Lab work is key for measuring metabolic health. But that doesn’t mean every lab test is useful.
Studies show 30% of lab tests are inappropriate for checkups. An additional 40% to 60% are downright unnecessary.
If your doctor isn’t ordering the right lab work, you may not know if you’re metabolically healthy.
You need to know which tests to order.
Here, I’ll help you make the distinction.
3 lab tests you shouldn’t get
I’m a firm believer in testing, not guessing.
But some blood tests can leave you with more questions than answers.
These include:
Obesity/genetic testing
I’ll be blunt: genetic testing for obesity is typically a waste of time. Less than 5% of all obesity cases have anything to do with genetics, and those that do are extremely rare (occurring in less than 1% of the global population).
If your family has a history of Bardet Biedl Syndrome or Alström Syndrome, then yes, you may want to get tested. But it’s much more likely you’ve inherited bad eating habits courtesy of our broken food pyramid.
If you’re considering obesity testing, you already know you’re not healthy metabolically.
There’s no need to buy an expensive test to affirm what you already know.
Glucose screening tests
High blood sugar can wreak havoc on your metabolic health. Keeping a close eye on dips and spikes can help you make decisions about the food you eat.
However, physician-administered glucose screening tests aren’t the best way to go about this. Not only do they require multiple hours in a doctor’s office, but they’re much more expensive than over-the-counter glucose kits.
In case you’re unfamiliar, glucose screening tests involve drinking sugary liquid and waiting a few hours to test your blood. If your blood sugar spikes above the reference range (typically 140 mg/dL), your doctor may administer more tests or diagnose you with a ‘chronic’ condition.
There are a number of problems with this approach.
- As mentioned earlier, glucose screening tests can cost hundreds of dollars. Testing your glucose at home costs much less (and provides similar results).
- Trusting ‘reference ranges’ on your lab work could lead you in the wrong direction. Even if your blood sugar is less than 140 mg/dL, you still may be metabolically unhealthy.
- You’re only evaluating your glucose levels at a certain point in time. There’s no way to know what foods impact your blood sugar outside the doctor’s office.
For a better approach, use a continuous glucose monitor (or CGM). These measure blood sugar throughout the day so you can immediately see the impact of certain foods or activities.
Standard lipid testing
Testing your cholesterol is a great idea. But traditional lipid labs may fail to put your numbers into context.
Most standard lipid tests measure:
- Low-density lipoprotein (LDL)
- High-density lipoprotein (HDL)
- Triglycerides
- Total cholesterol
But they miss key components like:
- Apolipoprotein B, lipoprotein, and A-I levels
- The size of LDL and HDL particles
- The number of LDL and HDL particles
If all you see is a high LDL, you’re likely going to panic about your risks for heart disease.
However, the relationship between cholesterol and heart disease isn’t so cut and dry. A standard lipid panel removes all nuance from the conversation. It could also make statins look like your only possible solution.
Take it from me: they aren’t.
3 lab tests you should get
I want you to receive the best possible insights surrounding your metabolic health. This means ordering lab work with interpretable results — they must be accessible, holistic, and comprehensive.
Ask your doctor to order tests like:
Complete blood count (CBC)
A complete blood count measures the types of cells in your body. It’s an excellent way to monitor metabolic health and check your risks for heart attack. It can also track your response to lifestyle treatments (like eating whole, real foods) and doing resistance exercises.
Most CBCs require 12 hours of fasting, although you don’t have to limit your water intake.
Each test measures your blood for:
- Absolute Basophils
- Absolute Eosinophils
- Absolute Lymphocytes
- Absolute Monocytes
- Absolute Neutrophils
- Basophils
- Eosinophils
- Hematocrit
- Hemoglobin
- Lymphocytes
- Mean Corpuscular Hemoglobin
- Mean Corpuscular Hemoglobin Concentration
- Mean Corpuscular Volume
- Monocytes
- Neutrophils
- Red Blood Cells
- Red Cell Distribution Width
- White Blood Cells
Complete metabolic panel (CMP)
CMP is a blood test measuring metabolic functions. This includes particles in your kidney and liver, as well as blood sugar and electrolytes so you can get a holistic picture of your health.
Each test measures:
- Glucose: Your blood sugar levels.
- Liver function: Includes albumin, globulin, and more.
- Electrolytes: Like sodium, potassium, chloride, and more.
Keep in mind you may need to fast from food and water at least 12 hours before your draw.
Advanced Lipid Testing
Standard lipid testing can be a decent start for your lab work, but advanced lipid testing paints a more complete picture of current cardiovascular risks.
You can use the ratio between your triglycerides and your HDL as a predictor of metabolic health. The optimal ratio has triglycerides at 150 mg/dL and your HDL at 40 mg/dL (>50 mg/dL for women).
You can also take a look at the size and distribution of your LDL. Remember: LDL by itself isn’t the boogeyman.
If your doctor orders a lipid test, be sure to check if it’s advanced. If not, you may want to politely ask for an updated referral.
How to order the right blood work
No form of blood testing is inherently “bad.” But many are unnecessary (and needlessly expensive). It’s better to spend your money on more efficient lab work so you can get a full picture of your metabolic health.
You can order blood tests without a doctor’s recommendation, but this could be difficult depending on where you live. You also won’t have an expert to evaluate your numbers or translate data on your behalf.
But if you don’t have a doctor who ‘gets’ it, I understand. Now is the time to find a new physician.
Check out my free guide to firing your doctor here.
