What does your functional stool test actually tell us?
We talk a lot about gut health here at Above Health, and the best tool we have to understand and support the unique environment of the gut is a functional stool test called the GI Map.
If you’re experiencing any of these symptoms:
Constipation
Loose stools
Heartburn or acid reflux
Nausea
Skin flares: Eczema, psoriasis, acne, keratosis pilaris, etc
Fatigue
Autoimmune conditions
Headaches
It might be time to run a GI-Map test to get a deeper look at the environment of the gut and identify the root causes at play leading to your symptoms.
A GI Map test is a comprehensive stool test that measures over 75+ different gut health markers to provide deeper insight in the environment of the gut. The markers on the GI map test are functional markers, meaning they uncover information needed to build a customized healing protocol to restore optimal digestion and eliminate symptoms. The key to best outcomes with the GI map test is not to just treat the test, but to work the client's history, symptoms, personal story and test results to best identify the true root causes and create protocol that reflects nutrition, lifestyle and supplements. The most important part of getting a functional stool test is working with a provider who understands what the true root causes are for gut health and who interprets the results with a critical eye. As the stool test results alone are often more nuanced, which we will explore as we dive deeper into what you can find on a GI Map stool test.
Some highlights of the GI Map test include:
Health of the protective beneficial bacteria population
Presence of any pathogenic organisms including H. pylori, parasites, worms, yeast, candida and other opportunistic bacteria species
Levels of digestive markers to uncover any areas of maldigestion
Presence of gut inflammation
Strength of the protective gut immune function
Gluten sensitivity marker
Let’s take a look inside at the GI Map test:
Before we dive in, let’s quickly go over what the values mean. Below examples will show you what the GI Map test looks like. The middle “results” column is sharing the results of the individual test, a value of <dl means below detectable limits which essentially means not present or negative. The “reference” column refers to the potential level that the organism or marker could be at without causing pathogenic activity. That is because we have to remember the gut is a transient organ where lots of microbes come and go - we are only really focused on microbes that stay and build a substantial population…but accurate interpretation really relies on a seasoned practitioner as exceptions to that rule exist. Lastly, when we look at the results, there is an exponent value after the results number such as 1.21e5, the e5 value means the actual number has 5 zeros after it. So when we compare the results number to the reference number, I am really only comparing the exponent values and not the actual number in front to understand the level of significance.
O.K., Lets dive in!
Pathogens
The first section of the GI Map shows the potential presence of bacterial, parasitic and viral pathogens. These are some bigger pathogenic infections that can often result in diarrheal disease-type symptoms and can often be the culprits behind events of food poisoning or travel sickness. Others, like C.difficile can come from overuse of antibiotics that clear out protective beneficial bacteria and can put a gut at risk of acquiring opportunistic overgrowth from the environment. This is often called a hospital acquired infection and can be challenging to clear but not impossible at all! Treatment protocols are based on the test as a whole to fully address and heal the gut so as to not increase more risk of future infection which is why we often will use herbal blends or high dose probiotics that have clinically shown to clear the specific infection we aim to support.
H.Pylori
The next section looks specifically at H.Pylori, which is a bacteria that lives in the stomach environment. This bacteria is hotly debated as to its role as a potential pathogen or normal part of the body's ecosystem. H.Pylori can cause chronic inflammation in the stomach, suppress stomach acid and depending on the specific virulence factor strain can increase risk of ulcers and stomach cancer. When this is present and more pathogenic we typically see it cause upper GI symptoms most notably heartburn, pain, burping and can also lead to bloating and constipation due to disruption of optimal digestion at the top of the system. It also can play a major role in skin conditions such as acne, eczema and others. However, H.Pylori can also exist without symptoms and has even been shown to play a protective role against upper GI pathologies. So as you can see, if H.pylori is present it is not always straightforward as to its role and the skilled provider needs to take the whole test, individual symptoms and history all into account. If H.pylori does need to be treated we use directed anti-inflammatory products that work to suppress and clear the overgrowth without devastating the protective microbiome that is actually the main long term protection from reinfection.
