The principles of Functional Medicine are anchored by an unraveling of the core imbalances that underlie, or cause ill health. Rather than simply offering a treatment for the symptoms of a problem, it looks at the root causes that might come from the client’s environment, nutrition, genetic attributes, and even psychological state.
Functional Tests in Clinic
This clinical approach uses the client’s personal story as a key tool for integrating signs and symptoms, and ultimately diagnosis. Evidence of clinical imbalances are integrated into a comprehensive approach to improve both the client’s environmental inputs and their physiological function.
functional test examples
TOTAL NUTRITION EVALUATION
NutrEval® provides a framework of core nutrients in 5 key areas: Antioxidants, B Vitamins, Digestive Support, Essential Fatty Acids, and Minerals.
STRESS CORTISOL TEST
The Adrenal Stress Profile is a powerful and precise noninvasive salivary assay that evaluates bioactive levels of the body’s important stress hormones, cortisol and DHEA. This profile serves as a critical tool for uncovering biochemical imbalances underlying anxiety, depression, chronic fatigue, obesity, dysglycemia, and a host of other clinical conditions
OPTIMUM NUTRITION EVALUATION
ONE FMV™ nutritional test helps to give an understanding of individual diet and supplementation needs, and offers a personalized functional nutrition assessment covering Antioxidants, B Vitamins, Digestive Support, and Minerals.
Nutritional deficiencies can be a factor of many complex chronic conditions, and ONE FMV™ utilises an easy first-morning urine collection (called a first morning void) to provide nutritional recommendations based on a patient’s individual nutritional test results. Clinicians commonly use such nutritional testing to determine the nutritional deficiencies that are at the root of chronic conditions.
References from dna Nutrigenomix's report
Vitamin A: BCMO1 Elevated. Focus on consuming pre-formed sources of vitamin A.
· Lietz G et al. Single nucleotide polymorphisms upstream from the β-carotene 15,15'-monoxygenase gene influence provitamin A conversion efficiency in female volunteers. Journal of Nutrition. 2012;142:161S-5S.
Vitamin B12: FUT2 Elevated. Focus on consuming bioavailable sources of vitamin B12.
· Hazra A et al. Common variants of FUT2 are associated with plasma vitamin B12 levels. Nature Genetics. 2008 Oct;40(10):1160-2.
· Tanwar VS et al. Common variant in FUT2 gene is associated with levels of vitamin B(12) in Indian population. Genetics. 2013;515:224-8.
Vitamin C: GSTT1 Elevated. Meet the RDA for vitamin C daily.
· Cahill LE et al. Functional genetic variants of glutathione S-transferase protect against serum ascorbic acid deficiency. American Journal of Clinical Nutrition. 2009;90:1411-1417.
Vitamin D: GC and CYP2R1 Elevated. Consume 1000 IU (25 mcg) vitamin D daily.
· Slater NA et al. Genetic Variation in CYP2R1 and GC Genes Associated With Vitamin D Deficiency Status. J Pharmacy Practice. 2015:1-6.
· Wang TJ et al. Common genetic determinants of vitamin D insufficiency: a genome-wide association study. Lancet. 2010;376:180-88.
Low iron status: TMPRSS6, TFR2, TF Elevated. Meet the RDA for iron and consume sources of vitamin C with iron-rich foods.
· Benyamin B et al. Variants in TF and HFE explain approximately 40% of genetic variation in serum-transferrin levels. American Journal of Human Genetics. 2009a;84:60–65.
· Benyamin B et al. Common variants in TMPRSS6 are associated with iron status and erythrocyte volume. Nature Genetics. 2009b;41:1173–1175.
· Ganesh SK et al. Multiple loci influence erythrocyte phenotypes in the CHARGE Consortium. Nat Genet. 2009 Nov;41(11):1191-8. doi: 10.1038/ng.466.
· Pichler I et al. Identification of a common variant in the TFR2 gene implicated in the physiological regulation of serum iron levels. Hum Mol Genet. 2011 Mar 15;20(6):1232-40. doi: 10.1093/hmg/ddq552. Calcium: GC Elevated. Consume 1200 mg of calcium daily.
· Fang Y et al. Vitamin D binding protein genotype and osteoporosis. Calcif Tissue Int. 2009;85:85-93.
Caffeine: CYP1A2 Elevated. Limit caffeine intake to 200 mg/day.
· Cornelis et al. Coffee, CYP1A2 genotype, and risk of myocardial infarction. Journal of the American Medical Association. 2006;295:1135-41.
· Palatini et al. Association of coffee consumption and CYP1A2 polymorphism with risk of impaired fasting glucose in hypertensive patients. Eur J Epidemiol. 2015;30(3):209-17.
