Stool Testing FAQ’s

Clinicians often ask us about sensitivity markers when yeast or bacteria are found on a stool test, so with the help of Metametrix we’ve put together some FAQ’s to help:

Q: When is sensitivity testing provided:

A: Sensitivity testing done when a yeast, fungi or opportunistic bacteria are identified on a stool test. Sensitivity testing is not performed for parasites or pathogenic bacteria.

Q: I’ve got a positive yeast result on my stool test, but the sensitivity page is blank, reporting “Unable to determine sensitivity to pharmaceuticals and botanicals due to the lack of growth of fungi / yeast in vitro”.

A: We identify the yeast /fungi by DNA. If something is found we do sensitivity testing by growing the yeast/ fungi in culture and then testing specific anti-fungal agents against it to see what may slow growth or kill the organism. Yeast are very difficult to culture (grow), they have specific preferences for nutrients, oxygen and pH, and all labs struggle with this issue. If it will not grow in vitro we cannot perform the sensitivity testing.

You will note that most labs utilizing culture as their means of identifying yeast also employ a visual or microscopic report of yeast for this very reason. Again, labs struggle to grow yeast. So they may tell you there is yeast present by microscopy but because it did not grow they cannot ID the yeast or provide a sensitivity report.

In the case that the yeast does not grow and no sensitivity report is available a product that contains a blend of known anti-fungal botanicals or pharmaceuticals like Fluconazole or Nystatin are commonly used.

Q: What about pathogenic bacteria – when the sensitivity page is blank for these, is it for exactly the same reason?

A: The pathogenic bacteria are mostly anaerobes (grow without oxygen) and therefore culturing them would be very costly (you must create anaerobic conditions to grow them). Regardless of what method is used to ID them, DNA or EIA tests you still have the same issue when performing a sensitivity test: labs must grow it. The recommended practice is to refer to a PDR or another reference for treatment options and dosages.

Q:  Why are sensitivities tests not conducted for parasites?

A: There are no commercial labs culturing parasites. The reasoning is twofold. First, they are very difficult to grow in vitro. Researchers can get them to grow and have for studies but at a high cost. The second reason is that unlike bacteria and even yeast to a smaller extent, protozoa evolve very slowly and therefore effective treatment options have remained the same for decades.

For more information on DNA Microbial Comprehensive Stool Testing in the UK www.nutritiongeeks.co.uk

Clinician under the Spotlight: Heidi Bohrn

It was great to see so many clinicians at our conference last month. Consistently the feedback from these events is that, on top of the fabulous clinical insights, clinicians really enjoy the network opportunities and the chance to learn and grow from each other. We thought we could help maintain those sharing opportunities with a new feature “Clinician under the Spotlight’. Stepping up to be the first one under the spotlight is Heidi Bohrn.

NG: Tell us a bit about yourself: how long have you been in practice, where did you train?

HB: “My name is Heidi Bohrn (NT dip CNM mBANT AFMCP) and I have been practising as a nutritional therapist over the past 2 years. I studied at the College of Naturopathic Medicine in London and have conducted further studies via The Functional Medicine University as well as recently completing the AFMCP-UK course run by The Institute for Functional Medicine. I became interested in nutrition after being diagnosed with M.E, after 5 years of suffering with the debilitating illness I turned to nutrition and supplements to get myself better and have never looked back since. I am very happy to pronounce that I’m symptom free since turning to the powers of nutrition. Like many people in this profession I want to enlighten as many people as possible as to how food really does make an impact on people’s health and their overall wellbeing.  I am also a zest4life practitioner where I run weekly weight loss health seminars to the local community.”

NG: What was the first lab test you ran and what did you learn from it?

HB: “When at college studying, I released that I definitely wanted to take a more scientific approach in identifying underlying causes as I feel you can be more targeted in your treatment plan and you gain more compliance from your patients. My first test was a cardiovascular panel for one of my case study which so happened to be my mother. She had been suffering from high blood pressure and didn’t want to go onto statin’s. The test allowed me to be so targeted that within 6 weeks her blood pressure went from 168/80 to 139/80, even my teacher was surprised at such results.”

NG: What’s your favourite test panel and why?

HB: “For me it has to be the Metametrix Comprehensive Stool Test (Gifx), I find I am ordering a least 2 of these tests a week. Time after time I find positive results for pathogenic invaders; this is a must for anyone who is suffering from any digestive disorders. I really find this test so useful, it covers the whole spectrum of pathogens including H. Pylori and this is one key areas that I feel other stool tests are lacking. This stomach bacteria seems to rife in the UK and from once my patients have addressed their H. Pylori we find that lots of their symptoms seem to disappear, even symptoms that are not even related to digestive function such as high blood pressure and heart murmurs . I find this test to be so much more precise in picking up parasites as it tests the DNA rather than the culture that other tests analyse.”

