Join me and my trusted friend, Tracey O’Shea, FNP, for enlightening conversations that empower you to take charge of your health! Discover the fascinating world of functional lab work as we delve into why these ranges differ from conventional models. Uncover the hidden gems of lab testing that could provide invaluable insights into your overall well-being. Tune in for a captivating exploration of holistic health with Tracey O’Shea, FNP!
Listen to the full episode
Welcome to the Best Life Blueprint, your connection into stepping into your most undeniable self through healthful lifestyle change. Let’s talk all things food, fitness, mindset, family, and joy to help you step into your best life. I’m Megan Hansen, Registered Nurse, Integrative Nutrition Health Coach, Bikini Bodybuilder, and Triplet Mama.
Let’s have some fun.
Megan: Okay, so I’m with my pal Tracey today. I’m super excited. We’re going to go over my functional lab work. And here’s why I wanted to do this—because we all go to the doctor, right? And they say we’re fine. “Oh, your lab work looks fine.” And then you might have some random symptoms and you’re like, “Okay, well, what’s that about?”
They say, “You don’t have to worry about it, you’re fine.” I didn’t want to be that person that all of a sudden has a heart attack when they’re 42 or something because their lab work was “fine” and they weren’t thinking about certain things.
I’m in this for the long haul. I’m not in this just to go out at the age of 60. I want to have a long, fulfilled, healthy life. So that’s why I wanted to get some lab work done. And also, night shift is a lot. It’s a lot. So we’re going to make sure I didn’t already have underlying stuff going on that night shift was just going to blow up in my face, essentially.
Tracey: So smart. So smart. I’ve had a handful of registered nurse friends who start night shift, and most notably, their thyroid just goes nuts on them. Or if they already had kind of a preexisting condition, they’re just like, “Why am I dragging? Why am I gaining weight? Why do I feel awful?” And a lot of the time, I notice it just gets blamed on night shift. “Oh, it’s just because I’m working night shift. It’s fine. It’ll get better when I switch shifts.” But come to find out, when we do their labs, their thyroid is out of whack, their vitamin D is super low, and so on. So I commend you for having the forethought to just check on everything first, to make sure—like you said—that you’re not running up against a wall if you’re adding this extra layer of stress to your body.
Megan: And I know so many people that are on night shift—they’re lifers. They’re not coming off of night shift. And I can’t even imagine the adaptations their body has had to make over the years. I can’t do that to myself. This is a season of my life that is not ideal, but I know it’s just a season. We’re going to come out of it. So I’m all about data and science, and I nerd out on this so much. I’m very excited to get into the nitty-gritty with you.
Tracey: Well, good, because we speak the same language. I also like to nerd out. So just to give some background—I’m a functional medicine practitioner, and I got into this space because, to be frank, I don’t think the conventional medical model is set up to deal with chronic illness. It’s just not doing a great job at addressing that. If I’m in a car accident or have a major injury, yes, please send me to the hospital and take care of me. But a lot of the movement in the functional medicine space is in preventative medicine and in trying to identify suboptimal ranges and values before they become a problem. That makes a lot more sense than just trying to give you a medication after the fact, after you already have the disease.
I work at the California Center for Functional Medicine, and we have patients that come to us and commit to a year of membership. These people are already sick, or they’re in the same boat where they’re trying to put their best foot forward. But we recognized that there was a gap between patients who are really sick or don’t have access or don’t have the financial means to be in a full membership commitment, but who still need this level of care and assistance.
In the whole functional medicine space, there’s a movement happening to get these labs into the hands of people who either aren’t familiar with functional medicine, don’t know that there’s a better option, or financially cannot commit to a full membership.
So the Functional Medicine Checkup was basically created out of that. It’s an opportunity for people to come to the practice and talk to a practitioner. You get an initial consult where we listen to your symptoms, your goals, and do a full medical history. Then we order a comprehensive blood panel, you go get the labs done—like you did—and then you have this hour-long appointment to talk about all of those lab results. We really tell you whether there are any imbalances or anything you should pay more attention to.
Then the patient has the option of going and doing something about it on their own, trying to talk to their primary care provider—if that works—or, if things are significant enough that they want to invest, they can stay at the practice and become a patient with guided treatment therapies to help optimize those areas or dig deeper into what might be going on. So that’s kind of where all of this started. There are a handful of different companies and practitioners doing this, and it’s really starting to become a movement to get people access to these labs so they have a better understanding of their risk.
