Have you ever felt a little “off” and hoped to find the answer with your doctor? Your instinct says to run lab tests, but you don’t know what to ask for or how to interpret the results? Or perhaps you feel great so the idea of going to your doctor or paying attention to your lab tests seems pointless? In this blog I go into why you should be paying attention to your yearly lab tests, what to ask for and how to interpret the results.
Why get yearly lab tests?
If you have ever looked at your lab tests, you will see that each result is compared to a reference range. A reference range is an upper and lower limit that is based on the results of 95% of the healthy population. Although this is helpful when it comes to a diagnosis, the most powerful thing is to look for is trends.
For instance, let’s say your TSH was 1.25 mlU/L for most of your life and then it rises to 4.00 mlU/L. Both of these falls within the reference range but when you compare them to each other, it might be a clue that something else is going on. By noticing this trend early on, you can potentially take preventative action.
When to get blood work?
Typically, your doctor will order lab tests after your yearly exam. Then you get an email or phone call saying everything is fine and you sit tight until next year. I would recommend shooting a quick note to your doctor and ask them to order the lab tests prior to your exam so you have the results to review when you meet. Sitting down and walking through the results with your doctor can be really informative and allow you to ask questions.
What labs should you get each year?
Here is a list of the lab tests that I recommend you get from your doctor each year. For any that aren’t standard, I included a note of why this might be helpful for you and concerns you can bring up to your doctor or insurance to try and get them included.
The Basics
CBC (Complete Blood Count)
CMP (Comprehensive Metabolism Panel)
Blood Sugar
HgA1c
Fasting Glucose – this is typically included in your CMP
Fasting Insulin – this is slightly less common to run but very valuable as an early indicator of insulin resistance. It’s especially helpful with PCOS, weight loss resistance and a family history of diabetes.
Heart
Lipid Panel – this is the standard panel that looks at Total Cholesterol, LDL, HDL and Triglycerides.
Apo B – this is becoming more common but you still might get some push back from your doctor. If you have a family history of cardiovascular disease, this can be a better indicator of risk and I would encourage you to advocate for this test.
Lipoprotein(a) – this is a genetic independent risk factor for heart disease. It doesn’t change much after the age of 5 so you should only have to run this once. If high cholesterol runs in your family, I would recommend getting this tested.
Nutrients
B12
Vitamin D
Iron/Ferritin
Magnesium RBC
Thyroid
TSH
Free T3, Free T4, Antibodies – TSH is fairly standard but doing a deeper dive would be helpful if you are experiencing fluctuations in weight, mood, hair loss or change in hormones.
Inflammation
Hs-CRP
Homocysteine
Now, this is the basic panel that I like to see each year. If you feel like something might be going on hormonally or are experiencing specific symptoms, shoot me an email and I can send you some personal recommendations.
How to review your lab tests – Reference Ranges vs. Functional Ranges
Your doctor will most likely look at the reference range. There is, however, another smaller range called a functional range. This range shows a more optimal level. Falling out of this range doesn’t necessarily mean anything is wrong with you, but can help explain symptoms and indicate things that might need a little more support.
What to do if your doctor won’t order lab tests?
Being able to have an open conversation with your doctor is really important. If they feel there is a reason that something shouldn’t be run that is specific to you – meaning “we don’t typically do that” doesn’t count – I would be open to really understanding their point of view. However if you are not satisfied with their response I would suggest finding another doctor. I fully respect that this process can be such a pain! Advocating for yourself and having a partner in health is worth the hassle.
Running lab work is also something that I offer in my practice. My preference is to always have labs done with your doctor so it is covered (at least partially) by insurance. However if you hit a dead end or want another set of eyes on your lab tests that will look at them from both a reference and functional range, contact me and we can figure out the next best step!
