This is one of my most controversial clinical opinions: I don't work with functional lab tests, including DUTCH testing, GI Map, organic acids, and microbiome panels. In this episode, I walk through exactly why and some considerations for those who do work with these tests.
In this episode, we cover:
What I mean by "functional labs" and which tests fall under that umbrella.
Why I only recommend tests when the results will actually change what I do.
The validity problem, with fecal samples for microbiome testing as an example.
Why "accurate results" and "clinically actionable results" are two very different things.
The evidence problem: how recommendations attached to these labs are often theoretical rather than based on clinical data.
The conflict of interest issue.
A harder question for practitioners: if a lab is telling your client what to take, what exactly are they paying you for?
Timestamps:
0:00 - Introduction
0:10 - My most controversial clinical opinion
0:35 - On not judging practitioners who use these labs
1:38 - Reason 1: I don't think I need them
2:03 - When I think testing matters (iron as an example)
4:07 - Reason 2: Validity concerns
5:01 - Reason 3: The "what do we do about it" data is mostly theoretical
6:05 - The supplement recommendation problem
9:38 - A question for practitioners who rely on labs to guide recommendations
10:45 - What I'd rather clients spend that money on
