Labs To Get Checked Every Year

A huge part of my practice is checking key wellness markers that guide my personalized recommendations for lifestyle, diet, and supplements. Some of these are not typically checked during routine annual physical “check-ups”, which means that early signs of disease in the body are often missed – until they become severe and more entrenched. You can advocate for your right to learn about your body and optimize your health proactively! 

While there are many insightful markers to consider, these apply to nearly everyone as smart proactive data: 

CBC with Differential- Complete Blood Count. Looks at white and red blood cells. Shows things like acute or chronic infection, anemia, inflammation, and possible heavy metal overload and parasites.  

CMP- Complete Metabolic Panel. Looks at kidney and liver function, blood sugar, electrolytes, markers for digestive issues, and more.  

Vitamin D- Ideally checked at least twice a year, or more often if taking a Vitamin D supplement. There is widespread debate in the medical community about “optimal” Vitamin D levels, and as with most nutrients, the answer likely varies for each unique person given their genetics, environment, lifestyle, and existing health challenges. However, clinical research is starting to uncover that significantly elevated Vitamin D might have as much negative consequence as too little. It’s important to know that Vitamin D is a steroid and a pro-hormone!  

Generally, I aim to support my clients to maintain their Vitamin D in the 40-60 ng/ml range. Lower levels are associated with a variety of types of immune deficiency. However, higher levels can be immunosuppressive; this may be useful short-term in the case of autoimmune or other aggressive, inflammatory disease. It’s important to work with a knowledgeable practitioner who can make recommendations based on your unique needs. 

RBC Magnesium (not serum, as RBC is more accurate)- You ideally want it in the upper third of the normal reference range. Magnesium is an essential mineral, involved in over 300 enzymatic reactions in the body, from nerve and muscle function to protein synthesis and blood sugar regulation. Not only is magnesium essential to optimal health, but it has also been researched for its ability to prevent chronic inflammatory diseases such as Alzheimer’s disease, hypertension, and heart disease.  

Full thyroid panel- TSH and Free T4 are not enough! Along with these you need Free T3, Reverse T3, TPO and Tg antibodies. By looking at the full panel, I have caught MANY cases of the autoimmune condition called Hashimoto’s thyroiditis, which is the most common cause of hypothyroidism. Thyroid function affects every metabolic process in the body, including mood, immunity, gut health, detoxification capability, sex hormones, cholesterol levels, and more. Checking a full thyroid panel is so important if you’re not feeling your best!  

Fasting Insulin-  One of the earliest markers for insulin resistance that is rarely (if ever) checked traditionally. Optimal is around 5 mIU/L. Here’s a scenario: Your fasting blood sugar looks “normal”, so no need to worry about insulin resistance right? Wrong. Your blood sugar might be kept within normal range by an excessive amount of insulin, which can lead to insulin resistance (and Type 2 Diabetes) over time. Our carbohydrate tolerance is unique and depends on our genetics, lifestyle, stress, and nutrition. 

Homocysteine- This is an amino acid that gets converted to other amino acids in a process called methylation. Vitamins B12, B6, and B9 (folate) are required to make this conversion. The optimal range for homocysteine is 5-15 mcmol/L. If homocysteine is elevated, that may indicate a need for B vitamins and an increased risk of heart disease, dementia, and stroke.  

When interpreting these labs I use “Optimal” ranges, because “Normal” reference ranges are not healthy or target ranges; they simply represent the statistical average (or “norm”) of what a population actually has. Keep in mind we have epidemics of chronic diseases at play in our society. In a world where the average life experience is not what we want, why would you want to be “normal”? 

Work with a Functional Medicine Practitioner who aims for “optimal” and also considers your unique symptoms. Make this your healthiest year yet!  

Be Well,  


Melissa Bunkers, MSN, FNP-BC

[email protected]

IG @revivefunctionalmed