Functional Health Testing: What Can DUTCH, Gut Testing, Genetics, and CGM Actually Tell You?
Table of Contents
Your bloodwork came back “normal.” But you still do not feel like yourself.
Maybe your energy is low. Your belly fat is not budging. You are bloated or constipated. You wake up during the night and may or not fall back asleep with easy. Cravings are harder to control. Or perhaps hot flashes, brain fog, hair changes, or a menstrual cycle that suddenly seems to have a mind of its own have entered the picture.
So now what? More bloodwork? A DUTCH hormone test? A stool test such as GI-MAP? Genetics? A continuous glucose monitor?
Maybe. Maybe not.
One of the biggest mistakes I see with functional health testing is starting with the test instead of starting with the question.
I do not want to collect data just because we can. I want to know what we are trying to understand and whether additional information is likely to change what we do next.
That is what Part 2 of this liver and metabolic health series is about. In Part 1, we explored how liver health connects with blood sugar, insulin, triglycerides, belly fat, energy, and other pieces of metabolic health. Now we are going one step deeper: What can different types of data actually tell us, and just as importantly, what can they not tell us?
More Functional Health Testing Does Not Automatically Mean More Answers
When someone comes to me saying, “Something still feels off,” I do not immediately reach for a specialty test.
I start with the person.
What is your biggest concern?
How long has it been happening?
What symptoms are you experiencing?
What does your existing bloodwork show?
What medications and supplements are you taking?
What are you eating?
How are you sleeping and training?
What does stress look like?
How is digestion?
What has changed hormonally?
When was your last cycle?
What have you already tried?
This is where my Investigate → Integrate → Implement approach matters.
Investigating does not mean ordering everything. It means figuring out what question still needs an answer. Integrating means putting the data beside your symptoms, history, lifestyle, goals, and other information. Implementing means deciding what is actually worth changing, then paying attention to how your body responds.
For example, if your biggest concern is weight that will not budge, I do not assume you need a “weight-loss test.” Bloodwork may deserve a closer look first. In another person, sleep, nutrition, menopause, medications, gut symptoms, alcohol, stress, or glucose patterns may change the question.
“I don’t start with the test. I start with the question the test needs to answer.”
Different Tests Answer Different Questions
Think of your health like a house with several windows. Looking through one window can show you something real, but it cannot show you every room. Different tests are different windows.
DATA EXAMPLE
A SIMPLE WAY TO THINK ABOUT IT
Bloodwork
What can we learn about what is happening in your body now or over a recent period of time?
Cortisol & Hormones (DUTCH urine/saliva) test
What additional patterns can we see in sex hormones, hormone metabolites, and cortisol?
Microbiome (stool) test
What can we learn about digestion, certain organisms, inflammation-related markers, and aspects of the gut environment?
Genetics
What inherited tendencies might be worth putting into context?
Continuous Glucose Monitor (CGM)
How is glucose responding throughout real life, including meals, sleep, activity, stress fasting, and timing?
None of these gives us the entire story. And this is important: what a test measures is not always the same as what we can conclude from it.
A CGM measures glucose in the fluid between your cells. It does not measure insulin. A stool result can show organisms or microbial functions that were detected. It does not automatically explain why you cannot lose weight. A genetic variant can point to a predisposition. It does not tell us that a pathway is currently “broken.” And DUTCH can provide additional information about hormone metabolism, but it is not an overall score of how well your liver “detoxifies.”
What Can DUTCH Tell You That Routine Bloodwork May Not?
If someone is dealing with hot flashes, PMS, cycle changes, brain fog, sleep problems, hair changes, androgen-related symptoms, or feeling wired and exhausted, I may want to understand more about the hormone picture.
Routine bloodwork can be very useful. But sometimes we are asking a question that one blood measurement was not designed to answer.
Cortisol: A Snapshot Versus a Daily Pattern
Cortisol is not supposed to stay at one level all day. Think of it like the volume on your phone. The setting should change depending on the time and what your body needs.
DUTCH test shows free cortisol at several points during the day and cortisol metabolites, which give us different information about cortisol physiology. I can then put that pattern beside sleep, stress, energy, training load, symptoms, and other data.
That does not mean every tired person needs DUTCH. It means that when cortisol is part of the question, a daily pattern may sometimes add information that one measurement cannot (i.e., cortisol measured through blood in the a.m.)
