10 years ago, I got into this business as a health coach, just wanting to help people. And over the years of helping people improve their health in a personalized way, it became more and more clear that the data they needed to make improvements simply wasn’t available. I could tell them all I wanted to ask their doctor for x, y, or z tests, and inevitably, they’d come back saying, “My doctor won’t run that, because it’s considered a preventative test.”
Before I rant on this statement, let me say very clearly: I love medical doctors. I use medical doctors. And goodness knows if I am in a car accident or break my arm or have a heart attack, I want to be brought to a Western-medicine-trained medical doctor, stat. They are excellent at fixing those problems. And the fact that some of them are not (yet) excellent at preventative medicine is not their fault. There are a whole lot of issues – the insurance system doesn’t reimburse preventative care like it should, the time limitations mean they don’t get enough time with each patient, the medical school curriculum doesn’t cover preventative medicine. It’s a system issue, not a doctor issue – everyone in this profession is ultimately in it to help people in the way they’ve been trained.
But let me return to that statement … we can’t run a preventative blood test?!? Wouldn’t every human agree that it’s better to prevent a disease than to fix it once it’s there? Wouldn’t we save a ton of time, money, stress, and life by focusing on prevention? That’s not a rhetorical question, and the answer is yes. Even going back to 2010, the NIH published on the billions (with a B) of dollars that could be saved annually by focusing on preventative care. I’m no longer an economist (did you know that’s what my undergraduate degree is in?!), but I can tell you that we need that. And we’re leaving so much on the table by not focusing on this.
This is one of the main reasons why, after starting with my certificate of health coaching, I went on to add a Masters in Holistic Nutrition, a Board Certification in Holistic Nutrition, a Board Certification in Clinical Nutrition, and (now) a Doctorate of Clinical Nutrition. I don’t want to just suggest what you should do, I want to walk with you, step by step, through actually doing it.
The Solution: Taking Charge of Your Preventative Health
There are a few ways you can start reversing the problem on your own. First, like almost everything, educating yourself is half the battle. I know it’s nice to think that someone else will be the CEO of your health, but that role falls on YOU. And that’s why you’re here, so congrats! Second, you’ve got to speak up. If you see a Western-medicine-trained MD, and you ask specifically for the tests I’m going to list below, they will sometimes oblige! And this is huge! And if they don’t, it may be worth considering adding to your healthcare team (I’ll provide a solution below). In this post, I’m going to go over 4 functional medicine lab tests that you are likely missing in your normal check-up, and why you may want to include them.
4 Functional Medicine Lab Tests You May Be Missing
Almost all lab panels will include things like a CBC (blood cell counts and sizes), CMP (electrolytes, kidney, and liver function tests, etc.), and total cholesterol measure, so I’m excluding those and other basic metrics. These 4 are the “next step” that I believe should be standard practice but are not generally included. These are the four crucial functional medicine lab tests that are often overlooked in conventional medical settings: hs-CRP, Full Lipid Panel, Hemoglobin A1c, and Fasting Insulin. Understanding these tests can provide valuable insights into our health status and help prevent the onset of chronic diseases.
High-Sensitivity C-Reactive Protein (hs-CRP) is a marker of systemic inflammation in the body. While inflammation is a natural response to injury or infection (like a swollen ankle when it’s sprained), chronic inflammation is a silent accomplice to numerous chronic diseases.
Functional medicine practitioners use hs-CRP to assess an individual’s risk of heart disease because elevated levels are strongly correlated with cardiovascular events. Reducing inflammation through dietary modifications, stress management, and targeted supplements can significantly lower the risk of heart disease and other inflammation-related conditions.
This Harvard Health article quotes the New England Journal of Medicine, saying “CRP outperforms LDL cholesterol as a predictor of cardiovascular risk” and “C-reactive protein was a better predictor of cardiovascular events (heart attacks, strokes, bypass surgery, or angioplasty) than other inflammatory markers”. And Dr. Mark Hyman says directly, “This simple blood test could save your life.”
- Full Lipid Panel
I often tell my clients that their total cholesterol number is like telling me the total score of a basketball game. If the total score is, say, 200, I have no idea which team won, whether it was a landslide or a buzzer-beater, or who played well. It’s just not that interesting. Similarly, the conventional cholesterol test provides an incomplete picture of lipid metabolism. In contrast, a comprehensive Full Lipid Panel examines not only total cholesterol levels but also factors like LDL, HDL, triglycerides, and particle size. Understanding these nuances allows functional medicine practitioners to assess cardiovascular risk more accurately.
Research indicates that optimizing lipid profiles, especially reducing small, dense LDL particles and increasing beneficial HDL levels, is crucial for preventing heart disease. Lifestyle changes, such as adopting a heart-healthy diet and regular exercise, can have a profound impact on lipid profiles, leading to improved cardiovascular health.
