Recently I interviewed Tracy Farrell, and we chatted about testing for thyroid triggers. If you would prefer to listen the interview you can access it by Clicking Here.
I am very excited to interview today’s guest, who happens to be one of my staff. Her name is Tracy Farrell. We are going to be chatting about testing for triggers. Let me go ahead and dive into Tracy’s bio.
Tracy has more than 20 years of experience in health care, starting on the administration side, working as director of children’s hospitals with a think tank on women’s and children’s health. Then as a Functional Diagnostic Nutrition practitioner and integrative health and nutrition coach at Natural Endocrine Solutions. She did her undergraduate at St. John’s University. She also received a post-graduate research certificate from Adelphi University. Thank you so much for joining us, Tracy.
Tracy Farrell:
Thank you for having me. I’m looking forward to this.
Dr. Eric:
Very excited to chat with you. Tracy does an amazing job going over tests. She has also done health coaching. We are going to focus here on the testing side. Why don’t we start off by you talking about your background? Why did you decide to become a health coach and then go on and become a FDN practitioner?
Tracy:
Like many people who do what we do, it’s usually a health event for ourselves or our family. For me, it probably started really young. A lot of my parents’ friends were activists and health-focused people. My oldest had a diagnosis of we didn’t know. They wanted to give him medication. I am happy to do what we need to do, but why not find out what’s wrong with him? It turned out he had a little bit of ADHD and a little bit of dyslexia, not necessarily an appropriate use of pharmaceuticals in my opinion for a kid under 10. I started at that point focusing on what can I do in a natural healthy way to support him and our family? That started me on my journey.
Years later, I finally pulled the trigger of going back and getting my degrees and certificates in functional health. Since then, it’s made a huge difference in my family’s health from my oldest to my parents to myself. That’s how I got in here.
Dr. Eric:
Wonderful. As far as testing, we’ll of course talk about the difference as we do. I know there is overlap when it comes to the ones you learned about. Can you talk about what they taught you, as far as what tests they covered during your FDN training?
Tracy:
Yeah. It’s a little bit different today; they have updated their tests. I know you interviewed Reed, so he will probably update those tests for you. On myself, since I did it a little while ago, I did a comprehensive stool panel test; a saliva adrenal test, which is the adrenal stress test; hair and mineral analysis; organic acids; and MRT testing, which is a food sensitivity test.
Post-graduate, I have since added the dried urine test, the Dutch test; functional blood chemistry analysis certificate; an advanced gut health course; a SIBO certificate and update just this year; neurotransmitter testing and remediation; Zoomer for both the gluten and histamine. I like to be as updated as possible. Then I took the DNA course on sensitivities and other testing, just in the middle of that right now. I clearly like school.
Dr. Eric:
If you had to pick two, three, four tests, which do you enjoy looking at?
Tracy:
As you know, I love gut health. That’s one of my favorite things. I didn’t start off as being a big testing person. I thought to myself as long as we change food. But the more I dig in, and the more I do FDN, I have to say the gut health I really love. I do it way too much from a personal standpoint. I love to see it in patients just because I find the field of microbiome and how it affects people and how it has so many different gut/brain, gut/thyroid effects.
I recently have fallen in love with the Dutch test, probably because I am slightly middle-aged, and I like to check my hormones. I can see how valuable it is for our patients.
Organic acids is nice. I have to admit, I used to roll my eyes at food sensitivity testing because I felt our immune patients are so sensitive to everything that everything shows up.
The MRT testing, I’m starting to really enjoy and see how it works. Seeing a value for our patients in that more, just from a this is where you’re at now standpoint. That new test is starting to become something that I am looking at a little bit more for our patients.
Dr. Eric:
What I like to do is go down the list of some of the different tests that we do in our practice. If you could talk about some of the things you’re looking for, and I can jump in as well. We can go back and forth. I’m sure there are some listening to this who are familiar with these tests, but there are others who have no idea what’s included. What do I look for when I am doing an adrenal saliva test or a Dutch test or a hair and mineral analysis, etc.
If you’re okay with it, why don’t we start with the adrenal saliva test? What are some of the things that you look for when we do an adrenal saliva test?
Tracy:
I’ll tell you a quick thing about what is an adrenal saliva test. It’s done during the course of the day. It’s a saliva test, as the name suggests. It’s looking at your adrenals. We call it an adrenal stress index because that’s what we use. It measures the Circadian rhythm of your cortisol levels. You begin in the morning when you wake up, and you go all the way through the evening.
The challenge for me when doing this test was not having coffee, I will admit that. Make sure you read the directions. No exercising. Those are a few things to be aware of when you get it.
