Your labs are lying to you--Why functional medicine may give you more answers about your health: Tracey O'Shea FNP

I love my talks with my pal Tracey O'Shea, FNP!

We go over my personal lab work, why functional lab ranges differ from conventional medical model ranges, and what labs you might be missing out on to get a better insight into your health!

Tracey O'Shea, FNP https://www.instagram.com/tracey_a_oshea_fnp/
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Transcript

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. 

 Okay, so I'm with my pal Tracy 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 like random symptoms and you're like, okay, well, what's, 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.

, because  I'm in this for the for the long haul. I'm not in this,  just to go out at the age of 60. I want 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... It's a lot. It's a lot. So we're going to make sure I didn't have already underlying stuff going on that night night shift was just going to like blow up in my face essentially.

So, 

so smart. So smart. I've had a handful of registered nurse friends who start night shift and. Most notably the thyroid just like goes nuts for them or if they already had kind of a pre existing condition and they're just like, why am I dragging and why am I gaining weight and why do I feel awful? And you know, a lot of the times.

I noticed just gets blamed on night shift. Oh, it's just because I'm working night shift. Like it's fine. It'll get better when I switch shifts, but like, you know, come to find out when we do their labs, like their thyroids out of whack, you know, and their vitamin D is super low. And you know, so I think I commend you for, , having kind of the forethought to, to just kind of check on everything first, just to kind of make sure like you said that you're not running up.

Against, , a wall if you are kind of adding this extra layer of stress to your body. 

And I know so many people that are night shift, like they're lifers, like they're not coming off of night shift. And so I can't even imagine like the adaptations their body has had to make over the years. And I, , like, I can't, I can't do that to myself.

I, this is like 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 this is just, I'm all about like data and science. And I just, , I nerd out on this so much. So I'm very excited, uh, to get into the nitty 

gritty with you. Well, good, because we talk the same language.

I also like to nerd out. So just to kind of give some background, right? So I think that , I'm a functional medicine practitioner, and I also got into this space because, um, I just, to be frank, don't think the conventional model, medical model, is set up to deal with chronic illness. We just, it's just not.

It's, it's not doing a great job at controlling for that. Um, if I'm in a car accident, or have a major injury, yes, send me, please, take care of me. , and so a lot of the movement in the functional medicine space is in preventative medicine and in trying to identify these suboptimal ranges, these suboptimal values before they become a problem like.

That makes a lot more sense right than just trying to give you a medication after the fact after you already have the disease and so I work at the California Center for Functional Medicine and you know, we have patients that come to us, , commit to a year of membership and and you know, these people are, you know, are already sick or are, you know, maybe also in the same boat where they're trying to just You know, get their best foot forward, but we recognize that there was this gap between patients that are like, you know, really sick or don't have access or don't have the financial means to, , be in a full membership commitment, but also need this level of care and this level of assistance.

And I think in the whole functional medicine space, there's this movement that is happening of trying to get. These labs into the hands of people that either maybe aren't familiar with functional medicine, don't know that there's another better option or just financially cannot commit, , to a full membership.

And so this is, you know, the functional medicine checkup basically was created out of that. So it's an opportunity for people to come to the practice. to talk to a practitioner. So you get an initial consult where we listen to your, your symptoms, we listen to your goals, we do a full medical history, and then we order a comprehensive blood panel.

And then you go and get the lab done like you did. And then you now have this appointment, um, which is an hour long appointment to talk about all of those lab results. And really tell you, are there any imbalances? Is there anything here that you really should pay more attention to? And then that patient has the option of going and doing something about it on their own, trying to talk to their primary care, uh, some, , if that works.

And, or... If things are enough where they feel like they want to invest, then they can stay at the practice and become a patient and have, you know, really guided treatment therapies given to them to really help optimize those pieces or dig deeper to figure out what might be going on. So that's kind of where all of this started, and there's a handful of different companies and practitioners that are doing this, and it's really starting to become a movement and trying to get people to these labs.

So that they have a better understanding of their risk. So just to give some background of why this all got started and why we're even here talking about it. Love 

it. And I love, I love the comparison. So Tracy gave me, um, basically a report and it compares. the functional ranges for where my lab should be compared to like the traditional medical model.

Because like I said, you can go to the doctor with symptoms and they say, Oh, you're fine. But actually on the functional medicine side, you might not be fine. So that's 

what I'm excited for. Yeah. And, , if people want, we can share those ranges. I think, you know, the important thing to remember here is when we're talking about ranges is.

That conventional range, which is the range you get on your LabCorp Quest, whatever panel, whatever lab you're going to. These ranges are not, like, super scientific,  they're doing these huge studies, healthy people, , and basically averaging, okay, where are the most of the people at? And it's a bell curve.