· Palatini et al. CYP1A2 genotype modifies the association between coffee intake and the risk of hypertension. J Hypertens. 2009;27(8):1594-601.Energy balance: UCP1 Diminished. Aim for an energy deficit of 650 calories/day from your calculated energy needs for weight loss.
· Nagai N et al. UCP1 genetic polymorphism (-3826A/G) diminishes resting energy expenditure and thermoregulatory sympathetic nervous system activity in young females. Int J Obesity. 2011;35:1050-5.
Saturated and unsaturated fat: FTO Enhanced. Limit intake of saturated fat to no more than 10% of energy. Consume at least 5% of energy from polyunsaturated fat.
· Phillips CM, Kesse-Guyot E, McManus R, Hercberg S, Lairon D, Planells R, Roche HM. High dietary saturated fat intake accentuates obesity risk associated with the fat mass and obesity-associated gene in adults. J Nutr. 2012 May;142(5):824-31. doi: 10.3945/jn.111.153460.
· Rodrigues et al. A single FTO gene variant rs9939609 is associated with body weight evolution in a multiethnic extremely obese population that underwent bariatric surgery. Nutrition. 2015;31:1344-50.
Lactose: MCM6 Elevated. Limit dairy intake.
· Al-Abri et al. Distribution of the lactase persistence-associated variant alleles -13910*T and -13915*G among the people of Oman and Yeman. Hum Biol. 2012;84(3):271-286.
· Canadian Digestive Health Foundation. (c2016). Lactose intolerance. Available from: http://www.cdhf.ca/en/disorders/details/id/13
· Dzialanski et al. Lactase persistence versus lactose intolerance: Is there an intermediate phenotype? Clinical Biochemistry. 2015. doi: 10.1016/j.clinbiochem.2015.11.001.
· Enattah et al. Identification of a variant associated with adult-type hypolactasia. Nature Genetics. 2002;30:233-7.
· Enattah et al. Independent introduction of two lactase-persistence alleles into human populations reflects different history of adaptation to milk culture. Am J Hum Gen. 2008;82:57-72.
· Hassan et al. Genetic diversity of lactase persistence in East African populations. BMC Res Notes. 2016;9:8.
· Hill et al. Brief communication: effect of nomadic subsistence practices on lactase persistence associated genetic variation in Kuwait. Am J Physical Anthro. 2013;152:140-144.
· Imtiaz et al. The T/G-13915 variant upstream of the lactase gene (LCT) is the founder allele of lactase persistence in an urban Saudi population. J Med Genet. 2007;44:e89.
· Itan et al. A worldwide correlation of lactase persistence phenotype and genotypes. BMC Evolutionary Biology. 2010;10:36.
· Koek et al. The T-13910C polymorphism in the lactase phlorizin hydrolase gene is associated with differences in serum calcium levels and calcium intake. Journal of Bone and Mineral Research. 2010;25:1980-7.
· Morales et al. The European lactase persistence genotype determines the lactase persistence state and correlates with gastrointestinal symptoms in the Hispanic and Amerindian Chilean population: a case-control and population-based study. BMJ. 2011;1:e000125.
· Raz et al. Frequency of LCT-13910C/T and LCT-22018G/A single nucleotide polymorphisms associated with adult-type hypolactasia/lactase persistence among Israelis of different ethnic groups. Gene. 2013;519:67-70.
Fat taste perception: CD36 Enhanced. You have an enhanced ability to sense the fatty taste of foods.
· Melis et al. Associations between orosensory perception of oleic acid, the common single nucleotide polymorphisms (rs1761667 and rs157483) in the CD36 gene, and 6-n-propylthiouracil (PROP) tasting. Nutrients. 2015;7:2068-2084.
· Lopez et al. Genetic variant in the CD36 gene (rs1761667) is associated with higher fat intake and high serum cholesterol among the population of West Mexico. J Nutr Food Sci. 2015;5:353.
Eating between meals: MC4R Elevated. You are more likely to eat between meals.
· Stutzmann F et al. Common genetic variation near MC4R is associated with eating behaviour patterns in European populations. Int J Obes. 2009;33:373-378.
Pain: COMT Enhanced. You have a heightened pain tolerance.
· Tammimäki A, Männistö PT. Catechol-O-methyltransferase gene polymorphism and chronic human pain: a systematic review and meta-analysis. Pharmacogenet Genomics. 2012;22(9):673-91.
· Zubieta et al. COMT val[sup158]met genotype affects μ-Opioid Neurotransmitter Responses to a Pain Stressor. Science. 2003;299:1240-3.