In some cases, based on many factors, I will skip some of these tests. In many cases we add additional tests.

In addition to the number of tests, the evaluation I do differs from conventional medical evaluation in two important ways. First, I employ an optimal, as opposed to a "normal", reference range. Secondly, I utilize a nutritional-metabolic interpretation of the data. These objectives are facilitated by use of a computer program.

When I get test results on a patient, I enter the data into the Blood Detective program, which was created by my colleague Dr. Michael Wald. This program analyzes hundreds of these tests with two different sets of reference ranges. We look at the results with the laboratory's reference range, which is what all doctors go by. In addition, the computer program flags test values that are outside of the more ideal healthy range.

This is a critical concept. Laboratories typically establish reference ranges by testing a sample "apparently healthy" group of individuals. Reference ranges are then set up so that 95 out of 100 people tested will fall into the normal range. Two and a half percent of people will have low levels, two and a half percent will have high values, and everyone else will have test results that are considered normal. These reference ranges are not God-given; they are far, far from perfect. Should you be comfortable and at ease just because your test result is "normal" compared to the average American? Look around you. The average American is not the specimen of optimal health, wellness, and vitality! Being "normal" or average is nothing to brag about. Optimal is a better goal.

As an example, let's look at blood sugar values with the hemoglobin A1C test. This test measures the percent of the oxygen-carrying protein called hemoglobin that has been structurally damaged by sugar. Hemoglobin is found in red blood cells, which live about 3 months. Therefore hemoglobin A1C gives an indication of the individual's average blood sugar over the past three months. We are all continually suffering structural damage from sugar throughout our bodies and hemoglobin A1C is one of the readily available tests to check this. (For more on this subject see my newsletter entitled "#1 Under-Appreciated Factor in Health and Aging"). If your hemoglobin A1C is over 6.5 you are diabetic. In recent years, their is finally a recognition that people are not simply normal or diabetic. There is a continuum whereby things slowly deteriorate and blood sugar gradually creeps up. (This is the case with most lab tests: you don't simply jump from optimal to abnormal; first you pass through a "gray" zone near the lower or upper end of the reference range. Isn't it better to catch and act upon a borderline abnormality before the condition becomes more advanced?) Many labs now report that if your hemoglobin AIC is 5.7 or higher then you may be at increased risk to diabetes. However, I have known of research for about ten years that associates a hemoglobin A1C of 5.5 with an increased risk for heart disease. A more optimal goal for this blood test is 5.0 or less. The Blood Detective program will report any hemoglobin A1C above 5.0 as abnormal.

Briefly, a few other examples: Conventional laboratory reference ranges may consider values of ALT to be normal if they are under 60. However, values over 18 in women may actually be an indication of liver cell damage.

Thyroid hormone levels are a very contentious subject. Thyroid stimulating hormone (TSH) levels increase when the thyroid is underactive. Laboratories commonly set an upper limit at about 5.5. So, if your value is 5.4 your thyroid is supposedly fine. TSH measurements are logarhythmic, so that small changes represent big changes in function. In reality, a TSH above 2.5 is suspicious for an underactive thyroid.

Lastly, if your total cholesterol is 120 your doctor may celebrate...but this number is too low. Most laboratories don't have a lower limit on the cholesterol reference range. Does that mean a cholesterol of zero is O.K.? Cholesterol is most concentrated in the brain and low levels have many associated adverse effects. (For more, see "Is Your Cholesterol Too Low?"). My Blood Detective program flags a total cholesterol level of less than 160 or more than 180 as abnormal.

The Blood Detective report lists the patient's value, the conventional laboratory reference range, and the optimal reference range for each test. Only tests that are abnormal (by either reference range) are included in the report. Normal test results are not discussed.

Below is a report on an actual patient of mine. This is my most striking case for illustrating the value of the Blood Detective analysis. She had received no help from conventional medicine for her digestive symptoms. I referred her for the routine comprehensive blood work-up. Not a single test came back abnormal. The conventional interpretation shed no light on what was wrong with her. An allopathic doctor might conclude the condition was all in her head: she needed a vacation or an antidepressant. However, the optimal health reference range found 18 different tests to be abnormal. Based on this information my treatment plan helped resolve her symptoms quickly and I only saw her a total of two or three times.

  

Blood Detective Lab Results Report - giving more meaning to blood test results

The Blood Detective results are described with an Evaluation Report, which gives a definition of the abnormal test, common conditions that cause the abnormality, follow-up investigations to consider, and supplements and foods that may help to improve the value. The Evaluation Report is typically dozens of pages long. (Click below for a sample report). The Evaluation report not only discusses diseases associated with a given lab abnormality but also discusses metabolic and nutritional relationships. Many of the routine blood tests are not simply an evaluation for the presence or absence of disease. They also give insight into a variety of physiological functions. For example BUN, or blood urea nitrogen, is a breakdown product of ammonia, derived from amino acids or protein. When BUN is low it likely is an indication of either inadequate dietary protein or impaired digestion.

Click for a sample Evaluation Report

 Don't wait for a "full-blown" disease to show up in your blood work. Have a Blood Detective analysis to understand what is going on in your body at a deeper level and catch things earlier.