The GI-MAP: Functional Testing (& Not Guessing) When Your Conventional Assessment Says Your “Fine” But You Don’t Feel Fine

“Gut Health” has become a trendy phrase, but it’s also “a real thing” as there is medical literature that supports and validates the topic of “gut health” as more than a fad. Research also speaks to how poor gut health goes hand in hand with chronic health problems.

How is gut health defined?

In short, gut health can be described as effective digestion and proper absorption of food, the absence of GI illness, and a normal intestinal microbiome that supports well-being and quality of life.

Assisting a patient on their gut health journey is very much in wheelhouse of a registered dietitian and a topic I am passionate about.

Registered dietitians (myself included) like science and objective, tangible data. Enter in the GI-Map for one functional health tool we can use for evidence and insight for “what is going on inside” the gastrointestinal tract to help guide nutrition related interventions

This highly sought after GI-MAP (Gastrointestinal Microbial Assay Plus) test is a FDA cleared at home stool test ordered by physicians (and dietitians too!) around the country. It has become such a wonderful option in my tool kit to assist with in depth nutrition related assessments. It is not a replacement for medical evaluation; view it as an adjunct tool when formal diagnostic testing is not showing disease.

What makes this GIMAP stool test unique?

This test is special as it’s “a one stop shop” stool sample (versus multiple tests and stool samples). Additionally, it uses the cutting edge Quantitative PCR technology that has a high sensitivity and high specificity to take a deep dive into the microbiome to see exact microbes that tend to disturb the normal balance.

An imbalanced gut can contribute to digestive problems as well as chronic health conditions. Of course, there can be other etiology when it comes to GI related illness, but the very comprehensive GI-MAP test is one excellent avenue to explore gut health (or lack thereof).

Why I often use this tool with patients

While some breath testing indirectly confirm general presence of bacteria, the GImap analysis of the gut takes it a step further and spells out what bacteria is in a patient’s stool sample, and how much. The GI-MAP also measures certain non-microbial factors that are valuable for a dietitian to evaluate and then be able to provide nutritional guidance from this. It does not replace medical evaluation, but can be one telling piece of the puzzle. Even as a registered dietitian I say that nutrition and nutraceuticals do have limitations; in the same breath they are often a underutilized measure in healthcare.

Many patients end up accessing a dietitian on their own, and a good thing to point out is that many health insurance companies do NOT require a physician referral for a patient to be evaluated by a dietitian; many people just don’t know this yet and why I wrote this article about what dietitians bring to the table and that it usually insurance covered to have a dietitian consultation.

What are some specifics of this GIMAP test?

You can Click here to see a sample report to see the details. Obtaining and reviewing this data is very valuable for a dietitian as the results add in tailoring nutrition related interventions. This test goes above and beyond disease screening and management in the sickcare system; it is about measuring function and pursuing optimization.

What’s the deal with “good” and “bad” gut bacteria?

Commensal bacteria as shown on the sample report are the “good guys.” (In a healthy gut, we should have plenty of commensal bacteria.) The GI-map test measures levels of a dozen different probiotic and commensal microbes and/or phyla. Low levels of “good bacteria” are linked to difficulty with weight loss, unintentional weight gain, insulin resistance, and constipation among other concerns.

On the other hand, dysbiotic or “bad” pathogenic organisms are opportunistic and will take over. An overgrowth of dysbiotic microbes is linked to many conditions and symptoms. IBS, acne, autoimmunity, depression, anxiety are just a few serious chronic conditions related to overgrown bacteria.

Undiscovered and unchecked gut dysbiosis can create a domino effect of other health conditions over time. As a registered dietitian in functional and integrative nutrition, my care philosophy is to dig to get to the root cause when applicable of the dysfunction (lower stomach acid, not chewing food well, a zinc deficiency, low b12, etc.) and leave no stone unturned! Each of the above areas I briefly touched on can be partially and sometimes fully addressed with nutrition and nutraceuticals. Read here a fascinating study demonstrating the efficacy of nutraceuticals for intestinal bacterial overgrowth.

Who is an appropriate candidate for a GI-map test?

Those 4 and older who report any of the following:

• Acid reflux
• Unintentional weight changes
• Elevated blood glucose/prediabetes/type 2 diabetes
• Acne
• Depression and/or anxiety
• Bloating
• Burping
• Ezcema
• Gassiness
• Constipation
• Diarrhea
• Mold illness or CIRS
• Antacid usage
• Birth control pill usage
• Metformin or GLP1 usage
• Many more to list!

What is the process like for getting a GIMAP?

Once I order the GImap test, the patient receives the testing kit (see picture above) in the mail within days. The stool is collected at home by the patient, and placed into the provided test tube. The patient then ships the sample back to the lab in the provided medical shipping package with prepaid postage.

In about 3 weeks, the results populate into my medical records system. There are a few markers that depending upon the results, require me to refer out (like if occult blood is found) as it is out of my scope of practice. In this instance, I refer back to your primary care doctor or GI physician for something that is completely medical in nature. Most of what is found in a GI-map test lends itself to needing skilled nutritional guidance.

What’s the scoop on GI-map and health insurance coverage?

This is a functional test so generally not insurance covered. The investment to getting valuable data about your health is about $300. It’s worth asking how much is it costing you living with your symptoms, on various prescription medications that might not be working, and jumping around from Doctor to Doctor.

Once the results are back from lab, I meet with the patient again for additional consultation to create an individualized action plan that addresses what was found.

What are some recommendations that are concocted based off the GImap test results?

• Specific ideas for fiber and FODMAP intake
• Specific instructions for prebiotic and probiotic usage
• Specific instructions for herbal usage (after careful review of medical history and prescription usage, which is in the skillset of a Registered Dietitian)
• Specific instructions to address gut motility via nutrition
• Specific instructions on what to use in regards to supplementation
• Possible other testing to check for nutrient deficiencies that might be a part of the GI problem, and then correct what is abnormal
• Explore environmental concerns that can alter normal gut function like checking for heavy metal bioaccumulation or toxic indoor mold exposure
• Meal planning that goes into detail for what is needed for calorie, protein, fat, and carbohydrate intake

I do not recommend doing any of this “piece-mealed” or on your own. There is a right and wrong time to do any of these above. Certain things can worsen the situation (like certain prebiotics and probiotics can contribute to cross feeding of the “bad bacteria,” and herbs need to be carefully chosen if appropriate to use).

Accessing a skilled registered dietitian who knows what they are doing when it comes to the Gimap test and medical nutrition therapy for gut health is so important – I’ve order over 1000 tests so far. Safety, individualized care, and being results oriented are all a mainstay in my care philosophy when it comes to gut health.

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