The Diagnostic Tests Your Doctor Probably Isn’t Running But Should Be

Most people get their blood tested at some point in their lives.

But for patients at Parsley Health, diagnostic testing goes far beyond the basic blood panel you might receive at a typical primary care physician’s office. That’s because common lab work only goes so far. “Conventional medicine has a way of looking at your health to see if you’re sick versus not sick,” explains Harika Pal, MD , a board-certified family medicine physician.

Parsley’s focus is on a different question. It’s not “Are you sick?” Instead, it’s, “Are you healthy?”

“Answering that question really requires us to do a deeper dive into your health, and in-depth testing gives us a better idea of what’s actually going on in the body,” Dr. Pal explains. While testing is always tailored to the individual patient, this usually means doing some comprehensive blood testing such as a broad thyroid panel , a full nutritional analysis to check for nutritional deficiencies, a complete metabolic panel, a complete blood count, and looking at inflammatory markers.

Lab-based blood tests are often incredibly useful and can uncover health issues such as leaky gut and food sensitivities . They can also help pinpoint what might be causing thyroid problems or mood disorders like depression and anxiety .

Aside from blood testing, another tool Parsley doctors use to get to the bottom of symptoms is at-home specialty and functional medicine tests. Often, these tests can shed light on issues that standard testing simply wouldn’t be able to pinpoint.

“A classic example is a patient I had who was suffering from rosacea,” Dr. Pal says. Rosacea is an inflammatory skin condition that causes redness, flushing, discomfort, and sometimes breakouts. The patient had seen a dermatologist and tried many different topical medications, but Dr. Pal also noted the patient had some digestive symptoms. They did an at-home test for small intestinal bacterial overgrowth (SIBO ) and uncovered that she did in fact have SIBO. “Once we treated her SIBO, that treated her rosacea almost instantaneously, and she was able to get off a lot of the medications that she was previously using,” Dr. Pal says.

Without that at-home test, the patient might have dealt with rosacea a lot longer.

When in-depth diagnostic testing can help

Not everyone needs to do every type of advanced functional medicine testing . According to Dr. Pal, it all depends on your symptoms and any existing health issues you may have.

Health issues that signal more in-depth testing is a good idea include:

• chronic fatigue
• metabolic syndrome
• weight loss resistance and weight gain
• diabetes
• high blood pressure
• headaches and migraines

In these cases, certain tests can be really useful in uncovering any risk factors or triggers for these conditions, Dr. Pal explains.

And while it’s impossible to list all the symptoms that could indicate at-home functional medicine testing is necessary, there are several situations when it’s more clearly indicated.

#1: You’re struggling with digestive problems, inflammation, and/or mental health issues.

These are all signs something could be up with your gut health .

“When we talk about gut health, we typically think of just digestive symptoms, like bloating , constipation, and diarrhea,” Dr. Pal says. When a patient is having digestive complaints, looking deeper into their gut health makes sense.

But there are quite a few other indicators that give Parsley doctors a heads up that deeper lab testing of a person’s gut health is warranted. “Our digestive tract makes up a huge pillar for our health, and a lot of disease actually originates in and from our digestive tract,” Dr. Pal explains. “We have a strong mind-gut connection , and our digestive tract also influences how we feel. So I like to look at gut health testing when a person’s experiencing symptoms of mood disorders like depression and anxiety .”

Dr. Pal also looks at gut health when a person has symptoms or markers of inflammation or autoimmune disease . (Remember the rosacea example from earlier?) “A big reason for this is about 70 percent of our immune system lines our digestive tract,” Dr. Pal explains. “So when we’re starting to see some imbalances in our digestive tract, when our gut microbiome and other ecosystems of our body are thrown off, that can manifest as chronic inflammation that irritates our immune system , and we can feel those symptoms head to toe.”

Diagnostic tests that can help:

Testing for SIBO is a great first step for people who show possible symptoms of it, such as bloating, GERD, diarrhea, and constipation. The test for SIBO is a breath test that can be conducted with a home-testing kit.

For a more detailed gut microbiome testing , an at-home stool test is preferred. These tests can provide a wealth of information including how well you’re digesting and absorbing your food, whether or not there are markers of inflammation in your digestive tract, what the balance of good and bad bacteria in your gut looks like, whether you have an overgrowth of yeast , and whether parasites are present. “It’s a more comprehensive overview of what’s going on in your digestive tract,” Dr. Pal adds.

#2: Your hormones are out of whack.