So they're saying, most healthy people... Quote, healthy people. There's no like stringent requirement for these studies are within this range. I mean, that's how that's decided, right? It's just the bell curve of running a bunch of people's labs and averaging them and figuring out where those people are. So there's really not a whole lot of like science behind that range and determining where people are when they have disease is what that lab range is, right?

So great. Like, you come in, you get your thyroid done, like, you already have hypothyroid, like, you already have disease. The functional medicine range is either narrowed or expanded, depending on what, , depending on the marker. And the idea for the functional range is exactly what we tried to talk about before, is to identify.

The very beginnings of imbalances and to kind of clue you in to something starting to be off so that you have an opportunity to then address it before it's a diseased state. And so that's really the difference between the functional range and the lab range when we're talking about that in conversation.

And I think the other thing to note is we do a really extensive panel because patterns are important and very rarely is there one single marker. That is diagnostic of a disease. It, , it does happen, but most of the time we are trying to look at a collection of markers. That form a pattern that start to tell a story and so you're going to hear me when we go over this.

We're going to talk about patterns. We're going to talk about collections, groupings of markers that point in a certain direction. So that's why we do such an extensive panel is because we need to look at multiple markers. They are all telling a story and collectively. They tell us something sometimes it's really hard to discern whether somebody's forming a disease from one single marker and this is just checking you one day of your life for one minute.

You know, it's not always indicative of some major scary thing. And that's why. , we recommend these yearly annual comprehensive panels so that you can see both patterns of early disease and trends. So you can see over time if things are transitioning away from where we want them to be. 

I love it.

Well, and just to give a little context, because everybody, like you said, it kind of tells your story. Everybody has like their own story, their own lifestyle. So anybody who's listening who might not be super familiar with me, , I'm 36. I'm a registered nurse. I currently work. , night shift part time. And then I have my own health coaching company.

And then, so I'm very busy on that side. And then I have three seven year olds I 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. I try to get as many veggies, but you know what? 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. 

Agreed. And, um, yeah, I think you'd probably check a lot of boxes, but as you say, , the stressors of life and the stressors of world, you know, no matter I think how well we do, there's always going to be some dynamic between your genetics and your environment.

And I think we control a lot for them, or some people control a lot for them. And don't get me started on how, , we can go down way crazy rabbit holes, but, um, But yeah, I think, you know, there's only so much we can control, so I just want to, , put that out there too, right? We can make ourselves crazy town sometimes, trying to, um, adjust every variable in our life to make ourselves healthy.

Um, but the idea here is... This is information for you to use and information for people to use so that you can make informed decisions about where you have the energy and space to spend on some of these lifestyle changes and some of these, , hacks or, , whatever else that we're kind of focusing on to increase longevity.

And health span, you know, I think that's a really important difference. Actually, I'm doing a post on this, um, this week, but there's a, yeah, there's a , very big difference between lifespan and health span. Like, we have a longer lifespan than we ever have, , , but we don't really have a longer health span.

And, , probably most of the time, if you ask anyone, do you want to live a long, long life, regardless of your health? , and not really have quality in the last 20 to 30 years, or do you want to have a really vivacious quality fulfilling , life health span, not necessarily live to 102, , so I think they're just, I think that's the goal of all of this is to increase health span and quality of life for people, not necessarily longevity, , to live forever, , yeah, so I'm excited to dive in.

And ask away any questions that you have as we go. Um, and like I said, I'm going to be kind of going over the lab results, um, in patterns. Do it. Okay. So, um, we can probably take a picture of this and show it somewhere, hopefully, and give some people some ideas. So, part of the comprehensive blood panel that we do at the California Center for Functional Medicine as part of this Functional Medicine Checkup is, Blood sugar markers and cholesterol markers.

So we're looking at your fasting glucose, we're looking at hemoglobin A1c, which is kind of a three month average of blood sugar regulation. I think historically hemoglobin A1c is a great marker for people with diabetes, just to kind of give that out. It's not always super accurate for people who don't have diabetes, um, because there are a lot of variables that can impact the result of the hemoglobin A1c, including just the lifespan of your blood cells versus somebody else's.

Um, so we, this is why. We look at multiple markers because, , 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 and we check uric acid and triglycerides.

Triglycerides are a type of cholesterol that tend to be mostly impacted by metabolic dysfunction. So that's kind of the grouping for the metabolic markers. So your fasting glucose was 92, a touch higher. Then I might like it, um, on the norm, so 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, where you were at, you know, what, what you had the night before, whether you exercised in the morning. So there are a bunch of other 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, so I like it between 4.

