Top Functional Medicine Lab Tests To Consider Before and After a Detox

A detoxification protocol is a great way to hit the reset button on your health by eliminating toxins that disrupt the body's natural balance and cause sluggish metabolism. However, detox strategies are most effective when tailored to individual needs, and functional medicine testing can provide important insights into the root cause of low energy, brain fog, or stubborn weight gain. 

Here are my favorite functional medicine tests to enhance detoxification, why they matter, and how their results can guide and optimize a detox protocol.

When and Why to Test in a Detox Protocol

It’s not always necessary to run expensive functional medicine lab tests prior to a detox. 

However, for women who have very specific health issues like chronic fatigue, debilitating brain fog or focus issues, persistent weight gain despite diet and exercise, or hormonal issues like PCOS or fertility struggles, identifying the root cause of these issues and addressing them during a detox can be life-changing.

In these settings, functional medicine tests should be performed before starting a detox protocol to identify imbalances, toxin burdens, or compromised systems that may require targeted support. Testing provides a personalized approach, reducing risks and maximizing detoxification effectiveness. 

Followup testing can also be run after detox to monitor progress and confirm toxin clearance.

Hormone Testing

Hormone testing can involve blood, urine or saliva samples. For the purpose of detoxification support, I generally prefer urine testing like the DUTCH Plus test to look at how sex hormones like estrogen, progesterone, and testosterone are metabolized, as well as getting a full adrenal assessment. 

A true detox protocol should only be done once a person’s adrenal glands are resilient enough to handle the increased stress of toxin release and processing.

Why It’s Important

Toxins like heavy metals, pesticides, and mold disrupt hormonal pathways, leading to imbalances that can hinder detox efforts. Not only that, toxins can be a hidden cause of perplexing and troubling health problems like PCOS, endometriosis, or infertility. 

Identifying these imbalances helps address metabolic dysfunction, improve detox outcomes, and support women’s health.

Tests to Include

• DUTCH Test: provides a comprehensive view of cortisol and sex hormones, identifying stress-related or endocrine disruptions caused by toxins.

• Thyroid Tests: a comprehensive thyroid panel, including TSH, free and total T4, free T3, thyroid antibodies, and reverse T3 assess thyroid function. The thyroid gland, which is fundamental to cellular metabolic processes including energy production and detoxification, is highly sensitive to the damaging effects of environmental toxins. 

How This Guides Detox Protocols

Hormone testing can provide important information for detoxification protocols.

DUTCH Test Findings

Elevated cortisol may require adaptogens (e.g., ashwagandha) or stress-reduction strategies, while imbalanced sex hormones might necessitate targeted supplementation with DIM or calcium-d-glucarate to optimize estrogen metabolism. 

These tests can also signal whether particular dietary adjustments, increased hydration, more exercise and/or better stress management are necessary for the individual. 

Thyroid Test Findings

Low thyroid function may call for iodine, selenium, or tyrosine supplementation, while detoxifying specific endocrine disruptors (like heavy metals) may be prioritized to restore thyroid balance.

A note about iodine: this should be used under the guidance of a medical professional, as both iodine deficiency and excess can cause or exacerbate thyroid problems.

Toxin Screening

When considering toxin screening, a variety of tests are available to screen for the presence of many different possible toxins.

Why It’s Important

Identifying toxic exposures helps target specific toxins and identify the detox pathways necessary for their removal. 

Follow up testing can also ensure that harmful substances like heavy metals, mold toxins, or pesticides are effectively removed from the body.

Tests to Include

• Heavy Metal Panel: detects levels of heavy metals like lead, mercury, and cadmium that impair detox enzymes and burden organs like the liver, brain and kidneys.

• Mycotoxin Test: screens for mold toxins that suppress immunity and disrupt hormonal function.

• Glyphosate Screening: measures exposure to this herbicide, which is linked to many health problems including hormone disruption and gut dysbiosis.

