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In my first article, I explained the differences with conventional (a.k.a. traditional) compared to functional medicine and their relations to testing. I also touched upon what and when to test.  I made it clear that testing can be necessary to uncover “what’s going on in there” (your body), but testing to just test is not a good plan.  Be wise about testing and the timing of them you choose and if you are going to test, you should be willing and able to address whatever you find in the results.

The focus of this article (Part 2) is to get into more details of specific testing.  I will mention tests that are available through a conventional doctor and most of the time, covered by insurance or health share plan.  I will get into more typical functional medicine testing in the next article (Part 3).

Tests – Typically Covered By An Insurance or Health Share Plan

For these types of tests, I along with many doctors and experts in the functional medicine field recommend serum (blood) labs to be run for the following tests at minimum.  Though they may be covered when claimed with insurance/health share plan, keep in mind that many doctors do not order some of these.  It is up to you to be your best “patient” advocate (I’ll be writing another article on that) and request them.

Even though insurance/health plan may cover this testing, it is possible you may be able to save money by ordering these tests online (I have resources for that) and paying for them directly, without claiming them on your insurance.  Here is why.  Though they may be covered by insurance, the final charge that you may have to pay (based on insurance contract pricing with the lab and your deductible and other plan out-of-pocket responsibilities) may actually be more than paying for them on your own.  The links with these tests can be used to order them directly if you choose to do that compared to having your doctor order them and claiming them with your insurance. You can also compare the pricing between ordering direct or the out-of-pocket you will have with insurance/health share plan so you can make an informed choice. Also, whether your doctor orders these tests and the lab handles the claim paperwork with your insurance or you order them online and receive them directly, you may use HSA, HRS, or FSA account funds to pay for them.

Next, another key important to understand regarding test results is that traditional doctors are typically looking for gross abnormality and formal diagnosis related to clinically high and low lab values.  In most cases then, as long as your results are within the reference range (according to the lab and included with your test results), your doctor will say all looks good.  However, does it mean that all is well?  No!  Many reference range targets are created based on healthy individuals and many do not represent levels for optimal health. They especially are not complete accurate ranges for those who already have health issues.

Also, for appropriate confidentiality, privacy, and HIPPA compliance, when you order your testing online, your results will be sent to you and in some cases, you may request a copy be sent to your doctor.  If you are working with a practitioner like me, it is your choice as to whether you want to share your lab results, as they would not be sent to me directly.  Of course, it is very helpful for my clients to share their lab results with me regardless the way they obtained them, but it is always the client’s choice.

Here is a list of foundational tests that can be obtained through your doctor that are typically covered by insurance/health share plan:

• CBC (Completed Blood Count): Evaluates the components of the blood – white & red cells, and platelets and elements relating to them.  For healthy individuals, no previous result abnormalities/less than optimal results, and no health condition that may trigger less than optimal result, getting this done once per year is fine.  Otherwise, more often may be necessary.
• Advanced Lipid Panel Including Lp(a): This is far more than the typical cholesterol levels that are ordered in a much more accurate story.  This will show HDL, LDL, triglycerides, total cholesterol, and sub-particles of HDL and LDL.  Though LDL is typically called the “bad” type, there are elements that are necessary and positive as part of LDL.  For healthy individuals, no previous result abnormalities/less than optimal results, and no health condition that may trigger less than optimal result, getting this done once per year and possibly twice is fine.  Otherwise, more often may be necessary
• CMP (Comprehensive Metabolic Panel): Measures liver and kidney function, electrolytes, blood glucose, etc.  Though certain minerals, such as magnesium, are measured in the CMP, this is not the most accurate measurement for some of them.  More accurate testing can be ordered directly by you online and I will cover that testing in the next article (Part 3 of this topic).  For healthy individuals, no previous result abnormalities/less than optimal results, and no health condition that may trigger less than optimal result, getting this done once per year is fine. Otherwise, more often may be necessary.
• Fasting Insulin:Much more accurate and helpful in determining blood sugar or insulin resistance issues even before fasting blood glucose or HbA1c levels are shown to be out of line.  Depending on someone’s diet and when they were tested, the blood glucose test alone can be misleading.  For healthy individuals, no previous result abnormalities/less than optimal results, and no health condition that may trigger less than optimal result, getting this done once per year or maybe twice is fine.  Otherwise, more often may be necessary.
• Thyroid Testing (never accept TSH alone). The following minimum labs should be ordered to see a full picture.  Unfortunately, many doctors, even specialty endocrinologists, are not familiar with much more than TSH.  Because I have Hashimoto’s (autoimmune hypothyroidism) and my training, I am very familiar with these tests and what their levels mean.  I get these several times per year to ensure my medication level is what I should continue with and to be aware of my antibodies so I can address if they have risen.  It is imperative you work with someone who is able to interpret these results. Of course, that applies to all the testing you invest in.  For healthy individuals, no previous result abnormalities/less than optimal results, and no other autoimmune conditions, getting this done once per year is fine.  Otherwise, checking them more often (as I do), even as many as 4 times per year may be necessary:
  • TSH
  • Free T4
  • Free T3
  • Reverse T3
  • TPO & TGA Antibodies – determines if a thyroid condition is autoimmune and the level of antibodies

• Methylmalonic Acid (MMA) to uncover a low or deficient B12. Tells a better picture versus the B12 test alone. For healthy individuals, no previous result abnormalities/less than optimal results, and no health condition that may trigger less than optimal result, getting this done once per year is fine.  Otherwise, more often may be necessary.
• Homocysteine:Risk factor for heart/cardiovascular disease and can help uncover a B6, B9 (folate), and/or B12 deficiency.  For healthy individuals, no previous result abnormalities/less than optimal results, and no health condition that may trigger less than optimal result, getting this done once per year is fine. Otherwise, more often may be necessary.
• High Sensitivity C-Reactive Protein (Hs-CRP): Biomarker for inflammation.  For healthy individuals, no previous result abnormalities/less than optimal results, and no health condition that may trigger less than optimal result, getting this done once per year is fine.  Otherwise, more often may be necessary.
• Vitamin D (25-hodroxy vitamin D): The most common form of vitamin D measured. Having optimal vitamin D levels is critical to avoiding a multitude of health problems.  Vitamin D testing is recommended twice per year for all since levels can vary greatly in different seasons.  If abnormalities exist, testing more often should occur to ensure appropriate dosage of supplement is taken as necessary.
• Ferritin:Ferritin is a more accurate view of iron compared to the typical iron and iron saturation tests.  This links includes testing of Ferritin and the others merely because it is more economical with the combination.  For healthy individuals, no previous result abnormalities/less than optimal results, and no health condition that may trigger less than optimal result, getting this done once per year is fine. Otherwise, more often may be necessary.

Until next time, here’s to YOU thriving in wellness!
Kelly