Annual Blood Work? Good Idea or Bad Idea?

By Dr Ernst
July 24, 2017

The answer lies in who is requesting the labs, what values/markers are being tested, which lab is processing the specimen, and who is interpreting the results.

It’s not uncommon for me to receive an email asking me to review “annual physical blood work” for a current or prospective client. Often it’s for a second opinion or a natural solution to prescriptive recommendations. My answer is almost always the same: ‘I need to see the real labs, i.e. your functional blood work so I can see the real story.’

Did you know that most “medical blood work” is simply used for the diagnosis and management of disease? This means that they only test markers that have coinciding prescription medication. To put it another way, if there is something going on with your health that doesn’t have a clear path to prescribing you a medication, they’re not going to test for it.

  • Elevated Glucose/A1C: Metformin/Glucophage/Insulin
  • Elevated Cholesterol: Crestor/Lipitor/Vytorian
  • Elevated TSH: Synthroid / Levothyroxine
  • Elevated Uric Acid: Allopurinol, Uloric, Colchicine, etc

While it’s important to know these numbers, it’s more important to know WHY THEY ARE ELEVATED – and there are various blood markers that will give an answer to that (but often they are not included in medical blood work and if they are, the reference ranges are usually incorrect).

Abnormal Normal Values

It’s important to note that almost all “normal ranges” are defined by the labs running the samples and the people who regularly get tested.

Who gets the blood work done more: Healthy People vs Sick People? Obviously the answer is sick people, so the “average normals” are defined by a sick-considered-as-normal population. If Labcorp runs 100,000 TSH tests and averages 5.0 as a value, they will throw in a + and – standard deviation to come up with their “normal” bell curve.

In addition, the pharmaceutical/medical community will suggest that laboratories stick to suggested ranges (i.e. Total Cholesterol <200) which have only been getting lower and lower every 5-10 years (so that more prescriptions that can be written to the now “new” group of people at risk).

Normal Normal Values

These are the reference ranges defined by healthy people getting blood work done, and recommendations put forth by the various Holistic and Wellness communities.


  • TSH should be less than 2.0.
  • Total cholesterol is meaningless, it’s the ratio of total to various other markers (Triglycerides, HDL, LDL) and the size of the cholesterol particle.
  • Glucose should be 71-85 after 12 hours of fasting.

Blood markers to monitor yearly (or every 6 months) because they define CAUSE not symptoms

I am not opposed to having blood work run regularly. In fact, I encourage you to do it yourself (not with your MD). As mentioned, they rarely include what you really need monitored to know the status of your health.

Here are some must-know markers:

CRP: C-Reactive Protein: It’s a blood marker that is produced when inflammation is in the body. This is incredibly important to monitor regularly as inflammation is linked to EVERY DISEASE known. Textbook normal is less than 3.0 mg/dl but functionally you want this to be as close to 0 as possible.

Homocysteine: This marker is a stronger indicator of heart attack and stroke risk than cholesterol. It elevates when there is inflammation in the blood vessels (vs. CRP which is inflammation in general). Normal levels are less than 10umol/L but functionally you want this to be as close to 0 as possible.

Full Thyroid Panel: TSH and T4 are poor indicators of thyroid health as 93% of thyroid activity is in the liver and intestines which convert T4 (inactive) to T3 (active). Additionally, 90% of patients with a thyroid issue have autoimmune thyroid (Hashimoto’s) which elevates to two antibodies, TPOab and TGab. Also, a toxic liver will not convert T4 to T3, instead, it produces rT3 (reverse t3) which blocks the thyroid receptor, not allowing any thyroid hormone to work. All must be tested in order to overcome a thyroid issue.

Vitamin D3: It’s rare to have D3 included in annual blood work, even if you ask. If it is, the ranges are incorrect as the medical normal is above 30ng/dl. All research shows that it takes 60ng/dl or higher to have proper immunity and prevent major diseases (cancer, thyroid, diabetes, heart etc). Clinical studies show the target range is 80-100ng/dl

These are just a few of the many important blood markers for CAUSE and overall health. And if you want to do annual blood work, make sure these are a part of it all the time.

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