Which Labs Are Essential?

Live Webinar Date: Wednesday, September 11th, 2019, 7-8pm. Register Here. Lab tests are your health’s early detection, warning and guidance system. They can catch critical changes in your body before they manifest as heart disease, cancer, diabetes, or worse. Lab test results guide 70% of medical decision-making, yet they remain remarkably cost-efficient for patients and healthcare providers alike.

“From early detection and diagnosis of disease to individualized treatment plans based on a person’s unique genetic makeup, clinical lab testing is key to improving healthcare quality and containing long-term health costs.”

-American Clinical Laboratory Association.

But given the many lab tests now available, how can you know which lab tests are essential?

In “Which Lab Tests Are Essential for Optimal Health?” You Will Learn How Lab Tests Can…

  • Catch, detect and diagnose disease early on before it progresses
  • Guide a person’s individualized treatment plan
  • Monitor the results of the treatment plan so that necessary adjustments can be made in a timely way.
  • Potentially help avoid costly procedures and tragic outcomes.

You will also…

  • Learn which labs are essential to your annual health assessment.
  • Gain a general understanding of the blood biomarkers
  • Learn how to use blood work for prevention and optimal health.
  • Understand the difference between normal and optimal lab values.
  • Learn how a Naturopathic Functional Medicine Physician uses your blood biomarkers to help you make more informed decisions about diet, lifestyle, fitness, and supplement

Benefits of attending this webinar:

  • Learn how you can objectively know your health condition rather than guessing.
  • Avoid potentially tragic health conditions by detecting and acting early on.
  • Enjoy a longer, healthier, more active and satisfying life.
  • Be able to focus on creating and nurturing satisfying relationships rather than being forced to focus on your own health issues.

Dr. Angela Carlson, ND - Certified Doctor of Naturopathic Medicine, Las Vegas, NVWho is Dr. Angela Carlson, ND?

Dr. Angela Carlson is a Board Certified Naturopathic Doctor. She received a Doctorate Degree from the National University of Natural Medicine in Portland, Oregon in 2012. She then completed 2 years of Residency, in General Medicine and Women’s Health. Dr. Carlson worked as a Primary Care Physician in Oregon, prior to moving to Las Vegas where she opened her own practice.

Dr. Carlson has many areas of expertise, including thyroid conditions, gastrointestinal issues, hormone imbalances, autoimmune disease, chronic fatigue, diabetes and prediabetes, and cardiovascular concerns like high blood pressure and high cholesterol. She really enjoys working with clients that are looking for a different approach to their health care.

When she works with a client, Dr. Carlson helps to determine and address the underlying causes of the symptom or disease. She uses both her expertise as a Doctor and a Health Coach to help her clients achieve their health goals and reach optimal wellness. Dr. Carlson has medical training in conventional diagnosis and pharmacological treatments and offers cutting edge natural medicine therapies. She is an attentive listener and spends quality time with her clients.

Dr. Carlson loves the desert sunshine and is thrilled to have her practice based in Las Vegas!

Webinar Slides

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Which Labs Are Essential, Webinar by Dr. Angela Carlson, ND, in the series Achieving Your Optimal Health, Las Vegas, Nevada

Webinar Notes

Which Lab Tests Are Essential for Optimal Health?

How to use laboratory assessments to develop YOUR health monitoring strategy.

Dr. Angela Carlson, Licensed & Board Certified Naturopathic Doctor

Today We Will Discuss the Following

  • Understand the difference between ”NORMAL” and “OPTIMAL” lab values
  • What labs are essential to your annual health assessment?
  • How often should you have lab work?
  • How to use blood work for prevention of chronic disease and developing a strategy for optimal health.
  • Tips on how to get the most accurate results

Be Your Own Health Advocate

This presentation is intended to be a resource that you can reference in the future.

Be sure to review this information the next time that you have blood work or the next time that you are DUE for labs.

Remember, YOU need to be YOUR OWN health advocate!

Shortcomings of Current Medical System. There are many….

The system is designed to DIAGNOSE DISEASE not to PREVENT DISEASE.

Most Primary Care Physicians order minimal tests and often use markers that are not adequate at detecting early imbalances.

Most patients are misinformed by the Physician and are told that the labs are NORMAL and that they are healthy, when the patient is actively developing a chronic disease.

