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Five Important Labs You Might Want to Check

Tommy McElroy, MD

WHEN I WAS IN TRAINING THERE WERE FEW LABS RECOMMENDED FOR A ROUTINE PHYSICAL. In practice, I developed my own style and it involves checking a basic panel, plus a few extras depending on the the patient’s personal and family medical history.

The routine labs are:
  • Complete Blood Count
  • Comprehensive Metabolic Panel
  • Lipid Panel
  • Thyroid Stimulating Hormone
  • Urinalysis
I check those in everybody. Depending on age I may check once a year, or less often. Cost is not a concern because it costs only $38 at my practice. If those all come back normal, I’m reassured by a normal exam that everything is ‘okay.’

Now here’s a few extras I check for special cases:

Homocysteine - I check this level in patients with risk factors for coronary disease or early family history of vascular disease. It’s a less studied factor in the development of plaques in vessels, but when I was in training the stroke doctors I worked with at TGH checked it regularly and I’ve found quite a few elevated cases in patients with strong family history of vascular disease. It’s easily treatable with vitamin B complex.

Testosterone - This is a popular test among both men and women and the reason for it is this: if you are low and get treated, you might notice a huge change. Both men and women with low testosterone may complain of low energy, muscle loss, and low libido. Also those treated for low testosterone often report an improved mood which of course is a great thing!

LP(a) - This is a subclass of lipid that can cause damage to blood vessels. It is bound to ‘bad’ cholesterol LDL and can lead you to be more aggressive in treating risk factors for heart disease. Again I check this in those at risk for coronary disease. You could always check in anyone if you wanted, its fairly inexpensive through a membership medicine practice.

Vitamin D - The most overlooked blood test in my opinion. Many patients have low vitamin D levels and aren’t treated appropriately. I test anyone with bone or muscle pain, weakness, or fatigue. Again if you are deficient it is easy to treat with a high quality vitamin. I recommend checking levels before taking vitamin D even if you think you are low. It’s good to have a baseline and you may adjust the does depending on the level.

Tie - Lipid Ion Mobility, Estrogen, Progesterone, Vitamin B12, HS C Reactive Protein, MTHFR mutation, the list goes on and on.

The truth is for most patients, there are a number of labs that can be checked in conjunction with a full history and physical that might turn up something that needs to be addressed, or it may just give reassurance. I am a proactive doctor and am always looking for ways to prevent disease whenever possible, but your doctor should give you his or her best advice, so always consult your physician before starting any new drug or treatment.

Questions about this article? Feel free to ask them

Dr. Tommy McElroy is a concierge medicine physician in Wesley Chapel, Florida. He is the founder of Echelon-Health.

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