LAB TESTS RECOMMENDATIONS Cardiovascular
Recommendations CARDIOVASCULAR LAB TESTS
Complete Blood Count (CBC) with differential
Comprehensive Metabolic Panel
Vitamins/Nutrients
Vitamin D3
Magnesium - RBC
Folate
Serum B12 with MMA
CoQ10
Complete Thyroid Panel, including antibodies
TSH
Total T4
Free T4
Free T3
Thyroid Peroxidase antibodies
Antithyroglobulin antibodies
Complete Blood Sugar Panel
Fasting Glucose
Hemoglobin A1C
Fasting Insulin
Complete Iron Panel
Serum iron
Serum Ferritin
Transferrin saturation
TIBC
UIBC
Homocysteine
GGT
Inflammation Markers
C-Reactive Protein (CRP), High Sensitivity (Cardiac Risk Assessment)
Erythrocyte sedimentation rate (ESR)
Myeloperoxidase
Uric Acid
Omega 3:6 index
Lipoproteins
Oxidized LDL
LDL small
LDL medium
LDL large
HDL large
VLDL
Non-LDL cholesterol
LDL Particle number
Lipoprotein(a)Lp(a)
Apolipoprotein B
Apolipoprotein A-1
Lp-PLA2
Clotting Markers
Fibrinogen Activity (Factor I Activity)
D-Dimer
ADMA (Asymmetric dimethylarginine) / SDMA (Symmetric dimethylarginine)
TMAO
F2-Isoprostane (Cardiometabolic Urine Test) F2-Isoprostane, F2Isoprostane/Creatinine, Creatinine, Urine, F2-Isoprostane/Creatinine
Microalbumin/creatinine urine test
Heavy Metals in Blood: Arsenic, cadmium, lead, Hg
serious/acute heart issues
Creatine Kinase (CK), Total NT-proBNP
Galectin 3
Troponin T (Cardiac Troponin T)
Selected Tests DESCRIPTIONS
Complete Blood Count (CBC) with Differential
WBC White blood cells are the body's primary defense against disease. White blood cells help fight infection.
RBC Red blood cells are responsible for carrying oxygen to and carbon dioxide away from all cells. Iron deficiency will lower RBC.
Hemoglobin A chemical compound inside red cells that transports oxygen through the bloodstream to all cells of the body. Oxygen is needed for healthy organs. Hemoglobin gives the red color to blood.
Hematocrit — Hematocrit measures the amount of space red blood cells take up in the blood. It is reported as a percentage.
Lymphocytes The results of this and basophils, eosinophils, monocytes and neutrophils deal with white blood cell function. Important to the body's defense against infection. Also important in the assessment of nutritional status.
Monocytes The results of this and basophils, eosinophils, lymphocytes, and neutrophils deal with white blood cell function. Important to the body's defense against infection. Also important in the assessment of nutritional status.
MCV - Mean Corpuscular Volume measures red blood cell volume.
MCH - Mean Corpuscular Hemoglobin a way to measure the average hemoglobin concentration within red blood cells, which varies from normal with different diseases.
MCHC Mean Corpuscular Hemoglobin Concentration.
White Blood Cell Differential White Blood Cells are the body's defense against infection. Each type has a range of functions, and organisms it is most suited to protect against. By looking at the % of each type, it’s possible to predict the type of infection your body may be fighting against.
Neutrophils bacteria
Lymphocytes - virus
Basophils – parasites
Eosinophils – allergies and parasites
Monocytes – elevated in recovery stage and in low grade chronic infection and sometimes autoimmune conditions
Platelets — Blood cell particles involved with the forming of blood clots.
RDW Red cell distribution width (RDW) is a calculation of the variation in the size of your RBC's. In some anemias, such as pernicious anemia, the amount of variation in RBC size, along with variation in shape, causes an increase in the RDW.
Comprehensive Metabolic Panel
Lipids
Cholesterol, Total A sterol in the blood. Knowing your cholesterol may be as important as knowing your blood pressure. Elevated cholesterol is associated with an increasing risk of coronary heart disease.