I am looking at this as I particularly like this for the Circadian rhythm of your cortisol levels. Frequently as our thyroid patients can tell you, I am always talking about the HPA axis and how things are tied together, sort of like teenage lemmings following each other and how our hormones are interconnected.
What I like about it is you measure this, so we can see a snapshot of the stress in your life and how it’saffecting you. It’s looking at everything throughout the day. Versus a blood test, which is just a snapshot of that moment in time and can be affected by what’s known as medical office stress. I particularly like the adrenal salvia test for that. It’s a nice snapshot into it. You can detect food infections, where your possible triggers are, why you’re having trouble sleeping. I like that.
Dr. Eric:
I agree. As Tracy mentioned, there are different companies out there. The company we use not only looks at the Circadian rhythm of cortisol. Cortisol should be at the highest in the morning and should gradually decrease throughout the day.
Tracy:
On a ski slope.
Dr. Eric:
Exactly. It also looks at DHEA, 17-Hydroxyprogesterone, secretory IGA. It lines the mucosal surfaces of the body, including the gastrointestinal tract as well as the respiratory system. It’s a form of protection. It has a few other markers, like insulin. I don’t do that test for that purpose. Really, it’s the Circadian rhythm of cortisol and DHEA.
When I dealt with Graves’, my cortisol was flatlined, at least the first two morning cortisol levels. You want those to be the highest, especially that first one. The third and fourth one should be on the lower side. But my first one and the second one was low. Some people have the opposite, where their cortisol is high, and we are doing things to calm down the adrenals.
Tracy mentioned the HPA axis, which is the hypothalamic pituitary adrenal axis. Hypothalamus communicates with the pituitary that communicates to the adrenal. The adrenals tend to get dysregulated, so we are doing things like stress management, mind/body medicine, adaptogenic herbs to support HPA axis. I have been in remission since 2009, so since then, I have been recommending it to patients.
In some cases, we will recommend Dutch testing, which is the next test I want to discuss because the Dutch test also looks at adrenals. It looks at a lot of other things as well. What are you looking at when we do a Dutch test, Tracy?
Tracy:
A little bit about the Dutch test. It’s dried urine testing. I feel like I say this about all the tests, but it’s easy to do. Not our tests are easy inthe sense that you are doing it at home, so it’s easy to do on the road. I did mine between travels recently. It’s another take anywhere test. You don’t have to go somewhere special. You just order it, and it comes, which is nice.
This test utilizes urine to analyze your sex and adrenal hormones and their metabolites. You will get little strips with it and pee on them several times a day. For some people, this test is easier than the adrenal stress index. Some people can’t produce enough saliva. In my house, saliva is a little difficult for my husband, as I am more salivay than he is.
I found it a little bit harder for me because I hydrate a lot. One of the things I mentioned with the ASI that you will have to be aware of is they like to have you a little restricted on your water. I think it’s 44 ounces a day you will be limited to. For somebody who is hydrating more, that’s annoying. That’s the worst thing I have to say about it. It’s a good thing to be aware of. It’s easy to use. I really enjoyed getting it back because I was right under his nose when I tried it. I also don’t like the adrenal stress of avoiding caffeine, another hard thing, and exercise.
A couple of foods. You can look at that list. It’s just a good thing to know. I like what this test looks at: your sex hormones, estrogens, testosterone, androgens, and their metabolites. Your adrenal hormones, oxidative stress bio marker, and your organic acids, which is on an expanded test of this. Depending on which ones you order, you could add cortisol morning with the spit. It’s a little bit about the test.
As a middle-aged woman, I kind of love the test for myself personally to get a snapshot. For our patients, I love it for the metabolites. What I mean by metabolites is the usable hormones that are excreted in your urine. This is the only test that does that. As I mentioned earlier, our HPA axis is tied to it.
In our Graves’ female patients, we see frequently hormone dysregulation. Men, too, but women are grander in our hormones. We are more showy. I love the fact that this gives us those metabolites and what we can see in them. It forces us to see them, and they are important for helping us diagnose certain conditions.
A good example of what kind of condition they can help us, for women, phase one and phase two with progesterone can show us fertility issues, confirm autoimmune issues. I can see where PMS is at. On the male side, we can use some androgen metabolites, some prostate issues. Both sides, acne issues, we can check in on that. It helps tie it in to how we approach the treatment and how we deal with it.
When I was a health coach, I didn’t have as much knowledge of diet and lifestyle. What am I going to do for that? Here, it might be making suggestions on estrogen regulation. Some of our patients are younger, and they are looking to have children. How can we get that together and help them achieve their goals? I really like that about the test.
Dr. Eric:
I agree. I like the Dutch test a lot. As Tracy mentioned, it also looks at the Circadian rhythm of cortisol, just like the ASI test does.
