Personalized Coaching
Lab Testing

lab testingLab testing is a tool used to determine the status of your organs and glands as well as many of your nutrients.

Introduction to Lab Testing

What’s in a Number?

Lab testing allows you to take a peek into the inner workings of your body, measuring a variety of important functions and levels.

When you know how to analyze your lab results from a functional medicine perspective, you get important clues about what’s working and what’s not. With this information in hand, you and your Functional Nutrition Coach can work together to get to the root cause of your health challenges and get you on the road to balance.

Labs determine what “normal” results are by comparing your results to a range of results from society. However, since most of society is eating SAD (Standard American Diet) and living well below wellness potential, a “normal” result doesn’t mean an “optimal” result.

personalized health careWhen most medical doctors review lab results, they simply check to see if the lab flagged a result that is considered “out of range”; some may even dismiss the flagged result if the number is only slightly “out of range”.

We prefer to look at the optimal ranges of lab numbers.

We compare your lab findings with ranges considered to be ideal, rather than just paying attention to findings that are into the pathological or disease range.

What Can Be Tested?

Lab tests usually require samples of various and sundry secretions and fluids in your body.

lab testsExamples include:

  • Blood
  • Urine
  • Saliva
  • Stool
  • Hair

Which samples are chosen depends on what you want to measure. Throughout the program you’ll learn about how to test yourself for particular imbalances using any or all of these, as appropriate to your condition.

Which Tests Are Needed?

There are a number of basic lab tests I recommend everyone get as a baseline.

There are also more in-depth and specialized tests and you coach can help you determine if they are necessary in your specific case.

If you’ve had any of these tests within the past 6 months and have not made significant changes in your diet or supplement regime, then you can use your previous results as a baseline. However, if anything has changed (i.e. your diet, supplements, symptoms), it’s a good idea to redo the testing.

Testing Facilities and Access

Direct LabsFor the basic lab analysis, you can either get your own practitioner to order tests for you or use Direct Labs. I’ve been using Direct Labs for many years and have found them to be reliable, quick, and priced very reasonably. They allow you to order without a doctor’s referral.

State law in New York, New Jersey, and Rhode Island have special requirements, so you need to contact Direct Labs to make sure you fill in the correct forms. If you live in Canada (close to the border), you can cross the border to get tested.

Regrettably, we can’t do lab testing through Direct Labs for overseas clients. You’ll need to work with a lab or doctor’s office in your own country. Some of the specialty labs we use do offer services overseas.

There are other labs that offer lab testing directly to consumers. I have never used them, but I have heard of them through colleagues. Personal Labs and Accessa Labs are options you are welcome to explore. Life Extensions offers lab testing to members at discounted prices.

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Recommended Tests

Basic Screening Tests

I recommend that you order these to get started (Note: You’ll find a selection of combined test packages further down the page below):

  • Comprehensive Wellness Profile (CWP): This is a set of measurements that give a report on how your various body systems are working. It includes liver, kidney, lipids (cholesterol, etc.), a few thyroid tests (not complete), blood counts and anemia markers, and electrolytes. I recommend you repeat the CWP annually unless there are abnormal findings. Abnormal findings should be retested within 3 months to determine the effectiveness of your program. Click HERE to see what’s included in the CWP from Direct Labs.
  • Vitamin D (D3): Vitamin D is a very important nutrient for digestion, hormone balance, brain function, and much more. Due to being indoors so much, many people are very deficient. Test to get a baseline. If the level is low, repeat within 2 – 3 months of beginning supplementation and continue to retest and adjust supplement dose until it is in the ideal range. We can help you get the right dose and reach optimal levels in your blood.
  • Thyroid Peroxidase or Thyroid Antibodies Panel: Autoimmune thyroid problems are very commonly overlooked. Many people go years allowing their thyroid to be attacked because most doctors don’t test for antibodies. And even if they do, most don’t know what to do that’s different from their approach to hypothyroidism. There is a lot that can be done to restore balance for people with autoimmune thyroiditis. Order this test if you have a history of thyroid problems or have symptoms that would be consistent with thyroid problems. Here are some of the major symptoms to look for:
    • Tired, physical sluggishness
    • Feel cold – hands, feet, all over
    • Require excessive amounts of sleep to function properly
    • Increase in weight – gain even with low-calorie diet
    • Gain weight easily
    • Difficult, infrequent bowel movements
    • Depression, lack of motivation
    • Morning headaches that wear off as the day progresses
    • Outer third of eyebrow thins
    • Thinning of hair on scalp, face, or genitals — or excessive falling hair
    • Dryness of skin and/or scalp
    • Mental sluggishness

    In the presence of the above symptoms, you should also consider a full thyroid panel (see options here) or, at the very least, add Free T3 to the above.

