In our Longmont and Denver, Colorado offices we’re often asked how and why functional blood chemistry differs from more conventional readings of blood tests. The simplest answer depends on the evaluation of reference ranges (what’s deemed low, high or normal) and seeing this information through the lense of evidence-based research that helps us parse this information.
When a patient comes in with a complaint that may be considered more of a “metabolic complaint,” we like to examine lab work for an entire picture of what might be going on with them. Some examples of metabolic complaints may be tiredness, inability to shed weight and constipation. Patients will often have one or two key complaints but frequently secondary complaints, also.
For instance, the inability to lose weight could be the principal complaint that brings a patient in to see us, but as we collect more information they may also suffer from constipation, bloating, brain fog, inability to finish tasks, or trouble falling/staying asleep at night, for instance. Patients frequently present for all kinds of different reasons, but they may all fall into what we call the “grey zone” The “gray zone” is when a patient has symptoms that continue to worsen and are on their way to a disease process, but they aren’t so far enough along to be diagnosed with a specific disease or condition.
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Many of us are familiar with the expression “pre-diabetes” or “pre-diabetic” – this is a terrific example of this”grey zone” Unfortunately, unlike with diabetes, many ailments don’t have a codified”pre” point, but it doesn’t mean it is not possible to make educated recommendations prior to a real diagnosable condition or disorder is present. In our clinic we have many patients who have previously visited multiple healthcare practitioners to get help only to be told they’re”normal” or are only given a prescription or two to handle their symptoms.
These patients continue to feel worse and are only surviving on a day to day basis. Discouraged, they understand if they continue to wait, the issue will probably get worse, but at least they’ll be diagnosed with something! When these patients eventually make their way to our office (often quite disappointed ) we promise them that this is a fantastic thing.
The reason why this is a fantastic thing is, these patients aren’t far enough yet to be diagnosed with a full-blown illness or disease. This means that much less intervention is essential and lots of these patients may heal by natural means versus using pharmaceuticals. More often than not, these varieties of symptoms are the body’s way of providing early signs that something has to be addressed.
Let’s understand it
That being true, we constantly enable individuals to have open conversations with all their healthcare providers and to be honest when things aren’t appropriate or not getting better. Our patients are right when they tell us something is wrong, or not quite perfect. You’re on your body all day, every day and know when something isn’t right. Trust your intuition! We’re delighted to talk about our findings and recommendations along with other health care providers in an integrative approach to general health and wellness.
In therapy, in order to correctly diagnose and/or treat metabolic difficulties and conditions we conduct basic labs, which we’ll discuss in more detail, and examine them using evidence-based reference ranges commonly utilized in functional medicine. Herein lies the significant difference between conventional and operational medicine: we use different amounts compared to the normal reference ranges, since standard reference ranges are based on population averages. It isn’t always useful to be compared with everybody else.
Although all human bodies are put together the same way, not all bodies flourish with fitting chemical compositions to the rest of the world! We’re all special and our diagnostics should reflect that! Let’s take a look at a number of the evaluations we rely on. This is a test that checks to see how well one’s immune system is working. We’re also able to glean other significant information from this evaluation like a vitamin B12, folic acid, or iron deficiency.
We have the ability to examine patterns with the white blood cells such as lymphocytes, and neutrophils, to establish whether a patient has an acute or chronic infection. Lymphocytes are broken down between T and B cells. The B cells produce antibodies so as to attack invading bacteria, viruses and toxins, while the T cells destroy the body’s own cells that have themselves been taken over by viruses or have become cancerous. Neutrophils are a type of immune cell which counts itself among the first cell types to go to the site of a disease.
They assist the immune system by both ingesting invading microorganisms while also releasing an enzyme that kills germs off also. This is very important because during periods of high stress the immune system may weaken and older, latent viral infections can flare back up. A very frequent stress-reactivated viral disease is EBV (Epstein Barr Virus) a.k.a Mononucleosis.
