Most of us don’t think much about blood work tests — they’re something your doctor periodically orders for you, and that’s that. But there are actually tons of different types of laboratory tests that can tell you important information about your body and help you feel your absolute best. It can be confusing to figure out which tests you need, and how to interpret the results, so we sat down with functional medicine practitioner Dr. Carrie Jones to demystify the topic. Read on to learn what types of laboratory tests you really need, the difference between a natural medicine doctor (or naturopath) and an MD, and much more.
ND vs. MD: The Difference Between a Natural Medicine Doctor and a Medical Doctor
When it comes to an ND (natural medicine doctor or naturopathic doctor) vs an MD (medical doctor), what’s the difference? Turns out there are a lot of similarities — but also a lot of differences.
Just like MD’s, natural medicine doctors go to medical school for four years, and then have the option of doing a two-year residency. The differences lie, primarily, in the overall attitude each type of practitioner takes toward healing. “A naturopathic doctor definitely has the bigger view of the healing power of nature, a more vitalistic approach, really getting to the root cause,” says Dr. Jones.
One of the most important guiding principles for a natural medicine doctor is something called the therapeutic order, which stipulates that a doctor’s interventions should go from least invasive to most invasive, in that order. While Dr. Jones wishes that more conventional doctors would follow that order, it’s much more common for MD’s to jump straight to the most invasive option: the pill or the surgery.
A natural medicine doctor, on the other hand, wants to look at why you’re experiencing a problem, and reverse engineer to see if there’s a natural approach, like diet and lifestyle changes, herbs, or supplements that could solve it. If a natural approach doesn’t work, then the therapeutic order has you move up to a more invasive intervention, like pharmaceuticals or surgery — but you always try using natural remedies before anything else. This is because, as you move up the therapeutic order, the more invasive interventions like drugs or surgeries are much riskier and come with many more side effects like possible adverse reactions, life-threatening medical errors, or complications from surgery, for example.
“It’s a really nice option to be a naturopathic doctor,” says Dr. Jones. “We have this huge scope that we can work in, and lots of tools that we can use for you as a patient.”
The Moment that Led Dr. Carrie Jones to Become a Natural Medicine Doctor
When Dr. Jones went to medical school, she had every intention of being a traditional medical doctor. But early in her educational journey, she had a realization that led her to switch tracks and become a natural medicine doctor. As with many of the experts that we’ve interviewed, Dr. Jones had a specific experience that led her to shift courses from conventional to naturopathic medicine. “It was definitely a moment,” she says.
During her education, Dr. Jones spent time working in two different hospitals. One was the pediatric wing of a hospital, which she describes as “very sterile, not humanistic.” She remembers thinking, “if this is medicine, if I’m just going to prescribe and it’s going to be very scrubbed down, very impersonal, very fast — that’s not the kind of medicine I want to practice.” At the other hospital, she worked in the outreach program, doing blood pressure checks and educating people on blood pressure, weight, and diabetes. “It was very education-based, and I loved it,” Dr. Jones says.
It was the contrast between those two experiences that made her realize she wanted to study naturopathy and become a functional medicine practitioner. Her school in Ohio didn’t have functional or naturopathic medicine, and so she moved to Oregon to continue her education. With naturopathic medicine she loved that she could really spend time with her patients, work with them on lifestyle and dietary changes, and talk about nutrients, minerals and herbs before jumping to the prescription pad.
“I just got really disillusioned, and I’m really happy that I found naturopathic medicine,” Dr. Jones says. “It’s the medicine for me.”
Today, Dr. Jones has over 12 years experience in the field of naturopathic and functional medicine, which includes serving as an adjunct faculty member for the National University of Medicine and taking on the role of medical director for two large integrative clinics. As a specialist in women’s health, she has taught courses in both gynecology and advanced endocrinology, and is the current medical director for Precision Analytical, which makes a hormone test called the DUTCH Test (btw, WellBe readers can get $50 off a DUTCH test with code gwb50. How great is that?!!).
The Two Issues with Conventional Blood Work Tests
We’re all familiar with getting blood work tests done at the doctor’s office, and it’s natural to think that lab work is lab work, right? Why does it matter if it’s performed by a functional medicine practitioner or a conventional doctor? Well, as Dr. Jones explained to WellBe, not all blood work tests are created equal. In fact, Dr. Jones says there are two main issues with the laboratory tests that conventional doctors run vs those run by natural medicine doctors or functional medicine practitioners.
First of all, there’s the fact that routine blood work tests just don’t cover very much. If you’re experiencing health issues — hair loss, fatigue, brain fog, whatever — and go into a conventional doctor asking them to run a full panel, they’ll do something called a CBC, or complete blood count. Though a CBC looks at your red and white blood cells and gives you some good information, Dr. Jones explains that it’s not super helpful unless you’re outright anemic or have an outright infection.
Still, many doctors stop at this point. Some might run a CMP — comprehensive metabolic panel — which gives kidney and liver markers, as well as glucose, potassium, and calcium levels. Again, this is a quick screen that provides some good information, but isn’t all that useful. Usually, Dr. Jones says, conventional doctors will see that the results come back within normal range for these tests and declare that everything is fine. Unfortunately, she says, these one or two tests are generally not enough. Doctors need to look at more specific and subtle indicators, things like the thyroid, for instance.
Dr. Jones’s second irritation with routine blood work tests has to do with the ranges given for various tests. She explains that most ranges are WAY too large, and conventional doctors are quick to say that someone is healthy if they’re anywhere within the range. For instance, with TSH (thyroid stimulating hormone), the healthy range might go up to 4 or 5, “but, functionally, we might want it down around 2.0 or 2.5. But if you’re at 4.9 and 5 is the cutoff, you might get told you’re fine, and you’re not fine,” says Jones. “You’re almost out of range. You’re almost abnormal. Why wait to get to abnormal?”