• Other Persistent Organic Pollutants (POPs): many of these chemicals build up in a person’s body over time, causing constant inflammation and hormonal disruption and other problems. Many of these compounds have been linked to infertility or to hormonal problems in future generations.

How These Tests Guide Detox Protocols

Depending on the findings, these tests may indicate the need for additional, targeted detoxification support. 

Heavy Metal Panel Findings

High levels of metals may require chelation agents (e.g., EDTA, chlorella, modified citrus pectin) or targeted organ support (e.g., milk thistle for the liver).

Mycotoxin Test Findings

Positive results may indicate the need for targeted detoxification strategies that specifically target mycotoxins and optimize their removal from the body and environment. 

Glyphosate and POP Screening Findings

Elevated levels of glyphosate and/or persistent organic pollutants (POPs) call for enhanced gut function and repair protocols (e.g., gut-healing compounds, probiotics, prebiotics, and more), cellular support to optimize cellular detoxification processes, and environmental and dietary changes to reduce pesticide and POP exposure.

Glyphosate is a chemical used in herbicides to kill weeds by blocking a plant process called the shikimate pathway, which is needed for making certain amino acids. It’s widely used in farming but has raised health concerns. Studies suggest it can damage cells, cause DNA changes, disrupt hormones, and affect the immune system. 

Glyphosate is found in the environment, food, water, and even in people’s bodies. Some health agencies label it as "probably cancer-causing," though its safety is still debated worldwide.

POPs are harmful chemicals that persist in the environment for a long time, spread through air and water and build up in the food chain, harming people and animals. 

They were used in pesticides, factories, and burning waste but can cause serious problems like cancer, hormone issues, and immune system damage. The Stockholm Convention, a global agreement made in 2001, works to reduce or stop the use of POPs to protect health and the planet.

Comprehensive Gut Health Analysis

In naturopathic school we learned that health or disease start in the gut: so does detoxification. 

A comprehensive stool test can provide so much good information about your gut health, which is especially important for women living with mystery gas, bloating, belching, constipation or loose stool. 

Why It’s Important

The gut plays a pivotal role in toxin elimination, housing enzymes and bacteria (part of the microbiome) critical for processing and excreting toxins. Poor gut health can lead to toxin recirculation and systemic inflammation, undermining detox efforts.

Test to Include

GI-MAP Test: this is one of my favorite functional medicine tests. It analyzes gut flora, pathogens, enzymes, and inflammation markers, providing a complete picture of gut health and providing important information about its ability to eliminate toxins effectively.

How This Guides Detox Protocols

Gut support will depend on test results. For example:

• Dysbiosis: probiotics and antimicrobial herbs may be added to rebalance the gut microbiome.

• Low Enzyme Levels: digestive enzyme supplementation (e.g., lipase, amylase) can support nutrient absorption and general gut and microbiome health. 

• Inflammation Markers: anti-inflammatory nutrients (e.g., omega-3s, curcumin) and gut-healing protocols (e.g., bone broth, L-glutamine) may be considered to repair intestinal lining in the setting of gut inflammation.

Blood Sugar Testing

Discovering underlying blood sugar issues is actually a wonderful thing: it provides the opportunity to support increased blood sugar sensitivity, and there’s no time like a detox to do that. 

Why It’s Important

Toxin exposures are a hidden driver of inflammation and metabolic dysfunction, which can manifest as high blood sugar and insulin resistance. 

Toxins like endocrine disruptors and heavy metals can impair insulin signaling, disrupt glucose metabolism, and contribute to insulin resistance. Testing blood sugar provides essential insights into metabolic health and helps guide metabolic support during a detox.

Tests to Include

The tests I most often order include:

Fasting Blood Glucose

Indicates immediate glucose regulation and can suggest insulin resistance or impaired glucose tolerance. Elevated levels suggest the need for further blood sugar assessment and may indicate a need to stabilize blood sugar through healthy dietary changes, a sleep assessment, and exercise.