Example of a de-identified DUTCH cortisol report showing three different views of cortisol: the daily free cortisol pattern, total 24-hour free cortisol, and metabolized cortisol. These measurements answer different questions and should be considered alongside symptoms, sleep, stress, medications, training, and other health data.
Estrogen: It Is Not Just “High” or “Low”
Your body also breaks estrogen down into different metabolites and a DUTCH report gives us 2-OH, 4-OH, and 16-OH. What do these ‘fancy’ markers and names mean?
Think of these as different roads estrogen can travel as your body processes it. They are normal pathways, not a simple “good road” versus “bad road.” DUTCH can also provide information about methylation of certain estrogen metabolites, plus progesterone and androgen-related measurements depending on the panel.
The useful part is not staring at one pathway by itself. It is asking how the pattern fits with age, menstrual or menopausal stage, symptoms, hormone therapy when applicable, nutrition, body composition, gut health, and other information, including medications.
Sometimes that information changes the conversation toward food, fiber, bowel regularity, body composition, sleep, recovery, supplementation, or collaborating with a hormone or menopause clinician.
“DUTCH can give us additional information about hormone metabolism. It does not give us a score for how well your entire liver detoxifies your body.”
Example from a DUTCH estrogen metabolism report. Hormone levels are only part of the story. This type of testing can add information about how estrogen is converted and processed, but the results need context from symptoms, bloodwork, medications, and lifestyle.
What Can Stool Testing Tell You If Your Stomach Does Not Hurt?
Gas, bloating, constipation, diarrhea, reflux, and abdominal discomfort are obvious reasons to ask questions about digestion. But I do not look at the gut only when someone says, “My stomach hurts.” or “I feel bloated often.”
Depending on the test, stool testing may provide information about certain pathogens, H. pylori, pancreatic elastase related to digestive function, calprotectin as an intestinal inflammation marker, secretory IgA, beta-glucuronidase, and microbial patterns. StoolOMX, an add-on to GI-MAP, also reports bile acids and short-chain fatty acids such as acetate, butyrate, and propionate.
Short-chain fatty acids, or SCFAs, are small compounds made when gut microbes ferment certain fibers. Think of fiber as food for some of your gut microbes, and SCFAs as some of the useful products they make from that food. These compounds participate in gut-barrier function, immune signaling, and metabolic processes.
This is one reason the gut can be relevant even when we are talking about blood sugar, weight, or metabolic health.
But there is an important reality check: microbiome science is moving fast, and our ability to measure organisms has moved faster than our ability to know exactly what every result means for every person. An international expert consensus published in 2025 concluded that evidence supporting the clinical usefulness of many commercial microbiome tests remains limited.
That does not mean I throw the information away. It means I use it as additional information, not as an oracle. Low Akkermansia from one stool collection, for example, does not prove that Akkermansia caused your weight or blood sugar problem.
Beta-Glucuronidase: A Simple Example of the Gut-Liver Connection
Beta-glucuronidase is a great example of why we have to understand what a marker actually measures.
Imagine your liver is preparing a package your body wants to send out. During a process called glucuronidation, the body attaches a small chemical “tag” to certain compounds. Some of those tagged compounds travel through bile into the gut on their way toward elimination.
Certain gut bacteria make an enzyme called beta-glucuronidase. Think of that enzyme like a pair of scissors that can remove the tag from some packages. When that happens to certain estrogen compounds, some may have another opportunity to be reabsorbed and recirculated.
This is a real gut-liver connection. But elevated beta-glucuronidase in stool does not automatically mean your liver is bad at Phase II detoxification. Phase II is just one step in a larger three-phase process. The stool marker is telling us about enzyme activity in the gut. It is not directly measuring the liver’s ability to perform glucuronidation.
“A stool marker can give me a reason to ask another question. It doesn’t automatically give me the answer.”
Genetics Can Show Predisposition. Bloodwork Shows Me What Your Body Is Doing Now.
I love data, including genetics. But I rarely look at genetics by itself, and I seldomly make recommendations simply because a genetic report flags something.
One of the first things I like to put beside genetic data is bloodwork.
Think of genetics as part of the blueprint you were born with. It may point toward tendencies or predispositions. Bloodwork gives us another window into what your body is showing us now or over a recent period of time.