When it comes to triggers, because I didn’t mention with the saliva test, stress is a potential trigger. Stress without question affects the adrenals. You need to have healthy adrenals to have healthy sex hormones.
Arguably, not everybody needs to test the sex hormones, which is why I don’t recommend Dutch testing to every single person. It’s not going to hurt for everyone to get it, but it is more expensive than the saliva testing. If we are just focusing on adrenals, saliva testing is sufficient. If you do want to look deeper into the sex hormones, you could also do blood testing for sex hormones.
As Tracy mentioned, the big advantage of Dutch testing is that it looks at the metabolites of the hormones, which you can’t look at through the blood or the saliva. The different metabolites, cortisol, the androgens, but the main ones I focus on are the estrogen metabolites. There are three estrogen metabolites it looks at. When I talk about estrogen dominance, that you could have high estrogen levels, or you could have normal estrogen levels and low progesterone. You could do saliva testing for sex hormones as well, but you can’t look at the metabolism of the hormones.
I have seen people with lower estrogen levels, yet they have higher 4-hydroxy or 16-hydroxy metabolites, which are the so-called bad metabolites. Nothing is really good and bad. You want everything to be within a healthy range. Again, this could be estrogen dominance or problems with estrogen metabolism. It could be a potential trigger or contributing factor. If someone has thyroid nodules or uterine fibroids or ovarian cysts, that could also be a factor.
I don’t think everybody necessarily needs to do this test, but for those willing to do it, it is very valuable. A lot of people have thyroid nodules, so I can’t say I have everybody with nodules do a Dutch test. If they have other conditions related to estrogen metabolism issues, so nodules, fibroids, ovarian cysts, endometriosis, that might be an indication to do the Dutch test. As Tracy mentioned, if they are having fertility problems, that is another good reason to do the Dutch test. If there is a family history of estrogen dependent cancers or a personal history of, like breast cancer, then it’s probably a good idea to consider doing the Dutch test.
She also mentioned it has a section where it looks at organic acids. More on the basic side, we are going to talk about a more comprehensive organic acids test later. It is kind of cool that it looks at some of the organic acids related to glutathione and some of the B vitamins, like B12 and B6, and some other oxidative stress markers. You do get a lot of information with the Dutch test. Melatonin also. I can’t say enough good things about the Dutch test.
Tracy:
I also like the oxidative stress marker, which I didn’t appreciate as much until more recently, coming from the nutrition end of it. I like to look at OHDG as the marker. I like that one because we talked about triggers, and it seems like a lot of them are stress, stress, some estrogen. This is a nice marker to show patients oxidative stress. It gives a fuller picture to see how stress affects them on a cellular level. You have heard about DNA damage generationally. This is showing you on your body. I didn’t appreciate that as much as I have recently, where I have been reading up on oxidative stress and how to combat it for things. I thought that was interesting.
Dr. Eric:
I agree. It’s also probably a good idea to let people know that for women who are cycling, who are menstruating, you can do a cycle mapping, a cycling hormone panel. You can collect samples throughout your cycle, which is arguably more accurate than just doing a single sample, which most cycling women would do in the second half, the luteal phase. That is better than nothing. A lot of doctors use that. You can look at it through your whole cycle.
Tracy:
It is. I did not do that one. I couldn’t give up exercise.
Dr. Eric:
Let’s talk a little bit about hair mineral analysis testing. If you want to dive into that, what is it? What do you look for when you do that test?
Tracy:
This test can be a little more challenging in the sense of it’s an easy at-home test. We have to cut our hair and not color it for a month. Some of us have more hair than others. I always suggest to patients, “Hey, grow out your hair for a month. Do the test. Bring it to your barber or hairdresser, and let them take a patch in the back, so you’re not having some spouse, family member, friend take too much or too little.” That is my tip of the day. It is actually easier than it sounds.
I have found this test valuable with patients because it gives us a snapshot of heavy metal exposure, which I love. It’s not perfect. Part of the reason why that is good is because our body is an extraordinarily efficient machine, even when we are sick. It detoxifies and pulls out all the things we are not supposed to have in our body, and it stores it in our tissues, hair, bones. This can give us a non-invasive way of seeing how you are absorbing nutrients. Do you have any heavy metal exposure? Things like mercury, copper, aluminum, along with some trace minerals like zinc, selenium, magnesium, calcium, and others. It’s a nice snapshot.
If you’re telling me you’re taking vitamins, and I’m not seeing them being deposited in your hair, hmm, what kind of gut issues are you having or not? Things like thyroid health. We can confirm or eliminate copper toxicity, which is definitely a possible trigger. I am sure Eric has seen this, but I have not personally seen this: I know that copper toxicity is related to estrogen production, and zinc and copper are levers for each other.