Megan: Love it. And I love the comparison. So Tracey gave me basically a report that compares the functional ranges for where my labs should be to the traditional medical model. Because like I said, you can go to the doctor with symptoms and they say, “Oh, you’re fine.” But on the functional medicine side, you might not be fine. So that’s what I’m excited about.
Tracey: Yeah. And if people want, we can share those ranges. The important thing to remember when we’re talking about ranges is that the conventional range—the range you get on your LabCorp, Quest, or whatever lab panel—these ranges aren’t super scientific. They’re running these huge studies on “healthy” people and basically averaging where most of the people fall. It’s a bell curve. They’re saying most “healthy” people—and I use that term loosely, because there’s no stringent requirement for these studies—are within this range. That’s how it’s decided. It’s just the bell curve of running a bunch of people’s labs, averaging them, and figuring out where those people are. So there’s really not a whole lot of science behind that range.
The functional medicine range is either narrowed or expanded, depending on the marker. The idea behind the functional range is exactly what we were talking about before: to identify the very beginnings of imbalances and clue you in to something starting to be off, so you have an opportunity to address it before it becomes a disease state. That’s really the difference between the functional range and the standard lab range.
The other thing to note is that we do a really extensive panel because patterns are important. Very rarely is there one single marker that’s diagnostic of a disease. It does happen, but most of the time, we’re looking at a collection of markers that form a pattern and start to tell a story. So you’re going to hear me talk about patterns—collections and groupings of markers that point in a certain direction. That’s why we do such an extensive panel: we need to look at multiple markers because they’re all telling a story, and collectively, they tell us something. Sometimes it’s really hard to discern whether somebody is developing a disease from one single marker, and this is just checking you on one day of your life, for one minute. It’s not always indicative of some major scary thing. That’s why we recommend yearly, comprehensive panels so you can see both patterns of early disease and trends—how things are transitioning over time away from where we want them to be.
Megan: I love it. Well, just to give a little context, because everybody has their own story and their own lifestyle. For anybody listening who might not be super familiar with me: I’m 36, I’m a registered nurse, and I currently work night shift part-time. I also have my own health coaching company, so I’m very busy on that side. I have three seven-year-olds, and I’m married. I feel like I’m pretty busy. I do heavy strength training about four times a week. I’m very focused on nutrition—I have a high-protein diet—and I try to get as many veggies as I can, but it’s still hard. Even being focused on getting the veggies in is still hard. So I feel like I’m pretty healthful, but there’s always room for improvement.
Tracey: Agreed. I think you’d probably check a lot of boxes, but as you say, the stressors of life and the world—no matter how well we do, there’s always going to be some dynamic between your genetics and your environment. Some people control a lot for them, and don’t get me started on how far down those rabbit holes we can go. But there’s only so much we can control, and I want to put that out there, too. We can make ourselves crazy sometimes trying to adjust every variable in our lives to make ourselves healthy.
The idea here is that this is information for you to use—and for people to use—so that you can make informed decisions about where you have the energy and space to spend on lifestyle changes, hacks, or whatever else we’re focusing on to increase longevity and health span. I think that’s a really important distinction. Actually, I’m doing a post on this this week, but there’s a very big difference between lifespan and health span. We have a longer lifespan than ever, but we don’t really have a longer health span.
Probably most of the time, if you ask anyone, “Do you want to live a long, long life regardless of your health, without really having quality in the last 20 to 30 years? Or do you want to have a really vivacious, quality, fulfilling health span—not necessarily living to 102?” I think the goal of all of this is to increase health span and quality of life for people, not necessarily longevity in the sense of living forever.
So I’m excited to dive in, and ask away with any questions as we go. I’m going to be going over the lab results in patterns.
Megan: Do it.
Tracey: Okay. So we can probably take a picture of this and show it somewhere to give people some ideas. Part of the comprehensive blood panel that we do at the California Center for Functional Medicine as part of the Functional Medicine Checkup includes blood sugar markers and cholesterol markers.
