Hello, health enthusiasts, and welcome to Rev Up Health, your go-to podcast for all things wellness. I'm Dr. Mark Hechler, and I'm Tandi Hechler. Together we're here to fuel your health journey with the best of functional medicine and holistic well-being. Each episode, we'll dive deep into topics that matter to your health, bringing you the latest insights, research, and inspiring stories. Whether you're on a quest for vibrant health or just looking for daily health tips, we've got you covered. So let's embark on this journey together and transform the way you live. So, Tandi, what's on our wellness radar for today?
Hello, and welcome to the Rev Up Health Podcast. I'm Tandi, and I'm Dr. Mark, and we are in a new place today — welcome to our kitchen. Things are a little uncontrolled in our office today, with some electrical work and, as a result, internet issues. So we've come to the less uncontrolled part of our life — which is still a little uncontrolled, because we had some apples the other day that we grew some fruit flies on, and our dog is close, so we have a secret weapon to keep him quiet just in case he decides to entertain us.
So welcome, we're happy to have you. Today we're going to talk a little about what our comprehensive labs look like, hoping to help you take a look at your own labs and know when to ask more questions — to be informed, get educated, and decide, "There are a few things I'd like to have, and maybe your doctor would order those for you." Hopefully we can get you a little more educated about some of the things you may want to look at. We'll go through and talk about each of the different body systems and what labs we're looking at in those systems.
A Word on Cost and Insurance
One thing I want to mention off the bat is that the cost of some of these might be a factor. Your doctor will order your labs, and yes, there are wellness labs that can be ordered — but with some of the labs they may order, they may have to have a diagnosis code for those to be paid for through insurance.
That was an issue for us. Many years ago, when we decided to start going down this path of looking more in depth at a functional level of our labs, we put together an extremely extensive lab order and didn't really think about the cost. We went in, got the draw, and then our insurance EOB came, and it was outrageous. We both got labs drawn — they were a little different — but it was a lot of labs: $1,200 apiece that we had to pay out of pocket. So we've since curated a list and solved that problem to an extent — we've brought it down to close to about $300 for a complete metabolic profile.
There's also a difference between what we did back then and now, because we went through insurance back then. The price your insurance is contracted to pay the lab is different than if you were to do self-pay through another provider or service. There's Function Health that offers a similar thing, so you can be a self-pay patient and get a discounted rate that's more of the flat fee of what it actually costs to do the labs, as opposed to dealing with insurance and their contracted rates.
For instance, you can get a CBC or a complete metabolic panel done for the cost of a fancy latte — it's really incredible to think about it in that respect. But if you get it done through your insurance, they're going to file it because it's a code number, and that code is going to be set by that insurance company on what they pay, and that dictates how it's split, so it can be really costly for you. So you have to be very aware of that before you go to your doctor — know that this may be something that's going to cost you a little more money.
Just to explain — we're getting way off into insurance, but I think it's important, and a lot of people don't understand these things. The other thing is, your doctor isn't the lab. So if they say, "Yes, I'll order all these labs for you," they aren't the lab most of the time, and they don't even know what the cost is for those labs, because that's the lab's job — you get a bill from the lab for that. It's not that they're doing anything to be deceiving; they just don't know, that's not their job. It's very complex. So we've looked at all the options and narrowed it down to get the most bang for your buck. Not to say that once we get results back there might not be a little more digging to do, but this is a pretty comprehensive list that will let you see where you're at — a good initial screening — and then you can learn from that: what do I need to work on, where have I got problems, and why are these levels the way they are?
Heart Health
So first, for your heart, we're looking at an advanced lipoprotein assessment, which includes several different tests in that one test — apolipoprotein A and B. Those are good indicators associated with your HDL and LDL markers, so there's good and bad, and if someone's elevated, then we start to dig a little deeper. Then triglycerides, total cholesterol, LDL, HDL, and your ratios. And C-reactive protein — this is one you won't often get from primary care — an inflammatory marker.
Thyroid Health
For thyroid, TSH, and different types of antibodies — a couple of different types of antibodies for the thyroid to look at autoimmune diseases — and then, of course, the hormone levels themselves: free T3 and free T4.
Autoimmunity
For autoimmunity, we are going to be adding this — this is one we haven't done, but we're planning to add it, and we'll check on the price: an ANA and an RF, which is for rheumatoid factor and antinuclear antibodies. It's always good to know what's going on there. And then CBCs — everybody usually gets CBCs and basic chemistry panels, so those are something you may get from your doctor, and we do those too, of course.