HDL Cholesterol
High-density lipoproteins are believed to take cholesterol away from cells and transport it back to the liver for processing or removal. They have become known as the "good" cholesterol as persons with high levels of HDL may have less heart disease. Low HDL could be the result of smoking and lack of exercise.
LDL Cholesterol
Low-density lipoproteins contain the greatest percentage of cholesterol and may be responsible for depositing cholesterol on the artery walls. For that reason, they are known as the "bad" cholesterol.
Triglycerides Triglycerides are fat in the blood responsible for providing energy to the cells of the body. Triglycerides should be less than 400 mg/dl even in a non-fasting state.
Liver
Alanine Aminotransferase (ALT or SGPT) An enzyme found primarily in the liver. Abnormalities may represent liver disease.
Albumin Serum One of the major proteins in the blood and a reflection of the general state of nutrition.
Alkaline Phosphatase A body protein important in diagnosing proper bone and liver functions.
Aspartate Aminotransferase (AST or SGOT) An enzyme found in skeletal and heart muscle, liver and other organs. Abnormalities may represent liver disease.
Bilirubin, Total A chemical involved with liver functions. High concentrations may result in jaundice.
Globulin, Total A major group of proteins in the blood comprising the infection fighting antibodies.
Lactate Dehydrogenase (LDH) An enzyme found mostly in the heart, muscles, liver, kidney, brain, and red blood cells. When an organ of the body is damaged, LDH is released in greater quantity into the blood stream.
Protein, Total Together with albumin, it is a measure of the state of nutrition in the body.
Gamma-glutamyl transpeptidase (GGT), also known as GGT helps to detect liver and bile duct injury. Some doctors use it in all people they suspect of having liver disease, others use it only to help explain the cause of other changes or if they suspect alcohol abuse.
Kidney
Urea Nitrogen (BUN) Another by-product of protein metabolism eliminated through the kidneys. BUN is an indicator of kidney function.
Creatinine, Serum An indicator of kidney function.
Uric Acid Another by-product of protein metabolism eliminated through the kidneys. Uric acid is an indicator of kidney function.
Glomerular Filtration (eGFR) Provides an assessment of the filtering capacity of the kidney.
Minerals and Bone
Iron, Total An abnormally low test result may indicate iron deficiency anemia.
Calcium A mineral essential for development and maintenance of healthy bones and teeth. It is important also for the normal function of muscles, nerves and blood clotting.
Phosphorus — Together with calcium, it is essential for healthy development of bones and teeth. Associated with hormone imbalance, bone disease and kidney disease. It is found mainly in bones and teeth.
Fluids & Electrolytes
Chloride, Serum Similar to sodium, it helps to maintain the body's electrolyte balance. High or low findings can be indicative of adrenal dysfunction.
Potassium Helps to control the nerves and muscles.
Sodium, Serum One of the major salts in the body fluid, sodium is important in the body's water balance and the electrical activity of nerves and muscles. High or low findings can be indicative of adrenal dysfunction.
Carbon Dioxide Detects the level of carbon dioxide in the blood and can be indicative of acid-base balance.
Glucose Fasting blood sugar level. It’s a crude measure of tendency towards diabetes and insulin resistance. Elevation of fasting glucose is generally a late stage indicator of blood sugar dysregulation. Better indicators are insulin and hemoglobin A1C, which are not usually run on a routine screening test.
Vitamins/Nutrients
Vitamin D (D3) Vitamin D is a very important nutrient for digestion, hormone balance, brain function, and much more. Due to being indoors so much, many people are very deficient. Test to get a baseline. If the level is low, repeat within 2 - 3 months of beginning supplementation and continue to retest and adjust supplement dose until it is in the ideal range. We can help you get the right dose and reach optimal levels in your blood.
Magnesium-RBC a marker of magnesium in the blood. Magnesium is a mineral that plays an important role in energy production, blood sugar regulation, immune function, and is involved in hundreds of other critical processes in the body.
Folate (B9) a key component of red blood cell formation and a critical component of cell growth and function.
