Health Evaluation Tools
Dr. Kiona has access to various functional tests to get clear information on the state of your health. Some possible routes of evaluation are as follows:
Assess how well the gut is functioning (Doctor's Data Complete Stool Analysis and Parasitology X3):
This test reveals the balance of "good" vs. "bad" bacteria, overgrowth of yeast, and presence of parasites. It also assesses for inflammation within the gut and how well the good bacteria are doing their job to nourish the lining of the gut. In addition it evaluates the adequacy of digestion such as production of stomach acid, pancreatic function, and gall bladder function. Most illness starts with gut dysfunction, so Dr. Kiona orders this test on most of her patients. More information here.
Measure the presence of bacteria in the small intestine (Commonwealth Labs - Lactulose breath test):
Small Intestinal Bacterial Overgrowth (SIBO) is a condition that has been found to play a role in many illnesses including IBS, rosacea, acne, heartburn, and fibromyalgia to name a few. There is also implication that it may be one of the processes at work in autoimmune disease. SIBO occurs when bacteria, which should reside in the colon, migrate up to the small intestine. The small intestine is not equipped to have a high bacterial count so it doesn't function as well which causes other health problems. This test is done at home and measures the amount of hydrogen and methane which is created in your breath by these bacteria after you drink a solution of a special type of sugar. SIBO can be treated with herbal or conventional antibiotics. There are certain dietary management strategies which can be used as well. Since it is possible to have SIBO without having any gut symptoms, Dr. Kiona also orders this test for most of her patients. More info here and here.
Assess the health of your mitochondria (Genova Diagnostics - NutrEval):
Your mitochondria are the organelles inside your cells which produce energy for your body in the form of ATP. The process of energy production is very dependent on vitamins and minerals. The NutrEval test by Genova Diagnostics tells Dr. Kiona how well your mitochondria are functioning by measuring nutrients and organic acids in the urine and in the blood. By assessing the buildup of different organic acids in the energy manufacturing pathways we can see which nutrients may be depleted in your body. More info here.
Assess stress hormones (Precision Analytical - DUTCH):
By testing the levels of cortisol and DHEA metabolites in your urine, Dr. Kiona can see how well your stress hormones are serving you throughout the day. Sometimes we can produce an excess of cortisol (when we are chronically stressed) which adversely effects our health in many ways. Other times we can have a depressed level of cortisol which means we stay very fatigued. High or low cortisol is called Hypothalamic-Pituitary-Adrenal (HPA) axis dysfunction. Some practitioners call it adrenal fatigue but HPA dysfunction is probably more accurate. More info here.
Assess how well you're metabolizing your estrogen (Also through DUTCH test):
Your body wants to make estrogen, use it, then get rid of it. It's not good to have a lot of extra floating around. When estrogen is detoxified in the liver in order to be eliminated from the body, you can form protective estrogen metabolic byproducts or you can form toxic metabolic byproducts. Toxic metabolic byproducts (when present and not adequate eliminated via the gut) can increase the risk of breast cancer. By analyzing these byproducts we can support liver detoxification in order to shift the byproducts from toxic to protective. More info here.
Testing for heavy metals with hair, urine, or blood samples:
Heavy metals as a source of illness has a complicated and controversial history. However, the evidence has continued to accumulate to implicate lead, mercury, and arsenic as problems for certain sensitive individuals. Your ability to become ill from heavy metals depends on your body burden of the metals as well as genetic susceptibility to damage from the metals. If we find an elevated body burden Dr. Kiona can design a regimen of foods and nutrients to help your body eliminate the heavy metals from your body. More info here, here, and here.
Analyzing genetic data:
Personalized medicine based on our genetic variation is the wave of the future. Clinically we're getting tiny glimpses into the implications of small genetic variations in our genetic code called SNPs (short for single nucleotide polymorphisms). "23 and me" is a company which analyses your DNA to find genetic polymorphisms for enzymes in your body. A SNP is a variation in the coding which causes the subsequent enzyme for which it codes to be less or more effective that usual. Dr. Kiona cannot assess all of the data which is provided by this report but she is aware of the some of the clinical implications of certain SNPs such as MTHFR and COMT. More info here and here.
Food sensitivity testing:
Specific foods can adversely effect our health in many ways. Traditionally, conventional medicine has only recognized the effect of food allergy on health. Even in that arena the appreciation of the subtlety of food allergies on our health is often over looked. However, there is more and more evidence of the existence of food sensitivity which is mediated by IgG antibodies rather than IgE antibodies which is the usual route for allergy. Cyrex offers a wide array of food sensitivity testing and currently offers the most extensive and complete serum testing for celiac disease available. More info here.
Advanced Lipid testing:
This test is offered by Quest and is covered by most insurance carriers. It tells Dr. Kiona not only the amount of cholesterol in the body but also the type of cholesterol and whether it is more atherogenic (artery clogging) or less atherogenic. Treating underlying causes such as increased intestinal permeability, heavy metal exposure, or dietary factors can improve the type of cholesterol you produce which decreases the risk of developing heart disease. More info here.
All of this testing is in addition to conventional labs for diabetes, kidney and liver function, thyroid testing, blood count, antibodies for chronic viruses, inflammation, and levels of certain vitamins in the blood such as iron, B12, folate, and vitamin D.