110 | Why I Don't Work with Functional Labs
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著者:
This might be my most controversial clinical opinion: I don't work with functional lab tests. Not DUTCH testing, not GI Map, not organic acids, not microbiome panels. In this episode, I walk through exactly why and some considerations for those who do work with these tests.
In this episode, we cover:
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What I mean by "functional labs" and which tests fall under that umbrella.
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Why I only order tests when the results will actually change what I do.
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The validity problem, with fecal samples for microbiome testing as an example.
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Why "accurate results" and "clinically actionable results" are two very different things.
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The evidence problem: how recommendations attached to these labs are often theoretical rather than based on clinical data.
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The conflict of interest issue.
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A harder question for practitioners: if a lab is telling your client what to take, what exactly are they paying you for?
Timestamps:
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0:00 - Introduction
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0:10 - My most controversial clinical opinion
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0:35 - Full disclosure: not judging practitioners who use these labs
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1:38 - Reason 1: I don't think I need them
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2:03 - When I think testing matters (iron as an example)
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4:07 - Reason 2: Validity concerns
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5:01 - Reason 3: The "what do we do about it" data is mostly theoretical
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6:05 - The supplement recommendation problem
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9:38 - A question for practitioners who rely on labs to guide recommendations
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10:45 - What I'd rather clients spend that money on