Each week you will see in the media and definitely social media articles about the different tests that you can do to find out what is going on with your health. Genetic testing, stool testing and gut microbiome testing are the most frequently cited.
In my work with clients I use these tests along with urine, saliva, hair and blood to look at hormones, thyroid, immune function as well as liver and detoxification capacity.
It’s always important to pick the right test or the right body tissue to sample to ask the right question, so we are more informed on the right road forward for each client.
In this day and age the challenge with this type of work is keeping up with this sea of functional lab testing, its relevance, application and importance. The practitioners judgement, which evolves from client experience is a continual learning process for discovering how and when to use a test, and when not to.
Using certain functional lab tests may or may not be useful for each individual client. Additionally, functional lab testing can become an expensive expedition, particularly if a practitioner cannot properly identify which type of tests to use for each client.
Enter functional blood chemistry analysis. Routine blood tests are a relatively inexpensive, minimally invasive test, which when evaluated functionally rather than for pathological or disease assessment, can yield a tremendous amount of physiological and science based data.
I am a big fan of recommending less protein or meat because of actual digestive issues that are present in the here and now and can change and should for greater health, than going with a fad and having all my clients go plant based because thats where all the social media posts are going. If there are genetic inefficiencies backed up with loss of function in for example digestion exacerbated by stress and an infection or loss of enzymes then we can make rational decisions on the correct food and supplements. Using testing you can advise clients to avoid meat, eat more meat, avoid raw vegetables, eat more cooked vegetables and on it goes.
In most instances, functional blood chemistry analysis serves as a foundational clinical test to:
- Understand where and what the physiological priorities are.
- Obtain an understanding of the individual’s primary areas of physiological and biochemical imbalance and dysfunction.
- Identify the next level of lab testing, lead us towards the best use of various functional tests.
- Create an effective, individualised protocol, aimed at supporting and improving biological functions.
- Track progress and effectiveness of protocols and health markers over time.
Functional blood chemistry analysis can greatly assist in sorting out what are the big picture main issues we are dealing with and what to do about them.
To test blood or not to test blood
Sometimes a blood test will come back and it looks like all is ok as your levels are in the “normal” range, they may be high or low of normal but they are not outside that range and therefore not truly low or high. They can be “normal” but that doesn’t mean you feel normal. Low or high on a blood test run by your Doctor would be seen as a clinical finding and they may then respond with a medical intervention. In a functional nutrition and nutritional therapy setting, not being medical, we are looking for patterns that outline the overall style of functioning.
Running a blood test and finding low blood sugar, and low thyroid levels alongside elevated blood fats may point to low energy, high stress, poor sleep, digestive issues and an inability to lose weight all corroborated by the client from their self-reported symptoms and feelings. None of this maybe medical but can definitely lead to you feeling down right hellish and maybe even that your situation feels fairly hopeless. The reality, now that we know some blood levels to go hand in hand with how you feel, is far from it. We are more likely to be striding off with a far more clear game plan. Knowing you are not the best version of yourself and finding patterns demonstrating loss of function and balance in a lab test but be quite exciting for me and my clients. You cant underestimate the value in finally having some science and a clearer picture of what’s going on in the inside to help dig up the drive to get into action and seek resolution.
Blood test limitations
It’s still worthwhile being aware of some of the limitations of using a blood test so you feel more informed and educated, pulling the wool over your eyes and blinding you with science tends not to fuel compliance to the program. These limitations may include:
- Understanding that certain factors on a blood test can change frequently due to the body’s homeostatic nature or need to stay in balance and equilibrium.
- Understanding that most blood chemistry factors are under the influence of multiple, physiological factors, making it difficult to discern “what is causing what”.
- Understanding that because many blood chemistry factors may be changing more frequently, a single blood test may not effectively identify the physiological patterns over a longer period of time.
- Be aware that certain results may require a referral or recommendations to perform further tests, such as urine, saliva, stool or hair.
Fortunately, there are ways around some of these potential limitations. While we cannot stop the body from its homeostatic fluctuation, we can track your blood tests over weeks, months and years. This provides a better understanding and appreciation for an individual’s inherent tendencies over the long-term. In fact, tracking an individual’s blood chemistry over a long-term may actually be more useful than single isolated tests, as it may figure out your organ, system and physiological patterns more clearly.
