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Posts Tagged ‘blood test’

functional versus lab ranges

Did your blood test for a health problem say you’re perfectly healthy even though you suffer from fatigue, brain fog, hair loss, digestive issues, joint pain, or other symptoms that make you miserable? Does your doctor give you a prescription for antidepressants or tell you to seek therapy because your problems “don’t exist.”

Many doctors dismiss people’s health complaints because of an incomplete blood test that only looks for full-blown diseases instead of trends toward disease. In functional medicine, however, we use a blood test for assessing risk of disease before it develops. This way you can do something about it before it’s too late. For instance, a fasting blood glucose over 100 mg/dL can identify a risk for diabetes long before a diagnosis. Or more complete thyroid testing can explain hypothyroid symptoms when a standard test shows results are “normal.”

Functional medicine uses a blood test for a return to health

Functional medicine addresses the underlying causes of symptoms instead of overriding them with drugs or surgery. One tool we use to accomplish this is to interpret blood tests using functional ranges, which outline the parameters of good health.

In contrast, the ranges most doctors use are based on a bell-curve analysis of all the people who visited that lab over a certain period of time, many of whom are very sick. These lab ranges have broadened over the last few decades as health of the American population has declined. As a result, more and more people with real health problems are told they’re fine because their lab results fall within these wide ranges.

Do you really want to evaluate your health in comparison to all the sick people who visited your lab, or do you want to look at a blood test for what constitutes good health?

Looking for blood test patterns 

Because functional medicine is based on an in-depth knowledge of human physiology and how various systems in the body work together, we also look at a blood test for patterns instead of just looking at individual markers. By doing this, we see how these different systems influence one another to cause a constellation of symptoms.

For instance, looking at different white blood cells reveals whether an immune reaction is chronic or acute, and whether a virus, a bacterial infection, allergies, or parasite may be causing it. Other patterns can help us identify fatty liver, leaky gut, different types of anemia, or even a possible autoimmune disorder.

Blood test for functional medicine is more thorough

A blood test for functional medicine also includes more markers that standard blood tests. For instance, many doctors only look at TSH, a basic thyroid marker, when running a blood test for hypothyroidism. In functional medicine, however, we know that Hashimoto’s, an autoimmune disease that attacks and destroys the thyroid gland, is responsible for 90 percent of hypothyroid cases in the United States. Therefore we also test thyroid antibodies to screen for autoimmunity along with other thyroid markers for more information.

A blood test for a functional medicine approach can also help us know what other tests may be necessary, such as a gastrointestinal panel or further testing for anemia.

Principles of functional medicine

Once the potential problems or risks have been assessed, the functional medicine practitioner uses a variety of science-backed, non-pharmaceutical approaches to restore health. These include:

  • Adjustments to the diet
  • Lifestyle changes (such as eating breakfast, proper sleep hygiene, physical activity, or reduction of stress)
  • The use of botanicals or nutritional compounds to improve physiological function
  • Other natural medicine approaches customized for the patient based on lab testing
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tsh-hypothyroidism-hashimotos-afternoon

If you check your thyroid levels in the afternoon with a blood draw, results may come back normal even though you’re hypothyroid, according to a new study. Checking your TSH in the morning can give you more accurate results.

Like other hormones in the body, thyroid-stimulating hormone (TSH) follows a daily rhythm and is not consistent throughout the day. Researchers in the study evaluated untreated patients with subclinical hypothyroidism along with patients taking a T4 hormone. They tested the participants’ TSH before 8 a.m. and again between 2 and 4 p.m.

In both groups TSH dropped substantially during the afternoon test, which would have led to hypothyroidism not being diagnosed in about 50 percent of the untreated participants.

Their TSH was 5.83 mU/L in the morning and 3.79 mIU/L in the afternoon. In the group being treated with thyroid medication TSH was 3.27 mIU/L in the morning and 2.18 mIU/L in the afternoon.

2004 study also showed that late morning, non-fasting TSH dropped 26 percent compared to early morning, fasting TSH.

Timing of TSH test adds new ammunition to thyroid range controversy

The researchers concluded that the timing of your blood draw plays an important role in how to decipher the results of your thyroid panel.

Unfortunately, even with an early morning blood draw, many hypothyroid patients still slip through the cracks because most doctors use ranges that are too wide.

It’s still very common for doctors to diagnose hypothyroidism using a TSH range of 0.5 to 5.0 mIU/L even though the American Association of Clinical Endocrinologists recommended years ago the range should be 0.3 to 3.0 mIU/L.

Functional medicine uses narrower ranges and more markers to identify hypothyroidism

In functional medicine we use an even narrower range of 1.8 to 3 mIU/L. We also know in functional medicine that looking at TSH alone can miss hypothyroidism.

For some, TSH may be normal but other thyroid markers are off. That’s why it’s important to order a thyroid panel that looks at a more complete thyroid picture, which can include total and free T4 and T3, reverse T3, free thyroxine index (FTI), T3 uptake, and thyroid binding globulins. Many conditions can cause poor thyroid function, including inflammation, hormonal imbalances, and chronic stress. Evaluating other thyroid markers gives insight into these imbalances.

Always screen for autoimmune Hashimoto’s hypothyroidism

In addition to these markers, anyone with hypothyroid symptoms should be screened for Hashimoto’s, an autoimmune disease that attacks and destroys the thyroid gland. Hashimoto’s accounts for about 90 percent of hypothyroid cases in the United States. You screen for Hashimoto’s by checking TPO and TGB antibodies.

Although thyroid medications may be necessary to maintain thyroid function, they do not address the immune system’s relentless attack against the thyroid gland. Not managing Hashimoto’s increases the risk of developing other autoimmune diseases. These can include pernicious anemia, rheumatoid arthritis, vitiligo, and Type I diabetes.

Ask my office how to properly evaluate your thyroid symptoms and lab markers for appropriate thyroid management.

 

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