When patients bring in their lab results from their annual check-ups, there are always a few tests that I wish were included but almost never are. Routine lab testing offers us a glimpse into the health of a patient, but I've noticed that certain important tests are left out. In addition to routine lab work, I also recommend the following:
Full thyroid panel (especially for women)
This fat-soluble vitamin is actually classified as a steroid hormone and ideally we acquire it from healthy sun exposure, but it can also be obtained through supplementation and certain food sources. It is a powerhouse and has several functions in human health. To name only a few big ones, it is anti-inflammatory, it improves immune function, it helps you build stronger bones, it maintains healthy brain function, and prevents heart disease. I recommend supplementation during the winter months, but it’s ideal for us to know your levels before you begin to supplement. I have yet to hear of a case of the flu from anyone in my practice who has maintained their Vitamin D3 levels adequately through out the year. I recommend testing this annually, and supplementing accordingly.
High-sensitivity C-reactive protein is a measure of inflammation, and can also tell us about cardiovascular disease risk. As inflammation increases, so does C-reactive protein. We know that inflammation plays a big role in many chronic diseases, so I think it’s important to know your levels. There are two versions of this test: the basic CRP test also measures inflammation, but your levels would have to be extremely high before it picked it up (between 10-100 mg/L). The high sensitivity test picks up inflammation at levels as low as 0.5 mg/L (I like to see hs-CRP levels under 1) so for the purposes of prevention, I want to see the high-sensitivity version of this test.
Full thyroid panel:
Most thyroid testing stops at TSH, and perhaps Free T3 and T4. Thyroid disease is quite common, especially among women, and it can part of the issue when a woman is having difficult conceiving. I ask all of my female patients to get a full thyroid panel so that we can fully assess the health of this vital organ. This includes anti-TPO and thyrotropin receptor antibody (these two tests tell us about auto-immune thyroid conditions). I have seen several cases where TSH is absolutely normal, even in the ideal range, and the patient has no symptoms, and there are still antibodies present.
Apo-lipoprotein B (Apo-B):
There is emerging evidence to suggest that the Apo-B test is more accurate and more comprehensive than just LDL cholesterol in predicting cardiovascular disease risk. One study from 2009 found that almost half of patients taken to the ER due to a heart attack had normal or low levels of LDL. That being said, LDL is still a good test, but Apo-B may be able to give us more detail. Ideally I like to see a routine cholesterol panel, as well as Apo-B for a comprehensive picture. I especially find it important in a situation where cholesterol is borderline or high.
If you'd like to have any of these tests run, I offer full lab testing and would be happy to work with you.