Health & nutrition insights.

Credible or Concerning? Popular “Diagnostic” Wellness Tests

Credible or Concerning?

Popular “Diagnostic” Wellness Tests & Lab Interpretations

*If you want to listen to this in podcast form, click here: https://podcasters.spotify.com/pod/show/achievingyourbest/episodes/Credible-or-Concerning–Part-2-Validity-of-Popular-Wellness-Tests-e2bd69c

  • Intro: 
    • The last episode of Practical Nutrition was the first piece of a mini-series we are calling “Credible or Concerning.” We reviewed the scopes of practice of several disciplines of health practitioners, as well as red flags to look out for when consulting with health professionals. 
    • Today we are going to continue with that “Credible Vs. Concerning” topic, and look at the pros and cons of some popular “diagnostic” wellness tests. 
    • We live in a very interesting world right now. Health and wellness is becoming increasingly popular and accessible via wellness clinics and private health practices (I swear a new one pops up weekly)…
    • Recently (over the past few years) there has been an uptick in the amount of clients bringing in results from various ”diagnostic” wellness tests, and the results can cause people to feel overwhelmed. Sometimes these professionals use the results of the tests to prescribe unnecessary supplements, medications, products, or even more testing.
    • Our goal is to help people feel empowered with the knowledge to be their best health advocate, to understand the validity of these common wellness tests, and make sure that their test results and treatment plans are being ethically communicated to them by health professionals.

 

The tests we will cover today:

  1. IgG “food sensitivity” tests
  2. Hormone panel tests
  3. Cortisol and stress tests
  4. DNA and Nutrigenomics tests

 

IgG “Food Sensitivity Testing

  • What is IgG?
      • A type of antibody (immunoglobulin) which is naturally present in the human body and becomes active when we put substances (food, beverages, medicines, foreign objects like piercings or implants) into our body. 
  • What is the IgG food sensitivity test?
      • $30-$400
      • Blood is drawn, and exposed in vitro (in a test tube) to a large panel of foods (90-100 foods) and food components. 
      • The amount of IgG that binds to each food is quantified. 
      • The patient is typically presented with a multipage document that itemizes foods by category. For example, under “dairy” may be listed cheddar cheese, cottage cheese and so on. 
      • Included with the report may be instructions for patients to strictly or temporarily avoid all foods to which the highest degree of IgG binding is reported. 
      • Sometimes a sample diet may be suggested, with a list of foods to be eaten and avoided on a rotating schedule. 
      • Accompanying information may list a range of conditions possibly associated with IgG antibody complexes including weight gain, fluid retention, hyperactivity, depression, asthma, hypertension and others.
    • Pros: 
      • May help people become more aware of what they are eating
      • May offer peace of mind to people who struggle with GI issues
  • Cons:
      • Statement of the American Academy of Allergy, Asthma, and Immunology:
        • “It is important to understand that this test has never been scientifically proven to be able to accomplish what it reports to do. The scientific studies that are provided to support the use of this test are often out of date, in non-reputable journals and many have not even used the IgG test in question. The presence of IgG is likely a normal response of the immune system to exposure to food. In fact, higher levels of IgG to foods may simply be associated with tolerance to those foods… Due to the lack of evidence to support its use, many organizations, including the American Academy of Allergy, Asthma & Immunology and the Canadian Society of Allergy and Clinical Immunology have recommended against using IgG testing to diagnose food allergies or food intolerances / sensitivities.”
        • Link to statement article: https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/igg-food-test
      • Statement of Academy of Nutrition and Dietetics:
  • *Dietitians discuss cons they have experienced in practice
      • Not covered by insurance
      • Causing stress, disordered eating, etc
      • Overprescription of supplements or meal replacement products
  • What to do if you think you have a food allergy or sensitivity?
    • Ask for a referral to an Allergist who can do the real allergy testing protocol:
      • “A full medical history, physical examination, skin prick testing, carefully selected food-specific IgE levels and oral food challenges to suspected food allergens” (AAAI)
    • Ask for a registered dietitian to help you follow an elimination diet such as Low-FODMAP.