Speaking of heavy metals, it had a significant impact two challenges ago. There were two patients. One was a jeweler. When I looked at her test, oh my god, this person had lead poisoning. It was really concerning. We were doing a group call, and I emailed them separately because it was the highest numbers both of us had ever seen. I asked you about it. It turns out she was soldering jewelry without protection. Not only was she infected, but her whole family was infected with lead poisoning. There you go. There’s another thing. That’s just one example.
Somebody worked at a mechanic shop, and she had some poisoning/toxicity. She ended up remediating her whole shop. That is just two extremes, but it does show up.
I did mention copper toxicity. Things that can cause it are pipes, cookware, industrial stuff, hormone replacement, copper IUDs. That is another subject that I am sure one day you will cover. Vegan diets, smoking.
It’s a nice test to find those things. Thyroid and hormonal imbalances and mood and depression and weight gain and everything is all connected to this one simple, small amount of hair test. I didn’t know that I liked it as much as I did until we did this talk.
Dr. Eric:
I like the hair test. I have been doing it for years. It’s not a perfect test. Some practitioners will criticize the hair test being that it’s not perfect, and I admit that, too. You could have heavy metals deeply embedded in the tissues and not showing up. Same thing with urine testing. Some practitioners use urine testing for heavy metals. Same thing. It’s not perfect either. Some practitioners use provoked testing, especially in the urine. They’ll do a baseline urine test and give a provocation agent or key later to mobilize the metals and then do another urine test. There is controversy over that as well.
When we see the metals, then we know that there is a problem. When we don’t see the metals, it doesn’t completely rule out a problem. Sometimes, we see a few things high initially. Someone goes through a detoxification and retests a few months later. Some things that weren’t high the first time are now high. The reason for that is because by detoxifying, a lot of times, we will release metals that were more deeply embedded in the tissues. It’s not necessarily a bad thing. Ultimately, of course, you want to see everything start decreasing. You will never see zero across the board because we are always being exposed to heavy metals.
I like that test. As far as minerals go, it’s definitely not perfect with the minerals. Some of them, I definitely pay attention to. Others like iron, I usually don’t pay as much attention to. I don’t rely on iron for the hair test; I recommend a full iron panel through the blood. If someone has hard water, it will spike up the calcium levels. You have to keep that in mind. If someone is using anti-dandruff shampoo, usually it has selenium, so you might see elevated selenium. Again, you need to understand that there are certain variables that can affect minerals in that way and cause elevations. As Tracy said, if there are other minerals where you see a lot of them that are low, you might be suspecting a gut issue.
It’s a good test. It’s inexpensive, affordable for most people to do not only initially. The challenge with testing in general is that when you find something, not everybody can afford to retest. As a result, not everybody retests.
When I did my adrenal saliva test, everything was low. A few months later, I did another test because I wanted to make sure that what I was doing was helping the adrenals. You can go by symptoms improving or maybe your thyroid test. I wanted to do another saliva test.
Some people want to do another saliva test or Dutch test or comprehensive stool panel. I’m not saying everybody has to do an initial test and then do a retest. In some cases, you would want to consider doing that. With hair, it’s usually not a problem just because it is so cost-effective.
Tracy:
Exactly.
Dr. Eric:
Next, maybe your favorite test. I know you mentioned earlier how much you liked the stool test. Let’s talk about the comprehensive stool panel. In our practice, we use the GI Map. There are other really good stool tests, like GI Effects from Genova Diagnostics. We have been using the GI Map from Diagnostic Solutions. There are other companies as well. I am mentioning the name because she is going to go over certain markers that might just apply to GI Map. I will let you talk about it and what you look for. Then I will fill in the gaps.
Tracy:
There will be gaps. A comprehensive stool panel, exactly what it sounds like. Sometimes I tell people my tip of the day is I learned from my youngest who said she spreads out something on the floor when she does it. When you come to my house, I am a nutritionist, and I do functional diagnostic testing. Instead of a mint on your pillow, there might be some testing on your pillow. If you’re a family member, at-home testing and experimentation is a real thing in my house.
I have trained on the GI Map and Genova, Cyrex, Nordic. What most people will be able to recognize about it would be it’s DNA-based, quantitative PCR testing. You are most familiar with it by hearing the Cologuard, the colorectal, instead of getting your colonoscopy if you don’t have a risk. I lovingly call it “poop in a box.” The alternative colon cancer test, the camera thing. Instead of doing a long DNA test, it’s a faster test that extrapolates more information, which we love. Until recently, in gut health, we could only see what was the aerobic, the oxygen-breathing bacteria that survived when you poop it out. This test was a gamechanger in gut health in that you can now get the DNA from the anaerobic, the non-oxygen-breathing that are committing suicide the minute they get out of your body. That has opened up a whole field of the microbiome.
