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The Importance of Labs

lab test vials

We get it, getting your blood dawn or collecting a sample of urine or stool is not always a fun experience. But the data we can get from these important tests can mean the difference between throwing darts in the dark or getting clear, actionable answers.



Do I Really Need Labs?

Why are they so important?

The answer here depends - when were they last completed? Have you had recent health changes? What is your family medical history like? Are there screening markers that should be evaluated based on age, gender or lifestyle? How is your nutritional?


Getting a proper set of personalized laboratory recommendations is essential for some, but not all patients. We typically avoid drawing labs on infants or those with severe needle phobia unless medically necessary. It's important to understand that labs are only one tool that we can utilize to assess the overall health and function, nutrition and genetic risk of an individual. They should be utilized when needed, but not over utilized either.


A comprehensive look at a new patient's health and baseline does often include some lab work, usually blood work and often urine examination. If this hasn't been completed in the last 6 months to a year, we will generally order it after discussion and agreement with the patient at the first visit, and a comprehensive panel will include the following:


  • CBC, or complete blood count

  • CMP, or comprehensive metabolic panel, looking at liver and kidney function as well as electrolytes and general organ function

  • Iron Panel, including TIBC, % saturation, serum iron and ferritin to get a good picture at iron levels and storage as deficiency is quite common.

  • Serum B12 and Folate levels - two B-vitamins that are commonly deficient

  • Hemoglobin A1c in adults or children at risk or suffering from diabetes to assess blood sugar over the last 3 months.

  • Standard Lipid Panel to assess cholesterol in adults and children at risk of heart disease or stroke.

  • Vitamin D3 deficiency, especially in the Pacific Northwest, but also around the world, is very common

  • Full Thyroid panel including TSH, Free T4 and Free T3 to assess thyroid function and hormone production

  • OmegaCheck, a test of essential fatty acids and their balance (think Omega-3 and Omega-6 fats) because again, deficiency of these nutrients is incredibly common.


Of course, this list is tailored to the individual and adjusted by removing unnecessary items and adding others when needed. In our years of experience seeing patients, these are the most commonly needed labs to screen for common nutritional deficiencies, screen for common diseases and assess overall organ function. When combined with a physical exam and a full medical history, this creates a powerful set of parameters from which we can make more accurate diagnoses and address foundational pieces to health which may have been easily overlooked at a general PCP's office where the 7 minute visit is the norm. At Pacific Clinic of Natural Medicine, we take our time to gather the needed information the first time, but this requires a lengthier visit with the provider in order to do so.


Want labs now? Check out our Comprehensive Thyroid Profile and our Liver and Metabolism Profiles;

Comprehensive Thyroid Test - Blood
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Comprehensive Liver and Metabolism Test
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sick cartoon woman being told her labs are normal

What if everything is normal?

This might be good news, especially if you are feeling healthy and having no problems or concerns. But if you are having symptoms and you keep being told your labs are "normal", then your providers haven't been asking the right questions of your lab tests (i.e. not ordering the right tests), or they might not be looking at the results from a more functional perspective.


Lab tests should never be the only piece of information that is looked at as no test is perfect, and they can all make mistakes (less common, but do happen) or be misinterpreted (more common). When interpreting a laboratory report, we have to take into account the patient and what they are experiencing.


A classic example that we commonly see includes thyroid hormone testing. Often only a TSH is run by most providers, even if a patient is experiencing classic symptoms of hypothyroidism, or low thyroid function, such as weight gain, fatigue, hair loss, constipation, dry skin and menstrual changes. Then they are told their thyroid testing is normal, even when all common sense and subjective findings clearly point to the problem being the thyroid. When we take a closer look at the actual result, it's 3.8, and technically still within the normal reference range, but clearly elevated when viewed through a functional lens, where optimal is ideally between 0.50 - 2.00. This example patient clearly has hypothyroidism, based on their symptoms and their labs, but it was "missed" because the TSH was still within the reference range and no additional thyroid function tests were ordered which could have revealed low free T3 and free T4 levels.