We’re looking at fasting glucose and hemoglobin A1c, which is kind of a three-month average of blood sugar regulation. Historically, hemoglobin A1c is a great marker for people with diabetes, just to put that out there. It’s not always super accurate for people who don’t have diabetes, because there are a lot of variables that can impact the result, including just the lifespan of your blood cells versus somebody else’s. This is why we look at multiple markers—if you just looked at one marker, you could be diagnosed with prediabetes or diabetes without really taking any of the other markers into context. We also check fasting insulin, uric acid, and triglycerides. Triglycerides are a type of cholesterol that tend to be mostly impacted by metabolic dysfunction. So that’s the grouping for the metabolic markers.
Your fasting glucose was 92—a touch higher than I might like it. On the norm, I usually like it below 85. Now, same thing: this is one single fasting glucose marker. It may not mean much. It could have anything to do with your sleep schedule, what you had the night before, or whether you exercised in the morning. There are a bunch of factors that can impact that.
But I would probably say your A1c is at 5.3. That’s kind of the top of the functional medicine range that I like it at—I prefer it between 4.6 and 5.3. Your fasting insulin was 7.7. I like it less than 7. So just barely there. The rest of the markers were great. Your triglycerides were below 80, coming in at 56. Your HDL, which is also the beneficial cholesterol—all cholesterol is good, but let’s just call it the “good cholesterol” for now—was also fine. When it gets really low, that can be an indication of blood sugar dysregulation.
So for the most part, all the blood sugar markers were good—maybe just flirting a little bit on the higher side of the functional range. Usually in this situation, I’ll suggest a continuous glucose monitor if the patient wants to try one. I know they’re all the rage right now, but sometimes it’s nice to slap a CGM on for a couple of weeks, do some tracking, and just see if there are noticeable patterns with your fasting glucose and your postmeal or postprandial glucose. That’s really the best way to assess how your body is responding to your meals, your workouts, your night shift—all of it. I don’t think there’s a ticking time bomb situation, but it’s probably interesting to keep an eye on and track to make sure it’s not trending in the wrong direction, especially as we get older and our hormones shift and we have different stressors. Nothing major here, but it might be enough that I’d say, “Hey, it might be worth doing a continuous glucose monitor.” I have some parameters and some things I can give you.
Megan: Yeah, the student in me—when I saw those, I was like, “Oh!” And this is interesting, too, because I’m in a building phase of really trying to put on as much muscle as I can. So my carbohydrates are really high. I’m between 220 and 320 grams of carbs each day.
Tracey: Oh, wow. Yeah.
Megan: So I feel like that kind of plays in a little bit as well. I’d be curious, when I’m not really in this phase as much, what my labs look like in the future.
Tracey: Yeah, it’d be really interesting to have some baselines or markers that represent different phases of where you’re at. It’s important to know that a temporary marker like this is likely not going to cause problems. It’s the trend and the pattern that we’re interested in. So if you have these moments of higher carb intake that are pushing you a little bit toward this level, maybe it’s not diagnostic in that sense. But knowing where you’re at and seeing how your body is responding to that level of carbs might be helpful using a continuous glucose monitor.
And I know you’re on the nutrition train—you’ve got all your stuff figured out—but even sometimes just how you’re pairing those carbohydrates with your other macronutrients and when you’re eating them in the day can be really revealing. For me, the same meal at night does not cause a blood sugar spike the way it does in the middle of the day. I imagine it’s because I’m not as active while I’m working. So I’ve learned to adjust. The exact same meal—leftovers—just causes a much bigger spike with certain things. Having that information has helped me adjust where I’m putting my foods, what I’m eating, and what types of carbohydrates I’m consuming. That’s more of a little hacker thing, but helpful to know if that’s on your priority list.
Megan: Yeah, awesome.
Tracey: Okay, cholesterol looks beautiful. Cholesterol is a hot topic and there’s a lot of range variation about where people want the values. In the conventional model, there’s a much more conservative target for cholesterol. I could nerd out about this and talk about it for hours, so I’m going to really hold back.
For your labs, your cholesterol looks fine. Your total cholesterol is 150, well within an optimal range. Your triglycerides were also in optimal range. As a reminder, metabolically driven high cholesterol usually presents with a high triglyceride and a low HDL—that tends to be the pattern for somebody who has blood sugar or metabolically driven high cholesterol. People who don’t have that but still have high cholesterol generally just have a high LDL and a high total cholesterol. All of yours looks great.