Hemoglobin A1c (HbA1c)

Provides a 2-3 month snapshot of blood sugar control. High HbA1c levels highlight prolonged metabolic stress from higher than optimal blood sugar levels and increased risk of oxidative stress. Interventions might include dietary changes, exercise, and antioxidants like glutathione. 

Fasting Insulin

Fasting insulin levels rise as blood sugar levels rise. Testing fasting insulin detects early insulin resistance before blood glucose rises. High levels point to metabolic dysfunction caused by toxins, guiding the use of nutrients like magnesium or chromium and strategies to enhance insulin sensitivity.

How These Tests Guide Detox Protocols

Identifying high blood sugar allows us to tailor detox protocols to support increased insulin sensitivity through a low-glycemic diet, sweating it out through a mix of strength workouts and cardio, and proper sleep and stress management. 

It may also indicate a need to increase antioxidants and plant-based compounds like vitamins C, E, and glutathione, as well as the abundance of phytonutrients naturally found in fruits and vegetables. 

People with high blood sugar may also benefit from toxin testing to see if EDCs or other pollutants are impairing metabolism.

Organic Acid Testing

Organic acid testing (OAT) checks for chemicals called organic acids in your urine to see how your body is working: OAT helps find problems like nutrient shortages, cellular energy production problems causing slowed metabolism, toxin buildup, or gut imbalances.

Why It’s Important

OAT provides a comprehensive snapshot of metabolic health, offering valuable insights into cellular processes, detoxification pathways, and showing the effects of toxins on the body. 

Toxins like mold, heavy metals, and pesticides disrupt important pathways in mitochondria, leading to inflammation, impaired energy production, and a reduced ability to clear toxins. 

Organic acid testing detects these metabolic disruptions, which reveal hidden issues that may not appear on other lab panels and provide important insights into detoxification and wellness strategies. 

How These Results Guide Detox Treatments

Organic acid testing results are actionable and direct targeted interventions to enhance detoxification. Whether it indicates gut dysbiosis, mitochondrial and metabolic impairment, increased inflammation or nutritional deficiencies, OATs provide a wide range of important information to help individualize a detox strategy for cellular support.

Key Takeaways

Personalized Testing Enhances Detoxification: functional medicine tests identify imbalances and toxin burdens, optimizing detox protocols for specific issues like hormone imbalances, fatigue, or brain fog.

Targeted Lab Results Guide Protocols: tests like DUTCH, GI-MAP, blood sugar testing and organic acid testing reveal hidden hormone imbalances, blood sugar problems or toxin impacts, enabling tailored support for hormones, gut health, and cellular detox pathways.

References

Abenavoli, L., Capasso, R., Milic, N., & Capasso, F. (2010). Milk thistle in liver diseases: past, present, future. Phytotherapy research : PTR, 24(10), 1423–1432. https://doi.org/10.1002/ptr.3207

Agostini, L. P., Dettogni, R. S., dos Reis, R. S., Stur, E., dos Santos, E. V. W., Ventorim, D. P., Garcia, F. M., Cardoso, R. C., Graceli, J. B., & Louro, I. D. (2020). Effects of glyphosate exposure on human health: Insights from epidemiological and in vitro studies. Science of the Total Environment, 705, 135808. https://doi.org/10.1016/j.scitotenv.2019.135808

Awuchi, C. G., Ondari, E. N., Nwozo, S., Odongo, G. A., Eseoghene, I. J., Twinomuhwezi, H., Ogbonna, C. U., Upadhyay, A. K., Adeleye, A. O., & Okpala, C. O. R. (2022). Mycotoxins' Toxicological Mechanisms Involving Humans, Livestock and Their Associated Health Concerns: A Review. Toxins, 14(3), 167. https://doi.org/10.3390/toxins14030167

Bonini, M. G., & Sargis, R. M. (2018). Environmental Toxicant Exposures and Type 2 Diabetes Mellitus: Two Interrelated Public Health Problems on the Rise. Current opinion in toxicology, 7, 52–59. https://doi.org/10.1016/j.cotox.2017.09.003

Calcium-D-glucarate. (2002). Alternative medicine review : a journal of clinical therapeutic, 7(4), 336–339.

