I’ll admit, the data we can collect these days with the awesome functional labs we have at our disposal is pretty dang phenomenal. 

Here’s a more unpopular opinion: functional medicine practitioners lean on these babies way too much. 

And from what I’ve seen in my practice, many people who walk in wanting to do an in-depth probe of their innards with X, Y, and Z functional labs, 9 times out of 10 don’t have the basics in place yet.

And it’s usually putting these basics into place that does most of the heavy lifting in terms of meaningful health gains. 

I don’t mean to poo-poo these tests. Truly, for me, they ended up being the cherry on the cake that allowed me to switch my own health from surviving to thriving.  

Beu, using these tools too early, without addressing more foundational steps first, can waste your time and money. And for the clinician, it can result in the tendency to do too much, and potentially make things worse by doing so.

So let’s talk about what you should be doing *FIRST*, before you embark on the functional lab train.

1) Fix your upper gastrointestinal secretions.

Eye roll – you’re probably so tired of me saying this, but I repeat it over and over again because it is just.that.important.  

Modern life is full of factors that weren’t present in our evolutionary history, which can result in impaired digestive secretions in the upper gastrointestinal tract: 

• Chronic stress

• Toxin exposure

• Too many starches and carbs in the diet

• Nutrient poor, processed food that cause nutrient deficiencies

• And so many more…

As a result, many of us are walking around with tummies that are way less acidic than our ancestors’ were, which results in all kinds of health troubles. Most commonly: acid reflux, heart burn, GERD, and digestive distress. Other possibilities: fatigue, anemia, nutrient deficiencies, dysbiosis, and leaky gut… among others.

See, the rest of digestion pretty much directly depends on these upper GI secretions being flawlessly potent in order to function correctly. The sensitive intestines – which is where functional labs tend to focus – are so important, but they are not an isolated system. Stomach acid directly impacts what happens in the intestines, making it a pivotal leverage point for you to look to first and foremost, before you tackle those bad boys.

Working with your intestines first would be akin to a leaky pipe causing flooding in your basement, but you choose to go ahead and fix only the water damage, without fixing the leaky pipe. Do you think that would be a smart way to go about fortifying your basement? Or would damage just keep happening from that blasted leaky pipe?

Scenario: you invest in lab testing, which, no surprise, shows dysbiosis in your intestines. You engage in an expensive and challenging rebalancing protocol, and it works! You see your symptoms and intestines normalize. But then a few months later… everything comes back.

I hear this sob story all.the.time. Don’t let this happen to you. 

The reason everything came back, you ask? You never addressed your upper digestive impairment, so the root cause never resolved. 

 Now, a quick warning before we move on, please do not try to fix your stomach acid by:

•       Using Apple Cider Vinegar 

•       Taking Digestive Bitters

•       Engaging in the typical methods of an HCl Challenge

Fixing your stomach acid is serious business, and requires some hand holding. Using supplemental Betaine HCl is a non-negotiable but you’ve got to be sure you’re using a smart, personalized approach. 

That's why we created the S.E.E.D. process that we teach in our acid reflux programming, to deliver this needed approach.

Finally, there are other secretions that may be sub-optimal in your upper GI, beyond stomach acid. But, they tend to be suppressed for the same reasons that stomach acid is and often adjust accordingly during the S.E.E.D. process. 

2) Eat real food.

After you’ve got your tummy acid in line, it’s time to think about what you’re asking it to break down. 

Adopting a diet that is…

• Nutrient dense

• Properly prepared

• Whole foods-based

…is a non-negotiable!

If you’ve got questions about what constitutes a healthy diet, a good rule of thumb is to think about what kinds of foods humans have evolved to eat throughout their 250k years of history. Additionally, considering which “foods” may not have been in our repertoire, and thus may present confusion for the body, is useful. No surprise, the latter would probably constitute most synthetic fillers, preservatives, and additives. So you’ll want to avoid processed foods of any kind.

If you’d like to understand more about what ancestral diets looked like, to better approximate them with your choices, I highly suggest consulting the material below.

Contrary to popular belief, this does not mean embarking on a restrictive elimination diet. As I talk about in this article, this is really just about committing to eating only food, and not eating… not-food items… like McDonald’s, Doritos, and Diet Coke.

