If you’re like most people, you visit your doctor for a yearly physical exam and possibly bloodwork, and then probably assume that you’re covering your bases and all is OK. The problem is that a basic blood test might be missing key information about the status of your health, such as whether you’re dealing with food intolerances, digestive issues like SIBO (small intestinal bacterial overgrowth), nutrient deficiencies or poor adrenal function.
The point of staying up to date on medical exams and tests is to screen for health-related issues (many of which don’t have noticeable symptoms), assess your risk for future medical problems, determine whether any lifestyle changes are needed based on current symptoms you’re experiencing, and to keep you updated about the need for interventions like immunizations/vaccines, the flu shot, medication changes and so forth.
Before we discuss tests that are intended to uncover more detail about certain health markers and help diagnose common problems, let’s first establish the basic tests that every adult should have done to rule out any major concerns:
- Physical exam — A yearly physical exam is recommended in order to check your weight, blood pressure and body mass index. You also should see your doctor annually to discuss any mood-related changes/depression, your diet and exercise habits, your use of alcohol and tobacco, and information about your sexual partners/any signs of STDs.
- Blood pressure screening — This test should be done every three to five years, unless you are pregnant, have diabetes, heart disease, kidney problems or are taking blood pressure medication.
- Cholesterol screening — This test should be done at least every five years, or more often if you’ve recently gained a lot of weight or have diabetes, heart disease or kidney problems.
- Blood sugar screening — Your blood sugar level can indicate if you have or are at risk for diabetes. The frequency of this test depends on your current health, any history of diabetes, and your treatment plan if you do currently have diabetes.
- Dental exam — It’s recommended that adults visit a dentist one to two times yearly for cleanings and exams.
- Pelvic exam, Pap smear and mammogram for women — Women who are sexually active should be screened for cervical cancer at least every three years and should have a Pap smear to test for HPV at least every five years. If you’re pregnant, taking oral contraceptives (birth control pills), have had your uterus or cervix removed (total hysterectomy), or have been diagnosed with cervical cancer or an STD, you’ll need to see your doctor more often. Women should perform monthly breast exams and also discuss with their doctor the need for mammograms, depending on their breast cancer risk.
- Skin exam — Dermatologists recommend yearly skin exams to check for signs of skin cancer, especially for people with a history of skin cancer before or close relatives with skin cancer. Also, you should see your dermatologist annually if you have a weakened immune system.
- Eye exam (especially if you wear glasses or contacts) — If you have a prescription for corrective eyewear, you’ll need to have an annual exam. Adults should otherwise get an eye exam every two to three years unless they notice changes in their vision or have diabetes.
Even after you take care of the basics, of course it’s also important to continuously monitor your health by paying attention to how you feel and how you’re functioning. If you experience new symptoms, pain or other unusual changes in your mood, weight or so on, then this is a good time to see your doctor for further testing.
Below are additional health-related tests that I recommend you consider seeking out, as well as questions to ask your health-care provider with respect to these tests:
- Leaky gut tests — Leaky gut syndrome (also known as “intestinal hyperpermeability”) is a condition that occurs when the gut lining becomes abnormally permeable, triggering widespread inflammation. Leaky gut has been linked to autoimmune reactions and diseases, inflammatory bowel disease (including irritable bowel syndrome and ulcerative colitis), mood-related issues, food allergies or sensitivities, skin problems and more. There are several tests that can identify if you’ve developed this condition, including the following:
- Zonulin or lactulose tests: High zonulin levels can indicate gut permeability and damage to “microvilli,” the tiny cellular membranes that line the intestines and absorb nutrients from your diet. An intestinal permeability assessment can also measure the ability of two sugar molecules to permeate the gut lining—lactulose and mannitol.
- IgG food-intolerance test: This test is used to identify food sensitivities or allergies by measuring levels of antibodies. Some food sensitives may be obvious, such as those to foods like peanuts, gluten or dairy that tend to cause symptoms, but others may be subtle and go unnoticed, despite causing low-grade inflammation. You can either have the test done by having blood drawn or by using dried blood.
- Stool tests: These tests reveal information about any pathogenic micro-organisms, such as yeast, parasites and bacteria that are present in your GI tract and end up in your stool. You’ll have the option of collecting a stool sample at a doctor’s office or at home in private, and then mailing the sample to a lab.
- SIBO test — Small intestinal bacterial overgrowth (or SIBO) occurs in many people suffering from irritable bowel syndrome and symptoms like persist bloating, gas and abdominal pain. This condition describes excessive bacteria in the small intestine, or small bowel, where usually relatively low levels of bacteria are found. (Bacteria are supposed to be at highest concentrations in the colon.) SIBO can contribute to malabsorption of nutrients, particularly fat-soluble vitamins, vitamin B12 and iron.
A hydrogen breath test is done to measure the amount of gas produced by the bacteria in the small intestine (hydrogen and methane) after consumption of sugar molecules, which “feed” the bacteria. Treating SIBO can involve the use of antibiotics such as rifaximin (brand name Xifaxan), oregano oil and an elimination diet.
- Nutrient-deficiency tests (especially for vitamin D, magnesium, iodine and iron deficiency) — These are some of the most common deficiencies found in people living around the world, especially those who don’t eat much vegetables or seafood, who avoid eating animal proteins (vegetarians/vegans), and who live in cold climates where they aren’t often exposed to direct sunlight.You also might choose to have an organic acid test done, via a urine test, in order to look for other vitamin and mineral deficiencies, amino-acid (protein) deficiencies, and antioxidant, probiotic and bacteria levels. If you have a GI issue that contributes to malabsorption of nutrients or damage to the gut’s microvilli, this test can tell you which supplements you’ll benefit from taking.
- Heart disease tests — Aside from the basic tests mentioned above (such as for blood pressure and cholesterol), there are other heart disease tests that can uncover important information about your risk for cardiovascular issues. A combination of an EKG, a limited CT scan and three blood tests will improve your doctor’s ability to predict heart attacks and strokes, heart failure and atrial fibrillation. Talk to your doctor about doing a blood test to check your C-reactive protein level (indicates inflammation) and NT-proBNP hormone level (shows stress on the heart). Also, ask your doctor about performing a test to check for high-sensitivity troponin T (shows damage to the heart muscle).Additionally, make sure to discuss risk factors for heart disease with your doctor if you suspect you’re susceptible to heart issues, such as if you live in a low-income area, eat a mostly processed diet, have poor grip strength, are very stressed and are exposed to chemicals/toxins often at work.
- DUTCH hormone test (typically if you’re experiencing hormone-related symptoms) —The DUTCH test stands for “dried urinetest for comprehensive ” It’s used to measure important hormones like cortisol, estrogen, testosterone, other androgens and melatonin, plus organic acids and oxidative stress markers. This type of test is highly beneficial and informative for people who are potentially dealing with issues like high or low testosterone, polycystic ovarian syndrome, estrogen dominance or low progesterone, irregular or absent periods, infertility, fatigue or depression, and poor thyroid or adrenal function.The DUTCH test uses dried urine collected four times per day to get the best idea of how your hormones fluctuate throughout the day. You can work with your doctor to review your results and decide whether you should be making any lifestyle or dietary changes, modifications to medications you’re taking, or if you might require the use of certain supplements or bio-identical hormones. Note that if you choose to have a standard blood test to check your thyroid function, be sure to measure T3, reverse T3 (or T3RU), T4 and TSH. Testing only TSH isn’t always enough to identify a problem, so discuss with your doctor about having a more comprehensive test done.
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