 

Hormone Testing:

  • To date, scientists have identified about 50 hormones that are produced by the human body. These chemicals control many metabolic processes that are important for quality of life. 
  • Hormones being “out of whack” are often blamed when we don’t feel our best. And many practitioners will encourage clients to have hormones tested in order to diagnose some type of issue.
  • The common hormone tests:   ($45-$500)
      • Saliva test
      • DUTCH test- dried urine
      • Blood test
  • Pros:
      • Can help you see what your hormone levels are at a specific point in time
  • Cons:
      • Hormones fluctuate throughout the day, month, and related to specific events (such as work, stress, relationships, etc). It is very difficult to analyze the levels of hormones because of this constant fluctuation.
  • Statement from North American Menopause Society:
      • Practitioners can use these “results” to prescribe hormone replacement therapies, which may do more harm than good in the long run. 
        • Statement from the Endocrine Society
          • “The controversies surrounding the safety and efficacy of “bioidentical hormones” illustrate the need for further scientific and medical scrutiny of these substances. Until such studies are completed, physicians should exercise caution when prescribing “bioidentical hormones” and counsel their patients about the controversy over the use of these preparations. Additionally, patients should educate themselves about hormone therapies and engage in candid discussions with their doctors. Much consideration should be given to the decision to undergo any hormone therapy, and “bioidentical hormones” present unique and additional concerns because of the process by which many of them are made.”
          • Link to statement: https://www.menopause.org/docs/default-document-library/bioidenticalht_endosoc7FEEC6FE637F.pdf?sfvrsn=3799660e_2
  • What should you do if you think you have hormonal imbalances? 
      • Talk to your primary care doctor or ask for a referral to an accredited endocrinologist

 

Cortisol/Stress/Inflammation Tests:

    • What is cortisol?
      • Often called the “stress hormone,” is a vitally important hormone that is necessary to eliminate inflammation in the body. 
      • Made by the adrenal gland that sits on top of the kidneys.
      • Should be the highest in the morning and slowly decrease throughout the day; hitting its low point late in the evening in order to fall asleep easily
  • How is cortisol tested? 
      • ($50-$150)
      • Blood 
        • Typically shows higher than normal cortisol because cortisol automatically rises during a blood draw due to stress and inflammation to heal from the needle-stick. 
        • Not shown to be accurate for assessing the fluctuation of cortisol throughout the day, and can be misinterpreted by clinicians as “high cortisol.”
      • Urine 
        • Samples taken over 24 hours
        • Helps us understand total cortisol production and average cortisol levels (this is the gold standard for diagnosing Addison’s or Cushing’s diseases which is an extreme over- or under-production of the hormone that is deadly if untreated)
        • Not helpful for seeing fluctuations in cortisol levels throughout the day
      • Saliva 
        • Typically measured at 4-6 different intervals throughout the day.
        • Results can be impacted by saliva quantity, temperature of storage and transportation of the samples, and how long the sample sits before being tested.
        • Research on the viability of this method is inconclusive. 
  • What should you do if you think you have abnormal cortisol?
    • Understand that in our society, it is common for people to experience high levels of stress and thus, high levels of cortisol. And as long as it’s not an issue with the adrenal gland itself, it can be controlled through the following methods:
      • Working with a mental health professional to find ways to better cope with stress
      • Optimal nutrition
      • Optimal fitness routine
      • Self-care and de-stress techniques (meditation, yoga, etc)
      • Proper sleep patterns
      • Reducing stressful stimuli (social media, blue light, unhealthy relationships, job distress, etc)
      • Community or group support

DNA and Nutrigenomics Testing

  • What is this?
      • Tests your DNA from a saliva or hair sample. 
      • Claims to be able to suggest optimal lifestyle, foods, supplements, and fitness routines based on your DNA profile.
  • Cost:
      • $120-$500 (depending on brand)
  • Pros:
      • Can diagnose rare genetic conditions or if children are at risk for developing certain diseases, such as cystic fibrosis, Parkinson’s or Alzheimer’s.  
  • Cons:
    • The science is not precise enough yet.
    • For example- there are hundreds of genes that determine eye color. So to determine someone’s risk for obesity or heart disease would be much more complex than that. 
    • Stanford researcher Christopher Gardner has looked at this for over 2 decades. He said in 2018, “It doesn’t really matter because it doesn’t really work. Genes cannot predict who will lose weight on a certain type of diet.”
    • Larry Brody of the National Human Genome Research Institute (NHGRI), one of the National Institutes of Health said, “the science just isn’t there yet.” 

In conclusion: 

  • Keep your wellness journey as simple as possible. 
  • Not all wellness tests are viable, accurate, or necessary. Sometimes they can lead to feeling overwhelmed, poor relationship with food, or spending money on unnecessary treatments. 
  • It is important to make sure that if you receive a wellness test, the results are being accurately interpreted for you. And the treatment plan has your best interest in mind, rather than trying to sell you “cure-alls” like pills, powders, shakes, or compounded hormones. 
  • The human body is an extremely complex system, and there is much we don’t know about it yet (and probably never will). If someone says they have all the answers, we should be concerned because that’s simply impossible. 
  • If you have a question about a specific wellness test, results or treatments that were suggested for you, a registered dietitian would be a great resource for guidance.