9 Most Commonly Ordered Functional Medicine Labs For Inflammation

Inflammation is the body's natural immune response to injury or infection. However, when inflammation becomes chronic, it may contribute to the development of various health conditions, including autoimmune diseases, cardiovascular disease, and metabolic disorders.

Chronic inflammation is a common underlying factor in many diseases, and targeted lab testing is an effective method for identifying and managing it. These tests can help determine the root causes of inflammation, guide treatment decisions, and enhance overall health.

This article introduces the most commonly ordered functional medicine labs for identifying and managing inflammation. Whether you're a patient seeking a deeper understanding of your health or a practitioner looking to refine your diagnostic approach, this guide will help you understand when and why to order these tests.

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Why Testing for Inflammation Is Important

Many of today’s chronic illnesses are driven by inflammation.

Inflammation as an Underlying Factor

Inflammation plays a role in many chronic diseases, including heart disease, autoimmune conditions, and metabolic syndrome.

Chronic inflammation can silently damage tissues and organs over time, leading to significant health complications. Identifying inflammation early may help prevent the progression of these diseases.

How Functional Medicine Approaches Inflammation

Functional medicine emphasizes treating the root causes of disease rather than just addressing symptoms. By using personalized lab testing, functional medicine practitioners can uncover hidden sources of inflammation and develop tailored treatment plans to address those specific causes.

While functional medicine primarily focuses on improving nutrition and lifestyle to reduce inflammation, co-management with a rheumatologist may be necessary in some cases to manage autoimmune conditions.

The following tests are often considered by functional medicine practitioners to identify underlying causes of inflammation.

1. Inflammatory Markers: CRP, ESR, and hs-CRP

CRP (C-reactive protein), ESR (erythrocyte sedimentation rate), and hs-CRP (high-sensitivity CRP) are key markers used to detect inflammation in the body.

• CRP: Measures acute inflammation and tissue damage.
• ESR: Detects generalized inflammation over time.
• hs-CRP: Assesses low-grade chronic inflammation, often associated with cardiovascular risk.

When to Order

These markers are commonly ordered when patients present with symptoms of chronic diseases, cardiovascular conditions, infections, or autoimmune diseases. 

How Results Guide Treatment

Treatment for elevated inflammatory markers may involve anti-inflammatory protocols such as dietary changes, the use of supplements (e.g., omega-3s), or medications that target the inflammatory process. 

Monitoring these markers over time allows practitioners to assess the effectiveness of treatment strategies.

2. Cytokine Testing: TNF-alpha and IL-6

TNF-alpha and IL-6 are pro-inflammatory cytokines that play a significant role in promoting chronic inflammation. They are often elevated in autoimmune and metabolic disorders.

• TNF-alpha: a cytokine involved in systemic inflammation and implicated in diseases such as rheumatoid arthritis and Crohn’s disease.

• IL-6: another key cytokine that promotes inflammation and is involved in conditions like asthma, atherosclerosis, cancer, depression, heart disease, AIDS, kidney injury, and sepsis.

When to Order

Cytokine testing is often ordered in cases of suspected autoimmune disease or chronic inflammation, especially when patients show symptoms of fatigue, pain, or autoimmune flare-ups.

How Results Guide Treatment

High levels of TNF-alpha or IL-6 may warrant anti-inflammatory interventions such as cytokine-lowering therapies (e.g., curcumin or omega-3 fatty acids). In more severe cases, biologics may be used to modulate the immune response. 

Results from cytokine testing help practitioners determine whether immune-modulating therapies are needed to address inflammation at the cytokine level. These decisions are best made in consultation with a medical professional, such as a rheumatologist.

3. Autoimmune Screening: Thyroid Antibodies and ANA with Reflex

Autoimmune screening tests help detect the presence of antibodies that target the body’s own tissues, signaling an autoimmune process.

• Thyroid Antibodies (TPO & TG): detect autoimmune thyroid conditions, such as Hashimoto's thyroiditis.