I tell people I have been interested in poop for far longer than has been exciting. As we know in recent studies, we are seeing deficiencies in kids on the spectrum; in people with colitis and SIBO and SIFO and thyroid health; all immune and inflammatory diseases. Everybody is inflamed. Obviously, I have a lot to say about this test.
I like the ranges in the test that we use. Instead of just a positive or negative, we are getting an entire range of numbers. I can see your secretory IGA, which we also get in the ASI. What’s interesting is a tremendous correlation for us between the two. Saliva in my upper tract is good, but in my lower tract, it’s not. The tying in of the tests help.
I love to look at all the markers. I probably first became familiar with it here. I like to look at the H-pylori portion of it. If it’s too high or too low. It’s the most comprehensive. It gives a range and virulent factors and lets us know is it anti-bacterial resistant or not?
There are parasite markers, which I have seen but I don’t see very often. We had a patient who claimed never to have gone outside of the country. She was a florist and picked up a parasite from her floral deliveries from overseas. We had to help treat her. It’s fascinating.
I can also tell what you’re eating by what your poop tells me. If you’re telling me you’re being good and you’re not, I can see it in your artigesic trigger markers, your zonulin portion, your cow protein. It’s a nice snapshot if you can do it.
There are other tests that will tell us more from a thyroid perspective. I happen to like it from an overall health perspective. I probably do it too much in my household. We had H-pylori. An interesting factoid about the H-pylori was how you react. The highest marker individual in my household did not have any symptoms. The lowest marker individual in my household, Bertie had some gastric markers from GERD. They were already having some erosion in their stomach from possible ulcerations. This helped us treat it. Your symptoms and how you are feeling are going to base on what your markers are and let you know how your snapshot is.
I don’t know if I answered all the interesting things about it, but I clearly like the GI Map.
Dr. Eric:
You covered most of the highlights. As you said, it’s a quantitative PCR. For example, you mentioned H-pylori. If you go to a regular lab, it will just say if you’re positive or negative. They will put a number on it, unless it’s below detectable limits. Otherwise, they will put a number. If someone is elevated, so clearly positive, and then they follow either a natural protocol or antibiotics, and then let’s say they test after that protocol, if the H-pylori is still high, which would be a bummer, but it does happen, then you can see if it got lower at least. If you went to a regular lab, you would see it still positive maybe.
Another advantage is being that it’s PCR, it does seem to be more sensitive than regular labs. Some labs won’t pick it up, whether it’s a stool antigen or a breath test. This will pick it up. I like this test.
It also gives virulence factors. Most of the time, these are negative. The other day, I had someone who had two positive virulence factors. With these there is an increased susceptibility to developing—it depends on the virulence factors, but some of them are developing ulcers, which sometimes correlates with H-pylori; or some gastric carcinoma, which is not good. It doesn’t mean that if you have positive virulence factors, you will develop ulcers or gastric carcinoma. It’s just an increased susceptibility.
I like the H-pylori part of this test. Some other tests, like the one from Genova, you have to add on the H-pylori. I am pretty sure it’s just the stool antigen, positive or negative, through that test.
You mentioned parasites. I will say Genova does have a little bit more in the parasite department on their test. They give more information. But with parasites, it’s definitely not perfect. There is no perfect test out there with any of the tests we discussed. It does get tricky because if someone is negative for parasites, it doesn’t always rule out parasites. That’s why there are some practitioners, including some I have interviewed, who don’t do stool testing for parasites. They will just treat for parasites. There is definitely controversy over that. Obviously, if you see a parasite, if someone tests positive for blastocystis hominis, then it’s nice that you know you have it. You can choose to retest if you want to retest.
Tracy mentioned some other markers like cow protein, which is an inflammatory marker. Especially if someone has ulcerative colitis, that type of inflammatory bowel disease, you will often see that elevated. Pancreatic elastase is another marker that we see on this test. Those markers, we see those usually on other comprehensive stool panels. We should probably differentiate. Maybe I will have you do the difference between comprehensive and going to a regular lab.
Before you do that, you mentioned zonulin, which is a leaky gut marker. If you test for zonulin, and it’s elevated, then it typically confirms that you have that increase in intestinal permeability, which is the medical term for a leaky gut. The thing is, I usually don’t recommend that. It is an add-on test. I just see false negatives a lot with that marker. It’s not a perfect marker. If someone wants to do it, that’s fine. I just assume that most of the people we are working with have a leaky gut.