For most of my clients, and especially those at high risk of cardiovascular disease, I go beyond this panel and include a Lp(a), ApoB, oxLDL, and homocysteine level – all of which give us more detail into what’s going on with the cholesterol system in the body.
- Hemoglobin A1c
Hemoglobin A1c (HbA1c) is a marker used to measure average blood glucose levels over the past three months (technically, it measures the percentage of your red blood cells whose hemoglobin proteins are glycated, or covered with sugar, but just think of it as an “average blood sugar” test). While it is primarily associated with diabetes management, its significance goes beyond that. Research shows that even slight elevations in HbA1c levels are linked to an increased risk of cardiovascular disease, stroke, and kidney damage, among other conditions.
Functional medicine practitioners utilize HbA1c to identify prediabetes and insulin resistance in their early stages, allowing for timely interventions through diet, exercise, and lifestyle changes. By monitoring and maintaining optimal HbA1c levels, individuals can significantly reduce their risk of developing debilitating diseases.
If someone tells you not to get the A1c test unless you’re diabetic, feel free to share that a lower HbA1c is associated with decreased all-cause mortality, decreased all-cause dementia and Alzheimer’s, and, according to Dr. Matt Dawson (MD), reduced risk of cardiovascular disease, cancer, and dementia. Unfortunately, up to 88% of Americans are metabolically unhealthy. But the great news is that an HbA1c that’s creeping up is completely reversible with focus on nutrition and lifestyle! I help clients who are pre-diabetic (or on their way there) reverse that literally every week. Knowledge is power!
- Fasting Insulin
If HbA1c tells you how low or high your blood sugar has been over 3 months, fasting insulin tells you how hard your pancreas has had to work to keep it there. Insulin, a hormone produced by the pancreas, plays a crucial role in regulating blood sugar levels. Balancing blood sugar and insulin is a constant juggling act, and disruptions in this delicate balance can lead to metabolic dysregulation and a host of health issues, including weight loss resistance, so it’s a great thing to check if my clients have been diligent about making healthy changes to their diets but haven’t experienced the results we would expect.
Elevated fasting insulin levels are closely associated with insulin resistance, which is a precursor to type 2 diabetes and metabolic syndrome. Insulin resistance is linked to a higher risk of metabolic syndrome, heart disease, cancer, cognitive decline, reproductive health issues, and fatty liver disease. Addressing insulin resistance through lifestyle changes and targeted interventions can prevent or even reverse the progression of these conditions.
Bonus Lab Tests to Consider
This post is already long enough, but here are just a few bonus tests that I consider running for my clients based on their situation:
- Full thyroid panel: Simply put, TSH alone does not tell the whole picture (similar to total cholesterol above). We need, at minimum, T3 and T4, with ideally the free forms of both and reverse T3 as well. For anyone at risk of Hashimoto’s, which these days is most people, I also want to run antibody tests.
- Stool test: I adore the Gut Zoomer test that I use in my practice, which gives a complete rundown of digestive capacity, the presence of pathogens, bacterial strains that are out of balance, and more. This is an expensive test, but in cases of complex GI dysfunction, it’s excellent.
- Omega fatty acid panel: The right balance of omegas is essential, and for those consuming a standard American diet or at risk of cardiac events, this is helpful.
- Full hormone panel: this is another blog post for another day, but getting a complete picture of hormone health (sometimes through a urine test like DUTCH and other times through blood) is essential for those dealing with sex hormone-based issues.
- Leptin and other metabolic hormones: for those with weight loss resistance, these are go-to’s.
- RBC magnesium: the traditional serum magnesium test is not indicative of how much magnesium your cells are absorbing and able to use. And magnesium is essential; see this post for why.
- Cortisol: best tested through saliva 4x during one day, this helps us see if cortisol, one of the stress hormones, is dysregulated and causing other downstream issues.
Reboot Functional Nutrition Package
Based on demand for those who wanted a full functional nutrition lab workup, without the months-long associated coaching, I developed a new program in January of this year, and it’s been a hit with the clients who have taken part in it.
My Reboot package is simple: a few consultations, combined with Labwork (which is included in the price), to give you a customized protocol to improve your health on your own.
The schedule is like this:
- Fill out New Client Intake Form and sign up for package.
- Schedule your first 25-minute consultation to discuss your goals and current health.
- Megan will determine appropriate labs to include, with your guidance, and place the order.
- Get blood drawn and wait for results (which will be sent to Megan, and Megan will send to you).
- Schedule your 50-minute consultation to review labs and develop protocol.
- Schedule your last 25-minute consultation to answer any questions and check progress 3-4 weeks later.
Interested in taking part? Sign up here, and we can get started today!
Now it’s your turn! Have you gotten any of these 4 tests run lately? Are you going to ask for any of these next time?