A hormone plan can look clean on paper and still leave you bloated or stuck on the scale. The same stall shows up on a medically supervised weight loss program. Appetite quieted. Protein was decent. The midsection did not move.
Some clinics reach for another hormone tweak. At Thrive Hormonal Health in Lakeway, Kristine Kjolhede, FNP-C, sometimes orders a stool panel first: GI-MAP. This is an explainer. It is not a diagnosis or a promise that a stool test will restart a stalled plan.
What GI-MAP is
GI-MAP stands for GI Microbial Assay Plus. Diagnostic Solutions Laboratory, a CLIA-certified lab, runs it. The method is quantitative polymerase chain reaction (qPCR). The lab looks for the DNA of specific organisms in a single stool sample and reports how much of that DNA is there, not only a yes or no.
Older stool cultures wait to see what grows in a dish. Plenty of clinically relevant organisms do not grow well that way. GI-MAP uses a pre-selected list of targets, then quantifies them. Diagnostic Solutions also runs ELISA assays for several intestinal-health chemistries on the same sample.
It is not a food-sensitivity quiz. It is not a consumer microbiome app that ranks “diversity” and sends a smoothie recipe. A licensed clinician has to order it. Diagnostic Solutions says so on the public test page: the company will not sell the panel as a standalone consumer product, because the report is meant to be read by someone who can act on it.
Collection is one sample, kept at room temperature in the vial the kit provides, then mailed back in the prepaid envelope.
What is on the panel
Diagnostic Solutions groups the report into eight categories. Thrive orders the base GI-MAP or GI-MAP + Zonulin. We do not add the lab’s extra panels (StoolOMX, fecal gluten peptide, the universal antibiotic-resistance add-on) as Thrive options.
Pathogens cover bacterial, parasitic, and viral organisms commonly tied to intestinal gastroenteritis. A DNA hit is not the same as an active infection you can feel. Diagnostic Solutions notes that not everyone with a positive pathogen finding has symptoms. Virulence-factor genes, when they appear, mean the strain can make a toxin. They do not measure toxin sitting in the stool.
H. pylori gets its own section, including virulence factors and a set of H. pylori antibiotic-resistance genes. That is useful only if a clinician is weighing treatment. It is not a reason to start an antibiotic on your own.
Commensal or keystone bacteria are the organisms that should be present. They help extract nutrients, make some vitamins, and occupy space that trouble would otherwise take. Low numbers here are a pattern, not a brand of probiotic to buy tonight.
Opportunistic or overgrowth microbes show up in healthy stool often enough. They become a problem mainly when the rest of the community is off, after antibiotics, or when the immune system is already strained. Quantity is why qPCR matters. A trace amount and a frank elevation are not the same clinical sentence.
Fungi and yeast, including Candida species, sit in their own block. A high Candida mark in stool does not map the small intestine. Diagnostic Solutions says extra tests are sometimes needed if a clinician still suspects fungal overgrowth after this panel.
Parasites include pathogenic organisms and protozoa that commonly appear in the GI tract, plus some that are not pathogenic. If something is found, the next question is exposure, not a store-bought “cleanse.”
Intestinal health markers are the chemistry block: digestion, inflammation, immune activity in the gut, and (when zonulin is ordered) a marker tied to barrier permeability. The four people ask about are in the next section.
Resistance genes on the base GI-MAP are the H. pylori resistance-gene set. A positive gene for a drug class means that class is a poor first choice if antibiotics are even on the table. It is not a prescription.
The intestinal markers people ask about
Diagnostic Solutions lists these four among the ELISA markers on the panel. Cutoffs stay on the report. A number outside a range is not automatically a treatment target.
Calprotectin is a protein neutrophils dump into the gut when they are active. Clinicians use it as a stool marker of intestinal inflammation. It does not tell you why the inflammation is there.
Zonulin is a protein involved in the tight junctions between cells in the small intestine. Diagnostic Solutions describes elevated stool zonulin as a finding associated with increased intestinal permeability. At Thrive, zonulin is the only add-on we order with GI-MAP. The base panel can be run without it.
Secretory IgA (sIgA) is an antibody the mucosa makes. It is one way the gut immune system talks to what is passing through. Low or high can both be interesting. Neither one diagnoses a disease by itself.
Pancreatic elastase-1 is a digestive enzyme marker. It is used as a window on whether the pancreas is putting out enough enzymes to break food down. If elastase is low, “eat cleaner” is not a plan. The question becomes absorption.
The report also includes other chemistries (steatocrit, beta-glucuronidase, occult blood, anti-gliadin sIgA, eosinophil activation protein). Those can matter in context.
