Do you want to improve your health, naturally?
To do that effectively and efficiently, you need a good understanding of what’s going on inside your body.
We can use a common and relatively inexpensive set of blood tests to determine your specific needs, deficiencies, challenges and imbalances, in order to guide you as you work on improving your health.
Blood testing is a key aspect of my health and wellness treatment plans, in part because everyone is different. What one person needs in order to feel their best is often very different than another person’s needs. Loading up on supplements without first getting targeted blood testing and a customized treatment plan is often a waste of time and money, and can actually do more harm than good!
Blood tests can reveal the beginnings of degeneration, aging and disease well before significant health problems begin to arise and adversely affect your health and quality of life. And, when problems have already begun, blood tests can help direct treatment so that it is customized, targeted and highly effective.
You might wonder: “I get a blood test with my annual physical. Isn’t that enough?”
The routine blood testing done with annual physical examinations offers a few – but far from all – of the health answers you need for truly improving your health and wellness, and reversing or preventing disease. These standard blood tests are geared towards finding overt and serious disease, not optimizing and fine-tuning your health and well-being.
What I recommend – and have seen work best for my 1,000s of patients over my 25+ years of experience as a holistic doctor – is to get certain essential blood tests done regularly, and analyze them thoroughly and carefully, to catch problems early on so you can begin to turn things around asap (or avoid them in the first place!)
These essential blood tests can not only indicate the earliest stages of disease processes, but also provide you with opportunities to slow aging and improve your:
- quality of life
- hormone balance
- body composition
- and much more
Another important aspect of blood testing is the analysis. Most doctors just look at blood tests quickly, to check if your numbers fall within the very broad “normal” ranges.
But hold on a minute…
Folks, look around you – “normal” ain’t healthy!
And what I want for you – and what I encourage you to aim for and claim for yourself – is optimal health. To achieve this, we look at blood test values through the lens of optimizing, which is a much narrower range of blood test values. This gives us early indicators of trouble brewing behind the scenes, so we can work together to get you – and keep you – optimally healthy.
Look at it like this: Conventional medicine’s “normal” blood marker ranges are like the Grand Canyon, and the optimal ranges of functional medicine are a narrow stream.
The very broad “normal” ranges will really only tell you if you are already quite out of balance and possibly quite sick. That’s all most doctors are looking for when reviewing bloodwork, and when they tell you that your bloodwork looks “fine”, what they really mean is, you’re not in serious trouble yet.
The optimal blood value ranges, on the other hand, will show you very early on when things are moving even slightly in the wrong direction, long before you’re sick, so you can avoid getting sick!
When patients bring me their bloodwork, I study it thoroughly, looking for markers that are out of the optimal range, and also looking for patterns among those markers that aren’t optimal. Then I create a customized treatment plan that summarizes, prioritizes, and addresses the most pressing issues, and that aims to bring improvements to as many areas at once as possible, so you can move closer to optimal health as simply and quickly as possible.
And when you get bloodwork done regularly, this provides an opportunity to closely monitor your health status, so we know if what you’re doing to improve your health is working, and so we can make adjustments as things change along the way. (Which always happens, naturally – our bodies are dynamic and ever-changing!)
Blood testing provides a personalized roadmap so I can make customized, accurate and properly prioritized recommendations for each individual, including dietary and lifestyle changes, and supplements such as vitamins, minerals, and herbal medicines.
Essential Blood Tests
Here are the essential blood tests that I recommend you have done at least 2x per year, and ideally quarterly. And you can even do them more often than that, too, such as every 1-2 months, which I recommend if:
- you like measuring tracking the numbers like I do
- it helps motivate you to stay on track with your recommended treatment plan
- and/or you are actively working on reversing more serious health issues
So let’s dive in!