The blood results need to be used alongside sophisticated questionnaires and intake data, diet diaries, fitness tracker information, blood pressure, blood sugar, heart rates and a whole load of other data collection will be factored in.
How is the test sample taken
It is a simple finger prick blood spot, blood test that takes minutes to complete and can be done in the privacy and convenience of your own home. This type of blood test can be used instead of a full blown blood draw carried out by the nurse or phlebotomist at your local medical centre. It eliminates blood draw needles, blood draw fees and also saves time and money. A blood draw performed at your doctors will yield more information of course but it is surprising how much in the absence of disease and thinking how your body works and functions that can be found in a blood spot test like this. Even better you can do it yourself at home and a courier turns up at your front door to take it off to the lab for you. Typically it is completed in the morning following a 10-14 hour fast.
Who are blood tests for?
It is aimed at individuals of all ages. It is an excellent entry level test for people young and old for establishing base levels of many important health markers which can then be actively monitored for changes.
You may not necessarily experience any symptoms at the moment. That’s why regular health checks are so helpful in detecting the early signs of medical problems.
A blood test is great tool to be used as a general health assessment without symptoms however it can be used when the following symptoms and conditions are present or suspected:
- Mood swings, feeling easily angered
- Uterine fibroids
- Unexplained weight gain
- Feeling fatigued or lethargic
- Memory loss
- Skin problems such as acne, psoriasis, or a red flushed appearance
- Breast sore, tender, and/or enlarged
- Low sex drive
- High blood pressure
- Facial hair – excessive growth
- Hot flashes
- Thinning hair or excessive loss
- Irregular periods
- Hot flashes
- Night sweats
- Memory lapses
- Difficult concentrating
- Joint pain
- Vaginal dryness
- Dry skin (which can lead to premature aging, wrinkles, and brown age spots)
- Loss of libido
- Vaginal infection
- Panic attacks
- Low self esteem
- Breast tenderness
- Feeling bloated
- Mood swings
- Excessive sleepiness
- Susceptibility to yeast infections
- Thyroid dysfunction or disorders
- Fibrocystic breasts
- Weight gain
- Gallbladder disease
- Low blood sugar
- Panic attacks
- Water retention
- Irregular menstrual cycle
- Blood clots during menstruation
- Magnesium deficiency
Blood chemistry markers measured
- HDL Cholesterol
- LDL Cholesterol
- VLDL Cholesterol
- Haemoglobin A1c
- Free T4
- Free T3
Vitamin D Markers
- Vitamin D2
- Vitamin D3
What do blood tests tell us?
Blood tests are used to show whether the levels of different substances in your blood fall within a normal (healthy) range.
Triglycerides are a type of fat in the bloodstream that is taken up by tissues and used as a primary energy source. Triglycerides are derived from fats consumed in food and synthesised in the body from carbohydrates (sugars). Triglycerides are stored by tissues and released into the bloodstream in response to hormonal signals and used as a source of fuel for all muscles of the body. Triglycerides contain a glycerol and 3 fatty acids. Elevated triglycerides are associated with increased risk for heart disease and stroke. It can also signal insulin resistance/ metabolic syndrome and is often found in untreated type 2 diabetes.
We have all heard about cholesterol, “good” and “bad” cholesterol and most of the time it comes with media scare stories, avoid fat, heart disease and the need to take statin drugs. Cholesterol is so important that the body makes 80% in the liver and intestines. It’s found in every cell and is a crucial building block in cell membranes. It’s used to make vitamin D, hormones (including testosterone and oestrogen), and fat-dissolving bile acids. It should be evaluated in parallel with other lipid risk factors, which include triglycerides, LDL (“bad” cholesterol) and HDL (“good” cholesterol) cholesterol. High levels of triglycerides and LDL cholesterol further increase risk, whereas high HDL cholesterol decreases risk. HDL cholesterol can be found to be low, which many health experts consider a higher risk for cardiovascular disease.
