A Doctor of Osteopathic Medicine (DO) is a fully licensed doctor who uses a patient-focused and preventative approach, combining modern medical treatments with an in-depth understanding of how the body’s muscles, bones, and nerves work together for overall health.
DOs integrate patient-focused care with an emphasis on prevention, using lab tests to support comprehensive health assessments.
Rooted in the philosophy of considering the whole person rather than isolated symptoms, DOs emphasize the interconnectedness of the body’s systems. This perspective extends naturally to their use of laboratory tests, which play a vital role in comprehensive patient assessments and treatment planning.
This article outlines the ten most commonly ordered lab tests by DOs, highlighting their clinical relevance in both traditional and functional medicine practices. We’ll also explore how DOs can adapt their osteopathic philosophy to functional medicine approaches to augment their practice and provide additional insight and individualized treatments for their patients.
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What is Functional Medicine?
Functional medicine is a patient-centered approach to healthcare that complements traditional medical approaches by focusing on identifying and addressing the root causes of disease. It is designed to work alongside standard medical practices to optimize patient outcomes.
By considering the interplay between genetics, environment, and lifestyle, functional medicine practitioners aim to restore balance and optimize health. This approach emphasizes personalized care, preventive strategies, and the use of advanced diagnostic tools to uncover underlying imbalances before they lead to chronic disease.
Overlaps Between DOs and Functional Medicine Practitioners
DOs and functional medicine practitioners share a holistic philosophy of care, emphasizing the interconnectedness of the body’s systems and the importance of treating the whole person, not just isolated symptoms.
Both prioritize prevention, lifestyle modification, and patient education, fostering a collaborative doctor-patient relationship. The osteopathic focus on structure and function aligns seamlessly with functional medicine’s emphasis on uncovering systemic imbalances.
For DOs new to functional medicine, incorporating this philosophy into practice can lead to more personalized, integrative care through evidence-based diagnostic tools.
The Role of Lab Testing in Osteopathic Medicine
DOs and functional medicine providers both rely on lab tests alongside patient history and clinical evaluations to uncover the root causes of illness and guide care. Functional interpretations should complement traditional diagnostic methods and be guided by clinical judgment.
Patient History Taking
A detailed history, including medical background, lifestyle, diet, stress, and environmental exposures, may help identify patterns driving symptoms. It also guides imaging and lab test selection.
Clinical Evaluation
Physical exams, imaging, and lab testing are the next steps in comprehensive diagnostics.
DOs use palpation and structural assessments to detect imbalances, imaging for structural insights, and lab tests to confirm conditions, identify imbalances, and track progress. Functional medicine providers use similar tools to identify the root cause of their patients’ illnesses.
Now, let’s discuss commonly utilized lab tests and how they inform care in traditional medicine and functional medicine.
Top 10 Commonly Ordered Lab Tests
Here are 10 of the most commonly-ordered lab tests in various medical settings; in the following section, we’ll see how we can use these tests to uncover deeper patterns in a patient’s health using functional medicine interpretation.
Commonly Ordered Tests Across Medical Specialties
The following tests are staples in many medical practices, including osteopathic care:
1. Complete Blood Count (CBC): identifies infections, anemia, and immune system abnormalities.
2. Basic Metabolic Panel (BMP): monitors kidney function, electrolyte balance, and blood glucose levels.
3. Comprehensive Metabolic Panel (CMP): adds liver function tests and common blood proteins to the BMP.
4. Lipid Panel: assesses cardiovascular risk through cholesterol and triglyceride levels.
5. Thyroid Function Tests (TSH and Free T4): evaluates thyroid health and detects hypothyroidism or hyperthyroidism.
6. Hemoglobin A1c (HbA1c): monitors blood sugar control over the previous 2-3 months.
7. Prostate-Specific Antigen (PSA): screens for prostate health in men, especially in those at risk for prostate cancer.
8. Liver Function Tests (LFTs): identify liver diseases and assess liver function and detoxification capacity.
9. Coagulation Panel (PT, aPTT, INR): monitors blood clotting and bleeding risks.
10. C-Reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR): detect systemic inflammation and monitor conditions like arthritis or infections.
Functional Medicine Perspectives on Lab Interpretation
Functional medicine expands on the traditional use of these common blood tests by interpreting results through a whole-body lens.