6 and 5. 3. Your fasting insulin was 7. 7. I like it less than 7. So, you know, just barely there. The rest of the markers were great. Your triglyceride was below 80. That was at 56. Your HDL, which is also the beneficial cholesterol. All cholesterol is good, but let's just, we'll just call it the good cholesterol for now.

Um, what's also fine when it gets really low, that can be an indication of blood sugar dysregulation. So for the most part, I think all the blood sugar markers were good. Maybe just flirting a little bit with just kind of on the higher side of the functional range. Usually this happens for my patients. I will, um, suggest if they want to do kind of a continuous glucose monitor.

I know it's all the rage right now, um, but sometimes it's nice to slap a CGM on, you know, for a couple weeks, do some tracking and just see if there's some noticeable patterns that you're seeing with your fasting glucose and your post meal or post cran deal. I think that is really the best way to assess how your body is responding to your meals, how your body is responding to your workouts, how your body is responding to your night shift, how your body, , so I don't think there's a ticking time bomb situation, but You know, it's probably interesting to keep an eye on and track and make sure that it's not trending, um, in the wrong direction, especially as we get older and our hormones shift and, , we have different stressors.

So again, nothing major here, but it might be enough that I would say, Hey, it might be worth doing a continuous glucose monitor. And I have some parameters and some things that I can give you. Um, yeah, 

the student in me when I saw those, I was like, Oh, well, and this is interesting to because I'm in like, like 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. 

Oh, wow. Yeah. 

So I feel like that kind of plays in a little bit as well. Um, I'd be curious. When I'm not really in this phase as much, what my labs look like, like in the future. So this is, 

this is... Yeah, it'd be, yeah, it's really interesting to have some baselines or some, , markers.

, that kind of represent different phases of where you're at. And, , it's important to know, like, 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 kind of pushing you a little bit towards this level, maybe it's not diagnostic in the sense, but for sure.

Knowing where you're at and seeing how your body is responding to that level of carbs might be helpful, you know, using a continuous glucose monitor. And I know you, you're on the nutrition train, you got all your, you know, you, you know, all, all your stuff. Um, but even sometimes just how you're attaching those carbohydrates, , to, to your other macronutrients and when you're eating them in the day can be really revealing, you know, like for me.

Like my, the same meal at night does not cause a blood sugar spike for me as it does in the middle of the day. And I imagine it's because I'm not as active, you know, while I'm kind of working. So I've learned to kind of adjust, I mean, exact same meal, like, you know, leftover and it just causes a much bigger spike with certain things.

So having some of that information has helped me kind of adjust where I'm putting. My foods and what I'm eating and what I'm choosing, um, in the types of carbohydrates that I'm consuming. So, you know, that's kind of more of like a little hacker thing. Um, but you know, helpful to know if that is on your priority list.

Yeah. Awesome. 

Okay. Cholesterol looks 

beautiful. , cholesterol is a hot topic, but we're all talking about, and there's a lot of. range variations about where people want them. And definitely in the conventional model, there's a much more conservative number of, um, uh, for cholesterol value. And I could nerd out about this and talk about it for hours.

So I'm going to really hold back on you. Um, but for your labs, your cholesterol looks fine. So your total cholesterol is one 50 well within kind of an optimal range. Um, your triglycerides were also in optimal range. So as a reminder, Metabolic metabolically driven cholesterol is Jeff is usually going to have a high triglyceride and a low HDL that is just tends to be the pattern for somebody that has blood sugar or metabolically driven high cholesterol people who don't have that who have high cholesterol generally just have a high LDL.

and a high total cholesterol. So the interest, all of yours looks great. Um, but just for educational piece, we also add in more advanced cholesterol markers and this advanced cholesterol marker is called an apolipoprotein B and yours was also stellar at 62. The thing is here is when we're talking about atherosclerotic risk, so the risk of having plaque form in your arteries and increase your risk of having a cardiovascular event or stroke, it's not just the cholesterol by itself.

Like the cholesterol is important, but it is the ecosystem of the vessel. It is what's happening in the body because you need a lot of things to be happening all together to start to have that risk. Yes, you need cholesterol, but you also need inflammation. You also need inflammatory molecules. You'll start to have white blood cells aggregate to the area.

So we start to see this pattern of... It's almost like a recipe. Yeah, it's like a recipe of things. Like, oh, we only have one ingredient. Like, okay, great. What are we gonna do with this flour? Like, you know. Cool. Like it's just going to be there, but like, Oh, then you, then you have sugar, then you have some eggs, , you started to have all these ingredients adding before, you know, it, it's starting to form that risk of atherosclerosis.

