Virtual Clinic for Women's Hormonal Health & Digestion in Ontario

Get to the root of the problem:

Curated Lab Testing

It’s hard to heal when you don’t actually know what’s going on, and lab testing can be the most direct route of knowledge acquisition when it comes to your health.

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Need to get to the bottom of what's bothering you?

At Sequence Wellness, we believe that knowledge is the cornerstone of better healthcare. Our licensed naturopathic doctors are dedicated to improving outcomes and expediting the healing process. While we understand that personal circumstances may sometimes limit access to lab testing, whenever feasible, we prioritize the use of laboratory diagnostics to confirm diagnoses and to tailor our treatment plans. With more data at our disposal, we can chart a more precise and effective path forward in your journey to wellness.

 

Comprehensive Lab Testing Services for Holistic Health

It’s hard to heal when you don’t actually know what’s going on, and lab testing can be the most direct route of knowledge acquisition when it comes to your health.

Naturopathic doctors offer an accessible entry point to a more in depth investigation of what’s going on underneath the hood. We are a means by which you can learn more about your own body. It’s your body after all, and we are the interpreters you need to understand what it is trying to tell you.

We will give you the rundown on your suite of testing options, and help you understand what is warranted, what is relevant, what is necessary, what is not needed, and what is bonus. It’s up to you to decide what route we take.

Some patients need to know the numbers and they’d like to be tested through and through. Others just want the basic testing, and still others prefer trying gentle dietary and lifestyle interventions first to let their symptoms point them towards health.

It’s totally a choose-your-own-adventure, with your naturopath guiding you, but where you steer the ship.

Our Approach to Lab Testing

The Sequence Wellness Difference

We have a data-driven medical approach, which requires looking under the hood and gathering any data available. We rely on lab testing to properly assess the whole person and determine the root cause of their health concern. Not only do our licensed naturopathic doctors have access to extensive lab testing (including blood, urine, stool, saliva and breath testing), but we also have the medical training and clinical knowledge to be able to effectively interpret the results in a way that you can understand, and also apply to a practical and fruitful treatment plan. Each treatment plan is as unique as each patient, as we must take into account their baseline diet and lifestyle, as well as weaving together all aspects of their biology.

Lab Testing Services

In Ontario, licensed naturopathic doctors have the privilege of offering regulated lab tests. Our role is to guide patients towards appropriate tests that will provide truly impactful data and effectively guide a proper treatment plan.

Blood Testing

Blood testing is the most common form of testing in family practice in Canada. It allows us to gather data on vitamins and minerals, hormones (including thyroid, estrogen, progesterone, testosterone), blood sugar levels, inflammation, and organ function. It’s often used to assess overall health, identify nutrient deficiencies, and screen for various medical conditions.

At Sequence Wellness we use either Dynacare or Lifelabs for the blood sample collection. We provide patients with a requisition, and receive their blood test results usually within 1-2 days of their blood draw, which we immediately upload to our patient’s portal to give them access to their results. We believe that the data is yours, and that we are just the custodians of your medical information. 

(link to patient guide fo process and FAQs)

Blood tests commonly used by our naturopathic doctors include:

  • CBC, iron panel, C-reactive protein to measure oxygenation and inflammation (link to article about why it’s important to test %saturation)
  • Liver panel (AST, ALT, GGT, bilirubin) to assess liver health
  • Kidney panel (GFR, creatinine), urinalysis to assess kidney health
  • Cholesterol/lipid panel to rule out a cholesterol problem, and to take a closer look at the patient’s ability to process the amount of carbohydrates in their diet (via triglycerides)
  • B12, Vitamin D and other vitamins to assess intake, absorption and utilization
  • HbA1c, fasting insulin to test for diabetes, as well insulin sensitivity. This will help guide us on WHEN and WHAT to eat
  • Thyroid hormone panel: thyroid stimulating hormones (TSH), free T4, free T3, and possibly thyroid antibodies such as Thyroid Peroxidase Antibodies (TPOAb or TPO Antibodies) and Thyroglobulin Antibodies (TGAb). Testing reverse T3 may also be appropriate. 
  • (link to article about thyroid by Midori)
  • PCOS: LH, FSH, fasting insulin, HbA1C, testosterone, DHEA, thyroid, prolactin, lipid panel,  17 hydroxyprogesterone (17-OHP), progesterone, estradiol
  • We can also test for female hormones in a general patient, but other testing options may be more illuminating (see below).
Who needs it

Everyone should get annual blood work done to make sure you are in optimal health.

