The OS for functional medicine — built around what each patient tells you
iksa is the harness for n‑of‑1 medicine. A patient’s two-hour history becomes the endpoint you run on, with every panel, every food and every message read back against their own words.
Each panel answers something your patient told you, and how far you lean on it depends on what stands behind the test
The patient reached you after being told their labs were normal, and the two hours you spent on their bloating and fatigue are the baseline of a trial of one. A report can print a calprotectin that gastroenterology guidelines rely on beside a secretory IgA whose range changes from lab to lab.
- Stool analysisCalprotectin and elastase have cutoffs that hold up, so with no alarm symptoms in the patient’s history those two set inflammatory bowel disease and pancreatic insufficiency aside. An international consensus in The Lancet Gastroenterology & Hepatology calls the evidence for microbiome tests scarce and wants dysbiosis scores and treatment advice kept out of reports, so those lines stay questions. At the start, and again only if what the patient reports hasn’t moved.
- Breath testBloating like theirs brings up small intestinal bacterial overgrowth, whose definition an AGA expert review says lacks precision. Of 80 patients whose breath tests had cleared after antibiotics, in a series in The American Journal of Gastroenterology, 44% turned positive again by nine months, so a positive is read beside what your patient reports. Only when their history points there, and after treatment only if the bloating returns.
- Celiac screenThis is the one draw with a deadline, because the serology fades once wheat is gone, so tTG‑IgA goes in while they still eat it. The total IgA beside it tells you a negative can be believed. Once, before any wheat comes out.
- MicronutrientsIn a CMAJ trial, iron eased fatigue in menstruating women with no anemia and ferritin under 50, so a value in range can still decide something. The Endocrine Society suggests against routine vitamin D testing. When you replace or re-test vitamin D or magnesium, your note says why. At the start when the history gives a reason, then three months after a replacement begun on a value low for the patient, not as routine.
- MetalsWhole blood mostly reads the fish of recent months and urine the inorganic forms, so the patient’s history picks the sample. The American College of Medical Toxicology recommends against a urine provoked with a chelator, so this plan rests on an unprovoked draw. Once, then three months after the diet changes, about one half-life on, so that draw shows direction and no more.
The lab flagged the secretory IgA and not the ferritin of 31, and the fatigue in the patient’s history says which one matters
A calprotectin, an elastase and a celiac screen drawn on wheat set aside what a gastroenterologist would look for first, so the doctor started iron and moved the patient to small fish.
When a specialty report flags a line your first-visit history gives you no reason to act on, what does your protocol do with it?
Request a walkthroughRequest a walkthrough for functional medicineYour endpoint is what each patient told you across a two‑hour first visit, which a trial would have written down before anyone started
A sponsor pays for one validated lab, one validated scale and the people who keep them comparable. Here the patient pays for their own panels, so the reason for each one lives in the history you took.
Endpoints
You ordered the stool panel for the bloating, the metals for the tuna and the ferritin for the fatigue, and a month later only the first-visit note ties each report to its reason.
Data capture
Two hours of the patient’s story land in free text, each specialty lab answers with a long PDF and colored bars, and getting their words beside their results means rereading all of it before they sit down.
Safety reporting
You asked them to report every symptom through the elimination phase, and a bad day after dairy sits in the same thread as the blood they noticed once, the one line that can’t wait for the re-test.
Blinded challenge
When bloating comes back with wheat, an open re-challenge can’t say whether that was gluten, fructan or expectation. In a double-blind crossover in Gastroenterology, people sure they reacted to gluten scored worse on fructan than on gluten, with gluten no different from placebo. Your one patient knows what they just ate.
Dairy goes back in after eight weeks, and that week’s bloating gets read against the bloating the patient described at their first visit
When they write that the bloating is back, the harness has the note from that visit and works inside the phases the doctor wrote. Whether dairy stays out comes back to the doctor who took that history.
When an internist asks why wheat came out, the doctor pulls up the patient’s own words and the celiac screen that came first
Both come back quoted, each with its source. A specialty lab’s value counts only once it has been checked against that lab’s page and matched to the patient, and one that fails never reaches the doctor’s screen.
Clinical Intelligence: clinical AI and lab trackingThe nurse has the ferritin of 31 on the list because the doctor is watching it, even though the lab never flagged it
Your nurse reviews and resolves each card on that list. When someone asks what a stool panel would add, Agentic CRM drafts from the answers you approved, says where those stop and waits for someone on your team, and a patient’s question about their own result goes to a person with no draft.
Agentic CRM: scheduling and follow-upIn week three the patient’s question is whether oats count, and when dairy comes back, what the doctor told them to watch for
Patient AI answers from the list the doctor wrote for them. Blood in their stool brings safety questions ahead of any answer and, if it takes a person, a card to the nurse or doctor with what the patient reported, what’s unknown and why.
Patient AI: the treatment companion
What a stool panel changes about a plan is what an internist would ask, and histories like yours could hold the answer
In a retrospective Cleveland Clinic cohort of all comers in JAMA Network Open, physical health scores rose 1.59 points at six months under functional medicine against 0.33 in primary care, a gap that held at a year only in a sensitivity analysis, with no GI endpoint. Your histories hold which panel went with which complaint, so with each patient’s consent and identifiers removed, a research group could count how often a panel changed the plan. How your histories could feed a first study →
For the practitioner who reads every line of a specialty report and acts on a few
Some lines on my panels have thin evidence, and I know which. Does iksa weigh them for me?
It keeps your reading.Each value that comes in has passed checks against the lab’s unit, printed range and flag, and iksa makes no ruling on the test itself. How much a line counts is in your note, so a secretory IgA you’re not acting on stays that way on the patient’s record.
Our panels come from several specialty labs. Do they sit together?
On each patient’s record.The reports sit on that record beside the first-visit note, and each value iksa’s reader knows comes through with its date and its report behind it. A line it doesn’t yet know is held back for review instead of guessed at, and your note carries it until then.
Supplements are a large part of our plans. Are they on the record?
With dose and timing.Each supplement your note names goes on the patient’s plan, with its dose and timing if you wrote them, and a way back to that note. iksa doesn’t tie a supplement to the result it was meant to move, so that reading stays with you.
My patient sees a red bar on their report. What do they hear about it?
Your reading of that line.Patient AI works from their record and your note, so the red bar comes to them with the reason you wrote for leaving it alone. If they want something done about it anyway, they hear that the decision is yours, and if they agree, your nurse is told.
A patient arrives with a provoked urine result. How does it go in?
As the lab printed it.It goes on the patient’s record as that report’s values and flags, once its lines pass. iksa won’t know a chelator came first unless the report or your note says so, which makes that worth writing down.
I’ve charted for years in a functional medicine EHR. Is this meant to replace it?
You keep charting there.Those long first-visit notes stay where you wrote them and reach iksa by connection or by upload, so what changes is that the patient’s words sit next to each lab’s report when you read it.
Is this the OS for functional medicine that turns a two-hour history into a template?
No template here.We call it the harness for n‑of‑1 medicine, because no two histories send you to the same panels, so the work has to start from what each patient told you, with the reading of each result still yours.
What is n‑of‑1 medicine?All practicesiksa beside your EHRProtocol management softwareWhat iksa adds
Somewhere in your first-visit history is the question that sends you to a stool panel, and that’s what we’d ask to hear
Bring a protocol you run. We’ll walk one patient through it.