Functional Medicine Approach To Labs

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Functional medicine lab evaluation TulsaAs 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

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.

Labs - functional medicine tulsaOur labs are divided into sections which are identified by the blue box in the far left column. The picture to the left has red arrows highlighting these sections.

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.

Lipids

Lipoprotein Particles and Apolipoproteins

Inflammation / Oxidation

Endothelial Function

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.

Genetics

Metabolic Labs

This section includes nutritional and metabolic labs:

Renal function

These labs help us understand your kidney function

Liver function

  • AST
  • ALT
  • Alk Phos
  • Total Bilirubin
  • GGT

Autoimmune Labs

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-Chromatin
  • 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)

Men only.

Hormones

Hormone labs include:

  • Estradiol (E2)
  • Progesterone
  • Follicle-Stimulating Hormone (FSH)
  • Testosterone.

Thyroid Labs

  • TSH
  • Free T4
  • Free T3
  • Reverse T3
  • Thyroid antibodies

Diabetes Prevention and Management Panel (DPMP)

This is the single most comprehensive panel for diabetes I’ve ever seen. We can evaluate metabolic physiology quite comprehensively with this panel.

  1. Glucose
  2. A1c
  3. Estimated Average Glucose
  4. Fructosamine
  5. 1,5-anhydroglucitol
  6. Glycation Gap
  7. Post-Prandial Glucose Index
  8. Leptin
  9. Adiponectin
  10. Free Fatty Acids
  11. Ferritin
  12. Alpha-hydroxybutyrate
  13. Oleic Acid
  14. Linoleoyl-GPC
  15. HOMA-IR
  16. Insulin
  17. Proinsulin
  18. C-peptide
  19. Proinsulin:C-peptide Ratio
  20. Anti-GAD

Blood and Iron Labs

complete blood count (CBC)

Iron studies:

  • Ferritin
  • Transferrin
  • Serum Iron
  • % Saturation