Why a hormone or GLP-1 plan can look resistant when absorption and inflammation are off
Oral progesterone, thyroid tablets, and a long list of supplements have to survive the gut. If pancreatic enzymes are low, or if the lining is inflamed, the dose on the bottle is not the dose that arrives. That is one reason a lab-guided hormone therapy plan can look “resistant” when the hormone labs themselves are not the whole story.
Inflammation is the other common mismatch. You can have estradiol and testosterone in a range you like and still feel wrecked if the gut is busy. Bloating after meals, energy that falls off in the afternoon, skin that flares, and a scale that will not move are reasons clinicians consider looking at stool. They are not proof the gut is the cause, and they are not a promise that a GI-MAP will restart weight loss.
GLP-1 and GIP medicines change appetite and slow gastric emptying. They do not inspect the microbiome, parasites, or fecal calprotectin. If nausea, constipation, or a stall shows up after the dose is already where it should be, some clinicians want a clearer picture of the gut before they keep escalating. GI-MAP is one tool for that picture. It is not a requirement to stay on a weight-loss program.
Thrive does not treat a stool PDF as a hormone protocol.
How testing works at Thrive in Lakeway
GI-MAP stool testing in Lakeway is offered two ways: GI-MAP, or GI-MAP + Zonulin. Those are the only two kit options. Online payment is required before we ship.
New patients do not need a visit first. Most kits are drop-shipped. A few stay in the office for people already seen here.
You collect one sample at home. The vial does not need refrigeration. You send it back in the prepaid envelope.
Diagnostic Solutions states that GI-MAP qPCR reports are released in 7 to 10 business days after the lab receives the sample. That is the turnaround we use.
When the report is in, results are emailed to you. The team then books a 30-minute results visit, usually 10 to 14 days after the report arrives. Clinic hours for that visit are Tuesday through Thursday in the Lakeway office. Friday through Monday the office is closed.
The kit price does not include that follow-up. Interpretation is a separate visit, priced as a visit. For a current kit price, call (737) 242-6722 or use the GI-MAP page. This article does not post a dollar figure, because the service page is the place that should stay current.
Established patients can reach the practice through the Espre portal at thrive.esprehealth.com. Kristine Kjolhede, FNP-C, reads these panels with physician supervision. A result without that conversation is a long PDF that makes people anxious.
What the test does not do
GI-MAP does not diagnose you. It is a laboratory report. Kristine still has to put it next to your history, your medicines, and the rest of your labs.
It is not a parasite cleanse kit. A positive organism is a finding to interpret, not a shopping list. It is not a food-sensitivity panel, and it will not tell you to drop twelve foods. It does not measure hormones. If the question is estradiol, progesterone, testosterone, or thyroid, that is blood work, not stool.
It does not guarantee that bloating will stop, that weight will move, or that a hormone plan will suddenly “take.”
It also does not replace a gastroenterologist when alarm symptoms are present: blood in the stool, black stools, unexplained iron-deficiency anemia, progressive weight loss you did not mean to have, or a family history that needs a different workup. Say that in the visit. Do not use GI-MAP as a way around a colonoscopy you already need.
Who it is, and is not, for
Clinicians consider this panel when the story still does not add up: bloating or bowel habits that have become “normal” and should not have; IBS-like symptoms that never got a useful name; weight-loss resistance on a plan that was otherwise followed; skin flares with no clear dermatologic cause; brain fog that sat through hormone or thyroid work; repeated antibiotics, travel illness, or a bad GI infection; autoimmune disease where gut barrier function is already part of the conversation. Those are reasons to consider testing. They are not promised cures.
It is a poor fit if you want a kit mailed with no one responsible for the result, or a gut-heal protocol written before anyone has read the report. The 30-minute results visit is the product as much as the lab is.
If you are already on lab-guided hormone therapy or medically supervised weight loss and the plan has stalled, ask whether stool testing belongs in the next conversation. Sometimes the answer is no.
To order or ask whether the panel is even the right next step, use the GI-MAP stool testing in Lakeway page or call (737) 242-6722. This article is educational. It is not medical advice.
Sources (fetch-verified 200)
- Diagnostic Solutions Laboratory, GI-MAP test page: https://www.diagnosticsolutionslab.com/tests/gi-map
- Diagnostic Solutions Laboratory, GI-MAP qPCR overview (includes 7 to 10 business day turnaround): https://www.diagnosticsolutionslab.com/blog/why-clinicians-trust-gi-map-to-optimize-clinical-outcomes
- Thrive GI-MAP service page (live process details in this draft follow Kristine’s 8/20 answers, which the live page had not yet been updated to match as of 2026-08-22): https://www.thrivehormonalhealth.com/vitality-wellness-regenerative-therapy/gi-map/
This article is for educational purposes and is not medical advice, a diagnosis, or a treatment recommendation. Individual results vary. Always consult a qualified healthcare provider before starting any treatment. Kristine Kjolhede, FNP-C, reads these cases with physician supervision.