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Lab testing has long been the domain of our doctors. They decide what boxes to check, they review the results and they decide whether action needs to be taken. While I too value the importance of having objective measures of your health, there are two critical manners in which I view and use your lab testing differently than most MDs.
1. I want you to understand what I am ordering, why I am ordering it and what the results really mean. Your blood work is about you.
2. I am using lab testing to help understand the functionality, not just the pathology (the problem) of and in your body.
The traditional use of lab testing has been about determining whether there is something wrong with you, and, if so, the magnitude of the problem. Little or no emphasis has ever been placed on understanding how well your system is performing. This slight change in perception is one of the most fundamental differentiators when we are considering how naturopathic medicine approaches your health in a preventative context. Preventative analysis is not about telling you that you are getting close to the ‘cut off’ for a particular disease, preventative analysis is about looking at new or different values that illustrate whether you are at risk in the first place.
Whether you have your blood work completed with me or with your doctor, here are the top 3 tests I see frequently overlooked and underutilized.
1. Thyroid panel – most physicians will run your TSH, but very few will additionally look for the active thyroid hormones, T3 and T4. A proper thyroid evaluation should also include a marker for thyroid antibodies. An elevation of thyroid antibodies often goes unnoticed until someone has developed full-blown thyroid disease such as Hashimoto’s thyroiditis. Often an autoimmune reaction can be detected and managed before significant damage has been done. A full thyroid panel will include TSH, T3, T4 and TPO (thyroid antibodies).
2. Vitamin D – This test, unfortunately, is no longer covered by most provincial health plans. It is valuable because it not only provides an accurate evaluation of vitamin D levels, but can also suggest the depletion of other fat soluble nutrients such as vitamin A, coQ10 or vitamin E. As an aside, testing two forms of vitamin D (1,25-hydroxy and 25-hydroxy) can be helpful for detecting stealth infections such as Lyme disease.
3. hs-CRP – High (h) sensitive (s) C Reactive (R) Protein (P) is a marker for inflammation, with a particular sensitivity for the cardiovascular system. Despite it’s relatively low cost, this is one test I see routinely rejected by most medical doctors when we ask for blood work to be completed. Inflammation is implicated in most chronic conditions and this sensitive marker is very effective for flagging and monitoring changes with respect to inflammation in the body. In particular, hs-CRP should be run alongside cholesterol to provide context to chronically elevated scores. Emerging evidence suggests that hs-CRP is 3-times more accurate in interpreting potential cardiovascular ‘events’ than elevated cholesterol.
More concerning than the omission of the tests listed above, are the number of new patients who have reported that it has been ‘years’ since they last had blood work completed. In the spirit of prevention, there is no time like the present, to look at how we could and should be supporting your system for maximum performance.