Functional Lab Testing: Getting to the Root Cause
Functional Adrenal Stress Profile – Cortisol x 4, 2 averaged DHEA-S
- Functional Adrenal Stress Profile w/ sIgA x 4
- Functional Adrenal Cortisol Rhythm (Cortisol x 4)
- Functional Adrenal Stress Profile plus V: Cortisol x 4, 2 averaged DHEA-S, estradiol, estriol, testosterone (AM), melatonin (bedtime), progesterone (bedtime)
- Functional Adrenal Stress Profile plus V w/ sIgA : Cortisol x 4, 2 averaged DHEA-S, estradiol, estriol, testosterone (AM), melatonin (bedtime), progesterone (bedtime); Secretory IgA x 4; includes 1-Day Patient Diary
Functional Adrenal Stress Profile
This profile is used to evaluate the adrenal glands and hormone balance. In the event of adrenal exhaustion, underlying causes must be determined through additional lab testing and investigation into environmental and lifestyle factors; while also supporting the adrenals with nutritional protocols and lifestyle modifications. When the body is under chronic stress, pregnenolone, the precursor to all other steroidal hormones, is diverted to produce cortisol (known as pregnenolone steal or cortisol escape). This is to the detriment of all other steroidal hormones (such as DHEA and its metabolites, including progesterone, testosterone, and the estrogens). As pregnenolone is diverted to cortisol, DHEA depletion begins. The result is an elevated cortisol to DHEA ratio. A normal ratio is approximately 5:1 to 6:1.
Functional Adrenal Cortisol Rhythm
Cortisol levels start high in the morning and decline as the day transpires. Levels may fluctuate high or low at any of the four times of measurement, due to stress, acute or chronic. This test is applicable to individuals not requiring DHEA-Sulfate measurements in their adrenal health diagnostics. This test is often run on pre-adolescents, but not exclusively; and not all pre-adolescents should do this test.
Functional Adrenal Stress Profile plus V with Estrone
This profile is used to evaluate the adrenal glands and hormone balance. In the event of adrenal exhaustion and imbalances in the reported hormones, underlying causes must be determined through additional lab testing and investigation into environmental and lifestyle factors; while also supporting the endocrine system with therapies and lifestyle modifications. This profile includes the estrogen estrone, the weakest of the three naturally occurring estrogens. It is often seen elevated in postmenopausal women and in some cases where a patient is taking too much DHEA.
Functional Adrenal Stress Profile plus V
This profile is used to evaluate the adrenal glands and hormone balance. In the event of adrenal exhaustion and imbalances in the reported hormones, underlying causes must be determined through additional lab testing and investigation into environmental and lifestyle factors; while also supporting the endocrine system with therapies and lifestyle modifications. When the body is under chronic stress, pregnenolone, the precursor to all other steroidal hormones, is diverted to produce cortisol (known as pregnenelone steal or cortisol escape). This is to the detriment of all other steroidal hormones (such as DHEA and its metabolites, including progesterone, testosterone, and the estrogens). As pregnenolone is diverted to cortisol, DHEA depletion begins. The result is an elevated cortisol to DHEA ratio. A normal ratio is approximately 5:1 to 6:1. This profile includes additional hormones for a more complete view into the impacts of chronic stress on the individual’s core body systems. A vast amount of information can be gathered through this profile.
Why Assess the Adrenal Glands?
The Adrenal Glands The two, walnut-size adrenal glands are the command post of the endocrine system and the glands are located in the small of the back just above the kidneys and underneath the last (twelfth) rib. These small but powerful glands are strategically located in the body near the aorta and vena cava to quickly receive information from the anterior pituitary via the release of Adrenocorticotropic Hormone (ACTH). The adrenals are also in close proximity to critical organs that the adrenal hormones act upon including the liver, pancreas, kidneys, and others. The adrenal glands are divided into two parts: the outer cortex, which consists of three main rings and the inner medulla. The very thin outer ring of the cortex is the zona glomerulosa which secretes aldosterone, the middle ring is the zona fasciculate which primarily secretes cortisol, and the inner ring is the zona reticularis which primarily produces androgens, including DHEA and its metabolites. Despite the diminutive size of the adrenal glands, they are involved in regulating virtually every aspect of body function. Physiological Effects of the Primary Hormones of the Adrenal Cortex The adrenal hormones cortisol and DHEA have genetic influence on the body, they penetrate cells and enter the nucleus, where DNA is unlocked and transcribed. Cortisol is the main hormone that directs immune function and its levels are tremendously valuable in assessing overall health. Cortisol and DHEA are also involved in carbohydrate, protein and fat metabolism; eicosanoid modulation; detoxification capacity; endocrine function; and the health of muscle, bone and neural tissues, etc. Effects of Divergence from Normal Levels of Cortisol and DHEA Maintaining physiological balance is an important aspect of vibrant health, and nowhere is this more evident when it comes to cortisol. The production of too much cortisol can