Ever go in for labs and get a note that says “everything is in the normal range, no additional follow up is necessary.”
BUT YOU ARE NOT FINE. You know that something is just not right.
Lab reference ranges are set to represent 95% of the normal population. Problem is, lots of people considered “normal” have a suboptimal lab result that needs attention.
These reference ranges are often huge. For example, ferritin (one of the best indicators of iron status) ranges from about 15 to 150 and vitamin D can range from 30 to 100. TSH (a marker of thyroid status) can range from 0.45 to 4.500! Just because you have a TSH of 4.500 does not mean “you are fine.”
It’s important to look at lab values ALONG WITH patient symptoms. For example, an incredibly fatigued patient, struggling with weight gain, who has a TSH of 3.5, most likely needs some thyroid support, whereas a healthy, active individual with no fatigue, might be just fine at a TSH of 3.5.
This is where “individualized treatment” comes into play.
I look at lab values with a microscope because I want to OPTIMIZE each person’s health. A ferritin of 20 needs attention (even though it is IN the reference range of normal). Without an adequate ferritin level, the production of red blood cells will slow, possibly leading to fatigue, hair loss, muscle weakness, brain fog, anxiety, and other symptoms.
So which labs should you ask your doctor to run as part of a basic check-up?
These are my top choices:
- 25-hydroxyvitamin D3 (simply put, Vitamin D). Why? Important for the immune system, bone health, mental health, cognition, and to reduce inflammation. My goal value? At least 50.
- TSH, free T3, free T4. Why? Thyroid function is crucial for overall health and well-being (tied to bone health, heart health, digestion, and more). I almost always run TSH with a fT3 and fT4 since these are your actual thyroid hormones. More information = more accuracy in treatment and better clinical outcome. It’s a win-win.
- Lipid panel looking at cholesterol, HDL (heart healthy cholesterol), and LDL (bad heart cholesterol). Why? I want to see what dietary and lifestyle modifications are needed to optimize heart health.
- CMP or complete metabolic panel. Why? It’s crucial we look at blood sugars, electrolytes, liver, and kidney function.
- CBC or Complete Blood Count. Why? Looks at a number of cells in your blood, rules out diseases and infections, and checks for anemia.
- Ferritin. Why? Ferritin is the best indicator of iron status. Low ferritin has been linked to hair loss, fatigue, anxiety, distraction/ADHD, restless leg syndrome, and more. Goal value? At least 40.
- HbA1c. Why? Fantastic indicator of how well the body is regulating blood sugars.
- Homocysteine. This is a toxic amino acid and it must be broken down with vitamins B12, B6, and folic acid. If levels are too high, we see increased risk of heart disease, dementia, and stroke.
- Vitamin B12 and/or methylmalonic acid. Why? Vitamin B12 is crucial for cognition, mental health, energy, and memory.
- C-Reactive Protein (cardiac). Why? Indicator of systemic inflammation. Inflammation is the driver of chronic diseases, such as diabetes, heart disease, and cancer.
My opinion? Let’s take NO SHORTCUTS WHEN IT COMES TO YOUR HEALTH.
These labs help to guide lifestyle modifications and nutraceutical recommendations so you can THRIVE.
Will your doctor run all these labs? It depends. If highly regulated and under the watchful eye of administrators, your doctor might be limited in what they can order.
Options? Find a naturopathic doctor who is trained in functional medicine and understands the importance of these labs.