The Ins and Outs of Lab Tests
Wikipedia defines a laboratory test as, “a kind of medical procedure performed to detect, diagnose, or monitor diseases, disease processes, susceptibility, and determine a course of treatment.”
At Pacific Naturopathic, we implement a number of conventional and cutting-edge tests as part of our conscientious approach to implementing what has become known as “Evidence-Based Medicine (EBM).”
EBM is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of patients.
At Pacific Naturopathic, we ask our patients to bring recent lab reports with them when they come to the office, whether for a first office call or return visits.
This is for several reasons.
- If appropriate and sufficient labwork has been done recently, it may not be necessary for us to repeat the labwork.
- If the labwork is incomplete, we can immediately see what is lacking.
- If relatively recent work has been done, but requires retesting, we then have the ability to compare the patient’s current values with their past values.
Comparing the patient to themselves is more revealing than comparing the patient’s values with the standard conventional range. This is because the conventional range simply gives us the 5th to 95th percentages for the not-necessarily-well general population.
Many times, patients come to us indicating that they have recently gone for a general checkup, and they’ve been told by their doctor that everything is perfectly normal.
This simply means that their values on that particular test fall within the conventional ranges listed on the lab report.
But these values have little to do with what is normal for an individual patient. These values are based on the diagnosis of disease, rather than on the optimization of health.
A good example is testing for vitamin D levels.
The range for 25 hydroxy vitamin D on conventional lab tests is anywhere from a low of 20-30 to a high of 100. While a value of 21 is within the range, the optimal value, as understood in functional medicine, is 60. In the situation of hormonally driven cancers, the optimal is from 60 to 80. So – no, the patient cannot be diagnosed with a Vitamin D deficiency by the numbers. But the low values may correlate with autoimmune disease, endocrine cancer, and other disease states.
Another example is serum vitamin B12 levels. Time and again, we’ve seen patients improve with vitamin B12 when blood values are well within the norm.
High values may not indicate a need to discontinue the B12 the patient may have been taking, but rather a need to change the form of the vitamin so that the patient is actually able to utilize what they are taking in. In this case, intracellular nutrient levels (or the even better serum test for B12, methylmalonic acid) will reveal the true situation.
Quite often, patients come into our office with reams of findings, often outdated, and from sometimes obscure labs. We see patients who’ve been limiting their diets for years due to old IgG food sensitivity testing, although food sensitivities are known to shift over time.
We love the obscure lab findings, but however fascinating they are, abnormal findings do not always dictate any particular treatment course.
Our goal with laboratory testing is to discover what we might affordably do to enhance health maintenance and disease prevention; to clarify the patient’s treatment options; and of course, to diagnose diagnosable disease.
Our unique 12-hour Fasting Wellness Panel, which we’ve negotiated with Quest Labs at a deeply discounted cash price of $172, is a good baseline starting point for almost all patients.
Normally, This extensive set of tests can run as high as $3000 when the individual components are ordered separately. Our Wellness Panel looks at heart, liver, kidneys, immune system blood proteins, blood chemistry, inflammatory markers, blood sugar, and other markers.
If you would like to establish your personal biochemical baselines, please make an appointment to discuss your specific needs, and receive a requisition for our unique Wellness Panel.
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Read more about the medical services Dr. Connie offers here: http://www.naturopathichealthconsultations.com