A large percent of the population are EBV carriers, but not all old EBV infections will reactivate. While EBV is just 1 example of a virus that may reactivate, it is a excellent illustration of just how helpful a Complete Blood Count is. Another incredible mark on the CBC are Monocytes. Monocytes are a kind of white blood cell generated in the bone marrow that travels through the blood to cells in the body where they become macrophages. Macrophages surround and kill germs, ingest foreign substance and remove dead cells. Thus, Monocytes are a terrific mark in determining if a patient has inflammation in their system. Inflammation may result in chronic pain and/or inability to lose/gain weight among many of its adverse effects.
The Complete Metabolic Panel is another fantastic test in determining especially where a patient is fighting. It gives us a snapshot to the health of the internal organs. It may also tell us a great deal about the individual’s blood glucose regulation (or dysregulation). By identifying patterns on the evaluation we could hone in on insulin resistance (this is a significant problem with hard weight loss), hypoglycemia (low blood glucose and tiredness associated with this), or hyperglycemia (elevated blood sugar resulting in diabetes). Regulating and knowing what’s happening with sugar and insulin levels is extremely important.
Food is only one thing that affects glucose (blood sugar). Stress is a massive impediment to successful glucose regulation. Glucose dysregulation may also be at play unrelated issues such as the” Energy Crash at 3pm”, waking up all night, or with dizzy spells also. We’re also able to determine kidney dysfunction. The Complete Metabolic Panel shows us early signs of kidney failure. The CMP generally covers BUN (which could rise when the body is not able to remove urea from the blood), Creatinine (a waste product of Creatine, a compound used by the muscles for energy, later filtered by the kidneys for elimination ) eGFR (a test designed to gauge the kidneys’ filtration speeds ), and BUN/Creatinine ratio. All these combine to show us a fairly complete picture of the health of the renal system.
The Complete Metabolic Panel also appears at electrolyte function. This can give us insight on hydration, hydration difficulties, and adrenal function. A CMP will also supply amounts for calcium and magnesium. Many patients show magnesium deficiency. With a deficiency in calcium a patient may suffer from mood difficulties, leg cramps (at rest) and constipation. We also like to ascertain the reason for the calcium deficiency, as to fix or support it. The proteins element of the CMP results can help us determine digestive function.
We can successfully associate these amounts with symptoms. A good deal of people have problems digesting due to our stressful lifestyles. Our body sees all stressors in precisely the exact same way: whether you’re running from a bear or you’re attempting to get a paper completed for a deadline, this is all stress. Since we’re constantly worried, this leads to decreased digestive function. This often leads the way to gastrointestinal ailments, gas, bloating, and undigested food particles in the feces. Utilizing a CMP we could identify early dysfunctions with the liver and liver.
The hepatic systems are significant because they filter all the environmental toxins we’re exposed to on a daily basis. These systems also help detoxify and convert compounds. For instance, the majority of the conversion from T4 to T3 in the thyroid gland occurs in the liver. Thyroid health is extremely important and frequently overlooked. More recently in practice, we’ve been finding a growing number of problems with the gallbladder and can give patients relief that don’t need their gallbladder removed.
Lastly, we’re able to check at a panel of iron markers. Anemia, low iron, or hemochromatosis (high iron), are very important to identification. Where you have low iron that the individual will struggle with intense fatigue, brittle nails and hair loss. If the individual has a lot of iron it serves as an oxidant. It’s like being continuously exposed to some heavy metal. Ultimately, this can create key issues later on, or even addressed. We also run a complete thyroid panel. Running TSH or T3 isn’t sufficient enough to see the whole thyroid picture. Most patients come in and tell us that their thyroid gland is normal, yet if we look at their present labs, just a TSH was run. TSH is just one very small portion of the general thyroid picture. We see conversion issues, autoimmune thyroid, pituitary thyroid problems, and even excess estrogens creating thyroid symptoms. Functional blood chemistry is invaluable for both illness and illness treatment, but also identification and preventative maintenance. If you end up suffering needlessly in the”gray zone” we strongly suggest making an appointment with a Functional Medicine specialist.