The Basic Lab Numbers You Need to Know (And one to Skip)
How do you know if you’re really healthy?
Your health is far more complicated than just a single data point – such as your weight – but most folks don’t really understand which data points do matter: and no wonder - most doctors don’t have the bandwidth to go over these numbers in depth.
Regardless of your size, do you know what the state of your health is INSIDE your body?
I’m here to help! I’m Beth, a registered dietitian who supports my clients with a functional nutrition approach. I like to explore all of the data my clients have so that we can have a comprehensive understanding of what is going on with their health right now and then forge a doable path forward.
In this article, I’ll walk you through the basic lab data so that you can have a clear picture of your health, right now.
Why do we need data?
Data is necessary because individual genetics, environmental toxins, chronic infections, and lifestyle factors like over or under-exercise, stress, and sleep habits all play a role in our internal health.
Many people may say they feel fine because they don’t have extreme symptoms, but often the reality is that we slowly have gotten to a place of diminished health, so we don’t realize the impact it has on us until we are bottoming out.
We often hear (and have said ourselves) after clearing up a food sensitivity, gut infection, or improving nutrient status, “I didn’t realize how bad I felt until I started feeling so good”.
Good news: this is exactly the way that I help my clients.
Top basic lab tests for understanding your health
Here are seven basic lab tests you can do to see what’s happening metabolically in your body:
1) Complete Blood Count (CBC):
Your CBC is a measure of your total, plus a breakdown, of red and white blood cells. The red blood cell information lets us know if you have enough red blood cells and if they have what they need to carry around oxygen, so every cell in your body can breathe.
From a nutritionist's view looking at your CBC also gives insights into iron and B12 status, which is important because these are both critical nutrients in overall health and nerve health, if are low in these nutrients it has dramatic impacts on how you feel energy-wise.
White blood cells specifically may give you clues about a current or chronic infection, allergies, or how well your immune system is doing on the whole. Your overall nutrition status has an impact on your immune system function as it uses protein, vitamins, and minerals to be able to function properly.
2) Metabolic Panel (CMP):
The metabolic panel includes several labs, including electrolytes (minerals), protein, glucose, liver, and kidney status.
These labs are important to me as a dietitian because each of the tests is heavily influenced by your diet. I use them to help determine if you getting adequate amounts of protein, vitamins, minerals, fluid, and more for your body to do their necessary jobs.
For the many of the lab values in the section of the labs you are looking to see if you are not near lab high or new lab low, nice mid points (not every lab in the section will apply to this rule). Glucose, if fasting, should be under 95; I like to see fasting glucose between 80-90. The liver markers AST and ALT have a large range and ideal functional ranges are below 30, though there may be some variations in people where they may run higher that do not indicate problems in the liver.
3) Cholesterol panel basic:
This panel includes total, HDL, LDL, and triglycerides. It can give you insights into how much and ratio of cholesterol. LDL cholesterol's main job is to take cholesterol to the cell to make hormones and provide cell structure. HDL cholesterol takes what is left over from all that back to the liver to get repackaged & reused or to get excreted from the body.
High cholesterol levels are implicated in heart disease. Your diet and lifestyle play a role in your cholesterol numbers, talking with a dietitian about easy changes to your diet can have a big impact on your overall heart health.
Triglycerides are the short-term storage of fat. This means they’re available for energy between meals- kind of like having a granola bar in your purse but inside your body. When fasting triglycerides get over 90, it may be an early predictor for insulin resistance or signs of excess storage of various sources of carbohydrates. (Please don’t stop eating carbs, they are needed in a balance that is right for you!)
There are a few more lab tests that I recommend asking for to get a better look at your current nutritional and health status.
4) Vitamin D:
Even though vitamin D is vital for bone and immune health and even your mood, most of us are deficient. The ideal range is to be between 35 and 70ng/mL
If you are not going outside and exposing large portions of bare skin for 10-15 minutes between 10 am and 4 pm, most days of the week, you probably aren’t getting enough D. If you are covering your skin with clothing and/or using sunscreen, you’re not able to make any vitamin D.
