The history picks the first lab
The visit starts with a timeline. When the symptom started, what else changed, what has already been tested, and what you are afraid is being missed. That timeline points at a system. Hormones, gut, metabolism, or an exposure each suggest a different specimen. Functional lab testing is the decision, not a product. Dr. Tara Kohen says the question in a sentence before any kit is named.
Prior records change the decision. A thyroid panel from last month is not redrawn for atmosphere. A stool test done in the middle of antibiotics may need to be set aside. Bringing results is part of the exam. A free 20-minute consultation can be enough to learn that you do not need a new lab yet. That is a successful consult.
DUTCH, stool, blood, or breath
DUTCH hormone testing fits a question about sex hormones, metabolites, and the shape of cortisol across a day. It is dried urine at home. It is a poor tool for a thyroid dose decision, which wants blood. GI-MAP stool testing fits a question about organisms, digestion markers, and inflammation such as calprotectin. It does not draw a breath-gas curve.
A breath test fits a question about hydrogen and methane after a substrate, with a prep diet and a long morning. Bloodwork fits glucose, insulin, iron, B12, lipids, or thyroid hormones. Chronic fatigue might lead to any of these, or to none, depending on the timeline. Hormonal imbalance does not automatically mean DUTCH if the story is actually a thyroid medication problem. The specimen follows the story.
Ordering less on purpose
Each lab creates pages that demand attention. Ordering four kits on day one produces a review that skims. It also confuses cause: you cannot tell which change mattered. FRI sequences. One lab, a decision, then another only if the first left a defined hole. Dr. Sani Kohen will tell you which popular test is being skipped. The skip is part of the plan.
Brain fog and gut health together still do not justify a stack. If the gut story is louder, stool or breath comes first. If the hormonal story is louder, urine or thyroid blood comes first. The second test waits until the first has been read. Patience here is cheaper and clearer.
The extra cost, said before the kit
Labs are an additional cost on top of the clinical visit. The amount depends on the lab and the panel, and this page will not invent a number. You should hear, in the room, that there is a separate fee and what has to be true for the fee to be worth it. HSA and FSA cards can be used for many of these expenses. The office is out of network and provides a superbill for the visit. Reimbursement is between you and your plan.
The review of results is its own visit and often runs 30 to 60 minutes depending on the plan. You are not emailed a highlighted PDF as the whole interpretation. If the result is urgent, you hear sooner. If the result changes nothing, you hear that too. A lab that changes nothing was still a decision, and the next one is harder to justify.
What a Functional Lab Testing visit is like
Expect more questions than vials at the first visit. You will talk through sleep, cycle, bowel pattern, diet, buildings, work exposures, and prior tests. The end of the visit is either one lab with a reason, a request for records, or a decision to wait. Leaving with three kits is the exception and needs an unusually clear set of separate questions.
When results return, the review ties them back to the sentence that ordered them. Unrelated abnormalities are not hunted for sport. Anything that belongs with a physician is handed off in plain language. You should be able to say which test you did not do, and why.
Before you get on the 5
No referral is required. Bring shoes you hike or walk the trail in if the foot or knee is the issue. Prior MRIs are useful and not mandatory. If you have bowel or bladder changes, saddle numbness, or a rapidly weakening leg, do not drive past an emergency department to reach us.
The practice is out of network. San Clemente patients typically use HSA or FSA funds and a superbill. We will not guess your benefits. The doctors are Drs. Sani and Tara Kohen. Their biographies are on the about page, and the clinic layout is on the office page.
Pier Bowl, Talega grades, and Trestles mornings
San Clemente has two terrains that matter clinically. The Pier Bowl, the beach trail, and the streets near the water are relatively level and sandy. Talega, Forster Ranch, and the newer hills are the opposite: repeated grades, youth sports, and a drive just to reach I-5. Surfing at Trestles and along the pier loads shoulders and low backs. Hill neighborhoods load knees on the way down and necks on the drive. We ask which part of town you live in because the home program has to match the grade outside.
A lot of San Clemente patients are trying to stay active while working north of here. The I-5 commute itself is a sitting test. If your low back or sciatica eases when you walk the beach trail and worsens in the car, that detail changes the exam. Tell us the direction of the commute and how long you sit, not only where it hurts.
Coming north on I-5 to the clinic
The drive is I-5 north through San Juan Capistrano into Mission Viejo, about 16 miles. Without a slowdown it is a little over 20 minutes. A backup through the Capistrano stretch pushes it toward 35. Exit for the La Alameda side of Mission Viejo and come to 26400 La Alameda, Suite 100, CA 92691. Parking is on site. The doors are open Monday through Thursday, 9 to 6.
Because the drive is simple, people sometimes stack a visit onto a day that already includes a surf and a commute. Say if that is the plan. We may want the exam before the surf, or we may want you to skip the session that morning so the tests mean something. Call (949) 312-1754 if you are sorting the order. The 20-minute consultation can be the first appointment if you are not ready for a full evaluation.
Questions patients ask
Why not order DUTCH, stool, blood, and breath together?
They answer different questions. Running all of them at once blurs which result matters and spends money before the history has earned it. One lab is sequenced before the next.
How much do the labs cost?
They are an additional cost beyond the visit, and the figure depends on the test. FRI will not quote a made-up price here. You are told there is a separate fee before you order.
Do I need labs to start care?
No. Many mechanical problems need an exam and treatment, not a kit. Functional labs are for questions the history cannot answer by looking and moving.
What if my results are normal?
Normal is an outcome. It closes that question and makes the next kit harder to justify. The visit says so instead of finding a new panel to keep the search going.
Related methods and problems for San Clemente
Functional Lab Testing is one tool inside Functional Medicine. It is not booked as a standalone trick disconnected from the exam. These links are the neighboring methods and the problems that most often lead someone from San Clemente to ask about it.
- Functional Lab Testing overview
The clinic-wide technique page, without a city attached.
- San Clemente chiropractor
Drive, neighborhoods, and the rest of the care offered to San Clemente patients.
- Functional Medicine
The pillar this method belongs to.
- DUTCH Hormone Testing
The DUTCH test uses dried urine collected across a day to look at sex hormones, their metabolites, and the shape of cortisol.
- GI-MAP Stool Testing
GI-MAP is a stool test that uses a PCR-style method to ask about microbes, including possible pathogens, and about selected markers of.
- Advanced Bloodwork
Advanced bloodwork goes past a bare metabolic panel when the question needs more context. Lipids in more detail, glucose with insulin, iron.
- SIBO Breath Testing
A SIBO breath test measures hydrogen and methane in the breath after you drink a substrate, either lactulose or glucose. A rise.
- Chronic Fatigue in this city
Persistent exhaustion that does not match your effort deserves a careful look, not a single explanation. FRI does not offer a specialty.
