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Advanced Laboratory Testing

What lab tests do naturopathic doctors order?

Naturopathic doctors often use a variety of lab tests to assess and manage chronic diseases, aiming to discover which markers of health are imbalanced. While the specific tests ordered can vary based on your condition, common lab tests that naturopathic doctors may use include:

Standard Blood Tests


  1. Complete Blood Count (CBC): Evaluates overall health and detects a variety of disorders, such as anemia, infection, and many other diseases.

  2. Comprehensive Metabolic Panel (CMP): Measures glucose levels, kidney function, liver function, and electrolyte and fluid balance.

  3. Lipid Panel: Assesses cholesterol levels, including LDL, HDL, and triglycerides, to evaluate cardiovascular risk.

Hormone Testing


  1. Thyroid Panel: Includes tests like TSH, Free T3, Free T4, and thyroid antibodies to assess thyroid function and detect conditions like hypothyroidism or hyperthyroidism.

  2. Adrenal Function Tests: Measures cortisol levels (often through saliva tests) to assess adrenal gland function and diagnose issues like adrenal fatigue.

  3. Sex Hormone Panels: Tests levels of estrogen, progesterone, testosterone, and other sex hormones to evaluate hormonal imbalances.

Nutritional and Metabolic Tests

  1. Vitamin and Mineral Levels: Tests for deficiencies in key nutrients like vitamin D, B vitamins, iron, magnesium, and zinc.

  2. Homocysteine Levels: Elevated homocysteine can indicate B vitamin deficiencies and increased cardiovascular risk.

  3. Amino Acid Profile: Assesses the levels of amino acids to identify deficiencies or imbalances.

Inflammatory Markers

  1. C-Reactive Protein (CRP): Measures the level of inflammation in the body.

  2. Erythrocyte Sedimentation Rate (ESR): Another marker for inflammation and can help diagnose conditions causing chronic inflammation.

Gastrointestinal Testing

  1. Comprehensive Stool Analysis: Evaluates gut health, including the presence of beneficial and harmful bacteria, yeast, parasites, and markers of inflammation and digestion.

  2. Food Sensitivity/Allergy Testing: Identifies specific food intolerances or allergies that could be contributing to chronic conditions.

Lyme Disease Testing

  1. Enzyme-Linked Immunosorbent Assay (ELISA):

    • The first step in conventional Lyme disease testing.

    • Detects antibodies against Borrelia burgdorferi.

    • A positive or equivocal result typically leads to further testing.

  2. Western Blot:

    • Confirmatory test following a positive ELISA.

    • Detects specific proteins (antigens) of Borrelia burgdorferi.

    • Looks for both IgM and IgG antibodies, indicating early or late infection stages.

  3. Polymerase Chain Reaction (PCR):

    • Detects the DNA of Borrelia burgdorferi directly from blood, cerebrospinal fluid, or joint fluid.

    • Highly specific but less sensitive due to the low presence of bacterial DNA in these fluids.

  4. C6 Peptide ELISA:

    • Targets the C6 peptide, a specific part of the Borrelia burgdorferi bacterium.

    • Used for both initial screening and confirmation.

  5. Tick-Borne Relapsing Fever (TBRF) Tests:

    • Specific tests for Borrelia species causing relapsing fever, different from Lyme disease.

    • May include PCR and specialized serological tests.

Co-Infection Testing

  1. Babesia Testing:

    • Blood Smear: Direct observation of Babesia parasites in red blood cells.

    • PCR: Detects Babesia DNA.

    • Indirect Fluorescent Antibody (IFA) Test: Measures antibodies against Babesia species.

  2. Bartonella Testing:

    • PCR: Detects Bartonella DNA.

    • IFA: Measures antibodies against Bartonella species.

    • Culture: Grows Bartonella bacteria from blood samples (less commonly used due to difficulty in culturing).

  3. Ehrlichia and Anaplasma Testing:

    • PCR: Detects DNA of Ehrlichia and Anaplasma species.

    • IFA: Measures antibodies against these bacteria.

    • Blood Smear: Identifies characteristic inclusion bodies (morulae) in white blood cells.

  4. Rickettsia Testing:

    • PCR: Detects Rickettsia DNA.

    • IFA: Measures antibodies against Rickettsia species.

Advanced and Specialty Tests

  1. Multi-Species PCR Panels:

    • Comprehensive panels that test for multiple tick-borne pathogens simultaneously using PCR.

  2. Lymphocyte Transformation Test (LTT):

    • Measures the immune response (lymphocyte activation) to Borrelia burgdorferi.

    • May indicate active or recent infection.

  3. T-Cell Tests:

    • Evaluates T-cell reactivity to Borrelia burgdorferi antigens.

    • Can provide information on immune system response to the infection.

  4. Advanced Serology Panels:

    • Use a combination of ELISA, Western Blot, and other immunoassays to increase sensitivity and specificity.

Naturopathic doctors often prefer labs specializing in Lyme disease and co-infections for these tests, as these labs may offer more sensitive and specific testing options compared to standard laboratories. Interpreting these tests can be complex, requiring a thorough understanding of the disease stages, your symptoms, and potential cross-reactivity with other conditions. Proper diagnosis and treatment often involve a combination of test results, clinical evaluation, and symptom history.

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