Complete Blood Count (CBC) with Differential
This panel is the most basic and common set of blood tests, and is done just about any time you go to the doctor and get bloodwork. It contains a lot of valuable information (as long as you make sure the differential is included), and it’s low cost. This panel can be used to detect a variety of disorders, including infections, immune disorders, and anemia. The blood markers in this panel include:
- Hematocrit (HCT): a measurement of how much of your blood is made up of red blood cells
- Hemoglobin (HGB): a protein in red blood cells that carries oxygen from your lungs to the rest of your body
- Mean Corpuscular Hemoglobin (MCH): the average weight of hemoglobin per red blood cell
- Mean Corpuscular Hemoglobin Concentration (MCHC): the average concentration of hemoglobin in your red blood cells
- Mean Corpuscular Volume (MCV): the average size of your red blood cells
- Mean Platelet Volume (MPV): the average size of your platelets
- Platelets: stop bleeding in injured tissues by helping your blood to clot
- Red Blood Cells (RBC): carry oxygen from your lungs to the rest of your body
- Red Cell Distribution Width (RDW): a calculation of the variation in the sizes of your RBCs
- White blood cells (WBC): fight infections and other diseases. There are five major types of white blood cells, which are measured by the Differential:
- Neutrophils – used by the body as the primary defense against bacterial infections
- Lymphocytes – used by the body to destroy and eliminate excess systemic toxins
- Eosinophils – respond to allergic and parasitic disorders
- Monocytes – the body’s second line of defense against infections
- Basophils – play an important role in the inflammatory process, preventing clotting in inflamed tissues; also a secondary aspect of the body’s defense against intestinal parasites
Comprehensive Metabolic Panel (CMP)
This panel is another very commonly done set of tests, and like the CBC, it’s valuable and low cost. The blood markers tested in the CMP reveal important information about your blood sugar management, the balance of your electrolytes and fluids, the levels of certain minerals, and the health of your liver, kidneys, blood cells, and vascular system. The CMP includes:
- Alanine aminotransferase (ALT) is an enzyme primarily found in the liver and is liberated into the bloodstream following cell damage, particularly from viruses, exposure to chemicals, and in fatty liver disease
- Albumin is a protein produced primarily in the liver, and plays a major role in the distribution of water and hormones throughout the body
- Alkaline phosphatase (Alk Phos) is an enzyme found in tissues throughout the body, and supports numerous biological processes
- Aspartate aminotransferase (AST) is an enzyme present in highly active tissues such as skeletal muscle, liver, heart, kidney and lungs, and is released into the bloodstream following cell damage, especially in the cardiovascular system
- Bilirubin is a waste product that is produced from the natural breakdown of hemoglobin in red blood cells
- Blood Urea Nitrogen (BUN) is formed from protein metabolism and digestion, and is primarily a measure of kidney function; it reflects the ratio between the production and clearance of urea in the body
- Calcium is a critical mineral that enables bone health, the functioning of muscles, and the cardiovascular and nervous systems; this mineral’s level in the blood does not normally fluctuate based on diet, but rather, calcium in the blood is typically drawn from teeth and bones; calcium absorption is dependent on having sufficient stomach acid, and is also affected by the amount of phosphate and magnesium present in the system
- Carbon Dioxide (CO2) is an electrolyte that is primarily produced from cellular respiration; this marker measures the level of bicarbonate in your blood, and is used by the body for acid-base balancing
- Chloride is another electrolyte and is involved in regulating the acid-base balance in the body; it is also essential component for producing sufficient hydrochloric acid (stomach acid)
- Creatinine is a by-product of normal muscle activity, and is a waste product that is normally filtered and removed from the blood by the kidneys
- Estimated Glomerular filtration rate (eGFR) is used to check how well the kidneys are working, by estimating how much blood passes through tiny filters in the kidneys – called glomeruli – each minute
- Globulin is the collective term for most of the blood proteins other than albumin
- Glucose is a type of sugar found in the blood (aka blood sugar) that provides quick energy for the brain and body
- Potassium is an electrolyte present in all tissues of the body, that helps nerves and muscles communicate and moves nutrients into cells and waste products out of cells
- Protein is a measurement of the sum of albumin and globulins, which are proteins related to blood vessels and immune function
- Sodium is a type of compound known as an electrolyte; these minerals promote healthy fluid levels and acid-base balance in the body. They also facilitate proper muscle and nerve function. Most sodium comes from your diet, and the kidneys help regulate your body’s sodium levels.
Note: I recommend adding Phosphorus (Phosphate) to this panel, as phosphorus works together with calcium to build strong bones and teeth, and is an important indicator of carbohydrate metabolism and kidney function, as well. And, if you are getting my Bloodsmart reports package, this is a required marker to get the most accurate results out of these reports.
