Providing a diagnosis can be confirmed when both the symptoms and laboratory values correspond to a disease or condition. Screening tests provide information for further and more detailed tests, biopsies and imaging which leads to a diagnosis. Treatment is best initiated when all tests and diagnostics have been completed and interpreted in most cases. Testing can also be used as a tool to monitor treatment response and look at preventative strategies when test results are borderline.
What is a Full Panel Blood Test?
Depending on the panel ordered, there can be multiple tests run. The Healthy Living Assessment includes hematology (platelets, red and white blood cells and their statistics), metabolic markers (4 of which relate to blood sugar and minerals), basic thyroid testing, inflammatory proteins, electrolytes, liver, kidney and lipids. If more information is desired, individual tests can be added on to this panel, or the upgraded version, the Enhanced Healthy Living Assessment can be requisitioned. Additional tests in the Enhanced panel include Vitamins B12 and D, insulin, and the inflammatory marker ESR (Erythrocyte Sedimentation Rate).
Hematology
Examining the components of blood gives great insight into the immune system, reasons for fatigue, possible cancer, clotting disorders and infections. Hematology is also referred to as a CBC, or complete blood test. The standard CBC panel includes details about white blood cells, red blood cells and the platelet count. The total amount of white blood cells can help screen for infections, cancers and nutrient deficiencies. There are multiple types of white blood cells and several are tested for to provide more details about infections and cancers.
Red Blood cells can be too high or too low in numbers. Different statistics such as size, volume, shape and amounts of components such as hemoglobin will allow for different conditions to be confirmed. Anemia, or lack of red blood cells, can be due to multiple nutrient deficiencies including iron, Vitamin B12 and folic acid. These parameters help to narrow down the cause. This Healthy Living Assessment also includes multiple ways to evaluate iron levels such as ferritin, iron saturation and total iron binding capacity.
Platelet numbers can help to investigate clotting disorders or monitor treatments such as prescription drug doses. Some nutrients, when deficient, can also contribute to low counts.
Lipids
Several different types of lipids, or fats are found in the blood stream. Monitoring levels of cholesterol and triglycerides can lead to treatment which helps prevent coronary artery disease, stroke and heart attacks. Lipid panels typically provide levels of LDL, HDL and total cholesterol. From these numbers, a risk ratio is calculated to provide insight when the risk of cardiovascular disease is higher than normal.
Triglycerides are a different type of fat that has also correlates, when high, to cardiovascular disease. The combination of elevated triglycerides and low levels of HDL puts patients at a particularly high level of risk.
Liver
Enzymes that are made in the liver can be monitored for inflammation of the liver and bile ducts. Normally, levels of these enzymes are low and other proteins such as albumin which is made in the liver are well regulated. Liver enzymes ALT, AST and GGT are the primary markers most often tested for liver health and to rule out conditions such as fatty liver disease, metabolic syndrome and cirrhosis. Other markers such as different forms of bilirubin provide insight into bile production and breakdown. Cholesterol is made in the liver, thus a complete panel should evaluate both lipids and liver enzymes.
Kidney
Renal, or kidney function can be tested both by blood and urine analysis. Conditions that affect the kidneys are serious because kidneys filter and control what leaves the blood and is turned into urine. Filtration rates are tested using values such as creatinine and blood urea nitrogen (BUN). Kidney function and electrolyte balance are helpful to look at together and often are ordered at the same time.
Electrolytes
Potassium, chloride, sodium and bicarbonate are the typical electrolytes tested. The Healthy Living Assessment also includes calcium and phosphate which can be considered both electrolytes but also metabolic and cardiac. Hydration levels, kidney filtration and serious diabetic complications become evident when evaluating electrolytes.
Inflammation Markers
C-Reactive Protein (CRP) is a very common blood marker that provides information about general inflammation in the body. If elevated, it can point to inflammation in the cardiovascular system, but multiple other sources can trigger high levels. Fibrinogen is a protein involved in clotting and elevated levels can be a sign of blood clots. If the Enhanced Healthy Living panel is ordered, an additional test is run called the erythrocyte sedimentation rate (ESR) to learn about an acute inflammatory response.
Thyroid
While only the basic TSH value is included in the Healthy Living Assessment, a full thyroid analysis can be ordered. This panel is called the Enhanced Thyroid Assessment and tests TSH, Free T4, Free T3, Reverse T3, antithyroglobulin and anti-thyroperoxidase antibodies. Evaluating the interactions between the hormones and the levels of the antibodies can help to confirm a diagnosis of Hashimoto’s thyroiditis, hypothyroidism, hyperthyroidism, subclinical hypothyroidism and cellular hypothyroidism.
What is the Process for Getting a Full Panel Blood Test?
