Precision Medicine: Test Not Guess, Part 1

Functional medicine testing aims to determine the root causes of dis-ease by identifying core metabolic and biochemical imbalances.

Have you been told your blood test results are within normal range, and yet don't feel too great? You may be feeling exhausted, unable to get through the day, or experiencing painful digestive symptoms, brain fog, anxiety, or a child may be diagnosed with ADHD or Tourette’s, but the blood tests are all ‘fine’. You may just benefit from functional testing.

We have people who, one year, have a clean bill of health and a year later are diagnosed with diabetes. The body does not work in this manner.

Dis-eases take time, they do not just ‘turn up’ at your doorstep one day unannounced.

Take a moment to look at the recommended dietary allowances (RDAs) for vitamins and minerals. These guidelines were developed primarily to prevent deficiency diseases and to keep blood markers within a defined 'normal' range. We need optimum levels, not the minimum levels to prevent disease.

In clinical practice, we regularly see individuals who are symptomatic, fatigued, hormonally imbalanced, and inflamed, while their lab results still sit comfortably 'within normal range'. Modern medicine is incredibly powerful in acute, life-threatening situations. If you break a leg or need surgery, mainstream medicine is your 'go-to', and we are grateful for it.

But when it comes to chronic health conditions and long-term prevention, it often lacks the depth needed to understand what the body requires to function optimally. It lacks the ability to look at patterns, even in the simple standard blood tests, and understand the 'patient'. We do not treat lab tests; we understand you first before looking at tests. And tests are incredible tools when used correctly, analysed and interpreted in context.

Imagine a bucket with small holes in it.

If you keep pouring water in quickly enough, it won’t empty, but it will never be full.

This is what chronic stress and depletion look like in the body: a system constantly trying to compensate, but never fully replenished.

In clinic, this is what we see time and time again. Individuals operating in survival mode are often unaware that their baseline has shifted so far from health.

As an integrative practitioner in nutrition and functional medicine, I ask ...

Where are the holes?

And why isn’t the body able to restore itself?

Without understanding that, we are simply pouring more water into the bucket.

This is where functional testing changes things

Rather than guessing or simply treating symptoms, we use functional testing to understand what is happening beneath the surface at the biochemical and physiological levels.

These tests allow us to move beyond 'normal ranges' and instead ask:

• How well is this body actually functioning?

• Where are the bottlenecks?

• What is being depleted, blocked, or overloaded?

• What is your story?

Functional tests assess how systems work in real time, rather than just screening for disease. Traditional medicine looks at markers from a 'dis-ease' lens. Whereas, we use functional tests to understand patterns, deficiencies, blocks, toxins, etc to support the body to heal.

Two people can present with the same symptoms…but for completely different reasons.

• One may have sluggish detox pathways

• Another may have nutrient depletion

• Another may have gut-driven recirculation of toxins

Without testing, we are guessing. With testing, we are working with precision.

Functional tests do not come back ‘normal’ or within range when one has been told their blood test results are all 'normal'. These tests address the ‘holes in the bucket’, not just the amount of water in the bucket.

So, instead of endlessly trying to 'top up the bucket' with supplements, diets, protocols, or quick fixes…

• We identify the holes

• We understand why they are there

• And we support the body to restore balance

Precision medicine, personalised medicine, nutrition medicine, ...call it what you will, is at the heart of integrative practice. The individual sits at the core, not the diagnosis.

Food is foundational. It is not an optional extra, and it is never overlooked. If you choose to work with us, be prepared to look closely at what’s on your plate, because without meaningful dietary change, true progress is limited, and both your time and investment are not fully honoured.

Personalised medicine is the future of health

Personalised or precision medicine is not just a trend, it is the future of healthcare.

We already see this in practice. One person may take a medication and experience side effects such as migraines, while another feels completely fine. One person thrives on a ketogenic diet, losing weight and feeling energised, while another feels sluggish, constipated, and depleted.

This is what we call biochemical individuality.

No two people are the same. Our biochemistry is shaped by our environment, the food we eat, our stress levels, our thoughts, and the cumulative experiences of our lives.

Various functional tests help us better support you in achieving your health goals. We use a variety of functional tests as needed. From stool tests, urine tests, saliva, through to blood, and even hair! Which test(s) we use for you are guided by what your body is showing us, which systems are under strain and 'asking' for support.

These may include various systems, which include the following:

Digestive function

(digestion, absorption, assimilation, microbiome)

• How well is food being broken down and absorbed

• Microbiome balance and diversity

• Inflammation and gut integrity

• The gut’s role in hormone and toxin clearance

The gut is central to everything. You can be eating all the 'right' foods, organic, nutrient-dense, thoughtfully sourced, but if digestion and absorption are compromised, those nutrients are simply not reaching where they are needed.

Functional testing allows us to understand what is happening within the gut, beyond symptoms alone. Using comprehensive stool testing, such as a Complete Stool Analysis (Gut Profile), we are able to assess:

• the balance of beneficial and pathogenic bacteria

• the presence of parasites, viruses, or overgrowths

• markers of inflammation and immune activity

• digestive function, including enzyme activity and fat absorption

This allows us to identify whether digestion is efficient, whether the microbiome is balanced or disrupted, whether inflammation or infection is contributing to symptoms, whether bile may need some 'smoothening', etc.

Sometimes, we may look deeper if needed, employing other tests, such as food intolerance or specific tests for systemic candida etc. Many symptoms can be rooted in the gut, even when they do not appear digestive in nature, such as skin issues (eczema, psoriasis, acne), hormonal imbalances (infertility, PCOS, PMS, hormonal migraines), fatigue and mood disturbances. Believe it or not, many of these symptoms can be driven by a gut that has become imbalanced or compromised. Without assessing the digestive system, we risk addressing symptoms without resolving the underlying cause(s).

