Functional Testing

In addition to standard blood tests (such as CBC, liver enzymes, blood glucose, etc.) Naturopathic Doctors may offer additional testing to help identify underlying causes of illness or reveal sub-optimal functioning via blood, urine, saliva or stool analysis. Below are some examples of testing that may be utilized for conditions within my area of focus. Alternative tests, not listed here, may be utilized for other conditions.

Gut Health

Tests for gastrointestinal (GI) health may include serum (blood) testing and stool testing. Functional GI testing can be beneficial for anyone looking to improve their overall health, however, it may be most beneficial for individuals with or suspected:

  • Autoimmune disease

  • Unexplained fatigue

  • Digestive complaints of unknown origin

  • IBS/IBD

  • Brain fog or poor concentration

  • Skin disorders (acne, eczema, psoriasis, rosacea)

  • Mood disorders (anxiety and depression)

  • Those with weight loss difficulty or metabolic impairment

  • In infants or children, testing may be indicated in the assessment of ADHD, Autism, skin disorders and digestive complaints

Testing may include, but it is not limited to:

  • Celiac Testing

  • Food Allergy (IgE) & Sensitivities (IgG)

  • Nutritional Deficiencies

  • Tests specific to Inflammatory Bowel Disease (Crohn’s, Colitis)

  • Zonulin testing for intestinal permeability/”leaky gut”

  • Small Intestinal Bacterial Overgrowth (SIBO)

  • pH or stomach acid testing

  • GI-MAP Testing is the most comprehensive GI test offered which includes a full pathogen profile of your gut (bacteria, viruses, parasites, fungi/yeast, opportunistic infections, H. pylori,), measures levels of “good bacteria”, lists potential autoimmune triggers and includes markers of digestive health such as inflammatory markers, gut permeability and immune response markers. It may also include genetic information such as the presence of antibiotic resistance genes.

Hormones

Hormonal Testing may involve serum (blood), dried urine or salivary samples.

Female Hormone Testing can identify a number of women’s health issues such as:

  • PCOS

  • PMS or PMDD (including cycle related anxiety or depression)

  • Fertility workup

  • Causes of cycle irregularity, anovulatory cycles

  • Mood swings, difficulty coping, fatigue, memory or concentration issues, migraines and even the effects of chronic stress on the body.

Tests may include but are not limited to:

  • Estrogen, Progesterone and their metabolites

  • Androgens and their metabolites (Testosterone, DHEA-S, Androsterone, 5-DHT)

  • Cortisol and metabolites throughout the day

  • Organic Acids Testing (B12, B6, Glutathione markers)

  • Neurotransmitter Metabolite Testing which provides information about the body’s status of Dopamine, Epinephrine/Norepinephrine, Melatonin, Oxidative stress & DNA damage

  • Thyroid panel

  • Cycle Mapping Test used in cases when testing on one specific day of the cycle does not provide adequate insight into hormonal changes throughout the month

Male Hormone Testing is important for individuals that are experiencing:

  • Low energy

  • Brain fog, memory impairment

  • Low libido, erectile dysfunction

  • Increased breast size

  • Mood changes (anxiety, depression, apathy, irritability)

  • Bone or muscle loss

  • Prolonged or chronic stress

  • Trouble conceiving, optimization of sperm health

Tests may include, but are not limited to:

  • DHEA-S, Testosterone, Estrogen, Progesterone

  • Cortisol

  • Thyroid Panel

  • Organic Acid Tests and/or Neurotransmitter Metabolites (see above)

Stress & Fatigue

The hypothalamic-pituitary-adrenal axis (HPA axis) involves stimulation from the brain (hypothalamus and pituitary gland) to our adrenal glands which then secrete cortisol (the “stress hormone”), Norepinephrine and Epinephrine. These hormones and neurotransmitters then feed back to the brain affecting further secretion.

Chronic stress (physical or mental), sleep dysfunction, psychological burnout, mental health conditions, chronic pain, functional GI diseases, inflammatory or autoimmune disease and chronic diseases can all effect our HPA axis function. Cortisol changes can then effect male and female sex hormones leading to other hormonal complaints as well.

Symptoms of HPA axis dysfunction may include trouble waking up in the morning, insomnia, constant fatigue, inability to handle stress, anxiety, depression weakness, body aches, decreased exercise tolerance, feeling wired but tired, feeling burnt out, blood sugar irregularities, blood pressure and weight changes, lowered immunity, sugar or salt cravings and reliance on caffeine or stimulants.

Testing for fatigue and HPA function may include, but is not limited to:

  • Inflammatory and autoimmune markers

  • Environmental allergen or toxic exposure

  • Gut health, nutrient panel and food sensitivities

  • Thyroid panel

  • 4 point cortisol

  • Cortisol Awakening Response (measures cortisol upon wakening and again 30 and 60 minutes later).

    • A weak response may be due to an underactive HPA axis, autoimmune disease, functional GI disorders, sleep dysfunction, psychological burnout, mood disorders including post-partum depression and SAD (seasonal affective disorder), and chronic pain or fatigue.

    • An elevated response may be due to an overactive HPA axis due to ongoing stress (financial, job, familial), waking with pain, blood sugar irregularities, Depression and Major Depressive Disorder (not SAD).

It’s always helpful to bring in any lab work or imaging that you have already completed with your MD to your visit so that additional testing may not be required. My goal is to work as a team with your other healthcare practitioners to achieve an integrated medical approach to your health.

Dr. Samantha Zahavi, ND is available for both virtual appointments and in-person visits at her Midtown Toronto clinic.