I used to do a lot of leaky gut testing using Cyrex Labs, their Array #2. There are other tests like the lactulose mannitol test. I and a lot of practitioners I know just assume people have a leaky gut. There are so many different tests that you have to prioritize. Some people want to do everything, but most people have a budget.
The flaws with leaky gut testing is it doesn’t tell you what is causing the leaky gut. If you are doing zonulin as part of the GI Map, the rest of it can tell you what might be causing that leaky gut and what potential triggers, like H-pylori could be a trigger for Graves’ or Hashimoto’s, or parasites.
Feel free to expand on anything I just mentioned. If someone wants to get a stool panel, like a regular lab, what is the difference between this and the test we are discussing?
Tracy:
First, I would say about the leaky gut: We assume that everybody has one because they have an inflammatory disease. If you are inflamed, your entire body is inflamed from your blood vessels to your heart. As I always tell our patients, if you have an inflammatory disease, you have an immune disease. You may agree or disagree on that. We are treating you for inflammation. With food testing, everything is going to irritate you. It’s like being locked in a closet with somebody who irritates you particularly well, and you are not getting it out. They may not make it out. Part of it is you are in a heightened state of inflammation, so we are treating it as thus.
There is another marker that I recently started looking at more, the methyl bacteria marker that we see sometimes elevated in people with SIBO. Even though you can’t get into your small intestine either way, when people have it really bad, I have noticed we have started to see that more when it’s coming down into the marker.
I don’t know how you feel about that because I didn’t ask you how you felt about that. I have noticed we have seen more of it, and when they do do SIBO Testing, they test on SIBO. I threw you under the bus there, so sorry about that. I tend to think about people having more SIBO with Graves’ or thyroid issues. They are off because of our SAD diet.
I will talk about the comprehensive stool panel. I digress. If you go to LabCorp and their stool panel, it’s just collecting and testing a small amount of markers. What they are picking up, they are not doing the full DNA. They are not running it. They are not doing the PCR test. It’s basically like what are they seeing or not seeing?
With the GI Map, they do both the DNA and then on parasites, they do a visual scan on most of them. It’s less comprehensive. It’s testing fewer things. It’s looking at fewer markers. It’s not burning the full DNA on all of them.
I’ll be honest. I think part of it is that the companies that specialize in this have larger data sets because they have a larger amount of people coming in. They have more of a background and more training on what they are doing versus a LabCorp. I’m not saying that LabCorp isn’t good; it’s good. It’s not giving you the full amount for it. It’s just limited. If you are going to pay for a test, you might as well get the whole test.
Dr. Eric:
I agree with what you said. There is a time and place for a basic stool panel. If someone is having diarrhea for example, especially if it’s covered by insurance, you go to your primary care doctor and get that test because that’s what it’s testing for. If you look at the GI Map report, there are four main pages. That basic test is looking at what’s on page one of the GI Map, which are parasites, bacteria, and viruses that cause gastroenteritis and commonly diarrhea. If you are having chronic diarrhea, experiencing it for a number of days, then it’s not a bad idea to get that test. Arguably, maybe even a better idea than the GI Map because the GI Map will take some time to get the report back. You might want to go for that basic test.
As far as looking for triggers and parasites, it’s definitely flawed. It will look at maybe a few parasites that relate to diarrhea. If you are relying on that to look at parasites, you could be missing out. I mentioned even with the GI Map or Genova or other panels, those are not perfect for parasites. Arguably, the one that you get through a regular lab is going to be the bare basics, as Tracy mentioned.
You mentioned SIBO. The comprehensive stool panel is looking at the large intestine. Yeah, there are markers. Some of the opportunistic bacteria, if they are high, it might give a hint that maybe someone might have SIBO. If I am highly suspecting SIBO, typically I would recommend the SIBO breath test. That is specific for the small intestine, looking at the methane and hydrogen. Now there is one lab that looks at hydrogen sulfide as well. Good point as far as that you could maybe get an idea of if someone has SIBO. Again, it’s not-
Tracy:
It’s not perfect. Sometimes if it’s really raging, the patient knows. There are a few markers that we see down there that occasionally tip us off. It’s just an added bonus there.
Dr. Eric:
Thanks for mentioning that.
Organic acids testing, let’s talk about that. There are a few companies that do that. We use more commonly Great Plains Laboratory. Genova also has one called the Organics that is pretty good as well.
Tracy:
The Dutch also has an OAT addition, too.
Dr. Eric:
Exactly. It has some brief organic acids markers. Let’s talk about the one that we use mainly.