Beneficial Bacteria
The next section focuses on the protective beneficial bacteria that are the most important foundation for a healthy gut and body. These bacterial species are known as keystone species which mean when they are present in optimal ranges the entire microbiome is more stable and thus the individual experiences greater resiliency in their gut health. These bacteria eat the fibers in our foods and produce as a by-product essential nutrients such as B vitamins, vitamin K, anti-inflammatory compounds such as short chain fatty acids (SCFA), protect from pathogenic organisms, build and maintain the protective barrier of the gut and much more. Just like goldilocks, we don’t want to have too high or too low levels of our beneficial bacterial species. Depending on the result, there are specific interventions to nourish our beneficial bacteria back into optimal levels.
Opportunistic Bacteria
Opportunistic bacteria are organisms that can exist in the gut environment for a whole host of root cause reasons and interpretation of this section is extremely important to have an expertly trained eye as the solution is not just to treat overgrowths but to understand why they are able to persist in the gut in the first place. Opportunistic bacteria are opportunists, meaning they are taking advantage of a gut environment that is typically not functioning optimally. Often we can see overgrowths of opportunistic bacteria due to:
Low levels of protective beneficial bacteria
Congested drainage systems especially involving the flow of bile
Inflammatory diet
Low stomach acid
Poor eating hygiene
High stress levels
Poor oral health or dental hygiene
Mold toxicity or environmental toxins
Antibiotic use
Parasitic or other pathogenic infections
These opportunistic bacteria can be problematic and lead to symptoms if there is an imbalance but do not necessarily always lead to digestive symptoms depending upon the species present. However, in high levels many of these microbes can cause inflammation especially in vulnerable individuals and can lead to symptoms such as:
Loose stools
Abdominal pain
Constipation
Bloating
Skin conditions: eczema, acne, rosacea, etc
Autoimmune flares
While this is not a formal test for Small Intestinal Bacterial Overgrowth, higher levels of some specific opportunistic bacteria is often seen in conjunction with SIBO.
The autoimmune related bacteria section shows the bacteria that have been associated with autoimmune conditions but that alone should not ring the alarm for autoimmune conditions; however, the health of the gut has a tremendous impact on the immune system and can play a significant role in the progression and development of autoimmune conditions. That is why we always suggest clients with autoimmune conditions or any practicing prevention of autoimmune conditions to explore their gut health with a functional stool test.
Fungi/ Yeast/ Viruses
Fungal organisms are part of normal flora in the body; however, when they show up as overgrown on a stool test, this can be indicative of other dynamics present in the body such as:
What causes overgrowth of fungus and yeast?
Impaired immune function
Nutrient deficiencies
Mold or environmental toxin exposure
Parasite or pathogen infection
High antibiotic use
Imbalanced blood sugar
Low stomach acid
When yeast and fungus are present at an elevated level it is most important to understand how and why these organisms are able to thrive rather than just blindly treat with anti-fungals. As with so many aspects of Functional Medicine, it is most important to understand the bigger picture of why.
The GI map tests for two viruses but it will only appear if the virus is active, it doesn’t show prior cases.
Parasites
The GI map test also includes a section for stealth infections that test for both parasites and worms. These organisms are notoriously challenging for any test to show positive and often when working with clients we assess for stealth infections through symptoms, presentation and history along with functional test results.
Parasite and worm symptoms can manifest in many forms such as:
Digestive symptoms often constipation but not limited top
Challenges with sleep
Mood imbalances
Fatigue
Skin conditions
Itchy butt
Teeth grinding
Nutrition deficiencies
Muscle and joint pain
Infections come from:
Water or food
Ocean or lakes
Pets
Soil
Insect bites
If a parasite or worm infection is present or believed to be present protocols based on the specific organism and other areas of the GI map test as well as history, symptoms, and client experience, are all taken into account to develop a customized protocol to address all key areas to clear and heal the gut environment for long term resilience.