So we include this advanced marker because. Apolipoprotein B statistically is a much better predictor of atherosclerotic risk. It represents particle number and particles are the things that carry around all of the cholesterol. It's kind of like the transport protein, um, for all of the cholesterol. And just through literature and through research and what we know now, that the transport vehicles are a better predictor of risk.

So we also include that. You will not find that when you go to your Primary care, regular doctor, you'll be lucky if you get a cholesterol panel, and I think this can go in either way, either direction. Either somebody is... underrecognized for their cardiovascular disease risk because they don't have a full comprehensive advanced marker done or they're unnecessarily put on, , cholesterol lowering medications as the first, I mean, you know, I don't talk to you about this, but as the first option without really trying to understand why their cholesterol is high, because thyroid function, heavy metal toxicity, vitamin deficiencies, like, there's a number of things that can impact cholesterol synthesis that is not just related to the food that you're eating.

And I would hate to be on a medication I don't need to be on. 

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 I think barely high cholesterol without any lifestyle adjustments or assessments into why that person might be having high cholesterol is just a real disservice to people and these medications have side effects.

And, um, those can be rather, um, impactful for a lot of people. And some of them can even contribute to diabetes and blood sugar dysphoria. So it's just this really slippery slope. Um, and so that's, , part of this is trying to help people be informed. Okay, thyroid looks good as well. So, , we do a comprehensive panel that looks at your full thyroid function.

So we're looking at low functioning thyroid, high functioning thyroid, and we're also looking at antibodies. So autoimmune thyroid or Hashimoto's, all your antibodies were normal and negative. So it's definitely a screening. That's a a huge percentage of people that have hypothyroidism have an autoimmune form of hypothyroidism.

And it's not often checked because, um, I think, you know, the traditional models just doesn't know what to do about it. Uh, so I think they're not really checking for it. So your thyroid was, um, pretty solid. I would say you're, T4 and T3. T4 is the primary hormone that your thyroid gland makes. And then the T4 is then gone, goes out into your tissues and is converted to T3.

So most of this looked pretty good. No major markers. , , your, your teeth, your total T3 was maybe just a smidge low at 82. I like it above a hundred. Your free T3 was 2. 7. I like it above 2. 5. Still good, nothing I would write home about, um, I just, you know, might be something I would check, , in a year or six months or so, just to kind of make sure, especially with the, the night shift stuff that I was kind of talking about, you know, just kind of that circadian disruption can impact the function of the thyroid, but all of this looks pretty good.

I would just say probably something I would just pay attention to. 

Yeah, if I'm still on night shift in a year, we have problems. 

Yeah, um, we need to have a bigger, bigger discussion to have. Um, okay, so, also looking at, um, kidney and liver function, all of that looks pretty good. Your AST and ALT, which are your liver function, um, tests, for me just a touch higher than I like them to be nowhere near liver like failure or liver issues.

Your AST was 25. Your ALT, um, was 27 and you can kind of see I like them, , kind of lower to closer to 20 and 23. Again, not a big deal, but definitely something to pay attention to. And I think, Sometimes this is just a transient little uptick got, , exposed to something or, um, yeah, I don't know that you're doing this, but sometimes all people do their labs after they came back from a weekend, like at a wedding and was like having a good old time.

And I was like, what were you doing, , and, um, and it always returns back to normal. So, um, again, nothing major here, but just a touch higher than I would like them to be for really kind of looking at optimal liver function. So it might be worth. Repeating that, you know, in a few months and 

I'll have to look back because I had I had preeclampsia with my triplets and I'll have to look back at what I think I had some follow up labs.

Maybe like three years ago. I'll have to look to see what those works. I'm curious if they like are just hanging out there. 

Yeah. Yeah. That's really interesting to know. Um, I think some people do just kind of hang out on the higher end and, , speculation, you know, there could be. Could have been history of a little bit of liver stress, , that kind of just shifted that balance for the person or something they're doing, , is just kind of creating a little bit of extra liver stress.

So yeah, it's really interesting. And this is why keep all your labs guys so you can go back and compare them. Um, yeah, so it'd be interesting to kind of hear and see what that looks like. Um, your, I don't know that this is as important, but your protein total was, um, A little low, lower than functional range, and so is the globulin level.

Um, I don't think this really has anything to do with your protein intake, because you have quite a lot of protein intake. Sometimes I will see this just as far as like, um, protein digestion, you know, like if there's any maldigestion of protein or if you're having You know, trouble digesting that protein and getting it to where it needs to go.