Functional interpretations are informed by emerging research and clinical observations but should be confirmed with additional testing and patient history.
As we’ll see, common lab tests can be interpreted through both traditional and functional lenses to provide comprehensive insights. Here’s how each biomarker can provide deeper insights into the root causes of illness and opportunities for prevention:
Complete Blood Count (CBC)
Traditionally, a CBC is used to screen for infections, anemia, and immune abnormalities.
Functional Medicine Perspective:
- Nutrient Deficiencies: evaluates potential deficiencies in iron, B12, or folate contributing to anemia.
- Inflammation: monitors elevated white blood cell (WBC) counts for signs of new or ongoing inflammation, which can be due to infection, smoking, or other causes.
- Immune Health: analyzes different types of WBC levels to assess immune function, which may indicate infections including dental cavities, some cancers or autoimmune conditions. Alterations in WBC levels can also be associated with dysbiosis or stress.
Basic Metabolic Panel (BMP)
Traditional Use: tracks kidney function, electrolyte balance, and glucose levels.
Functional Medicine Perspective:
- Hydration and Electrolytes: investigates the root cause of imbalances in sodium, potassium, or chloride levels, which can be linked to anything as serious as adrenal crisis to more common causes like high stress hormone levels or poor hydration.
- Metabolic Health: interprets fasting glucose, potentially indicating metabolic syndrome or insulin resistance.
Comprehensive Metabolic Panel (CMP)
The CMP builds on the BMP by adding liver enzyme markers for a broader metabolic view.
Functional Medicine Perspective:
- Liver Detoxification: evaluates AST, ALT, and other important enzyme levels to assess liver function and detoxification efficiency.
- Nutritional Deficiencies: considers low albumin or total protein levels as potential indicators of malnutrition or gut malabsorption.
- Metabolic Problems: early changes in liver enzymes, especially ALT and GGT, can be associated with earlier diagnosis of non-alcoholic fatty liver disease (NAFLD).
Lipid Panel
Traditionally, a lipid panel evaluates cholesterol and triglycerides to assess cardiovascular risk.
Functional Medicine Perspective:
- Metabolic Problems: the triglyceride/HDL ratio in a lipid panel can signal early insulin resistance.
- Nutritional Insights: high cholesterol and/or high triglycerides can prompt early dietary changes to optimize levels, for example, following a lower-carbohydrate diet or reducing saturated fat intake.
Thyroid Function Tests (TSH, Free T4)
Traditionally, TSH and free T4 tests are used to diagnose hypothyroidism or hyperthyroidism.
Functional Medicine Perspective:
- Subclinical Dysfunction: identifies subtle imbalances that don’t meet the criteria for a traditional diagnosis but impact energy, mood, and metabolism.
- Hormonal Balance: when used with additional testing, it can inform thyroid health alongside adrenal and reproductive hormone interactions.
Hemoglobin A1c (HbA1c)
The HbA1c test measures average blood glucose over the last two to three months to monitor diabetes.
Functional Medicine Perspective:
- Inflammation and Oxidative Stress: high HbA1c may also signal systemic inflammation or oxidative damage that accompanies high blood sugar.
- Provides Opportunities for Early Intervention: tracks trends to catch early signs of insulin resistance before diabetes develops by initiating important diet and lifestyle interventions.
Prostate-Specific Antigen (PSA)
The PSA test is one screen for prostate cancer or other prostate-related conditions in men.
Functional Medicine Perspective:
- Chronic Inflammation: PSA levels may rise in otherwise healthy men in the context of systemic inflammation or dietary influences.
Liver Function Tests (LFTs)
LFTs diagnose liver diseases and evaluate liver health.
Functional Medicine Perspective:
- Toxin Burden: elevated liver enzymes may indicate environmental toxin exposure (especially elevated ALT).
- Nutritional Deficits: low albumin, an important protein produced by the liver, may be caused by protein malabsorption or poor dietary intake.
- Gut-Liver Axis: alterations in liver function tests have been seen in gut dysbiosis.
Coagulation Panel (PT, aPTT, INR)
Coagulation panels monitor blood clotting and bleeding disorders.
Functional Medicine Perspective:
- Inflammation and Oxidative Stress: clotting issues may be signs of chronic inflammation or oxidative stress impacting vascular health.
- Nutritional Factors: consider vitamin K or magnesium deficiencies that may influence clotting times.
