Tests Sold in Integrative Practice: Evidence-Based Testing vs Broad Panels, Food IgG, Hair Mineral, "Adrenal" and Microbiome Tests

Start here: when a test is a reason to see a doctor

This page is information only and does not replace medical care. Severe symptoms need a clinician before any panel. In the US, call 911 for sudden swelling of the lips, mouth or throat, or trouble breathing after eating; the NHS lists the same signs as an emergency in the UK. [1] Weight loss you cannot explain, blood in stools, or fatigue that does not lift also deserve a medical visit rather than a mail-order kit.

What this page covers

Many kinds of practitioner order or sell tests: medical doctors, naturopathic doctors, unlicensed naturopaths, nutritionists and health coaches, as well as direct-to-consumer companies. Who orders a test is not the question here. The question is what the test measures, whether that measurement has been shown to answer the question being asked, and what happens next. NCCIH notes that licensed naturopathic doctors can diagnose, which may include lab tests, and that the scope of practice varies by state licensure and regulations. [2] Rules on who may order which test differ by place, so ask the person in front of you what they are licensed or certified to do.

Evidence labels used on this site: established, mixed, insufficient evidence, no good evidence of benefit, evidence of harm, marketing claim.

The tests at a glance

Evidence-based testing versus broad panels

A test is useful when it has been shown to measure what it claims and the result changes what a clinician does. A cortisol blood test ordered because a doctor suspects adrenal insufficiency fits that pattern. The Endocrine Society guideline, for example, recommends testing for Cushing's syndrome in people with multiple and progressive features of the syndrome, using tests of high diagnostic accuracy. [9] A long panel offered to anyone who feels "off" is different. MedlinePlus explains the problem for food allergy tests: used on people with no symptoms, they can show signs of an allergy when there isn't one, a false positive result. [10] A single borderline number can then lead to more tests, more supplements, restricted eating and worry.

Three questions fit every test:

• What condition is this looking for, and how was the test shown to find it?
• What would I do differently with a high, a normal and a low result?
• Does a medical society recommend this test for this purpose?

Food IgG tests

These blood tests measure IgG antibodies to a list of foods. The Canadian Society of Allergy and Clinical Immunology states that the presence of specific IgG to food is a marker of exposure and tolerance to food. [3] A European task force concluded that testing IgG4 to foods is irrelevant for the work-up of food allergy or intolerance and should not be performed for food-related complaints. [4] Real food allergy is tested with other methods, such as skin tests and IgE blood tests, matched to your symptoms. [10] The NHS lists a short diet that avoids a suspected food, then reintroduces it, as one way a food intolerance is assessed, and says bought home tests are not recommended. [11] Full guide: food IgG sensitivity tests. Biohacking coverage: food-sensitivity panels.

Hair mineral analysis

A JAMA study sent a split hair sample from one healthy volunteer to six commercial US laboratories. Reported mineral levels differed by more than 10-fold for 12 minerals, and the labs gave conflicting supplement advice. [5] The authors recommended that practitioners refrain from using such analyses to assess individual nutritional status or suspected environmental exposures. [5] The study is from 2001 and we did not find a newer comparison, so we cannot say whether labs have changed. See hair mineral analysis.

Saliva cortisol and "adrenal" tests

Cortisol testing is real medicine. MedlinePlus says a cortisol test measures cortisol in blood, urine or saliva to help diagnose or rule out conditions such as Cushing's syndrome and Addison disease. [12] It also says a cortisol test alone cannot diagnose the cause of abnormal levels, and that the most common cause of abnormal levels is taking steroid medicines for a long time or stopping them suddenly. [12] "Adrenal fatigue" is a different claim. A 2016 systematic review of 58 studies found conflicting results and noted that it has not been recognized by any endocrinology society. [6] See saliva cortisol and adrenal tests.

Microbiome tests

A 2025 review says many companies offer gut microbiota analysis of dubious quality, or as a way to sell supplements. [7] We looked for a current guideline recommending a consumer stool-sequencing kit to guide treatment and did not find one, so: Proper evidence not found for that use. A stool test ordered by a clinician for a specific problem is a different matter. See stool and microbiome tests.

Organic acids and other specialty panels

We searched for a readable guideline or review on urine organic acids panels sold for wellness and did not find one. Proper evidence not found. The same goes for several other panels offered in some clinics; the index of tests and treatment claims checked on this site shows where each is covered.

Provoked urine metal tests

The American College of Medical Toxicology position, as quoted in a family-medicine journal, is that post-challenge urinary metal testing has not been scientifically validated, has no demonstrated benefit, and may be harmful. [8] The same article notes that a chelating agent increases the urinary concentrations of heavy metals. [8] See the provoked urine test guide.

Before you pay for a panel

• Tell your regular doctor, and bring any result so it can be put in context.
• Do not stop or change prescribed medicines because of a panel result.
• Ask who benefits if the result is abnormal, for example if the same practice sells the supplements.
• More checks: lab tests ordered in integrative practice, home and direct-to-consumer tests, and red flags in health claims.