For educational purposes, we also add in more advanced cholesterol markers. This advanced marker is called apolipoprotein B, and yours was stellar at 62. The thing is, when we’re talking about atherosclerotic risk—the risk of having plaque form in your arteries and increasing your risk of a cardiovascular event or stroke—it’s not just the cholesterol by itself. The cholesterol is important, but it is the ecosystem of the vessel. It’s what’s happening in the body, because you need a lot of things happening all together to start to have that risk. Yes, you need cholesterol, but you also need inflammation, inflammatory molecules, and white blood cells aggregating to the area.
We start to see this pattern—it’s almost like a recipe. “Oh, we only have one ingredient. What are we going to do with this flour?” It’s just going to sit there. But then you have sugar, then you have eggs—you start to have all these ingredients, and before you know it, it’s starting to form that risk of atherosclerosis.
We include this advanced marker because apolipoprotein B is statistically a much better predictor of atherosclerotic risk. It represents particle number, and particles are the things that carry around all of the cholesterol—kind of like the transport protein. Through literature and research, we now know that the transport vehicles are a better predictor of risk.
You will not find that when you go to your primary care or regular doctor. You’ll be lucky if you get a cholesterol panel at all. And this can go in either direction. Either somebody is underrecognized for their cardiovascular disease risk because they don’t have a comprehensive advanced marker done, or they’re unnecessarily put on cholesterol-lowering medications as the first option without really trying to understand why their cholesterol is high. Thyroid function, heavy metal toxicity, vitamin deficiencies—there are a number of things that can impact cholesterol synthesis that are not just related to the food you’re eating. I would hate to be on a medication I don’t need to be on.
Megan: Yeah, and I think it happens quite a bit. I’m not dissing medication—I think there are appropriate times and places for them—but barely high cholesterol without any lifestyle adjustments or assessments into why that person might have high cholesterol is just a real disservice to people. These medications have side effects, and some of them can be rather impactful. Some can even contribute to diabetes and blood sugar dysregulation. It’s a really slippery slope. So that’s part of this—trying to help people be informed.
Tracey: Okay, thyroid looks good as well. We do a comprehensive panel that looks at your full thyroid function. We’re looking at low-functioning thyroid, high-functioning thyroid, and we’re also looking at antibodies—autoimmune thyroid, or Hashimoto’s. All your antibodies were normal and negative. That’s a huge screening, because a large percentage of people who have hypothyroidism have an autoimmune form of it. It’s not often checked because I think the traditional model just doesn’t know what to do about it, so they’re not really checking for it.
Your thyroid was pretty solid. Your T4 and T3—T4 is the primary hormone that your thyroid gland makes, and then the T4 goes out into your tissues and is converted to T3. Most of this looked pretty good. No major markers to flag. Your total T3 was maybe just a smidge low at 82—I like it above 100. Your free T3 was 2.7—I like it above 2.5. Still good, nothing I would write home about. I just might check it again in a year or six months, especially with the night shift stuff I was talking about. Circadian disruption can impact the function of the thyroid. But all of this looks pretty good—probably just something I’d pay attention to.
Megan: Yeah, if I’m still on night shift in a year, we have problems.
Tracey: Yeah, we’d need to have a much bigger discussion. Okay, also looking at kidney and liver function—all of that looks pretty good. Your AST and ALT, which are your liver function tests, were for me just a touch higher than I like them to be. Nowhere near liver failure or liver issues. Your AST was 25, your ALT was 27, and you can see I like them a little closer to 20 and 23. Again, not a big deal, but definitely something to pay attention to. Sometimes this is just a transient little uptick—got exposed to something, or maybe someone did their labs after coming back from a weekend at a wedding where they were having a good old time. It always returns back to normal. Nothing major here, but just a touch higher than I’d like for really optimal liver function. It might be worth repeating that in a few months.
Megan: I’ll have to look back because I had preeclampsia with my triplets, and I’ll have to look back—I think I had some follow-up labs maybe three years ago. I’ll have to check what those were. I’m curious if they’re just hanging out there.
Tracey: Yeah, that’s really interesting to know. Some people do just kind of hang out on the higher end. Speculation: there could have been a history of a little bit of liver stress that just shifted that balance for the person, or something they’re doing is creating a little bit of extra liver stress. So it’d be interesting to see what that looks like. And this is why you should keep all your labs, everyone, so you can go back and compare them.