Does your doctor offer it/when your doctor offers it

Yes, often family doctors run annual labs. The list may not be as extensive as that of a naturopathic doctor, but your ND can provide you with a secondary requisition to fill in any gaps missed by your family doc. 

What it tests for

Blood work tests for vitamins and minerals, hormones (including thyroid, estrogen, progesterone, testosterone), blood sugar levels, inflammation, and organ function. 

How it’s valuable

It’s often used to assess overall health, identify nutrient deficiencies, and screen for various medical conditions.

Hormone Testing

The more we know, the better positioned we are to succeed. Even though symptoms of hormone imbalance can be very informative of the underlying hormonal situation in a woman’s body, assessing the actual hormonal terrain can allow us to be much more precise with treatment plans. Hormone testing is an invaluable way to get specific insights into the underlying mechanism of a woman’s symptoms.

Hormone Assessment Intake

If you know the language, and if you’re listening well, the body is very good at giving us hints about what’s going on underneath the surface. Depending on what the symptoms are, and when in your cycle they’re happening, we can often very precisely nail down the root cause of your health concern. Tools like basal body temperature testing and ovulation predictor test strips are a cheap and easy way to really fine tune our understanding of your hormonal cycling. And because naturopathic doctors (aka naturopaths) mostly use gentle interventions, we can often start a simple treatment plan and see how the body responds to help guide the deepening of the plan. 

Many times however, it is best to get some objective data via lab testing to be 100% sure that we are on the right track.

Blood Testing For Hormones

Serum hormone testing is the standard for assessment for most family physicians and OBGYNs. It is the best form of testing when working in collaboration with a patient’s other care providers. 

A typical female hormone panel would include estradiol, progesterone, LH, FSH, testosterone, DHEA, and prolactin. It’s important that estradiol and progesterone are tested 1 week after ovulation (day 21 of a 28 day cycle, or 1 week after a positive at-home OPK test), and that the others are tested on day 3 of the cycle. This is also a good opportunity to test other markers that could indirectly impact hormones, or cause symptoms that mimic a hormonal imbalance like a full thyroid panel (TSH, T4, T3, and possibly thyroid antibodies), iron/ferritin, B12, vitamin D, blood sugar and fasting insulin, and inflammatory markers. 

Blood hormone testing usually costs about $100, and is often covered under your extended health care plan.

Laboratories that we use for blood hormone testing:

Dynacare

Lifelabs

Salivary Hormone Testing

Salivary hormone testing gives us a tissue measurement of the hormone values, and as it’s easily collected at home, we have the added benefit of collecting multiple samples. Serial sampling is ideal for cortisol hormone testing, as there is a circadian (daily) rhythm and being able to measure cortisol levels at multiple points across one day gives a very usable data set with which we can specifically tailor a targeted treatment plan addressing each observed imbalance. 

Salivary hormone testing usually costs about $200-300, and is often covered under your extended health care plan.

Laboratories that we use for salivary hormones testing include:

Rocky Mountain Analytical

Doctor’s Data/Labrix

Urine Hormone Testing | Dutch Test

Dutch hormone testing is the Cadillac of hormone testing. Not only does it test for a broader range of hormones, but by testing the hormone metabolites it helps us determine not just the what but also the why of hormone imbalance.

A complete Dutch test assesses your 3 types of estrogen (estrone, estradiol, estriol), your progesterone, your androgens, testosterone and DHEA, as well as melatonin and cortisol. Samples are taken 4 times in one day, so that we get an accurate view of your daily cortisol circadian rhythm. 

