The chronic toxicity, inflammation, hormonal imbalances, and infections that people have seem to be the root cause of why they have chronic conditions in the first place. This is why it’s very crucial to get your regular lab tests done to restore and optimize our own health. In this episode, Dr. Trish Murray points out the important labs that you may want to ask your traditional primary care doctor – either family medicine or internal medicine doctors – on an annual or a bi-annual basis based on your medical history. Don’t miss out on this very important show so you can jumpstart your journey toward restoring and optimizing your health.
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Important Labs To Ask For
I am a doctor of osteopathic medicine and I’ve practiced for many years in the beautiful white mountains of New Hampshire. My clinic is called Discover Health Functional Medicine Center. I originally trained in internal medicine and I was a primary care internist after my residency. As I practiced as an internist, I realized that prescribing pill after pill for chronic diseases was not helping people get better. It was not helping them restore their health. I went on to specialize in traditional osteopathy and essentially non-surgical orthopedics. I became a pain specialist. Over the years of practicing this, I’ve realized that the chronic toxicity, chronic inflammation, chronic hormonal imbalances and chronic infections that people have seem to be the root cause of why they have chronic conditions in the first place. I learned in the Institute of Functional Medicine and I’ve gone on to become a specialist in functional medicine. It is practicing this specialty that has led me to do these and my present mission of empowering you to restore and optimize your own health through education, community and support. If you liked this talk and would like to learn more, please go to my website, DiscoverHealthFMC.com.
Lab Tests In The Traditional Medical Model
We’re calling this the Important Labs to Ask For. I am going to be talking about exactly that, important labs in the functional medicine world that you may want to ask your traditional primary care doctor for. Primary care, either family medicine or internal medicine doctors, on an annual or a bi-annual basis based on your medical history and your health would typically do what’s called a comprehensive metabolic panel. This involves fasting, you’re asked to fast and you go in without having any food and getting your blood draw done. That complete metabolic panel typically tests for your fasting blood sugar, which is an important number to determine if someone is not metabolizing sugar well and having metabolic syndrome or diagnosed possibly with diabetes. That’s why that’s done. The other reason a complete metabolic panel is done is it looks at your electrolytes. It also looks at your kidney function and your liver function. These are the reasons why complete metabolic panel are done and that is one of the most basic common tests done by your primary care doctor in the traditional medical model.
Another typical test done in the traditional medical model is a complete blood count that looks at your white blood cells, your red blood cells and the size of your blood cells to determine if you’re anemic or not. Also, if your immune system is functioning normally in basically all the systems that are producing blood cells. It’s done in the traditional medical model on a regular basis. The other tests that are typically done on an annual or bi-annual basis by your primary care doctor and always has been is a lipid panel. It looks at your total cholesterol, your triglycerides, your LDL, the bad guy if you will, they may typically call it and the HDL, the good guy, the garbage truck that takes the bad cholesterol away. However, I will tell you that the traditional lipid panel that is still done on the street by the traditional primary care doctors is actually many years outdated. There is a more advanced test called the advanced lipid panel and I’m going to talk about that. Another thing that the traditional doc will usually test for is what’s called a TSH, a thyroid-stimulating hormone. That tests supposedly your thyroid glands’ function. We’re taught in medical school that that TSH test is very sensitive and it is the only test we need to determine if someone has a thyroid problem or not. In the functional medical model, I’m going to comment on that as well.Lab tests are extremely important to help us determine why you have any symptoms or any disease. Click To Tweet
It may not be enough of a test to determine the full function of your thyroid gland. Another test is for men across the country that is tested on an annual or bi-annual basis, basically a screening test for prostate cancer, is the PSA. If someone has a history of diabetes and has diabetes, then of course a hemoglobin A1c is also done by your primary care doctor, depending on how well your sugar is controlled. It’s probably more than once a year or at least once a year. These are the tests that you may or may not be familiar with, but they are the traditional medical model typical tests. What I’d like to do is talk about a few tests that I do on a regular basis and most functional medicine doctors would be doing on a regular basis that is above and beyond the ones I’ve already listed.
