About 80% of the people I talk to who have digestive issues tell me they have no idea what’s wrong.

They know something is wrong because of symptoms, but they don’t know what or why.

There are 2 big reasons for this:

1) Just about every digestive issue has overlapping symptoms

2) Most people don’t do testing

If most digestive issues share the exact same symptoms, figuring out what’s wrong based on symptoms alone is tough.

I have seen issues misdiagnosed more times than I can count because of this.

This is where testing can be very helpful. But it is unfortunately not often utilized.

If you were going on a long road trip, what would you do before you leave?

Probably pull up maps to figure out where to go, timing, traffic info, etc.

You could get there without a GPS and use an old school map, but it wouldn’t have turn-by-turn directions, timing expectations, notifications about changes in routes, etc.

It would be much harder and you wouldn’t have as much confidence as you would with a GPS.

You'd likely end up getting lost at some point and the trip is likely going to take you longer.

GPS isn’t always perfect.

In some places apps like Waze works better than google maps.

Sometimes it tells you one route is faster, but it ends up being slower.

At the end of the day, it still makes your life far easier than if you were trying to get around with a paper map.

Health testing is sort of the same way.

Certain forms of testing can be accurate & helpful in some situations but not as accurate or helpful in others.

They’re not always perfect in terms of understanding exactly what is going on.

But when the right tests are used in the right situations, they provide information that is invaluable for resolving health issues.

Yes, there are health issues that can be addressed without needing to run testing. But this requires a certain level of understanding.

It’s also not always possible.

There are many situations in which health issues involve a complicated web of factors, many of which are simply not possible to identify or have a solid understanding of without any testing whatsoever.

No matter how knowledgeable you are.

What I am talking about today are those situations where:

• People do not have the proper knowledge & understanding to accurately identify their issues based off symptoms
• Health issues involve many factors, some of which would not be possible to identify entirely without testing

Let me give a few examples of these types of situations.

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One of my friends was dealing with digestive issues.

He considers himself fairly knowledgeable when it comes to health. Listens to tons of podcasts, stays plugged into health twitter, reads books about different health topics, etc.

But he had no idea whatsoever what was causing his symptoms.

He came up with several ideas based on some of the health content he consumes, but none turned out to be right.

He wasn’t able to get any lasting relief from his symptoms when addressing what he thought the issues were.

After eventually running testing, he found high levels of intestinal permeability, high inflammation, low pancreatic enzymes and many nutrient deficiencies.

None of these were issues he considered previously.
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Another example is a coaching client I worked with in the past.

This person was dealing with a whole slate of symptoms: bloating, constipation, fatigue, anxiety, acne and many others.

Testing a few years ago revealed SIBO and so he went through several detoxes to address it.

But it kept coming back.

He eventually ran more comprehensive testing, not just looking into SIBO, but also blood and hair testing to look at other things as well.

These showed several issues like hypothyroid, high iron, mineral deficiencies, high levels of heavy metals and several other abnormal metrics that were tied to the SIBO he kept dealing with over and over again.

Simply addressing the SIBO helped provide relief from symptoms, but it kept returning because the other factors contributing to it were not being addressed.
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The tests that I think make most sense for people to run usually depends on the situation.

Below I'll list some tests that I think are effective at identifying different problems that cause, contribute to or are linked in some other way to most common digestive issues.

This doesn't mean these are the only tests I'd ever use or that they're the best options for all situations.
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Blood Work

Understanding what is going on in the gut requires also understanding what is going on outside of it.

Many digestive issues can be the result of or worsened by issues in other parts of the body like the liver.

When it comes to blood work, getting a fairly comprehensive slate of panels is helpful.

I often look into complete blood count (CBC), comprehensive metabolic, lipids, thyroid, liver, hormones (like estrogen, test, progesterone, cortisol) as well as inflammation markers like c-reactive protein.

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WBC Micronutrient Test

A white blood cell micronutrient test is also done via blood, but a bit more specialized than the previously mentioned panels.

This measures the levels of micronutrients within the WBC for a more accurate depiction of nutrient status compared to serum.

Serum nutrient testing shows the levels of nutrient in the blood, which is more susceptible to short-term fluctuations.

Measuring nutrients in WBC is considered more functional & accurate as it is more reflective of longer-term nutrient status and how much of the nutrients are in the cells where they’re actually stored & utilized.

As I talked about in this post, high serum nutrients levels can actually be a sign of cellular/functional deficiencies.

​SpectraCell (below) is the gold standard in the US for this in my opinion.

But you definitely pay for their quality.

There are other options as well, but I can’t speak to them directly.

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Stool Test

A comprehensive stool test provides a fairly thorough look at digestive health.

It looks at microbiome composition, digestion, immune function, inflammation, gut lining integrity & more.

This is not a bulletproof test that answers all questions and provides complete certainty in terms of digestive issues.

But it is one of the most comprehensive tests for getting an understanding of where various aspects of digestive health stand.

GI Effects from Genova Diagnostics (3-day preferably) and the GI MAP from Diagnostic Solutions are two good options in the US.

Both of which can be ordered directly without needing a doctor.

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Organic Acid

This is a great option for looking into a number of different issues like metabolic health, nutrient levels, neurotransmitters and digestive health.

This can be helpful for identifying mitochondrial dysfunction, nutrient deficiencies, pathogen overgrowth/dysbiosis, neurotransmitter imbalances, inhibited detoxification and

It can be helpful for indications of mitochondrial dysfunction, neurotransmitter & hormonal imbalances, intestinal pathogen overgrowth/dysbiosis, detoxification capability, oxidative stress and much more.

It looks into some of the same issues that a stool test can help identify but in different ways.

But there are many things in a stool test not included here & vice versa.

I have seen situations where one of these tests shows a negative and the other shows a positive.

Looking at things from different angles can be helpful.

Mosaic offers a good option in the US, which can also be ordered without going through a doctor on sites like Labify Health.

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Hair Mineral Analysis

This test looks (unsurprisingly) into mineral levels and also toxic metals like lead & mercury.

It does this by measuring the levels in the hair, which can be a decent way of understanding medium to long-term exposure levels.

This test can help understand mineral deficiencies and imbalances, heavy metals in the body and also susceptibility to metals & other toxins.

It can also help draw some downstream conclusions into thyroid, immunity, metabolic function, digestion/absorption and much more.

EquiLife offers a good test that I’ve used in the US.

When it comes to this test, I think it’s important to look at the substances it is measuring from other perspectives as well and not rely solely on this due to the way in which it is measured and factors that can influence these levels.

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As mentioned above, there are other tests that I think can be helpful.

Methylation testing, food sensitivity, mycotoxin urine testing, visual sensitivity testing, etc.

The tests that I listed are the ones that I think do the best job of helping identify the problems involved in the most common digestive issues I’ve seen.

Not all problems.

In the US, getting testing done can sometimes be harder than winning the lottery.

There are thankfully several companies that offer testing to you directly without the need for a doctor.

Such as Labify Health mentioned above.

Also, just to reiterate, yes, there are situations where testing isn’t necessary.

If someone goes on vacation for a couple of weeks and comes back with some stomach symptoms, going to run a bunch of tests probably isn’t necessary.

What I’m talking about are the very common situations where health issues involve a web of different factors that cannot all be thoroughly understood strictly based on symptoms.

Or the situations where someone has been dealing with issues for a while, has no idea what’s wrong or what caused it and nothing is working for them.

This is where testing can be extremely helpful if not necessary.

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- Nick