The Most Important BLOOD TESTS

At Joy Wellness Partners, we believe that blood testing is one of the most important ways to start optimizing and maintaining health.

Some doctors do not order yearly blood tests, or only focus on a few basics, unless someone displays symptoms of disease. We believe in prevention, however, so if a disease is already symptomatic, it may be too late to stop it.

Many illnesses and risk factors for disease can be detected with blood testing, long before symptoms begin to show. Identifying sub-optimal areas early allows you to work with your provider to fix them – ideally preventing the disease overall.

BENEFITS OF BLOOD TESTS

1. Catch diseases early. Blood tests can detect abnormalities long before a disease begins to show outward symptoms. Cancer and diabetes are a few examples of problems that are far easier to treat or prevent when discovered early.
2. Reveal causes of quality-of-life issues. Some tests can identify problems that may be dramatically impacting your overall wellbeing. Abnormal hormone levels are one great example. Fatigue, weight gain, lack of motivation, difficulty sleeping, hot flashes and lack of sex drive, for example, can be connected to blood test results, and then things can be done to resolve these symptoms.
3. Determine changes to make. Blood testing can identify risk factors for future disease and loss of function. As Peter Drucker said, “What gets measured gets improved.” When you have a baseline, you can use that to make changes with your doctor like improving your diet, exercise and sleep regimens, take specific supplements and medications, and watch for improvements on the repeat blood tests.
4. Track responses to treatment. After obtaining a baseline, you and your provider can add additional tests or repeat initial tests to confirm whether changes you’re making are working.

Here are some of the most important yearly blood tests that we recommend at JWP for issues that affect quality of life and alert one of risk factors for future problems.

1. Chemistry panel/complete blood count
2. Lipid panel / Apolipoprotein B100 / VLDL
3. Hemoglobin A1c
4. Prostate-specific antigen (for men)
5. Homocysteine
6. C-reactive protein
7. Thyroid stimulating hormone, T3, T4
8. Testosterone (free and total)
9. Estradiol/progesterone (for women)
10. Vitamin B12
11. Vitamin D

1. Chemistry Panel (CMP), Complete Blood Count (CBC)

The CMP includes blood sugar, and levels of electrolytes, minerals and proteins. High blood sugar levels can suggest metabolic syndrome and diabetes, and a risk for future cardiovascular disease. It also shows the function of your liver and kidneys. Abnormalities may indicate a kidney problem, thyroid disorder, or even possible cancer.

The CBC identifies types and numbers of blood components, including platelets, red blood cells and various types of white blood cells. These can help identify anemia, infection, and other blood and bone marrow conditions.

2. Lipid Panel, Apolipoprotein B100, & VLDL

The lipid panel evaluates healthy and unhealthy fats in the body, which contribute to your risk for cardiovascular disease, including heart attack and stroke. For example, high levels of “bad” LDL cholesterol can contribute to the buildup of plaque in blood vessels, but can be balanced out by high levels of “good” HDL cholesterol.

Apolipoprotein B100 (Apo B) is a component of low density lipoprotein (LDL) and very low density lipoprotein (VLDL) cholesterol. It is present in all the lipoprotein particles that are not HDL. Non-HDL particles are known as “bad” cholesterol because higher levels contribute to the development of atherosclerosis, the buildup of plaque in artery walls. Atherosclerosis leads to cardiovascular disease, heart attacks and strokes.

3. HbA1c

Abnormally high blood levels of glucose are a major cause of long-term health issues, from cancer to heart disease -and of course, the hallmark sign of diabetes. Practically all tissues in the body are negatively impacted by high blood sugar.

A blood glucose test, however, is only a snap-shot of a moment in time. Glucose levels rise and fall throughout the day, so this may miss a problem.

A hemoglobin A1c test is a superior way to screen for glucose problems, because it shows an average of blood sugar levels across the past three months. The higher the level, the more severe the problem with blood glucose control. Studies have shown that an elevated HbA1c is an independent predictor of risk for head disease, even in individuals who do not have metabolic syndrome or diabetes. ln those with existing metabolic syndrome or diabetes, hemoglobinA1c can be used to track response to treatment, confirming that blood glucose control is improving. Dietary changes, exercise, nutrients (including magnesium and vitamin D) and medications can help bring elevated hemoglobin A1c and blood sugar under control.