These, in my opinion and in the functional medicine world’s opinion, are extremely important to help us determine, for example, why do you have any symptoms you have, any disease process you have or trying to determine why and not just what you have? One, how would I put what at the top of the list are next on the list or a priority list? I don’t know that I do that, but I would talk about categories. For example, very common in the chronic disease world, inflammation is a problem. In many of my talks and books that you’ll read in the functional medicine world, we’re all talking about the fact that chronic underlying inflammation and hypersensitivity of a person’s immune system is many times the primary reason why they have the development of chronic diseases. It’s why their bad genes are becoming active in developing different chronic diseases.
High-Sensitivity C-Reactive Protein
One test that I absolutely do on all of my patients is what’s called a high-sensitivity C-reactive protein. That test or an hs-CRP, is a test that when ordered is assessing your level of generalized inflammation in your system. This is a test you may want to ask your primary care doctor to do if you’ve never had it done and it should be less than 1.0. If it’s elevated above that, then you do have underlying inflammation and you are at risk for many chronic diseases because you have underlying hypersensitivity of your immune system and underlying inflammation. I talk about this in my book, Make a D.E.N.T in Chronic Disease in chapter one. That’s the whole discussion of your immune system. I explain in my book how the immune system works and the fact that our immune system is our military. It’s our Army, our Navy, our Air Force, our Marines and it is defending us against foreign invasion by bugs or toxins or stress. If we are hypersensitive to our environment which majority of Americans are, that’s why we have a chronic disease epidemic, then we need to know if you have underlying inflammation and if you are hypersensitive. This test called the hs-CRP or high-sensitivity C-reactive protein is the marker that will help you know. The whole point of this is to educate you but also to suggest that this is not an esoteric test. This is a basic test that can be done and you just ask your primary care doc to include it in the next panel of blood work you have done when you have an annual physical.
Another lab test I would suggest people consider is a homocysteine level. Homocysteine is a marker in the pathway of your detoxification system, in a pathway called the methylization pathway. Homocysteine, if it is elevated, is one window into your detoxification system whether you are detoxifying and particularly methylating toxins well. If you’re not, then that’s showing you that your detoxification system is not functioning optimally. If it’s not, you’re maintaining or building up too many toxins in your system, which will put you at risk for heart disease or many other chronic disease processes. Homocysteine is used in the cardiology world to determine if someone is at higher risk of heart disease. My point here is that this is another marker that you could be asking your primary care doctor to add to your panel to determine if you have issues with detoxification.
If it is elevated and out of the normal range, one thing you would want to consider doing is taking a methylated form of B12 and a methylated form of folate. These are two very basic B vitamins in order to help your methylation system, detoxification system work more optimally. We’re not talking about a test that if it’s elevated, you have to have big procedures or big workups done to figure it out. First of all, you would want to clean up your diet and clean up any toxins in your world, but also you would want to take simply methylated B12 and folate. It’s a lab test that is not a huge cost. It’s not a zebra of a test and it may help improve your overall health and decrease your risk of many chronic diseases.
Advanced Lipid Panel
The third test I’ll talk about is the discussion of an advanced lipid panel or what’s called an advanced cholesterol panel. Because when you get your typical fasting lipid test that’s been done by primary care doctors across the country for many years that tests your total cholesterol, your triglycerides, your HDL and your LDL, how about this statistic? 50% of people who have had a normal traditional lipid panel in in the last year are actually 50% of people having a heart attack now had a normal traditional lipid panel within 2018. If this test is supposed to be assessing your risk of having a stroke or a heart attack and 50% of those who are having a heart attack had a normal lipid panel within 2018, do you see that this test is not accurate? It’s not good enough to help assess whether you have an increased risk of a heart attack or a stroke. There’s a better test.A lab test is not a huge cost and it may help improve your overall health and decrease your risk of many chronic diseases. Click To Tweet
This is not a zebra, it’s not horribly expensive. It’s called an advanced lipid panel. What’s different about it is that it will give you all the numbers I already talked to you about. The total cholesterol, triglycerides, HDL and LDL, but it also will give you what’s called the LDL particle number. The LDL particle number is extremely important because it is not necessarily big cholesterol particles that cause problems. It’s small, inflamed and toxic cholesterol particles that typically cause plaque. Plaques, when they’re unstable, break off from the inside of the wall of the vessel and go down your bloodstream. They then go into smaller vessels and then block a small, tiny vessel or capillary within your heart and cause a heart attack. That’s why they happen. First of all, the LDL particle number is extremely important. The other thing about an advanced lipid panel is it will look at the particle size. What I mean by the particle size is the LDL, the bad guys, how big or small and what is the size of the particles?