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Extra Tests

You may need some of these tests. Your Functional Nutrition Coach can help you determine which tests are best for you once you’ve completed your Present Health Assessment and Nutrient Assessment forms.

  • 23 and Me Genetic Test: Take a peek into your genes. You can control your gene expression by diet and lifestyle choices. Knowing some of your potential weaknesses can increase your commitment to avoiding stressing your system. We’ll have an entire module devoted to helping you understand what’s in your genes, so if you’d like to participate, you’ll need to order the test. Go to the 23 and Me website and order your genetic test. Use this link to get the 20% discount we’ve arranged for you: http://www.23andme.com/drloscalzo. Generally, it takes 4-8 weeks to get results once you submit.
  • Fasting Insulin: Order if you have a history of pre-diabetes and/or a history of elevated triglycerides or glucose.
  • Hemoglobin A1C: Order if you have a family history of diabetes, weight accumulation around the middle, cravings for sweets after meals, and/or have had glucose readings above 95 on more than one occasion. This test should be repeated every 3 months if it is out of range.
  • Ferritin: Order this test if you have had more than one low iron reading or a history of anemia or chronic fatigue. If it’s been low in the past, retest every 3 months until normal.
  • Homocysteine: Order if you have a family history of heart disease or diabetes.
  • Free T3: Order if you have a history of thyroid issues.
  • C-reactive Protein (CRP- hs): A marker for inflammation (especially in the cardiovascular system), get this if you have a family history of heart disease or a personal history of inflammatory conditions. If it was elevated in past, repeat at 3 month intervals until normal.
  • Sedimentation Rate: Another marker for inflammation, get this if you have a history of inflammatory conditions.
  • Methylmalonic Acid (MMA): A reliable indicator of Vitamin B12 status, especially when combined with the Complete Blood Count marker MCV and with homocysteine. MMA can be tested in blood or in urine. A lab called Norman Clinical Laboratory does the urine test. It should be repeated within 3 months of beginning Vitamin B12 supplementation if found to be elevated.
  • Gluten Sensitivity Stool Test: Order through www.enterolabs.com if you have a history of autoimmune or inflammatory conditions, have unexplained health issues, or suspect you have a gluten intolerance. If you need the test to prompt you to be serious about being gluten-free, run the test. We will explore this in more detail in the gluten section of the program.
  • Iodine Loading Test: Iodine is important for breast and thyroid health, but it’s important not to take too much. To determine if you are in need of iodine before supplementing, do the iodine loading test at http://www.hakalalabs.com. I have heard feedback that their support is great, and they will tell you what the test results mean.
  • If you’re ordering through your practitioner, click on this Comprehensive Wellness Profile (CWP) link for a list of the tests you should ask your practitioner to order for you.

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Dr. Ritamarie’s Pre-Packaged Test Combinations
Direct Labs Special Panels

To make it easier to order the tests you need, I’ve put together a few packages at Direct Labs. To order, go to Direct Labs, locate the “Order Tests” link beside “Home” in the top menu and then scroll down to find these panels. Or, simply click each link below.

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Advanced Functional Tests

Once we’ve begun our work on body systems balancing, there may be some advanced testing recommended.

Your coach will be able to help you determine which of these tests are indicated for you, based on your assessments up to that point. You can get a sneak preview of and even order some of the advanced functional tests on a special page of my website set up exclusively for participants in our coaching programs:

Advanced Functional Testing: Details and Order Links

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Tracking and Submitting Your Lab Results

Master Health Tracker Spreadsheet

Health TrackingI have given you access to a specially designed worksheet where you can record the results of your lab tests. The worksheet includes references for interpretation of out of range values and follow-up testing guidelines. This allows you to keep a snapshot album of your health over time.

The worksheet is part of a comprehensive tracking spreadsheet created in Microsoft Excel, called the Master Health Tracker spreadsheet. It includes summaries of your health assessment forms, goals, labs, and exam findings.

