Several years ago, when I began to prioritize my health, I started asking for more from my healthcare providers. In the past, the ten minutes allocated to me for my annual health check-up would pass far too quickly as I tried to convey to my doctor that my energy level was low, my hormones felt “off”, and I just didn’t feel like myself anymore. Sometimes my doctor would humour me and order the occasional lab test, but more often than not I was patronized and reassured that what I was feeling was completely normal. I got used to being told that I was a woman of a certain “age” and that I would simply just have to get comfortable feeling this way. I would always leave the doctor’s office feeling defeated, stuffing my running list of questions and symptoms back in my purse and telling myself I would be more forceful with my request the following year.
This became my annual dance: reviewing my growing list of questions and symptoms before my appointment and prepping myself to not take no for an answer. “I just don’t feel well”, I would tell the doctor. “Can’t I get my hormone levels tested?” I would press. The doctor continued to push back, giving me the same old song and dance, and again and again I was told that the way I was feeling was normal. That all women felt this way at one time or another. That I was simply getting older.
The following year I made it a point to stand my ground. I had done enough personal health research to know the way I was feeling was not “normal”, that all women do NOT feel this way at one time or another, and that my health destiny was not written in stone.
Finally, the doctor agreed and completed a comprehensive lab requisition that entailed more than just the basic lab work we did every year. It included a complete hormone panel as well as thyroid markers, a metabolic panel (CMP), iron, ferritin and c-reactive protein test, along with checking various vitamin levels including vitamin D, B12 and magnesium. Hallelujah. Perhaps now I would get some answers.
I anxiously awaited the results and finally I was called back to the office to review them. The doctor looked at the numbers on the page and told me that everything seemed fine. Perhaps my vitamin D and my iron levels were on the lower end but I was right where I needed to be for a 43-year-old woman. I was in the average range. There was nothing to worry about.
But I still wasn’t happy. Being “average” is NOT where I wanted to be. I don’t want to rank “average” based on a reference range of a bunch of random people with varying degrees of health! I want to be ABOVE average. I don’t want to feel mediocre for the rest of my life.
While I was happy to see that I didn’t have any dire health issues, I knew it was time to seek out other health care providers with varying degrees of backgrounds who had spent their careers looking beyond “average” health markers. Over time I found and met with other like-minded people and my world opened up.
I no longer accept lab results that are normal. I will always strive to live my life in optimal health and I simply refuse to accept a doctor’s opinion (particularly those that see me for ten minutes a year) as gospel.
ADVOCATING FOR MYSELF
Advocating for myself (and others) became my mission and I feel it is important to share this message. If you don’t feel well, continue to press and don’t take no for an answer. Change doctors. Ask your friends for referrals. Ask your friends what is working for them. Do your own research and never settle for “average”.
One important lesson I had learned through all of this is that having regular blood testing is one of the most important ways you can track your overall physical well-being. Your lab results are a snapshot in time of your health, and by comparing these results year over year, you will be able to see any changes in your health and be able to catch illness or disease early which will give you even more tools to advocate for yourself. A doctor will recommend having routine blood work at least once per year, however this is bare minimum. Anytime you experience unusual symptoms whether its abnormal weight gain, fatigue or excess pain you should request updates to your lab-work.
Keep a file of your results. Consult them each time you have new labs done. Treat your health as a priority. And never let anyone try to tell you it is ok to be average!
SOME LAB-WORK TO CONSIDER REQUESTING AT YOUR NEXT APPOINTMENT
Basic metabolic panel (BMP) checks for levels of certain compounds in the blood such as:
- Carbon dioxide
- Blood urea nitrogen
Abnormal results may indicate kidney disease, hormone imbalances or diabetes.
A routine complete blood count (CBC) test checks for levels of every major cell in your blood:
- White blood cells
- Red blood cells
- Platelet levels
Any abnormal levels of these components may indicate an iron deficiency, bone marrow issues, tissue inflammation, infection, nutritional deficiencies, heart conditions, or even cancer.
If you are concerned about your liver health, a complete metabolic panel (CMP) includes all of the measurements that a basic metabolic panel (BMP) test does. The CMP will look at levels of:
- Total protein
- Alkaline phosphatase (ALP) – High levels could indicate cirrhosis of the liver, gallbladder inflammation, gallstones, hepatitis, Paget’s disease, or a bile duct blockage. Low levels could mean you are malnourished (perhaps due to celiac disease), have bone metabolism disorders or are deficient in zinc and magnesium. It could also be an indicator or a rare genetic disease called hypophosphatasia (HPP), which affects bones and teeth.
- Alanine aminotransferase (ALT) – High levels could indicate cirrhosis of the liver, hepatitis, liver cancer or liver damage. Low levels are considered normal.
