Gut Tests

HOW TO ORDER LAB TESTS….

You can view details, sample reports, collection instructions and order all tests mentioned via
Regenerus (RG),
Medichecks (MC),
Invivo, (IV, use code BO2QKE_890 when prompted when registering)
Genova (G, use code A42RS when prompted during the order process)
Biological Testing Services (BTS, email and give my name Micki Rose).

Use the search facility at each lab to find the test I’ve mentioned. Please direct all questions on doing tests, shipping, payment and getting results etc to the lab, thanks. Medichecks includes phlebotomy, Regenerus, Invivo and Genova have lists of phlebotomy clinics where you can get blood samples taken. For help before ordering or with results afterwards, see Support options here.

Unsure if you need a Gut Test?

The gut is usually where we start looking for clues in any chronic condition, especially in any kind of food sensitivity, digestive issues like boating, wind, poor immunity, autoimmunity, but also for things like brain fog. Have a read of these factsheets and see if anything resonates with you: IBS, SIgA, SIBO, Leaky Gut, Allergy & Intolerance, Low Stomach Acid, Acid Reflux/Gerd.

Testing Summary

The best overall gut test is the DD GI360 (RG). It just gives so much useful, practical information about your gut. I especially like the markers included to help find causes of food sensitivity. For specific tests, use the SIBO, Leaky Gut, GastroPanel and Candida from IV or BTS as below..

The GI360

After a detailed review (2020) of the gut tests available – no easy task, I can tell you! – I rate the DD GI360 (RG) as the best gut test around. The DD CSAP3 (RG) is a bit cheaper because it doesn’t include the extensive PCR testing, but is still very useful. The Genova CDSA (G), GI-Ecologix (IV) GI-Effects (G) and the GI-MAP are also good (however the latter is not easily available now in the UK), but I think the GI360 supercedes all of those. You an read my blog post here if that helps:

Gut Tests Review – GI-MAP, GI-360 or GI -Effects?

Essentially, the GI360 covers PCR and MALDI-TOF types of testing for bacteria, yeasts (including candida), parasites and some key gut viruses, but also uses microscopy and culture to confirm things.

It gives you useful clinical information on inflammation levels, malabsorption, short chain fatty acids (important for food sensitivity, infections etc), leaky gut, blood presence and SIgA (the gut immunity and food ‘safety’ marker) and also gives you an idea of what natural and antibiotic remedies any ‘baddies’ found are most sensitive to – in your particular case.

You have the option of doing 1, 2 or 3 day collections – I always prefer at least 2, preferably 3, because parasites hide and you’ve more chance of finding them.

If you wish, you can do versions with Zonulin (a leaky gut marker) and/or H pylori. If you wish to test the microbiome only (ie. look for pathogens, check progress of them) without the stool markers, you can do that with the GI360 Essentials (RG). If you wish to check the markers (ie. the inflammation, SCFAs, absorption etc) but not the microbiome, you can do that using Stool Chemistries (RG).

Candida

Candida and yeasts are generally covered in the comprehensive tests above. But, if your test comes up negative and you still suspect it OR you simply want a good candida test done OR you want to double-check if a positive finding is a significant one, I would look for a SAPS positive candida. Everyone has a level of candida in their gut. The question is whether it has changed to the mycelial form, which is when it becomes pathogenic (ie. needs treating). There is only one lab who looks for that, and they also include a moulds check too – have a BTS Candida (Mycology) Test (BTS). This is a stool test with a mouth swab to check for candida in the mouth too – is that where it’s getting in?! See in Tips below for what supplements to stop before the test.

SIgA (Secretory IgA)

This is a measure of mucosal immunity (ie. in the gut, sinuses, vaginal areas etc). Put simply, if your SIgA level is too low, you will find it very difficult to fight off ‘baddies’ like yeasts and bacteria. You then need to work to raise your levels first. If your SIgA is too high, it suggests an acute problem somewhere – usually inflammation, infection or a sensitivity to something (eg. a food intolerance). You can read much more about SIgA in my SIgA factsheet here.

