This modern day life is busy and stressful and it is “normal” to feel a little bit tired from time to time after a busy week, a few late nights, an illness or stressful events. We all need rest and for many, a bit of extra sleep and down time is all that is required to bounce back.
But lingering fatigue that doesn’t go away and begins to interfere with everyday life is NOT normal. It isn’t normal to:
- Constantly wake unrefreshed even after a good nights sleep
- Experience daily brain fog, headaches or difficulty focussing and concentrating
- Experience malaise after exercise or periods of intense mental activity
- Feel too tired to be able to do your job effectively, socialise with friends or walk your dog
- Experience lingering fatigue months after an illness, accident or big stress
If you are experiencing any of these symptoms, your first port of call is to see your doctor to rule out anything that could be serious. However, many people see their doctor, doctor runs some tests and everything comes back normal.
If this has been your experience and you are wondering why you feel so tired all the time, here are some additional tests that may help you get to the bottom of your fatigue symptoms.
Medical – Blood Test
The following tests will mostly be available through your doctor, although some markers, like thyroid antibodies or T3 aren’t typically tested. Alternatively you can use a private testing company like Medichecks that may offer things that may be trickier to advocate for. Most of our clients use the Medichecks Wellwoman or Wellman Panel as a starting point so we can begin to rule certain things in or out and address low hanging fruit such as the need for better regulated blood sugar, oxygenation of the body which requires healthy red blood cells and nutrients such as vitamin B12, folate and iron.
- Thyroid including TSH, T3, T4, rT3 and thyroid antibodies
- Full Blood Count
- Iron Panel including Ferritin, Serum Iron, Total Iron Binding Capacity and % Transferrin Saturation
- Vitamin D3
- Liver Function
- Albumin and Globulin which can be an indicator of malabsorption syndromes
- Kidney Function
- Blood lipids and glucose including lactate dehydrogenase which can be an indicator of functional hypoglycemia
If there is something obvious here such as hypothyroid or iron deficiency anaemia, this is usually already picked up by your doctor. However, many of our clients fall through the cracks where they don’t feel well and yet they are often told their test results are normal.
But normal and optimal are two different things.
We interpret these tests using reference ranges as defined by Weatherby and Ferguson. These reference ranges are narrower which means that we can identify imbalance before it becomes dis-ease and therefore, we take a preventative approach designed to optimise the biochemistry of our clients.
Additionally, some markers which are not typically screened, such as thyroid antibodies, may give important information that will help to inform clinical decisions. See here for more detail.
Analysis of bloodwork in this way usually reveals some clues which can inform further testing and from here we can make decisions about Functional Testing and dig deeper into what is going on.
Functional Testing (Blood, Urine, Stool, Saliva)
Functional Testing is not diagnostic, which means that it is looking for dysfunction in the working of the different body systems, not necessarily disease.
There are hundreds of Functional Tests available which offer extensive opportunity to test many different body systems and biochemical pathways. Yet, there are a select few that 14 years of clinical experience have me using time and time again.
Here they are:
GI Effects Comprehensive Stool Test by Genova Diagnostic (stool)
Almost all of our clients have some digestive imbalance and testing helps us to create a personalised support plan to bring their digestive system into balance. The digestive system is intimately connected to the immune system, the nervous system and the brain. When there are imbalances in the gut, it has a knock on effect on how these systems operate and function and this can significantly impact energy levels.
Expect to pay: approximately £350*
NutrEval By Genova Diagnostic (blood and urine)
The NutrEval is a one stop shop for understanding your nutritional requirements. It covers everything from vitamins, minerals, essential fatty acids, amino acids and heavy metals. It offers a deep insight into malabsorption, dysbiosis, cellular energy production, neurotransmitters, detoxification and oxidative stress.
Expect to pay: approximately £600*
Organic Acids By Genova Diagnostic (urine only)
If you are not up for the full NutrEval we find the Organic Acids urine test, which is a portion of the NutrEval, very beneficial for understanding nutrient requirements that could be impacting mitochondrial function and therefore energy production. There are some malabsorption and dysbiosis markers which can suggest if stool or mycotoxin testing would be beneficial. The test also includes insight into neurotransmitters, detoxification and oxidative stress.
Expect to pay: approximately £200*
Mycotoxin Test by Mosaic Diagnostics Laboratory (urine only)
This is a good option if you suspect that mould could be contributing to your fatigue symptoms. You may be living or have previously lived in a water damaged building and you may also be experiencing headaches, sensitivity to light, digestive issues, sinus congestion, join stiffness and pains, cognitive impairment, coughing, chest pains and shortness of breath, excessive thirst, hormonal imbalances, numbness and tingling and unusual pains (to name a few).
Expect to pay: approximately £300*
Dutch Hormones Test + Cortisol Awakening Response (saliva and urine)
Many of our clients are in their late 30’s and early 40’s and we have to consider that the natural transition in sex hormones could be a factor in their fatigue experience. This test is also useful if hormonal imbalance is one of the client’s main symptom complaints. This could look like heavy periods (which may be contributing to anaemia), painful periods, cyclical changes in mood, cyclical changes in energy, painful breasts or irregular cycles.
The Dutch Test gives a comprehensive breakdown of oestrogen, progesterone and testosterone as well as the metabolism of these hormones as they are naturally detoxified from the body. It includes an adrenal profile with cortisol awakening response and a small selection of organic acids which can be useful to understand oxidative stress, melatonin and the need for vitamin B6 and vitamin B12.
In some cases the cycle mapping profile can be beneficial to see the pattern of oestrogen and progesterone production across a cycle. This can help get to the bottom of cyclical changes in mood, energy or symptoms and the role that hormones may be playing in symptom amplification.
Expect to pay: approximately £270*
Cyrex™ Testing
Cyrex™ is a Clinical Immunology Laboratory Specialising in Functional Immunology and Autoimmunity. Cyrex™ offers multi-tissue antibody testing which is ideal for those who may be experiencing autoimmune conditions. They have a broad selection of tests which includes food sensitivity testing, gluten sensitivity testing, gluten-cross reactive foods, neurological autoimmune reactivity and pathogen associated autoimmune reactivity.
Expect to pay: £200-£500 depending on the test
* we offer testing to my 1:1 clients at a discounted rate.
Where to begin?
Reading through the list of tests you are probably thinking: “This looks overwhelming and expensive! Do I need all of these tests or just one or two?”
Functional Testing is a big financial investment and not everyone has endless financial resources to invest in these tests. When we work with our clients, we take a detailed health history, including family history, review current symptoms and tests already completed – usually blood work that has been done by the client’s general practitioner or previous Functional Medicine Practitioner or Nutritional Therapist.
Once we have all the information we create a short list of additional testing that could be beneficial. We discuss budget with the client, pro’s and con’s of choosing testing and how test results would influence the decision making for the case.
We don’t want budget to be a handicap to healing so we will always do our best to move the case forward within the clients budget, that being said, sometimes testing can have a big influence on clinical decisions, especially where autoimmunity is concerned.
On average our clients will do between 1 and 3 tests when they work with us. Some will do more. Although it can be a significant investment, we can speak from experience when we say that what you invest in testing can often save hundreds of pounds in the long term because we are able to create a much more personalised support plan.
If you are interested in working with us and getting to the bottom of your symptoms, you can find out more here.