Your total protein was a little lower than the functional range, and so was your globulin level. I don’t think this has anything to do with your protein intake, because you have quite a lot of protein intake. Sometimes I’ll see this as far as protein digestion goes—if there’s any maldigestion of protein, or if you’re having trouble digesting that protein and getting it to where it needs to go. Sometimes I’ll see a little bit of low protein in malabsorption, maldigestion, or malnourishment, which I don’t think applies to you—you’re not malnourished. So I don’t know that there’s anything to write home about, but it could be a little clue for us.
Sometimes I’ll just say, “Make sure you’re doing mindful eating and really chewing your protein and your foods well.” Sometimes you can consider a digestive enzyme. Unless you’re going to retest this, you won’t probably know for sure. And a lot of times we’ll also do gut testing—stool testing—to really assess the macronutrient content in the stool. How big are those proteins? Are you digesting your food? Are you breaking them down? How much elastase is in your stool? So there are complementary labs that we’ll often do to match that and say, “Okay, yeah, you are having some other issues with protein digestion.”
Your creatinine was maybe a little on the low side at 0.75. That may also just be your norm. It’s not diagnostic of a kidney issue—creatinine is a marker of kidney function—but I’ll also sometimes see on the lower range of that somebody who is deficient in protein or not digesting and absorbing their protein well. So there may be a couple of small enough things here to just think about. That might just mean chewing slowly, getting the right kinds of protein, or maybe adding a little bit of bitters or digestive enzymes to help you break those down. That’s just one consideration.
All right, iron levels look great. All of this is fine. B12 and folate are also pretty solid, as well as your homocysteine. B12 and folate are B vitamins, and there are different reasons why people might have nutritional deficiencies. One is not eating enough of those foods. The second can be not absorbing the nutrients from the foods, which can happen from bacterial gut infections, autoimmune conditions like pernicious anemia, and a handful of other things. So even if you’re eating a ton of nutrient-dense foods, there can be other reasons why you might not be absorbing those nutrients.
And then there are genetics and other factors that might just impact the utilization and absorption of the nutrient—like everyone knows about methylation panels, or variants like MTHFR and MTR. There are also some vitamin D-related variants. So it’s not always straightforward. Most of the time, we start with, “Get the food, actually get those nutrients in your body first, and see if we can get those numbers up.” But sometimes we do use supplementation to get those numbers up, especially if there are genetic variants or mutations where somebody just needs a little extra help.
Your B12 and folate look great. And then the other marker I mentioned was homocysteine, which is an indirect way of measuring methylation and how well you are using certain nutrients to methylate. Methylation is a little buzzword everyone loves right now. Really quickly, methylation is basically a process that’s happening in your body thousands of times a second. It’s a very crucial piece of the processes in your body—basically adding and taking off a methyl group to turn things on and off. It’s really vital that we are properly and efficiently using and having enough of those nutrients in order to methylate.
Homocysteine is what we call an intermediate marker. If you don’t have enough ingredients—enough nutrients—you kind of get stuck halfway at the intermediate marker, which is homocysteine. So if you’re only going halfway, homocysteine is going to start to build. It’s an inverse marker: the higher the homocysteine is, the less efficient your methylation process is, and it means you’re not really completing that cycle as efficiently as possible.
Your homocysteine is stellar at 4.7. This looks really great. You’re getting enough of those nutrients, and they are doing what they should be doing based on this lab work. So that all looks really good.
Megan: What’s so interesting is just breaking down some of these things, because like you said, you can be eating perfectly, but if your internal processes aren’t firing as they should, you’re not going to be functioning ideally or optimally.
Tracey: Yes. And there are so many various reasons that sometimes you don’t always know what’s contributing to that. Your biological need changes and shifts sometimes, too—heavy, stressful events, having babies, being pregnant, hormonal changes—all of those things can impact the need and utilization of those nutrients. So if you just cover your bases and do your best, then really having these labs to spot-check you occasionally to make sure those needs don’t shift is really important.
Megan: I know you mentioned you have a lot of patients that come to see you and they find out that they have the autoimmune—shoot, what were we talking about?
Tracey: Thyroid.