Sometimes labs are completely normal, even from a functional perspective, and it's important to remember that this is also important data because labs can also help rule out certain causes and comorbidities. Ruling out some causes helps open the door to finding lesser common causes of your symptoms by utilizing the process of deductive reasoning.



What about the reference ranges?

It's easy to think that the reference ranges provided on laboratory reports are what's considered "healthy", but that is not the case at all. These numbers are solely created by the use of statistics from large observational review of test results the lab has collected. They pool the result data and call the highest and lowest 2.5% "out of range", the remaining 95% is then called "normal".


But common, doesn't equal normal.


The population they collect this data from is never asked any questions about their health, their history, their lifestyle or their genetics. So the "normal" reference range includes people with and without disease, inflammation and chronic symptoms.


Some tests you can mostly rely on the reference range that's given, whereas others, like the TSH, honestly needs to be thrown out. Another example of this is serum B12 levels. The reference range is generally noted around 200-1100, but optimally, healthy serum B12 levels should be at least 600! Quest Diagnostics even includes a footnote with their B12 testing that states symptoms of B12 deficiency can be seen with serum levels between 200 and 400 (which is still considered normal according to their reference range).


Why then, is 200 considered "normal"? If they aren't B12 deficient yet, they sure are on their way! If the reference range were adjusted to flag anything less than 600 as suboptimal, then patients with borderline serum levels - and early B12 deficiency symptoms - could be identified and supported earlier.


borderline low B12 footnote
Borderline serum B12 footnote. They also fail to note other symptoms of B12 deficiency that were not considered when serum levels were between 400 and 600 (i.e. fatigue, anxiety, depression). These symptoms often come long before the neuropsychiatric symptoms and changes in RBCs (anemia) seen with clear B12 deficiency.
Waiting for your labs to be abnormal is like waiting for your car's check engine light to start flashing after your car is making strange noises, sputtering and running poorly.

Assessing more functional and optimal reference ranges gives you time to address the problems before they escalate and become more difficult to treat.


doctor counseling patient

We Treat People, not Labs.

Holistic and functional medicine takes into account the patient and their experience as well as the lab findings. Above I gave the example of a hypothyroid patient with "normal" labs, this is just one example of having blinders on that cause providers to miss what's right in front of them. This can create under-treatment and over time, worsening of their condition.


Failing to look at the patient can also cause over-treatment when only looking at the labs. Bacterial testing is a prime example of this. Simply because something is found on PCR testing doesn't necessarily mean it's at infectious levels or that it's causing harm - just that it's genetic material was found in the sample. Is the patient even having symptoms of that infection? Could it be a normal, beneficial bacteria for that individual? Is there any risk to the patient with having that bacteria present? If the answer is no to those questions, then antibacterial treatment may cause more harm than benefit, by promoting bacterial resistance and nuking the healthy microbiome, making it harder to treat later when the treatment may be truly warranted.


Labs Help Track Progress

When a deficiency is found, or we are working on addressing the root causes to someone's illness, tracking changes in lab values during the treatment can provide helpful information on our progress, as well as information on what is and might not be working as well as we'd hoped. This helps us fine tune the treatment plan over time so we can get better healing and better results.


woman completing at-home lab test

Standard Labs vs. Functional Labs

Standard lab panels can be incredibly helpful, especially when screening for already developed, or soon to develop disease, and when looking for already drained nutrient levels. Standard labs are limited in their offerings, depending upon insurance coverage for their tests, and providers are understandably hesitant to order tests that may be expensive and out of pocket for the patient. In addition to this, many conventional providers are not trained to interpret nutrient levels or other less common testing options that are available through standard lab companies such as Quest Diagnostics, LabCorp or similar. If a test marker, new technology, or advanced methods are used, this is also often not covered by insurance and conventional providers just don't know about them.


