When patients eat poorly, they often feel bad. This can hinder their recovery and response to care—sometimes healing more slowly than expected or not at all.
Incorporating nutritional testing into my practice stemmed from a desire to provide more effective and individualized treatment plans.
An estimated 90% of Americans fail to meet their daily nutrient needs from food alone,1 making nutritional testing a valuable tool to identify and address deficiencies. Understanding the potential interactions and benefits of these nutrients opened my eyes to the profound role nutrition plays in healing.
I noticed that even when I applied physical therapy modalities and adjustments, some patients weren’t improving as quickly or as fully as I thought they could. Nutrition became a key part of my history-taking process and workup. It has made a significant difference in my patients’ outcomes and the growth of my practice.
By addressing nutritional deficiencies and imbalances, you can improve clinical outcomes, enhance patient satisfaction and diversify your revenue streams. Here’s how:
Improving patient adherence and results
Your patients are more likely to follow treatment plans when they feel personally invested. Nutritional testing plays a key role in fostering this commitment by:
Offering personalized care: A holistic approach shows patients you care about their overall well-being, not just their spinal health. Patients are getting this information from other professionals if it’s not from you, so incorporating it into your plan allows them one source of care that is very thorough.
Providing tangible results: Measurable improvements, such as reduced inflammation or increased energy, reinforce the value of continuing care. For example, running a test that flags inflammation markers, such as CRP, ESR, uric acid and ferritin, can facilitate your treatment plan and the patient’s improvement.
As you’re treating the patient, it’s easy to retest these blood markers to evaluate whether they’re decreasing. You can also test for B12, folate, B6 and iron, which are commonly low when a patient is experiencing fatigue. By simply supplementing with either a product or nutrition that is higher in these vitamins and minerals, the patient will find they have an increased energy level as they go through treatment.
Empowering patients: Knowledge is power, and nutritional testing educates patients about their health, motivating them to make better lifestyle choices. A lot of patients tell us that they eat a healthy diet, yet their diet could still not be nutritionally dense. For example, it’s very difficult to get adequate levels of magnesium through diet, so patients may experience a lot of muscle cramping. A simple solution can be proper supplementation.
Reducing chronic inflammation: Nutritional testing that I’ve mentioned above can identify dietary triggers and inflammatory markers, allowing you to recommend interventions, including omega-3 fatty acids to decrease inflammation and antioxidants to neutralize free radicals and protect joint health. In addition to muscle cramping, chronic inflammation exacerbates conditions like arthritis, disc degeneration and nerve irritation.2
Antioxidants, such as vitamin C, vitamin E, CoQ10, cystine, glutathione and selenium, can be assessed in a micronutrients test, where you can evaluate them in the serum and at the cellular levels.3
Supporting tissue healing: Post-adjustment or injury, nutrients like vitamin C, protein and magnesium support the repair of muscles, ligaments and cartilage. Testing for deficiencies identifies what your patients need for optimal recovery.
Hydration is part of good nutrition. Anion gap, BUN, creatinine and GFR are blood markers that can identify dehydration. Proper hydration is another way to support tissue health, faster recovery and healing.
Enhancing nerve and muscle function: Nutrients like magnesium and B vitamins play a critical role in nerve health and muscle function. Addressing deficiencies reduces muscle cramps, spasms and nerve pain, directly improving the results of chiropractic care.
Be thorough and assess all the Bs in a micronutrient test, such as B1, B2, B3, B5, B6, B9 and B12, as they work better in unison. It’s also appropriate to test for methylation defects, as this will determine what form of B vitamins to use or whether additional nutrients, such as trimethyl glycine, would be beneficial.
Adding revenue streams
Nutritional testing can open the door to multiple income sources, including:
Consultation fees: Offer initial nutritional analysis consultations as a premium service as either a one-time appointment or part of a package. It’s also important to follow up on nutrition. Just because we prescribe something doesn’t mean it’s working or the values are appropriate, so retest the levels to ensure supplementation is working.
Supplements like vitamin D, B12 and iron can be rechecked in as soon as 30 days; others can be rechecked in six to 12 months to reassess for new needs the patient may have as they relate to diet, lifestyle or injuries.
Testing kits and supplements: Partner with reliable labs to offer testing kits (e.g., food sensitivities, micronutrient levels) and supplements tailored to each patient’s needs. Be aware there are multiple labs on the market. If the sensitivity and specificity aren’t high enough, the results will be less accurate. Vet fair pricing and helpful results for your patients.
