95% of the population will fall into a “normal range” on a standard lab test. We all know that 95% of the population is not in good health! The ranges were set to flag things when you already have a problem. They are then usually addressed with conventional medicine. Functional ranges look at smaller ranges so something can be addressed before it goes out of the standard range (this is called prevention!). We also look at algorithms that help us see patterns. By looking for optimum function of our client’s body we are able to detect dysfunction long before a problem manifests when it may be too late. Think of the person who appears healthy and exercises and when they all of a sudden become sick, we all think…but he/she was so healthy! Were they? Could we have seen something if we had not been handed back the lab slip with no (H) or (L) from our doctor saying you are fine keep up the good work? Often we can, and these are some of the markers with their optimal ranges that you can look for with simple blood tests from your doctor that you should have run each year at your exam.
Blood Glucose Regulation: Optimal Range (female)
Hemoglobin A1C 4.5-5.5
Insulin – Fasting 2-5
Renal Markers: (kidney function)
BUN/Creatinine Ratio 10-16
eGFR Non-Afr. American 90-120
eGFR African American 90-120
Uric Acid 3-5.5
Anion gap 7-12
Protein, total 6.9-7.4
Globulin, total 2.4-2.8
Albumin/Globulin Ratio 1.4-2.10
Liver and Gallbladder:
Alk Phosphatase 70-100
AST (SGOT) 10-26
ALT (SGPT) 10-26
Bilirubin – Total 0.10-0.90
Bilirubin – Direct: (only run if total is high) 0-0.19
Bilirubin – Indirect: (same) 0.10-0.70
Iron – Serum 85-130
% Transferrin saturation 20-35
Cholesterol – Total 160-200 (particle size most important)
LDL Cholesterol <120
HDL Cholesterol 55-70
Cholesterol/HDL ratio <4.0
Triglyceride/HDL ratio <2.0
An expanded lipid profile measuring lipids, lipid sub-fractions, particle size and number and APO (B) companies: (choose one)
Lipoprotein particles – Spectracell labs
Nuclear magnetic resonance testing – Liposcience (NMR)
Berkely Heart Labs test – Berkely heart labs
Vertical auto profile – Atherotec (VAP)
Full Thyroid panel:
Free T3 3-3.5
Total T3 90-168
Free T4 1-1.5
Total T4 6-11.9
T3 Uptake 27-35
Reverse T3 10-25
Thyroid Peroxidase (TPO) Abs 0-34
Thyroglobulin Abs 0-1
C-Reactive Protein <4.5
Vitamin D (25-OH) 40-70
Vitamin B12 450-800
Testosterone, Free 1-2.2
Testosterone, Total 35-45
Total WBCs 5.5-7.5
How do you compare? If you would like help optimizing your blood work and therefore your health, or learning more about what these markers mean, please contact me. I have male ranges too! (Their ranges are a little different). Most naturopathic doctors and preventative medicine doctors will run all of these. If your doctor says they are unnecessary you can work with me on picking the most important ones, or there are on-line labs where you can order your own blood work. It is not covered by insurance but is very reasonable and after considering how much your co-pay for an appointment is sometimes even less!
My other favorite Functional Medicine tests I recommend people run to see a bigger picture:
- DUTCH Hormone test – this uses dried urine at 4-5 points throughout a day. Hormones fluctuate a lot so a point in time blood marker may not be as accurate as a daily average. It also provides useful markers not found in blood. Includes sex and adrenal hormones.
- Individualized Optimal Nutrition (ION) test – The ION Profile is a nutritional analysis that measures over 125 key nutrient biomarkers and ratios that can help identify nutritional shortfalls that may be a root cause of complex chronic conditions. The ION Profile evaluates organic acids, fat-soluble vitamins, Coenzyme Q10, homocysteine, oxidative stress markers, nutrient and toxic elements, fatty acids, and amino acids.
- If you suspect food allergies or intolerances run an IgE panel (immediate immune response) and an IgG panel (a delayed immune response)
(remember if your food intolerance test comes back with more than 10 foods you may just have an impaired gut lining).
- A stool test (yep you poop in a cup) can show us the type of bacteria present with ratios, abnormal bacteria, fungi or parasites (If you have parasites your baso, mono and esonophils on your CBC will normally all be elevated) yeast markers, inflammation markers, immune markers, and digestion markers. As these tests use DNA they can also tell us what conventional antibiotics or botanical medicines will work against whatever dysbiosis they find.
- A DNA test – 23 and me has taken away some of the markers I like to look at but still has a lot we can work with. I find it very helpful with eating psychology, weight, mood, and other things like when we can see “why we are the way we are.” A few examples of nutritional related things we can look at: If you are a vegetarian does your body convert ALA (found in flax) to the EPA/DHA that our bodies need and that is only found in animal products? Will a ketogenic diet work for you to lose weight? Some genes predispose us to not doing well on a keto diet. Do you have high homocysteine? We can look at the enzymes used in this pathway and see where we might supplement. Do you clear your caffeine slow or fast? If you are a slow metabolizer and drink coffee in the afternoons you are probably impeding sleep. And so on and so forth there are so many things we can look at and confirm with nutrigenomics!
*Lab ranges taken from Blood Chemistry and CBC Analysis, Clinical Laboratory Testing from a Functional Perspective by Dicken Weatherby, N.D. and Scott Ferguson, N.D. as well as Dr. Weatherby’s blood chem software which I use in my practice to analyze results. My analysis looks at prevention and nutritional support it does not diagnose.