What Labs Are Essential in Evaluating HEALTH, not DISEASE?

Overview List:

  • CBC with diff
  • CMP
  • Fasting blood sugar
  • HgA1c
  • Post-meal blood sugar
  • Insulin
  • Iron assessment
  • serum iron, TIBC, ferritin
  • Lipid assessment
  • lipid panel, Apo B or LDL-p
  • Inflammatory markers
  • hs-crp, homocysteine
  • Thyroid assessment
  • TSH, total T4, total T3, reverse T3, free T3, free T4, TPO antibodies, TG antibodies
  • Vitamin D
  • Methylmalonic acid
  • RBC folate
  • RBC magnesium

”NORMAL” vs “OPTIMAL” Lab Reference Ranges

  • The normal range for a blood test is generally determined by the population of people that get tested for that particular lab.
  • Most people getting the testing are not in optimal health, so the reference range is based on an average of mostly unhealthy people.
  • With routine blood testing, you want to focus on OPTIMAL, not AVERAGE.
  • Always remember that NORMAL does not mean HEALTHY when it comes to your lab assessments.
  • Consider working with a doctor that is trained in using optimal ranges!

Complete Blood Count (CBC) Differential

Contains the following tests

  • Red blood cells (RBC)
  • White blood cells (WBC’s)
  • hemoglobin, hematocrit
  • MCV, MCH, MCHC
  • platelets, MPV,
  • RDW
  • absolute and relative neutrophils
  • lymphocytes
  • monocytes
  • Eosinophils
  • basophils

Used to Evaluate

  • nutritional deficiencies
  • anemia
  • Infection
  • cancer

Comprehensive Metabolic Panel (CMP)

Contains the following tests

  • Fasting glucose (blood sugar)
  • uric acid
  • BUN, Creatinine, eGFR (kidney function)
  • sodium, potassium, chloride, carbon dioxide, calcium, phosphorus (electrolytes)
  • total protein, albumin, globulin
  • total bilirubin
  • alkaline phosphatase
  • LDH
  • AST (SGOT), ALT (SGPT) (liver enzymes)
  • GGT

Used to Evaluate

  • Blood sugar levels
  • evaluates for prediabetes / diabetes, cardiovascular disease risk
  • Kidney function
  • involved in blood pressure, maintaining body pH, act as a filter for the blood to absorb nutrients and remove waste products
  • Liver function & inflammation
  • medications, infections, excess body fat
  • Electrolytes
  • electrolyte balance is needed for muscle contractions, including the heart, nerve impulses to send message around the body, and to maintain fluid balance
  • And, much more!

Tests to Evaluate Blood Sugar

  • Fasting Blood Sugar
  • Hemoglobin A1c
  • Oral Glucose Tolerance Test
  • Fructosamine
  • Post-Meal Blood Sugar

Fasting Blood Sugar

Measures the concentration of glucose in the blood after an 8-12 hour fast.

The most common, but LEAST sensitive marker to evaluate blood sugar

Limitations

  • Only provides information about your blood sugar in a fasting state, not about how your blood sugar responds to the food you eat.

Hemoglobin A1cb (HgA1c)

Reflects your average blood sugar over the past 2-3 months

Based on the theory that if a red blood cell lives an average of 3 months, if we measure the amount of sugar that sticks to these cells, we can get an idea of how much sugar has been in the blood over the previous 3 months.

The number reported is the percentage of hemoglobin that has become ”glycated” or stuck to sugar.

Limitations to the HgA1c Test

Assumes that everyone’s red blood cells live for 3 months.

The lifespan of a Red Blood Cells VARIES ….

  • Longer than average with normal blood sugars, causing FALSE ELEVATIONS. Hemoglobin is around longer and will accumulate more sugar.
  • Shorter than average with higher blood sugars, causing FALSE LOW LEVELS
  • Also impacted by common conditions including
  • Anemia
  • Dehydration
  • Pregnancy

Epidemic of DIABETES!

Fasting blood sugar and A1c are the LEAST SENSITIVE markers for predicting future diabetes and heart disease.

This is a big problem because they are almost always the only tests doctors run to screen for diabetes and blood sugar issues.

Oral Glucose Tolerance Testing

Measures your insulin response to glucose (sugar).

  • Insulin is made by the pancreas to help sugar move from your bloodstream to inside the cell.