Patients with irregular menstrual cycles , problems getting pregnant, low sex drive, and other signs of hormonal imbalance often benefit from a closer look at their hormones .

High cortisol is common in both women and men, and having high levels long-term has been associated with high blood pressure, diabetes, obesity, and osteoporosis.

Diagnostic tests that can help:

The DUTCH Test is an at-home saliva and urine test where the patient collects samples at several points throughout the day to get a fuller picture of their hormone levels and fluctuations. It can be used by both women and men, and it looks at a wide range of hormones including cortisol , estrogen, progesterone, and testosterone. “I really like to use DUTCH testing for women struggling with their periods or struggling with fertility ,” Dr. Pal says.

If a person’s symptoms seem to be more related to stress and adaptation to stress, then a saliva test that looks just at cortisol may be more appropriate, according to Dr. Pal.

Dr. Pal also considers gut health testing when there are signs of hormonal imbalance, so she may also use some of the tests mentioned above. “One of the major ways we detoxify hormones is through our digestive tract, so it’s important to have a healthy digestive tract when hormonal issues are present,” she said.

#3: You’re experiencing vague symptoms, and there isn’t an obvious cause.

When a patient is dealing with symptoms like lingering headaches, digestive complaints, brain fog , rashes, joint aches, and fatigue —and no obvious cause has been uncovered yet—testing for food sensitivities may be helpful.

Food sensitivities are different from food intolerances and allergies . They’re not life-threatening like an allergy, and unlike an intolerance, the symptoms don’t hit immediately after eating the food you’re sensitive to. That can make it really tricky to discover the problem food (or foods).

“If you’ve tried an elimination diet and it hasn’t been able to identify the foods you may be sensitive to, we can do a deeper dive in using a food sensitivity test to help us better determine what those triggering foods for you may be,” Dr. Pal explains.

Diagnostic tests that can help:

Food sensitivity testing is done via an at-home blood test. The test Parsley uses looks for sensitivity to 132 different foods, food colorings, and food additives. “Once we get the results of a food sensitivity test, we can set up another elimination diet using those results to see if they are true sensitivities for you,” Dr. Pal says. Gut health testing may also be helpful in this situation, she adds.

#4: You’re showing signs of exposure to environmental toxins.

Mold, heavy metals , and other environmental toxins can cause symptoms like:

• word finding difficulties
• trouble concentrating
• low energy levels
• numbness and tingling
• weakness
• chronic digestive issues

“In these cases, we want to see if a person has a history of exposure to any of these substances,” Dr. Pal says. “For example, did they grow up in a moldy environment, or live in a building that had some water damage to it?” If it seems like a patient could have potentially been exposed to any of these toxins, further testing may be a good idea.

Diagnostic tests that can help:

Parsley uses at-home tests that pinpoint toxic metals and various species of mold in urine. “Whenever we do identify positive toxin exposure through these labs, the first step is to clear it out of your environment so we can reduce how much you’re exposed to on a day-to-day basis,” Dr. Pal says. “Once that’s done, we can start to talk about different techniques to reduce some of the burden your body’s already holding on to.”

How does at-home diagnostic testing work?

If you’re a Parsley Health member , most of these tests are shipped directly to you with a prepaid return label, which makes getting samples back to the lab as seamless as possible. You can expect test results back in about 2 to 3 weeks, though some may take more or less time.

The majority of the functional medicine tests are available in all states, with some exceptions. For instance, New York has stricter rules around tests that involve genetic information.

Insurance may not directly cover at-home specialty testing, so it might need to be paid for out of pocket. This is something Parsley doctors always consider when recommending these tests to patients, and they don’t recommend them unless they truly believe they’re necessary. The good news is that you can use HSA or FSA funds to pay for the tests, and Parsley members get special prices with many of the labs used for at-home testing.

Despite the potential cost, having an at-home test is a unique opportunity for people who have struggled with chronic concerns or who want to get really detailed, in-depth data about their own body that they wouldn’t be able to get through another medical provider.

What happens after testing?

Once the results come back, your practitioner will review them with you in-depth during your next visit. “I always want to make sure they have a really good understanding of how their body is functioning,” Dr. Pal says. From there, it’s time to form a treatment plan and take action, if necessary.

But no matter what the result is, Dr. Pal emphasizes that she doesn’t make treatment decisions based only on test results. Instead, they’re more like a piece of the puzzle, together with the patient’s health history and symptoms. “I don’t just treat based on a test result,” she explains. “I treat based on the whole person.”