Functional Lab Testing... What Can We Learn?
By Debra Gibson, ND
T
he plot of “The Fantastic Voyage”, a science-fiction movie from the 1960’s, centers on the adventures of a group of scientists who are miniaturized by a newly invented machine to a size small enough to enter an ill colleague’s body. Their mission? To navi- gate (inside a tiny submarine) the colleague’s cardiovascular system to his brain, save his life by dissolving a blood clot, and safely exit his body before the miniaturizing effect wears off and they revert to normal size. Along the way they witness up close the miraculous workings of the human body: the beating of the heart, the oxygen- ation of blood by the lungs, and, when their submarine comes under attack by white blood cells, the unerring power of the immune system to target invaders. A fun, imaginative and fascinating movie, even today, and one I am often reminded of when I review results of a functional laboratory test with a patient.
Because like that journey into “inner space”, this new breed of
laboratory evaluation gives physicians and patients a window on the inner workings of the human body not provided by standard lab tests. Functional medicine biomarkers and test profiles are ahead of the curve of standard lab assessments, offering the closest thing to real-time insights into the way the body actually functions, and more importantly, providing specific information about body system dysfunctions. It is these “system failures” that can cause complex and puzzling symptom pictures and create the negative physiologic momentum that drives the development of many diseases. The ability to examine deeper, fundamental causes of illness through functional testing can guide treatment in more effective directions and allow progress and outcomes to be tracked in ways never before possible. But it may be as tools for disease prevention that functional lab markers hold greatest potential for benefit, enabling us to “look upstream” and identify patterns of risk for illness that can often be resolved or significantly reduced with lifestyle and natural therapies. These markers also provide a practical and accurate way to per- sonalize healthcare, as they reveal the unique metabolic “footprint” of an individual at a particular point in time. It’s a kind of brave, new world of laboratory testing, and it can be credited for many “miracu- lous” healing outcomes by those who work with it.
Biomarkers in Functional Assessment
The term “biomarker” can be applied to everything from some- thing as basic as a red blood cell count to sophisticated genetic testing which checks the appropriateness of a particular drug for a person. Functional biomarkers are a special category of tests which identify otherwise hidden patterns of body system dysfunction.
34 Natural Nutmeg March 2013
Some biomarker tests with functional applications are available from standard laboratories; those listed below can easily be added to an order for basic lab tests such as a metabolic panel or cholesterol test to screen for functional systemic imbalances. • Homocysteine: originally identified as an independent risk factor for cardiovascular disease, an elevated serum level of this breakdown product of the amino acid methionine points to impair- ment of one or both of two crucial and common metabolic path- ways. Because of this, increased homocysteine is a risk indicator for many diseases, among them rheumatoid arthritis, Type 2 diabetes and its complications, Alzheimer’s dementia, depression, anxiety, and osteoporosis. Nutritional support in the form of folic acid, vitamins B12, B2, and B6, and betaine leads to reduction in homo- cysteine and normalizes the flow of the metabolic pathways. • Insulin: Elevated serum insulin, either in the fasting state or
after a “challenge” of carbohydrate, contributes to heart disease and stroke, obesity, Type 2 diabetes, high blood pressure, high choles- terol, inflammation, polycystic ovary syndrome, and many other undesirable health issues. I also pay attention to a low insulin level, as that may indicate declining insulin output by the pancreas. An abnormal insulin level can appear years or decades before diagnos- able disease presents itself, so it is the best kind of prevention to find it and treat it. Identifying this very commonly abnormal functional marker and prescribing lifestyle changes and nutritional support can lead to dramatic improvement, and while reducing long-term risk for serious disease, in the near term it improves weight, energy, mood and well-being. • CardioCRP: Also called “highly sensitive CRP”, this test mea-
sures very small blood amounts of a protein which is produced by the liver in response to inflammation. Elevations in cardioCRP have been associated with significantly increased risk of atherosclerosis and cardiac events, as well as stroke, cancer, and depression. Natu- ral medicine approaches to normalizing elevated cardioCRP include reducing inflammation by means of lifestyle change (a high-fiber Mediterranean diet is effective) and taking natural anti-inflammatory supplements such as fish oil, vitamin C, flavonoids, and curcumin. Other biomarker tests which can be performed by standard
laboratories include the VAP (Vertical Auto Profile), which provides more detailed information about blood lipids than standard choles- terol measurements; and the marker Lp-PLA2 (Lipoprotein-Associat- ed Phospholipase A2), which can be paired with cardioCRP to more precisely identify those at greatest risk of cardiovascular disease, particularly stroke.
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