Bloodwork: Beyond the Basics

By: Jillian Foley, RD, LDN

Nutritionista

It's hard to know what blood work we should be looking at or asking for. Your doctor gives you routine lab work and either:

A. Most of it looks normal and you think that's good.

B. Some results are out of range.

OR

C. Most of it looks normal but you still question why you feel tired or sluggish.

Either way, I find that doctors almost never go over the results in detail, explaining what everything means. Probably because doctors are overwhelmed with appointments and by default will only make a big deal if something is a big deal.

Regardless of the reason why, it's a big deal to us.

We want to know if we are checking everything we should be and if our results are a true representation of our health status.

While blood work doesn't show us everything, it can still give us clues to how our metabolism is running, if the body is fighting a disease, if our immune system is overreacting, or if we are deficient in something. In t(his article I will cover some of the things we could start looking for.

Lipid Panel

While it's common to look at your good cholesterol and bad (HDL/LDL), it's not as common to look at the lipoprotein (a). This is a newer test that shows the density of the cholesterol molecules. This helps give a better picture of whether we should truly be concerned about our lipid numbers. Beyond that is a calcium score test to show old accumulation in the blood vessels that supply blood to the heart. This, however, isn't performed through routine blood work.

Blood Sugar

This is checked through either fasting, which is a snap-shot of that moment, or A1C which is the average over 3 months. Fasting is becoming far less accurate because some peoples livers release higher amounts of blood sugar in the morning, if it dropped too low at night. While A1C is more accurate, everyone is different and worrying about the prediabetic range can be preemptive. Instead, we should use these stats to watch for trends and also watch the results of bun/creatinine for signs of urinating too much blood sugar.

Vitamins/Minerals

This category is tricky because deficiencies won't always show up here. For example, calcium status has nothing to do with a calcium level. Even if you aren't getting enough, your blood work with almost always show a normal calcium level, while your body is stealing it from your bones. Same with sodium, it has less to do with how much salt you consume and more to do with your hydration status.

Some of the more common vitamin stats you could be asking for are Vitamin D and B12.

Minerals you could ask to add could be iron and magnesium.

Hormones

The most common hormone that is checked is for the thyroid. When a person reports feeling tired or questions a slow metabolism, testing you TSH can show if the thyroid is funtioning properly. Recently it's been more common for men to check testosterone if still feeling fatigued. Women can get their estrogen checked but because of the fluctuations in the cycle, the first 2-4 days are the most accurate time to do it.

The point of all of this is to have a balance relationship with what you want to get from your lab results. They can't tell us everything, but they certainly can guide us in the right direction. It's also to know when to trust what your doctor is saying or question them if they aren't saying enough. You have to advocate for yourself! Additional labs can be checked by other providers like myself by https://us.fullscript.com/welcome/jfoley1777914469 when you feel like you need more answers.

Jillian Foley, RD Nutrititionista is a Registered Dietitian that specializes in Food Therapy. She believes that weight-loss & disease prevention/management is 20% food education & 80% psychological. She owns her own practice for 1-on-1 sessions as well as courses. You can find more info @www.Nutritionista267.com Follower her on IG @Nutritionista_1