Megan: Yeah. What are some other ones that surprise a lot of people, or that you see all the time?
Tracey: Yeah, the autoimmune thyroid, for sure, hands down, is the number one thing I think people had no idea they had or had any issues with. On occasion, with a stool test, we will diagnose Crohn’s or ulcerative colitis or some sort of autoimmune GI condition where people are like, “I just thought I had IBS,” and they have a full-fledged autoimmune condition.
Some other things that come up on these tests are major vitamin deficiencies. Vitamin D especially—we’ll talk about yours—but I would say 95 percent of people that I test have pretty significant vitamin D deficiency. That’s a pretty common marker that people just had no idea was really low. And then the cholesterol piece is also big—navigating that because the standard testing is just the first part of cholesterol testing. We also do coronary calcium score scans and CIMT, so we really look at the vessel.
People come in not sure what to do with their cholesterol values, or they’ve been told it’s fine and it’s not fine, or they’ve been told it’s high and it’s not high. A lot of people who come in for this particular Functional Medicine Checkup have never had a full, comprehensive panel done, so almost everything is probably surprising to them. But those are the things that really stick out to me—things people just had no idea existed or that could be a problem.
Megan: Well, and I think some people might feel like, “Oh, I don’t need this kind of comprehensive panel.” But I think of it kind of like self-care. The more you learn about yourself and your body, the better you can take care of it. Could it be an investment? Yeah, but it’s your self-care. You’re loving yourself by knowing this about your body.
Tracey: Yeah. And you could even argue it will cost you more later. I get that it’s not always how we think as humans—”Oh gosh, $500 now, I don’t know”—but they’ll be shelling out thousands of dollars later in life for additional care, wheelchairs, and missing out on the things that aren’t monetary in nature, like enjoying your life.
That’s the conversation I sometimes have with people. It does feel like an investment in your health, especially when you’re paying upfront to have labs done. But like you said, you’re getting real information from this. It’s not like paying for something and not knowing if it’s helping. We all do that sometimes—the science says sauna helps, cold plunges help, and whatever else—but unless you’re closely tracking all of your labs while you’re doing that, you don’t know. It’s kind of a leap of faith with some of these things.
But this is real, tangible, guided information. You’re working with a practitioner to make informed decisions, because we only have so much time, energy, and money to give. I’d much rather have something like this to know where to put that time and energy. Some people like to keep their head in the sand—I get it, sometimes it’s easier to pretend—but I do think it will come back to bite us if we aren’t paying attention to these things now.
Megan: Well, and I’ve heard of several people just within the past month who were really physically fit, in-shape, healthy individuals who just keeled over from a heart attack. It’s like, could that have been prevented? I don’t know. But I would like to know certain things—like have little warnings, recognize red flags—so that it doesn’t get to that point.
Tracey: Yeah, I agree. I order labs for my husband and make him do them. I think you’re right—we live in a world where there are a lot of stressors, a lot of toxins, and a lot of issues with our food supply. No matter how hard we try, there are just variables and hurdles. But we have the science and the technology to have this information and to make better informed decisions about where to put your energy.
So I’m probably biased, but I think everyone should be having these comprehensive panels at least once a year, especially as we get into our 30s and 40s. I can’t tell you how many times I have found significant imbalances and borderline disease states in people who had no idea, because they were just a little fatigued. If you asked every parent or every person in their 30s, “Do you have low energy? Do you have moments of fatigue? Do you have aches and pains?”—those are the things that start to happen as we push our bodies and don’t fuel with the things we need. We get into habits of brushing some of that off and not really taking the time to consider that it could be something. Our bodies tell us stuff, and we are really great at ignoring it. So it’s just a reminder to listen to your body and take care of it. This is part of that—evaluating what’s happening on the inside.
Okay, your vitamin D was 45, which is pretty good. It’s definitely not low or deficient. I prefer it between 50 and 70. This is also coming out of summer, so you have to consider what this might become in the winter if you’re not supplementing or supporting. I do think most people probably need some vitamin D supplementation. For various reasons—sun exposure, sunblock, food supply, food quality—all of those things have just left us in a place where humans need a little bit of support for vitamin D.
Are you taking vitamin D right now?
Megan: Yeah.
