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Lab Tests and Prevention

Michelle — Fri, 20 Oct 2017 15:42:21 +0000

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)

Glucose 75-86

Hemoglobin A1C 4.5-5.5

Insulin – Fasting 2-5

Renal Markers: (kidney function)

BUN 10-16

Creatinine 0.80-1.10

BUN/Creatinine Ratio 10-16

eGFR Non-Afr. American 90-120

eGFR African American 90-120

Uric Acid 3-5.5

Electrolytes:

Sodium 135-142

Potassium 4-4.5

Chloride 100-106

CO2 25-30

Metabolic:

Anion gap 7-12

Proteins:

Protein, total 6.9-7.4

Albumin 4-5

Globulin, total 2.4-2.8

Albumin/Globulin Ratio 1.4-2.10

Minerals:

Calcium 9.2-10

Phosphorus 3-4

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

GGT 10-30

Iron panel:

Iron – Serum 85-130

Ferritin 30-70

TIBC 250-350

% Transferrin saturation 20-35

Lipids

Cholesterol – Total 160-200 (particle size most important)

Triglycerides 70-80

LDL Cholesterol <120

HDL Cholesterol 55-70

Fibrinogen 200-300

Cholesterol/HDL ratio <4.0

Triglyceride/HDL ratio <2.0

Lipoprotein subfractions:

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:

TSH 1.3-3

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

Inflammation/Oxidation:

C-Reactive Protein <4.5

Homocysteine 5-7

Nutritional Panel:

Vitamin D (25-OH) 40-70

Vitamin B12 450-800

Hormone Panel:

DHEA-S 275-390

Testosterone, Free 1-2.2

Testosterone, Total 35-45

Estradiol 150-350

Progesterone 18-27

CBC/Diff:

Total WBCs 5.5-7.5

RBC 3.9-4.5

Hemoglobin 13.5-14.5

Hematocrit 37-44

MCV 82-89.9

MCH 28-39.10

MCHC 32-35

Platelets 155-385

RDW 11.7-13

Neutrophils 40-60

Lymphocytes 24-44

Monocytes 0-7

Eosinophils 0-3

Basophils 0-1

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.

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Got bloat? Three tests to help identify digestive problems

Michelle — Mon, 29 Aug 2016 01:23:37 +0000

Up until a few years ago I had a stomach of steal; not like a six-pack, I mean my digestion! In my 20’s I could eat whatever I wanted with no stomach distress at all (that I can remember, do any of us really remember our 20’s?)…But as I’ve gotten older, my digestion does not work as well. I find myself with odd bowel movements, stomach bloat and/or a stomachache after a lot of meals. As someone who thinks they eat very healthy, knows a lot about the gut and what causes symptoms; I’ve had a hard time being my own patient. I don’t know about you, but I have a hard time making a change without significant motivation or data to make me do it. So because a wise professor once told me, “if you can’t get your client to be able to enjoy a hotdog and a beer once in awhile you haven’t done your job” (and I can’t! I get a stomachache or look like I’m 6 months pregnant) I’ve decided to figure out what’s going on in my body.

There are a few ways you can approach your symptoms:

Go to the Dr. and get medication, probably a protein pump inhibitor (antacid) to mask the indigestion. I understand wanting to eliminate the symptoms and the pain, but you aren’t figuring out what’s causing the stomach distress; you are just covering it up. PPI’s will not heal your body and long-term there can be some serious side effects.

Do an elimination diet. These are great and I highly recommend for most people. It’s a good way to see if you feel better when not eating certain foods (honestly this may help 95% of you!), and then when you add them back in one at a time you can gage how you feel. I have seen this help a lot of people. But if you get to a point where you can’t pinpoint a particular food(s) or you just feel crappy most of the time no matter what you eat, there are other options. (Favorite elimination diets below)

Get some tests! In functional medicine, we look at the whole body and how everything is connected. Indigestion or heartburn is not just a disease to be dealt with by giving it a drug; it’s often a symptom of something else. In functional medicine we look at your whole history to figure out how you got there and what we can change to make the symptom go away. For me I’m guessing lifelong food sensitivities, Advil use, long distance running and genetics have contributed to my weakened gut in my 40’s and so I am going to work with a practioner, do some tests and figure our whats going on in there.

If you are having severe pain please go see a gastronoligist. Most functional medicine doctors will refer you for a scope if they feel you need it. But for most cases of heartburn, Gastoesphageal Reflux Disease (GERD), Irritable Bowel Syndrome (IBS), bloating, abnormal flatulence and burping, undigested food in your stool, diarrhea and constipation a functional medicine practioner can you help you figure out whats going on. Remember if you have problems in your gut, you probably have other symptoms that are impacting the quality of your life as you may not be absorbing basic nutrients properly!