This is where functional lab companies truly shine. They are able to utilize more advanced testing techniques, new methods, different reference ranges, functional markers and more because they aren't under the thumb of insurance companies and whether or not they choose to cover that test. Insurance companies and the standard of care in regards to testing and treatment is often many years behind where research is currently at, and it's difficult to get system-wide changes made in these standards when it comes to labs and reference ranges.


Functional lab companies like US Biotek, Doctor's Data, Genova, GI Map, Precision Analytical Inc. (DUTCH test), and others are root-cause focused with their testing, not just looking for disease. They have better, more functional reference ranges so they can catch problems sooner, they have more expansive testing panels looking for additional markers to make the diagnosis and assessment more clear, and they focus more on the patterns that can provide real context into what's going on physiologically. They are also more preventative, and not reactive, helping optimize health and performance long before disease sets in. Last, they utilize a team of holistic professionals who put together personalized insights based on the results, such as targeted nutrition and lifestyle support and supplement protocols. Not just a "bandage" of medication for the rest of your life to manage the problem.


Here is an example of stool testing. A provider might order stool testing for digestive pathogens and common infections to see what's causing their patient's chronic diarrhea. Compare the Quest Diagnostics Gastrointestinal Pathogen Panel markers to the those tested on the US Biotek GI Advanced stool test below:


Quest Diagnostics Gastrointestinal Pathogen Panel:

Methodology - Real-Time Polymerase Chain Reaction

  • Campylobacter Group

  • Salmonella species

  • Shigella species

  • Vibrio group

  • Yersinia enterocolitics

  • Shiga Toxin 1

  • Shiga Toxin 2

  • Norovirus GI/GII

  • Rotavirus A


9 markers are tested in the stool to look for two viruses, two bacterial toxins and 5 bacteria that could cause diarrheal illness. If they are interested in looking more deeply, they might also order an ova and parasite test with giardia which would include a microscope examination of the stool for parasites, eggs and worms, as well as giardia antigen in the stool to assess for a parasitic infection. Two additional test markers for infectious causes, making 11 total.


Compare this to the US Biotek GI Advanced test markers that are evaluated via a single stool test:


US Biotek GI Advanced Panel:

Methodology: PCR, ELISA, Macroscopy and Maldi-tof Culture Technology

Expand each section to see a list of individual tests and markers assessed.

Key Phyla % Commensal Abundance

  • Bacteroidetes

  • Firmicutes

  • Firm/Bact Ratio

  • Proteobacteria

  • Actinobacteria

  • Verrucomicrobia

  • Euryarchaeota

Parasites & Worms

  • Cryptosporidium

  • Ent. Histolytica

  • Giardia Intestinalis

  • Blast. hominis

  • Dient. Fragilis

  • Endolimax nana

  • Ent. Coli

  • Pent. Hominis

  • Ascaris lumbricoides, round

  • Necator americanus,hook

  • Trichuris trichuria, round

  • Taenia species, tape

  • Enterob. Vermicularis

  • Strongyloides stercoralis

  • Enterocytozoon spp

  • Hymenolepis spp


Opportunistic Bacteria

  • Bacillus sp.

  • Enterococcus faecalis

  • Enterococcus faecium

  • Morganella sp.

  • Pseudomonas sp.

  • Pseud. aeruginosa

  • Streptococcus species

  • Streptococcus aureus

  • Streptococcus agalactiae

  • Streptococcus anginosus

  • Streptococcus mutans

  • Streptococcus oralis

  • Streptococcus salivarius

  • Staph. aureus

  • Methanobacteriaceae

  • Desulfovibrio piger

  • Enterobacter sp.

Potential Autoimmune Triggers

  • Citrobacter sp.

  • Citrobacter freundii

  • Klebsiella sp.

  • Klebsiella pneumoniae

  • Prevotella copri

  • Proteus sp.

