As a patient in our Tulsa, Oklahoma Functional Medicine Clinic, you’ll notice that we do a lot of things different. Our primary goal is to ‘dive deep’ looking for any disruption in your health. We want to find any deviation from optimal and fix it as early as possible.
We aren’t interested in “Normal.” We want optimal! You may want to listen to this podcast about what “normal” means on your labs and why we may view them differently.
For starters, we check a lot of labs! Why? Because they tell us about what is going on inside your body.
Your body is not a series of individual functions. It contains a very complex, interwoven series of biochemical reactions performing very complex functions. In order to understand your overall health we need to ask a lot of questions about your physiology. Each lab we check is asking a specific question. These lab results give us specific answers. They help us understand what is going on inside your body.
We generally start with what we call a “Full Panel” lab evaluation. It is a great start for almost all of our patients.
Vital signs are not blood labs for sure. However, they are called “vital signs” for a reason. They give us vital information about what is going on with you.
A full explanation of each of your vital signs are found on other, specific posts but here is an overview:
- Blood Pressure: our goal for optimal is <120/<80. I recommend that everyone also have an Ambulatory Blood Pressure Monitor which is the Gold Standard for blood pressure evaluation. We can arrange this test for you.
- Heart Rate: this should certainly be <100 for “normal” but we want it lower than that. Preferably less than 80.
- Respiratory Rate: 12-20 is normal
- Temperature: Normally around 98.6
- Pulse Ox (oxygen saturation): we don’t check this on everyone, only if there is a question of lung function and/or oxygen delivery issues.
I mention these vital signs here because they are the start of our lab review appointments.
You can simply follow along below and each lab will be explained in much greater detail. Hopefully, you’ll gain a better understanding of what we are checking, why we are checking it, and why we make the recommendations we make.
Lipoprotein Particles and Apolipoproteins
Inflammation / Oxidation
ADMA, SDMA, and L-arginine are important to help us understand your ability to make Nitric Oxide. Nitric oxide helps balance chemicals such as aldosterone, angiotensin II, and endothelin and their potentially detrimental effects.
On some occasions we will check stanols and sterols.
This section includes nutritional and metabolic labs:
These labs help us understand your kidney function
- Microalbumin/Creatinine Ratio
- Serum Creatinine (SCr)
- Glomerular Filtration Rate (eGFR)
- Alk Phos
- Total Bilirubin
Celiac Disease – Gluten is a protein in the wheat plant and is actually composed of 2 proteins: glutenin and gliadin. There are a number of antibodies that can be analyzed that correlate with an antibody response to wheat and gluten. However, the 4 most common antibodies checked in labs are anti-gliadin (IgA & IgG) and Tissue Transglutaminase (IgA & IgG).
Rheumatoid Factor (RF) and Anti-Cyclic Citrullinated Peptide (Anti-CCP)
Anti-Cardiolipin Antibodies (IgA, IgM, and IgG)
Anti-Nuclear Antibody (ANA) Screen – if this is positive then the lab will reflexively perform an additional panel of labs including:
- Anti-Centromere B
- Anti-dsDNA (double stranded DNA)
- Anti-Jo 1
- Anti-Ribosomal P
- Anti-Ribonucleic Protein
- Scleroderma Antibody (Scl-70)
- Sjogren’s Antibody (SS-A)
- Sjogren’s Antibody (SS-B)
- Anti-Smith (Sm)
- Sm/RNP Antibody
Prostate Specific Antigen (PSA)
Hormone labs include:
- Estradiol (E2)
- Follicle-Stimulating Hormone (FSH)
- Free T4
- Free T3
- Reverse T3
- Thyroid antibodies
This is the single most comprehensive panel for diabetes I’ve ever seen. We can evaluate metabolic physiology quite comprehensively with this panel.
- Estimated Average Glucose
- Glycation Gap
- Post-Prandial Glucose Index
- Free Fatty Acids
- Oleic Acid
- Proinsulin:C-peptide Ratio
Blood and Iron Labs
complete blood count (CBC)
- Serum Iron
- % Saturation