Functional Labs and Detecting Toxicity

I love Biochemistry. So WARNING- this is a bit of a Science Nerd Alert Blog!

HOW DO YOU KNOW YOU ARE "TOXIC".

This is a topic I get a lot. Not all people need to go down the rabbit whole of testing for toxicity in my professional opinion. Also- remember our body naturally detoxes and if you are relatively healthy you should not need to chronically do detox protocols to interfere with that. But here in lies ROOT CAUSE approach to practicing medicine!

Sometimes chronic issues that are not resolved are a tall tail sign that something is being missed. 

** Your Clinician tells you your labs are "normal". The ranges are "within a normal range"- but you STILL do not feel better?

Why is that? Potentially we need to look on a CELLULAR level. So as someone who thrives on thinking outside of the box this is kind of how my brain works:

- Assess micronutrients- in many cases this is best with serum/blood testing

- Assess organic acids- compounds your body makes- rule out hormonal, metabolic, cellular issues- issues with methylation- the actual true chemistry on a cellular level- THIS is EYE OPENING. 

I do this by a few approaches. I really listen to the patient. I really learn about how they live, what they eat, how they move and how they manage their stress- AND THEIR EXPOSURES. This all affects how our body works on a cellular process. This process affects our hormones, our gut, our mitochondrial health, which in turn causes chronic symptoms- fatigue, mood changes, muscle/joint pain, neurological health, chronic inflammation-chronic illnesses, weight changes, skin/hair changes, gut/urinary and sexual health.... I know I listed about everything. 

Sometimes I recommend work ups like the following:

Organic Acid Test (OAT):

Urine Testing: Rule of thumb- can measure a lot- but specifically for hormones this measures the metabolite and not the actual hormones themselves. A metabolite is the substance made by the body after it has essentially broken something down- such as food, medications, supplements, chemicals, or even its own tissue (fat/muscle). I like to use urine testing (usually dried sample kits) if I feel I need to determine how your body is metabolizing your hormones. This does not reflect tissue levels like salivary testing.

The OAT test is obtained by a urine sample via a kit that is mailed to your home. The turnaround time is fairly efficient and turn around for results is great. This specific test helps evaluate the metabolic function on a cellular basis by measuring organic acids that are metabolic byproducts we excrete in our urine. These compounds provide an in depth look at how the actuals cells in your body are working, specifically looking at those lovely mitochondria- the cell powerhouse or engine if you will- which is responsible for energy and helps with cell turn over and repair.

Aside from cellular metabolic processes, our gut microbiome- the bacteria in our gut- also produces organic acids. Evaluating these processes via the urine helps us understand if you have a hormonal or metabolic cellular level imbalance that is causing a lot of symptom burden for many people. I can see if there is an issue with methylation. Methylation is a basic chemical process your body uses to regulate genes, make neurotransmitters, detox, and keep systems balanced.

When methylation isn’t working well, people may notice:

• fatigue

• anxiety or low mood

• hormone imbalances

• brain fog

• trouble detoxing

Support often comes from nutrients like folate, B12, B6, choline, plus reducing stress and toxin load.

Methylation is your body’s mail delivery service.

Tiny “methyl groups” are like postage stamps that help messages get delivered correctly:

• hormones reach the right tissues

• neurotransmitters affect mood and focus

• toxins get packaged and sent out

Without enough stamps, messages get delayed or lost- we can see this with the OAT!

With the OAT I can see if there are energy imbalances with actual energy production, your gut composition, how your body metabolizes and methylates materials and neurotransmitters, toxin exposure, and deficiencies are also information I can obtain from the OAT. - Just a simple urine test. 

Serum (blood) Testing: For hormones this method of testing tests your bound and unbound hormones, so usually additional testing to check globulins (binding agents) to actually bound hormones (hormones your body uses) would be helpful to help us understand the true active bound hormone in your system (bound meaning what you are using). Certain assessments like liver, kidney, inflammatory, cardiac, lipid profile, and micronutrients should really be assessed via blood. 

Salivary Testing: Love it and I used a lot for hormone and adrenal assessments. Helps assess more of an accurate picture of fluctuations, highly precise and painless. If you need to supplement, then follow up testing will also likely include serum depending on the ailment we are trying to resolve. 

HEAVY METAL HAIR AND URINE TESTING

Hair Mineral Analysis (HTMA)

What it’s best at

• Longer-term exposure (weeks–months)

• Chronic heavy metal burden (mercury, arsenic, lead, aluminum)

• Mineral patterns & ratios (calcium, magnesium, sodium, potassium, zinc)

• Insight into mineral balance, stress response, adrenal patterns

Strengths

• Non-invasive

• Reflects what the body is holding onto, not just excreting

• Helpful for chronic, low-level toxicity

• Good functional-medicine tool for trends and patterns

Limitations

• Not ideal for recent or acute exposure

• Can be affected by hair treatments (bleach, dye)

• Shows tissue deposition, not current blood levels

• Doesn’t directly measure vitamin deficiencies (like B12, folate)

Best used when

• Symptoms are chronic and unexplained

• Suspecting long-term metal exposure

• Looking at mineral imbalances over time

• Designing a gentle detox or mineral repletion plan

Urine Testing (Heavy Metals / Nutrients)

What it Shows

• Recent or current exposure

• What the body is actively excreting or eliminating

• Acute toxicity or recent environmental exposure

• Detoxification activity

Best Uses

• Known or suspected recent exposure

• Monitoring detoxification progress

• Occupational or environmental exposure documentation

• Evaluating active elimination pathways

Strengths

• More standardized and widely accepted

• Useful for detecting recent exposures

• Can be paired with provoked testing when appropriate

Limitations

• A normal result does not rule out stored metals

• Results can vary based on hydration and kidney function

• Spot urine samples can fluctuate day to day

• Provoked testing may not be appropriate for everyone

Micronutrient Deficiencies: An Important Note to Take

• Hair testing reflects mineral patterns over time, not absorption efficiency

• Urine testing reflects what is being lost, not what is available in cells

• Neither test alone is ideal for assessing vitamin deficiencies (B12, folate, iron, vitamin D)

For micronutrients, interpretation often includes:

• Blood markers

• Symptom patterns

• Dietary intake and digestion/absorption assessment

   

Further gut microbiota testing- Stool Testing (which a whole other topic) and other testing may be prudent pending what your clinical scenario is. 

Want to dive deeper into a "thinking outside the box" approach to your care?

Contact me and we can discuss how I can help you more!

Cheers,

Katie