Fasting insulin can point to insulin resistance. Insulin resistance predisposes you to significantly increased lifetime risk for developing more serious health conditions such as metabolic syndrome (high blood pressure, excessive weight gain in the waist, elevated blood lipids), diabetes, and cardiovascular disease.
Haemoglobin A1c (HbA1c) is a measure of red blood cell haemoglobin glycation. Because red blood cells have about a 120 day life span, a high HbA1c reflects average hyperglycaemia (elevated glucose) for the previous 3 months.
People with diabetes have higher HbA1c values because their bodies have difficulty managing their blood sugar levels (hyperglycaemia). With persistently high levels of HbA1c, there is increased risk of developing problems such as eye disease, kidney disease, nerve damage, heart disease, and stroke. The recommendation is to measure HbA1c every 3-6 months.
Insulin-Like Growth Factor
Insulin-Like Growth Factor is a hormone produced by the liver that controls the function of Growth Hormone and is influenced by protein and energy intake. It plays a crucial role in regeneration and healing. IGF-1 has been implicated in heart disease, diabetes and cancer and some studies indicate it can have a protective effect. It tends to lower with fasting which can support increased levels of programmed cell death called autophagy and apoptosis, alongside increases in resulting stem cell production creates greater levels of repair and regeneration.
High Sensitivity C-Reactive Protein (hs-CRP) is a marker of inflammation and contributor to pro-inflammatory and pro-thrombotic (blood clotting) elements of cardiovascular disease risk.
Free T4, Free T3, TSH
The thyroid gland is a butterfly-shaped organ located in the base of your neck. It releases hormones that control metabolism. The thyroid’s hormones regulate vital body functions, including:
- Heart rate
- Central and peripheral nervous systems
- Body weight
- Muscle strength
- Menstrual cycles›
- Body temperature
- Cholesterol levels
The thyroid uses iodine from the food you eat to make the two thyroid hormones T4 (Thyroxine) and the active form, T3 (Triiodothyronine). The hypothalamus in the brain releases Thyroid Releasing Hormone which in turn leads to the release of TSH (Thyroid Stimulating Hormone) from the pituitary also in the brain. In turn the thyroid makes more less T4 and T3 to keep balance and the metabolism in check based on the bodies needs.
The thyroid markers can indicate the presence of an imbalance in thyroid function, which can cause a wide variety of symptoms, including feeling cold all the time, low stamina, fatigue (particularly in the evening), depression, low sex drive, weight gain, and high cholesterol. Thyroid deficiency can also be a cause of infertility.
Thyroid function can be affected by nutritional deficiencies including iodine & selenium and by exposure to elements including bromine, arsenic, selenium, mercury & cadmium.
Thyroid peroxidase (TPOab) antibodies when found to be elevated can indicate a condition known as autoimmune thyroiditis, often referred to as Hashimoto’s thyroiditis. This condition is associated with elevated circulating antibodies to thyroid peroxidase, the enzyme found within the thyroid gland responsible for manufacturing thyroid hormones (T4, T3). When the level of TPO antibodies is elevated this can lead to destruction of the thyroid gland and acute release of high levels of thyroid hormones T4 and T3. Continued autoimmune destruction of the thyroid gland eventually results in fibrosis and depletion of the thyroid hormones from the thyroid gland, thus causing an eventual hypothyroid or low thyroid state. Individuals with autoimmune thyroiditis can suffer from symptoms of both thyroid excess and deficiency, depending on the state of the disease (ie, autoimmune attack on the thyroid and hyperthyroidism or post-attack and hypothyroidism).
Vitamin D Markers
Vitamin D isn’t so much a vitamin it’s more strictly called a pro-hormone. Most of our vitamin D is made when our skin is exposed to sunlight. Due to a lack of sun exposure insufficient levels of vitamin D are common, especially in northern climates where people don’t spend as much time outdoors. Studies indicate that even people in sunnier regions are often deficient due to the counter concern of the ill effects of too much sun.
Vitamin D is important due to its role in calcium regulation and in the mineralisation of our bones. Vitamin D can play a protective role against certain cancers, development of diabetes and heart disease. Vitamin D deficiencies are associated with high insulin and increased belly fat as well as contributing to psoriasis and acne.