Ooh, I have spent hours today comparing the main gut tests now available. It is a veritable minefield, I can tell you – and you’re never quite sure where the ‘sales’ information is coming from, if you know what I mean.
Anyway, I have tried to cut through the inevitable ‘this is the best thing since sliced bread’ enthusiasm you get when a new type of test launches and assess it with a beady eye on clinical utility for you. ‘Will it work, is it worth it, what should I do?’ sort of thing.
I have much to learn and assess yet, but I have today rejigged the Gut Tests Overview a bit to reflect the new molecular PCR/DNA microbiome testing for pathogens and added the Diagnostic Solutions’ GI-MAP test for you.
Here’s my blurb on the Gut Tests shop page for you and you can get the test and more info here:
Gut Tests Overview
There are lots of different types of gut test and it generally depends on what you want to know. Here is a simple (ha!) overview with my key recommendations. Click on each test link to go to the lab sites for details, collection instructions and sample reports.
In general, most gut tests will look for absorption, inflammation and immunology markers. The difference comes in how we look for any bacterial, yeast, parasitic and viral pathogens present and your choice of test really comes down to what you most want to know.
There are now two main ways to test the microbiome – the gut environment – for pathogens. You can do the usual culture, microscope and mass spectrometry way of looking at what’s in the gut, such as the DD CSAP3 and CDSA2 tests below, or you can use molecular DNA/PCR testing, such as the GI-MAP and GI Effects below; a new way of picking up stuff you can’t find in the samples. There is mass controversy about which is best in the industry, of course, and it really depends who you are listening to at any given time! Here is my take on it – and I will update this as necessary, of course. I have listed both types because I get asked for both.
In short, in my view: if you want a general gut screen, do a DD CSAP3. If you want specifically to look for baddies in the gut, do a GI-MAP. Check what each test includes as they vary. In an ideal world, most experts think you should do both types if you want to find the most stuff. Sorry, don’t shoot me 😉
The DD CSAP3 is the best ‘traditional’ test in my view. There are lots of reasons for this and I have studied the different tests long and hard. In the end, I think this one gives you the most useful and effective testing for the money. It covers bacteria, yeasts, inflammation, parasites (3 days, which is important as they hide!), malabsorption, short chain fatty acids, leaky gut, blood presence and SIgA. You can do the same test without parasites if needed as the DD CSA (Comprehensive Stool Analysis). You can also add several things onto this test and/or do the elements separately. See here for a list of Doctors’ Data gut tests. I can confirm prices if you need something. The DD test samples are returned to a UK lab for onward shipping.
Incidentally, sometimes you only need to go back and check if a bacteria found in the CSA/CSAP3 has gone and you don’t need a full re-test. In this case, use the DD Bacteriology Culture Test.
There are two main other alternatives to this kind of comprehensive testing: Genova’s CDSA2P, which includes parasites and CDSA2 without. Some people prefer this one historically as it’s been around a long time. Again, you can add stuff on or do elements separately. See here for a list of Genova’s stool tests.
Molecular DNA/PCR Testing
Here, I like Diagnostic Solutions’ new GI-MAP (Microbial Assay Plus). The GI-MAP measures opportunistic organisms (including H pylori which is an add-on with the other tests usually and a very useful one to look at), normal flora, yeasts, parasites, viral pathogens and antibiotic resistance genes as well as absorption markers (Elastase), inflammation (lactoferrin) and immunology (SIgA). It also includes occult blood and an anti-gliadin test. You can see a sample report and collection instructions here.
And, if you want to read much more deeply about microbiome testing using PCR and see the whole list of pathogens included, see Diagnostic Solutions’ white paper here. The difference with this one is mainly the viral pathogens, H pylori, a coeliac gliadin test (which I would not rely on to rule out coeliac disease – see the Gluten tests section) and the antibiotic resistance genes. You don’t get a lot of interp help or a pretty report on this one but they have written the huge white paper above which certainly will help you. This is returned to the UK lab for onward shipping.
You can also do PCR testing using the Genova GI Effects Comprehensive test. This measures similar pathogens (but not viral) as well as markers for absorption (elastase, fecal fat), inflammation (calprotectin, EPX etc) and immunology (SIgA). I also like the fact it includes the SCFAs including the butyrate level as I see that a lot as a main cause of leaky gut (this is also in the DD CSAP tests which is one reason I like it). If you read the GI Effects Interpretation Guide, it shows how each bacteria is linked to illness. It can be very useful to make connections, of course, if a bacteria comes up which matches your symptoms – at least you have more of an idea what’s causing it! I do like their instant interpretation on the report and the Interpretive guide is very useful. Again, returned to the UK lab for onward shipping.
Overall: check the sample reports and read up to establish which test covers what you most want to know.
Ok, hope that is clear. I shall be testing you later on it – ha ha, see what I did there?! See the Gut Tests here, especially if you need more info on candida, SIBO etc.