SIgA is measured in the stool tests but you can do it separately too. Do SIgA Stool (RG) if you suspect a gut problem, or SIgA Saliva (G) if you have problems elsewhere. Often, doing both gives you a better picture.

SIBO (Small Intestine Bacterial Overgrowth)

The AeroDiagnostics SIBO breath test (IV) is a good choice here. I like the report on this one because it clearly shows the result rather than just a graph. This breath test is done using lactulose as the test substance which is what SIBO guru Alison Siebecker recommends. There is a glucose SIBO test (IV) if you prefer.

For info, the ingredients of the lactulose substrate in tests is: 10 g lactulose (and less than 1.6 g galactose, less than 1.2 g lactose, and 1.2 g of other sugars). Also contains FD&C Yellow No. 6, purified water, USP and wild cherry flavoring. A minimal quantity of sodium hydroxide, NF is used to adjust pH when necessary. (Not dairy free). And the glucose: DEXTROSE, HYDROUS, POWDER, USP. Synonyms: Corn sugar; Dextrosol; Glucose, monohydrate (not grain free). However, please check with the labs before use as this may not be up to date!

Here is my video about the SIBO test:

There is also a new type of SIBO test from Cyrex now – Cyrex 22. This is very different to the breath test in that it is looking for antibodies to bacterial cytotoxins released in SIBO rather than the gases we produce. It also looks for evidence to see if the cytotoxins have caused a leaky gut. I can’t say I have done much of it as the breath test is usually sufficient, but I alert you to it anyway.

Leaky Gut

In terms of leaky gut, a lot of the time you can assume it is present because of the case and just treat. If you have food sensitivity or autoimmunity, it’s practically a given. Testing leaky gut is surprisingly complex. There are several different markers and just because one says it is negative, it might well be that others could be positive. Of course, life would be simple if there was a test that looked at all the markers, but there isn’t yet.

Overall, I would say assume and treat for leaky gut anyway, but sometimes it can be useful to have a marker you can check for monitoring progress. The Advanced Intestinal Barrier Assessment (IV) looks for zonulin, histamine, DAO and the all-important LPS (lipopolysaccharides), which show bacterial complexes are getting through into the system. I also like the PEG test you can get from Biolab.

Stomach Problems

Most of the issues so far have concentrated on the lower gut, but what about the stomach? This is where the GastroPanel (IV) comes in useful. GastroPanel® is a blood test, which provides information on the status of your stomach mucosa, possible helicobacter pylori infection or low stomach acid, also known as achlorhydria or hypochlorydia. The test can also estimate the risk of developing vitamin-B12 or micronutrient deficiency. It measures four antibody markers to pepsinogens, gastrin and Helicobacter pylori and the test comes with a report on what the specific mix of results on your report means. So useful.

HOW TO ORDER LAB TESTS….

You can view details, sample reports, collection instructions and order all tests mentioned via
Regenerus (RG),
Medichecks (MC),
Invivo, (IV, use code BO2QKE_890 when prompted when registering)
Genova (G, use code A42RS when prompted during the order process)
Biological Testing Services (BTS, email and give my name Micki Rose).

Use the search facility at each lab to find the test I’ve mentioned. Please direct all questions on doing tests, shipping, payment and getting results etc to the lab, thanks. Medichecks includes phlebotomy, Regenerus, Invivo and Genova have lists of phlebotomy clinics where you can get blood samples taken. For help before ordering or with results afterwards, see Support options here.

Testing Summary

The best overall gut test is the DD GI360 (RG). It just gives so much useful, practical information about your gut. I especially like the markers included to help find causes of food sensitivity. For specific tests, use the SIBO, Leaky Gut and GastroPanel from IV as described below.

Testing Tips…

Q: Why do you like the Doctors’ Data GI360 so much?

