Laura Schoenfeld: All right, so I do have an article on my own site about the lab tests that I recommend to my clients. Sorry, I’m just laughing because I’m losing my voice and this is probably not the most good-sounding question-and-answer session. But anyway, so if you, let me see if, yeah. So Lauren has it up on the screen. If you want to scroll down to the part that says “recommended basic lab tests,” it has my little list there and people can look at that. So I’m not 100 percent sure how this compares to Chris’s panel that he recommends. I usually just sent this to my clients. I have a little packet that I’ll send to them before their appointment that has this information in it about the recommended basic lab tests. And so this is my list that I give them.
Now I don’t have a way for them to order tests through me. If they’re going to order tests, they can either do it through their doctor, they’ll just bring this list, and then also there’s options for things like DirectLabs.com or just other lab ordering websites if they want to do it that way. I normally just recommend them going to their general care provider because if they can get the doctor to order this, then usually it’s covered by insurance, and I’d much rather somebody get their labs covered than having to pay out of pocket. Because this can get kind of expensive if you’re paying just out of pocket to an online lab service. But basically my recommended basic tests are a comprehensive metabolic panel, which is going to cover mostly the electrolyte levels, protein levels, blood sugar, different things that are showing. Basic kidney function, that kind of thing. The lipid profile, which is going to do total cholesterol, HDL and LDL, triglycerides. If somebody has a history of heart disease, you might go deeper into some of those more in-depth lipid profiles like the NMR profile. But if somebody is not worried about that, then I’m not going to have them try to get a ton of things done along the lines of the heart disease risk if it’s not really something that’s relevant.
Sometimes I’ll ask for C-reactive protein. It’s not a way of something I would want to see, but it can be helpful especially if somebody has any sort of inflammatory disorders, autoimmune disease, anything like that. I usually want to see somebody’s blood sugar control, so that includes fasting blood sugar and also hemoglobin A1c just to get a general picture of their blood sugar function. Now if somebody’s dealing with blood sugar issues, I will also request a fasting insulin as well just to see if their insulin is low, high, normal, anything like that. I usually want to see a full thyroid panel, which includes TSH, free T3, free T4, maybe reverse T3 if we can get it, I like to see that, and then if Hashimoto’s is a concern, then we will ask for the thyroid autoantibodies. I always want to see a vitamin D on somebody, especially if they’re supplementing with vitamin D, because I do have a lot of clients that are taking vitamin D and they don’t actually know what their vitamin D levels are. And as Chris has pointed out in lots of his writing and podcasts and that kind of thing, you don’t want to be pushing vitamin D levels super-high. So if somebody has levels above 50, they shouldn’t be supplementing.
Another thing I’ll want to see is a complete blood count, which is going to include things like iron, ferritin, transferrin saturation, it’ll show if there is any sort of anemia, which can indicate either iron deficiency, B12 deficiency, folate deficiency, that kind of thing. It can also show if there’s any sort of elevated white blood cells. So if there’s an infection going on then, you’ll see that there. So that’s usually important to see. And then if we can get a B12 and a red blood cell folate, I like to see that as well because a lot of clients, if they’re not supplementing with those things, they tend to be at risk for deficiencies, especially if they have any sort of methylation issues.
So those are the basic lab tests I recommend for most of my clients. There might be some things I’ll recommend for people with any sort of specific health issues, but I don’t do a lot of testing with my clients. I tend to do more coaching than functional medicine. But if you are doing more of a functional medicine approach, then that list is going to cover a lot of the basic issues that somebody might run into. And then of course there are additional things that may not be that important in the beginning unless you see some specific symptoms or issues that you want to do further testing on certain things. I often do DUTCH tests with my clients becuase I get a lot of people with HPA axis dysregulation, and then also I refer out to a lot of SIBO tests as well. Because a lot of my clients with gut issues end up having SIBO. But that’s not something I would obviously do for everybody. So these ones I would say, if everyone wanted to do these, if they can, it’s always helpful. And then I don’t always have this stuff before my first appointment. I do ask my clients to send me any labs that they’ve had done. It’s always nice to have them because again if you’re, if something’s off like if somebody has a hypothyroidism or if their vitamin D is low, or if they have some low vitamin B12, you don’t want to miss that stuff. So having this stuff done before the appointment is always helpful. But I don’t, just honestly, don’t always have it done before the first appointment.