Which labs to order, and why?

This post highlights the labs I recommend for proactive heart health—because when it comes to your heart, prevention is essential, and a LOT more enjoyable too!
The evolution of lab testing: Why once-a-year labs aren’t enough
Let’s face it: the old practice of running labs once a year at your annual physical just doesn’t cut it anymore.
While this approach is perfectly fine if all your markers are looking good, it falls short when something needs attention.
- For example, if your triglycerides are flagged as high, you might focus on improving them for a few weeks immediately after you receive your results—only to forget about them until next year’s labs reveal they’ve worsened.
This reactive approach leaves little room for meaningful change. That’s why many of my clients now monitor their labs more frequently.
Regular lab reviews allow us to spot trends early and make adjustments before problems escalate. This is the essence of proactive heart health.
Don’t overlook the potent power of information on basic labs
While advanced tests provide detailed insights, we can garner great insights from basic labs like the Complete Blood Count (CBC) and Comprehensive Metabolic Panel (CMP).
Here’s what these tests can reveal about your cardiovascular health:
- Insights from the CBC:
- Low hemoglobin may indicate anemia, which forces your heart to work harder.
- Elevated white blood cell (WBC) counts can signal chronic inflammation.
- High platelet counts may increase clotting risk, while low counts could result in excessive bleeding.
- Insights from the CMP:
- Elevated fasting glucose significantly increases heart disease risk.
- Poor kidney function can lead to fluid retention and high blood pressure.
- Elevated liver enzymes may indicate fatty liver disease or inflammation, both linked to metabolic syndrome and cardiovascular risk.
By regularly reviewing CBC and CMP results, we can detect potential issues early and take action to improve heart health before complications arise.
Key labs for proactive heart health
Here are the labs I recommend reviewing regularly to assess and optimize cardiovascular health:
Standard Labs:
- CBC & CMP: Foundational tests for overall health insights.
- Hemoglobin A1c (HbA1c): Reflects average blood sugar levels over ~3 months.
- TSH (Thyroid-Stimulating Hormone): Thyroid function directly impacts heart health (more details in a previous newsletter)
- CRP & ESR: Non-specific markers of inflammation.
- Uric acid: High levels are associated with increased cardiovascular risk.
Cardiovascular specific markers:
FYI - Thankfully these are being tested more frequently these days...if they're not being tested make sure you ask why.
- ApoB: A key marker for assessing LDL particle count and cardiovascular risk (more details in a previous newsletter)
- Lipoprotein(a): A genetic factor linked to cardiovascular disease (more details in a previous newsletter)
- Homocysteine: Elevated levels can indicate inflammation and increased heart disease risk.
Functional medicine reference ranges matter
When interpreting lab results, functional medicine practitioners often use narrower, aka “optimal”, ranges rather than standard lab reference ranges.
For example:
- Fasting blood sugar: Standard range goes up to 99 mg/dL, but ideally it’s <95 mg/dL.
- HbA1c: Standard range goes up to 5.6, but ideally it’s between 4.8–5.4%.
- Fasting insulin: Standard reference ranges vary, but Ideally it should be <8 mIU/mL.
- Uric acid: Standard range is 2.5–7.1 mg/dL, but optima/functional medicine prefers ≤5.5 mg/dL.
- TSH: Standard range is 0.45–4.5 mIU/L, but functional medicine prefers <2.5 mIU/L.
- C-Reactive Protein (CRP): Standard range goes up to 3.0 mg/L, but iIdeally it’s <1.0 mg/L.
These tighter ranges help identify potential issues earlier and allow for more precise interventions.
Additional markers for fatigue & overall wellness
Many clients come to me with fatigue as a primary concern, which often overlaps with cardiovascular health issues.
In addition to the labs above, I recommend checking:
- Vitamin D
- Iron & Ferritin
- Vitamin B12 & MMA (Methylmalonic Acid): MMA detects B12 deficiencies earlier than B12 alone.
The path to better heart health
Improving lab markers typically takes 3-4 months but every step you take brings you closer to better overall, and heart, health.
By addressing blood sugar imbalances, reducing inflammation, optimizing thyroid function, and supporting nutrient levels, you’re laying the foundation for lower blood pressure readings and long-term cardiovascular wellness.
Ready to be proactive about your heart health?
For new clients I offer a complimentary 30-minute proactive heart healthy strategy session to make sure we’re a good fit, confirm my expertise matches your needs and to agree your most appropriate path forward. Click this link to apply for your FREE strategy session.