Dutch hormone test reports are very extensive and are presented pictographically for ease of understanding, but once your results are in, your naturopath will thoroughly comb through each item with you and translate that into actionable plan sections so that you can finally achieve hormonal balance. 

The Dutch test costs about $450, and is often covered under your extended health care plan.

Who needs it

Women who are experiencing “hormonal symptoms” or women who are interested in a preventative holistic look at their hormonal balance can both benefit from hormone testing. Indicative symptoms include  period troubles like pain and heavy flow, PMS, PMDD, irregular cycles, perimenopausal insomnia or hot flashes, PCOS, hormonal hair loss or hormonal acne, and low libido. 

Does your doctor offer it/when your doctor offers it

Family doctors sometimes offer basic blood hormone testing like estradiol, progesterone, FSH, LH and prolactin, but advanced hormone testing is not covered by OHIP and therefore rarely suggested. 

What it tests for

Hormone testing is looking for an imbalance in the delicate equilibrium of female hormones.

How it’s valuable

Hormone testing is valuable because not only does it inform us of any imbalances, but it also let’s us know how bad this imbalance is, and therefore how much intervention is required. The testing allows us to create an effective and appropriate treatment plan that addresses the woman’s hormonal symptoms.

Tests for Digestive Function

Bad digestion can be really disrupting to a person’s life. The discomfort of constipation and bloating, the social complexity of gas/flatulence, and the logistical stress of diarrhea can all negatively impact a patient’s wellbeing. Many times the solution is obvious, and a good naturopathic doctor can suss out the cause within the initial intake, but at times digestive testing is beneficial.

Testing options for digestive health:

  1. Breath test: Used to diagnose conditions like SIBO and food intolerance.
  2. Comprehensive Digestive Stool Analysis (CDSA): Provides detailed information about digestion, absorption, gut flora, and the presence of pathogens (such as parasites, yeast/fungi, bad bacteria/archaea)

Digestive analysis can provide insights into digestive health, including assessments of gut flora, digestive enzymes, and the presence of pathogens such as bacteria, parasites, or yeast. It is often used to diagnose conditions like small intestinal bacterial overgrowth, intestinal methanogen overgrowth, irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD – crohn’s and colitis).

Laboratories/devices that we use for digestive testing include:

Food Marble

ICL Hospital Network

Doctor’s Data

Who needs it

People who have digestive upset, gas, bloating, irregular bowel movements (too many, too few, or poor quality stool), or those who want to make sure their gut health is optimal to better impact their overall health are great candidates for digestive function testing.

Does your doctor offer it/when your doctor offers it

These types of tests are not usually offered by family doctors.

What it tests for

These test for gas production, bacterial species balance, digestive enzymes, and more.

How it’s valuable

What we put into our bodies is to fundamental to our overall health, but if what we put into our mouths is not being properly digested and absorbed, our cells aren’t getting the fuel they need, AND we often get digestive symptoms that are bothersome. Testing to determine how you’re processing your food can make a huge difference in your day to day experience, as well as your long-term health.

Food Intolerance Testing

Identifying a food trigger can be very difficult as reactions can span over a number of days, and severity levels can vary depending on overlapping factors. Testing can be a very effective guiding tool that can fast track the patient to a clear answer and allow them the whole picture needed to properly implement the dietary change. 

There are 3 primary ways of testing for food intolerance:

  1. Elimination diets: if you cut out a food and feel much better, then there you go, you have determined your food intolerance! However, for some people the lengthy process of food elimination is challenging, and not always clear. 
  2. Breath testing: breath testing tools (like FoodMarbleFood Marble FAQ and process (use videos: https://www.youtube.com/@FoodMarble)) allow us to measure fermentation gas with a simple handheld device. If gas production occurs 3+ hours after eating, it means that the food has passed all the way to the large intestine in an under digested state, and therefore indicates that the patient does not produce enough of the digestive enzymes to break down that particular food. There is a clear demarcation between a small intestinal bacterial overgrowth and an inability to process the food itself.
  3. IgG food intolerance testing is a measure of a patient’s immune reaction to a food (link to article with difference between IgE and IgG reaction). If the patient is having systemic symptoms triggered by foods (such as migraines, eczema, psoriasis, hashimoto’s thyroiditis, endometriosis, joint pain, brain fog, congestion, etc) then IgG can be appropriate.

