Routine testing often happens on a regular schedule, such as at an annual physical. But all too often, health care practitioners don’t explain what these tests are looking for, or what the results might mean for their patients. My clients are sometimes surprised at how closely I look at the numbers, not only from the most recent test, but from several of these routine tests taken over an extended time frame.
I believe that the more information we have, the better I can serve you. And numbers at an isolated moment in time don’t really tell us all we need to know. Comparing the results of tests from one year to the next can give you a lot of information about your health. It can help you catch problems before they begin, even if you are feeling fine. Staying healthy is so much easier when you are well informed.
Routine testing can also help you make sense of any troublesome symptoms you have developed. They can alert you to trouble that may be brewing, but hasn’t started to impact your life yet. Having some tests on a regular basis allows you to catch anything out of the ordinary right away. If you know what your body is telling you, you can begin to think about how you can make positive changes.
If you’re already managing symptoms with lifestyle and dietary changes, lab results help track your progress. And as you see the numbers moving in a positive direction, you often have more ability to control your own health and the incentive to keep making changes that can have a huge impact on your quality of life.
Understanding Your Lab Test Results
There are so many tests that your healthcare practitioner can perform to better understand what is happening in your body. Sometimes, the range of tests available can feel overwhelming. But if you understand the purpose behind each test, you can also understand how the information could help.
Below is a summary of some common medical tests, and how they can help. By having a basic knowledge of these routine tests, you can better advocate for yourself if something looks amiss.
Mammograms are used to assess your breast health and screen for breast cancer. While there is much debate in the medical community about how often mammograms should happen, and how effective they are in early detection of breast cancer, it’s certainly better than no screening at all. I suggest that women have a mammogram every two years, starting at age 50, unless they have a family history of breast cancer and I urge them to perform self exams in between.
TSH (thyroid-stimulating hormone):
Your thyroid gland is responsible for producing the vital hormones T3 and T4, which need to be well balanced for optimal health. This balance begins in the brain. The hypothalamus produces Thyroid releasing hormone (TRH) which lets the pituitary gland know how much TSH to release, which then signals to the thyroid whether it should increase or decrease production of T3 and T4. Knowing how much TSH is circulating in the blood can help determine how well the thyroid gland is functioning. If levels are too high, it can indicate hypothyroidism (underactive thyroid), while low levels can suggest an overactive thyroid (hyperthyroidism). The full picture is quite complex, but knowing TSH levels is a great place to start.
T3, Reverse T3 and Thyroid Antibodies
To get a complete picture of how the thyroid is functioning – and whether you have a predisposition to thyroid disease, it’s important to look at all of the different pieces. TSH prompts the release of T4 and small amounts of T3, the active form of thyroid hormone. T4 is converted to T3, which helps regulate things like metabolism, body temperature and heart rate. So it can be a real problem if you aren’t producing enough T4!
Some T4 is also converted into reverse T3 (rT3), an inactive form of T3. When rT3 binds to T3 receptors, no response is activated. If levels of rT3 are too high in comparison to T3 levels, T3 can’t always do its job, and symptoms of hypothyroidism can result.
Testing for thyroid antibodies can help determine if there is an underlying autoimmune problem contributing to thyroid dysfunction.
CRP and hs-CRP (C-reactive protein)
These are indicators of how the inflammatory processes in the body are operating. Chronic inflammation can be behind a wide range of chronic health issues, including osteoporosis, heart disease and diabetes. Inflammation is a normal response to infection or trauma, but when it becomes an ongoing process, it does more harm than good. Checking levels of CRP and hs-CRP (high sensitivity c-reactive protein) can help your practitioner determine if chronic inflammation is a problem that needs to be addressed.
Iron and ferritin
These tests both offer important information on iron levels. Iron is an essential component of red blood cells, so it has a significant role in carrying oxygen throughout the body. Iron deficiency comes with numerous symptoms, including low energy and fatigue, headaches, and muscle cramps. Low iron levels can also be behind more serious problems, such as infection, restless leg syndrome, and neurological issues such as mood disorders and difficulty focusing.
Testing iron levels alone doesn’t give you complete information. Ferritin is a protein that stores iron, so low levels of ferritin can lead to iron-deficiency anemia, meaning your body doesn’t have enough red blood cells.
DEXA Scan (Dual energy x-ray absorptiometry)
Commonly known as a bone density test, a DEXA scan can help you understand your risk of fracture as you age. Too many women limit their activities needlessly out of fear. Women with bone density scores that are 1 to 2.4 points below the norm are diagnosed with osteopenia and those with 2.5 or more below the norm are diagnosed with osteoporosis. But bone density loss happens to everyone as we age, so at some point, everyone’s T-score will fall outside the “norm.” They certainly won’t all need medication or to live an ultra careful life. Although bone density tests have many limitations, when comparing your own scores to each other over time, they can offer some insight into what is best for you.
This test measures rate of resorption, which can help in diagnosing bone disorders and monitoring the effectiveness of medications used to treat osteoporosis and other bone disorders. Elevated levels of NTx are a marker of increased bone resorption, and can indicate increased risk for faster progression of osteopenia/osteoporosis. After therapy, a 30% or more reduction in NTx is considered an adequate therapeutic response.