You fast, then drink 75 grams of glucose dissolved in water.

Blood sugar is tested 1 and 2 hours after.

Provides more information about your blood sugar response to glucose.

Limitations

  • Not realistic –no one ever drinks 75 grams of pure glucose
  • Can cause dangerous and uncomfortable spikes in blood sugar

”Normal” verse OPTIMAL

(See chart above in PowerPoint Slide Images)

Studies show that using the American Diabetes Association criteria of A1c of 6% as normal MISSED 70% of individuals with diabetes and 82-94% with pre-diabetes.

Fructosamine

Measures blood sugar concentrations, but over previous 2-3 weeks.

Not affected by lifespan of RBC.

Especially helpful in those with anemia and pregnancy

Post-Meal Blood Sugar

  • Performed at home using a glucometer.
  • Blood sugars are collected at specific times AFTER meals for 3 days.
  • The data is evaluated to determine your glucose tolerance or how your glucose and insulin RESPOND to the food you eat.
  • Tests your post-meal blood sugars after your normal meals, making it the MOST RELIABLE AND ACCURATE way to predict future diabetic complications and heart disease.
  • More important to know how many hours a day your blood sugars are elevated over levels that are known to cause complications (140 mg/dL).

(See chart above in PowerPoint Slide Images)

Insulin

Used to evaluate

  • INSULIN RESISTANCE or PREDIABETS
  • The higher your levels, the closer to developing diabetes you are.

Insulin is made by the pancreas and works to keep your blood sugar levels even.

A diet high in refined carbohydrates from bread, pasta, rice, and potatoes requires high amounts of insulin to maintain blood sugar levels.

Routinely testing insulin can determine high levels of insulin years or decades before diabetes develops.

Often insulin will change BEFORE fasting blood sugar.

Iron Assessment

Evaluation of IRON DEFICIENCY and IRON OVERLOAD is recommended for all patients.

Assessment involves

  • Iron panel -serum iron, Total Iron Binding Capacity (TIBC), transferrin saturation
  • Ferritin

Serum iron –most common marker ordered by clinicians

LEAST RELIABLE

  • Levels are affected by
    • Alcohol
    • Drugs –oral contraceptives, methotrexate, testosterone, aspirin, metformin
    • Stress, Sleep Deprivation

Ferritin–storage for of iron

MOST SENSITIVE marker for iron deficiency

  • Affected by inflammation, so that needs to be taken into consideration when evaluating levels

Iron Deficiency

Iron deficiency can occur WITHOUT accompanying anemia. This is actually more common.

Iron deficiency has 3 stages and anemia is the final stage

Most Primary Care Physicians look at the CBC to evaluate iron deficiency anemia and do not routinely order an iron panel or ferritin.

By ordering an iron panel and ferritin, iron deficiency anemia could potentially be PREVENTED.

(See chart above in PowerPoint Slide Images)

Iron Overload

Hemochromatosis

  • genetic condition that causes iron overload

One of the most common genetic disorders, but often goes misdiagnosed or is missed entirely.

Those who have mild iron overload with borderline high markers that are still in the lab reference range can have significant problems.

Iron overload associated with

  • cardiovascular disease
  • Alzheimer’s, Parkinson’s
  • Infertility
  • Irritable Bowel Syndrome
  • Rheumatoid Arthritis, Lupus
  • Lung disease
  • Osteoporosis
  • Osteoarthritis

Lipid Assessment

Lipid panel

  • Contains the following
  • total cholesterol, LDL, HDL, VLDL, triglycerides

Apo B or LDL-p

  • reflects the number of LDL-particles carrying the LDL-cholesterol
  • More adequately correlates to cardiovascular risk than LDL cholesterol

Inflammation Markers

Hs-crp–high sensitivity c-reactive protein

  • Marker for cardiovascular inflammation

Homocysteine

  • Marker for cardiovascular inflammation
  • Also used to indirectly evaluate B6, B12, and Folate levels

Comprehensive Thyroid Evaluation

Be sure to request the following tests because “Thyroid Panel” is not standardized.

