110 | Why I Don't Work with Functional Labs

This is one of my most controversial clinical opinions: I don't work with functional lab tests, including DUTCH testing, GI Map, organic acids, and microbiome panels. In this episode, I walk through exactly why and some considerations for those who do work with these tests.

In this episode, we cover:

• What I mean by "functional labs" and which tests fall under that umbrella.

• Why I only recommend tests when the results will actually change what I do.

• The validity problem, with fecal samples for microbiome testing as an example.

• Why "accurate results" and "clinically actionable results" are two very different things.

• The evidence problem: how recommendations attached to these labs are often theoretical rather than based on clinical data.

• The conflict of interest issue.

• A harder question for practitioners: if a lab is telling your client what to take, what exactly are they paying you for?

Timestamps:

• 0:00 - Introduction

• 0:10 - My most controversial clinical opinion

• 0:35 - On not judging practitioners who use these labs

• 1:38 - Reason 1: I don't think I need them

• 2:03 - When I think testing matters (iron as an example)

• 4:07 - Reason 2: Validity concerns

• 5:01 - Reason 3: The "what do we do about it" data is mostly theoretical

• 6:05 - The supplement recommendation problem

• 9:38 - A question for practitioners who rely on labs to guide recommendations

• 10:45 - What I'd rather clients spend that money on

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