Sometimes I'll see a little bit of a low protein, I'll see it in, , malabsorption or maldigestion or malnourishment, which I don't think you're, you're malnourished. Um, so I don't know that there's anything to write home about. Um, but it could be like, ah, 

wonder what? That's, 

could be a little, a little clue for us.

, I don't know if it's. And sometimes I'll just say, okay, guys, like make sure you're doing mindful eating and really chewing your protein well, , chewing your foods really well, , sometimes you can consider a digestive enzyme to see if, you know, I mean, unless you're going to retest this, you won't probably know, um, and a lot of times we'll also do.

Gut testing, you know, stool testing to really assess the macronutrient stuff in the stool, meaning like, 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 kind of complementary labs that, you know, will often do to also kind of match that.

Like, okay, yeah, you are having some other issues, um, with protein. Digestion and I mean your your creatinine is maybe a little on the lowish end 0. 75. Um, that also just may be your norm. Um, again, not like diagnostic of kidney issue creatinine is, , as a marker of kidney function, but I will also sometimes see on the lower range of that somebody who is deficient in protein or, or, or not digesting and absorbing their protein.

So there may be a couple of small enough things here to just kind of think about that a little bit. And that might just be chewing slowly, , getting the right kinds of protein, maybe even adding a little bit of bitters or digestive enzymes to really kind of help you break those down. So that's just one consideration.

All right. Iron levels look great. All of this is fine. Um, B12 and folate are also um, pretty solid as well as your homocysteine. So B12 and folate are B vitamins and um, there are kind of different reasons why people might have nutritional deficiencies. One's can be not eating enough of those foods. Um, second can be not absorbing.

The nutrients from the foods that can be from like bacterial gut infections from autoimmune conditions like pernicious anemia. So there's just like a handful of different things that can impact. Even if you're like, I'm eating a ton of nutrient dense foods, there can be other reasons why you might not be absorbing nutrients.

And then the other thing is like genetics and other factors that might just impact the utilization and absorption of the nutrient, like, , MT, like everyone knows about methylation panels and, or,  variants like MTHFR, MTR. So there's just a lot of, um, there's some vitamin D tact, there's some vitamin D ones.

So I think, , it's not always straight. , straight and easy. Most of the time we do start with, okay, like support, like get the food, like actually get those nutrients in your body first, see if we can get those numbers up. But sometimes we do use supplementation, right, in order to kind of get those numbers up, especially if there are genetic variants or genetic mutations that exist where somebody really just doesn't need a little bit extra help to get those numbers up.

But your B12 and folate look great. And then the other marker I mentioned was homocysteine, which is, um, Kind of a indirect way of measuring methylation and how well you are using certain nutrients to methylate. And methylate's like a little buzzword everyone loves right now. Um, but really quick, methylation is basically a process that's happening in your body like thousands of times a second.

I mean, it is, it's a very crucial piece of... The processes in your body, basically adding and taking off a methyl group to turn on and off things. And so, , it's really vital that we are properly and efficiently using and having enough of those nutrients in order to methylate. And so homocysteine is what we call an intermediate marker.

And if you don't have enough, ingredients. If you don't have enough nutrients, you kind of get stuck right halfway at the intermediate marker, which is homocysteine. So if you're only kind of going halfway, homocysteine is going to start to build. So 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. So your homocysteine is stellar. It's like 4. 7. I mean, so this looks really great. You're getting enough of those nutrients and they are doing what they should be doing based off this lab work.

So that all 

looks really good. What's so interesting, just like breaking down some of these things, because like you said, you can be eating perfectly, but if like your internal processes aren't firing as they should, you're not going to be functioning. Ideally, or 

optimally. Yes. Um, and I think, . You there's so many various reasons that sometimes you don't always know what it is that's contributing, , to that.

And I think your biological need changes and shifts sometimes to, , heavy, stressful events, having babies, being pregnant, hormonal changes, all of those things can. Impact the need and utilization of those nutrients. And so, um, I think if you just cover your bases, do your best, but then really having these labs to kind of spot check you occasionally to make sure that those needs don't shift is really important.

I know you mentioned you have a lot of patients that come to see you and they find out that they have like the autoimmune, um, shoot, what were 

we talking about? Thyroid. Yeah. 

What, what are some other ones that like. surprise a lot of people, or you see all the time that are like surprise ones. 

Yeah, I think, , the autoimmune thyroid for sure, hands down, is like the number one thing I think that people had no idea, , that they had or any issues.

On occasion with a stool test, we will diagnose like Crohn's or ulcerative colitis or some sort of autoimmune GI condition where people are like, I just thought I had IBS, you know, and they have like a full fledged autoimmune condition. Um, some other things I think that come up on these tests are, um, like major vitamin deficiencies.