literally burn up the body, and insufficient cortisol production causes the body’s internal machinery to malfunction, especially at the cellular level. The adrenal glands produce both cortisol and DHEA in the adrenal cortex under the stimulation of adrenocorticotropic hormone (ACTH), which is released by the pituitary gland. ACTH acts like a whip on the adrenals. It is in many ways similar to a jockey whipping a horse to make it run faster. If the jockey ignores the clues that his horse is fatigued and keeps whipping it, the horse will keep running until it collapses in total exhaustion or death. In the case of the human body, if we allow stress levels to become chronic and out of control, we can sooner or later expect the same result. Optimal adrenal function exists when the ratio of cortisol to DHEA is in proper balance. This is why measuring this ratio is the best way to both evaluate adrenal function and determine the effects stress is having on overall health. When cortisol levels are elevated and DHEA is low we are considered to be in a Chronic Stress Response. When this happens we are losing (or have already lost) our ability to modulate bodily functions and are on the road to further hormone, immune, and metabolic breakdown. For example, if cortisol levels are too high at night, rather than getting the rest and recovery necessary to maintain optimal physical repair and psychic regeneration, the body will be in a catabolic state (high nighttime cortisol levels inhibit the release of growth hormone necessary to repair and rebuild body tissues). This high cortisol will also have a negative effect on brain function, memory, learning and mood. This is especially true if this condition is ongoing (chronic in nature). We all have noticed individuals who have excess fat around their hips, thighs or waist and yet they do not seem to be particularly overweight. In fact, these people may be slender except for those “problem” areas. More than making them uncomfortable wearing a bathing suit in public, this unsightly accumulation of fat is a telltale sign of adrenal dysfunction and hormone imbalance, specifically an elevated ratio of cortisol to DHEA. An elevated cortisol to DHEA ratio will also interfere with the surface integrity of the body’s mucosal linings that act as its first-line immune defense. This mucosal barrier is primarily under the direction of the adrenal glands, specifically cortisol and DHEA. Cortisol and DHEA systemically modulate the production and turnover of specialized immune cells called immunocytes (also known as plasmacytes) that produce the secretory antibodies that protect us. The primary antibody of defense is secretory IgA (sIgA). When cortisol is elevated and DHEA is low, suppression of these mucosal immune cells occurs, compromising our first-line immune defense, resulting in low sIgA output. The longer a person is in a state of chronic stress (high ratio of cortisol to DHEA), the more compromised his or her first line of immune defense will be and the greater the risk for opportunistic infections and allergic reactions to foods. This could ultimately lead to cancer, cardiovascular disease as well as autoimmune disease, a variety of degenerative diseases and accelerated aging. In a Chronic Stress Response all body functions have become compromised due to prolonged hormone, immune and metabolic breakdown that can lead like falling dominoes to a cascade of chronic degenerative diseases from which the weakened body has a reduced chance to recover. Stages of Adrenal Exhaustion Adrenal exhaustion progresses in three stages . Stage I is distinguished by an increase in output of ACTH by the anterior pituitary gland, increased adrenocortical stimulation, increased cortisol output and an increased probability of pregnenolone steal and decreased DHEA. When in a Chronic Stress Response, pregnenolone, the common precursor to cortisol, DHEA and other hormones is preferentially diverted to cortisol production at the expense of the rest of the steroidal hormones. Generally in Stage I cortisol increases and DHEA and its metabolites decrease or an imbalance occurs especially between testosterone and estrogen. Stage II Adrenal Exhaustion is marked by the transition from increased to decreased cortisol output. This stage is characterized by continuing high levels of ACTH and thus: adrenocortical stimulation, normal total cortisol output, low or borderline low morning, noon or afternoon cortisol levels, normal nighttime cortisol level, and an increased probability of pregnenolone steal and a further decrease in DHEA. This is a transitional phase in which although ACTH stimulation remains high or even increases, the adrenal output of cortisol declines due to the adrenal fatigue associated with continued hyper stimulation. Stage III Adrenal Exhaustion is an advanced stage of adrenal exhaustion characterized by decreased total cortisol output. This stage is characterized by continuing high levels of ACTH and thus adrenocortical stimulation, low total cortisol output, and increased probability of a low nighttime cortisol level and pregnenolone steal and even further decrease in DHEA. The adrenal glands are now exhausted to the point that even though there is ongoing hyperstimulation (high ACTH); they continue to lose their capacity and reserve to produce enough cortisol. The eventual result is a crash of the hypothalamic-pituitary-adrenal axis (HPAA) in which essential neuroendocrine feedback loops are unable to return the system to homeostasis.
