Last review: February 15, 2021.
Introduction.
Many important blood and urine tests are often omitted in the labs ordered by medical practitioners and patients themselves. Below, we listed some of them with short comments and suggestions.
The list below includes only selected markers. This list is not exhaustive.
There is no need to test all of the markers listed below each time you do blood and urine tests.
Your past laboratory test results usually contain a lot of information already. You can save money by skipping the tests that are unlikely to bring new information about your health.
Blood tests:
Sometimes or often absent on standard panels:
Phosphorus
Potassium
“Iron status”
Iron status is extremely important.
Physiological Literacy, Significance:
“hemochromatosis (a hereditary disease leading to iron overload) can cause both primary and secondary hypogonadism.”
Even when mild, iron excess may expose to long-term complications.
Liver biopsy in athletes with elevated blood ferritin:
“Liver biopsy was normal except for the presence of a marked parenchymal siderosis mimicking genetic hemochromatosis.” (DEUGNIER, 2001).
Parenchymal siderosis develops as abundant iron-rich granules around bile canaliculi.
From an exam question in a medical school:
“Up to 45% of men will be impotent at the time of diagnosis (of hemochromatosis).”
Analysis: Iron overload without hemochromatosis may have similar deleterious effects, affect other tissues.
Liver health:
Total protein
Albumin
ALT
AST
AP
GGT
Bilirubin, total
Bilirubin, direct
(SHBG)
(Glucagon)
(Iron status)
A non-invasive assessment of liver fat content and liver iron content.
Calcium metabolism. Minimalist blood tests.
PTH
25(OH)D, [“vitamin D”]
(Calcium)
(Phosphorus)
(Albumin)
Also, minerals in urine, if there are indications.
Significance:
From Yu, 2017:
Vascular calcification occurs frequently in patients with chronic kidney disease (CKD) and is a consequence of impaired mineral homeostasis and secondary hyperparathyroidism (SHPT).
Male reproductive hormones.
Minimalist male reproductive hormones panel.
Total testosterone
SHBG
Estradiol
(Cortisol)
(Albumin)
(Complete Blood Count (CBC))
(Iron status)
Not necessary:
Free testosterone measured by commercially available immunoassays.
Male reproductive hormones panel with LH and FSH.
This male reproductive hormones panel is for the case where the “Minimalist panel” above showed suboptimal levels.
Total testosterone
SHBG
Estradiol
(Cortisol)
(Albumin)
(Complete Blood Count (CBC))
(Iron status)
+
LH
FSH
Prolactin
Not necessary:
Free testosterone measured by commercially available immunoassays.
Related:
The New Neander’s Challenge: Who has the highest SHBG?
We are launching a “Challenge”: we want to discover the highest and the lowest levels of SHBG that people achieve through diet and other interventions.
“Iron status”, Significance for reproductive hormones and health:
From an exam question in a medical school:
“Up to 45% of men will be impotent at the time of diagnosis (of hemochromatosis).”
Analysis: Iron overload without hereditary hemochromatosis may have similar deleterious effects, affect other tissues.
Blood lipids
Nuclear magnetic resonance (NMR) blood lipid profile with Lipoprotein insulin resistance index (LP-IR).
The NMR blood lipid profile usually also includes a conventional lipid panel:
Total cholesterol (TC),
LDL cholesterol (LDL-C),
HDL cholesterol (HDL-C),
Triglycerides (TG).
Make sure you have TC, LDL-C, HDL-C and TG measured.
Also,
Free fatty acids (FFA, NEFA)
Lp(a), if never done before. If it was done before and it was “low”, no need to do it again.
A non-invasive assessment of visceral fat.
Significance of visceral fat:
Related:
CAC score can decrease over time in a notable proportion of people.
From a post on The New Neander’s Medical:
CAC score can decrease over time in a notable proportion of people. In a study by Lee et al. 2009 (1), CAC score decreased in about 20% of the subjects during the 24 months of the observation period.
Interventions capable of decreasing CAC score should, therefore, exist. The goal is to identify them.
“Hormones” and “growth factors”.
Often absent on standard panels:
Cortisol
Insulin-like growth factor 1 (IGF-1)
Vitamins.
Vitamin C
Urine tests.
24h urine is better, but there are challenges with storage. Urine composition may change during several hours of storage. Read attentively the instructions on the optimal ways to collect and to store 24-hour urine.
Calcium
Phosphorus
Sodium
Potassium
Magnesium
Albumin
Creatinine
Additional information.
As mentioned above, your past laboratory test results usually contain a lot of information already. You can save money by skipping the tests that are unlikely to bring new information about your health.
If you need help with interpreting your past laboratory tests, you may want check the “express consultations” at The New Neander’s Medical, our online medical consultancy.
If you are a medical practitioner, a coach, a consultant, or a person interested in optimizing your own health, you can participate in our Collaborative Working Groups. In our Collaborative Working Groups, we share our ideas and recommend competent practitioners to those who need help.
Related:
From a post on The New Neander’s Medical:
When he is 85, his biological age is 33. The “Optimal Phenotype” explained.
The New Neander's Physiological Literacy 
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