So, like vitamin D especially, we'll talk about yours, but I mean, I would say 95 percent of people that I test have, , pretty significant vitamin D deficiency. Um, so that is a pretty common marker that people just had no idea were really low. Um, and then the cholesterol piece I think is also. Like navigating that because it's just kind of the first part of cholesterol testing.

And then we do like coronary calcium score scans and we do CIMT. So we really look at the vessel. So people come in, , not sure what to do with their cholesterol values or have been told that it's fine and it's not fine. Or I've been told that it's high and it's not high. , a lot of people that come in for this particular functional medicine checkup, I've never had like a full, comprehensive panel done.

So almost everything is probably surprising to them. But that's the majority, I think, of stuff that really sticks out to me that, , people just had no idea even existed or that it could be a problem. 

Well, and I think some people might feel like, Oh, I don't, I don't need this kind of a comprehensive panel.

But I think of it, it's kind of like, I'm a huge lover of self care. And like, the more you learn about yourself and your body, like the better you can take care of it. So Is it, could it be like an investment? Yeah, but it's, it's like your self care. You're, you're, you're loving yourself by knowing this about 

your body.

Yeah. And I mean, and you could even argue it will cost you more later. I mean, , people, and I get it where that's not, that's not who we are as humans. It's not like we're like, Oh gosh, , 500 now, I don't know, you know, but they'll be shelling out thousands of dollars, you know, in the later part of their life.

For additional care and wheelchairs and missing out on, , the things that aren't monetary in nature that are, , enjoying your life and so that is kind of the conversation I sometimes have with people is it is, it does feel sometimes like an investment in your health, especially when you're paying up front to have labs done, but like you said, you're getting information from this, , so it's not just like, Okay, like I'm going to pay this and just not even know if it's helping like we all do that sometimes, you know, the science says sauna helps and the science says, , cold plunges help and and whatever, but you know, unless you're like really 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 that we invest our time and energy in to but this is real tangible information and guided. Information, you know, that you're working with a practitioner, um, to be able to make, like, like we were saying before, make informed decisions, because we only have so much time, energy and money to give.

And I'd much rather have something like this to know where to put that time and energy. And, you know, some people like to keep their head in the sand, I get it, , sometimes it's easier to pretend, um, but I do think it will come back, , to bite us if we aren't paying attention to these things now.

Well, and 

I've heard of several people just within the past month of, like, really physically fit, in shape, healthy individuals, like, 

keel over, heart attack, and 

it's, it's like, could that have been prevented? I don't know. But. I would like to know certain things, like have little warning, like, like little red, like recognize red flags so that it doesn't get to that point.

Yeah, I agree. I mean... So I order labs for my husband and make him, make him do them. Um, no, and yeah, I think, I think you're right. I think that, um, we live in a world where there are a lot of stressors, a lot of toxins, a lot of issues with our food supply, , no matter how, how hard we try, I think there just are variables and there are hurdles.

Yeah. We have the science and we have the technology to have this information and to be able to make better informed decisions about, like I said, where to put your energy. So I, of course, I'm probably biased, but I think everyone should be having, , these comprehensive panels, um, at least once a year, especially as we kind of get, you know, into our 30s and 40s.

And I don't know how many times I have found, , significant. imbalances and, you know, borderline disease states and people that just had no idea because they were just a little fatigued. And I think if you probably asked every parent, , every person starting to be in their thirties, like, do you have low energy?

Do you have moments of fatigue? Do you have aches and pains? , I mean, those are the things that start to happen as we push our bodies and we don't fuel with the things that we need. And so I think we do get into habits of just kind of brushing some of that off and not really. Um, taking the time to consider that it could be, you know, our bodies tell us stuff and we are really great at ignoring it, usually.

Um, so, , it's just kind of a reminder to listen to your body and take care of it, you know, and this is part of that is evaluating what's happening on the inside. Um, okay. So your vitamin D, um, was 45 and Which is pretty good. I mean, I, it's definitely not low, not, not, um, deficient. I prefer it between 50 and 70.

So, , maybe, and this is also coming out of summer, , so you have to kind of consider what this might become in the winter, um, if you're not supplementing or supporting. And, I do think most people probably need some vitamin D supplementation. I just think, for various reasons, sun, sunblock, exposure, um, food supply, food quality, all of those things have just kind of left us in a place where I think humans do need a little bit of support for vitamin D.

So I would, are you taking vitamin D right now? Yeah. So I mean. I would probably recommend like, , a thousand or two thousand IUs going into the winter just to kind of give you, especially with your, your night shift, depending on how long you're doing that. Um, but I really like it closer to 50, 50 to 70.