Laboratories/devices that we use for digestive testing include:

Rocky Mountain Analytical

Dynacare

Food Marble

Doctor’s Data

Who needs it

People with digestive issues or systemic inflammatory symptoms like eczema, migraines, joint pain, thyroid conditions, and anyone with an autoimmune condition can benefit from food intolerance testing. 

Does your doctor offer it/when your doctor offers it

This type of testing is not usually offered by family physicians.

What it tests for

These tests assess your digestive and immunological reactions to food. 

How it’s valuable

These tests are valuable because they allow you to pinpoint your ideal diet. Knowing what foods you should be putting into your body is by far the most powerful health intervention you can have. Not only are you able to avoid foods that can be harming or triggering your system, but you can be fully nourished and therefore able to heal your full system.

Stress Testing

The adrenal glands are factories, not magical fairies. They pull ingredients from the bloodstream, and then build stress hormones and pump them out. But this system was only designed for short-term activation. Many people nowadays are overtaxed by busy family schedules, work pressures, and no downtime to recover. To exacerbate the issue, if there is a nutritional deficiency or hormonal imbalance, the system falls totally out of whack and has a hard time coming back on line on its own. 

The first disruption that we see is that the adrenal glands hyperfunction, responding really strongly to the high demands. After that the person usually transitions to an erratic response (where they are tired but wired, no energy in the day but insomnia at night). And lastly the adrenal glands start to under function, and the person is not able to respond to their daily demands anymore. 

Lab testing can help us assess where the patient actually is, as often the way they are presenting is conflated with their values and coping strategies and is difficult to determine without concrete data. 

Our goal is to prevent, or recover quickly from, burnout, so knowing how close a patient is to that is extremely useful. 

We primarily use 3 tools for testing stress levels:

  1. Burnout questionnaire
  2. 4-point salivary or urine diurnal cortisol and DHEA testing
  3. Continuous glucose monitoring (as a proxy measure of minute-by-minute cortisol levels)

These tests can help us understand the body’s stress response and circadian rhythms, and formulate a treatment plan that replenishes the system and re-patterns the daily stress cycle. The stress impacted patients range from mild (feelings of stress but no physical impacts yet) to severe (sick leave from work), and all levels in between. Proper assessment and support (including nutrition, lifestyle recommendations, supplements and botanicals) make an enormous difference in the person’s day to day well being.

Laboratories/devices that we use for digestive testing include:

Rocky Mountain Analytical

Precision Analytical

Doctor’s Data

Who needs it

Stress testing is not for everyone. If you are someone on the edge of (or currently on) a leave from work due to burnout, cortisol testing can be useful information to document. And for many people who may be presenting in a complicated way like tired but wired, testing allows us to more effectively direct a treatment plan to the actual underlying hormonal state. For others, their symptoms and stress environment are clues enough to create a stress management strategy.

Does your doctor offer it/when your doctor offers it

Family docs usually only test for morning blood cortisol, which has limited value. Doing 4-point cortisol testing across one day has more clinical significance for the assessment of burnout.

What it tests for

This tests for your adrenal function and stress resilience.

How it’s valuable

This testing allows us to determine where on the burnout spectrum a patient is. Do we need to support their adrenal system to permit their bodies to continue to function under high chronic stress, or have they passed that point and need more aggressive intervention and rest in order to recover.

For a full list of testing available via a naturopathic doctor in Ontario please see the College of Naturopaths of Ontario's webpage

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Find out what’s going on under the hood

Want to learn more about your body and what it needs to be healthy? Take the first step by scheduling lab testing at Sequence Wellness.

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