Lab Tests Ordered in Integrative Practice: Standard vs Specialty Tests and Questions to Ask

This is general information, not medical advice, and it never tells you to buy or order a test. Tests should be explained by a clinician who knows your history. If you have urgent symptoms such as chest pain, trouble breathing or stroke signs, call 911 rather than waiting for a test.

What a lab test is for

MedlinePlus explains that a lab test checks a sample of blood, urine or other body fluid or tissue for certain substances. [1] A provider may order one to learn about a specific part of your health or to get a general picture; results can help diagnose or rule out a condition, monitor it, or choose a treatment. [1] MedlinePlus also notes that lab tests do not give a complete picture of your health, and that results are combined with your physical exam, health history and family history. [1]

Who can order what

NCCIH says licensed naturopathic doctors can diagnose, which may include lab tests and diagnostic imaging, and that scope of practice varies by state. [2] Whether other practitioners may order tests depends on the profession and place; ask the practice and check with the relevant licensing board. See credentials, licensing and scope of practice.

Reading results

• Reference ranges. A reference range is based on results from large groups of healthy people. MedlinePlus says a result outside the range may or may not signal a health problem, and a result inside it is not always a guarantee of good health. [1]
• Labs differ. MedlinePlus says labs often use different methods and ranges, so you cannot compare results from different labs and should use the same lab to track trends. [1]
• No test is perfect. A false positive shows a condition you do not have; a false negative misses one you do. [1]
• Things that change results. Certain foods, medicines, supplements, hard exercise and not following preparation instructions can affect results. [1]

For plain definitions see lab test and clinical terms.

Standard and specialty tests

Standard tests, such as the common blood tests the NHS describes (blood counts, blood glucose, lipid profile), are used to check for or manage defined conditions. [3] "Specialty" tests are an informal group, not a defined category: they may measure something unusual, use a sample such as hair, stool or saliva, or bundle many markers into one panel. Tests of this kind are covered as claim checks on tests sold in integrative practice, with more in hair mineral analysis, stool and microbiome tests and food-sensitivity panels.

One example of a position from a professional body: the Canadian Society of Allergy and Clinical Immunology says positive food-specific IgG results are to be expected in normal, healthy people, and strongly discourages using the test to identify or predict adverse reactions to food. [4] It also warns that a person with a true IgE-mediated food allergy may not have raised IgG to that food. [4] For the other specialty tests named here (hair mineral, stool and microbiome, saliva hormone and similar), proper evidence not found in the general MedlinePlus, NHS and NCCIH pages we read; their evidence is checked on the linked pages instead.

Questions to ask before a test

• What question is this test meant to answer?
• What will we do differently depending on the result?
• Is it a test doctors use for that purpose in standard care?
• What is the chance of a false or borderline result, and what happens next?
• What does it cost, who is the lab, and does the practice sell anything based on the result?

The Choosing Wisely campaign was begun to spark conversations between clinicians and patients about which tests and treatments are needed and which are not. [5]

Home and mail-in tests

MedlinePlus says at-home tests are not a replacement for guidance from your provider, advises using only FDA-approved or FDA-authorized tests, and says not to change your medicines because of a result without talking with your provider. [6] It also says genetic home tests cannot diagnose disease and are not as accurate as traditional lab-based genetic tests. [6] See biomarker tracking and at-home tests and over-testing and false positives.

After the result

Ask for a copy, and share it with your regular doctor. MedlinePlus advises talking with your provider about what results mean for you. [1] Do not stop or change prescribed medicines because of a result. [6]