Functional Labs
This lesson from the Functional Diagnostic Medicine Training Program provides a detailed guide for functional medicine practitioners on ordering, interpreting, and integrating blood chemistry and complete blood count (CBC) results. It begins with the clinical reasons for blood testing—nutritional assessment, disease screening, diagnosis, therapy monitoring, and toxin detection—then contrasts conventional reference ranges with functional‑medicine optimal ranges, emphasizing biological variability, time‑of‑day effects, and the need for consistent sampling. The historical development of optimal ranges (the “Biochemical Biopsy” study) is described, establishing a preventive, integrative approach. The authors present a core initial blood test panel (CBC with differential, comprehensive metabolic panel, lipid panel, iron panel, thyroid panel, vitamin D, eGFR, etc.) and a tracking form for merging lab data with patient history. Detailed sections cover each CBC component (white‑cell differential, red‑cell indices, hemoglobin, hematocrit, MCV, MCH, MCHC, RDW, platelets) with clinical significance of high and low values. The comprehensive metabolic panel is broken down into liver enzymes (AST, ALT, ALP, GGT), bilirubin fractions, protein fractions (total protein, albumin, globulin, A/G ratio), glucose, BUN, creatinine, BUN/creatinine ratio, electrolytes (calcium, sodium, potassium, chloride, CO₂), and derived calculations (corrected calcium, anion gap). Additional metabolic tests (HbA1c, uric acid, phosphorus, anion gap) and their pathophysiological implications are covered. Lipid panel interpretation (cholesterol, triglycerides, HDL, LDL, hs‑CRP) and cardiovascular risk stratification are explained. Iron panel components (serum iron, TIBC, ferritin) and thyroid panel (TSH, total/free T4, total/free T3) are detailed with associated disorders. The lesson concludes with vitamin D assessment, creatinine clearance and eGFR calculations, reference tables, and templates for clinical notes, assessment, and plan. Throughout, the authors stress CLIA‑compliant in‑office testing, consistent specimen timing, and integration of lab data with clinical findings for functional diagnosis.
Topics
Clinical Rationale for Ordering Blood Tests in Functional Medicine
Explains why practitioners order labs: nutritional status, disease screening, diagnosis, therapy monitoring, and toxin detection.