Women’s Hormone Profiles (Salivary)
- Premenopause Hormone Profiles 11 estradiol, 2 testosterone (AM), 11 progesterone; #208: 17 estradiol, 2 testosterone (AM), 17 progesterone
- Female Hormone Profiles : DHEA-S, estradiol, estriol, testosterone (AM), progesterone; Or: DHEA-S, estradiol, estriol, estrone, testosterone (AM), progesterone
Microbiology Menu (Stool and Serum)
- GI Pathogen Screen Ova & parasites x 4 (Trichrome stain) plus antibodies to the antigens of Giardia lamblia, Cryptosporidium parvum, Entamoeba histolytica. Plus culture x 1: Bacteria, fungi, yeasts, occult blood, Clostridium difficile: Colitis toxins A & B.
- Ova and Parasites Ova & parasites x 4 (Trichrome stain): protozoa, flatworms, roundworms, etc.
- Giardia Antigen Giardia lamblia antigen w/ Trichrome stain
- Cryptosporidium Antigen Cryptosporidium parvum antigen w/ Trichrome stain
- Entamoeba histolytica Antigen Entamoeba histolytica antigen w/ Trichrome stain
- Clostridium difficile: Colitis Toxins A & B Clostridium difficile: Colitis toxins A & B
- Helicobacter pylori Stool Antigen Helicobacter pylori antigen
- Helicobacter pylori Antibodies Antibodies IgG, IgM, IgA to Helicobacter pylori
For monitoring of therapies and follow-up tests, We offer each hormone test as a single marker:
GI Pathogen Screen (stool) (Excellent stool test for GI Pathogens)
- GI Pathogen Screen – Ova & parasites x 4 (Trichrome stain) plus antibodies to the antigens of Giardia lamblia, Cryptosporidium parvum, Entamoeba histolytica, and Helicobacter pylori. Plus culture x 1: Bacteria, fungi, yeasts, occult blood, Clostridium difficile: Colitis toxins A & B.
Thyroid Panel IV (serum)
Includes Free Triiodothyronine, Free Thyroxine, Thyroid Stimulating Hormone, Thyroid Peroxidase IgG, Thyroglobulin Ab IgG, T3 Reverse (Excellent thyroid function and thyroid autoimmune (Hashimoto’s test) (Available in Canada for additional shipping fees. Please inquire).
Analysis of elements in feces provides indirect information about the potential for toxic metal burden. For many toxic metals, fecal (biliary) excretion is the primary natural route of elimination from the body. Fecal elemental analysis also provides a direct indication of dietary exposure to toxic metals. Specimen collection is convenient for the patient and only requires a single-step procedure.
Urine toxic and essential elements analysis is an invaluable tool for the assessment of retention of toxic metals in the body and the status of essential nutrient elements. Toxic metals do not have any useful physiological function, adversely affect virtually every organ system and disrupt the homeostasis of nutrient elements.
Immunoserology of Lyme Panel A (serum) Immunoserology of Lyme Panel B (serum) (Panel B includes Western Blot test)
Array 2 Intestinal Antigenic Permeability Screen (serum) (Array 2 is an excellent test for leaky gut) Array 3 Wheat/Gluten Proteome Reactivity & Autoimmunity (serum) (Array 3 is an excellent test for Celiac disease) Array 4 Gluten-Associated Cross-Reactive Foods and Sensitivity (serum) All other Cyrex arrays are also available. See the link above for more information. Cyrex requires your client to pay for the lab fees in advance and get blood drawn at specific locations
(Excellent IgG “delayed” sensitivities test for 115 or 154 common foods. Reflex testing of sub-fractions available and you can easily add additional allergy testing for molds and inhalants, etc using the same blood specimen)
Good IgG “delayed” sensitivities test for 94 items. Dried blood spot tests are easy to collect at home and submit by mail from just about anywhere to the lab in U.S.
Excellent stool testing for GI pathogens and additional markers that may be clinically useful.
(The UMP is an Organic Acid Test. The UMP provides quantitative measurement of 36 metabolically derived organic acids from cellular energy production and detoxification, neurotransmitter degradation, and intestinal microbial activity. The EPP quantifies exposure to aromatic solvents, paraben and phthalates.)
This nasal culture is used to isolate and identify coag neg staphs.
Includes interpretation, phone consultation and lab fee. (No additional Med Dir. fee) Multi-Element Assay (36 Elements) of Hair includes: Comprehensive report for the client and a copy of test results (including graphic illustration of levels and ratios).
Includes interpretation, phone consultation and lab fee. (No additional Med Dir. fee) Provides a basic Multi-Element Laboratory Assay reporting the patient test results for macro and micro minerals, toxic metals and significant ratios. A chart is provided that identifies the patient/client information and graphically illustrates the test results.
Breath test to evaluate Small Intestinal Bacterial Overgrowth.