4. Prostate-Specific Antigen (PSA) for Men

Prostate-specific antigen (PSA) is a protein made in the prostate gland of the male reproductive system. Normally, PSA remains in the prostate, but when it leaks into the bloodstream and becomes detectable in a blood test, it indicates a condition such as inflammation, prostate cancer, infection, and/or age-related prostate enlargement.

Regular PSA screenings, starting between ages 40-50, depending on risk, are recommended by the American Cancer Society, because men will often have no signs of any abnormal condition in early stages of prostate cancer, and the PSA may be the earliest clue. As with most diseases, early detection of prostate cancer can enable the easiest treatment.

5. Homocysteine

Studies have linked the amino acid homocysteine to an increased risk of heart attacks, bone fractures, macular degeneration, gallstones, and declining cognitive function. Individuals with methylenetetrahydrofolate reductase (MTHFR) gene mutations can be at risk of elevated homocysteine levels, so this blood test is especially helpful to them. With increased intake of the active forms of B vitamins like folate, B2, B6, and B12, high levels of homocysteine can be lowered reliably well.

6. C-Reactive Protein

The level of C-reactive protein (CRP), or high-sensitivity CRP (hs-CRP), in the blood can indicate levels of inflammation throughout the body, and elevated levels can be predictive of heart disease, type II diabetes, cognitive decline, intestinal issues, and more.
Many nutrients can reduce inflammation, including omega-3 fatty acids from fish oil, curcumin found in turmeric, magnesium, zinc, vitamin D, and flavonoids, like those found in blueberries. One can track a reduction in CRP over time, as some of these interventions are implemented.

7. TSH, T3, T4 and TPO-ab

The Thyroid gland secretes thyroid hormone, T4, as a way to set the base level of metabolism in the body. T4, however, must be converted to the active form, T3 free, in order to enter the cell and generate cellular metabolism, i.e. increase production of ATP.

Sometimes the thyroid has an issue causing it to secrete too much T4, causing rapid heartbeat, anxiety, irritability, tremors, weight loss, and difficulty sleeping. When T4 or T3 free are too low, the patient may likely have a condition called hypothyroidism, which can be the explanation for weight gain, fatigue, depression, anxiety, cold hands and feet, constipation, dry skin, and low sex drive. Thyroid stimulating hormone, or TSH, is secreted by the pituitary gland in response to low levels of T3 and T4 in the body.

TPO-ab is the thyroid peroxidase antibody, and it’s a marker of a condition called Hashimoto’s, which is an auto-immune attack on the thyroid. Hashimoto’s can initially present as either hyperthyroidism or hypothyroidism, but it often eventually leads to hypothyroidism if left untreated.

Thyroid issues can be regulated through natural or synthetic thyroid replacement, as well as supplements like selenium, iodine, zinc, magnesium, B12, and more.

8. Testosterone (free and total)

Testosterone is the primary sex hormone in men, produced in their testes, while women produce it as well, in smaller volumes, in their ovaries and adrenal glands.

Testosterone is a major contributor to bone density, sexual drive and function, muscle mass, positive mood, and mental clarity. Beginning in the 20s and 30s, male production of testosterone can decline up to 1-3% a year, and female production of testosterone can decline 10%-40% in a year.  As individuals begin to age, they may develop symptoms of fatigue, declining concentration, depression, anxiety, and weight gain; testosterone may be a likely culprit to rule out in a simple blood test.

Optimizing testosterone through hormone replacement therapy is a way to reverse the low levels, reverse the symptoms, and age gracefully throughout the lifespan.

9. Estradiol and Progesterone

Estrogen (mainly circulating throughout the body in a form called estradiol), and progesterone are the two main female sex hormones, although men produce a small amount of these as well.

During the fertile years, women’s estradiol and progesterone levels can be tested to evaluate fertility and identify possible reasons for infertility. Aside from conception, these hormones play a role in bone density, mood, sleep, hot flashes, ovarian cysts, and migraines. During the perimenopause and postmenopausal years, as these levels decline, women can restore optimal levels and reduce noticeable symptoms such as hot flashes and vaginal dryness through hormone replacement therapy.

10. Vitamin D

Vitamin D is becoming more important as more is learned about it. Those with the highest levels of vitamin D generally live longer, healthier lives. Specifically, low vitamin D is linked to increased risk for cardiovascular disease, osteoporosis, infection, autoimmune disease, neurological disorders, diabetes, depression and cancer. Vitamin D is what draws calcium from your food into your bones to maintain bone density. Optimal vitamin D levels are between 50ng/dL and 100ng/dL, and those levels can be achieved through sunlight exposure, dietary intake and supplementation with Vitamin D3 with K2, as Vitamin K2 helps Vitamin D to pass from your stomach and into the bloodstream.

