During the months of December, January and February we reduce our lab fees to encourage patients to run a yearly profile. The profile changes from year-to-year but basically has become more extensive over the years.
This year’s standard tests include a hemoglobin A1c, comprehensive metabolic profile (fasting glucose, kidney and liver function, electrolytes, etc.), iron profile, ferritin, serum lipids (total cholesterol, triglycerides, HDL, LDL), CRP (C Reactive Protein), homocysteine, thyroid profile, CBC, vitamin D, and urine analysis.
I often add tests like a PSA for men or TPO (thyroid peroxidase) and thyroid auto-antibodies for Hashimoto’s thyroiditis, if the history indicates the need.
As January ends, I’ve spent hours reviewing lab tests and making nutritional recommendations. I typically use laboratory tests to confirm indications from QA testing but also find them valuable to see disease development in the early stages, when it’s relatively easy to correct.
Every year I see patterns emerge from my patient population. When you review 4-5 tests in a day, you can’t help but see certain trends developing. I thought you might enjoy seeing these trends through this clinician’s eyes.
The eGFR or glomerular filtration rate is a measure of kidney function. It’s a relatively new test and I wrote a blog about it last fall. Initially, the test results were only listed if the result was less than 60. This indicates kidney damage. However, levels between 60 and 90 indicate loss of kidney function. Now that most labs actually list the test results, I am finding a higher and higher percentage of patients in that fall in that 60 to 90 range. They are losing microcirculation to the kidney which may be the result of some aspect of metabolic syndrome, especially insulin resistance. However, the more medication a patient takes, the more likely their eGFR will be below 60.
