"Functional" pathology tests

This is a large and complex area covering a range of tests e.g.:
  • Liver Detoxification Profile
  • Complete Digestion Analysis (also described separately)
  • Intestinal Permeability
  • Amino Acid Profile
  • Organic Acid Profile
  • Neuroendocrine Metabolites
  • Essential Fatty Acids
  • Vitamins and Antioxidants
The Liver Detoxification Profile can vary from different laboratories. However most commonly it involves the person taking several common drugs e.g. paracetamol, aspirin and caffeine and then measuring their metabolites in blood and urine afterwards. The amount and ratios of metabolites present are an indication of the amount of phase I and phase II metabolism going on in the liver. However there is a lack of evidence that the results have any clinical utility in patients who are not suffering from advanced liver disease. The results are sometimes used by alternative practitioners to suggest that the patient has problems that are unrelated to liver function. People having this test may then be recommended to undertake “detoxification” treatment which as this WebMD article shows, may be beneficial if the person leads a healthier lifestyle but this has nothing to  do with removal of any "toxins".

Intestinal permeability testing is usually used to diagnose “leaky gut syndrome”. Increased intestinal permeability can occur in a variety of severe gastrointestinal disorders but this is not what is meant by “leaky gut syndrome” in alternative and fringe practice. Read the article by the UK National Health Service in NHS Choices for an unbiased assessment. Quackwatch has included "leaky gut syndrome" in a list of "fad" diagnoses.

For more information on the above two tests click HERE for an opinion by an Australian gastroenterologist.

Some of these “functional” tests have clinically valid uses in particular circumstances e.g. inborn errors of metabolism in very sick newborns and infants (organic acids, amino acids, fatty acids). In these cases the abnormalities are generally extreme and when combined with the clinical findings in the child the diagnosis can be made. However there is no good evidence that any of these tests are useful in the general population with vague symptoms. However it is common for an alternative health website to say something like; “Are you feeling unwell or tired and your doctor can’t find anything wrong with you? Come and have our range of functional health testing and we may find something wrong that will allow us to identify treatment options for you”. What do you think is going to happen when a large set of numbers are generated by the testing, normal variations due to diet and other factors are poorly defined and agreed protocols to interpret the results are non-existent? You will almost certainly be opening your purse or your wallet again to pay for more services.