Cheng, H., Yang, B., Ke, T., Li, S., Yang, X., Aschner, M., & Chen, P. (2021). Mechanisms of Metal-Induced Mitochondrial Dysfunction in Neurological Disorders. Toxics, 9(6), 142. https://doi.org/10.3390/toxics9060142

Cheung, M. K., Yue, G. G. L., Chiu, P. W. Y., & Lau, C. B. S. (2020). A Review of the Effects of Natural Compounds, Medicinal Plants, and Mushrooms on the Gut Microbiota in Colitis and Cancer. Frontiers in pharmacology, 11, 744. https://doi.org/10.3389/fphar.2020.00744

Collins, S. L., & Patterson, A. D. (2020). The gut microbiome: an orchestrator of xenobiotic metabolism. Acta Pharmaceutica Sinica B, 10(1), 19–32. https://doi.org/10.1016/j.apsb.2019.12.001

Freeman AM, Acevedo LA, Pennings N. Insulin Resistance. [Updated 2023 Aug 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507839/

González, P., Lozano, P., Ros, G., & Solano, F. (2023). Hyperglycemia and Oxidative Stress: An Integral, Updated and Critical Overview of Their Metabolic Interconnections. International journal of molecular sciences, 24(11), 9352. https://doi.org/10.3390/ijms24119352

Guo, W., Pan, B., Sakkiah, S., Yavas, G., Ge, W., Zou, W., Tong, W., & Hong, H. (2019). Persistent Organic Pollutants in Food: Contamination Sources, Health Effects and Detection Methods. International journal of environmental research and public health, 16(22), 4361. https://doi.org/10.3390/ijerph16224361

Jaishankar, M., Tseten, T., Anbalagan, N., Mathew, B. B., & Beeregowda, K. N. (2014). Toxicity, mechanism and health effects of some heavy metals. Interdisciplinary toxicology, 7(2), 60–72. https://doi.org/10.2478/intox-2014-0009

Janik-Karpinska, E., Ceremuga, M., Niemcewicz, M., Synowiec, E., Sliwiński, T., & Bijak, M. (2023). Mitochondrial Damage Induced by T-2 Mycotoxin on Human Skin—Fibroblast Hs68 Cell Line. Molecules, 28(5), 2408. https://doi.org/10.3390/molecules28052408

‌

Meftaul, I. M., Venkateswarlu, K., Dharmarajan, R., Annamalai, P., Asaduzzaman, M., Parven, A., & Megharaj, M. (2020). Controversies over human health and ecological impacts of glyphosate: Is it to be banned in modern agriculture?. Environmental pollution (Barking, Essex : 1987), 263(Pt A), 114372. https://doi.org/10.1016/j.envpol.2020.114372

National Institutes of Health. (2023, October 24). Office of Dietary Supplements - Ashwagandha: Is It Helpful for stress, anxiety, or sleep? Ods.od.nih.gov. https://ods.od.nih.gov/factsheets/Ashwagandha-HealthProfessional/

Palinkas, L. A., Reedy, K. R., Smith, M., Anghel, M., Steel, G. D., Reeves, D., Shurtleff, D., Case, H. S., Van Do, N., & Reed, H. L. (2007). Psychoneuroendocrine effects of combined thyroxine and triiodothyronine versus tyrosine during prolonged Antarctic residence. International journal of circumpolar health, 66(5), 401–417.

Peillex, C., & Pelletier, M. (2020). The impact and toxicity of glyphosate and glyphosate-based herbicides on health and immunity. Journal of Immunotoxicology, 17(1), 163–174. https://doi.org/10.1080/1547691x.2020.1804492

Pizzorno J. (2018). Environmental Toxins and Infertility. Integrative medicine (Encinitas, Calif.), 17(2), 8–11.

