First, all blood work has to be conducted through a healthcare professional. Only your doctor knows what tests are appropriate for you. You cannot get this information on the internet, since no one on the internet can examine or diagnose you. I know that healthcare is expensive and many people do not have insurance, but the internet cannot be a surrogate for a healthcare provider.
Be cautious with the recommended tests you read on low carbohydrate websites. Many of these "low carb doctors" and advocates will suggest a slew of useless tests that won't tell you much about your current metabolic state nor will help you make it better.
The best indicator of what your metabolic state is can be seen right in the mirror. Excess body fat is the canary in the coalmine of what's occurring internally and where it's headed.
Testing blood glucose at home is the second most important thing you can do. You have to test in the morning, while fasted, and again two hours after your largest meal. The rule of thumb is that the two hours begin after your first bite of food. You should do this continuously for ten days in order to see the trend in your blood glucose regulation. Isolated blood glucose tests, like the one done of your fasting blood glucose during your yearly physical, tells you nothing of how your metabolism is working.
You can suggest, to your healthcare provider, for certain tests to be ordered, but it is ultimately up to them to order them or not. If you are having issues acquiring the tests you want and you feel, that as a patient, you are not being listened to, change doctors. Remember, your doctor works for you but you also have to let them do their job. There must be a good patient/doctor relationship in order to get the most out of your healthcare.
In the United States, there are some labs that will perform tests without a doctor's order. These labs will usually not take insurance, so the tests would have to be paid for out of pocket.
Blood work can tell you if you are headed in the right direction with your dietary and fasting approach. Blood work should be done, approximately after a 12 hour fast. You should not be fasted for more or less, than that time, as it can skew your results.
It takes a long time to normalize lipid panels and HbA1C. For this reason, I recommend that you should have these tests done every 3 months, or however often your doctor chooses, if you are diabetic or have any other condition. If you are just having metabolic abnormalities, but have not yet developed diabetes, then you can be tested every 6 months. Everyone else can be tested once a year. If you test too often, you will get skewed results, since these values can change, up or down, for multiple reasons. Just like with weight, you want to keep an eye on the long term trend, not short term fluctuations.
In the United States, there are some labs that will perform tests without a doctor's order. These labs will usually not take insurance, so the tests would have to be paid for out of pocket.
Blood work can tell you if you are headed in the right direction with your dietary and fasting approach. Blood work should be done, approximately after a 12 hour fast. You should not be fasted for more or less, than that time, as it can skew your results.
It takes a long time to normalize lipid panels and HbA1C. For this reason, I recommend that you should have these tests done every 3 months, or however often your doctor chooses, if you are diabetic or have any other condition. If you are just having metabolic abnormalities, but have not yet developed diabetes, then you can be tested every 6 months. Everyone else can be tested once a year. If you test too often, you will get skewed results, since these values can change, up or down, for multiple reasons. Just like with weight, you want to keep an eye on the long term trend, not short term fluctuations.
Make sure that all your doctors are in communication with each other so that you do not have repeated tests done too often. If your primary doctor ordered a routine metabolic panel for you in August, then your endocrinologist shouldn't order another one in September, unless something changed with your health during that time. Let the doctor know the test was already done so they can look up your results.
You should have a general understanding of your markers, so you can see them in a hierarchy of importance. For example:
It is best to have all these tests done at the same time, so that you know, in real time, how each correlates with the other.
Supplements
A lot of people ask about supplements, but we want to keep this blog nutrition focused. Emphasizing the importance of diet is an encouragement for people to watch what they are eating. I also do not sell supplements, so I have no need to push them on readers.
The only times supplements are necessary is if you are deficient in a particular vitamin or mineral. You need to discuss, with your healthcare provider, the appropriate tests required to determine if you have a true deficiency. You can guide yourself by conventional medicine values or you can get a second opinion from a functional medicine doctor. In conventional medicine, values that are deemed as "normal" do not necessarily reflect optimal. Conventional medicine uses, as normal values, the absolute minimum that the body can have without showing signs of disease.
You also want to make sure that you do not just check serum (blood) values. You need to know if the vitamin or mineral is actually getting into your cells (intracellular). You might have a high serum value, of a particular vitamin or mineral, making it appear that you aren't deficient. In actuality, your serum values are high, because the vitamin or mineral is not making it into the cell, where it's needed. Your healthcare provider should be aware of this, and if they aren't, you need to remind them before they order your tests, so they can order the correct one.
Another reason you do not want to supplement yourself, without having the right testing first, is because sometimes vitamins and minerals are high or low because of certain health states. For instance, calcium supplementation has been found to increase mortality. This could be because calcium alongside high inflammation causes health issues, but calcium without inflammation is beneficial. In this context, there was a reason the body was keeping its calcium low. It was protecting itself from it. When a certain vitamin or mineral is low, there can be a biological reason for it and not necessarily because of a "deficiency".
