As our patient, you receive copies of all your test results. Dr. Herdman will carefully explain what they mean, so that you leave your visit with a thorough understanding of the reports and with a plan to improve your health.
In the clinic, Dr. Herdman carefully tests for many aspects of health and metabolic function. Her in-depth annual blood panel includes testing for thyroid function, liver and kidney health, protein levels, glucose and the long-term blood sugar marker HbA1c, fasting cholesterol and triglyceride panel, ferritin – an important measure of the body’s ‘savings account’ of iron that is often overlooked, blood cell count, and vitamins B12 and D3, which are often low and very easily replenished. For patients with possible inflammatory conditions, Dr. Herdman would run tests to rule out auto-immune disorders, such as ESR (sed rate), lupus and rheumatoid arthritis markers, and maybe Sjogren’s or scleroderma antibodies. To thoroughly assess cardiovascular risk, we like to run a high-sensitivity C-reactive protein (CRP) level, homocysteine – an amino acid made in the body that if elevated can increase heart risk. Other useful tests for cardiovascular health include a screen of lipid particle sizes, and lipoprotein (a) – a cholesterol-protein-fat molecule which can also raise cardiovascular risk if it is high.
For patients who are under stress or have sluggish thyroid function, we often check cortisol. This requires two blood draws on the same day, at 8-9am and then 3-4pm. Cortisol naturally has a diurnal rhythm, higher in the morning and low in the afternoon. We assess whether overall levels are adequate versus too high or low. Also we watch to see if the adrenals can produce enough morning cortisol – and if they cut back their afternoon production and allow the body to relax out of flight-fight readiness for action. If any levels are low or high, possibly affecting energy, mood, bone density, heart health and blood sugar levels, our first line treatments include botanical and nutritional support to restore adrenal function. For patients with unexplained high blood pressure, we may test another adrenal hormone called aldosterone, which regulates sodium balance in the body. Thyroid testing generally includes careful tracking of TSH; free T4 and T3 levels for people taking these replacements; TPO and other antibodies to screen for auto-immune thyroid disorders. Tracking parathyroid hormone is important for calcium balance.
Many vitamin and mineral tests are useful, and one of the most crucial is vitamin D3. We aim to bring blood levels of 25-hydroxy vitamin D to between 60-100 ng/mL for each patient to fully receive the benefits of vitamin D3.We regularly assess ferritin, the body’s iron store, and also vitamin B12 which is commonly low, and now very easy to correct with a tasty, safe tablet under the tongue. Other mineral testing includes red blood cell magnesium, rather than serum, because the body’s magnesium mostly occurs inside cells.
In addition to blood testing, Dr. Herdman may recommend bone mineral density measurement every 18 months to two years, to assess how effective hormone or progesterone prescriptions are to improve bone density; and to see if the patient’s calcium, magnesium, zinc and vitamin D3 intake are adequately supporting healthy new bone mineralization. Other tests that may be recommended for some patients include mammograms or breast ultrasounds for people who prefer those, EKG, and other imaging.