The End of Illness: 6 Blood Tests You Should Ask Your Doctor To Do

Jan. 17, 2012— -- The following passage is adapted from The End of Illness by Dr. David B. Agus. Find out more about The End of Illness at the ABC News special section.

***

Have your doctor run the following tests, all of which can be obtained through a simple blood draw:

Fasting lipid profile: This is a group of tests that are often ordered together to determine risk of coronary heart disease; they include your cholesterol and triglyceride numbers. You have to fast for about twelve hours prior to the test, but you can drink water.

Levels of high-sensitivity C-reactive protein: As previously indicted, this is a biomarker of inflammation, which can point to your risk for cardiovascular trouble, among other things, if your levels are high.

Comprehensive meatbolic panel (CMP): This is a frequently ordered panel of tests that gives your doctor important information about the current status of your kidneys, liver and electrolyte and acid/base balance as well as all of your blood sugar and blood proteins.

Complete blood cell count (CBC): This is one of the most commonly ordered blood tests, which is the measure of the concentration of white blood cells, red blood cells, and platelets in the blood. The size of your red cells can be a good indicator of nutritional deficiencies. You want this number, called the mean corpuscular volume, or MCV, to be between 85 and 95 fl. You also want to see that your red cells come in all different sizes, which shows cells at different stages in their life span.

Thyroid stimulating hormone (TSH) test: Your thyroid is your master metabolism hormone. If it's out of balance, guess what? So is your whole system. An underperforming thyroid (hypothyroidism) is one of the most underdiagnosed conditions in America, yet it's incredibly common -- especially in women. It's believed that 20 percent of all women have a "lazy" thyroid, but only half of women get diagnosed. Unfortunately, no single symptom or test can properly diagnose hypothyroidism. To arrive at a trustworthy diagnosis, you'll also need to look at your symptoms. These can include weight gain, fatigue, constipation, hair loss, and even shortened eye-brows, as one of your thyroid's functions is to regulate how quickly your cells replenish themselves. When your levels of theyroid hormone drop below normal, the effect can be seen in almost every cell in your body, including your hair follicles. To fix a thyroid problem, you'll also need to look at the whole picture -- all the things that make up your lifestyle. (A rarer condition called hyperthyroidism happens when the thyroid goes into overdrive, producing too much thyroid hormone. This also has negative effects on the body, triggering heart and bone problems among other things).

Hemoglobin A1C: To understand what a hemoglobin A1C is, think in the following simple terms: Suagr sticks to things, and when it's around for a long time, it gets harder and harder to remove. In the body, sugar also sticks, particularly to proteins. The red blood cells that circulate in the body live for about a hundred days before they die, and when sugar sticks to these cells, it gives doctors an idea of how much sugar has been around for the preceding three months. In most labs, the normal range is 4 to 5.9 percent. In poorly controlled diabetes, it's 8 percent or above, and in well-controlled patients it's less than 7 percent. The benefit of measuring hemoglobin A1C is that it gives a more reasonable view of what's happening over time (about three months), and the value does not bounce as much as finger-stick blood-sugar measurements. When there are no guidelines for using hemoglobin A1C as a screening tool, it gives a physician a good idea that someone is diabetic if the value is elevated. It's one of the few tools doctors can use to look at an "average" in you that you cannot fib. Diabetes can just happen. It's not just about being overweight, so if you suddenly develop this disease for whatever reason, you don't want to miss that.

Although your doctor will test your vitals, you need to remember that she is only testing these metrics at one particular moment in time. She won't have running averages for your numbers over the past six months. While it's common for many of us to keep track of our weight throughout the year, we might also want to track other metrics -- and should -- if we're at risk for certain things. You can easily track your temperature and blood pressure using kits you can buy at your local pharmacy. You may want to check your blood pressure at different times of the day two or three times a week to see what kind of fluctualtions you're getting. Make a spreadsheet and start to record the numbers at certain intervals throughout the day. Add notes to indicate what's going on when you take the test, such as that you've just had a relaxing glass of wine or just got off a troubling phone call that made you tense. Bring that spreadsheet with you to your doctor.

NOTE for Men ONLY: When you get a PSA test, have your testosterone levels checked as well. Testosterone controls levels of PSA, so your body's production of testosterone will affect your parameters for "high" versus "low" levels of PSA. What's considered high for one person might not be the case for another person. Also, abstain from sexual activity and bicycle riding for several days prior to the test. While these activities don't affect the PSA level of everyone, they can negatively influence results and cause undue stress if you're told to repeat the test.