Intestinal Health
The intestinal health markers are my personal favorite and often the most impactful part of the GI Map test for helping to support clients healing. These markers provide insight into the health and function of the gut organ as a whole which can have the greatest impact as to what may be leading to pathogenic overgrowth or infection markers as seen above. The intestinal health markers are the first area I often support with clients to rebuild the most health resiliency in the gut.
Digestion
These markers indicate the production of optimal amounts of key digestive secretions that help to chemically break down food. Steatocrit, if elevated, gives insight into maldigested fat in the stool. Bile is a key digestive substance to break down dietary fat and absorbs fat soluble nutrients key for immune function, skin health and brain health. It is also suggestive of congestion of bile from the liver which is a key area of our drainage system and can suggest impaired detoxification function. Elastase-1 if low suggests low digestive enzyme production from the pancreas which can lead to digestive symptoms most specifically post meal symptoms. Often a low level can suggest low levels of stomach acid due to stress, poor eating hygiene, lack of minerals, dehydration or H.pylori that impair the signaling to the pancreas to release digestive enzymes.
GI Markers
Beta-glucaronidase is an enzyme that helps to recycle key nutrients; however, if elevated can over recycle waste products from the gut such as estrogen and other waste products that can contribute to hormone imbalances and overall poor drainage and stress detoxification systems.
Occult blood assesses for blood in the stool and when elevated suggests inflammation and further investigation into the source of that blood in the GI tract.
Immune Response
Secretory IgA is an immunoglobulin that functions as the gut immune system and our first line of defense against antigens, pathogens or infection. If secretory IgA is too low or too high, this indicates need for gut immune support such as key immune nutrients, stress practices, immunoglobulin support or clearance of infection or antigens.
Anti-gliandin can indicate the immune system reacting to gluten, suggesting gluten sensitivity. When this is elevated a trial of a gluten free diet is suggested and often further testing into deeper gluten sensitivities and gut barrier health is warranted.
EPX is a protein released by activated gut cells that suggests inflammatory action in the gut often in response to pathogens and viral exposure. This marker can be elevated in IBD.
Inflammation
Fecal calprotectin is a marker of gut inflammation. Elevated calprotectin can be the marker that distinguishes between inflammatory bowel syndrome (IBS) and inflammatory bowel disease (IBD). A marker we focus and measure consistently when working with IBD clients.
The GI map test is an invaluable tool to more deeply understand the unique root causes at play in an individual's gut. But as the saying goes, “what happens in the gut, doesn’t stay in the gut” suggesting the influence the gut can have on the systemic body impacting everything from skin health, immune health, mood, brain and cognitive function as well as energy and fatigue. At Above Health Nutrition we provide our clients access to functional testing as a tool to more deeply understand what is driving poor health symptoms and utilize the results to create a customized protocol based on the unique client. Our goal is for our clients to understand the unique story their body tells when under stress, so that they can grow in deeper understanding to take the needed and appropriate actions now and into the future to better support their health from the inside out.
If you are interested in exploring functional testing, we would love to help guide you. The best way to guide you is by booking a complimentary 30-min strategy call with us to discuss your goals, any symptoms, and history and together we can discuss what support path would best fit your needs!
Take gut healing into your own hands with our FREE downloadable Supplement Guide to Gut Healing!
Inside of our Supplement Guide to Gut Healing, we share with you the top supplements that we use with clients to help support some of the most common digestive symptoms. Our goal is to empower you with hands-on tools to improve your gut health, reduce your digestive symptoms and increase your overall quality of life!
Each of these supplements in this guide target specific symptoms you may be experiencing. Choose the products that speak to your symptoms and track your symptoms over the course of using the supplements to best understand if the supplement is helping to alleviate the desired symptom or produce the desired result.
We hope this guide offers support and clarification on some of the most powerful tools we have to promote gut healing on top of foundational nutrition and lifestyle practices.
We look forward to hearing about how the guide has helped you!