Vitamins and minerals also work alongside each other. You might be low in Vitamin D, because you're deficient in Vitamin K2 and/or K7, not necessarily because you need more Vitamin D. Also, low cholesterol levels can produce low Vitamin D. High serum values of B12 can be the result of not enough B6.
Always consult with your doctor about any supplements you intend on taking. This is especially true when considering electrolyte supplementation, specifically potassium, as all electrolytes work together and too much or too little, of just one, can cause serious health effects.
Having said that, there are some general supplement recommendations, which are particular to low carbohydrate diets and the modern food environment. It is known that modern food is lacking or very low in vitamins and minerals because of soil depletion. So, even if you are consuming whole food, you might still not be acquiring optimal ranges of nutrients. You can supplement with:
You should have a general understanding of your markers, so you can see them in a hierarchy of importance. For example:
- HbA1C takes precedence over fasting blood glucose. This is because fasting blood glucose can be temporarily affected by multiple things. HbA1C is telling you what your average blood glucose has been for approximately the past three months, giving you a much broader view of your blood glucose trend. But, if you experience too many disparities in blood glucose, too often, then you need to address it, since this is a problem even when HbA1C is normal. So testing blood glucose at home, as recommended above, is very important.
- Triglycerides should take precedence over total cholesterol, because they are the direct, real time, marker of how your body is truly handling its lipids. Elevated triglycerides are a sure sign that too much energy is still being dumped into the bloodstream from primarily carbohydrates but also fat.
- hs-CRP also takes precedence over total cholesterol, because high values mean that there is chronic, systemic inflammation, in the body. If there is no medical condition for it, like an injury or disease, usually autoimmune in nature, then something else is going on that needs to be more closely examined and addressed.
- Advanced lipid panel with hs-CRP, this will include your triglycerides
- Fasting insulin
- HbA1C and fasting glucose
- Electrolyte panel
- Vitamin D
- Homocysteine
Advanced lipid panels do not have to be repeated as they do not change over time. Once you have one done, you can continue with a basic lipid panel from then on.
Supplements
A lot of people ask about supplements, but we want to keep this blog nutrition focused. Emphasizing the importance of diet is an encouragement for people to watch what they are eating. I also do not sell supplements, so I have no need to push them on readers.
The only times supplements are necessary is if you are deficient in a particular vitamin or mineral. You need to discuss, with your healthcare provider, the appropriate tests required to determine if you have a true deficiency. You can guide yourself by conventional medicine values or you can get a second opinion from a functional medicine doctor. In conventional medicine, values that are deemed as "normal" do not necessarily reflect optimal. Conventional medicine uses, as normal values, the absolute minimum that the body can have without showing signs of disease.
You also want to make sure that you do not just check serum (blood) values. You need to know if the vitamin or mineral is actually getting into your cells (intracellular). You might have a high serum value, of a particular vitamin or mineral, making it appear that you aren't deficient. In actuality, your serum values are high, because the vitamin or mineral is not making it into the cell, where it's needed. Your healthcare provider should be aware of this, and if they aren't, you need to remind them before they order your tests, so they can order the correct one.
Another reason you do not want to supplement yourself, without having the right testing first, is because sometimes vitamins and minerals are high or low because of certain health states. For instance, calcium supplementation has been found to increase mortality. This could be because calcium alongside high inflammation causes health issues, but calcium without inflammation is beneficial. In this context, there was a reason the body was keeping its calcium low. It was protecting itself from it. When a certain vitamin or mineral is low, there can be a biological reason for it and not necessarily because of a "deficiency".
Vitamins and minerals also work alongside each other. You might be low in Vitamin D, because you're deficient in Vitamin K2 and/or K7, not necessarily because you need more Vitamin D. Also, low cholesterol levels can produce low Vitamin D. High serum values of B12 can be the result of not enough B6.
Always consult with your doctor about any supplements you intend on taking. This is especially true when considering electrolyte supplementation, specifically potassium, as all electrolytes work together and too much or too little, of just one, can cause serious health effects.
Having said that, there are some general supplement recommendations, which are particular to low carbohydrate diets and the modern food environment. It is known that modern food is lacking or very low in vitamins and minerals because of soil depletion. So, even if you are consuming whole food, you might still not be acquiring optimal ranges of nutrients. You can supplement with:
- Magnesium glycinate 400 IU, once a day.
- A good quality, co-enzymated and chelated, multivitamin. Make sure the brand you choose contains the B complex vitamins.
- Electrolytes
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