11. Vitamin B12

As discussed earlier, Vitamin B12 can assist in reducing homocysteine levels and therefore protect the cardiovascular function of the person. Moreover, B12 is a major influencer in energy and nerve function. B12 improves Alzheimer disease, Parkinsonism, Dementia and neuropathic syndromes. It is an approved treatment for peripheral neuropathy. Low B12 may be a contributor to anemia, depression, memory loss, so it’s important to test it and get it optimized through shots or oral vitamins. Noticing that there are many individuals with a deficiency in the enzymes to breakdown all forms of B12 from food and vitamins, it’s best to stick with an active form of B12 when supplementing, called methylcobalamin.

References:

Drucker Quotes. 20200503. https://www.entrepreneur.com/slideshow/299936

https://www.cancer.org,/cancer/prostate-cancer/early_ detection/acs-recommendations.html. Accessed February 13, 2020.

Rallidis LS, Kosmas N, Rallidi T, et al. Homocysteine is an independent predictor of long-term cardiac modality in patients with stable coronary artery disease in the era of statins. Coron Artery Dis. 2O2O Mar:31(2):152-6.

Fratoni V Brandi IVIL. B vitamins, homocysteine and bone health. Nutrients. 201 5 Mar 30;7 (4):21 7 6-92.

Smith AD, Refsum H. Homocysteine, B Vitamins, and Cognitive lmpairment. Annu Rev Nutr.2016 Jul 17:36:211-39.

Huang P, Wang E Sah BK, et al. Homocysteine and the risk of age_ related macular degeneration: a systematic review and meta-analysis. Sci Rep. 201 5 Jut 21;5:1 0585.

Sakuta H, Suzuki T. Plasma total homocysteine and gallstone in middle-aged Japanese men. J Gastroenterol. 2OOS Nov;40(1 1):1061_4,

Stampfer, MJ, Malinow MR. Willett WC. et al. A prospective study of plasma homocysteine and risk of myocardial infarction in US physicians. JAAIA. 1 992 Aug 19:268(,7):877 -81.

Gupta SC, Kunnumakkara AB. Aggarwal S, et al. lnflammation, a Double-Edge Sword for Cancer and Other Age-Related Diseases. Front lmmunol. 20’1 8:9:21 60.

Sanada F, Taniyama y Muratsu J, et al. Source of Chronic lnflammation in Aging. Front Cardiovasc A/ted.2O18;5:12.

Pradhan AD, Manson JE, Rifai N, et al. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus, JAA,4A. 2OO1 Jul 18:286(3):327 -34.

https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284. Accessed February 6 2020.

Khosla S, Riggs BL, Robb RA, et al. Relationship of volumetric bone density and structural parameters at different skeletal sites to sex steroid levels in women. J Ctin Endocrlnot ttttetab.2005 Sep;90(9):5096-1 03.

Pitts R, Bhatt K, Varghese V et al. Apolipoprotein B predicts risk for acute coronary syndrome in patients with metaboljc syndrome. Eu ro pean Heaft Jou rnal. 201 3i3.1(suppl 1 p3097_p.

Pareja -Galeano H, AIis R, Sanchis-Gomar E et al. Vitamin D, precocious acute myocardial infarction. and exceptional longevity. Int J Cardiol. 2015 Nov 15;199:405-6.

Liu X, Baylin A. Levy PD. Vitamin D deficiency and insufficiency among US adults: prevalence, predictors and clinical implications. Br J Nutr. 2018 Apr;1 1 9(8):928-36.

Lobo RA. Fertil Steril 2009; 92:1025 and Lindsey R. Fertil Steril 2009; 92:1045

Intl. Journal. Alzheimer’s Disease; 2012: 1-18

Psychoneuroendocrinology 2010; 36:502-513, Silverman et al looked at 17B Estradiol vs CEE vs CEE plus progestin on 17-B Estradiol performed the best on verbal memory (an

early warning of Alzheimer’s disease) by more than 3 standard deviations.

Zmuda J., Amer. J. Card. 1996; 77:1244-1247, Zmuda J., Atherosclerosis. 1997; 130:199-202, and Collins P., Circulation. 1999; 100: 1690-1696.

Glaser R. Menopause: The Journal of the North American Menopause Society Vol. 21, No. 6