What Is The Best Lab Test For Leaky Gut?
The large majority of my patients have been to at least a few other doctors before they enter my office, many have been to specialists and as such, they have lab work that I can review. When people tell me that their labs are “normal”, with confidence I can assure them that likely someone didn’t scrutinize the labs enough and that I will probably find a few things that will at least suggest a direction to go without spending more money on advanced labs often seen in functional medicine. Most people want a SIBO test or stool test, but they are often overlooking in my opinion, the best lab test for leaky gut.
Before we get to the best lab test for leaky gut, lets discuss the difference between functional lab analysis and pathological or conventional lab analysis. To do this, lets use the example of a common headache. Most people with frequent headaches don’t have any abnormal lab values. Though, we know something is going wrong, overreacting or under functioning if you get headaches frequently. This means that further investigation needs to occur and more scrupulous inspection may benefit the patient.
When it comes to functional lab range values, this is what we are trying to do. We are trying to find an optimal range for a healthy individual, not a patient that has a disease condition. So when it comes to leaky gut, digestion and optimizing the digestive tract, we look a little closer at the lab ranges and really try to find out if your body is telling us anything.
The Best Lab Test For Leaky Gut Is…
I believe that the best lab test for leaky gut is a white blood cell count, which is usually performed with a common CBC test for less than $20. Yes, even more valuable than a stool test, SIBO test, candida test, etc., the white blood cell count can not only give us more information, but the price point is so wonderful that we can test and re-test without breaking the bank.
What if you wanted to run a stool test 4 times per year to make sure you had eradicated a parasite? The costs could quickly add up to over $1,500. As you know, then you still have to buy supplements, pay for doctor visits, etc. The costs add up quickly. With the CBC with white blood cells, you can take a close look at your health more often.
White Blood Cells & Leaky Gut
Before we go any further, you need to understand that the #1 cause of leaky gut is low-grade stealth infection. (Not food and NO it can not be treated with probiotics.)
Without going into the entire immune system, here is a simple look at how you can use your white blood cell markers as part of your assessment to diagnose your own leaky gut.
White Blood Cells (WBC) – measures the total number of white blood cells or leucocytes. The main function of the white cells is to defend against foreign invaders and infection. This is mainly accomplished by production and transport of antibodies and by phagocytosis. Several types of cells contribute to this total count and those are discussed below. Elevations can indicate infection, inflammation, tissue damage, trauma, stress or a leukemia. Decreases can signal bone marrow disorders, massive infections, autoimmune disorders and general immune system weakness.
Optimal range is 5,000 – 7,500/uL
Lymphocytes – protective especially against virus and cancer, lymphocytes are derived from either bone marrow – B cells for humoral immunity/formation of specific antibodies; or the thymus – T cells for cellular immunity/direct contact with pathogens. T cells are mobilized by interleukin 2. In general high values suggest defensive activity, particularly against viruses, while low values are seen with low protein, compromised immune function.
Optimal range is 30 – 35 %
Neutrophils – The primary function is phagocytosis. When elevated, they act as markers of active bacterial or viral infection. When suppressed or lower than normal, they can indicate chronic bacterial of viral infection.
Optimal Range is 50 – 60 %
Basophils – Are one of the smallest fractions of white blood cells. They are associated with allergies, sensitivities and inflammation. Basophils contain high levels of histamine and heparin. Basophils are capable of performing phagocytosis of antigen-antibody complexes and are hence related to allergic reactions. (In simple terms, when you immune system sees something it doesn’t like and binds to it, the basophil can destroy it.) Basophils also deliver heparin to areas of inflammation to prevent clotting. Elevations are usually seen in response to allergy, inflammation or exposure to toxins. These cells are not involved in viral or bacterial infections, but more in parasitic infections.
Optimal Range is 0 – 1 %
Eosinophils – These specialists produce peroxidase enzymes and proteins that are toxic to invading elements. They help to degrade and break down other proteins and toxins. Increases occur in response to parasites or some other toxin/allergen.
Optimal Range is 1- 3%
Monocytes – Monocytes are probably the most common lab value that I see out of functional range. Many patients come in with monocytes above 5, but are missing the marker because the conventional range right now usually is up to 10 or 12. Monocytes in the blood stream, are more of a second line of defense in infections and inflammation and thus are good at identifying chronic conditions that don’t require as much of an immediate response.
With regards to leaky gut, elevated monocytes may indicate that a viral infection is present. If you find monocytes elevated, basophils over 1.0 and any increase of eosinophils over 3.0 then there may be reason to suspect intestinal parasites. Monocytes are also associated with arteriosclerosis due to the inflammation and repair processes occurring in the arterial wall, thus from a holistic perspective you want to maintain optimal monocytes for optimal arterial health.
Optimal Range is 1-5%
Based upon these optimal ranges, I believe the best lab test for leaky gut is the lab test that gives you a direction to follow in your treatment plan rather than a negative lab test. Any test that is negative doesn’t help you in treatment of your condition. SIBO breath tests and stool tests have limited scope. They are very good at testing for a few specific problems, but they don’t truly assess the entire body. The traditional and affordable CBC lab test has stood the test of time as a glimpse into your overall immune system.
As I propose that infection is the #1 cause of leaky gut and that my practice is primarily composed of patients that have been treated with all kinds of therapies, but with inadequate attention to infection, I believe this is the missing piece to many chronic health puzzles.
A quick note on “normal” lab findings
Too many people leave their doctor with labs that say they are normal and healthy, yet they suffer from numerous pain and inflammatory conditions. If you look at this picture you will realize that the lab normal ranges are designed to only exclude those with live threatening conditions or acute problems. So while over 60% of adults are overweight and over 40% of adults are obese, in general, they still fall within the “normal” range. I only use weight to demonstrate that you can have a less than optimal metabolism and yet still be lab “normal”. So essentially, this is why we use functional lab values to further elucidate those suffering from low-grade and more chronic conditions.
How to Use A Common Lab Test For Leaky Gut
So, as a final note, please go look at your last white blood cell lab test. Take a close look at the numbers on your report and compare them to the optimal lab ranges I have provided. If you find that your lab ranges are outside of the optimal ranges, then you likely have leaky gut due to infection or inflammation, but you most definitely have an altered immune system that needs attention. With chronic disease plaguing millions today, both direct and indirect optimization of the immune system is critical to maintain long-term health.