In the functional medicine world, we are all about preventive care. But, there aren’t a ton of resources written on helpful testing – the sort to catch potential health conditions early or look deeper at the root cause of your symptoms.

I’ve prepared this list because I want you to be equipped with testing you can take to your doctor. With this approach, you’ll know if there are areas of your health you need to work on… earlier rather than later.

It is my hope that this list guides you and helps you catch issues before they become a problem. So you can get a handle on anything before it creeps into your life.

If you’re thinking “22 things to check – that seems like a lot of tests!” Do remember that many of these tests are interconnected and crucial to giving you a snapshot of your health at 30 years. You may not need all of them so best to discuss with your functional medicine doctor before ordering.

For example, so much emphasis is placed on the cause and the risks of autoimmune diseases – but can’t we see the potential for autoimmunity years before your symptoms start? We can!

So, why not find out early? When you can make changes that may even prevent clinical symptoms. Preventative care has the potential to save you a lot of time, money, and heartache.

Let’s begin!

1. Food sensitivity testing

Typically at least 96 types of food are tested. Symptoms for food sensitivity can often be very sneaky, masquerading as a headache or stomach bloat. An undiagnosed food allergy can provoke a low-level autoimmune response.

2. Micronutrient testing

Deficiencies in one or more vitamins or minerals is a national problem in the US, due to the popularity of the standard American diet. Even if you’re not experiencing any of the common symptoms, such as dizziness, tingling in the hands and feet, fatigue it’s worth exploring as lack of micronutrients can upset the balance of your immune system, weakening it, and causing inflammation. Vitamin B12, folate, zinc, magnesium, selenium, and copper are most important. Some of my favorite labs are Vibrant America and Spectracell.

3. Inflammatory cardiovascular markers

These tests include:

• Homocysteine
• PLAC
• hs-CRP
• Oxidized LDL
• MPO

Testing your inflammatory cardiovascular markers is crucial as autoimmunity and several heart diseases are intrinsically linked. Atherosclerosis, where plaque builds up in the walls of your arteries is an autoimmune disease. These tests help evaluate your heart health and whether your immune system is on high alert.

4. Advanced Lipid testing

A more detailed test for cholesterol in your blood, advanced lipid tests check for high levels of cholesterol particles which can lead to atherosclerosis (plaque build up). It includes tests for oxidized LDL and particle size which give a better indication that total LDL of your cardiovascular risk.

5. Heavy metals

Heavy metals can be tested through a blood or urine sample, and the test is crucial in determining if there are high levels of metals in your environment. Mercury in particular is linked to the development of autoimmune disease. Blood will typically reveal recent exposure while a chelated urine challenge can give a better idea of total body burden. It is important to check mercury, lead, cadmium, aluminum, and arsenic.

6. Complete thyroid panel

The following needs to be tested:

• TSH
• Free T4
• Free T3
• Total T3
• Total T4
• TPO
• TgAb
• Reverse T3

Your thyroid gland is a powerhouse that regulates your metabolism – controlling your temperature, heartbeat rate, hormone levels, and weight. If this balancing act is altered in any way, it can result in an autoimmune disease like Hashimoto’s. Thyroid dysfunction can be predicted with early testing.

7. Autoimmune antibodies

We call this “predictive autoandibody testing” because it can predict if your body may be brewing future autoimmune diseases. This umbrella term covers many tests but the two most common are:

• Antinuclear Antibody (ANA) Panel
• Extractable Nuclear Antigen (ENA) Panel

These tests check for misbehaving antibodies that may be attacking your healthy tissues. The antibodies are an early predictor of autoimmune disease. Other labs such as Vibrant America and Cyrex labs domore comprehensive auto-antibody testing.

8. Two-hour insulin glucose test

Testing for insulin resistance is crucial to determining if you are at risk of developing one of the leading autoimmune diseases – diabetes. Very important to reveal who is prone to an abnormal insulin response to glucose.

9. Hemoglobin A1c (HbA1c) Test

A test that goes hand in hand with the two-hour insulin glucose test, but the HbA1c test focuses on your average blood sugar level over the past couple of months. I like my patients to test less than 5.5.