Tracey: So I would probably recommend a thousand or two thousand IUs going into the winter just to give you a little extra support, especially with your night shift, depending on how long you’re doing that. I really like it closer to 50 to 70. It’s really crucial for your immune system function and a variety of other things.
I would say you’re probably pretty close to your biological need. The reason I say that is because we also check parathyroid hormone, which is PTH. The parathyroid is a gland on top of the thyroid—it doesn’t have anything to do with the thyroid—but the parathyroid gland produces parathyroid hormone, which is really integral in calcium regulation, getting calcium in and out of the bones, and managing vitamin D, phosphorus, magnesium, and a handful of other minerals. Your vitamin D level will impact how much hormone the parathyroid gland is producing.
Your parathyroid hormone is 29, which is solid. I’m usually looking for parathyroid hormone to be below 30 in somebody who has enough vitamin D for their body. So you’re at 29, your vitamin D is 45—that’s probably pretty good for your body. I don’t think you’re in a state where I’m stressing about your vitamin D level. But considering that it’s this number in the summer and that you’re on night shift heading into the winter, I think there’s no harm in getting that number up just a smidge to further support the natural fluctuations that happen with the seasons.
Megan: Yeah, that’s a good point about the winter, because I feel like I did a decent job trying to get sunshine while working night shift, but going into the winter, it’s going to be a little harder.
Tracey: Yeah, it is a little harder. And everybody’s body is a little different about how they absorb and metabolize vitamin D from the sun. It’s great, but it’s not always the most efficient way for every person to get it. Most people are like, “I’m out in the sun all the time, I don’t know why my vitamin D is low.” Well, everyone’s different. There are genetic variants, sunblock, skin color, melanin—all of those things impact how well you can absorb and utilize vitamin D. So again, having this information now helps give you some guidance on what to do about it.
We also check a systemic inflammatory marker called CRP, or C-reactive protein. We actually do a high-sensitivity C-reactive protein, which is exactly what it sounds like—it’s a more sensitive marker that narrows the range a little bit. Yours was fine at 0.53. I’m really looking for that to be less than 1.
The idea here is that this is just a marker of systemic inflammation. It’s nonspecific, so if it is high, it doesn’t tell us exactly where the inflammation is coming from. But it does give us an indication that there’s some inflammation happening in the body. That’s a nice clue that we need to look for the cause and the reason. This marker can go up in acute infections, like a major respiratory infection—it can soar pretty high. We always keep that in consideration. But mildly elevated C-reactive proteins are really common in some autoimmune conditions like rheumatoid arthritis. It can go up during a Crohn’s or ulcerative colitis flare. So we really use it as a gauge on what’s happening in the body as far as inflammation is concerned.
Megan: Yeah, I try to combat inflammation generally, because I know I strength train pretty heavy, my sleep is wonky, and I feel like I have a very stressful home life. So I feel like I’m always trying to bring it down. It’s nice that it’s not showing up like that.
Tracey: Yeah, no, it’s good. There are a couple other markers on here that can be indicative of inflammation that I didn’t go over too much. Ferritin, which is the stored form of iron, can also be an acute-phase reactant, so it can be elevated in states of inflammation. Copper, which we’re about to talk about, is a nutrient but also an acute-phase reactant, so it can be elevated in inflammatory states. Homocysteine, the methylation marker, can also be elevated in inflammatory states.
So there are patterns of markers that we look at. Yours are all stellar and great, but if we see a pattern and collection of these markers all on the high end, all kind of pointing in the same direction, then it’s a slam dunk in terms of saying, “Okay, you’ve got body-wide inflammation. We need to figure out what it is and what’s going on.” That doesn’t mean you don’t have localized inflammation somewhere if you have an injury, but these all look pretty good from an inflammatory perspective.
The last bit of nutrients we tested were your copper and zinc levels. These are pretty good. You were 87 for copper, 89 for zinc. I like them both a little closer to 100 each. Again, nothing to write home about here. I usually give people a handout on zinc and foods that are rich in zinc and copper so you can look at them and pay attention. I don’t think you probably need to do anything drastic, but I would say these are a little lower than I like them to be.