C-Reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR)
These biomarkers detect inflammation and are often used to monitor conditions like arthritis or infections.
Functional Medicine Perspective:
- Root Cause Analysis: these markers may identify the need for further exploration into chronic inflammation triggers such as dysbiosis, environmental toxins, stress or infections.
- Identifying Acute vs. Chronic Inflammation: CRP is considered an acute inflammatory marker, while ESR has value in monitoring chronic inflammatory conditions like lupus.
- Preventive Insights: subtle elevations in inflammatory markers may be associated with increased risks for chronic diseases like cardiovascular disease, diabetes, or autoimmune conditions.
Advanced Functional Medicine Tests for DOs
For DOs ready to integrate advanced functional medicine testing into their practice, the following assessments provide comprehensive insights into underlying imbalances, enhancing diagnosis and treatment strategies:
Vitamin D Testing
A simple blood test evaluates levels of this essential nutrient.
Vitamin D is critical for bone health, immune function, brain and heart health, inflammation regulation, and more, while low vitamin D levels are associated with cardiovascular diseases, diabetes, autoimmune disorders, and certain cancers.
Comprehensive Thyroid Panel
A more comprehensive assessment of thyroid function may be helpful in patients struggling with fatigue, metabolic issues, difficulty losing weight, mood issues, and more.
A comprehensive thyroid panel includes TSH, free and total T4, free T3, reverse T3, and anti-thyroid antibodies. It offers a complete evaluation of thyroid function, autoimmune activity, and metabolic regulation, enabling the identification of subclinical thyroid dysfunction and complex hormonal imbalances.
Adrenal Stress Index (ASI) with Cortisol Awakening Response
This test measures cortisol levels at multiple points throughout the day, including the cortisol awakening response (CAR). This more detailed testing provides greater insight into HPA axis function, stress adaptation, and adrenal health.
Organic Acids Testing
Organic acids testing evaluates key areas like mitochondrial function, nutrient deficiencies, oxidative stress, and detoxification pathways.
By testing organic acids which are often produced by mitochondria, it offers a cellular metabolic overview, helping practitioners uncover imbalances that may not be apparent in traditional testing.
Micronutrient Testing
Micronutrient testing analyzes levels of vitamins, minerals, and antioxidants, revealing deficiencies that can impair energy production, immune response, and overall health.
This test can follow up on initial tests that may indicate a potential nutrient deficiency, providing the opportunity for highly targeted dietary and nutrient protocols.
Sex Hormone Assessment
This includes testing for estrogens, progesterone, testosterone, and DHEAS. These insights are essential for addressing issues like hormonal imbalance, reproductive health, and age-related endocrine shifts, and results are often interpreted alongside thyroid and adrenal tests.
Hormone tests can be ordered using blood, urine, or saliva samples, and each sample type may reveal slightly different information.
Omega-3 Index
This test assesses the balance of omega-3 and omega-6 fatty acids, which can provide individualized dietary and supplement strategies. Optimizing a patient’s omega-3 index is important in managing inflammation, supporting cardiovascular health, and reducing chronic disease risk.
Methylation Assessment
Methylation is a chemical process that changes DNA, RNA, and proteins to control how genes work and how cells function. When methylation goes wrong, it can lead to diseases like cancer, brain disorders, and aging, but new treatments are being developed to fix these problems and improve health.
Testing genetic markers like MTHFR, MTR/MTRR, COMT, or others describes a patient’s genetic tendency toward methylation problems.
On the other hand, testing homocysteine, SAMe/SAH ratio, and/or folate or B12 levels can uncover actual methylation imbalances. Both testing methods can guide treatments to improve heart health, brain function, and overall well-being.
These advanced tests are tools for deeper exploration and are best used alongside standard diagnostic methods.
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Key Takeaways
- Holistic and Preventive Care: DOs integrate a whole-person approach with advanced lab testing to uncover root causes of fatigue, metabolic issues, and mood concerns.
- Functional Medicine Synergy: combining osteopathic philosophy with functional medicine enhances personalized, evidence-based care through advanced diagnostic tools like organic acids, thyroid panels, and adrenal tests.
- Deeper Lab Insights: functional interpretation of common tests, like CBC or lipid panels, reveals hidden patterns in inflammation, hormone imbalances, and nutrient deficiencies that may benefit from additional testing and targeted interventions.
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