As we learn more and more about gut health, and it becomes an increasingly popular topic, tests to identify specific problems in the gut are becoming popular and readily available.
Similar to anything in the “health and wellness” world, Some of these tests are useful and may help you to find answers, while others are just another clever marketing strategy after your wallet.
Let's discuss some of the things you need to know about testing before investing!
IS TESTING NECESSARY?
First and foremost, is testing even necessary? Some practitioners would answer this with a resounding YES! In my experience, the answer isn’t that straight forward. It depends on multiple factors unique to the individual, including:
Their budget - are they comfortable spending the money or is it going to cause financial stress?
How severe and persistent their symptoms are, and how long they have been experiencing these symptoms.
Is there an obvious explanation for their symptoms that doesn’t require testing to identify i.e. stress, signs of dysbiosis, diet, undereating, lifestyle, other diagnosed medical conditions.
Overall, I don’t think testing is essential for most people to improve their symptoms, however it can be useful in providing answers, and targeting treatment for those that can fit it into their budget. Sometimes just having an answer can help provide relief and validation, especially if you’ve been told time and time again that your test results are normal and there’s nothing wrong.
In my practice, I will discuss testing options with a client after completing an initial consultation, and I don’t believe practitioners should be selling these as part of a package before knowing if it’s appropriate or necessary.
WHICH TESTS CAN BE USEFUL?
SIBO Breath Test -
I use SIBO breath tests most frequently in my clinic, because they are affordable and scientifically validated.
SIBO breath tests have a reputation for being inaccurate due to the risk of getting a false negative or positive result. However, I find that when they are used correctly, prepped for correctly, and interpreted alongside other information like the clients symptoms and health history, they can be very useful in identifying and treating bacterial overgrowth.
Stool tests are another popular option that help to identify problems in the large intestine including gut pathogens, inflammation, and dysbiosis.
Stool tests can provide some useful information, and for some people, are worth the investment. However, I personally think they are inaccurately hyped up as the holy grail to gut healing and identifying your root cause. In most cases when someone invests in a stool test, they are expecting to find a parasite or bacterial pathogen that might explain all their symptoms, but in my experience, this doesn’t happen very often. Most stool tests will show imbalance in the normal microbiota (dysbiosis), but it’s not that common to see an actual pathogen that shouldn’t be there.
Stool tests can be useful in providing motivation for change. If someone sees a test showing that their gut microbiome is not optimal and they are showing signs of inflammation, they may be motivated to implement the dietary and lifestyle changes necessary to optimise it. But most of this information can be determined through symptoms and health history alone. The test just validates it.
In my practice, I typically use stool testing with people who have more complex issues like autoimmunity, and those who have tried many different treatment options with no results. But they are definitely not the first thing you need to invest in, or necessary in most cases to reduce symptoms and improve your gut health.
WHICH TESTS TO AVOID
Leaky gut test
The test for leaky gut or intestinal permeability is called a zonulin test, and is offered as an add on to stool test. While leaky gut is a real condition, and it is possible you do have this problem, it is not a ‘root cause’, so paying for this test is not very useful, and a waste of money. Leaky gut is caused by imbalances and inflammation in the gut, so identifying and fixing these problems is the key to healing leaky gut. Taking supplements to “heal” leaky gut, or drinking lots of bone broth is pointless if the source of inflammation remains. A good practitioner will be able to identify the likelihood of you having a leaky gut based on your symptoms, and will focus the treatment on the underlying cause.
Viome Gut Intelligence Test or similar
Viome Gut Intelligence Test is a popular test that uses artificial intelligence to assess your gut via your stool and blood, and then provides dietary recommendations based on this information. Although it is possible to identify specific problems through stool and blood tests, this information needs to be interpreted by a professional, alongside your symptoms and health history. Additionally, it is not possible to identify food sensitivities through any test, so the foods that this test suggests you avoid are likely to be inaccurate and unnecessary. More on this next!
Ombre Gut Health Test, another popular at-home stool test. I don't recommend this one due to the lack of transparency about their diagnostic process and formulations and lack of third-party validation or testing for their lab analyses of samples. It's cheap for a reason!
Food sensitivity tests
Food sensitivity tests are popular, non-invasive tests that claim to identify foods that you’re sensitive/intolerant to. Food sensitivity tests typically look for the presence of IgG antibodies, which have not been shown to reliably identify food sensitivities.
Most people produce IgG antibodies after eating food, but they are not specific to a person's sensitivity. So you end up with a long, inaccurate list of foods to avoid, causing you to unnecessarily restrict your diet.
The only accurate way to identify food sensitivities is by removing the food for a period of time, and then reintroducing it to test your tolerance.
WHAT NOW?
Hopefully this has helped to clear up some of the confusion around testing, and whether it is essential for you to overcome your symptoms, as well as which tests to prioritise and which to avoid.
Everyone is different, and what is appropriate for one person might not be for another.
So much about you is unique - your genes, your day-to-day, your diet, your stressors, etc. — so too does your journey back to better health require a unique plan.
Whether testing is part of your journey or not, the most important investment you can make is working with an experienced gut expert who has been in your shoes.
You’re not “just another patient.”
Your concerns are a big deal to you because they impact even the smallest things in your life.
They can make all the difference between having a productive, great day or barely treading water through one that’s a total disaster.
I know how this feels because I was ignored by doctors for months being told that I was fine. Though I felt horrible, my symptoms didn’t seem to matter.
The key to overcoming your gut issues, is to find someone who gets what you’re going through, believes your inner knowing that something is wrong, and is willing to put what seem like unlikely clues together.
To create an effective plan to heal from gut issues must include sifting through more of your health history than anyone has in the past.
It’s not uncommon that pieces of “your story” that have been blown off by your doctor are relevant. I’ve found through my training and clinical nutrition practice that they’re often critical clues. And they need to be framed around appropriate labs and patterns that help us uncover the root cause.
You don’t always need to do every test if your practitioner asks good questions and can make sense of a lot of information.
From there, the results need to be practically tailored to meet you where you are so that you can actually implement steps that get results.
If you’re in need of gut support, book a free introductory consultation with me, so we can discuss how I can help you and the options I have available to work with me. It’s my mission as a clinical nutritionist to provide you with tools and support so you can resolve ongoing gut issues and get back to feeling better than you have in a long time.