Since there are thousands of tests available, for both practical and economic reasons it behooves us to perform only those tests deemed most useful in order to identify the nature, cause, and or severity of a particular disorder. One important guideline is “never order a test if the results won’t change the way you will treat”. While there may be some exceptions, it is still useful to think in those terms.
The tests doctor Mundall finds most useful include the following:
General chemistry panel:
Nowadays this is often called a comprehensive metabolic panel, or CMP. This panel typically includes the blood sugar or glucose, electrolytes (sodium, potassium, chloride, etc.), certain other minerals (calcium, phosphorus), liver enzymes, kidney function tests, and occasionally another test or two.
Lipid panel:
This profile usually includes the cholesterol, triglycerides, HDL and LDL fractions of cholesterol, and occasionally other calculated values such as the VLDL and the Total cholesterol:HDL ratio.
CBC:
The CBC, or complete blood count, looks at the three types of blood cells:
White blood cells, or WBC’s, are the body’s “soldiers”, attacking microbes.
Red blood cells, or RBC’s, transport oxygen to all the cells of the body.
Platelets repair damage to blood vessels, creating blood clots to fill “holes” in the walls.
Sedrate:
The sedrate, or, more correctly, “sedimentation rate”, measures the lack of homogeneity of the blood, which increases in the presence of inflammation, whether from infection, anemia, immune disorders, tissue damage, or cancer. While non-specific, it is useful in monitoring the severity and trend of certain disorders. Another test which has a similar function is the C-reactive protein, or CRP.
Zinc Protoporphyrin:
The zinc protoporphyrin (ZPP), is ordered primarily to help detect iron deficiency in children and to detect and monitor chronic exposure to lead or other toxic heavy metals such as mercury in adults. Heavy metals inhibit the action of ferrochelatase, resulting in increased ZPP formation even when adequate amounts of iron are present. ZPP is thought to be a better screening test for lead burden (the total amount of lead being held by the body) than a lead concentration because lead levels tend to vary day to day in the blood and because lead moves from the blood into organs and bone. While blood samples for lead may be contaminated by any environmental lead present at the time of collection, ZPP is not affected.
Thyroid Stimulating Hormone:
Thyroid Stimulating hormone, or TSH, is a hormone produced by the pituitary (base of the brain) which tells the thyroid gland how hard it should work. More TSH usually means that the thyroid gland is not producing an adequate supply of thyroid hormone. In addition to checking the TSH, we sometimes choose to measure the amount of circulating thyroid hormone (T4), and other thyroid hormone levels.
Thyroid antibodies:
Anti Nuclear Antibody:
Rheumatoid Factor:
This test is used to identify the presence of antibodies directed towards the joint proteins, and is thus used to diagnose rheumatoid arthritis.
ABO and Rh blood typing
Other Cardiovascular risk factors:
Homocysteine
Lipoprotein a [Lp(a)]:
Other blood tests:
Occasionally other blood tests are ordered, depending on the symptoms.