• ANA with Reflex: Screens for autoimmune diseases like lupus, Sjögren’s syndrome, and other connective tissue disorders.

When to Order

Autoimmune screening should be considered in patients presenting with persistent fatigue, joint pain, skin rashes, or other symptoms that may suggest an autoimmune condition.

How Results Guide Treatment

If autoimmune markers are detected, treatment strategies might include thyroid hormone replacement, immune-suppressing medications, as well as diet and lifestyle measures such as anti-inflammatory diets and stress-reduction practices. 

The goal is to manage autoimmune activity and reduce tissue-damaging inflammation. Monitoring these antibodies over time can also help practitioners assess the effectiveness of their treatment protocols.

Any questions about these markers and/or a positive ANA test warrant a referral to a rheumatologist.

4. Adrenal Testing and Inflammation

Chronic stress can dysregulate the hypothalamic-pituitary-adrenal (HPA) axis, causing imbalances in a person’s inflammatory response.

Testing adrenal health can provide insights into chronic inflammatory conditions by revealing dysregulation in the HPA axis, which affects immune modulation and inflammation, especially in the context of chronic stress.

Cortisol and DHEA both have anti-inflammatory effects but can also be influenced by immune system imbalances, potentially contributing to inflammation. For example, low DHEA levels are seen in chronic inflammation, while cortisol may be higher or lower than expected. 

Although the relationship between HPA axis function and inflammation is complex, identifying patterns of unusually high or low cortisol levels can offer additional insights into the immune-adrenal relationship.

• Adrenal Stress Index (ASI): Measures diurnal cortisol patterns and DHEA levels, offering insights into adrenal function and the body’s stress response.

• Cortisol Awakening Response (CAR): An add-on test to the ASI that provides a more detailed assessment of HPA axis function.

When to Order

Adrenal testing is recommended for patients experiencing chronic stress, fatigue, or symptoms suggestive of HPA axis dysfunction, such as sleep disturbances, weight gain, and mood changes alongside chronic inflammation.

How Results Guide Treatment

Treatment may include lifestyle changes, particularly an anti-inflammatory diet and stress-reduction techniques. 

Healthy cortisol patterns can be supported using adaptogenic herbs (e.g., ashwagandha, rhodiola) and nutrient supplementation like vitamins and minerals.

Low DHEA levels may prompt the use of DHEA supplements to support adrenal health. 

5. Omega-6 and Omega-3 Fatty Acid Ratio

The balance between omega-3 and omega-6 fatty acids is essential in controlling inflammation. An elevated omega-6 to omega-3 ratio is associated with increased inflammation, autoimmunity and allergies, and obesity.

When to Order

This test is useful for patients with chronic pain, cardiovascular disease, or autoimmune conditions, as well as those on diets that may lead to an imbalance in fatty acids.

How Results Guide Treatment

If the ratio is imbalanced, increasing omega-3 intake (e.g., fish oil supplements or flaxseed) and reducing omega-6 intake (from processed foods and certain oils) may help restore balance. 

Improving this ratio may reduce inflammation and support cardiovascular health and immune balance.

6. Comprehensive Gut Health Stool Test

By testing key inflammatory and digestive function markers as well as a person’s microbiome, a comprehensive GI test assesses gut health and intestinal inflammation. 

Markers like zonulin and calprotectin can identify conditions like leaky gut (increased intestinal permeability) and intestinal inflammation, which are often linked to systemic inflammation.

Understanding the balance of healthy vs. opportunistic bacteria in a person’s microbiome also provides valuable information that may uncover hidden causes of chronic inflammation. 

When to Order

This test is ideal for patients with chronic digestive issues, irritable bowel syndrome (IBS), or suspected leaky gut. It is also useful when systemic inflammation is suspected to originate from the gut.

How Results Guide Treatment

Abnormal findings may lead to gut-restorative support which can include the use of probiotics, prebiotics, dietary changes, and/or antimicrobial herbs. By improving gut health, practitioners can reduce systemic inflammation and improve overall well-being.