  • Thyroid Stimulating Hormone (TSH)
  • total T4
  • total T3
  • free T4
  • free T3
  • reverse T3
  • Thyroid Peroxidase Antibodies (TPO Antibodies)
  • Anti-Thyroglobulin Antibodies (TG Antibodies)

Many Primary Care doctors ONLY test TSH

  • MOST SENSITIVE marker to evaluate hypo and hyperthyroidism
  • CANNOT rule out problems with the thyroid based solely on TSH
  • ”Normal” reference ranges DO NOT mean normal or optimal

Total T4 and Total T3

  • Gives you an idea how much thyroid hormone the gland is making
  • Refer to thyroid hormone that is bound to a protein carrier.
  • Many things impact hormone carrier proteins, making total T3 and total T4 helpful, but limited in assessing thyroid function

Free T4 and Free T3

  • Thyroid hormone that is no longer bound to the carrier protein
  • More helpful way of assessing the amount of metabolically active thyroid hormone

Thyroid antibodies

  • Thyroid perioxidase(TPO)
  • Thyroglobulin (Anti-TG)

Used to evaluate for Hashimoto’s Thyroiditis

  • Autoimmune condition where the body attacks the thyroid gland, decreasing its ability to make thyroid hormone over time.
  • Most common cause of low thyroid function in developing countries
  • Rarely tested by conventional doctors because it does not change their treatment.
  • They prescribe thyroid hormone replacement medications, regardlessof what the underlying cause is.

Addressing the ROOT CAUSE!!

Naturopathic Functional Medicine Physicians look at Hashimoto’s and thyroid disease VERY DIFFERENTLY

We seek to address the ROOT CAUSE of the problem, rather than suppressing the symptoms.

Hypothyroidism is often due to IMMUNE DYSFUNCTION, not so much the thyroid gland malfunctioning.

It is for this reason that thyroid antibodies are included in the initial workup of all patients.

NORMAL does not mean OPTIMAL when it comes to thyroid labs!

Many patients have ”normal” labs but DO NOT have optimal thyroid function.

Vitamins and Minerals

Vitamin D –(25-hydroxyvitamin D)

B12

  • Serum B12 -measures amount of B12 in bloodstream at the time of blood draw
    • Extremely variable, influenced by many common medical conditions
    • Tends to decline late in deficiency, but often the first and only test performed
  • Methylmalonic Acid (MMA) –reflects tissue availability of B12.
    • Much more useful due to less fluctuations.

Folate

  • Serum Folate–similar limitations as serum B12 –rapidly changes based on diet and absorption
  • RBC Folatebetter diagnostic tool to evaluate Folate status

Magnesium

  • Serum Magnesium
    • Does not correlate with tissue levels or total body content.
    • Only a small amount of magnesium is present in blood serum.
  • RBC Magnesium
    • Measures magnesium content of your red blood cells.
    • Preferred marker to evaluate magnesium status.

How Often Should You Have Lab Work?

Using lab work for PREVENTION

  • Get comprehensive blood work 1-2 times per year. Followed by smaller quarterly tests to make necessary changes.
  • Get a baseline of your health when your body is functioning well.
  • Compare results each year to identify areas that are improving and areas that need more attention.

Many people wait until it is too late to start monitoring their health or they rely on their PCP’s recommendations, which are often inadequate.

Helpful Suggestions For the Most Accurate Results

  1. Continue your normal routine the day before your test. Don’t start a new exercise routine or make a new change to your diet.
  2. Eat your normal diet before the test and avoid getting blood work done after a vacation or Holiday.
  3. Avoid having your routine blood work done when you are sick, unless you need to find out why you are sick.
  4. Be sure that you fast properly and drink plenty of water.
  5. Avoid rigorous exercise the day before your test.
  6. Avoid having blood work after a night of poor sleep unless insomnia / difficulties sleeping is a chronic issue.
  7. When having thyroid tests –take thyroid medication AFTER the blood draw and avoid biotin for 48 hours prior to the test.
  8. Stay hydrated –aim for 60 ounces the few days prior to your blood draw
  9. Avoid alcohol the few days before your blood draw
  10. Aim to have your labs done with the same company every year so that you have the most accurate results to compare.

Thank You!

CONTACT INFORMATION

Dr. Angela Carlson

Website :: DrAngelaCarlson.com
Phone :: 702-847-5377

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About David Smith

David Smith created Las Vegas Area Trails in November of 2018 to document his wilderness adventures near Las Vegas Nevada. An avid trail runner, David spends one day each weak exploring new trails and wilderness areas.

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