Is your doctor ordering the right lab tests?

What would you think if your mechanic told you your vehicle was 5 quarts of oil low? Would you sit up and pay attention? Are you about to lose your engine? Could this be serious?

There are a series of blood tests that have been used as the status quo by doctors for over 40 years. Modern medicine has been taught to use the same old lab tests as they predictably can show how to get patients to become dependent upon long-term use of beta blockers, statins, diabetes medications, insulin use, antibiotics, antacids, sleeping pills and pain pills.

Chances are if you have ever had your blood drawn for lab work, these tests have been performed  and unless your results were way out of line with the “normal range,” your results probably turned up “negative.” No big deal, right?

Usually the typical tests doctors order give little or no new information about the subtle changes involved in most chronic illness.

Further, there is no correlation between classic early symptoms of chronic illness like fatigue, brain fog, digestive discomfort (diarrhea, constipation, bloating, gas, feeling of partial emptying of stools), mood disorder and low libido.

Could your heart attack or stroke risk be high, even with regular lipid panel test findings? Could you have one or more unidentified chronic illnesses, such as hypothyroidism, early stages of dementia, and hormone imbalances and not know it because the newer, more specific and sensitive tests were not performed?

Shockingly, nearly two-thirds of all adults in America are suffering with one or more chronic illnesses; including being at risk for pre-diabetes — and sharing the same quadrupled level of risk as those with diabetes for: heart attack, stroke, cancer, and dementia.

This is much like being told your vehicle is five quarts low.

So what exactly are the new lab tests used to determine chronic illness? Are these newer, more recent tests with heightened specificity and sensitivity being used by your doctor to uncover the underlying causes of these conditions?

Old school testing

Historically a CBC (complete blood count) and Chem Panel are used to evaluate for the presence of imbalances in the blood stream, the immune system and health of the liver and kidneys. Although this gives us good information, if these values are way out of balance, they do not pickup nor give us more information regarding many chronic illness heavily burdening the adult U.S. population.

The lab tests for low functioning thyroid have been TSH, Total T4 and T3. By far the vast majority of conditions are not picked up by these tests. Hence, many cases of Hypothyroidism are missed.

Instead, most functional medicine practitioners use new Thyroid Hormone Panel – Free T4, Free T3, Reverse T3, TPO Ab, ThyroGlobulin Ab in addition to TSH to determine with more reliability and sensitivity, subtle changes in a malfunctioning Thyroid.

Another example is heart attack risk: Typically, for at least the last 30 years, doctors perform a lipid panel which includes Total Triglycerides, HDL, LDL, VLDL and total cholesterol. One can have results within reference interval for the lipid panel and be completely out of range — posing a huge cardiovascular health risk, detectable early on only with the more sensitive tests.

Now consider the newer LipoProtein Panel – Lipoprotein particles and apolipoproteins such as: Apo A-1, Apo B, sdLDL-C, Lp(a)-P. These tests turn out to be far more sensitive than just the Lipid panel mentioned above could ever be.

Newer blood tests

Functional medicine has a profoundly different perspective on the underlying causes of chronic illness. By looking at the combination of systems in the body — grouped in core physiological processes, and via a thorough health history, symptomology survey and proper testing — causes may be uncovered and unique solutions found.

The one constant in functional medicine is to look at system dysfunction and make a plan for reversal based upon the individual’s combination of underlying causes. That’s why sensitive testing matters.

Functional medicine lab tests may also include…

Metabolic Panel – Insulin, Glucose, HbA1c, Vit D 25 Hydroxy, Leptin

It’s crucial that both fasting Glucose and Insulin are tested. Glucose could be down in a normal range in one person, while Insulin is up. This says things are not ok and indicate a glucose problem possibly due to insulin resistance. Why not go one step further and test for Leptin as well. This is the hormone that tells us we are full. If Glucose and Insulin are within range, but Leptin is not, we still have a problem.

Lipoprotein Genetics – Apo E (T471C, C609T) is a biomarker that tells us our genetic susceptibility to lifetime dementia, heart attack and stroke risk. Based on the outcome of allele combinations one can know what kind of treatment and natural supplements or foods may prevent these risk factors from occurring. This test need only be performed once because our genes do not change. It provides a lot of information on how to treat naturally (without addictive, symptom-causing drugs) with a very simple test.

Coagulation Genetics – MTHFR (C677T) and MTHFR (A1298C) – these lab tests among others, let us know if our bodies are able to methylate Vitamin B12 or Folic acid (Vitamin B9) sufficiently (and at what efficiency). This could be crucial in metabolizing fats and proteins, as well as mood balancing, and heart health.

Inflammation/Oxidation – Hs-CRP, Myeloperoxidase, Fibrinogen, LP-PLA2 (has been around for over a decade but is underutilized and is probably the most specific for Stroke risk of any blood test).  This test is becoming more popular now as it may indicate inflammation from a variety of different causes, not just myocardial (heart muscle) involvement.

Omega 6:3 Index or high sensitivity-Omega 3. This test specifically breaks down the Omega 6:3 ratio. Remember 1.4:1 is a good ratio. Most Americans range between 15:1 and 24:1. These high numbers bring tremendous cardiovascular event risk as well as contribute to the symptoms of inflammation throughout the body.

Newer lab tests for digestive disorders, autoimmune conditions, immune dysfunction and hormone and toxicity imbalances include: food sensitivity tests; amino acid tests and metabolic tests.

If you’re going to get poked with a needle and have your blood drawn, you might as well get the most out of it. It’s your right to question your doctor about the most specific and most sensitive tests for any suspected underlying condition.

The most meaningful and sustainable treatments for a healthier life depend on that, and include natural remedies with a plan that is paired with your individual genetic make-up and lifestyle — not pharmaceuticals that just block symptoms.

Dr. Brad Cutler

By Dr. Brad Cutler

With over 30 years of clinical nutrition experience, Dr Brad Cutler has been a well-respected authority in digestive health, nutrition and natural anti-aging protocols. In 2014 Brad certified in Functional Medicine. His life is all about health, fitness, and what works nutritionally in the body. He coaches individuals in essential lifestyle principles as a part of his ongoing functional medicine practice. Brad’s mission is to inspire others to purposefully create thoughts and emotions that support wise food choices and lifestyle changes that improve health. Individual focus may include balance of digestion, detoxification, immunity, hormones, cardio-metabolic health, cognitive function and mood.

Brad may be reached for Health Coaching at