A naturopathic physician, medical doctor and a nurse practitioner can provide requisitions for blood and urine tests. Usually an appointment is required to discuss symptoms, family history and other risk factors for disease prior to ordering these tests. Once the requisition has been signed, the patient can make an appointment at a local laboratory or show-up and wait in line.
Preparing for a Blood Test
Many blood tests require a period of fasting prior to the blood draw. The Enhanced and Healthy Living Assessments require overnight fasting prior to visiting the lab. Testing in the morning within a few hours of waking up is ideal. No food should be consumed, no coffee either and drinking only water will yield the most accurate results. If testing Vitamin B12 or Vitamin D levels, it is best to stop supplementing 3 days before. Those individuals that take thyroid medications should not consume their thyroid medications before the blood test, but to take it right after so a dose is not missed. Other medications might also be postponed in the day, it is best to ask the ordering practitioner prior to testing.
During the Blood Test
Blood tests are usually very quick and cause minimal to no pain. A tourniquet is applied to the upper arm to help the veins become more full of blood and to speed up the process. With panels, multiple small tubes of blood will be extracted and the whole process takes only a few minutes. Applying pressure on top of a cotton or bandage will help to prevent or minimize bruises.
What Do Full Panel Blood Tests Test For?
Testing can be used to learn about current overall health and to monitor specific treatment. General wellness can be assessed for values that are starting to go out of range and preventative protocols initiated. Many times when borderline test results appear, dietary changes, improvements to sleep and stress and exercise can be all that is needed to return levels to a healthier range.
What are Common Results for Full Panel Blood Tests?
Results should always be interpreted by the ordering practitioner because multiple factors with testing, symptoms and family history combine to provide a diagnosis. Test reports give numerical values that are specific to the blood sample provided. A range of normal values called the reference range is stated beside the patient’s results to help with interpretation. Most often values are identified as normal, meaning within the range, or as abnormal. Results may also be stated as positive or negative.
Positive Results
Positive results means that the identifying factor (protein, antibody, bacteria, virus etc) was found in the sample. This usually confirms a diagnosis. Typical common examples of blood test positive results are for infectious conditions such as mono, sexually transmitted infections, and many other viruses, bacteria and fungi.
Negative Results
A negative result means that the factor in question was not found in the sample. Most often this excludes a diagnosis, infection or other condition. In the case of a pregnancy test, negative would mean that a woman is not pregnant.
Why is it Important to Get Regularly Tested?
Regular testing helps to identify early stages of a condition which usually results in preventing progression with interactions such as nutrition, exercise, herbs, vitamins and sometimes pharmaceuticals. Once a disease is present, regular testing can provide insight into medication doses, rate of progression or regression and if conditions have caused other systems to be involved.
Screening tests and panels such as the Healthy Living Assessment can be completed on an annual basis as a wellness check. Results can provide feedback to changes in diet, exercise, supplementation and medications. Keeping records of results over the years can also help to identify changes even if symptoms remain the same.
Questions to Ask Your Doctor
Naturopathic physicians can order the Enhanced and Healthy Living Assessment panels. These are both offered on the Lifelabs requisition as a group of tests performed together to ensure the complete panel is tested. Medical doctors and nurse practitioners can test the same panels, however each individual panel must be checked off to see all of the same results. Be sure to ask your ordering practitioner if testing requires fasting, stopping of medications and the best time to complete the blood draw.
Here are examples of a Healthy Living Assessment Report and an Enhanced Healthy Living Assessment Report.
Other Important Full Panel Tests
There are many other panels that can be ordered, depending on the specific area of evaluation. The Enhanced Thyroid Assessment gives the most complete picture of thyroid health and can confirm Hashimoto’s Thyroiditis, hypothyroidism, subclinical hypothyroidism, hyperthyroidism and cellular hypothyroidism. Other hormone panels are available, however there are multiple ways to test hormones including urine and saliva which may be preferred in some cases.
The Enhanced Thyroid Assessment
This panel is the best way to get a clear view of thyroid function and thyroid inflammation. Six blood markers including 4 hormones and 2 auto-antibodies are tested, add-ons for an even more comprehensive thyroid analysis can include iron (ferritin), Vitamin D25OH, fasting insulin, serum selenium, zinc and red blood cell (RBC) Magnesium levels.
Fatigue Assessment
Those with low energy that is unexplained would benefit from the Fatigue Assessment at Lifelabs. This includes hematology, basic thyroid, iron markers, Vitamin B12 and a test for mono. These tests can be individually ordered depending on other concurrent symptoms or put together as a panel.
Female Fertility Assessment
This complete panel looks at multiple hormones that influence fertility. AMH (anti-Mullerian hormone), TSH, free T4, estradiol, free and total testosterone, progesterone, prolactin, LH, and FSH. For best results, this panel should be split into two different blood draws according to the menstrual cycle. Day 3 and Day 21 are the preferred days to evaluate hormones for fertility.