There are many gut tests. The reason I went for this one is that it is really comprehensive and uses PCR/DNA testing as well as MALDI-TOF analysis so you’re likely to find more ‘baddies’ if they’re there, plus a really useful raft of stool chemistry markers that allow me to see patterns causing eg. food sensitivity, or reasons for poor detoxification, why you can’t fight off infections well etc. It looks for actual fibres of veg and protein in the stool and includes a carbohydrate malabsorption check as well as fat. It also has lysozyme, a good inflammation marker the others don’t have (they all have inflammation markers but this is an extra in the Doctor’s Data version). It also includes occult blood (an important bowel cancer test) and a consistency check, which the others don’t. Bonus: it’s cheaper both to buy and to return to the lab.

Q: Why do you do a 3 day version? Can I do 1 or 2 days?

The reason I recommend three is that parasites hide and it is best to have a 3 day sample to give yourself the best chance of finding them. One tip: if you wish to make sure parasites are found, some practitioners suggest you ‘purge’ your bowel eg. using Vitamin C, magnesium or something from your health shop/pharmacist (not salt or castor oil) on the 3rd day so you get a ‘clear-out’ if you like. Then use that for your third day sample. Yum!

Q: Sadly, I don’t go to the loo that often. What if it takes me several days to get the three samples?

I asked the lab this for someone who was taking 9-10 days to get the three samples, which is about the limit really I would say. They advised: The samples need to be with us within 4 days of the LAST day – the chemistry tube (frozen) and the parasites (preservative) keep them viable. The culture tube on the last day is the most time sensitive.

Q: Any advice on stopping supplements etc?

For gut tests, my standard advice is to do the following unless you are monitoring yourself on them – please be led by your health professional and the specific instructions in your test kit/on the lab sites; these are my general tips:

Please make sure you stop taking any probiotics (bacteria eg. acidophilus) at least 5 days before doing the test.

For candida, stop any form of anti-fungal (eg caprylic acid, oregano, garlic etc) at least a week before. You should stop taking all anti-fungal supplements at least a week before you take your sample (e.g. caprylic acid, garlic capsules, grapefruit seed extract, oregano oil). Two days before you take your sample avoid fungi-food eg. camembert, brie, stilton, kefir, kombucha and stop taking any probiotics for 5 days before the sample is taken. Natural probiotic yoghurt is fine.

For parasites, stop taking any anti-parasitics at least a week before.

For the pancreatic function test, this will be affected by any pancreas meds and pancreatic enzyme products, including glandulars.

The SIgA and leaky gut tests will be affected by any supplements designed to assist them eg beta glucans, glutamine, saccharomyces boulardii, collagen etc, so stop these a few days before unless you are monitoring yourself on them.

Immune-suppressant medication may affect the inflammatory markers, specifically Calprotectin and Eosinophil-Protein X, though the labs cannot predict exactly how these medications may impact the test results. They say: “We never recommend patients discontinue medically prescribed medications in order to do testing. With regards to medicines in general, we cannot know for certain how long a specific dosage will impact test results. Patients on regular medications can continue during testing to see how they are impacting. However if the medication is temporary they may choose to wait until the medication course has been completed.” Wise words.

HOW TO ORDER LAB TESTS….

You can view details, sample reports, collection instructions and order all tests mentioned via
Regenerus (RG),
Medichecks (MC),
Invivo, (IV, use code BO2QKE_890 when prompted when registering)
Genova (G, use code A42RS when prompted during the order process)
Biological Testing Services (BTS, email and give my name Micki Rose).

Use the search facility at each lab to find the test I’ve mentioned. Please direct all questions on doing tests, shipping, payment and getting results etc to the lab, thanks. Medichecks includes phlebotomy, Regenerus, Invivo and Genova have lists of phlebotomy clinics where you can get blood samples taken. For help before ordering or with results afterwards, see Support options here.