  • Proteus mirabilis

  • Fusobacterium sp.

Fungi & Yeast

  • Candida sp.

  • Candida dubliniensis

  • Candida glabrata

  • Candida intermedia

  • Candida krusei

  • Candida lambica

  • Candida lusitaniae

  • Candida parapsilosis

  • Candida albicans

  • Candida famata

  • Candida kefyr

  • Candida lipolytica

  • Geotrichum sp.

  • Saccharomyces cerevisiae.

  • Rhodotorula sp.

Bacterial Pathogens

  • Aeromonas sp.

  • Campylobacter sp.

  • difficile, Toxin A

  • difficile, Toxin B

  • Enterohaemorrhagic E. coli

  • Enteroinvasive E. coli/Shigella

  • Enterotoxigenic E. coli LT/ST

  • Shiga-like toxin E. coli stx 1

  • Shiga-like toxin E. coli stx 2

  • Enteroaggregative E. coli

  • Enteropathogenic E. coli

  • E. coli O157

  • Hypervirulent Clostridium difficile

  • Salmonella sp.

  • Vibrio spp

  • Yersinia enterocolitica

  • Helicobacter pylori PCR & EIA 

  • pylori virulence factors (x11)

Viral Pathogens

  • Adenovirus 40/41

  • Norovirus GI/II

  • Rotavirus

  • Sapovirus (I,II,IV,V)

  • Astrovirus (hAstro)

Normal Bacteria/Flora

  • Bacteroides fragilis

  • Bifidobacterium sp.

  • Bifidobacterium adolescentis

  • Bifidobacterium bifidum

  • Bifidobacterium breve

  • Bifidobacterium longum

  • Enterococcus species

  • Lactobacillus species

  • Lactobacillus acidophilus

  • Lactobacillus casei

  • Lactobacillus delbrueckii

  • Lactobacillus plantarum

  • Lactobacillus rhamnosus

  • Lactobacillus salivarius

  • Clostridium sp.

  • Enterobacter sp.

  • Akkermansia muciniphila

  • Faecalibacterium prausnitzii

Macroscopy Examination

  • Stool Colour

  • Stool Form

  • Mucous

  • Occult Blood

Short Chain Fatty Acids

  • Butyrate

  • Acetate

  • Propionate

  • Valerate

GI Functional Markers

  • Calprotectin

  • Pancreatic Elastase

  • Secretory IgA

  • Zonulin

  • b-Glucuronidase

  • Steatocrit

  • a-Transglutaminase IgA

  • PH Level

Microbial Culture Along-side PCR (Dual Method)

  • Bacteria

  • Yeast

Antimicrobial Sensitivities

  • Antibiotics

  • Natural

  • Antifungals

  • Natural Antifungals



This is more than 127 markers of infectious bacteria, viruses, yeast, parasites and worms, inflammatory markers, markers of GI function, prebiotics (short chain fatty acids), as well as stool culture, microbiome assessment and comparison with healthy reference ranges and balances.


GI Advanced Comprehensive Digestive Test
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In Conclusion:

Symptoms are clues, never the answer by themselves.

We all have hidden imbalances that can be hard to identify, especially when you can't see them easily with your eyes. Functional and standard Labs help uncover what we can't see, guide treatment, track progress and help identify root causes when symptoms alone fall short. With the right data, you can feel empowered to make informed decisions on your treatment and start feeling your best now, not years from now.



Ready to Dig Deeper?

If you're ready to go beyond "normal" and actually get some answers, we offer a wide range of functional lab tests you can order directly through our clinic. These tests give you powerful insights into your hormones, nutrient status, toxic burden and more.

Comprehensive Adrenal Function Test - Doctor's Data
Buy Now

Food Sensitivity Test Kit - 96 General Foods
Buy Now

Nutrient Testing - Metabolomix+ with Essential Fats
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DUTCH Complete Test Kit - Urine
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