Polak, G., Banaszewska, B., Filip, M., Radwan, M., & Wdowiak, A. (2021). Environmental Factors and Endometriosis. International journal of environmental research and public health, 18(21), 11025. https://doi.org/10.3390/ijerph182111025

Precision Analytical (DUTCH TEST). (2024). Dutchtest.com. https://dutchtest.com/dutch-plus

Rajoria, S., Suriano, R., Parmar, P. S., Wilson, Y. L., Megwalu, U., Moscatello, A., Bradlow, H. L., Sepkovic, D. W., Geliebter, J., Schantz, S. P., & Tiwari, R. K. (2011). 3,3'-diindolylmethane modulates estrogen metabolism in patients with thyroid proliferative disease: a pilot study. Thyroid : official journal of the American Thyroid Association, 21(3), 299–304. https://doi.org/10.1089/thy.2010.0245

Reddam, A., McLarnan, S., & Kupsco, A. (2022). Environmental Chemical Exposures and Mitochondrial Dysfunction: a Review of Recent Literature. Current environmental health reports, 9(4), 631–649. https://doi.org/10.1007/s40572-022-00371-7

Riley, L. (2024). Mean Fasting Blood Glucose. World Health Organization. https://www.who.int/data/gho/indicator-metadata-registry/imr-details/2380

Rutkowska, A. Z., & Diamanti-Kandarakis, E. (2016). Polycystic ovary syndrome and environmental toxins. Fertility and sterility, 106(4), 948–958. https://doi.org/10.1016/j.fertnstert.2016.08.031

Sears M. E. (2013). Chelation: harnessing and enhancing heavy metal detoxification--a review. TheScientificWorldJournal, 2013, 219840. https://doi.org/10.1155/2013/219840

Stockholm Convention - Home page. (n.d.). Www.pops.int. https://www.pops.int/

Strand J. (2022). Distinctive Detoxification: The Case for Including the Microbiome in Detox Strategy. Integrative medicine (Encinitas, Calif.), 21(4), 26–30.

Street, M. E., Shulhai, A. M., Petraroli, M., Patianna, V., Donini, V., Giudice, A., Gnocchi, M., Masetti, M., Montani, A. G., Rotondo, R., Bernasconi, S., Iughetti, L., Esposito, S. M., & Predieri, B. (2024). The impact of environmental factors and contaminants on thyroid function and disease from fetal to adult life: current evidence and future directions. Frontiers in endocrinology, 15, 1429884. https://doi.org/10.3389/fendo.2024.1429884

US EPA. (2018). Persistent Organic Pollutants: A Global Issue, A Global Response | US EPA. US EPA. https://www.epa.gov/international-cooperation/persistent-organic-pollutants-global-issue-global-response

Vaidya, R. A., Desai, S., Moitra, P., Salis, S., Agashe, S., Battalwar, R., Mehta, A., Madan, J., Kalita, S., Udipi, S. A., & Vaidya, A. B. (2023). Hyperinsulinemia: an early biomarker of metabolic dysfunction. Frontiers in clinical diabetes and healthcare, 4, 1159664. https://doi.org/10.3389/fcdhc.2023.1159664

Wang, F., Li, C., Li, S., Cui, L., Zhao, J., & Liao, L. (2023). Selenium and thyroid diseases. Frontiers in endocrinology, 14, 1133000. https://doi.org/10.3389/fendo.2023.1133000

Wilson, E. (2024, October 21). The GI MAP: How Comprehensive Digestive Health Testing Can Transform Your Hormone Health. Sanos Wellness. https://www.sanoswellness.com/articles/the-gi-map-how-comprehensive-digestive-health-testing-can-transform-your-hormone-health

Zimmermann, M. B., & Boelaert, K. (2015). Iodine deficiency and thyroid disorders. The lancet. Diabetes & endocrinology, 3(4), 286–295. https://doi.org/10.1016/S2213-8587(14)70225-6