- Asparate aminotransferase (AST) – High levels could indicate cirrhosis, heart conditions, hepatitis, mononucleosis, pancreatitis. Low levels are considered normal.
- Bilirubin – High levels indicates abnormal red blood cell destruction (hemolysis), adverse medication reactions, bile duct blockage, Gilbert’s syndrome, hepatitis. Low levels are not a concern.
A lipid panel test checks your cholesterol levels:
- High-density lipoprotein (HDL) “good cholesterol”- helps remove harmful substances from your blood and helps the liver break them down into waste. Helps to build cells and certain hormones.
- Low-density lipoprotein (LDL) “bad cholesterol” - can cause plaque to develop in your arteries, increasing your risk of heart disease.
- Triglycerides- a type of fat (lipid) stored in your fat cells that provide the body with energy. High levels can increase your risk of heart disease, stroke or heart attack as they can contribute to hardening of the arteries or thickening of the artery walls. High levels can also be a sign of type 2 diabetes (or pre-diabetes), low levels of thyroid hormones, or metabolic syndrome.
Thyroid panel, or thyroid function test checks how well your thyroid is producing and reacting to certain hormones such as:
- Thyroid-stimulating hormone TSH – regulates the levels of hormones your thyroid releases. It is a signal hormone sent from the brain to the thyroid instructing it to release thyroid hormones into the system. A high number means LOW thyroid function.
- Triiodothyroine (Free T3) – the active thyroid hormone. It indicates metabolic rate and is related to weight, skin, hair + mood.
- Thyroxine (Free T4) – a measurement of how well the thyroid is functioning. It is converted to T3.
Our thyroid, although only a small gland in the front-lower part of your neck, helps regulate mood, energy level, and overall metabolism and the smallest thing can throw it out of whack. Abnormal levels can indicate numerous conditions such as thyroid growth disorders, or abnormal levels of testosterone or estrogen. If your thyroid produces too many hormones, you may experience anxiety, tremors, or weight loss. If your thyroid produces too few hormones, you may experience weight gain, depression, lack of energy, constipation, cold sensitivity (cold hands and feet), brain fog, etc.
C-reactive protein (CRP) is made by your liver when tissues in your body have inflammation. The higher the level, the higher your risk of heart disease. You want this number to be very low!
High CRP levels indicate inflammation from:
- Heart disease
- Rheumatoid arthritis
- Artery inflammation
- Inflammatory bowel disease (IBD)
Hormone testing is another important one and tests vary depending on whether you are requesting these in the U.S. or in Canada. As I travel frequently and see functional medicine doctors on both sides of the border, I can attest it is much easier (and cheaper!) to have tests run in the U.S. There seem to be many more tests available in the U.S. as well. You will need to know how to convert the results however so you can maintain a baseline. Google will help you do the conversion, you simply type in the request in the search engine (i.e. nmol/l conversion to ng/dl).
As a baseline you will want to know:
- Estrogen - levels fall with age and cause many symptoms of menopause and unhealthy aging.
- Testosterone - relates to sex drive, muscle mass, strength of the bladder, and sense of well-being.
- Progesterone - low levels increase breast cancer risk, cause weight gain, hot flashes, fibroids or endometriosis, mood changes, infertility, irregular menstrual cycles.
- DHEA - an adrenal hormone that helps with muscle mass, libido + energy. There is some speculation that when this is low the body makes more cholesterol.
- Follicle Stimulating Hormone (FSH) - the most accurate measure of menopause.
- Cortisol -an adrenal hormone that promotes energy + the body’s ability to deal with stress.
The DUTCH test is also a great way to test hormones. It is a urine test that you do at home. Depending on where you live you may need to order through a physician. The DUTCH test measures estrogen, DHEA, progesterone, testosterone, 4-point cortisol and metabolites of all hormones.
OTHERS MARKERS YOU SHOULD REQUEST
- Vit D3 - Vitamin D3 is made by skin through direct exposure to sunlight. It decreases breast, colon & lung cancer risks and alleviates anxiety & depression.
- Vit B12 – keeps the body’s nerve and blood cells healthy, and helps make DNA, the genetic material in all cells. It also helps with red blood cell formation and anemia prevention.
- Ferritin -reflects iron STORES in your body.
- Iron – reflects the amount of iron in your blood. One doctor I trust told me this range should be somewhere between 30-50 ug/l as our body “rusts” when levels are too high (pre-mature aging).
- Hemoglobin A1c - shows how much damage you have in your body due to sugar. It measures glycation, which is the sugar build-up coating on your cells and blood vessels. Glycation is responsible for cancer, heart disease, 85% of high blood pressure, obesity and toxicity in the body. Glycation also increases when estrogen levels are low.
- Glucose Fasting- measures glucose (a form of sugar) levels in your blood. High levels may be a sign of diabetes (or signal pre-diabetes).
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