10. Vitamin D levels and 1,25 hydroxy vitamin D

Checking levels of vitamin D and 1,25 hydroxy vitamin D – the substance your body needs to metabolize vitamin D – is crucial to determining your metabolic health. Not only does vitamin D promote bone growth, but it acts as an anti inflammatory, keeping your immune system in check.

11. Stool test

A stool test checks for yeast, abnormal bacteria or parasites in your gut, while checking the number of ‘good’ bacteria in your gut microbiome. If your gut health is poor then it can lead to leaky gut and autoimmunity. Many patients don’t realize they are carrying around extra organisms or dysbiotic bacteria that can cause endotoxemia or toxicity from within.

12. Blood pressure check

You may have your blood pressure checked regularly at your doctor’s office, but a blood pressure check alongside these other tests can be illuminating. The new blood pressure guidelines mean that many more women are more likely to have prehypertension. High blood pressure indicates an autoimmune response in your body.

13. Celiac testing

I recommend testing for Celiac disease even if you have no symptoms because silent Celiac disease can lead to leaky gut and other immune system compromises. Not only should you be tested for things like TTG IgG and IgA and anti-gliadin antibodies but I also like to check all patients for celiac genes to determine their risk of autoimmunity.

14. Fatty acid testing

This test measures the levels of fatty acids in your blood, and more specifically Omega-6 and Omega-3. These fatty acids help ease inflammation in your body, so lower levels may indicate a increased risk of developing autoimmune issues. High levels of arachidonic acid may contribute to pain and inflammation.

15. Lipid Peroxide

High levels of lipid peroxides indicate damage on a cellular level by oxygen free radicals. Injury to cells increases the chances of inflammation and and autoimmune response to the damaged cells.

16. White Blood Cell Differential

This test checks the levels of your white blood cells, red blood cells and platelets. Low or high numbers may indicate an acute or chronic infection. Low hemoglobin may also indicate anemia.

17. Hormone panel

I advise checking your sex hormone levels to get ahead of metabolic autoimmune disorders such as polycystic ovaries syndrome (PCOS). This would include estradiol, estriol, estrone, free and total testosterone, DHEA-S, Am cortisol and progesterone at the minimum.

18. Adrenal profile

This test focuses on the hormones secreted by your adrenal glands. Of particular note is cortisol – your ‘stress’ hormone. High levels can suppress your immune system and in the long term can increase your chances of developing an autoimmune disease. Generally this is done through urine spot testing or saliva samples taken throughout the day.

19. Homocysteine

High levels of this amino acid in your blood indicates the potential of developing atherosclerosis. In addition this tells me about the patients ability to methylate and potential deficiencies of nutrients critical to methylation, like B12, folate, riboflavin, B6 and SAMe. I prefer that patients are less than 9 and if symptomatic, less than 7.

20. Iron panel including ferritin

Ferritin is a protein that stores iron, and releases it when needed. I prefer ferritin be greater than 50. They also work as an autoimmune suppressor, so high levels indicate a potential issue with your immune system. Too much or too little iron will both cause issues on patients so important to check if your levels are normal.

21. Genetics

Important genes to look out for Include:

• MTHFR gene mutation – the MTHFR gene controls the methylation process of your body, responsible for DNA repair, energy production, hormone regulation, and detoxification. The mutation makes you more susceptible to developing an autoimmune disease.
• Celiac genetics –important to determine if gluten could be a trigger to your health issues.
• HLA typing – your body uses these markers to determine which cells belong in your body – and what cells are intruders. If you carry a mutation of this gene, it can cause autoimmunity where your immune system begins to attack healthy tissue.

22. Sleep Study

Patients with obstructive sleep apnea have a higher risk of developing an autoimmune disease. As sleep apnea can often go undiagnosed for several years, I recommend undergoing a sleep study for peace of mind.

Conclusion

My list of tests for people in their early thirties should serve as a useful resource for anyone focused on maintaining their optimal health. The way each test compliments each other is testament to the importance of taking a systemic approach to your health.

In functional medicine it’s especially important to examine where your health and genetics are at currently, so we can tailor a individual treatment plan for you. These test also offer baseline information for the future.

I hope you opt to check early so you can take personalized steps to improve your health for a full and energized life!