6 minute read
If my blood test is OK – why don’t I feel OK?
Why functional pathology testing can be useful.
BY DIANA ARUNDELL, UNIVERSITY QUALIFIED NATUROPATH AND NUTRITIONIST
It makes sense that when we are unwell, we take a trip to the doctor and based on the discussion, the doctor may/ may not wish to request a blood test for further information. At times, a great line of questioning and physical examination may be sufficient for a physician to diagnose and at other times, further investigations such as blood tests, scans etc are required to confirm or establish a diagnosis.
Blood tests can be very useful however information is limited to what is being tested and what the actual results are being compared to. There are many parameters to consider when reviewing blood tests and just because abnormalities don’t show up in the blood, doesn’t mean nothing is wrong and the person in question is imagining feeling unwell. This is where orthodox medical practitioners and naturopaths may have differing opinions on a patient’s blood work.
For example, TSH (thyroid stimulating hormone) is often the basic go to for assessing general thyroid function. However, TSH indicates what the brain is telling the thyroid to do rather than accurately indicating actual thyroid output or function. Thyroid output is more indicated by levels of free T4, T3 and reverse T3. It is possible for TSH to be in ‘normal range’ but thyroid output to be sitting at an outer end of normal range and subclinical disease to be present and vice versa. Subclinical disease may show up as results ‘within’ the parameters but closer to the out limits of the reference range.
For example; a person may present with thyroid symptoms, even if their thyroid output markers are ‘normal’ but their TSH may be at the outer end of the ‘normal’ range suggesting that the thyroid is starting to struggle. In this instance it makes sense to try and prevent disease progressing rather than wait for blood test markers to be ‘out of range’ before treatment commences. Prevention is easier than cure with regards to most health conditions.
Another issue with blood test results is the issue of what we are comparing a ‘healthy normal’ to. Generally speaking blood test parameters are taken from 95% of the population and really, is 95% of our population healthy? We just need to look around and observe our population to see this is not the case. Another issue with these parameters is that the goal posts are continually changing to match 95% of the population. Rather than asking what has happened to our diet and lifestyle to affect changes in our pathology results across the board, the goal posts are changed to accommodate a new normal.
Many naturopaths focus more on functional pathology testing rather than just blood tests as sometimes deficiencies in nutrients, hormones and neurotransmitters etc can be difficult to accurately measure in the blood.
The blood is a tightly regulated system and the body’s intelligence runs a very tight ship to ensure homeostasis and parameters of the blood such as
B.H.Sc (comp medicine) B.A., N.D., Dip. Nut, D.R.M.
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temperature, pH and oxygen tension are maintained within a very narrow functioning window. For example, if blood becomes too acidic, calcium will be drawn down from the bones to buffer the acidity and bring the pH back to a specific range. The blood won’t tolerate too high levels of heavy metals and in order to protect the delicate system of the blood, toxic metals will be shunted out of the blood and stored in other tissue such as bone, fat and hair. In this case, blood testing to establish heavy metal toxicity may confirm current exposure however longer term build–up of heavy metals may be more accurately measured via hair tissue mineral analysis or an organic acids urine test looking at the by products of heavy metal metabolism.
Following are some of the functional pathology tests more commonly utilised by integrative medical doctors and naturopaths. These tests can be expensive and are not covered by Medicare so the benefit of the information provided by these functional tests needs to be weighed up and carefully considered.
Organic Acids Test (OAT)
This is a urine test looking at functional markers of nutrient and neurotransmitter deficiency and/or excess. Actual cellular levels of some vitamins and minerals can be difficult to capture via the blood and sometimes metabolic markers of inadequate cellular levels of nutrients may be more accurately measured and therefore useful. The organic acids test utilises this principle by measuring organic acid build up in the urine which is created when there are inadequate levels of certain nutrients and neurotransmitters. This test may be useful when treating mood disorders and unexplained fatigue. Dried Urine Test for Comprehensive Hormones (DUTCH)
This test collects 4–5 urine samples over a 24hr period to primarily measure sex and adrenal hormone function and diurnal fluctuations. It’s useful for detecting accurate levels of sex hormones, cortisol and melatonin to help monitor dosages of medication and identify underlying causes of some unexplained symptoms.
Comprehensive Digestive Stool Analysis or Gastrointestinal mapping (CDSA or GI MAP)
These tests use a stool sample to measure the health of the gut microbiome and other indicators of digestion, absorption, infection and inflammation. Specific treatment plans may be more confidently prescribed based on actual results of what is going on in the gut for that individual.
Hair Tissue Mineral Analysis (HTMA)
Scalp hair is believed to contain a record of element metabolism and toxic exposure accurately reflecting human organ and systemic levels. It is an easy to obtain, non–invasive test and when used in conjunction with other laboratory results, may be useful in establishing underlying metabolic disorders related to minerals and toxic elements.
Saliva tests
Saliva testing measures the biologically active or free hormone levels in the body. This is indicative of the level of a particular hormone that is actively delivered to the receptors in the body whereas many blood tests measure protein bound hormones which may be more indicative of the reserve amount of the hormone rather than the active form.
Diana Arundell is a university–qualified naturopath and consults from her Avoca Naturopath clinic. She has a special interest in fertility and pregnancy health, digestive health, immune function and family wellness programs. She was a nutrition lecturer at Macquarie University for 10 years, and is an accredited Journey Practitioner. For further information or to make an appointment please contact Diana Arundell at Avoca Naturopath on 0410 465 900.
