In root cause medicine, doctors often use blood work as a window into a patient’s health. Functional Medicine is a personalized approach to a patient’s chief complaint. An initial blood screen can help practitioners prioritize where they need to dig deeper, often in places overlooked by conventional medicine.
To give you more insight on this subject, we sat down with 5 of Rupa’s MDs to learn more about a functional medicine approach to conventional blood work.
Dr. Jennifer Simmons
Dr. Simmons spent the vast majority of her career as one of the country’s top breast surgeons until an unexpected autoimmune disease diagnosis drastically changed her trajectory. Dr. Simmons dove headfirst into educating herself on root-cause Medicine, through which she was able to regain her health.
In 2019, Dr. Simmons left her position as a renowned breast surgeon to start her functional medicine practice, Real Health MD, focusing on prevention and optimal wellness.
Dr. Simmons Annual Functional Medicine Blood Test
CBC w/ Diff
Often used in conventional Medicine to indicate organ failure, a CBC with a functional perspective not only focuses on blood cell count but also analysis of the size of cells. Learn more about the importance of the CBC from Dr. Weatherby in Rupa University.
C-Reactive Protein (CRP)
CRP, measured in conjunction with an extensive lipid panel, provides a full picture of both inflammation and cardiovascular health, making CRP a key screening tool for most chronic diseases.
Lipid Panel (total cholesterol, calculated LDL, triglycerides)
Dr. Simmons stresses the importance of paying close attention to both the size and number of HDL and LDL particles. When the LDL size is abnormal, the risk increases. Read more about the importance of advanced lipid testing here.
Fasting Glucose and Fasting Insulin
Practitioners often only measure fasting glucose, but adding fasting insulin is a practical and effective way to detect insulin resistance and get a better overview of the development of diabetes.
Extensive Thyroid Panel (TSH, Free T3, Free T4, Reverse T3, Total T3)
“The days of just checking TSH are gone,” said Dr. Simmons as she walked us through the complex interactions of the thyroid gland. Sometimes results do not show a production problem, but instead a conversion problem from T3 or reverse T3, which happens in the gut.
Vitamin D, 25-OH
Something conventional MDs often don’t measure. Vitamin D levels should be tested, supplemented, and reassessed until stable.
Order Dr. Simmons Panel on Rupa Here
Dr. Christopher Davis
As an interventional cardiologist, identifying risk early is critical in Dr. Christopher Davis’ practice. After ten years of practicing conventional medicine, Dr. Davis became frustrated with the system in which he was constrained to treat his patients. He felt it was more reactive than preventative, and he wasn’t able to spend the time with his patients that he wanted.
“From a reimbursement perspective, I had to see more and more patients to make up for the cost. That wasn’t the career I wanted, and it wasn’t why I wanted to be in medicine. I wanted to learn about nutrition and be an advocate for my patients.”
Similar to Dr. Simmons, Dr. Davis relies on bloodwork to indicate inflammation – often at the root of chronic cardiovascular conditions.
Dr. Davis incorporated functional medicine into his cardiovascular practice as a way to “look under the hood” of someone’s health. To do that, he uses the following blood tests.
Dr. Davis' Annual Functional Medicine Blood Test
CBC w/ Diff
Dr. Davis mentions he utilizes this as a strong indicator of liver function.
Complete Thyroid Panel (TSH, Free T-3, Free T-4, Thyroid Peroxid AB, Thyroglobulin AB)
In functional medicine, exclusively looking at TSH only scratches the surface. To truly understand autoimmune issues, Dr. Davis emphasizes the importance of a full thyroid panel.
Advanced Lipid Panels
“I focus a lot on preventative cardiology. I will not order a regular cholesterol panel. I use advanced lipid panels,” Dr. Davis explains that the standard lipid panels taught in conventional medicine often only provide an entry-level snapshot into cardiac risk. It’s not just about knowing cholesterol, HDL, and LDL numbers; it’s about the size of the particles, as well.
Micronutrient Panels
Laughing, Dr. Davis says, “We all know about B12, including your regular doctor. But what about B2, B9, B6?” Comprehensive micronutrient panels are often left out of the equations but are necessary to understand methylation reactions and “understanding what goes on under the hood.” Dr. Davis explains
Order Dr. Davis' Blood Panel on Rupa Here
Dr. Dave Gordon
Dr. Dave Gordon opened a conventional internal family medicine practice directly after finishing med school, but it didn't take long for him to realize that the things he'd learned in medical school didn't actually improve his patients' health – at least, not in the ways that he wanted to.