If you are not a Microsoft Excel user, you can still use the spreadsheet. Your coach can make it available to you on a special folder that’s only accessible to her, you, and Dr. Ritamarie on Google Drive (you will need a Gmail e-mail account to access Google Drive).

If all this sounds too complex for you, you will simply upload the results you get from the lab to your coach and she can either walk you through entering the data on the spreadsheet or do it for you if need be.

The beauty of using the lab worksheet within the Master Health Tracker is that it gives you a way to continue to track your results for many years to come. Plus, there is a spreadsheet that does the conversions. Some people even go back and put in all their old labs so that they can see patterns.

How to Use the Master Health Tracker Spreadsheet
(Optional)

The Master Health Tracker spreadsheet is a handy place for you to keep track of all your health information.

Using it yourself is purely optional, so don’t worry if “spreadsheet speak” makes your head spin. Simply upload your lab results to your coach and she can help you.

We’ll have a special session dedicated to teaching you how to use the Master Health Tracker spreadsheet and a video is forthcoming!

These instructions are for those who are spreadsheet savvy and want to manipulate the spreadsheet.

Lab Tracking Worksheet Features:

The worksheet is designed so that the cells where you enter your lab findings change color based on where your results fall with respect to reference ranges.

  • Green indicates your result is the ideal range.
  • Yellow indicates your result is outside the ideal range but still within the lab range.
  • Orange indicates your result is outside the typical lab range.

Choose Your Worksheet:

Within the Master Health Tracker spreadsheet, there are 2 versions of the lab tracking worksheet. There are two versions of the worksheet, one for US residents and one for international residents, because the USA uses different measurement units than the rest of the world.

Depending on your area of residence, select and use one of the worksheet tabs in the spreadsheet to track any results from your lab tests:

excel-icon-150x150Master Health Tracker: A complete set of spreadsheets to help you track your health and lab work over time. (Save and then make a COPY to work from)

 

Contains:

    • Goals and Obstacles
    • Appointment Tracker
    • Symptom Tracker
    • excel documentSymptom Scorecard Summary
    • Supplement Trackers
    • Medication Tracker
    • Lifestyle Plan
    • Diet Diary
    • Diet Plan
    • Glucose Tracking
    • Exam Findings
    • Lab Results – International
    • Lab Results – US
    • Lab Explanations
    • Summary Lab Findings
    • Lab Follow-Up

Since Dr. Ritamarie and all the coaches are most familiar with reference ranges in conventional US units, the international spreadsheet allows you to enter the results in international units, called SI units, and they are automatically converted to US units for ease of interpretation by your American coach.

We’ve recently added a nice feature within the spreadsheet whereby once you add your results, an interpretation is automatically created on another tab in the worksheet called, “Lab Explanation” and another called, “Summary Lab Findings”.

These sheets are automatically populated when you enter your findings into the lab results US sheet.

We have not yet figured out how to have the results from the international report feed into the summary, so if you would like to have the interpretation, you’ll need to transfer the numbers from the US column in the international form to the US sheet.

Please be sure to put the date at the top of the each column that contains data. Up to 10 lab results can be entered on each worksheet.

These worksheets give you the ability to track your health not just in this program, but for the rest of your life.

Important: Save a copy of an unchanged spreadsheet on your computer and then make changes to a copy so that you will always have a clean version to work from if you need more than one form.

Note: If you don’t have Microsoft Excel for opening spreadsheets, you can access the Google Drive form of the spreadsheet. There is alternatively a free set of tools called Open Office that can be downloaded at http://www.openofficedownload2011.com. The Open Office version of Excel is called Open Math.

If you use the Google version of the Master Health Tracker spreadsheet (contact your FNC for access), you’ll be able to easily share results with your coach and Dr Ritamarie.

Enter Your Results:

  • The spreadsheets are set up so you can report up to 10 lab tests side by side.
  • There’s a place for the date at the top of the column. Enter the date then copy the results from your lab report to the sheet.
  • If you have any lab results for the past year, copy the results to the appropriate column on your selected spreadsheet, US or international.

Submitting Your Labs:

document uploaderDocument Uploader: If you need to submit a lab report and/or document, you may use this uploader to share your file(s). Your coach will also be able to see the original lab report from the lab.

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