It's really crucial for your immune system function and just a variety of other things. I would say that you're probably pretty close to your biological need. And the reason for that is because we also check parathyroid hormone. Which is PTH, 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 that is really, um, integral in calcium regulation, and getting calcium in and out of the bones, and vitamin D, and phosphorus, and , a bunch of, a handful of other minerals, and magnesium, and so, your vitamin D level, will impact how much hormone the parathyroid gland is producing.

And so, your parathyroid hormone is 29, which is solid. I usually am looking for a 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. So I don't think that you are in a state where, , I'm stressing out about your vitamin D level.

Um, but just considering that it's this number in the summer and that you're on sleep shift and you're going into the winter, I think there's a little harm. Like no harm in getting that number up just a smidge to kind of further support the, the gap and the, the, the natural fluctuations that are going to happen in the seasons.

Yeah, 

no, that's a good point about the winter, because I feel like. I did a decent job trying to get sunshine with working night shift, but going into the winter, it's gonna be a little 

harder. Yeah, it is a little harder. And you know, everybody's body is a little bit different about how they absorb and metabolize vitamin D from the sun.

It's great. It's not always the most efficient way for every person to get it. Um, so most people are like, I'm out in the time. I don't know why my vitamin D is. I'm like, well, you know, everyone's different. There's 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, you know, helps give you some guidance on what to do about it. Um, we also check a inflammatory, a systemic inflammatory marker called CRP or C Reactive Protein, and we actually do a high sensitivity C Reactive Protein, which is just exactly what it sounds like. It's just a more sensitive marker, so it kind of narrows the range a little bit, and yours was fine at 0.

53. I'm really looking for that to be less than 0, or less than 1. And, um, The idea here is this is just a marker of inflammation marker of systemic inflammation. It's nonspecific. So it doesn't like, you know, if it is high, it's not like we're like, oh, it's coming from, , it's coming from this area, but it does give us an indication that, okay, there's some inflammation happening in the body.

That's a nice clue for us that we need to, , look for the cause and look for the reason. And this marker can go up in just acute infections, like a major respiratory infection, or I mean, you know, it can soar pretty high. Um, so we always have to keep that in consideration, but these mild elevated C reactive proteins are really common in like, um, some autoimmune conditions like rheumatoid arthritis.

Um, you know, it can go up when you're having like a Crohn's or ulcerative colitis flare, so we really kind of use it as a gauge on what's kind of happening in the body as far as inflammation is concerned. 

Yeah, I feel like, try to like, combat inflammation generally, because I know like, I, I, I strength train pretty heavy, my sleep is wonky, I feel like I have a very stressful home life, so I feel like I'm always trying to like, bring it down, so that's nice that it's not showing up like that.

Yeah, no, 

no, no, it's good, and , there's a couple other markers on here that can be indicative of inflammation, I didn't go over them too much, but um, like ferritin, which is the stored form of iron. Can also be an acute phase reactant. So that can also be elevated in states of inflammation. Copper, which we're about to talk about is a nutrient, but it also is an acute phase reactant, so it can be elevated.

Inflammatory states, homocysteine, which is the methylation marker can also be elevated in inflammatory states. So there are kind of patterns of markers that we look at that. I mean, yours are all stellar and great, but you know, if we see a pattern and collection of these markers that are all on the high end or all kind of point, well, then great, , it's a slam dunk in that perspective of saying, okay, you've got.

you know, body wide inflammation. We need to figure out what it is and what's going on. Um, doesn't mean you don't have localized inflammation somewhere if you have an injury, but, um, these all look pretty good just from an inflammatory perspective. Um, the last little bit of nutrients that we tested were your copper and zinc levels.

Um, these are pretty good. You were 87 for copper, 89 for zinc. I like them both a little closer to 100 each. Um, but again, nothing to write home about here. Um, I usually will give people a handout on like zinc and like foods that are rich in zinc and copper. So you can kind of look at them, pay attention to them.

I don't think you probably need to do anything about it, but I would say these are a little lower than I like them to be. Um, I do find it, it's typically a little hard for people to get zinc up. I, I don't know what that is, um, I don't know if there's some variance, I don't know if it's absorption. I mean, just in across the board, even with supplementation, sometimes it's really hard to get zinc levels up.

Um, spoiler alert, like oysters, and... And seafood, like clams, those things are really rich in zinc and copper, um, so, , sometimes I'll just have people do oysters during the week, um, to try to kind of get that zinc level up, but again, not deficient, but just could be better, , just, and zinc and these nutrients are really important for, like, thyroid function and metabolism and a handful of other things.

