In this episode of Functional Medicine Research, I interview Tom Fabian, PhD in a detailed discussion about the GI-MAP stool test interpretation. We covered virtually every aspect of the GI-MAP stool test including what the test results mean and how to use them in clinical practice.

Dr. Fabian has tremendous knowledge of the gut microbiome and the intricacies of the GI-MAP stool test markers. This is a vital interivew to listen to if you're utilizing the GI-MAP stool test in your practice.

Full transcript of the GI-MAP Stool Test Interpretation interview with Dr. Tom Fabian:

Dr. Hedberg: Well, welcome, everyone to Functional Medicine Research. I'm Dr. Hedberg, and I'm looking forward today to my conversation with Dr. Thomas Fabian. He is a PhD., and he's a clinical laboratory consultant, translational science expert, functional nutrition practitioner, educator, and speaker. He is a former biomedical research scientist and deep expertise in the role of the human microbiome and health, chronic disease and aging. As a leading expert in translational applications of microbiome research and functional medicine and integrative health settings, Tom's primary focus is on providing educational resources and consulting services for practitioners and scientific advisory and consulting services for clinical testing laboratories. Dr. Fabian, welcome to the show.

Dr. Fabian: Thanks so much, Nik. It's great to be here today, and I'm looking forward to the conversation.

Dr. Hedberg: Excellent. So, we're gonna be talking about the diagnostic solutions, lab, GI-MAP test, and we're gonna cover interpretation, you know, what these markers mean. And so, for all the practitioners listening, they'll have a strong idea of how to approach this test and how to use these things clinically. So, why don't we start with...take it from the top in the pathogen section? And I wanted to ask you specifically about C-diff. There's toxin A and toxin B Clostridium difficile markers on this test. And what is your interpretation of this if it's positive and the patient is symptomatic, and then you treat them, and then they're no longer symptomatic, but the toxin still shows up on the stool test? Can you elaborate a little bit on that type of presentation?

Dr. Fabian: Sure. No, I haven't personally seen that particular scenario but, in general, it's important to keep in mind a lot of people can be carriers of C-diff. So, the majority of the time that we see it detected positive, whether it's low levels or high levels, typically, patients don't have the classic symptoms. So, that suggests that they're probably just a carrier. And there's, sort of, kind of, a gray area in between where there still may be some effects of C-diff. Of course, that's one of the purposes of looking at the markers on GI-MAP like calprotectin, zonulin, etc. to see if there seems to be any evidence that may be have an impact, even if there aren't symptoms. So, we're also learning a lot more from research about factors that can control or influence the ability of various pathogens to thrive and also whether or not they can cause infection or if they have their, you know, typical pathogenic effects. So, that's essentially factors that influence virulence.

So, one of the first things I want to mention is all the microbial markers on GI-MAP are assessed based on detection of DNA. So, when you're looking at DNA, you're looking at detection of the organisms or the genes but not necessarily whether the genes are being expressed. And that's definitely true for toxins. So, lots of research has been coming out in research years in terms of, again, as I mentioned,