Serum B12 with MMA Serum B12 measures B12 levels in the blood, low levels or deficiency of which can result in fatigue, muscle weakness, GI issues and a B12 specific form of anemia that results from lack of intrinsic factor. Methylmalonic Acid (MMA) is a metabolic byproduct that when elevated may indicate a B12 deficiency.
CoQ10 aka ubiquinone, an antioxidant that your body produces naturally, used for cell growth and maintenance. Statins can deplete levels of CoQ10.
Thyroid Panel
Thyroid Stimulating Hormone (TSH) — TSH, produced by the anterior pituitary gland, causes the release and distribution of stored thyroid hormones.
Thyroid Antibodies — Autoimmune thyroid problems are very commonly overlooked. Many people go years allowing their thyroid to be attacked because most doctors don't test for antibodies. And even if they do, most don't know what to do that's different from their approach to hypothyroidism. There is a lot that can be done to restore balance for people with autoimmune thyroiditis. Order this test if you have a history of thyroid problems or have symptoms that would be consistent with thyroid problems.
Thyroid Peroxidase Antibodies (TPO) attack an enzyme, thyroid peroxidase, that assists the chemical reaction that adds iodine to a protein called thyroglobulin, a critical step in generating thyroid hormones.
Antithyroglobulin aka Thyroglobulin Antibodies (TAA) attack thyroglobulin proteins and can destroy the thyroid gland itself.
Total T4 this is a measure of the total amount of T4, the storage form of thyroid hormone. It’s an important measure of your thyroid glands’ capacity.
Free T3 this is a measure of the active thyroid hormone circulating in your bloodstream. Order if you have a history of thyroid issues or symptoms of thyroid dysfunction (see results of your hormone and gland assessment or symptoms listed below).
Total T3 (optional) — a measure of the protein bound plus free T3. While a good number to have, it’s not as critical to measure as are Total T4 (thyroid capacity) and free T3 (active hormone)
Free T4 (optional) a measure of the free form of the T4 hormone
Reverse T3 (optional) a measure of a form of T3 considered “the brakes”. It interferes with free T3 binding to the cells, and the conversion of T4 to T3. Reverse T3 is elevated under extreme stress, injury and illness.
Blood Sugar
Fasting Glucose Fasting blood sugar level. It’s a crude measure of tendency towards diabetes and insulin resistance. Elevation of fasting glucose is generally a late stage indicator of blood sugar dysregulation. Better indicators are insulin and hemoglobin A1C, which are not usually run on a routine screening test.
Hemoglobin A1C indicates the degree of glycation (sugar coating) of red blood cells. It can be used to predict the average blood glucose level over the last few months. This test is indicated if you have a family history of diabetes, weight accumulation around the middle, cravings for sweets after meals, and/or have had fasting glucose readings above 95 on more than one occasion. This test should be repeated every 3 months if it is out of range.
Fasting Insulin Insulin is the hormone that enables cells to take in glucose. Without insulin, glucose can't get into the cells and it stays in the bloodstream. With too little insulin, blood sugar remains higher than normal, and cells can't get the energy they need. With too much insulin, blood sugar may decrease (unless there is insulin resistance), causing symptoms such as sweating, trembling, light-headedness’, and in extreme cases, shock. Too much insulin also damages blood vessel linings and can lead to hypertension and cardiovascular disease. If you have a history of pre-diabetes, insulin resistance or metabolic syndrome, a family history of diabetes or insulin resistance, or a history of elevated triglycerides or glucose (either fasting serum glucose through your doctor or using a home glucose monitor), order fasting insulin.
Complete Iron Panel
Serum Iron — a measure of iron in the blood. Low serum iron can be an indicator of iron deficiency anemia. Signs of low iron can be fatigue, weakness, shortness of breath.