NG: Is there one intervention, dietary, supplement or lifestyle that you think delivers most change for your clients?

HB: “To me balancing out blood sugar levels via a low GL diet is quick, effective and doesn’t cost your patient the earth. Installing clients with a low GL food protocol such as eating 3 times a day and eating protein with each meal is such an easy and cost effective way for patients to see many benefits.  Not only weight loss, but other health benefits such as better mood, less cravings, reduced PMS, reduce blood sugar markers, an increase of energy and the elimination of acid reflux are all benefits that can be gained from the installation of this healthy eating plan. I am a big advocate of a dietary plan as it integral to the Zest4life plan designed by Patrick Holford, which I teach on a regular basis.”

NG: Who are your favourite educators / gurus in the nutrition or functional medicine field?

HB: “Such a tough question…with so many experts to draw inspiration from I really would find it impossible to pick just one. However I do love experts who provide clinical expertise and deliver material in such a fashion that it can be immediately implemented into working practises so I would have to say that I’ve always been impressed with experts such as Dr Weatherby, Kara Fitzgerald and from IFM -Kristi Hughes and Mark Hyman.”

NG: What’s the best business / practice advice you’ve ever received?

HB: “Always start with digestion. They say the seed to good health starts in the gut and from a clinical view point this has been proven for me. When I first started my treatment plans I was all over the place, I was trying to fix all symptoms at once and not focus on being targeted.  I now initially focus on digestion and then (un)surprisingly a lot of the other areas of concern tend to calm down, for me it the quickest way to make an immediate impact on your client. Immediate success obviously helps with client retention and from once your client returns you can then focus on deeper routed health concerns.”

NG: What’s the secret of your success?

HB: “Keep learning!  In our profession you can never stop learning, we are in a sector where new research is becoming available on a daily basis and you need to be up to date with your research and protocols. I love to learn from the experts and believe it has allowed me to grow as a practitioner very quickly!”

NG: How do you switch off after a busy day in clinic?

HB: “I live in a beautiful village set in rural area just on the outskirts of greater London, so I try and go for a walk each night to switch off. I think it is important to cut yourself off from work as what we do can tend to be quite demanding. I also try not to see clients at the weekend as this is my time that I reserve for my family because without them I would not be able to help others.”

Find out more about Heidi’s clinic from her Alternative Nutrition.

Who should we feature next? Send your nominations (or nominate yourself) to support@nutritiongeeks.co.uk

Angela Walker BSc Nut Med mBANT CNHC registered

Technical Advisor, Nutrition Geeks

 

The low down on Organix technology

We’re often asked about the differences are between laboratory testing methods and machinery used by Metametrix and some of the other laboratory companies. Its a great question to ask and so we wanted to share something from Dr Bralley, which we think does a great job at explaining the technical differences and the effects these have on the lab tests. There are links provided to a summary table and copy of the article mentioned

“Hi Don, Attached is a brief summary comparison of the two types of analytical techniques used to measure and report organic acids [download copy here]. We started years using GC/MS years ago when we pioneered the use of organic acid testing in integrative/functional medicine. In that sense you could say we have the most experience in the field, having introduced and written the book on this test. The reason it is so popular is that everyone realized how much useful information there is in this test after we came out with it. Everybody has pretty much copied us since.

We were attracted to the tandem mass spec methodology because of its robustness and flexibility, even though the equipment is significantly more expensive. We are very insistent on quality around here. This technology allows us to offer other compounds in the report that other labs do not have. These include 8-hydroxy-2-deoxyguanosine, a well documented marker of oxidant stress and damage to DNA. No other lab offers this in their profiles since it would add considerable additional cost. Also, we include D-Lactate, an important marker of gut dysbiosis. The LC/MS-MS (Liquid chromatography / Tandem mass spectrometry) allows us to report this. It cannot be done using the GC/MS methodology. Again, a value added service other labs don’t provide. We also are the only lab to report out the well documented Candida albicans marker, D-arabinitol. This is very useful to clinicians as it provides a reliable yeast overgrowth marker, again at no additional cost.

Finally, I would like to comment on the scientific inaccuracy some labs are perpetuating. This is the reporting on the “supposed” yeast dysbiosis markers of tartarate, citramalate and arabinose. I challenge anyone to find any support for these compounds as markers of yeast overgrowth in the medical literature. It simply does not exist and labs that say these are markers, I have no respect for. In fact, we published a paper in Clinical Chemistry on tartarate about this error. [download copy here]”
J. Alexander Bralley, Ph.D.
CEO – Metametrix Clinical Laboratory
3425 Corporate Way
Duluth, GA 30096 USA