Don’t Dismiss the Data: Why Baseline Tests Are Essential to Achieving Optimal Health
By Radley Griffin, M.D.
We hear a lot about preventative medicine these days, but for many of us it can be difficult to know where to start.
In order to understand where you’re headed, it’s important to know where you are now. Doing routine, baseline lab work is an essential starting point.
Baseline tests help you and your physician focus on what conditions you’re at risk for or already have. From there, you can create a customized health plan that focuses on reducing, reversing, and preventing disease.
Heading Off the Top Killers
When members join our practice, they’re not just looking for someone to turn to when they have a cold. Usually, they’re also looking for ways to increase their overall health and longevity.
In our practice, we start by considering which diseases statistically kill Americans most often and what factors indicate the highest risk.
For over a hundred years, the top killers of Americans have been heart disease, stroke, and cancer. In fact, according to the Centers for Disease Control and Prevention (CDC), heart disease has been the number one killer of Americans since 1921.
Fortunately, though genetic factors can play a role, heart disease is more often created or accelerated by lifestyle than by heritage. For example, diet, exercise, smoking status, and alcohol intake all have a big impact on heart disease.
This is actually good news, because it means heart disease is largely preventable. The key is to test for existing risk factors, like metabolic disease, and then take steps to reduce or reverse them.
How Is Metabolic Disease Connected to Heart Disease?
Metabolic diseases are conditions that disrupt the body’s normal metabolism and often occur together, such as:
- High cholesterol
- High triglycerides
- High blood pressure
- High blood sugar
- Excess fat around the waist
People with one or more of these conditions have a much higher risk of developing heart disease or type 2 diabetes, or of having a stroke.
On the positive side, metabolic diseases — especially when caught early — can be reversed or slowed with the right lifestyle changes. However, it’s important to remember that some of our lifestyle habits weren’t necessarily created by our choice. Many came from our upbringing, environment, and culture, including what the media and health community told us to do. And these forces still influence our lifestyle choices today.
Take the ever-changing world of nutrition as an example. Even if you’re committed to making positive diet changes, it can be incredibly hard to know which changes to make. Is coffee good for you, or bad? Should you eat a Mediterranean diet, or try Keto?
One year we’re focusing on eating plenty of whole grains, the next it’s all about low-carb diets.
Instead of getting pulled in different directions by current diet recommendations, one of the best ways to understand what nutritional and lifestyle changes you need to make is by doing regular baseline testing. This will show you where your system is out of balance and how to get it back on track.
Looking Behind the Blood Tests
Most doctor’s offices will perform tests like a complete blood count (CBC), comprehensive metabolic profile, hemoglobin A1C, cholesterol, urinalysis, and, for men of a certain age, a PSA test. In our practice, we check these numbers as well as others, such as inflammatory markers, insulin, and body-composition measurements.
The most important thing here isn’t just what we test for though. It’s what we do with that information. If we only watch blood test numbers until they rise or fall outside a predetermined threshold, and then recommend a pill or supplement to address that specific problem, we miss the bigger picture.
The primary goal with baseline blood work is to look for root causes and provide long-term, holistic solutions that decrease metabolic disease and increase heart health.
Discovering Excesses and Deficiencies
Regular blood work can indicate signs of excess or deficiency — both of which tell us that something in the body is out of balance. One sign of excess is inflammation, which can show up as an excess of fats or sugar in the blood. This often indicates damage to organs like the liver.
Blood work can also indicate deficiencies, which shouldn’t always be solved simply with a supplement. Take vitamin D deficiency as an example.
When blood work shows a deficiency in vitamin D, it’s easy to want to prescribe supplements or more time in the sun to normalize the number. But that doesn’t address the root of the problem. Vitamin D deficiency can mean excess fat tissue is pulling the nutrient out of the bloodstream, indicating an excess of fat for that person’s particular body.
Body composition, specifically excess fat tissue, is a major indicator for heart disease and type 2 diabetes.
Investigating the why behind test results that come back outside the normal range helps us to find underlying issues and hidden warning signs of disease that we can then address and mitigate.
Testing Insulin and Hormone Levels
One huge lack in medicine today is how infrequently doctors are ordering insulin testing. A high insulin level in a fasting state is a major warning sign for larger health issues like heart disease, diabetes, and cancer. Insulin resistance may even contribute to the development of Alzheimer’s and Parkinson’s diseases.
We also always test regularly for hormone deficiencies, including testosterone and estrogen levels. Hormone levels can naturally fluctuate as you age, but abnormal levels can also be indicators of underlying issues that need investigation.
For example, perhaps a man undergoes hormone testing and discovers a low level of testosterone. He could simply begin testosterone replacement therapy, a form of hormone replacement therapy (HRT), but that wouldn’t address the cause. If we look beyond the number, we may find that the man’s excess adipose (fat) tissue is reducing his testosterone production.
Getting Clues From the Liver
Many of our baseline tests look for indicators of inflammation related to the thyroid, liver, pancreas, and arteries.
We especially look to results related to the liver, which takes the brunt of the abuse we put our bodies through. A basic look at liver enzymes doesn’t tell the whole story, so we also test for ferritin, uric acid, and a liver marker called gamma-glutamyl transferase (GGT).
High levels of uric acid in the blood, for example, can drive up blood pressure, cause kidney damage, and lead to gout. This is usually a sign of eating too much sugar or red meat, drinking too much alcohol, or eating too many fatty foods, all of which are lifestyle habits that our members can change if they know they need to.
How Many Blood Tests?
Our physicians look at 96 markers in the lab panel alone, along with body composition and other tests. The great news is, these regular baseline tests are not expensive.
We don’t find that the more expensive tests are necessary, though they do exist. The trimethylamine N-oxide (TMAO) test, for example, is a very specific and expensive test that looks for heart disease. But so many cheaper and more reliable blood tests already exist that do a wonderful job of indicating where your system is out of balance.
The results from these tests then give your physician clues as to what lifestyle changes you can make to get your body back on track.
How Often Should You Do Baseline Tests?
We believe in testing as frequently as is beneficial. At minimum we test yearly, but we test more often when a member is experiencing health concerns.
If certain areas stand out in an initial exam, we’ll continue to recommend lifestyle changes — including diet, exercise, and medication when necessary — until lab panels are back in balance.
The Power Is in Your Hands
What’s most exciting about doing regular baseline blood work is that the results are actionable. They don’t just give you a report; they give you the power to take action to better your health.
You can affect most of your lab results through diet and lifestyle changes alone, which means you have a lot of control over your future health outcomes.