New to Functional Medicine? Here Are the Lab Tests You Should Start With

If you’re a newbie to holistic health care, you may be curious as to where you should even start. It can be overwhelming, from the change in paradigm (spending 90 minutes with a doctor instead of less than 10… what?!), to the variety of treatments and lab options. Well, we’re here to help. If you’re just venturing into holistic medicine, these are the baseline lab tests we recommend to get a full picture of your health.

Where to Start With Functional Medicine Lab Tests: The Basics You Need

Essential nutrients: Iron, B12, Magnesium, Folate, Vitamin D3

These essential nutrients are majorly important in many of your biological processes. From optimal bone and nervous system health, to proper metabolism and moods, sub-optimal amounts of these nutrients can alter your health outcomes. 

These are all tests you may have had before from your conventional doctor, but you also might have gotten that automated message telling you that everything was “fine,” that your results were in the “normal” range. In functional medicine, it’s important to talk about “optimal” numbers instead of the numbers that fall inside a clinic’s reference range. Being inside that “normal” conventional reference range doesn’t necessarily mean you’re in the optimal range for feeling your best. This is one of the big ways functional medicine is different—we consider the optimal range to be where your numbers should land in order to keep you in your best health.

Take vitamin D3 as an example. The bottom of most conventional reference ranges shows about 30 nmol/l to be within acceptable ranges. However, we’re finding that levels of at least 60-75 nmol/l are necessary for healthy bones and decreased fracture risk. This goes to show it’s not all about the test results, but also about the aptitude of the practitioner who is reviewing your results. 

Metabolic markers: HbA1c, Fasting Glucose & Insulin, Lipid Panel

Often times at your annual physical, you’ll get a lipid panel, and if you’ve potentially let slip that a family member has a history of diabetes, you’ll get a hemoglobin A1c (HbA1c) as well. However, we run these tests on everyone to get a good idea on how what you’re eating is being processed by your body.

HbA1c is how we measure the average of your blood glucose over about a 90 day period of time—essentially helping us measure how high your peaks are and how low your valleys get. Values hitting 5.7% are indicative of pre-diabetes and show that there may be a better strategy to controlling your blood sugar to promote optimal health. When your blood glucose is riding a roller coaster, that excess glucose is very oxidizing to the body and can create unwanted inflammation. Furthermore, the continuous high-highs to low-lows is very stressful to the body and can affect your adrenals, create thyroid hormone resistance, damage DNA, and affect your brain health. Coupling that information with knowing your fasting insulin, we can determine what type of nutritional plan you should be eating to optimize your health.

Inflammatory Markers: Homocysteine, Hs-CRP

It’s no secret that inflammation can create chaos on your biochemistry. Knowing your hs-CRP, a sensitive but non-specific marker, can allow us to know if high inflammation is a root-cause to your concern. This marker can be influenced by many factors, including current usage of hormonal birth control, acute and chronic injuries, autoimmune diseases, environmental toxicity, or irritable bowel syndrome. 

Homocysteine is an amino acid that is created during our bodies’ methylation cycle. Adding or subtracting a methyl group from our hormones, neurotransmitters, vitamins, amongst other things, is how we turn them on and off. High levels of this biomarker can indicate low levels of vitamins B12, folate, and B6. Discussing this gets incredibly important when we’re evaluating things like heart disease risk, mental and emotional health, and detoxification, as well as cancer risks. 

An In-Depth Thyroid Panel: TSH, Free T4, Total T4, Free T3, Reverse T3, Antibodies

Thyroid testing is another value commonly run by your conventional doctor, but often undervalued in its importance to your health. If you’ve received a TSH without notice of the other 6 important markers of thyroid function, you could be missing out on valuable information for your future thyroid health. 

With every lab test, we’re looking for “optimal ranges” versus “normal ranges.” But when it comes to thyroid hormone testing, optimal ranges become even more important. Normal TSH ranges are about 0.11—4.5. However, we know that when our TSH rises over about 2.5, our health can start to change. Specifically in women, we find that a TSH over 2.5 can increase the rate of pregnancy loss and miscarriages in the absence of thyroid autoimmune disease. 

Outside of clinical disease, we know that T3 is the gasoline that fuels our cellular energy—that same cellular energy that powers our liver to detoxify, fuels our brain to think and process, and our reproductive organs to create optimal amounts of hormones. And if we have suboptimal amounts and are already starting to exhibit symptoms, it may be affecting other processes as well.

Complete Blood Count & Comprehensive Metabolic Panel

These 2 test panels are great basic information to determine what your main organs are up to. A CBC can show us your immune system function, your red blood cells, and their size, shape, and color. We’ll be able to catch things like iron deficiency or B12/folate deficiency before your blood cells drastically change their function. 

A CMP will give us information such as your electrolyte status, kidney function, hydration status, as well as liver function. All of these can be extremely valuable in the assessment of your overall health. 

Adrenal Stress Test

In today’s modern society, we are all pushed to take on many different roles and responsibilities. These additional roles, along with our culture to over exercise, and to restrict our calories or certain macronutrient classes, can all take a toll on our adrenal glands, which facilitate our stress response. More than just fight or flight, cortisol is responsible for things like monitoring and manipulating our immune system, reducing inflammation, helping to maintain proper blood glucose levels during fasting periods, and much more. 

Without optimal levels of cortisol, you may find yourself with metabolism issues, catching every bug that gets passed around, getting hangry or shaky if you go more than 2 to 3 hours without eating, or waking up from sleep feeling very unrefreshed. For that reason, we test at minimum a morning cortisol in every patient. 

All of these are just basic tests we as functional medicine practitioners do. If you’re suffering from something specific, there will be other recommended tests that can look for the root cause of your concern. The key is finding a doctor who will listen to and help you investigate your symptoms—and knowing that they’ll stick with you until you can feel your best. If you’re interested in learning more about how we can be that support system, schedule a complimentary 15-minute consult with us.