Is your annual physical comprehensive enough? Are you getting all the lab tests you should?

The Missing Seven

Here are 7 tests I often find lacking when a client brings me lab work ordered elsewhere to evaluate:

1. D-Dimer

Measures for the byproduct of blood clot breakdown.

High levels indicate high clotting activity, which is an elevated risk factor for deep vein thrombosis (DVT), pulmonary embolism (PE), stroke and disseminated intravascular coagulation (DIC, which essentially means tendency to clot too much/quickly).

I order this test for all clients who have had any COVID-19 vaccinations and/or booster shots.

2. Insulin, fasting

Measures levels of insulin in your serum (blood).

Typically, only serum glucose levels are tested. This provides only half the picture: your body can maintain a “normal” serum glucose level while actually doing so by overproducing insulin. Your pancreas gets overstressed as it puts its “pedal to the metal” working hard to mop up all the excess sugar in your blood that it can, to the point of exhaustion, resulting in insulin resistance, and Type 2 diabetes.

By the time serum glucose testing demonstrates a problematic reading, the problem is very far advanced. Testing fasting insulin level is a necessary additional test to serum glucose to shed amplified light on this whole situation, catching problematic blood sugar before it goes too far.

Too high can indicate insulin resistance, Type 2 diabetes risk factor and elevated inflammation.

Too low can indicate Type 1 diabetes.

3. Uric Acid

Measures levels of uric acid in the blood.

Traditionally used only to detect gout and/or kidney stones, but new research shows the significance of this test to be much farther reaching than that limited application.

High levels of uric acid indicate a failure to properly catabolize the byproducts of normal DNA/RNA breakdown. This indicates excessive inflammation and accelerated breakdown of genetic material, as well as oxidative stress, more commonly known as “rusting out from the inside.” High levels of uric acid are associated with polycystic ovarian syndrome (PCOS), Alzheimer’s Disease (AD), diabetes, obesity, metabolic syndrome, high blood pressure (HBP), cardiovascular disease (CVD), liver function impairment, kidney disease and cancer.

4. Vitamin D, 25-Hydroxy + Calcitriol (1,25 di-OH Vitamin D)

Measures the active form of D3 in your body.

Often D is not tested for at all, or the wrong test for the wrong D is run.

Vitamin D3 deficiency is common. Low levels are associated with colorectal and breast cancer, various autoimmune conditions, insulin resistance, cognitive decline from neurodegenerative disease, Crohn’s Disease, leaky gut, osteopenia/osteoporosis, and a weakened immune system leading to increased risk of infection (viral, bacterial, parasitic, yeast, etc).

5. Ferritin + Iron + Total Iron-binding Capacity (TIBC)

Measures levels of stored iron, and by extrapolation, free iron.

Typically, only “total iron” is tested, which may suffice for measuring risk of anemia, but which misses a treasure trove of system information by not distinguishing between stored, free and saturated iron. Therefore, it doesn’t give us the measure of iron within the cell, bound to a protein for storage (ferritin).

When your body is fighting inflammation, it produces hydrogen peroxide as a by-product of the fight. If hydrogen peroxide comes into contact with free iron, it oxidizes it, which creates a highly unstable, very toxic product. So, to protect itself, your body isolates the iron out of the bloodstream, “tucking it away” inside the cells, bound to a protein molecule for stability. That is ferritin.

If we can drill down to measure the stored iron (ferritin) – not just the total iron – we can know if the body is reacting to inflammation.

High ferritin provides one more indication of inflammation, a process associated with cancer, autoimmune diseases, fatty liver disease(s), obesity, acute and chronic infections. High ferritin can also be interpreted as an indirect marker for infection somewhere in the body.

Low levels of ferritin indicate iron-deficiency anemia.

6. Magnesium, RBC

Measures intracellular levels of magnesium.

Rudimentary serum testing typically ordered for magnesium (when it’s ordered at all), can be skewed by transitory contributing factors, such as a single day’s worth of supplementation, for example. This test measures magnesium levels within the red blood cells, a reading that gives the 3-to-4 month level of this micronutrient, a much more stable, meaningful value.

50% of any cross-section of Americans has been found to be deficient in magnesium. Do you know the warning signs of a magnesium deficiency?

This vital mineral is used in at least 600 enzymatic reactions ongoing in the body every second – actually every millisecond – of every day (one of which is the formation and activation of Vitamin D – see how it’s all interrelated???).

Magnesium deficiency – like other nutritional deficiencies – can often masquerade as a variety of diseases. It is imperative to accurately determine levels of magnesium so as to replete when necessary, rather than run the risk of medicating what looks like a disease, but which is in fact merely a deficiency of this vital micronutrient.

7. C-Reactive Protein (CRP), High Sensitivity

Measures levels of protein in the blood.

High levels indicate an active inflammatory process as well as potential toxin overload, cardiovascular disease (CVD), infection(s), cancer and immune compromises.

Inflammation…again?

You might have noticed a repetition of “indicates an inflammatory process,” or “inflammation.” Why, you might ask, is more than one test necessary to indicate the presence of inflammation?

Test, then Validate.

Because the responsible way to help create as full a picture of health and disease for my clients as I possibly can is to use tests to validate findings, to cross-reference, and flesh out the nuances of that picture. That is the Functional Medicine process, or as I call my particular process, the IBSolutions Method©.

Beyond the basic tests that typically comprise the standard blood work component of an annual physical, these are 7 tests often missed that I would want to see as part of a satisfactory work up.

Is there more?

Of course, there is much more to a comprehensive workup than just these tests.

Beyond these 7, I use other readily available blood tests, as well as further specialized Functional tests (blood, stool, hair, saliva) as indicated by a client’s unique presentation to further uncover the underlying root causes of chronic disease, present or potentially developing undercover.

Be your own best advocate for health and make sure that these 7 tests are part of your annual exam.

If they are not, know that many providers like myself are available to create a more full lab order for you, personalized to your needs.

Please share with anyone you care about so that they also can make sure to get the complete annual physical they deserve. Knowledge is power!

Always looking out for you,

Dr. Wade