In this episode of The Wholistic Greatness Podcast, I outline exactly what labs to get on your next Western medicine doctor’s visit and why. Being our best and strongest means doing our research and advocating for ourselves. To be honest, affording a Natropathic Doctor can be challenging and hard to find one you can trust especially if you are new to this holistic health journey. So, if your insurance covers your annual visit, this is the post to reference to get the 411 on all the labs to request (and most insurance companies will pick up the bill)! As always, there is a free printable to print and bring with you when you head to your next appointment.
In this day and age, we must be the best advocate for ourselves when it comes to health and wellness. Trusting your doctor to make sure you are A-OK can be misleading. We must not only find a health practitioner that is willing to partner with you on your holistic health journey, but be up on the latest news of holistic healthcare. I personally work with a wonderful PA that understands my approach to health and will order the labs that I need after we discuss my “why”. I also have worked with Natropathic Doctors who fully support my approach as well, but they are out of pocket pay and I try to navigate the cost of my labs carefully.
The following are a list of INITIAL tests that are highly recommended to have done with followup of any labs that fall into abnormal functional medicine lab ranges. Many of these tests can be ordered through your primary care physician or specialist and covered by most insurance companies. I will outline them in priority and in sections:
“This is a list of INITIAL tests that are highly recommended to have done with followup of any labs that fall into abnormal functional medicine lab ranges.”
Testing is done to determine “where you are” at that moment. It can determine if your current interventions are working and if you need to implement new interventions. Always keep track of your symptoms if you are experiencing anything unusual. Thyroid disease can begin before symptoms start. For this reason, it is imperative to see what’s “under the hood” via lab work before you start experiencing problems.
There are many blood tests that can be done to assess thyroid function, yet the tests indicated in this post are the ones I start with each time.
TSH (Thyroid Stimulating Hormone) is actually a pituitary hormone that responds to low/high amounts of circulating thyroid hormone. TSH is used by health practitioners as a screening test for thyroid disease in general, Hypo and hyperthyroidism. If you are on medications for your thyroid, it is used to test for monitoring the correct dose of medication. The TSH test is not a one stop shop. You need to be able to look at the big picture and pull full thyroid panel. A normal TSH does not mean you are out of the woods. For example, elevated anitbodies, could indicate a thyroid condition called Hashimoto’s disease or even Graves Disease.
Free T3 and Free T4 are tests that measure the levels of active thyroid hormone circulating in the body. When these levels are low, yet your TSH tests in the normal range, this may lead your physician to suspect a rare type of hypothyroidism known as central hypothyroidism. The free T4 & free T3 test is useful measure to determine if a person is properly converting thyroid hormones.
There are various types of antibodies against the thyroid gland that can be detected in thyroid disease. The thyroid antibodies indicate that the thyroid gland has been recognized as a foreign invader by the immune system and that the thyroid gland is under attack. These antibodies can be detected for decades before changes in the other “standard” thyroid blood tests your primary care physician may pull on routine. That is why it is important to include antibodies in your blood work each year. You could have your standard thyroid TSH drawn each year and it be in the “normal range”, but your antibodies could be running high indicating that you, in fact, have a thyroid issue.
The thyroid peroxidase antibodies (TPO antibodies) and thyroglobulin antibodies (TG antibodies) are most commonly associated with Hashimoto’s Disease. There will be an elevation of one or both of these antibodies would be present. TPO antibodies are the most common and have been reported in 5-38% of the population, depending on the study. Thyroid antibodies are often elevated for decades before a change in TSH.
The most common antibodies found in Graves’ disease are TSH receptor antibodies, including thyroid-stimulating immunoglobulin (TSI). This marker is elevated in >90% of people with Graves’ disease. TSH receptor binding antibody (TRAb), also known as TSH-binding inhibiting Immunoglobulin or TBII, is elevated in >50% of people with Graves’ disease. Both labs can be used for diagnostic purposes and monitored to track remission.
The reverse T3 (rT3) test measures how much of the free active T3 is able to bind at thyroid receptors. RT3 is produced in stressful situations and binds to thyroid receptors but turns them off instead of activating them. When assessing your rT3 results, it is important to watch for trends of your levels going up. This usually indicates your body is reacting to a stressful situation. Your body produces rT3 to give it a break and to prevent you from becoming hyperthyroid. This is an evolutionary adaptation to slow your metabolism in times of famine. High rT3 due to stress has a snowball effect on hypothyroid symptoms. The adaptation by the body producing rT3 is not useful in our high-demand society when we must work and take care of our children, spouse, parents, etc. This test is sometimes used to identify cases of poor T4 to T3 conversion, or thyroid symptoms that are due to adrenal stress, instead of thyroid malfunction or autoimmunity.
