Working with nutritional therapy clients is sometimes a bit like being a detective – picking up clues from their symptoms, health history and food diary, following leads, and analysing evidence.
One crucial – and sometimes game-changing – piece of evidence is functional test results.
I know that testing can be an extra expense on top of everything else you’re doing, and you might wonder – is it really worth it? So here I’m going to answer some of the frequently asked questions on functioning testing: What is functional testing, which tests might I be recommending, why are they so important, and how much are they?
What is functional testing?
Functional testing uses laboratory tests to identify potential nutritional deficiencies, hormone imbalances and other health issues that are impacting a client’s health. The goal is to unveil the root causes of hormonal imbalances or fertility issues, so that we can support them with diet and lifestyle.
Which tests do I recommend?
I don’t have a standard set of tests that I recommend for every client. Instead, this is very much case by case, depending on what’s going on for you.
If you’re a potential fertility client, here are some of the tests that I might consider for you:
- Blood panel – this would be my starting point for most fertility clients, as it gives us a lot of information about nutrient status, hormone levels and inflammation. Ideally, I would want to use a test that looks at vitamin B12, vitamin D3, folate, iron status, thyroid hormones TSH, T3 as well as thyroid antibodies, sex hormones like oestradiol, testosterone, LH, FSH and prolactin, DHEA and cortisol, as a minimum. This kind of comprehensive blood test (testing over 50 biomarkers) tends to be in the region of £200. I would recommend this for both male and female partners.
- Advanced hormone testing – depending on your symptoms and age, I may recommend that we do a more detailed sex hormone test for the female partner. This is a dried urine test called the DUTCH test, which can be done from home. This would test for sex hormones like oestrogen, progesterone, testosterone, DHEA-S and cortisol, plus their metabolites. This gives us a much better picture of what is going on with your hormones, and how to support it. The price of this is around £319, or £459 for those with irregular periods.
- Vaginal microbiome test – again, this depends what we’ve already tested and what symptoms you’re experiencing. If you have recurrent thrush, BV or other vaginal infections and are having trouble getting or staying pregnant, I would strongly recommend this test. The balance of bacteria in the vagina (yes, the vagina has its own microbiome as well!) can play a really important role in our fertility, which is something we can then work to address. The test I use looks at the vaginal pH, inflammatory markers, and vaginal microbiome (including the presence of bacteria like ureaplasma which is potentially detrimental to fertility), and is £199.
- Semen analysis – fertility issues are just as likely to be because of an issue with the male partner than the female partner, so I would always recommend getting a semen analysis done on the male partner. This will look at the volume and concentration of sperm, as well as their shape and movement. This test can be done through the GP or fertility clinic (around £150-200 depending on the clinic). I’d recommend doing this rather than the ‘at home’ test kits, which are less accurate and don’t often test for things like sperm morphology or motility. Another potential test is sperm DNA fragmentation, which tests the level of DNA damage of the sperm – which can lead to lower pregnancy rates and higher miscarriage rates. The cost is of this test is around £260.
- Gut test – you might wonder why I’d recommend a gut test for fertility clients, but if we’re not digesting and absorbing our food properly, we aren’t going to get the right nutrients in to help support fertility. I’d usually only recommend this where a client has gut symptoms such as bloating, gas, diarrhoea, constipation, etc. The test includes inflammatory markers, immune markers, bile acids and enzymes, as well as bacteria, parasites and more biomarkers for gut health. There are a couple of different tests I use, but they are around the £350 mark.
Can’t I get these tests at the GP?
The GP will do some blood tests as part of fertility investigations (usually specific vitamins and hormones), but they won’t usually test for things like thyroid antibodies, vitamin D, cortisol, DHEA-S. If you have had a referral from the GP to a fertility clinic, they may do further tests, but again, these might not be as wide-ranging as the functional tests we would do.
Bear in mind also that what the GP says is ‘normal’ may not be optimal for fertility. You can read more about this in my blog here.
Is it really worth it?
The short answer is – yes!
The long answer is – there is some information that we just can’t know without testing, like levels of certain nutrients, hormones and semen quality. Without having this information, there is a certain amount of guesswork involved, and we may have to do more of a ‘trial and error’ approach. This means that it can take much longer to address underlying issues and imbalances than if we’d done the testing at the beginning.
We can also share the information we find with your medical team, if appropriate, which may help with their treatment plan.
I will never recommend a test without there being a very good reason, and I’ll always explain what this is in our consultations.
Having said all this, the decision to test or not is always your choice. I understand that financial pressures can be high, especially when you’re potentially looking at paying for fertility treatment as well, so I will always be mindful of that.
If you have any questions about this, please do get in touch and I’d be happy to have a chat. You can book in for a free 30-minute consultation here.