I do find it’s typically a little hard for people to get zinc up. I don’t know if it’s some variance or an absorption issue, but even across the board, even with supplementation, sometimes it’s really hard to get zinc levels up. Spoiler alert: oysters and seafood like clams are really rich in zinc and copper, so sometimes I’ll just have people eat oysters during the week to try to get that zinc level up. Again, not deficient, but could be better. Zinc and these nutrients are really important for thyroid function, metabolism, and a handful of other things.
Megan: Good to know.
Tracey: And then the rest of this looks pretty good. Your CBC looks pretty solid. Your hemoglobin might be just a touch high, but I don’t think that’s probably anything to worry about. All your other markers are really good, so I think that’s probably fine. Again, we’re looking at patterns, not just single markers. Your B12 and things look really good. Sometimes the MCV can be a little high in B12 deficiency, but this is just one unit off. So I think all of that looks good.
Your red blood cell indices are pretty solid. The only thing that was just a touch high on here was your eosinophil percent at 4. It’s also kind of a loose range. Sometimes I’ll see this elevated in people who have parasites, atopic issues, seasonal allergies, or histamine-related immune responses. I don’t always run to the hills with, “Oh my God, you have a parasite!” over a 4 percent eosinophil, but if the symptoms match—if somebody says, “Yeah, I have eczema, and I have a lot of seasonal allergies and hay fever, or I have a lot of GI symptoms consistent with a parasitic infection”—then using this slightly elevated eosinophil percent can be a clue that that’s a direction to investigate. I don’t think that’s probably the case for you here, but you never know. Other than that, everything else is pretty solid on the blood panel.
Megan: I am incredibly intrigued with those parasite cleanses that people do, and they see what comes out. It’s grossly fascinating.
Tracey: Yeah, it’s pretty interesting. Probably not surprising to you that I’m more on the science side of things—I really want labs, and I want to see what it is so I can guide treatment properly. I think sometimes those cleanses work for people, but there are also a lot of mucous strings that come out in those things that aren’t necessarily worms. Parasites are often microscopic—you can’t see them. Worms and some other things you can see, but I don’t know. I always worry that somebody is going to put themselves into a situation where they’re going to have worse symptoms afterward. But yeah, it’s pretty fascinating to watch and see what people are doing.
All right, any other questions?
Megan: No, I think, like you said, it’s comprehensive, it looks at a lot, and the patterns are super important. Because like you mentioned, you can have one marker and you might freak out about it, but if you look at the bigger picture, it could be normal, or there could be something that day or that week that threw it off. I think it is important to look at your patterns, and that kind of speaks to general lifestyle and just being consistent with certain things. I’m just fascinated. So I appreciate you sitting down and going over everything with me.
Tracey: Yeah, you’re so welcome. I think you make a good point. I usually tell my patients, “You’re going to get these labs before me,” or “You’re going to get these labs before we have a chance to talk.” I always tell them, “Don’t freak out about anything unless I contact you that something is concerning or urgent,” because how I interpret these and the patterns we see are likely going to be different than the information you’re getting directly from the lab.
I think that’s the advantage of meeting with a practitioner to talk about these labs. There are other companies where you don’t really meet with anybody—you just do a lab and then you get a handout about results. It’s still valuable and helpful, but then what do you do? You take it to your primary care, and they say, “I don’t know. I don’t know what to do with that lab. I’m not the one that ordered it.” It happens a lot to people. They did this thing, got a report, took it to their primary, and were told, “Sorry, I’m not the one that ordered it. I don’t know what to do with this lab.”
So that was the advantage of providing this extra service of a touchpoint with a practitioner, so that you really feel like you have somebody to help interpret these results and know what to do with them.
Megan: Cool. So if somebody wanted to reach out to you to get their own blood work, how would they do that?
Tracey: Yeah, they can go to the California Center for Functional Medicine website at ccfmed.com. There is an option there for the Functional Medicine Checkup. It’s a one-time fee, and then they can get set up and scheduled with me. We also have patient care coordinators and people that can help you navigate and answer questions if you get on there and want a little bit more information. So yeah, they can go straight there, sign up, and get scheduled to meet.
Megan: I love it. Well, I’m very excited to maybe get some more labs drawn in the future and do some comparison. The science nerd in me is rejoicing.
Tracey: Yes, I’m so happy we did it. And also, CCFM wanted to offer a discount code to people listening. So we’ll get that over to you so we can put it in the notes. If people want to come over and join and give it a try, we can give them a little discount for listening.