That is why I think the two can make a useful duo.
If the bloodwork someone already has is not comprehensive enough to answer the question we are investigating, I may recommend additional appropriate markers so we have better current information to evaluate beside the genetics.
Then we keep integrating. What symptoms are present? What is the health history? What are they eating? How are they sleeping and exercising? What medications and supplements are they using? What do other relevant results show?
Genes also do not operate independently of the environment. Nutrition, activity, aging, smoking, alcohol, medications, and environmental exposures can interact with our biology. Epigenetic mechanisms are one way environmental factors can influence gene regulation. That is more nuanced than saying a lifestyle choice simply “turns a gene on or off.”
MTHFR Is a Good Example
Someone sees an MTHFR variant and thinks, “My methylation is broken. I need methylated B vitamins.” Not so fast.
MTHFR helps the body process folate. Methylation itself is like one of the body’s tiny tagging systems. The body adds small chemical tags during many everyday jobs involving DNA regulation, hormones, neurotransmitters, and other processes.
A common MTHFR variant does not tell us that this entire system is broken. The CDC notes that people with common MTHFR variants can process folic acid and that these variants alone are not a reason to avoid it.
This is exactly why I want genetics beside bloodwork and the person in front of me.
A predisposition is not the same thing as a current problem. And a genetic report is not a supplement shopping list.
CGM Is Different: Sometimes the Data Help Change the Behavior
A continuous glucose monitor, or CGM, plays a somewhat different role for me.
Sometimes I use testing to investigate. Sometimes I use data to help someone see their behavior differently.
That is one reason I love CGM. You may discover that a breakfast you thought worked beautifully for you does not keep your glucose as steady as expected. You might notice what happens after a walk, a late dinner, a poor night of sleep, or a different meal combination.
That immediate feedback can turn an abstract recommendation into something personal: “Oh. Now I see it.”
Research suggests CGM feedback can support modest improvements in glucose outcomes and may help with behavior change, but the evidence is stronger in people with diabetes than in metabolically healthy people. In people without diabetes, CGM appears most useful as a biofeedback tool paired with lifestyle changes, not as a stand-alone weight-loss solution.
And remember what we discussed in Part 1: CGM measures interstitial glucose. It does not measure insulin, liver fat, cortisol, gut health, or your entire metabolic response.
Data are powerful when we understand what they can and cannot tell us.
Do Not Supplement the Marker. Support the Person.
This is another place where more testing can create problems.
Marker low? Take this.
MTHFR variant? Buy methylated B vitamins.
Marker high? Take that.
Gut marker outside the ideal range? Add another supplement.
That is not how I want to work.
I do not recommend supplements for a marker. I support a person.
Before deciding whether a supplement adds value, I want to know what else is happening.
What is the person’s nutrition like?
Are they sleeping?
Are they under significant stress?
Are their bowels moving regularly?
What medications and supplements are they already taking?
What does the bloodwork show?
What are the primary symptoms?
What can realistically be changed?
Some medications can affect the absorption, metabolism, or status of particular nutrients, so medication context can matter. I do not prescribe or change medications, but relevant information can help someone have a more informed conversation with your physician.
Sometimes targeted support may make sense while we also improve the foundation. Someone experiencing significant symptoms does not necessarily need to wait months before receiving appropriate support.
And sometimes the best next step is not another supplement or another test. It may be bringing a functional health coach/practitioner and/or a more holistic healthcare professional onto the team.
The test is not the plan. It is information that may help us build a better plan.
Action Steps: Before You Order Another Test, Do This
More data are not automatically better data. Before spending money on another test, start by figuring out what you already know and what question is still unanswered.
IF THIS SOUNDS LIKE YOU…
YOUR NEXT MOVE
WHAT YOU ARE TRYING TO LEARN
“My labs are normal, but I still do not feel right.”
Gather your recent bloodwork, symptoms, medications, supplements, and top concerns.
What information do you already have, and what is still missing?
“I want DUTCH, GI-MAP, or genetics because I heard about it online.”
Write down the one question you expect the test to help answer.
Would the result actually change what you do next?
“I already have several test reports.”
Stop collecting for a moment. Put the results beside your symptoms, history, and current habits.
What patterns become more useful when the information is integrated?
“I have no idea what test I need.”