Serum Ferritin Composed of iron and protein, ferritin is a storage form of iron in the body. Measurement provides an accurate picture of how much iron you have available in reserve. It is used to evaluate anemia and for diagnosing iron deficiency. Low Ferritin is a sign of iron deficiency. Ferritin is high with inflammation, infection, liver disease, iron overload, certain amends and certain cancers (leukemia and lymphoma). This test should always be ordered along with serum iron if you ’ re fatigued, or you have had more than one low iron reading or a history of anemia. If it's been abnormal in the past, retest every 3 months until normal.
Transferrin saturation this is a calculated value derived from dividing the iron by total iron binding capacity times 100. Transferrin is a protein in the blood that binds to iron and transports it throughout the body.
Total Iron Binding Capacity -TIBC is a marker of how much transferrin is available to bind to the iron. A deficiency of iron will often result in a high TIBC since there is an excess binding capacity, and not enough iron with which to bind.
UIBC Unsaturated Iron Binding Capacity, elevated levels may indicate iron deficiency or malabsorption. Low levels may indicate overload of iron.
Blood Markers of Inflammation
Homocysteine Order if you have a family history of heart disease or diabetes, symptoms of vitamin B12 deficiency on your Vitamin Assessment, history or family history of heart disease, elevated MCV on your CBC, or have been told that you have a genetic variance of the MTHFR or other methylation genes.
Gamma-glutamyl transferase (GGT) — is an enzyme found throughout the body, but it is mostly found in the liver. When the liver is damaged, GGT may leak into the bloodstream. High levels of GGT in the blood may be a sign of liver disease or damage to the bile ducts
C-reactive Protein (hs-CRP) A marker for inflammation (especially in the cardiovascular system). Get this tested if you have a family or personal history of heart disease or neurologic disorder, or a personal history of inflammatory conditions. If it was elevated in the past, repeat at 3-month intervals until normal.
Erythrocyte Sedimentation Rate (ESR) Another marker for inflammation, get this if you have a history of inflammatory conditions or autoimmune disorder.
Myeloperoxidase (MPO) an enzyme that when elevated can be an indicator of atherosclerosis and coronary artery disease.
Uric Acid - a waste product produced when purines are broken down. It is an independent risk factor for developing type 2 diabetes and is closely associated with insulin resistance.
Omega 3:6 Fatty Acid Index the ratio of omega 3 fats to omega 6 fats in the blood. The Standard American Diet tends to be very high in the more inflammatory omega-6 fatty acids. A proper balance is important for overall health, especially in lowering inflammation and reducing risk for cardiovascular and other chronic disease.
Lipoproteins
Oxidized LDL LDL particles that give up electrons when they interact with free radicals during normal metabolic processes. Too much oxidized LDL can lead to inflammation and damage to the endothelial lining of the arteries. This damage can result in plaque buildup in the arteries or atherosclerosis, which increases the risk for heart disease, stroke, and heart attacks.
LDL Small small dense LDL particles a subtype of LDL cholesterol that are more dangerous because they are more likely to oxidize and penetrate the endothelial lining of the arteries and contribute to inflammation and plaque buildup.
LDL Medium medium size low-density lipoprotein particles carry fats through the body. While still positively associated with increased risk for cardiovascular disease, they carry a lower risk than the small LDL .
LDL Large large LDL particles are the large, fluffy, buoyant particles that are easier to transport and clear from the blood. large LDL particles carry reduced risk of atherosclerosis because they are less likely to damage the endothelial lining and contribute to plaque formation.
HDL Large HDL cholesterol transports excess lipids in the blood back to your liver where they can be broken down and eliminated. Large refers to the size of the particles. These particles are associated with reduced risk for cardiovascular disease.
VLDL very low density lipoprotein (another form of LDL), this type of LDL particle carries the highest concentration of triglycerides.
Non-LDL Cholesterol Total cholesterol minus high-density lipoprotein (HDL), it includes all the types of LDL (VLDL, MLDL, SLDL, LLDL, etc).
LDL Particle Number the number of LDL cholesterol particles in your blood. Higher numbers tend to correlate with more of the small dense LDL particles and therefore, an increased risk for cardiovascular disease.