A thyroid ultrasound will help you and your physician determine whether you have changes consistent with Hashimoto’s (such as a rubbery thyroid, shrunken thyroid, enlarged thyroid, or if abnormal growths in the thyroid are present). Some growths may indicate an autoimmune process, others may indicate benign nodules, and others may signal cancerous nodules. It is recommend that at least one ultrasound for every person, especially women of childbearing age. If you have an ultrasound and see any of the listed abnormalaties, it is recommended to check your thyroid one time a year.
“Thyroid disease can begin before symptoms start. For this reason, it is imperative to see what’s “under the hood” via lab work before you start experiencing problems.”
Iron is an essential mineral that plays a key role in healthy bodily functions, including: Metabolism and energy, Muscle health, Brain function, DNA synthesis, Oxygen transportation. If your levels are too low, you may experience hair loss, extreme fatigue, inflammation, light headedness, brain fog, restless leg, dizziness, or ringing in the ears. Just because you are getting older does not mean you have to have thinning hair. It may just be your stored iron levels (ferritin)!
“Just because you are getting older does not mean you have to have thinning hair. It may just be your stored iron levels (ferritin)!”
B12 deficiency is more common than most healthcare practitioners and the general public realize. Data from a Tufts University study suggests that 40 percent of people between the ages of 26 and 83 have plasma B12 levels in the low normal range—a range at which many experience neurological symptoms. Nine percent had an outright nutrient deficiency, and 16 percent exhibited “near deficiency.” Most surprising to the researchers was the fact that low B12 levels were as common in younger people as they were in the elderly.
A complete blood count (CBC) is a blood test used to evaluate your overall health and detect a wide range of disorders, including anemia, infection and leukemia. A complete blood count test measures several components and features of your blood, including: Red blood cells, which carry oxygen, White blood cells, which fight infection, Hemoglobin, the oxygen-carrying protein in red blood cells, Hematocrit, the proportion of red blood cells to the fluid component, or plasma, in your blood, Platelets, which help with blood clotting. Abnormal increases or decreases in cell counts as revealed in a complete blood count may indicate that you have an underlying medical condition that calls for further evaluation.
Symptoms of bone pain and muscle weakness can mean you have a vitamin D deficiency. However, for many people, the symptoms are subtle. Yet, even without symptoms, too little vitamin D can pose health risks. Low blood levels of the vitamin have been associated with the following: depression, brain fog, fatigue, increased risk of death from cardiovascular disease, cognitive impairment in older adults, severe asthma in children, and cancer.
“Depression, brain fog, fatigue, increased risk of death from cardiovascular disease, cognitive impairment in older adults, severe asthma in children, and cancer are symptoms of vitamin D deficiency.”
Cortisol suppresses the immune system, breaks down tissues and has a generally catabolic effect. However, these effects are balanced out by DHEA, which has the opposite effect – activating the immune system and building up tissues. By finding out where your levels are, you can then see why you might be overly tired.
Wether we are aging or in our teens, every female must have their “female” hormones tested. I, personally, have experienced high testosterone and low progesterone my entire life and, in result, have experience PCOS, difficulty to conceive, and miscarriage. If you are estrogen dominant, then you run a higher risk of breast cancer among other diseases. If your primary care doc does not want to go this extra step, make sure you do this with your OBGYN annually.
“Wether we are aging or in our teens, every female must have their “female” hormones tested.”
Epigenetics is a blue print of how your DNA expresses itself. Knowing your genetic make up can help see a variety of reasons why you may be experiencing what you are feeling. For example, if you are low fatigued, you may have the genetic mutation MTHFR. This shows your practitioner that you have a hard time methylating, or breaking down, folate and therefore may be low in ferritin or iron.Homocysteine is another marker that may indicate that you are not methylating properly. It is a fascinating way of looking deeper into your cells to find out as much as we can about you to help you be your best self.
Remember to always record your symptoms. Record what they are, how long you are experiencing them, what you were doing when experiencing, and possibly what you were eating. It is imperative your your health practitioner to know how you are feeling. This is part of healthcare. Your symptoms are just as important as your labs. Take the time to record. It is worth it!
As always, I want to make taking care of yourself as easy as possible! I have created a PDF that outlines the list of tests provided in this post. i hope you take the time to download and tuck this away for your next appointment to embrace your #wholisticgreatness.
I am Claudine Phillips, a Registered Dietitian and Exercise Physiologist who in recovery from Hashimotos Thyroiditis and other autoimmune diseases. I journal, vlog, and podcast my experiences to help you find your healing as well. I termed the phrase #wholisticgreatness to embrace spiritual, emotional, and physical health in order to achieve complete recovery. I share my research and protocols to provide inspiration, tactics, and strategies so that you, too, achieve the best life you could image! Is that you? Then let’s do this! I can be found speaking locally and nationally, journalling and vloging my research and protocols on this site, and connecting with you on my podcast The Claudine Phillips Show and on all the socials at @claudinephillips. I can’t wait to connect!