Lab Testing

Basic labs I like to see:

• Complete blood count (CBC) - measures counts of red and white blood cells, as well as platelets. It can be used to identify malnutrition, immune system disorders, infections, anemia (from low iron, folate, or B12), leukemia, and clotting disorders, among other conditions.

• Comprehensive metabolic panel with eGFR (CMP) - provides snapshots of fasting blood sugar, liver and kidney function, and electrolyte and fluid balance, among other things.

• Hemoglobin A1c% (HbA1c%) - measures the average glucose levels in the blood over the past 2-3 months. It allows us to assess the presence of prediabetes and diabetes (types 1 and 2).

• Cholesterol panel: measures total cholesterol (TC), high-density lipoproteins (HDL, the so-called “good” cholesterol), low-density lipoproteins (LDL, the so-called “bad” cholesterol), and triglycerides (fats). These allow us to screen for heart disease, which is crucial as heart disease remains the number one killer in America.

• Iron panel + ferritin - measures iron in the body, its storage, and its transport.

• Thyroid panel - this one can vary, but a good thyroid panel will measure thyroid-stimulating hormone (TSH) and levels of thyroid hormones (total and free thyroxine (T4) and triiodothyronine (T3)). I also like to see reverse T3 (rT3) to assess how well a client is converting thyroid hormones into their active form.

• High sensitivity C-reactive protein (hsCRP) - measures systemic inflammation; correlates well with cardiovascular disease risk.

• Vitamin D, vitamin B12, and magnesium - these are critical nutrients that many Americans are deficient in; deficiency can cause multiple negative health consequences.

Advanced “functional” labs that may come in handy:

• NMR LipoProfile - measures the size and particle counts of HDL and LDL cholesterol; this panel gives considerably more information than a standard cholesterol panel. (blood)

• Lipoprotein (a), AKA Lp(a) - measures a different lipoprotein in the blood which carries cholesterol; while similar to LDL, it is considered “stickier” than LDL, and may reflect heart disease risk to a greater extent than an LDL measurement. (blood)

• Fibrinogen - measures this protein that is involved in blood clotting; higher levels may reflect an increased risk for stroke or other cardiac events. (blood)

• Homocysteine measures this cardiac marker, which can also be used to identify B-vitamin deficiencies, methylation status, and even blood-brain barrier health. (blood)

• Intracellular micronutrient testing - measures the levels of 55 different vitamins, minerals, antioxidants, essential amino and fatty acids inside cells; this intracellular measurement gives us information on how well nutrients are crossing cell membranes and entering cells. (blood)

• Food allergy and sensitivity testing - measures four separate immune reactions to 88 different common foods and ingredients (IgE, IgG, IgG4, and complement (C3b/d)). (blood)

• Stool testing - measures markers of digestion, absorption, microbiome balance, bacterial and fungal overgrowth, gut inflammation, occult blood, infection, parasites, pancreatic function, and short-chain fatty acid production. (stool)

• Organic Acids Test (OAT) - measures organic acids produced within multiple metabolic pathways; measures bacterial, yeast, and fungal markers; measures neurotransmitter metabolites (serotonin, catecholamines); measures metabolites from glycolysis, Krebs Cycle, fatty acid oxidation, and other pathways within the mitochondria; measures some nutritional markers. (urine)

• Nutreval - measures organic acids that are produced with multiple metabolic pathways; measures a variety of vitamins, minerals, antioxidants, amino acids, and fatty acids; measures oxidative stress and assesses mitochondrial function; measures various toxin exposures, and needs for methylation support. (urine, blood)

• DUTCH Test - measures multiple hormones and their metabolites (estrogen, testosterone, progesterone, DHEA, cortisol) to assess hormone balance and detoxification. (urine)

• MycoTOX - measures eleven different mycotoxins from 40 different species of mold. (urine)

• Methylation panel - measures nutrients that are required for methylation; measures methylation pathway metabolites. (blood)

• Methylation (MTHFR) - measures gene expression related to methylation (A1298C, C677T). (blood or swab)

• Apolipoprotein E (ApoE) - measures cholesterol transport, especially in the brain. This is a marker for Alzheimer’s disease risk. (blood, swab)

• Metals hair test - measures heavy metals and minerals in hair; can determine metal toxicity or mineral deficiency. (hair)

• Trio-Smart Breath Test - measures hydrogen, hydrogen sulfide, and methane production in the gastrointestinal tract; used to determine the presence of SIBO (small intestinal bacterial overgrowth), intestinal methanogenic overgrowth (IMO), and excess hydrogen sulfide production. (breath)