Tracy:
Sure. This is another urine test. It’s easy. You will probably want to be slightly dehydrated because we want to concentrate the urine, so we can catch it. It does 74 markers. It’s at home. It’s an easier test because you’re at home or at work, and you can do the collection. The 74 markers are organic acids. They are what your body produces and metabolizes when you are eating food and discarding it. By measuring the amounts of them, we can see if there is pathway clearing, your kidney function, too much, too little. Cellular metabolism. Some gut microbiomes are in it.
The limitation is that it’s showing us what you’ve eaten or what you’ve done within a 12- to 48-hour time period. When we go to the doctor, we will be good before our bloodwork. My tip to patients is I really want you to eat what you normally eat. Do not try to game the test. Don’t try to clean up your diet beforehand because the purpose of this is for us to see what you’re doing all the time, not on your best behavior. Then we can really help you, and we can really find your triggers, some other things going on by behaving in a normal manner. That is a good thing to keep in mind. Don’t do it around the holidays when you are eating cookies. Maybe just do it during your normal diet. It is important that you eat beforehand what you normally eat.
One of the best things about this test is yeast overgrowth is seen here. It shows some of that. A good highlight. Versus seeing it not necessarily in the GI Map.
It shows vitamin deficiencies on a neurotransmitter level. Mold, fungus exposure to a certain extent.
Like other tests, like the coffee and avocadoes for one test, you will avoid certain foods for this one. Look up that list, even if it’s in your normal diet.
It’s a quick and easy snapshot of your cellular health. High oxalates are good to know. Some patients are impacted on it. Eric, you had a high oxalate marker when you first were testing. You did some remediation.
It also indicates your detoxification. What your body is doing and your mitochondrial markers. This is another good snapshot of your health. Again, it’s limited. It’s 12-48 hours. There you go.
I mentioned yeast. Part of it is mitochondrial dysfunction we may see there. That’s a trigger. Every test has a little bit of a piece of the puzzle for what your triggers may be.
Dr. Eric:
OAT is a really good test. Tracy mentioned yeast overgrowth. The stool tests look for yeast, but it doesn’t show up a lot of times. If it shows up on the stool test, you probably have a real bad case of yeast overgrowth. I do prefer the organic acids test if we are going to look for candida overgrowth or other types of yeast.
She mentioned mold markers. It could give an idea if someone has aspergillus. It’s not a comprehensive mold test. Great Plains has their MycoTOX test, which is more comprehensive if someone wants to look into mold. There is also Real Time Labs and a few others that look into mold testing. Two of the more common ones are Great Plains and Real Time.
Tracy mentioned mitochondrial markers. This could be a factor, not just with autoimmunity, but with anybody.
She mentioned yeast particularly being a trigger, affecting that permeability of the gut. Mold also could be a trigger. It looks at some of the neurotransmitter markers.
She mentioned oxalates. When I did the OAT for the first time, it didn’t look too bad. I did have a bit of candida overgrowth as well. I did have the high oxalates. At the time, I was adding spinach regularly to my smoothies, so I cut that out. That is the main change I made. I was eating other sources of oxalates, but I can’t say I made dramatic changes in the other areas. When I retested, the oxalates were normal. It was the spinach in my case that was the main culprit. There could be other higher oxalate foods like Swiss chard and sweet potatoes or even nuts and dark chocolate. It will be difficult to eliminate oxalates completely, so we don’t recommend trying to do that. The spinach is probably the highest source of oxalates. Even if you cook spinach, it doesn’t have much of an impact.
She also mentioned nutrient indicators. It looks at B vitamins and CoQ10 and NAC. Some indicators of detoxification as well.
To me, it could find triggers, but also, it’s a good overall test, just looking at different areas. Some of the tests we spoke about, especially saliva testing, focus more on adrenals; Dutch, adrenals and sex hormones; stool testing, looking at the gut. This test looks at different areas. It’s more of a broad test.
This would be a nice screen for a physical. It probably will never happen, but if you go to a physical, they usually do a CBC, metabolic panel, lipid panel, and that’s it. They might do a Vitamin D. This would be a neat test to do as part of a physical, just to see one’s overall picture. Yeast overgrowth, clostridia, but that could be a factor. The oxalates, mitochondria, neurotransmitters, nutrients, detoxification. It’s a neat test.
It’s a urine test, so it’s easy to collect. Can’t say enough good things about this test. Genova’s test is pretty good, too. At least as of now, I don’t think they test for oxalates. Great Plains Lab is the only one that does. Same with clostridia. Clostridia, which stool tests will look at, but they don’t differentiate between potentially harmful strains of clostridia and commensal, whereas the OAT from Great Plains is looking at more of the problematic clostridia. If you are high in clostridia, you want to address that.