Vitamin D is well known for its role in bone health, but this fat soluble vitamin is connected to health in myriad other ways. It supports mineral absorption and metabolism, particularly for calcium and phosphorus; it is a precursor hormone for calcitriol; it helps with blood sugar regulation; and so much more.Research has shown that vitamin D deficiency is associated with major health problems, including diabetes, obesity, respiratory tract infections, immune dysfunction, and bone health among others.
Vitamin D deficiency is increasingly common, and simple to diagnose with a blood test. And once you know there’s a problem, it’s very easy to fix with some supplementation and targeted lifestyle changes. That’s why, in my office, this is a routine test.
LH and FSH (Luteinizing Hormone and follicle stimulating hormone)
These hormones, which stimulate the testes in males and the ovaries in females, are known as gonadotropins. They are essential to reproduction. Testing levels of these hormones can help your practitioner assess menopausal symptoms and diagnose PCOS (polycystic ovary disorder) or fertility issues.
Levels of LH fluctuate naturally throughout the menstrual cycle to help regulate the cycle. Low levels of LH could also indicate a problem with the pituitary gland.
FSH prepares ovarian follicles for ovulation. As egg quantity decreases, FSH secretion tends to increase in order to continue to support ovulation. Low FSH levels might be a sign of a pituitary disorder. Higher FSH levels can indicate that egg supply in the ovaries is running low.
High levels of both LH and FSH can be a sign of ovarian failure, which can result in infertility. This can also be a sign of approaching menopause.
Your body converts other forms of sugar and starches into glucose, which it then uses as energy. High blood sugar levels often indicate diabetes, while low blood sugar can be a result of eating disorders, adrenal insufficiency, and excessive alcohol consumption. Unstable blood glucose levels contribute to many health problems, including chronic inflammation and high cortisol production.
Hemoglobin A1C (HGB-A1C)
Hemoglobin is a protein in red blood cells that transports oxygen throughout the body. Hemoglobin A1c is hemoglobin with attached glucose. This test measures the amount of sugar in your blood over a period of 2 to 3 months by looking at the percentage of HGB-A1C in your blood. This is useful in detecting patterns that may indicate a risk for diabetes.
Just as blood glucose testing can alert you to the risk of diabetes, testing insulin levels in blood can help determine if you have sufficient insulin to manage glucose levels – or not enough insulin to get the job done! This can help determine the cause of hypoglycemia, and can also let your health care provider know if you have insulin resistance, which can cause either over or underproduction of insulin and lead to type 2 diabetes.
A lipid profile measures cholesterol levels – both the “good” and “bad” kind. A lipid profile can give your practitioner valuable information for assessing risk of cardiovascular disease.
Homocysteine is an amino acid that is typically broken down by B12, B6 and folic acid and converted into other things your body requires. High levels of homocysteine can indicate a B vitamin deficiency, heart disease, or a rare genetic disorder.
30 percent of the population is missing this important enzyme. If you fall in this category, you are at higher risk for developing a folate deficiency as well as being at higher risk for developing breast cancer.
If I want a comprehensive picture, I may also suggest stool testing, testing for amino acids, nutrients and adrenal hormones. While that may seem like a lot of tests, having as much information as possible helps me help women feel their absolute best.
I prefer “optimal” over “normal” limits
Now that you understand better what these common tests are evaluating, and how “abnormal” levels can impact your health, it’s important to discuss what “normal” actually means.
Many conventional practitioners look at lab results based on a “normal” range. Anything that falls within the upper and lower limits is considered fine, and no treatment is offered. That’s because conventional medicine is focused on disease. But I think it’s far better to focus on doing what we can to prevent ever reaching the disease state.
When I view my patient’s test results, I interpret them using a narrower scale. I usually take the average of the two extremes, plus 25% on either side of that number. If my patient’s result falls outside of this range, it’s time to initiate some changes. By being proactive, we can often avoid complications before they become permanent or more severe.
As I said before, much of today’s medical practice is aimed at fixing problems once they occur rather than at the prevention. Many practitioners use lab testing and imaging studies to diagnose disease rather than looking at them to paint a picture of a woman’s overall health and well-being before illness sets in. Many women tell me they had no idea they were sick until their disease had progressed to the point of requiring prescription drugs to treat their ailments.
The truth is, most medical offices are so busy – and ruled by insurance constraints – that most primary care physicians don’t have, or take, the time to go over each test result or its meaning with their patients. In today’s healthcare system, you are your own best resource. You must learn to advocate for yourself.
Charting your own course to wellness
Even the very best doctor can’t know what it’s like to live in your body. We all have our own personal stories and are living our own lives. Both individual history and present circumstances influence our health in multiple ways, making us all unique.
Because there’s so much going on in your body that’s all interconnected, you have to know what’s normal for you. Blood levels which are normal for you might not suit another woman at all, just like a weight which is healthy for me might cause problems for someone else.
All practitioners agree that some lab test results require immediate attention, regardless of the individual patient and their circumstances. But for most patients, the changes are incremental, and we need to know how to interpret them. When I review any of the tests I’ve listed above, I compare them to past results and look at the patient as a whole. If I see a pattern, we can intervene quickly, before disease sets in or worsens.
Medical testing and modern technology, coupled with the wisdom of your own body, allow us to prevent disease and assure you of a long and healthy future. If we use our knowledge, not to react, but to take steps necessary to prevent illness, we can live full and healthy lives without missing a beat!
Reviewed by Dr. Mark Menolascino, MD