---
title: "Hidden Drivers Lab Guide"
entity: "page"
canonical_url: "https://www.innatenaturopathic.com/hidden-drivers-lab-guide"
markdown_url: "https://www.innatenaturopathic.com/llms/page/hidden-drivers-lab-guide"
lastmod: "2026-11-03T21:04:50.501Z"
---

Dr. Holland's comprehensive lab guide

# The Hidden Drivers Lab Guide

A reference guide to the labs and assessments used to look for the hidden drivers behind persistent symptoms, organized by body system. Enter your details below and we will send it straight to your inbox.

## Get your free lab guide

## Core energy pillars

Start here. These five systems are the foundation of energy production and stress resilience, so they are often the first place to look.

### Adrenals / HPA Axis

Morning cortisol, DHEA-S, 4-point salivary cortisol curve, ACTH when indicated

### Thyroid

TSH, free T4, total T4, free T3, total T3, reverse T3, FT3:RT3 ratio, thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb)

### Gastrointestinal System

CBC with differential, CMP, iron panel with ferritin, vitamin B12, folate, magnesium, CRP, celiac panel. Comprehensive stool analysis when indicated: microbiome, short-chain fatty acids, calprotectin, secretory IgA, pancreatic elastase, parasites, and pathogens

### Detoxification System

Liver enzymes (ALT, AST, GGT), kidney function (creatinine, eGFR), ADH, red blood cell glutathione, red blood cell magnesium

### Immune System

ANA, CBC with differential, WBC, immunoglobulins (IgG, IgA, IgM, IgE), lymphocyte subsets (CD3, CD4, CD8, CD19, NK cells), NK cell count and function, complement C3 and C4, CRP, total protein and globulin, vitamin D, vitamin A

## Cellular health and communication

### Mitochondrial & Cellular Health

Carnitine (free and total), CK, lactic acid, LDH, organic acids test (OAT), pyruvic acid, 8-OHdG, genomic testing when indicated

### Nervous System

Clinical assessment of autonomic function, sleep, stress response, and neurological symptoms

### Hormones

Estradiol, progesterone, testosterone (total and free), SHBG, DHEA-S, LH, FSH, prolactin

## Hidden infections

### Epstein-Barr Virus (EBV)

EBV viral capsid antigen (VCA) IgM and IgG, EBV nuclear antigen (EBNA) IgG, early antigen (EA) IgG; EBV DNA PCR when clinically indicated

### Lyme Disease

Indirect testing: ELISA/EIA, Western blot (IgM/IgG), immunofluorescent antibody (IFA), immunoblots.

Direct testing: PCR (DNA), FISH (RNA), Nanotrap urine antigen testing.

Immune function markers: C3a, C4a, CD57, TGF-β1.

Inflammatory markers: ANA, CRP.

### Other Tick-Borne Infections

Testing for Babesia, Bartonella, Anaplasma, Ehrlichia, Rickettsia, and other vector-borne pathogens based on symptoms and exposure history

### Other Viral Infections

HSV-1 (HHV-1), HSV-2 (HHV-2), HHV-6A and HHV-6B, CMV, Coxsackievirus A and B, VZV, EBV and Parvovirus. Pathogen - specific antibody, antigen, or nucleic acid testing, as clinically indicated.

### Long COVID-19 / Spikeopathy assessment

SARS-CoV-2 semi-quantitative total antibody, spike (S-protein) - Consider results alongside symptom history, infection and vaccination history, and other clinical findings.

Section 4: Labs and Assessments

## Hidden toxins

### Mold & Mycotoxins

Screening: Mold IQ symptom questionnaire, exposure history, visual contrast sensitivity (VCS) screening.

Urine mycotoxin testing: Urinary mycotoxin panel.

Serum mycotoxin antibody testing: Mycotoxin IgG and IgE antibodies.

Organic acids testing: Urinary organic acids test (OAT), including fungal metabolites when colonization is suspected.

CIRS panel: HLA-DR/DQ, C4a, TGF-β1, MMP-9, MSH, VEGF, VIP, ADH, serum osmolality, ACTH, cortisol, leptin, T-regulatory cells (Tregs), anti-gliadin antibodies (AGA), anticardiolipin antibodies (ACLA), von Willebrand factor/profile (vWF), C3a, lipase.

Additional assessments: MARCoNS nasal culture; home moisture and mold assessment.

### Heavy Metals

Urine heavy metal testing

### Glyphosate

Urinary glyphosate testing

### Other Environmental Toxins

Exposure history and targeted testing based on suspected pesticides, solvents, chemicals, or other environmental contaminants

Clinical note

This table is a reference meant to be used for your individualized assessment. This is not a recommendation to order every test. Testing should be selected and interpreted in the context of your symptoms, exposure history, and clinical presentation.

This guide offers general wellness information and is not medical advice.