Lipoprotein(a) Lp(a) this lipoprotein is formed when LDL particles fuse with apolipoprotein(a) particles and create an irregular “kringle” shape. This shape contributes to its functional role of sweeping up oxidized LDL molecules, but it also makes it more likely to become lodged in artery walls. It’s known for accelerating the formation of arterial plaque due to its proclotting effect. It is heavily influenced by genetics and is not highly responsive to diet and lifestyle changes
Apolipoprotein B the lipid-protein molecules responsible for transporting LDL cholesterol particles through the bloodstream
Apolipoprotein A-1 the lipid-protein molecules responsible for transporting HDL cholesterol particles through the bloodstream
Lp-PLA2 measures the lipoprotein-associated phospholipase A-2 (LpPLA2), a blood vessel-specific enzyme that is mainly attached to LDL cholesterol. High levels correlate with inflammation of the arterial walls, and may be a warning sign that plaques are more unstable and prone to rupture.
Clotting Markers
Fibrinogen Activity (Factor I Activity) — Fibrinogen the main glycoprotein in a blood clot. The fibrinogen activity test measures how long it takes for a blood clot to form.
D-Dimer the protein that breaks down blood clots. A positive test may indicate the presence of a blood clot or a blood clotting problem.
ADMA (Asymmetric dimethylarginine)/SDMA (symmetric dimethylarginine) a naturally occurring product of metabolism found in human circulation. Elevated levels of ADMA inhibit nitric oxide synthesis which can impair endothelial function and promote atherosclerosis.
TMAO
F2-Isoprostane (cardiometabolic urine test) F2-Isoprostane
a metabolite produced by gut bacteria. High levels are associated with increased risk of cardiovascular disease. (cardiometabolic urine test) F2-Isoprostane is a marker of oxidative stress.
F2-Isoprostane/Creatinine (Urine)
the ration of F2-Isoprostane to Creatinine
Microalbumin/creatinine urine test
a biomarker for endothelial dysfunction. The test detects small amounts of albumin, a blood protein, in the urine and compares it to those of creatinine, a waste product produced by muscle. Albumin is a large molecule that circulates in the blood and should not be present in urine.
Heavy Metals - These have been found to be correlated with increase cardiovascular risk
Arsenic — a measure of arsenic in the blood. The long term effects of elevated arsenic include: heart, liver, lung, kidney, eye, dermal, gastrointestinal, hematological, immune, nervous system, and developmental damage. It can also impact the development of diabetes and some cancers. A common source is contaminated tap or drinking water.
Cadmium — a measure of cadmium levels in the blood. Cadmium affects the central nervous system and can impact cognitive function over time. Cadmium is also associated with kidney, bone, and lung damage. Cocoa products are common sources of cadmium exposure in our diets.
Lead a measure of lead in the blood. Lead poisoning can damage multiple organs including the brain where it can cause irreversible damage.
Mercury a measure of mercury in the blood. Mercury is neurotoxic and can damage the nervous system. Exposure can be from our water, seafood, animal fats. Dental amalgams are one of the main sources of inorganic mercury.
Serious/Acute Heart Issues
Creatine Kinase (CK), Total a measure of creatine kinase in your bloodstream. CK is found in skeletal muscle, heart, and brain tissue. When damaged, they leak CK into the bloodstream. Elevated CK levels may indicate muscle injury, heart muscle damage, or disease.
NT-proBNP — N-terminal pro b-type natriuretic peptide is a protein involved in making the BNP hormone and the test measures blood levels of BNP. When elevated, it indicates that your heart is working harder to pump blood.
Galectin 3 a protein secreted by macrophages (a sort of “first responder” of the immune system that attempts to surround and eliminate “intruders”). Galectin 3 is associated with high levels of inflammation and damage to the heart.
Troponin T (cardiac troponin T) a protein which is released when the heart muscle has been damaged (as in a heart attack). The more damage to the heart, the higher the level of Troponin T in the blood.
Testing HOME
Blood pressure cuff’
Glucose meter
Urine pH strips
Nitric Oxide Test Strips
Urinalysis strips
Body Bio Mineral Testing