"So the rest of my career, I started learning, talking to folks, and incorporating different tools to expand my practice to be more integrative. By the time I heard the term 'functional medicine,' I was already doing it."
Like many functional doctors, Dr. Gordon tailors his blood panels depending on his patient's age and needs. However, as a starting point, Dr. Gordon typically uses the following tests:
Dr. Gordon Functional Medicine Annual Blood Test
CBC w/ Differential
Basic Lipid
Comprehensive Metabolic Profile
TSH
Vitamin D
For patients who need to dig a bit deeper, Dr. Gordon recommends adding on his Expanded Thyroid and Cardiac Panels.
Expanded Thyroid (TSH, Free T3, Free T4, Reverse T3, Total T3, Anti-thyroglobulin, AB's, anti-TPO AB's)
Expanded Cardiac (Lipid panel, ApoA, ApoB, Lp(a), Oxidized LDL, total cholesterol, triglycerides)
Like all of the physicians we spoke to, Dr. Gordon adjusts his panels based on his patient's needs.
Functional medicine is about taking a personalized approach, and not all testing is necessary for everyone. For his patients over the age of 50, he errs on the extensive side of cardiovascular testing. For those under 50, he focuses more on metabolic health and chronic disease.
Order Dr. Gordon's Blood Panel on Rupa Here
Dr. Indira Maharaj-Mikiel
Dr. Maharaj-Mikiel is a family medicine doctor who began incorporating functional approaches to her practice after identifying gaps in the conventional system.
She did her own research to start connecting the dots, well before there was formal training for functional medicine practitioners.
“I remember thinking when I was in med school, ‘How do people function when we take out a third of them – [their whole appendix]? So much of your system is involved, and conventional testing doesn’t connect it all.”
Dr. Maharaj-Mikiel believes in the simplicity of care and acting as a teacher and guide for her patients to reach optimal health. She laughs as she describes to me how shocked her patients are when she tells them her philosophy:
“There is nothing I can do to make you healthy.”
But instead, she views her role as a teacher, educator, and coach, to equip her patients with the necessary tools to become healthy on their own—a simple philosophy and one that dramatically differentiates conventional doctors from integrative and functional practitioners.
Dr. Maharaj-Mikiel's Annual Functional Medicine Blood Test
CBC W/ Differential and Platelets
CMP
Iron
TSH
CRP
Order Dr. Maharaj-Mikiel's Blood Panel on Rupa Here
Dr. John Sosa
Dr. John Sosa is a Board Certified Family and Medicine Lifestyle Physician who emphasizes the importance of diet and lifestyle changes to replace prescription medications with healthy behavior and supplements. He focuses on primary, holistic care to prevent, treat, and reverse chronic diseases.
For Dr. Sosa, analyzing blood work becomes an opportunity to educate his patients, modify behavior, and improve their overall health.
“As a root cause practitioner, you have to weigh the risk. You have to be comfortable with finding something abnormal and up for the challenge of navigating your patients through that. You need to know what you’re looking for, and more importantly, you need to know what you’re going to do once you find it.”
Dr. Sosa’s Core Lab Panels
CBC w/ Diff and Platelets
CMP
HDL, Triglycerides, Total cholesterol, LDL
HbA1c
TSH with reflex
Vitamin B12 with folate
Vitamin D 25-05,
Urinalysis w/ reflex culture (when available).
Order Dr. Sosa's Blood Panel on Rupa Here
Ready to jump in with your own root cause approach?
None of the physicians we chatted with originally planned on incorporating functional medicine into their practice. In fact, the majority of them were adopting the root-cause approach well before they knew it had a name.
Through research, self-education, sometimes self-experimentation, and patience, these medical doctors discovered what works: personalized and systemic approaches to care.
They weren’t afraid to challenge the norms that conventional structures had imposed on them and instead relied on their medical intuition.
It can be a scary leap to convert your practice to root cause medicine, but our MDs’ advice? Start simple. Pick one area of your patient’s health that seems less than optimal, and dig deeper. Trust that the time, energy, and effort you will put into connecting the dots will pay off. Education is key, and Rupa has many educational resources, like Rupa’s Live Classes, Podcast, and Magazine, to help get you there faster.
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