and kills fungus
- Olive Oil Masks – decreases scaly skin build up and deeply moisturizes the scalp
- Aloe Masks – alleviates burning, calms down scalp, makes hair super shiny
- Specific Vitamin and Mineral Supplements – Make sure to have your levels checked before deciding to pop a bunch of vitamins. Taking supplements you are deficient in can cause hair loss. Some vitamins and minerals that may help are: Zinc, Vitamin A, B-Vitamins, Vitamin D, Biotin, Iodine, Copper. Always get your levels tested by your doctor first! And always discuss options and dosages with your doctor before taking supplements.
- Showering and shampooing daily – prevents scaly skin build-up
The test you can do is a punch test where the dermatologist will numb an area of your head, and punch out a piece of your scalp out (usually in the inflamed area) along with a chunk of the hair and send it to a lab for testing to confirm if the hair loss is due to genetics, different forms of Alopecia, Telogen Effluvium or another condition.
For mind/body practices please refer back to the Telogen Effluvium section above as those holistic practices can be applied here as well.
If you have any questions please feel free to email me at goodiegoodieglutenfree (at) gmail (dot) com or leave a comment below. I will get back to you as quickly as I can.
**Disclaimer: I am not a Doctor. I am not a Nutritionist. I am a Certified Holistic Health Coach. My information is from my doctors and my own personal research and experience. The information above is not intended nor suited to be a replacement for professional medical treatment or for professional medical advice relative to a specific medical question or condition. The above information is not intended to replace a doctor/patient relationship with any physician. There is no replacement for personal medical treatment or advice for your personal physician.