Why is that important? I like to explain in an analogy. If you take a laundry basket and imagine the size of a typical laundry basket sitting on your floor in your bathroom. If you put basketballs in that laundry basket, you will notice that you’re probably only going to fit five or six at the most in that laundry basket. Those are big particles and LDL cholesterol is fat. They should be big, fat, fluffy particles and they shouldn’t cause a problem. What happens when the particles get inflamed and toxic is they get smaller and denser. Think about taking the basketballs out of the laundry basket and putting in the laundry basket instead softballs. You’ll notice you’re going to put a lot more softballs than you did basketballs. Take out the softballs and put in ping pong balls and you are going to fill that laundry basket with a lot of ping pong balls in comparison to the number of basketballs you could fit in. The point about all of this is that the more particles you have, the smaller, denser and more toxic and inflamed they are, they are the ones that are dangerous.
As they go down your bloodstream through a vessel and through the hose of your blood vessels, they bang into the walls of the blood vessel and they cause a wound because they’re hot and toxic and inflamed. That wound causes an inflammatory response which causes the development of plaques. As those plaques keep growing or become unstable and a piece breaks off, it goes down in your bloodstream and may cause a heart attack or a stroke. It depends on whether that goes into a small vessel of your heart or a small vessel within your brain. The particle size and the particle number are extremely helpful to determine whether you are at increased risk of heart disease or stroke, which the traditional lipid panel does not do at all and does not give you any information about.
The other thing that comes in an advanced lipid panel or sometimes called a Cardio IQ, is the Lipoprotein(a). Lipoprotein(a) is a protein marker that if elevated, it tells you have an increased genetic risk factor for heart attack or a stroke. This Lipoprotein(a) is not included in the traditional lipid panel at all. That’s another marker you would want to test for. Finally, in that advanced lipid panel is also a marker called the plaque enzyme. If the plaque enzyme is elevated, it is a sign that you have unstable plaques, you have increased burden of plaques and you have some of them that are unstable and they may be spewing some of the plaque into your bloodstream.
You’ll notice these labs are very important to ask for. The traditional medical model, the traditional primary care doctor, family practice doctor or internal medicine doctor out there may not be educated about the advanced lipid panel, but the high-sensitivity C-reactive protein and the homocysteine they should be familiar with. They’re not esoteric tests. The advanced lipid panel is a newer test and they may not have heard of it or been educated about it. To be honest, the medicine on the street is typically several years behind the movement of the science and the most up-to-date things being done in the labs across the country as far as research and the most up to date science. That’s what I wanted to talk about on important labs to ask your primary care doctor about that you may want to ask to be added to your traditional or screening tests that are done when you have your physical exam.
To list those three I talked about. One is a high-sensitivity C-reactive protein or hs-CRP. The other is homocysteine and those are standalone lab tests. Those are two different ones. The third one I discussed is called an advanced lipid panel and it’s not just one lab test. It’s multiple and it’s an actual panel, but it includes beyond your total cholesterol, your HDL, your LDL and your triglycerides. It includes an LDL particle number, it measures the size of the LDL particles and big is better and small is bad and toxic and inflamed. It also tests for Lipoprotein(a), which is a genetic marker for increased risk of heart disease. It also tests for a plaque enzyme which would show that you are at increased risk of a heart attack because the plaques you may have built up in your vessels are unstable. I hope this helps and I hope to see you next time.
I hope this show has helped empower you on your journey to restore and optimize your health. If you would like more information, my clinic is called Discover Health Functional Medicine Center and our website is DiscoverHealthFMC.com. On our website is a great deal more information educationally, as well as information about our services. It’s also an opportunity to schedule a 30-minute free consultation with one of my team. During this 30-minute free consultation, you can get to know us, we can get to know you, you can learn about our services and see if it would be a fit for you to improve your journey toward restoring and optimizing your health. Another option is to go to our Facebook page. That’s Discover Health Functional Medicine Center. Join our Facebook group. Our Facebook group is filled in creating a community of people just like you that you can talk with and interact with about your questions. You can also ask us your most burning questions. Please go to my website or join our Facebook group at Discover Health Functional Medicine Center and let’s work together on our journey to restore and optimize health.