What type of blood test should I get regularly?

Annual blood testing is the most important step aging adults can take to prevent life-threatening disease. With blood test results in hand, you can catch critical changes in your body before they manifest as heart disease, cancer, diabetes, or worse. Having the proper blood tests can empower you to enact a science-based disease-prevention program that could add decades of healthy life.

Blood tests have benefits that go far beyond disease prevention. For example, by monitoring levels of sex hormones, you can take decisive steps to enhance your quality of life, perhaps by correcting a depressive mental state, erectile dysfunction, abdominal obesity, or by improving your memory and energy levels.

Chemistry Panel and Complete Blood Count: The Chemistry Panel and Complete Blood Count (CBC) test is the best place to begin your disease-prevention program. This low-cost panel will give you and your doctor a quick snapshot of your overall health. This test provides a broad range of diagnostic information to assess your cardiovascular, liver, kidney, and blood cell status. The Complete Blood Count measures the number, variety, percentage, concentration, and quality of platelets, red blood cells, and white blood cells, and thus is useful in screening for infections, anemias, and other hematological abnormalities, while the Chemistry Panel provides information on the status of your cardiovascular system by testing for total cholesterol, HDL (high-density lipoprotein), LDL (low-density lipo-protein), triglycerides, and the total cholesterol/HDL ratio.

Renal panel: This test tells you how well your kidneys are functioning. It includes measures of sodium, potassium, calcium, urea nitrogen, creatinine, carbon dioxide, chloride, glucose and phosphate.

Liver panel: This measures your liver enzymes. Results indicate the general health and functioning of that organ. Be sure to follow these test results if you’re taking any medication that might damage the liver.

Lipid (cardiac) panel: For this one you have to fast for at least eight hours. It measures your total cholesterol, LDL (“bad”) cholesterol, HDL (“good”) cholesterol, and triglycerides. If not included in the lipid panel, ask for tests measuring C-reactive protein (a marker of inflammation that can indicate cardiac risk independent of cholesterol); homocysteine¸ to detect the presence of a toxic amino acid which has been linked to heart disease risk; and fractionated LDL, which tells you more about the nature of LDL in your bloodstream (not all of it is bad) and can help with decision-making if drug treatment for high cholesterol is contemplated.

CRP: It is not enough to just know your total cholesterol, HDL, LDL, and VLDL levels. It is also important to test inflammation markers such as c reactive protein and homocysteine.

The addition of these two tests will help to give you a much clearer picture of your cardiovascular risk.

The process by which inflamed arteries lead to cardiovascular disease is invisible except for a tracer—an elevated level of C-reactive protein (CRP) in your blood. If your CRP as well as your total cholesterol is high, you’re at an even greater risk of having a heart attack than you would be with either risk factor by itself.

Make sure you feel perfectly healthy the day of your appointment: This highly sensitive test picks up all sorts of inflammation, even from a paper cut.

That’s a good reason to take it twice, at least a month apart, and average the two scores. Yours should fall under 1 milligram per liter; if it’s above 3, your heart-attack risk doubles.

Vitamin D: The Harvard School of Public Health estimates that 1 billion people worldwide have inadequate levels of Vitamin D in their blood. It is estimated that that number becomes almost 50% of the world’s population if you include those in the suboptimal range.

Having a deficiency of this super nutrient has been linked to osteoporosis, increased fracture risk, cancer, autoimmune dysfunction, cardiovascular disease, multiple sclerosis, lowered resistance to the common cold and seasonal flu, type 1 diabetes, and hypertension. 

Therefore, Vitamin D levels may just be the most important preventive lab measurement. Based on the current research, I recommend a target Vitamin 25D level of 30-50 ng/mL for most people.

Blood glucose: Blood glucose is critically important for detecting early-stage metabolic syndrome, diabetes, and coronary artery disease. Seeing as the endemic of diabetes has grown fast and is here to stay with its relatives called metabolic syndromes, monitoring your fasting glucose levels is as important as knowing your cholesterol level.

Testing blood glucose also requires fasting; it looks at how well your body utilizes sugar and is used to confirm and monitor diabetes as well as long term blood sugar control.

Although a fasting glucose is usually included in a basic blood workup, a far more useful marker is the 2-hour post meal glucose. This helps you to determine the amount of time that your blood sugar spends elevated over the level known to cause the complications such as diabetes and heart disease.

The food that we eat is eventually broken down into glucose, which is the sugar that circulates in your blood that provides your body’s cells with energy. Although glucose is crucial for providing energy, when it remains in the blood stream for too long it can damage the blood vessels and lead to cardiovascular disease.  

After monitoring hundreds of patient’s blood sugars each year, I have come to the conclusion that the American Diabetes Association (ADA) blood sugar targets are too high! 

If you are interested in optimal health and longevity, your ranges should be:

Fasting blood sugar: 75-90 mg/dL (ADA recommends <99)

2-hour post-meal blood glucose: <120 mg/dL (ADA recommends <140)

A complete thyroid work-up: Chances are, if you’ve had your thyroid tested recently, a lab marker called TSH was tested. The problem is, the thyroid hormone undergoes a complex cascade of steps before it is active and available to every cell of the body. 

Did you know that it is possible to have normal TSH blood levels but still experience the symptoms of a poorly functioning thyroid?

Thyroid disorders are on the rise. More than twelve percent of the U.S. population will develop a thyroid disorder in their lifetime, and up to 60 percent are unaware of their disease! One in eight women will develop a thyroid disorder in her lifetime.

A more complete thyroid screening includes:

1. TSH (thyroid stimulating hormone)

2. free T4

3. free T3

4. TBG (thyroid binding globulin)

5. T3 uptake

6. For those with an autoimmune disease or family history of thyroid disease, also include: TPO antibodies and antithyroglobulin antibodies.

Vitamin B12: It is common for someone following a vegan or vegetarian diet to be low in Vitamin B12. But, you can eat meat and still be deficient! 

Additional factors putting you at risk for low B12 absorption are digestive disorders, diabetes, taking proton pump inhibitors or acid blocking medications, and being older than 60 years old.

A review of 3,000 men and women in the ongoing Framingham Offspring Study found that 39 percent had B12 levels in the suboptimal range which are levels that can result in neurological symptoms!

B12 deficiency causes a type of anemia that can result in neurological symptoms such as walking and balance disturbances, memory loss, cognitive decline, confusion, and dementia. B12 deficiency has also been linked to infertility, autoimmune disease, and autism spectrum disorders!

Currently the accepted deficiency level is 148pg/mL. However, Japan and Europe have their lower limit at 500-550pg/mL.

If you suspect you have a B12 deficiency, an even more sensitive marker to include in your testing is methylmalonic acid (MMA).

understand your blood test results

 

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