7. Food Sensitivity Testing (Including Gluten Sensitivity)

Food sensitivity testing identifies various immune responses to certain foods, which can trigger systemic inflammation. Gluten sensitivity, in particular, is a common cause of chronic inflammation in susceptible individuals.

Food sensitivity testing may include assessment of various biomarkers including IgG, IgA, IgE, or IgM, as well as certain immune proteins (called complement), and/or responses of white blood cells to certain foods. 

Celiac disease testing requires a specific set of tests. The required tests for celiac disease diagnosis include the Tissue Transglutaminase IgA (tTG-IgA) test, total serum IgA test, Deamidated Gliadin Peptide (DGP-IgA and IgG) tests, and the IgA Endomysial antibody (EMA) test; a biopsy of the small intestine is also necessary for a definitive diagnosis.

When to Order

This test is recommended for patients with unexplained digestive issues, skin conditions, migraines, or autoimmune symptoms that may be linked to food triggers.

How Results Guide Treatment

Positive results guide dietary changes, such as eliminating gluten or other reactive foods. An anti-inflammatory diet can help reduce systemic inflammation, improve digestion, and alleviate symptoms related to food sensitivities.

8. Mold/Mycotoxin Screening

Chronic mold exposure may lead to systemic inflammation (a condition called chronic inflammatory response syndrome) and a host of symptoms from respiratory issues to chronic fatigue. Mold/mycotoxin screening helps identify exposure and related health risks.

When to Order

This test is useful for patients with chronic fatigue, respiratory symptoms, or unexplained health issues, particularly if they live or work in mold-prone environments.

How Results Guide Treatment

Positive results necessitate mold remediation in the environment and detoxification protocols, such as the use of binders (e.g., activated charcoal) and glutathione. Addressing mold exposure and detoxifying the body can help reduce inflammation and improve long-term health outcomes.

9. Lymphocyte MAP from Cyrex Laboratories

The Lymphocyte MAP analyzes various immune cells and biomarkers for a comprehensive immune balance assessment, providing insight into chronic inflammation patterns. It is particularly useful for identifying immune dysregulation.

When to Order

This test is ordered for patients with chronic infections, autoimmune diseases, or suspected immune imbalances that may be driving inflammation.

How Results Guide Treatment

Results from the Lymphocyte MAP help guide immune-modulating treatments such as vitamin supplementation or immune-supportive herbs. Balancing the immune system helps reduce chronic inflammation and improve health outcomes.

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Key Takeaways

• Critical Role of Inflammation: Chronic inflammation is a fundamental factor in many chronic diseases, including autoimmune disorders, cardiovascular disease, and metabolic syndrome.
• Comprehensive Functional Testing: Functional medicine utilizes a variety of lab tests—such as CRP, ESR, hs-CRP, cytokine panels (TNF-alpha, IL-6), autoimmune screenings (Thyroid Antibodies, ANA), adrenal assessments, Omega-6/Omega-3 ratios, gut health stool tests, food sensitivity tests, mold/mycotoxin screenings, and Lymphocyte MAP—to identify underlying causes of inflammation.
• When to Order Tests: These tests are recommended for individuals experiencing chronic symptoms like fatigue, joint pain, digestive issues, skin conditions, respiratory problems, or signs of autoimmune activity.
• Personalized Treatment Plans: Test results guide tailored interventions, which may include dietary modifications, supplements (e.g., omega-3s, probiotics), lifestyle changes, stress management techniques, and, in some cases, medications or specialist referrals.
• Holistic and Preventive Approach: Functional medicine emphasizes addressing root causes and preventing disease progression by integrating multiple aspects of health, thereby complementing conventional medical practices.
• Ongoing Monitoring: Regular testing allows practitioners to track inflammation levels, evaluate the effectiveness of treatments, and make necessary adjustments to optimize health outcomes.
• Empowerment Through Insights: Comprehensive testing empowers both patients and practitioners to make informed decisions, fostering proactive management of inflammation and overall well-being.