Do not guess. Start with the problem you are trying to solve and whether more data would add value.
What is the next useful question?
This is the difference between collecting information and using information strategically.
What Comes Next: Knowing Is Not the Same as Doing
There is one more piece of this conversation.
You can have excellent bloodwork. You can have a DUTCH report, stool testing, genetic data, a CGM, and a wearable full of sleep and recovery information. You can understand all of it.
And still not change your health.
Information does not implement itself.
In Part 3, we are going to talk about what happens after the data: why knowing what to do is not the same as doing it, how perfection can get in the way, and how to turn what you know into decisions and habits you can actually live with.
Because ultimately, better health is not about collecting the most information. It is about using the right information to make better decisions, then course correcting as your body responds.
Not Sure What Information You Need Next?
Maybe you have done bloodwork and still have questions. Maybe you are wondering whether hormones, gut health, genetics, blood sugar, or something else deserves a closer look.
You do not necessarily need more tests. And you definitely do not need to order everything.
You need to get clear on the question you are trying to answer and whether additional information would actually help.
Schedule a complimentary 20-minute Clarity Call. We will briefly talk about your primary concerns, what you have already tried, and whether working together may be the right next step.
Do I need functional health testing if my regular bloodwork is normal?
Not necessarily. Start by asking what question remains unanswered. Existing bloodwork, symptoms, health history, medications, lifestyle, and other information may already provide useful context. Additional testing may be worth considering when it addresses a specific question and has a reasonable chance of changing the next step.
Start with what you already have.
Identify the question that is still unanswered.
Ask whether another test would actually change a decision.
Can DUTCH or a stool test tell me whether my liver is detoxing properly?
Not as an overall measure of liver “detox capacity.” DUTCH provides information about hormones, hormone metabolites, and cortisol patterns. Stool testing can provide information about the gastrointestinal environment and specific markers. Some of those pathways interact with liver function, but neither test provides a simple score for how well your liver detoxifies your body.
DUTCH = additional hormone and cortisol information.
Stool testing = selected digestive, immune, microbial, and metabolic information.
Neither = an overall liver detox score.
Should I change my diet or supplements based on a genetic test?
I rarely make recommendations from genetics alone. I prefer to put genetic data beside current bloodwork first, then consider symptoms, health history, nutrition, lifestyle, medications, supplements, and other relevant information. A genetic result may point to a predisposition, but predisposition and what your body is showing today are not the same thing.
Genetics can suggest potential.
Bloodwork helps show what is happening now.
Recommendations should come from the bigger picture, not one SNP.
Why would urine and stool testing give me different information about bile acids?
Because they look at different parts of the same system. A urine test such as Fluids iQ’s Metabolic Wellness Profile includes Total Bile Acids, which can provide information about bile-acid handling and clearance. StoolOMX looks farther downstream in the gut, including primary and secondary bile acids and how they are being transformed.
Urine Total Bile Acids = another window into bile-acid handling and clearance.
StoolOMX = more detail about bile acids in the gut and microbial conversion.
Different sample, different question.
References
Porcari S, et al. International consensus statement on microbiome testing in clinical practice. Lancet Gastroenterol Hepatol. 2025;10(2):154-167. PMID: 39647502. Source
Blaak EE, et al. Short chain fatty acids in human gut and metabolic health. Benef Microbes. 2020;11(5):411-455. PMID: 32865024. Source
Hu S, et al. Gut microbial beta-glucuronidase: a vital regulator in female estrogen metabolism. Gut Microbes. 2023;15(1):2236749. PMID: 37559394. Source
Braakhuis A, et al. Consensus Report of the Academy of Nutrition and Dietetics: Incorporating Genetic Testing into Nutrition Care. J Acad Nutr Diet. 2021;121(3):545-552. PMID: 32624395. Source
Centers for Disease Control and Prevention. MTHFR Gene Variant and Folic Acid Facts. Updated July 16, 2026. Source
Richardson KM, et al. The efficacy of using continuous glucose monitoring as a behaviour change tool in populations with and without diabetes: a systematic review and meta-analysis of randomized controlled trials. Int J Behav Nutr Phys Act. 2024;21:145. PMID: 39716288. Source
Continuous glucose monitoring in non-diabetic populations: a systematic review of observational and interventional studies with meta-analysis. PMID: 41588451. Source
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