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Nicola Shubrook interview: How I use advanced functional testing in my practice

At Regenerus Labs, we're proud to work with a whole range of leading healthcare professionals, ranging from nutritional therapists, nutritionists, doctors, functional medicine practitioners and dietitians.

As such, we thought it would be a great idea to showcase some of our registered practitioners - and shine a light on how they're using our advanced functional testing in their practice to stay at the forefront of their fields.

In light of this, we interviewed Nicola Shubrook, founder of Urban Wellness, to get her take on advanced functional testing - and how she uses them to provide her clients effective and informed treatment protocols.

Would you say that using functional testing is necessary in clinical practice as a functional health practitioner?

Functional testing is not always necessary in clinical practice as it depends on the client and their presenting symptoms.  Sometimes some simple dietary changes and better lifestyle practices can achieve their health goals. However, depending on the complexity of the client, functional testing can be a valuable tool as it can provide a deeper understanding of what is driving a clients’ symptoms. 

In my clinical practice, I often work with clients who have been struggling with their symptoms for years, and so using the right functional testing can provide me with a better understanding of what is driving their symptoms and as a result, potentially a quicker route to resolution.

Why do you use advanced functional tests from international labs provided by us, as opposed to over-the-counter tests or ones found on websites like Thriva and Medichecks?

Over the counter tests or those provided by platforms such as Medichecks or Thriva can be helpful for basic blood results, but the functional tests offered by Regenerus provide a much deeper and more comprehensive insight into a client’s health.

For example, a client could pay for a blood test through a website or their GP to determine their hormone levels but this doesn’t show you how their hormones are being metabolised. 

Through Regenerus I can order a DUTCH test which allows me to understand at a much deeper level, not only what levels of hormones a client has, but how well she is using them, together with key markers such as cortisol levels and HPA axis as well as important nutritional organic acids and neurotransmitter markers.

Generally, what benefits do you feel using advanced functional tests bring to your clinical practice?

Advanced functional tests help me to identify the root cause/s of a client’s health concerns and create a personalised plan to address them. Client compliance is often greater too when I use these advanced tests. 

Often my clients have run generic blood tests which have come back as ‘normal’, and so when I am able to use advanced functional testing and show the client their results it gives them hope and a determination to make the necessary changes to improve their health.

Can you give any specific examples of how using advanced functional tests has aided your clinical practice?

One case in particular stands out for me. A client came to me experiencing perimenopause symptoms of anxiety, irritability, lack of periods and insomnia.  Her periods had been absent for two years, and her GP had put her on HRT as the assumption was that she was in early menopause. This client wasn’t feeling any better six months down the line, her HRT dose had been increased in this time) and in fact she felt worse. So we ran a DUTCH test to get a better understanding of her hormones and how well her HRT was (or wasn’t) working for her.  Her DUTCH results came back showing that her oestrogen levels were through the roof, she wasn’t in early menopause and more importantly that she shouldn’t have been on HRT.

Another test I use a lot with Regenerus is the Thyroid Monitor and Vitamin Home Test. Many of my clients have thyroid issues and I often want to check not just their thyroid hormone levels but whether they are presenting with any thyroid antibodies which can be an indication of an autoimmune disorder.  I have had several clients who have been taking thyroid medication for years but still struggle with low energy and weight gain, even when their medication is increased.  We then went on to identify thyroid antibodies, which allowed us to make the necessary changes to improve their health.

What advanced functional tests do you use most often in your clinical practice?

DUTCH is the test I use the most in my clinic, largely because I specialise in working with midlife women who are starting to experience menopause changes, or have been struggling with a hormone-related condition such as PMDD or PCOS for many years and want to improve their symptoms and heath.

Do you feel that a clinician needs to be skilled in order to use advanced functional tests effectively?

I think as a clinician we need to understand why we are ordering the test, what additional information is it going to give me to help this client.  Personally, I never order any tests for my client until we have had an initial consultation – if the client is investing a functional test or tests, then I want to make sure we are choosing the right test for them.  I have had clients who have come to work with me having already spent thousands of pounds on tests and yet they don’t know what to do with them nor feel any better!

The great thing about Regenerus is they also have a brilliant Clinical Support Team which allows you to book a support call to discuss your clients’ results.  For anyone clinician starting out with advanced functional testing it can seem daunting, but the more you run the tests the more you improve your skills of interpretation.

Do you feel that there are any drawbacks of using advanced functional tests in clinical practice?

I think there are two main drawbacks.  The first is that we cannot just take the test results as gospel – they are a snapshot in time and all results must be overlaid with the clients’ symptoms to ensure you are getting the most from them.  I think it can be very easy for some to get a client’s results and follow a protocol based on those results rather than tailoring it to the client specifically.

The other drawback I see is some practices ordering a suite of functional tests before a client even has a conversation with a clinician.  This can be costly and may not always be relevant for the client.

How do you ensure you are in control in understanding and using advanced health tests in clinical practice?

I regularly listen to podcasts, read the latest literature, and attend webinars hosted by the labs to ensure I am up to date with the latest research and test offerings.  In some cases, I will also have a conversation with Regenerus before ordering a test to make sure I am using the right one for the client, based on their symptoms, which is rally beneficial to my practice.

What’s your biggest gripe about using advanced testing in your clinical practice?

I wouldn’t say I have a big gripe about using functional tests.  Sometimes the test directions can take a bit of explaining to a client, especially for a DUTCH test which in some cases needs to be timed with a certain time in their menstrual cycle.  Probably one challenge is finding a private phlebotomist – some tests require a blood draw, or a client is unable to complete a finger prick home test, and it can be hard to find a phlebotomist to complete the test for the client.

Has Regenerus Labs helped ease any of the above issues for you?

Regarding the DUTCH test, yes.  Often my clients have irregular cycles, but I have been able to speak to Regenerus about working out the best time for the client to run the test.

What new functional tests have you got your eye on and would like to start using in the future?

I do a lot of work with microbiomes, gut and vaginal in particular. There is a new bladder microbiome test potentially coming to market and I have also got my eye on MicroGenDX which Regenerus now offer which will be really valuable for my clients who struggle with chronic urinary tract infections and bacterial vaginosis.

Learn more about Nicola Shubrook

Nicola Shubrook, Nutritional Therapist, Hynpotherapist and Eating Disorder Specialist

Nicola Shubrook is a qualified nutritionist registered with the British Association for Nutrition and Lifestyle Medicine (BANT), with over 10 years experience having graduated from the College of Naturopathic Medicine (CNM) in 2009.

Nicola is also a member of the Institute for Functional Medicine and has completed her training with the National Centre for Eating Disorders. As well as running her own private clinic, Urban Wellness, Nicola also writes health articles for leading publishers, including BBC GoodFood, Red Magazine UK, and Women's Fitness.


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