Good to know. Um, yeah, and then the rest of this looks pretty good, so your CBC, um, looks pretty solid, , your hemoglobin, um, Might be just a touch low, but not our touch high. Um, I don't think that's probably anything to worry about. All your other markers are really good. So I think that is probably fine.

Again, we're looking at patterns, right? Not just single markers, um, and your B12 and things look really good. So sometimes the NCB can be a little high and B12 deficiency, but this is again, just one unit off. So I think all of that looks good. So your red blood cell indices are pretty solid. The only thing that was just a touch high on here was your eosinophil percent at four.

Um, it's also kind of a loose range. Um, sometimes I will see this elevated in people that have like parasites or atopic issues or seasonal allergies, or like just kind of think histamine allergies, immune response. , I don't always run to the hills like, Oh my God, you have a parasite, you know, with a 4 percent eosinophil, but.

you know, if the, if symptoms match, you know, if some, somebody is like, Oh yeah, like I have eczema and I have a lot of seasonal allergies and I have a lot of hay fever, or I have a lot of GI symptoms that are consistent with a parasite infection, then using this eosinophil, the slightly elevated eosinophil percent can just kind of be a clue sometimes that that is a direction to go in.

I don't think that's probably the case for you here, but you never know. Um, so other than that, everything else is pretty solid. on the blood panel. I am 

incredibly intrigued with those like parasite cleanses that people do and they see what comes out. It's grossly fascinating. 

Yeah, it's pretty interesting.

I mean, um, probably not, uh, surprising to you that I am kind of more on the science side of things where I really want some labs and I want to see what it is because I want to be able to guide,  I think sometimes those work for people. I think there's also. A lot of mucous strings that come out in those things that are not necessarily worms, right?

Parasites you can't see, they're microscopic, um, but worms and some other, , some other things you can see, but, um, yeah, I don't know. I always, I always worry, you know, that somebody's going to put themselves into a situation where they're going to have worse symptoms afterwards. Um, so, but yeah, it's pretty fascinating to watch and look at to see what people are doing.

All right, any other questions? 

No, I think, I love that, like you said, it's comprehensive, it looks at a lot, and I think the patterns are super important because, like you mentioned, you can have one marker and you might, like, freak out about it, but if you look at the bigger picture, like, it could be normal, or there could be something that day or that week that might have thrown it off, so I think it is important to look at your patterns, and I think that's, kind of speaks to general, like, lifestyle, and just being consistent with certain things, and, Um, I, I, yeah, I, I'm just fascinated.

So I appreciate you sitting down and kind of going over everything with me. 

Yeah, you're so welcome. Um, I think you make a good point. , I usually will tell my patients, you're going to get these labs before me, or, you know, you're going to get these labs before we have a chance to talk. But, , I always tell them like, don't freak out about anything unless I contact you that, , something is concerning or urgent because how I interpret these and the patterns that we see are likely going to be different, , than the information that you're getting directly from the lab.

Um, so. Um, I think that is the advantage of meeting with a practitioner to talk about these labs, because there are other companies where you don't really meet with anybody. You just kind of do a lab and then you get a handout, , about results and things like that. And it's still valuable. I think it's still helpful, but , if you take them, what do you, you know, what do you do?

Like you take that to your primary care and then your primary care goes, I don't know. I don't know what to do with that lab. Like I'm not the one that ordered it. And I, I mean, it happens a lot to people where they're like, I did this. I did this thing and I got this report and I took it to my primary and they just told me, sorry, like I'm not the one that ordered it.

I don't know what to do with this lab. Um, and so I think there's a possibility that people get stuck in those situations. And so that was the advantage of, um, trying to provide this extra service of a touch point with a practitioner so that you really felt like you had somebody to kind of help you interpret these results and to know what to do with them.

Cool. 

So if somebody wanted to kind of reach out to you to get their own blood work, how would they do that? 

Yeah, so they can go to the California Center for Functional Medicine website, um, ccfmed. com and, um, there is an option there for the functional medicine checkup and, um, it's a one time fee and then they can get set up and then get scheduled with me on the schedule and then we also have, um, like patient care coordinators and, and, and people that can help you.

Navigate and answer questions if people kind of get on there and want a little bit more information. So yeah, they can go straight to there and sign up and then get scheduled to meet. I love it. 

Well, I'm very excited to um, maybe get some more labs drawn in the future and do some like comparison. The science nerd in me is 

rejoicing.

Yes, I know. I'm so happy we did it. And, um, I think also, um, the CCFM wanted to offer like a discount code, , to people listening. So we'll get that over to you so we can put it in the notes. Um, so if people want to, , come over and join and give it a try, we can give them a little discount, , for listening.