Female and Male Hormones
Then we've got female hormones and male hormones. Most of those are pretty much the same — there's pretty much just one that you add at the end. For men and women, we're looking at:
Testosterone, total and free
Prolactin
Estradiol
DHEA
FSH
LH
Sex hormone binding globulin
Then for women we add progesterone, and for men we add a PSA.
Stress and Aging
For stress and aging, we're looking at cortisol and DHEA.
Metabolic Panel
For the metabolic panel, we're looking at uric acid — this is a bit of a hot-topic lab, not necessarily a newer lab, but a hot topic — glucose, hemoglobin A1c, and fasting insulin. Fasting insulin is very important.
Nutrients
For nutrients, we're looking at vitamin D, magnesium, iron, ferritin, and homocysteine. Homocysteine is important because it can be an indicator of how you're methylating — methylation problems or deficiency, specific vitamin deficiencies like folate and B12. You see those elevated sometimes, and homocysteine will be elevated. And vitamin D and vitamin B12.
Liver
Then we're looking at the liver: total protein, albumin, total bilirubin, ALT, and BUN, creatinine, chloride, calcium, potassium, and sodium.
Pancreas
For the pancreas, amylase is an early indicator for pancreatic cancer, so it's always good to know that. Amylase can also be elevated if people have gallstones, which will cause problems with the pancreas. Amylase is one we've recently added, because it's an indicator for pancreatic cancer potentially, as well as inflammatory problems with the pancreas, whether it's gallbladder stones.
Electrolytes and CBC
Electrolytes we kind of already covered in the liver panel — sodium, calcium, potassium, chloride, carbon dioxide, and magnesium. And then we're going to do a CBC with differential, which includes your hemoglobin, your hematocrit, red blood cells — all that. That's a pretty common one, and you're going to get that most of the time from your general practitioner.
Normal Isn't Always Optimal
As you can tell, there are a lot of things to look at, and it's not necessarily just one thing or another. These things may be normal or within range, but they may not be optimal — and that's the important thing. It's easy to tell somebody, "Yeah, glucose is 100, so it's okay." Fasting insulin — you're probably not going to get a fasting insulin from your primary care — but those can be "normal" and in range and still be indicators of type 2 diabetes. You can identify these things years in advance, before the chronic disease even hits.
That's the whole point of emphasis in drawing these labs — trying to identify a chronic disease predecessor, something that could potentially lead you down the path to chronic disease problems. It could be anything: heart disease, type 2 diabetes and the insulin resistance that goes with it, cancers, brain health — there are a lot of things that lead to chronic disease.
A List You Can Use
So what we're going to do is put together a list of what we're looking at. You can then take that list and look at your own labs that you've had in the past. We'll give you some normal levels and optimal levels so you can compare and see where you're at, and that can give you an idea of whether you need to go to your doctor and ask some more questions.
This panel is not all-inclusive — there are a lot of things we can add on or change. Specifically, if your history leads us down that path, we may want to draw additional labs, and even genomic testing or gut testing, and food sensitivity testing. That's a whole other podcast, but food sensitivity is not necessarily an allergic situation — it's different. Sensitivities can give people a lot of problems, and gut health is a very important, vital part of health.
I feel like we say a lot of the same things over and over, but the truth is, everything is connected — that's why. So if you have any further questions, reach out to us at Revelation Health and Wellbeing, and keep following along. Hopefully we can answer all your questions, and if you have questions, shoot them out to us and maybe we'll include that in a podcast. Have a healthy day.
Thank you for tuning in to another episode of Rev Up Health. We hope you're leaving with some valuable insights to supercharge your health journey. Don't forget to follow or subscribe to Rev Up Health wherever you listen to your podcasts, and if you enjoyed today's episode, please leave us a rating and review. Have a topic you want us to explore? Reach out to us on our social media channels — we love hearing from our wellness community. Until next time, keep thriving, and remember: your journey to health is a journey to a better you. Stay well, and we'll connect with you again soon. This is Tandi, and this is Dr. Mark, signing off from Rev Up Health. Take care.
The information provided in this podcast is for educational purposes only and is not intended as medical advice. The content is designed to support, not replace, the relationship that exists between a patient and their healthcare provider. Always consult with a qualified healthcare professional before making any changes to your healthcare regimen, including diet, exercise, or treatment plans. The views and opinions expressed in this podcast are those of the hosts and guests and do not necessarily reflect the official policy or position of Revelation Health and Wellbeing.