What is the list of blood tests one should demand from a physician to gather quality information beyond the usual cholesterol measures?
Get baseline blood tests to answer important questions about your health. The basics--
Do I have a high level of inflammation?--c-reactive protein (CRP).
Am I prediabetic?--fasting blood sugar.
Am I anemic?--hemoglobin.
Am I hypothyroid?--start with thyroid-stimulating hormone (TSH).
Am I vitamin D deficient (and therefore at risk for cancer and cardiovascular disease)?--25-hydroxy vitamin D level.
All of these tests are included in a "standard" physical except CRP and 25-OH-D. "Normal" ranges vary between labs, but the minimum desirable level of 25-OH-D should be 50 or 60 nanograms, not 30.
Keep in mind that LDL cholesterol is typically "calculated" and not measured for standard blood tests. You can request to have it measured, but even then it will likely only tell you how much LDL you have, but not the ratios of types of LDL. See, there are various size and densities of LDL particles, with each having a different profile in how it affects cardiovascular health.
Small dense LDL particles are more likely to cause heart disease (more able to bind to vascular walls), while large LDL particles are typically benign and pass through the blood stream normally.
In order to determine the ratios of these subtypes of LDL, you would probably have to request more specific tests. These tests however might only be necessary for those with a predetermined risk for heart disease.
LDL-S3 GGE Test Proteins from your blood are spread across a gel palette. As the molecules move from one end to the other, the gel becomes progressively denser. Large particles of LDL cholesterol can't travel as far as the small, dense particles can, Dr. Ziajka says. After staining the gel, scientists determine the average size of your LDL cholesterol particles. (Berkeley HeartLab, bhlinc.com, about $15 with insurance)
The VAP Test Your sample is mixed into a solution designed to separate lipoproteins by density. "The proteins in your blood have to find their equilibrium," says Dr. Ziajka. "Small, dense particles sink, and large, fluffy particles stay at the top." The liquid is stained and then analyzed to reveal 21 different lipoprotein subfractions, including dominant LDL size. (Atherotech, thevaptest.com, direct cost $40)
NMR Lipoprofile Test Inside a magnetic field, radio waves charge the lipids in your blood. When the magnetic field is turned off, the protons give off energy, and that energy can be captured. Because energy emissions vary by particle size, this can be used to determine the type of LDL coursing through your veins. (LipoScience, lipoprofile.com, $100)
See this article in Men's Health for more info.
To add to the other good suggestions:
HbA1C (Glycated Hemoglobin) to determine your average blood glucose level over the previous 2-3 months.
Liver Enzymes (ALT/AST/ALKP). Elevated liver enzymes may be your first sign of metabolic syndrome, due to a fatty liver from poor diet. It was my first sign, about 15 years ago.
Serum ferritin level. Can give you a good hint about your iron stores (too low or too high are both bad), and is also another infection/inflammation indicator (it is an acute-phase reactant). If it is out of range, you'll need additional tests to figure out why.
See also the thread at http://paleohacks.com/questions/324/blood-tests-paleo-indicators/5155
Agree on much of the above CRP etc. Suggest you go to LEF.org (Life Extension Foundation), click on Products, then click Blood Tests. Their "Male Comprehensive Panel" covers all the best "dude tests." You don't have to purchase the tests from them but you can use their list to know what's advisable.
If you ask your doctor for a nutritional blood analysis, he should know exactly what you're after.
Some profiles to ask for are:
I would suggest getting a HS CRP (highly specific CRP).
Quote from Kruse:
HS CRP HS CRP = cardiac CRP just so you know. They are the same protein. 14.5 is off the charts. above three I get antsy. you are almost five times that level. I would recommend going to consumerlabs.com to get Rx info on Fish oil. I am a big fan of LEF.org supplements.Once TNF rises, it causes the liver to make an acute phase inflammatory protein called highly sensitive CRP. HS-CRP is therefore a very early biomarker for cellular inflammation before any disease is established.
If your HS CRP is treated aggressively with a Paleo diet, your HS CRP will be low and your HDL will be high, and then a moderate protein diet is protective. So I go hard after HS CRP in all of the patients I work with. It is a staple in my practice.
The best way to drop HS CRP is with high dose Rx grade omega three fish oil then you eat a good paleo diet.
TSH is okay, but not without the whole thyroid context.
Reverse T3 With the RT3 labwork, you are not necessarily looking for an absolute high Reverse T3, though that in itself can be a good clue. Instead, you are looking for a problem in the ratio between the RT3 and the Free T3. i.e dividing the Free T3 by the Reverse T3 (Free T3 ÷ RT3). For healthy amounts of RT3, The ratio result should be 20 or larger. If its lower, you have a an issue. you are looking for a problem in the ratio between the RT3 and the Free T3. i.e dividing the Free T3 by the Reverse T3 (Free T3 ÷ RT3).
You are looking for a ratio greater than 10. If lower, you have an issue. The real problem is that the units that rT3 and T3 are measured in are often different! Why I have no idea but it creates a calculation problem. I usually ask my lab to calculate it for me so I dont have too. Then I give the news to the patient.
Why am I still anemic? 11 Answers
The Pleistocene Diet - Your thoughts? 11 Answers
Your worst cheat to date? 27 Answers