This basic set of cholesterol tests provides the following measurements:
- Total Cholesterol (TC): the sum total of all types of cholesterol in your body
- IMPORTANT NOTE ABOUT TOTAL CHOLESTEROL: it is not an accurate measurement by itself for your risk of heart disease and in fact, as you age, higher levels of total cholesterol are protective against all causes of death, and low levels of total cholesterol correlate with higher risk of all causes of death
- Triglycerides (TG): fats in the blood, triglycerides are in important indicator of the development of insulin resistance, which is a primary precursor to and indicator of the development of many diseases, including overweight, obesity, prediabetes, type 2 diabetes, and cardiovascular disease
- High-Density Lipoprotein (HDL): the so-called “good” cholesterol, HDL serves as a transport molecule, moving cholesterol from peripheral tissues and vessel walls to the liver for metabolism into essential bile salts
- Low-Density Lipoprotein (LDL): the so-called “bad” cholesterol, LDL also serves as a transport molecule, moving cholesterol and other fatty acids the other way as HDL: from the liver to the peripheral tissues for uptake and metabolism by the cells
- Total Serum Iron: a measure of the amount of iron that is bound to blood proteins
- Total Iron Binding Capacity (TIBC): an estimation of the blood level of transferrin (the protein that carries most of the iron in the blood)
- % Transferrin Saturation (% Sat): a calculated value that indicates your iron saturation; a more sensitive screening test for iron deficiency than transferrin levels or TIBC alone
- Ferritin: the main storage form of iron in the body
Vitamin D’s importance to overall health has been a big newsmaker in recent years. Low vitamin D levels are extremely common, and that’s a big health concern, given that vitamin D is important to all the body’s cells and tissue. Vitamin D deficiency can affect immune function, bone density, heart health, and even mood. Optimal levels are 70-100, well above the “standard” range of 30-50, and studies have found that the full benefits of Vitamin D are not achieved until Vitamin D levels are at least 80.
Blood Sugar Regulation
- Hemoglobin A1C (hbA1c): This test provides information about your blood sugar control over the previous three months. The test can also predict heart disease risk in people with and without diabetes.
- Lactate Dehydrogenase (LDH): a group of enzymes involved in carbohydrate metabolism, LDH level can indicate the presence of hypoglycemia (low blood sugar), and correlates with pancreatic function and glucose metabolism
Dehydroepiandrosterone (DHEA) is often referred to as the “anti-aging hormone.” Low levels of this hormone are common as we age. Produced by the adrenal glands, DHEA levels peak in our 20s and then typically declines steadily through the decades. Studies suggest that having too little DHEA can negatively impact stress resilience, immune function, wound healing, bone density, abdominal fat distribution, libido and sexual functioning, and mood. Low DHEA is a leading indicator of adrenal fatigue.
One of the most important blood markers you can do, fasting insulin is an indicator of how much insulin you have circulating in your system when you haven’t eaten anything for several hours. Insulin is a fuel storage hormone, moving fuel (sugars and fats) into our cells to burn for energy now, or to store as fat to burn for energy later. Excess levels of insulin indicate metabolic imbalance – too much fuel storage, not enough fuel burning – and the development of insulin resistance, which is the precursor to many of the most common health problems that people struggle with today, including overweight, obesity, excess belly fat (central obesity), prediabetes and type 2 diabetes, metabolic syndrome, fatty liver disease, and cardiovascular disease, to name a few.
Both men and women produce testosterone and both experience (often dramatic) declines in this hormone as they age. Testosterone helps to regulate muscle mass, as well as energy, libido, and one’s sense of well-being. Generally, less than two percent of testosterone in the blood is in the “free state”, which means free to circulate in the brain and nervous system. Low free testosterone levels are linked to abdominal obesity, lower bone density and bone strength, increased risk of heart disease, and depression. In women, high levels of free testosterone are linked with polycystic ovarian syndrome (PCOS), often indicate low estrogen levels, and can cause excess unwanted hair growth.
Thyroid-Stimulating Hormone (TSH)
The most common and basic thyroid hormone test, TSH controls the thyroid gland’s production of the thyroid hormone, and indicates the body’s level of need for more thyroid hormone.
Side-note about thyroid testing:
- TSH is the main diagnostic tool for identifying primary hypothyroidism, and if it is out of range, then thyroid health needs to be addressed, but
- TSH can still be in the optimal range, even in the presence of hypothyroid and other thyroid problems; therefore
- If thyroid issues are suspected, running a more comprehensive thyroid panel is strongly recommended, as this will be much more informative and accurate than TSH alone
For women only
The primary circulating form of estrogen, estradiol is important for many physiological functions in both women and men (although men produce much smaller amounts than women). Higher-than-normal estrogen levels in women can indicate endometrial or breast cancer. Low estradiol in women – typically seen during and after menopause – can cause blood vessels to become stiffer and less elastic, leading to increased risk of heart disease and stroke. Low estradiol is also linked with a variety of other, less serious health issues, including hot flashes, night sweats, insomnia, anxiety, irritability, difficulty concentrating, palpitations, tachycardia (fast heartbeat), osteopenia and osteoporosis (reduced bone density), dry skin, thinning hair, vaginal dryness and pain, and low sex drive.