These are the tests I am doing:

– A hydrogen breath test (HBT): (I am doing Bacterial Overgrowth by Genova $185). This will test for abnormal growth of bacteria in the intestine. Symptoms you may be experiencing are abdominal pain, bloating, gas, belching, constipation and/or diarrhea. An HBT draws from the fact that there is not a source for hydrogen gas in our bodies other than the bacterial metabolism of carbohydrate. In this test after fasting for 12 hours and eating a low fiber diet the day or two before (chicken and white rice) the concentration of hydrogen (and sometimes methane) is measured in your exhaled breath for 1-2 hours after drinking a solution of some sort of sugar (usually lactulose). If you have defective sugar absorption, the unabsorbed sugars are available in the colon for bacterial fermentation. In SIBO (small intestine bacterial overgrowth) the bacteria migrates to the small intestine gaining access to the malabsorbed sugar causing your symptoms and hydrogen gas to be present in the collected breathe.

There can be false positives, it is important to work with an experienced practioner that can look at other factors/tests to confirm your diagnosis.

Treatment will include an antibiotic called riaximin, botanical antimicrobials and a SIBO diet protocol; there are certain foods and additives that exasperate this problem. I will list some resources at the bottom if you want to do some additional reading.

To order this test click here

– A stool test. Yes you heard me right. You poop in a cup, scoop some of it out, mix it in a test tube with some liquid and ship it off to a lab. If you can stomach that part, you can find out a whole host of things that are going on inside of your body! I am doing the GI effects by Genova and the Diagnostic Solutions GI-Map (both around $130) they tell slightly different things, you probably do not need both so discuss with your practitioner. Stool tests can help diagnose conditions affecting the digestive tract. They look for parasites, yeast and bacteria that can cause infection. Inflammatory markers and stool PH, which when low can show poor absorption of carbohydrate and fat or if high can indicate inflammation. It can look at your gut mucosal barrier integrity (leaky gut) and short-chain fatty acids. Poor nutrient absorption can be identified by looking for fecal fat, which can diagnose celiac, cystic fibrosis and pancreatitis and/or lack of enzymes, which can affect pancreatic function. A trained practitioner can analyze all of this and help you design a protocol to improve your gut health.

To order this test click here

– An Amino Acid test (Ion 40 with Amino Acids and Vitamin K, Genova $220)

This is a lab that will measure essential vitamins, minerals, amino acids, and fatty acids and to see if your body has the adequate reserve of these nutrients to meet the demands you body has as well as support your tissues needs. Markers are identified where there are special needs or dangers. If you have had a DNA test and have any genetic mutations (I did 23 and me and had some mutations. 23 and me is a DNA test like Ancesteralize me that reports back information on your ancestry, wellness, carrier status and traits based on your DNA from saliva) this test can help show whether these mutations will actually affect you. Just because you have a mutation does not mean it is actually doing anything in your body. This test can help identify whether the nutrients affected by these mutation are indeed low or compromised. Things such as dietary protein adequacy, gastrointestinal dysfunction, kidney function, inflammation, detoxification impairment, cardiovascular disease, neurological dysfunction, and metabolism problems are a few other things that can be indentified on this test.

To order this test click here

To summarize:

There are many things that can affect gut health. Because 70-80% of your immune system resides in your gut, symptoms of digestive distress can indicate that things are off in your body. Even symptoms that seem unrelated such as depression, fatigue, low concentration and pain could indicate poor gut health. I am choosing not to treat my digestive symptoms with a drug that may or may not work, cover the underlying cause and have substantial side effects, I am attempting to use functional medicine testing to identify the root cause of my problems. Working with a qualified practitioner can help identify areas that need to be addressed. Improvement in gut health will help to heal a whole host of problems in the body.

If you have been to more that one Doctor for chronic illness and cannot seem to find relief, I highly recommend first trying an elimination diet (Remove gluten dairy and sugar from your diet for at least 2-4 weeks)

My favorite elimination diets:

http://whole30.com

http://21daysugardetox.com

http://drhyman.com/10dd-course

http://jjvirgin.com/programs/

http://lyngenet.com

If you have tried changing your diet or you have not had success with diet alone here are my favorite resources:

To find a Functional Medicine practitioner to run these tests, go here: https://www.functionalmedicine.org/practitioner_search.aspx?id=117

To read about Gut health:

http://my.chriskresser.com/ebook/gut-health/?_ga=1.109802501.165779949.1418771164

To read about SIBO:

https://chriskresser.com/sibo-what-causes-it-and-why-its-so-hard-to-treat/