Tracy:
Yeah.
Dr. Eric:
For the most part, we covered what I wanted to. I guess the one thing that I will briefly mention, because you mentioned the MRT food sensitivity testing. I have spoken about it in the past with some practitioners, and there is a follow-up interview with Elizabeth Yarnell, who I interviewed previously. She has a new book coming out, so she will talk more about the MRT.
Mediator Release Testing, I do like it. I probably need to do more of it. I have been opposed to food sensitivity testing, but in the past, I was more familiar with IGG testing. I didn’t find that to be too reliable. Like Tracy said, if someone has a leaky gut, a lot of times, you will get a lot of foods being positive, which is related to the leaky gut. It’s a challenge because a lot of those foods may be healthy foods and foods that are allowed on an AIP or paleo diet.
I can’t say I never did IGG testing. I have done it in the past. It usually wasn’t the first thing I would recommend. If someone wasn’t progressing, then I would go to the food sensitivity testing and rely on the elimination diet initially.
I have heard so many good things about MRT. I have dabbled with it. Had some patients do it. After interviewing Reed Davis and Elizabeth Yarnell and a few others, it’s something that also could be very valuable. Everything does add up, so you need to prioritize and say, “This is the test.” I have had success without the MRT over the years. I am always looking to get even better outcomes than I do now and potentially get people better even quicker. That is definitely something else to consider.
Tracy:
I agree with you. I dislike the IGG test because I found you came back with numerous things that weren’t allergies. They were just sensitivities and other things.
I had to do the MRT test for taking my course. I don’t have food allergies or sensitivities. I am the GOAT of the family. A couple of my kids are allergic to different things and have severe EpiPen allergies to them. I found that was the most accurate test of them because it didn’t come back giving me a list of things that the other tests came back listing. I am not doubting it. For other people, it has been a gamechanger. It was interesting for me to do it because I already knew I wasn’t sensitive. I had already spent time working on my health because it’s my job. I was pleased to see that it did not come back with a lot of false positives and false things. I appreciated that. It turned my view of it.
My youngest is allergic to pecans, and it actually picked it up on one test. As an experiment, because I do love to experiment, I decided to run the IGG test, which didn’t pick it up. It’s an EpiPen sort of situation. It was interesting to see it. I guess we’ll be doing more in the future when we need to because we don’t need to do it all the time.
Dr. Eric:
I will say if it’s a true allergy, like if you had a pecan allergy, the IGG wouldn’t pick it up because that is an IGE mediated response.
Tracy:
Right.
Dr. Eric:
Looking for something different. The IGG, some labs are better than others. Still, I do like the MRT better.
Tracy:
I like to say we are in an inflamed state. When you get those sensitivities, I think in Reed’s interview, he mentioned he gets an updated list because when we are in an inflamed, immune state, sometimes things change because our bodies change. It may be that you are more sensitive or reactive. Our whole diet, our SAD diet, before we change it, is just a crowded room of unhealthy things and environmental toxins. Once you clear out, that little voice that used to bother you is now being able to be heard, so that’s a beauty. My plug for eating healthy and getting healthier is those quiet voices that we can’t hear in our bodies because we are so unhealthy, living in such a toxic environment, we can now hear. It’s a good thing.
Dr. Eric:
Agreed. Any last words before we wrap this up, Tracy? You did great. I think we both went into great detail with the tests. Just want to make sure there is nothing else that you wanted to add.
Tracy:
I look forward to seeing new patients and reading their tests and doing new programs and continuing- I love what I do, so I always joke that I am a skeleton here in this chair by the time I’m done because I love it. Our whole office, we love what we do. I look forward to the future.
Dr. Eric:
Which of course is important. You want to work with someone who enjoys doing what they do. Tracy is definitely passionate about what she does.
Tracy:
I was emailing you on my vacation for my anniversary on something I was reading about an update. I do love what I do.
Dr. Eric:
Every time I do an interview, I usually share the website of the person I am interviewing. In this case, the website is NaturalEndocrineSolutions.com. Tracy is also active in my Graves’ and Hashimoto’s support group on Facebook. You can check that out. I don’t know if you’re on Instagram.
Tracy:
I am not.
Dr. Eric:
I thought I was the only one that wasn’t on Instagram.
Tracy:
It’s the two of us. I can barely keep up with the Facebook group. Join the group and all the programs. It’s a fabulous group of individuals who contribute research and do stuff, so that’s a nice resource for everybody, along withthe podcast.
Dr. Eric:
Thank you so much for this interview, Tracy. It was a pleasure chatting with you. I am sure the listeners learned a lot about testing and the different triggers that go along with the test.
Tracy:
Thank you for having me.
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