If you live anywhere above the Texas panhandle you will not get the vitamin D from sun exposure from October to April, even if you’re walking around in your birthday suit.
Despite common fears about vitamin D being a fat-soluble supplement, It’s actually safe to supplement 2,000 IUs per day *
5) HbA1c (Hemoglobin A1C):
Hemoglobin A1c is the measure of your average blood glucose levels over the last 3 months. Having this data point in addition to your fasting glucose found in the CMP gives a better picture of blood glucose levels after meals. You could be having frequent higher than normal glucose levels after eating and not know. Over time having consistently high blood glucose levels can lead to Type 2 diabetes. Tracking your A1c helps to catch blood sugar problems before it becomes more serious like Type 2 diabetes.
An A1c of 5.7% is considered pre-diabetes. For my non-diabetic clients, I like to aim for A1c’s less than 5.5% to ensure optimal metabolic health.
6) Iron/Ferritin:
While the CBC can give a rough idea of iron status, it’s best to know what your total iron (what I call what’s in your checking account and ready to use) and ferritin (your savings account, what you have in reserves). It’s good to know because without enough iron you don’t have enough oxygen.
When you are low in iron you can feel easily fatigued and not able to concentrate. We also use iron as co-buddies in doing many metabolic processes.
Ferritin can also act as an inflammatory marker or an indicator of someone that has the genetic variation hemochromatosis, so for those reasons I like to see these values.
7) CRP or ESR (sed rate):
These are very general inflammatory markers produced in the body. CRP can be elevated when experiencing short-term or long-term inflammation processes like infections, auto-immune conditions, or heart disease. These tests are not specific to finding out exactly what is the source of inflammation in your body but are a good indicator to look further.
Diet and lifestyle can play a role in CRP/inflammation in the body, which is why I like for people to have this tested.
CRP levels should be less than 5mg/dL, though anything up to 10mg/dL is considered mild inflammation.
Which data point is…pointless?
Weight is almost always measured at the doctor’s office and when someone is considered overweight that is usually the talking point - lose weight then everything will be better, but that is not always the case. You can be thin and still have abnormal lab markers. You can be in a larger body and have good lab markers. Weight does play a role in your health, but it is not the only thing that drives our lab tests to be out of range.
Weight also fluctuates and does not provide a full picture of what it is comprised of like muscle mass vs. fat mass, carrying a baby, changes in daily fluid balances, and so on. Check out this blog post on the adventures in what might be moving the scale.
Taking a deeper look
There’s one more thing you need to know about all these labs. In functional medicine, we look at lab numbers in a more narrow range than what is reported on your test results. Why? Because the reference ranges that you see on your lab results have a big range and when you are outside of those ranges they represent that something is wrong.
But in functional ranges, the range is smaller and represents where the body would operate at an optimal level. You could have a magnesium level with clinical reference ranges, but if it were below optimal/functional levels you might still have muscle cramps and fatigue from not enough magnesium.
Another example would be seeing your blood glucose at the top of the range and your triglycerides starting to climb, we don’t want to wait until these are actually lab high indicating pre-diabetes or diabetes to make changes in your carbohydrate intake. We can catch many nutritional imbalances to improve health, long before disease sets in.
That’s a wrap
As a registered dietitian, I love empowering my clients to be more informed captains of their own health. Many primary care doctors simply don’t have the bandwidth to teach you about the individual lab values, their role in your health, and how to use them to track your nutritional and overall health.
Many healthcare providers just take a look at your weight and make a judgment about your health from that one single number.
…we can do far better than that, together.
What do I recommend?
Get a copy of your blood work and ask about your blood pressure. Don’t just accept when a healthcare provider says, “Everything looks fine”. You be in charge of you!
Not sure how to get your lab numbers? Reach out and I’ll help guide you to getting the tests you need. I review all new and existing labs with you so we’re able to make a clear plan for the health goals that are important to you.
You’ll feel empowered and excited to take the next steps forward.
*
Sources:
https://webmd.com
https://www.mdpi.com/2072-6643/16/3/391
https://clevelandclinic.com