Detoxification capacity

(toxic load and liver function)

• Phase 1 and Phase 2 detox pathways

• Glutathione status and antioxidant capacity

• Exposure to environmental toxins (chemicals, mould, heavy metals, microplastics)

• The body’s ability to process and eliminate toxins effectively

  
  

  

  
  

Most people think detoxification is something reserved for the “green juicing” crowd, when in reality, your body is detoxifying 24/7, it is that important.

However, in today’s modern world, the toxic load we are exposed to is unprecedented. Toxins are everywhere:

• Parabens in skincare and personal care products

• Phthalates hidden within synthetic fragrances

• Aluminium in antiperspirants and some cookware

• BPA and other plastics in food packaging and water bottles

• PFAS ('forever chemicals') in non-stick cookware and waterproof materials

• Pesticides and herbicides on non-organic foods

• Heavy metals such as mercury and lead in water, fish, and the environment

• Microplastics in water, food, and even the air we breathe

The body is designed to handle toxins, but not at the volume and frequency we encounter today. At this level, toxins don’t just pass through, they interfere with normal physiology and place a sustained burden on the system.

Using various tests depending on what is more pertinent to the individual, testing organic acids or a more  comprehensive panel, may be used, which allows us to assess:

In addition to assessing detox capacity, we can also measure toxic burden directly.

Specific testing can identify exposure to heavy metals (e.g. mercury, lead, arsenic), environmental chemicals (e.g. pesticides, solvents), mycotoxins (from mould exposure) etc.

This allows us to move from 'we suspect toxin exposure' to the exact toxin(s) involved.

Such tests may be indicated/suggested when there is:

• sensitivity to medications, supplements, or chemicals

• headaches or migraines, particularly those triggered by smells or environmental exposures

• hormonal imbalances such as oestrogen dominance, PMS, fibroids, or difficulties clearing hormones

• persistent fatigue or brain fog without a clear cause

• frequent use of medications (including painkillers, antibiotics, antacids, or hormonal medications)

• skin conditions such as acne, rashes, or unexplained reactivity

• a history of mould exposure, high toxin environments, or occupational exposure

• slow recovery despite doing 'all the right things' with diet and lifestyle

Nervous system and neurotransmitters

(regulation, resilience, communication)

• Levels and metabolism of neurotransmitters (e.g. serotonin, dopamine, GABA)

• Stress response and HPA axis function

• How the nervous system influences digestion, hormones, and detox pathways

Most people don’t realise just how vital the nervous system is to overall health.

Not only is it about stress, but also about regulation. Every system in the body is influenced by the state of the nervous system, from digestion and hormone balance to immune function and detoxification. See how vital it is?

However, in today’s world, many people live in a state of chronic stimulation or dysregulation. Constant notifications, poor sleep, blood sugar instability, emotional stress, and environmental demands keep the nervous system switched 'on', often without pause. Over time, this begins to impact key neurotransmitters such as serotonin, dopamine, and GABA, the very chemicals that influence mood, motivation, sleep, and resilience.

The stress response system, known as the HPA axis (Hypothalamus–Pituitary–Adrenal axis), can also become dysregulated. This may show up as feeling wired but tired

• energy crashes throughout the day

• poor stress tolerance

• disrupted sleep patterns

  
  

Sadly, the effects do not stop there, a dysregulated nervous system can:

• slow digestion and impair nutrient absorption

• alter hormone production and clearance

• reduce the body’s ability to detoxify effectively

In other words, the nervous system does orchestrates your entire physiology.

And when it is out of balance, your body starts to operate from a place of compensation not resilience.

The Adrenal Stress Test is one of the most useful tools in clinical practice for assessing how the body is responding to stress. Analysing cortisol and DHEA patterns throughout the day provides insight into the function of the HPA axis.

This allows us to determine:

• the degree to which stress is impacting the body

• whether the system is overactive, depleted, or dysregulated

• how this may be influencing energy, mood, sleep, and overall resilience

From here, we can put in place targeted support, including nutrition, lifestyle interventions, and, where appropriate, supplementation to help restore balance to the nervous system and improve overall function.

Neurotransmitters: our 'sanity' molecules

In addition to stress hormones, we can also assess neurotransmitter 'turnover'.

Using various organic acids tests, we are able to measure neurotransmitter metabolites, giving us insight into the turnover and activity of key neurotransmitters such as:

• serotonin

• dopamine

• norepinephrine

Rather than simply asking 'are levels high or low?' We begin to understand: how quickly neurotransmitters are being produced and broken down, whether there is an imbalance in specific pathways, potential causes of these imbalances, how these may be contributing to symptoms such as anxiety, low mood, poor focus, or sleep disturbances.

Choosing the right tests for YOU

These are some of the key systems we assess, along with a selection of functional tests we use to support them. Further systems and tests are discussed in Part 2, which consistently provide meaningful, actionable insights to support health and well-being in the 21st century.

If you’re unsure where to begin, we recommend a complimentary 15-minute clarity call with a member of the team, where we can guide you towards the most appropriate next steps.

• Current or returning clients of Khush: please contact Khush directly

• New clients: we recommend booking in with a member of the team

All functional testing is carried out following an initial full consultation, during which we gather your case history and essential background information to understand your unique physiological story. This also ensures that any test results are interpreted within the context of the whole person, not in isolation.

Find out more in Part 2 HERE.

To Health!