Why Conventional Bloodwork Falls Short: What Your Doctor Isn’t Testing (But Should Be)
Conventional medical bloodwork is designed to detect disease, not optimize health. And that’s a huge problem.
If you’ve ever gone in for your "annual check-up" only to be told that everything looks “normal,” yet you still feel "not normal." Maybe you feel exhausted, anxious, or just not quite right. You’re not alone.
Many routine lab panels miss early warning signs of chronic conditions like cardiovascular disease, insulin resistance, thyroid dysfunction, pernicious anemia, iron deficiency, and inflammation—conditions that, when caught early, are entirely manageable with diet, lifestyle, and targeted supplementation.
In my naturopathic medical practice, I take a preventative approach to bloodwork. Instead of waiting for something to go wrong, I order a comprehensive annual lab panel for my patients, designed to catch imbalances before they become full-blown diseases.
Here’s what’s typically included in conventional bloodwork—and what’s missing.
What’s Usually Tested (And Why It’s Not Enough)
Most conventional doctors order a Basic Metabolic Panel (BMP) or Comprehensive Metabolic Panel (CMP) and a Complete Blood Count (CBC) during an annual exam. Some may add a lipid panel (cholesterol) and occasionally a TSH (thyroid-stimulating hormone) only if they suspect thyroid dysfunction.
🔹 CMP (Comprehensive Metabolic Panel) – Measures glucose, electrolytes, kidney, and liver function.
🔹 CBC (Complete Blood Count) – Checks for anemia, infection, and overall blood cell health.
🔹 Lipid Panel – Measures total cholesterol, LDL, HDL, and triglycerides.
🔹 TSH (Thyroid-Stimulating Hormone) – Checks one aspect of thyroid function (but is not a complete thyroid panel).
💡 The Problem? This is the bare minimum for detecting severe disease—but not for catching early warning signs.
What’s Missing (And Why It Matters)
Here’s what I order for my annual patients—and why these extra tests are critical for identifying health issues before symptoms even start.
Metabolic & Inflammation Markers
🩸 Fasting Insulin – Even if your fasting glucose is "normal," high insulin levels indicate early insulin resistance—often years before diabetes develops.
🩸 Hemoglobin A1c – Measures long-term blood sugar levels and diabetes risk.
🩸 hs-CRP (High-Sensitivity C-Reactive Protein) – A marker of chronic inflammation, which plays a role in heart disease, autoimmune conditions, and metabolic disorders.
🩸 Homocysteine – Elevated levels increase the risk of cardiovascular disease and neurological disorders.
🩸 Sedimentation Rate (ESR)– Another key marker of systemic inflammation.
Iron & Nutrient Testing
🩸 Iron Panel + Ferritin – Low iron stores cause fatigue, hair loss, and poor exercise recovery—even if you're not technically anemic.
🩸 Vitamin B12 & Folate – Essential for energy, brain function, and nerve health. Low levels can mimic depression, fatigue, and even dementia.
🩸 Vitamin D 25-OH – 80% of Americans are deficient! Low vitamin D levels are linked to mood disorders, osteoporosis, immune dysfunction, and even cancer risk.
Complete Thyroid Panel
Most doctors only check TSH, but this alone does not give a complete picture of thyroid health. I order:
🩸TSH – Thyroid-stimulating hormone.
🩸 Free T3 & Free T4 – The active thyroid hormones that actually impact metabolism.
🩸TPO & Thyroglobulin Antibodies – Detects Hashimoto’s (autoimmune thyroid disease), which often goes undiagnosed for years.
👉 Why does this matter? Many people suffer from undiagnosed hypothyroidism because conventional medicine only tests TSH, which can be "normal" even when you have low thyroid function.
Advanced Cardiovascular Labs
For patients around 50 or older, or those at higher cardiovascular risk factors, I run advanced heart disease markers beyond the basic cholesterol panel.
🩸 Lipoprotein(a) [LPA] – A genetic risk factor for heart disease.
🩸 Apolipoprotein B (ApoB) and Apolipoprotein B (ApoB) – A more accurate marker of heart disease risk than LDL cholesterol alone.
🩸 Small density LDL (sd LDL) – is a subtype of low-density lipoprotein that is smaller, denser, and more prone to oxidation, making it more atherogenic and a stronger predictor of cardiovascular disease than regular LDL.
🩸 PLAC (Lp-PLA2) – an enzyme linked to vascular inflammation and plaque instability, making it helpful in assessing the risk of heart attack and stroke, especially in individuals with hidden cardiovascular risk.
Prostate health: PSA (For Men Over 40)
For my male patients over 40, I also test Prostate-Specific Antigen (PSA) to screen for prostate health.
Other Screening Guidelines We All Consider Important
The last thing to consider, which is often discussed in ‘Annual Check-Ups,’ is assessing risk and the need for other screenings dependent on your age, gender, and risk factors. These include Colonoscopy, Breast Mammography, DEXA scan to determine bone mineral density, skin checks, sexually transmitted infections (STIs), and PAP smears for women.
Not All Providers Interpret Labs the Same Way
Please note that functional medical providers may have different reference ranges than others, conventional or otherwise. While something may say ‘normal’ on the lab report, it may not be assessed the same with another provider!
Why This Approach Saves Lives (And Prevents Disease Before It Starts)
Taking a functional and preventative approach to bloodwork can identify imbalances before they become chronic conditions.
🔎 Example 1: A woman in her 30s comes in with fatigue, anxiety, and brain fog. Conventional bloodwork shows everything is “normal,” but my comprehensive panel reveals low ferritin, low vitamin B12, and suboptimal thyroid function. By addressing these deficiencies, she gets her energy and mental clarity back—without unnecessary medications.
🔎 Example 2: A 50-year-old man is told his cholesterol is "fine" based on his total cholesterol and LDL. My advanced cardiovascular panel shows he has elevated ApoB and Lp(a), putting him at high risk for a heart attack—years before conventional medicine would have caught it.
These are things that can be improved NOW before symptoms begin.
Take Control of Your Health with Comprehensive Testing
You're probably right if you’ve ever been told your bloodwork is "normal," yet you know something is off. Conventional bloodwork is designed to detect disease—not optimize health.
The good news? You can take a proactive approach. By testing for the right markers, we can:
Catch deficiencies before they cause symptoms.
Identify inflammation before it turns into disease, optimize thyroid, and improve metabolic health for better health.
I am here to help you along the way. Please note that I can only order blood testing for those who reside in California and Colorado, but I can still provide interpretation guidance if you have had these tests ordered by a local provider.
Here to empower you with the knowledge of health,
Dr. Meg Holpuch
Disclaimer: The information provided on this blog is for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. The content shared here is not meant to replace or supersede the guidance or recommendations of your personal healthcare provider. Always consult your physician or qualified healthcare professional before making any changes to your diet, exercise routine, supplement regimen, or overall health plan. Your health and well-being are unique, and decisions regarding your care should always be made in consultation with your trusted healthcare provider.