Follow-up services: Develop ongoing nutrition programs, including regular consultations and retesting, offered as subscription-based services.
Customized plans: Provide patients with tailored nutrition plans, meal guides or detox protocols based on their test results, further cementing your practice as a one-stop wellness center.
Competitive differentiation
Offering nutritional testing sets you apart in an increasingly competitive landscape. Many DCs focus solely on musculoskeletal care, but by integrating nutrition, you position yourself as a more comprehensive provider. Patients are seeking holistic solutions, and nutritional testing appeals to this growing market.
Help your patients understand that though they may focus on musculoskeletal care, that doesn’t mean their care can’t include nutrition. Incorporating even a small amount of nutritional consultation will make a profound difference.
Adding this service also elevates your reputation as an expert in integrative health. This not only attracts a broader patient base but also encourages referrals both from patients and from other healthcare providers.
The role of nutritional testing in my business model
Nutritional testing has become a cornerstone of my practice, impacting how I approach every single patient. During the initial consultation, don’t settle for a patient’s general assessment that they eat well. Instead, ask each patient what a typical day of eating looks like. What do they eat for breakfast, lunch, dinner and snacks—as well as what they drink throughout the day. I also dig into their supplement regimen, asking about every vitamin, mineral, herb or other product they’re taking.
What I find is that a lot of patients don’t understand what constitutes healthy eating, let alone know why they’re taking supplements. I justify everything I recommend—either because I have scientific research to back up the effects that correlate to a patient’s particular condition or, even better, because I have done the testing in my office to show that their individual needs call for specific supplementation.
Why is this so important? Just because a supplement is “natural” doesn’t mean that it’s beneficial for every patient. In some cases, improper supplementation can actually hinder recovery or contribute to ongoing symptoms. Pain, fatigue or an inability to heal may not stem from a structural issue at all. It may stem from nutritional imbalances or poorly chosen supplements.
Final thoughts
Incorporating nutritional testing into my practice has been one of the most impactful decisions of my career. It all began with a professor’s insight into the power of vitamins, minerals and herbs—and how they interact with the body and medications. That early lesson sparked a realization that nutrition is foundational to healing.
Patients who receive personalized nutrition guidance, including testing and tailored supplementation, report a 45% improvement in adherence to treatment plans compared with general recommendations.4
I see nutritional testing not as an add-on but as an essential part of patient care. It allows me to address the root causes of health issues, create more effective treatment plans and ultimately improve patient outcomes. I try to encourage my patients to do this at the onset before we begin. That way I have additional tools to allow for greater success during their treatment plan.
For my colleagues in the chiropractic field, I encourage you to explore this path. Start small, educate yourself and integrate nutritional testing into your practice step by step. The rewards—for both your patients and your business—are undeniable.
CINDY M. HOWARD, DC, DABCI, DACBN, FIAMA, FICC, is a board-certified chiropractic internist and nutritionist specializing in finding the root cause of symptoms and diseases. She earned her doctorate in chiropractic from the National University of Health Sciences and is in private practice in Orland Park, Illinois, where she focuses on individualized care. She is a frequent speaker for Protocol for Life Balance. For more information, visit innovativehwc.com. If you’d like any information about nutritional testing, please call Howard at 708-479-0020 or email her at drcindymhoward@gmail.com.
References
1. Americans do not get all the nutrients they need from food. [Fact sheet]. Council for Responsible Nutrition. https://www.crnusa.org/resources/americans-do-not-get-all-nutrients-they-need-food?utm_source=chatgpt.com. Accessed January 24, 2025.
2. Omega-3 fatty acids for joint health: A comprehensive guide. Rheum4us. https://rheum4us.org/omega-3-fatty-acids-for-joint-health/?utm_source=chatgpt.com. Accessed January 24, 2025.
3. Schwartz G. The ultimate guide to micronutrient testing: what you need to know. June 2024. GSK Live Healthy. https://www.gsklivehealthy.com/micronutrient-testing/?utm_source=chatgpt.com. Accessed January 24, 2025.
4. Jinnette R, et al. Does personalized nutrition advice improve dietary intake in healthy adults? A systematic review of randomized controlled trials. Advances in Nutrition. 2021;12(3):657-669. https://advances.nutrition.org/article/s2161-8313%2822%2900109-0/fulltext?utm_source=chatgpt.com. Accessed January 24, 2025.