For men only
PSA (Prostate-specific antigen)
Long used to detect enlarged prostate, prostate inflammation, or cancer of the prostate, this protein made in the prostate gland can also be elevated if a man has a urinary tract infection. It’s important to note that high PSA levels don’t necessarily mean prostate cancer; still, it’s a useful blood test for tracking prostate conditions and to determine patients’ risks of cancer and benign prostate problems.
Inflammation can be a good thing. When you suffer an injury, like a cut on your finger, your immune system sends in an army of white blood cells that fight infection, immobilize an injured area to prevent further damage, and promote healing. This is acute inflammation, and it is your friend.
But problems can occur when inflammation becomes chronic, as it obstructs the flow of blood and nutrients to our tissues, and results in constant irritation and injury to the inner walls of our blood vessels. Chronic inflammation is caused by lifestyle factors such as
- poor diet
- high stress
- insufficient sleep
- lack of physical activity
and also by infections and exposure to damaging toxins such as xenobiotics (man-made toxic substances) and heavy metals.
Chronic inflammation speeds aging, degrades health and well-being, and is linked with many diseases, including arthritis, autoimmune disorders, cancer, diabetes, overweight and obesity, pulmonary (lung) diseases, heart disease, and stroke.
An amino acid in our bodies, homocysteine is a marker of systemic (widespread) inflammation.
Highly sensitive C-reactive protein (hsCRP)
Another important indicator of systemic inflammation in the body, hsCRP can indicate the development of disease processes long before they become symptomatic. Recent studies have demonstrated that elevated hsCRP is a much more accurate indicator than high cholesterol of the level of a person’s risk of heart disease and stroke.
Uric acid is a waste product created when your body breaks down substances called purines, which are one of two chemical compounds that your cells use to make the building blocks of DNA and RNA. Most uric acid dissolves in the blood and then travels to the kidneys, and from there is gotten rid of via the urine. But if your body produces too much uric acid or does not remove enough of it, a high uric acid level in the blood develops – called hyperuricemia – which is correlated with many health problems, including insulin resistance.
For a deeper dive into the importance of measuring and controlling Uric Acid, check out Dr David Perlmutter’s book Drop Acid.
Not generally tested with basic bloodwork, but it should be! GGT is a very useful and relatively inexpensive marker to measure, and increases quickly in response to increased toxin load, indicating elevated toxin load even when in the “normal” lab reference ranges. GGT is a particularly important marker to watch because it is a key enzyme in the recycling of glutathione, the primary detoxification compound in the body. GGT production is stimulated to provide more glutathione, as well as to help handle oxidative stress. Even mild GGT elevations are strongly associated with several chronic diseases, and with exposure to various toxins, including heavy metals and persistent organic pollutants (POPs).
As you can see, targeted blood testing can give you a lot of great information, and help paint a personalized, accurate picture of what you need to work on to achieve optimal health.
The results from blood tests can help us identify and address what’s preventing you from having the best health and quality of health possible. With this valuable information, treatments can become individualized, safer, more cost-efficient and more effective.
Blood testing, starting with the above list of essential markers, is an important part of my customized, personalized approach to helping people reach optimal health.
Ready to get some bloodwork and analysis done? Great!
Click on the Ulta Labs image below to order labs directly yourself via my account with Ulta Labs, a quick, easy and highly discounted lab ordering service. You can search through Ulta Lab’s full catalog of lab tests here.
Want to save time and just order all of the above recommended tests quickly and easily? Good choice! Here are the direct links to get the full set:
- Baseline Biomarkers – Basic Plus
- Vitamin D
- Fasting Insulin
- Estradiol (pre-menopausal women), Estradiol Ultrasensitive (menopausal and post-menopausal women), PSA (men)
On a budget? Not ready to do the full set? Then start with just the Baseline Biomarkers – Basic Plus, and choose the Functional Blood Chemistry Analysis (FBCA) rather than the Bloodsmart Reports Package for the analysis portion (since the Baseline set doesn’t include all the markers you need for the Bloodsmart reports). We can get a lot of information about how things are working in your body by starting there, and then add more markers in subsequent lab tests, if needed!
If you’re getting your lab tests done through your MD, PA, RN, NP or other practitioner, print out my Essential Bloodwork Cheat Sheet and share it with them so you’re sure to get all the recommended tests included with your lab order.
Have your lab results in hand? Awesome!
It’s time to order your lab test analyses. You can choose from:
- The Functional Blood Chemistry Analysis (FBCA)
- The Bloodsmart Reports Package
- Or, get both and save!
Then, if you’d like to have me review them, create a customized treatment plan for you, and then have an in-depth consultation with me to discuss all of that, visit my Services page.
Next time, we’ll look at Advanced Blood Markers that you can track to do an even deeper dive into measuring and tracking, to facilitate even more health optimizing!