We don't look at a single value in isolation. We look at function, pattern, and context.
Functional tests provide additional insight into how certain biological systems behave over time. Depending on the type of test, they may include hormones and their metabolites, the daily cortisol rhythm, digestive function, the microbiome, organic acids, and other indicators of metabolic processes.
Their value is not to replace the patient history, clinical examination, or standard laboratory diagnostics. Their value lies in providing an additional layer of information when there is a clear clinical question.
Tells you how much of something is present.
Show which pathway it took.
Helps us understand how the system functions.
A functional test is not chosen because it is advanced, new, or comprehensive. It is chosen when it can answer a specific question and potentially change a clinical decision.
Before choosing a test, we ask:
Assessing reproductive hormones, androgens, estrogen metabolites, and cortisol metabolism patterns can provide broader context in appropriately selected patients.
Multiple sampling can reveal the daily pattern of free cortisol, while additional markers can help distinguish between free cortisol, total production, and clearance.
Selected tests can provide information about microorganisms, digestive markers, inflammatory indicators, and the gut environment.
Analysis of certain metabolic products can point to patterns related to energy metabolism, nutritional cofactors, and oxidative processes.
Hormones are not just a number
The DUTCH approach combines assessment of reproductive hormones, their metabolites, and markers of cortisol metabolism. DUTCH Plus also includes saliva samples used to assess the daily free cortisol rhythm and the Cortisol Awakening Response — CAR.
The training focuses on structured interpretation of findings:
From a list of microorganisms to clinical meaning
The presence of a microorganism alone is not enough to draw a conclusion. The result is evaluated together with symptoms, medications, diet, travel history, immune status, standard tests, and the methodology of the specific test.
The program may also include targeted tests related to digestive function, absorption, inflammation, nutritional status, and other physiological systems. AFLM does not teach participants to order as many tests as possible — it teaches them to choose the test that fits the clinical question, and to recognize when additional testing is not needed.
The AFLM clinical model
Age, sex, symptoms, reproductive status, therapy, supplements, sample collection timing, and previous findings.
What is measured, with which sample, using which technology, and with what limitations.
The result is always read in the same order, to reduce selective interpretation and overinterpretation.
We don't look for ten unrelated deviations. We identify two or three dominant, interrelated patterns.
Are the finding, symptoms, standard tests, and clinical picture consistent with one another?
We determine what the finding supports, what it cannot confirm, and what the safe next step is.
A functional test should not be presented as a standalone diagnosis. It cannot automatically determine the cause of every symptom, nor independently determine therapy. The finding should not be used to:
A special place in the training is given to red flags — findings and symptoms at which functional interpretation stops, and the priority becomes standard diagnostics or referral to the appropriate specialist.
The programs are intended for physicians, pharmacists, medical biochemists, nutritionists, and other qualified healthcare professionals, in accordance with the competencies and professional authorizations of each profession.
No prior experience with functional tests is required. The program begins with basic principles and gradually leads toward structured interpretation and work on clinical cases.
Understanding the test, the sample, the report, and the basic sequence of interpretation.
Working with more complex patterns, result discrepancies, therapy, pre-analytical factors, and correlation with standard laboratory findings.
Integration of multiple data sources, structured case presentation, critical decision-making, and mentorship.
Upon completing the relevant program, the participant will be able to:
AFLM training connects biology, laboratory methodology, and the real patient. The goal is not a greater number of tests, but a higher-quality, safer, and more precise clinical decision.