Another example she cites is the range for ferritin, a marker for iron storage, where the range is anywhere from 10 to 200 — that’s a 190-point spread that’s still considered healthy and normal by most doctors. The way Dr. Jones sees it, it’s not a good idea to accept a particularly high or low number as normal, just because it’s technically within range. “We can optimize this,” she says. “Why wait? Why wait until you fall off the cliff to do something about it?”
So while MDs and NDs might be running some of the same blood work tests, and even sending them off to the same labs, they’ll read them very differently. A conventional doctor will just look at the literal range and deem you normal or abnormal, whereas a functional medicine practitioner or natural medicine doctor will optimize the results for you and what you’re looking for.
What Types of Laboratory Tests Are Most Important?
There are so many types of laboratory tests out there, and for the average person it can be quite confusing to figure out which ones matter most for your health. Luckily, Dr. Jones spoke frankly with us about which types of laboratory tests are the most important.
“The number one test that people forget about is your lipid numbers, your cholesterol numbers,” she says. This is so important because cardiovascular disease is the number one killer for both men and women. But, Dr. Jones explains, it’s essential to get advanced tests, not just a basic one that tells you what your total cholesterol is. While looking at total cholesterol doesn’t tell you much, advanced tests look at particle size and markers of inflammation, telling you the size and composition of your cholesterol, and how inflammatory they are. “You can test this stuff every year and then track it,” Jones says. “You could have seen the pattern through the years and been like ‘Oh, I need to do something about this.’”
She also recommends getting tested for markers of diabetes: insulin fasting, glucose fasting, hemoglobin A1C fasting. Again, she emphasizes the importance of testing these specific levels and then monitoring them over the years. If the numbers start to rise, Dr. Jones says, she can swoop in and intervene while lifestyle changes — things like improving diet, reducing stress, sleeping better, and exercising — can still make a difference. Conventional testing often waits until somebody is already prediabetic to intervene, at which point the disease is much harder to reverse.
Another important type of laboratory test is vitamin D levels. Jones says that vitamin D deficiency is quite common, and that the “healthy” range is far too large. “I know a lot of conventional doctors just follow the range,” she says. “But if you’re down in the low end of the range, you might be at an increased risk for maybe cancer or autoimmune or mood issues or bone issues, and so we have to be careful of that lower vitamin D level.”
The last test that Dr. Jones recommends is thyroid levels. She explains that it’s important to look at more than just TSH, which is the marker between the brain and the thyroid, but doesn’t actually give the levels of the hormone that’s in our system. Both Hashimoto’s thyroiditis and Graves disease are autoimmune conditions related to the thyroid, and Dr. Jones says there’s been a rise in both over recent years. “It’s just incredible,” she says. “And if we can catch it and intervene early in somebody, then that’s so much better than 10 years from now, where you feel terrible and you’ve been falling apart for 10 years.”
While the types of laboratory tests listed above are very important, you can oftentimes simply take basic laboratory tests and expand upon them a bit to give a more comprehensive sense of what’s happening in your body. Then, track your numbers over the years. The tracking part, says Jones, is essential:
“I think people forget that health is their responsibility, so I’m always telling people, ‘Keep your lab results.’ If you’re organized, create an Excel spreadsheet, write it down, keep it in a file folder.”
This way, she says, you can watch trends and make changes before a problem arises, rather than being blindsided and scared by lab results in the future. “If you track and pay attention and do it regularly, then it’s so much easier,” Jones says.
The WellBe Takeaway: What to Remember About the Different Types of Laboratory Tests
With all the lab jargon and types of laboratory tests out there, this might seem like an overwhelming topic to navigate. But as Dr. Carrie Jones explains, it’s actually quite simple. The key points to remember are:
In most cases, a functional medicine practitioner or natural medicine doctor will read the results of your blood work tests much differently than a conventional doctor will. They will optimize for your health and consider long-term risk, rather than just looking at the “normal range.”
Blood work tests done by conventional doctors are often very basic, and seeing a functional medicine practitioner can help you get the more specific, advanced tests you need.
For many types of laboratory tests, the normal range is way too big. If you’re very close to the high or low end of normal, there may be an issue.
The most important types of laboratory tests that Dr. Jones recommends are: lipid/cholesterol markers, diabetes markers, vitamin D levels, and a full thyroid panel (not just TSH, which is what a conventional doctor would usually test for).
In order to take control of your health and catch a problem before it gets too serious to address with lifestyle changes (note that even at late stages, the problem may still be reversed with lifestyle changes, the problem may just get life-threatening enough that a drug or surgery is required), it’s important to keep your lab results, track your numbers over time, and look for trends.
Watch the rest of our interview with Dr. Carrie Jones to learn what conventional doctors miss in hormone tests, the best types of laboratory tests to diagnose inflammation or gut issues, what she thinks about at-home diagnostic testing kits, how to find a doctor who will give you the types of laboratory tests you want, and much more. You can also listen to an audio version of this interview on The WellBe Podcast.
The information contained in this article comes from our interview with Carrie Jones, ND, a Naturopathic Physician with a Master’s in Public Health. Her qualifications and training include graduating from the National University of Natural Medicine (NUNM), School of Naturopathic Medicine in Portland, Oregon where she also completed a 2-year residency in women’s health, hormones and endocrinology. Later she graduated from Grand Canyon University’s Master of Public Health program. As an Adjunct Faculty for the National University of Natural Medicine (NUNM), she has taught courses in both Gynecology and Advanced Endocrinology. She has been the Medical Director for two large integrative clinics in Portland, Oregon and currently is the Medical Director for Precision Analytical, Inc. You can find more information about her here.