Once I started practicing functional medicine, I realized this is some of the best PREVENTATIVE medicine! I was shocked when I learned the evidence and significance behind these lab values. And why did my 9 years of nursing education not include any of this critical, health-promotion information? Such as B vitamin deficiencies, inflammation, comprehensive thyroid function, iron metabolism disorders.
Not only has my practitioner mind wanted to know what or why someone was experiencing a disease state, but more so I became interested in prevention before one reaches the disease state.
I’ll review some critical labs everyone should have done at least as a baseline that you will likely not see on your routine lab panels from your conventional primary care.
- Homocysteine. Homocysteine is an amino acid, that in high levels, can damage your arteries, contribute to heart attacks and strokes. Because B12, B6, and folate break down homocysteine, elevated levels often indicate a need for additional B vitamins. When levels are elevated >10.0 you have a 2-fold increased risk of having a cardiovascular event (LPI, 2015). Why wait for that to happen? This value gives insight to methylation status (MTHFR) and inflammation. Optimal ranges are 5-8.
- Iron panel which includes your total iron, ferritin (iron stores), binding capacity (TIBC), and % saturation. Why is this important. Iron is a critical mineral needed for optimal thyroid function, detoxification, and oxygenation in the body. On the other hand, excess iron can be dangerous and can cause iron deposits in the organs like the liver, pancreas, joints even leading to liver failure. At least once per year I find a patient who has a dangerously elevated iron stores (ferritin >200 women, men >400) due to a hereditary condition called hemochromatosis. Optimal levels of ferritin in females are 50-100 and males is 100-200.
- CRP-hs. C-Reactive Protein high sensitivity. This is a systemic marker for inflammation. Ideal levels are <1.0, concern arises higher than that and alarm levels are >3.0. Some individuals have a genetic variant on a gene that makes them more prone to elevated CRP-hs/inflammation. Inflammation is the root of disease-heart disease, obesity, autoimmune disease, etc.
- Full thyroid panel. This includes a TSH, Free T4, Free T3, Thyroid antibodies (thyroid peroxidase, thyroglobulin), reverse T3. In conventional medicine, it is common to only look at TSH. The TSH tells us how the brain (pituitary/hypothalamus) is working to stimulate the thyroid to make T4. The TSH stimulates the thyroid gland in your neck to make T4 and some T3, but mostly T4 gets converted to T3. T3 is the active thyroid hormone which is so critical to see. Ideal levels of TSH are 0.5-2.5, Free T4 1.2-1.8, Free T3 3.0-4.5. It is critical to rule out early autoimmune thyroid disease with low or no levels of antibodies. Autoimmune thyroid is very commonly misdiagnosis in medicine.
- Fasting insulin. This is a great metabolic marker that determines your risk for metabolic syndrome. A healthy level is under 5.0, I get concerned about insulin resistance when levels are >7.0. If you have genetics or a family history of Alzheimer’s, optimizing your fasting insulin levels is critical to ensure healthy brain aging. I look at this look as well as fasting glucose and A1C levels for a full metabolic picture.
This is just the beginning of lengthy list of labs I order on my functional medicine patients. What is most important to me is not the levels, but that you are the owner of your health and understand what these labs mean, lifestyle interventions to optimize your levels. To learn more join me here in my Lab Learning class. I’ve created this 30-minute class to help you take charge of your own health.
Linius Pauling Institute: https://lpi.oregonstate.edu/mic/health-disease/high-homocysteine