And, honestly, there are so many incredible substitutions out there now, that you really don’t have to “give up” anything. For example, you could easily convert the meal above into a nutrient dense alternative via a grass-fed beef burger on a high-quality gluten free bun or lettuce wrap, crispy broiled duck fat potatoes, and a small glass of kombucha. 

Confession: I eat stuff like this ^ all the time. Eating healthier doesn’t mean you have to eat like a bird, or derive less satisfaction from your meals. It’s all still available to you. 

Simply by embracing quality, you can create an equation for way more nutrition in your life, which translates to health boons.

For all of you mathematicians out there:

Great stomach acid + more nutrients in the diet = rebalancing dysfunction in the body

3) Lifestyle factors

I’m only going to spend a brief while on this, because there’s so much to cover, and I won’t be able to do it all justice, but I plan to write an in-depth series on each of these four subcategories eventually. 

What you need to know is that your lifestyle choices, beyond the diet, have been shown in literature to impact your microbiome for good or ill. This means changing stuff around in the following categories could definitely impact your lab readings: 

• Toxin exposure (water, cookware, personal products)

I suggest using the Environmental Working Group’s database to understand whether or not your personal products, cookware, and cleaning items are toxin-free.

Exercise has been shown to result in higher numbers of beneficial microbes in the gut, it also helps to set your circadian rhythm (if you’re one of those insomniacs from above), and it moves your lymph, helping to propel toxins out of the body. In short? Exercise is maybe the most important pillar in your lifestyle efforts, so don’t let it fall by the wayside. 

• Stress management, and putting coping mechanisms into place

I’m sure you’ve heard it before so I won’t burden you with telling you stress is bad. We all kinda know that by now. But, really, in our culture, and especially right now, stress is inevitable. This makes it all the more important to have healthy coping mechanisms in place that allow us to release our anxieties and worries, and to give our poor nervous systems a break. 

Also, clean water is, as you might guess, extremely important, but surprisingly elusive. For example, that Brita filter is just not gonna cut it these days, with modern levels of pollution floating around in our water supply. I highly suggest the Berkey brand filtration system if you’re shopping for an effective and affordable water solution.

• Sleep, should be 7-9 hours a night

Check out the video below for insight into what may be waking you up at night. Spoiler: getting your food, and especially your macronutrients right is a major priority for you sleepless Sallys.

• Exercise and body movement, should occur daily

When we fail to do this, it doesn’t matter how great our stomach acid is, or how healthy our diet is, systems in the body begin to break down. 

I highly suggest developing a meditation practice, journaling or therapy sessions, connecting with loved ones (or learning to draw boundaries with those who stress you out!), and exercising to keep on top of the stress.

 4)    Probiotics!

Finally, before testing your microbiome, first try an intensive probiotic protocol.

Natural or herbal antimicrobials are potent and effective at eradicating problem bugs, but good guys can also die in the process. This friendly fire can be minimized by using probiotics for rebalancing instead.

Little known fact: probiotics can act as a gentle antimicrobial without disrupting beneficial flora, and while installing even more of them in the gut. 

Think of the gut as a parking lot with a set number of spaces, if you fill up all of your spaces with beneficial microbes, it crowds the pathogens and opportunists out, creating a healthier environment.

After working up to using all three kinds of probiotics, and staying there for at least 1 month, if you still aren’t where you want to be… it’s finally time to think about testing.

The Take Away

If a client comes to me with a recent GI-MAP and hasn’t put in place all 4 of these strategies, I sort of look at it as a moot point. 

We already know that living outside of these parameters is highly associated with imbalances, and that righting the ship requires getting these foundational pieces into place first. 

We also find that as we strengthen our immune system through the listed steps, it can allow the body to better eradicate any imbalances all on its own. 

Conversely, if all of these puzzle pieces are assembled and there’s still something afoot, that’s really when the targeted nature of lab tests comes into play. Sometimes we do need to introduce intestinal protocols, eliminate foods, and move to the more intensive therapies. But, going there right away won’t do you any favors because the root causes won’t have been addressed.