01
Full thyroid panel
Most PCPs test only TSH. Half of all thyroid dysfunction is invisible at TSH alone.
- TSH Pituitary signal. Lab “normal” up to 4.5, optimal is 0.5 to 2.0.
- Free T4 Storage form. We want mid range, not just “in range.”
- Free T3 Active hormone. The one that drives energy and metabolism.
- Reverse T3 Stress shunt. High in chronic illness, dieting, inflammation.
- TPO antibodies Hashimoto’s flag. Often elevated years before TSH moves.
- Thyroglobulin antibodies Second autoimmune marker. Catches what TPO misses.
02
Sex and adrenal hormones
Hormone balance is rarely about one number. It is the ratios that matter, and the carriers (SHBG) that determine what is active.
- Estradiol Primary estrogen. Cycle-day matters for women.
- Progesterone Day 21 ideally for cycling women. Critical for sleep and mood.
- Total + Free testosterone Both, always. Total tells the pool, free tells what is usable.
- DHEA-S Adrenal reserve. Drops with chronic stress and age.
- SHBG The carrier protein. High SHBG hides usable hormones.
- AM cortisol Adrenal rhythm. Best paired with 4-point salivary cortisol when stress is suspected.
03
Metabolic and advanced lipids
Standard lipid panels miss the markers that actually predict cardiovascular risk and insulin resistance.
- HbA1c 90-day blood-sugar average. Optimal < 5.4.
- Fasting insulin + HOMA-IR The insulin resistance picture, years before HbA1c moves.
- ApoB Atherogenic particle count. Better than LDL-C alone.
- Lp(a) Genetic cardiovascular risk marker, tested once in a lifetime.
- Particle size + number (NMR) Small dense LDL is the real risk.
- Fasting glucose + uric acid Round out the metabolic picture.
04
Inflammatory markers
Chronic inflammation is the common thread under almost every chronic disease. We measure it before symptoms become diagnoses.
- hs-CRP Systemic inflammation. Optimal < 1.0.
- ESR Slower-moving inflammation tracker.
- Homocysteine Methylation-related risk for cardio and cognitive decline.
- Ferritin Both iron status and inflammation marker.
- Fibrinogen Clotting and inflammation crossover.
05
Micronutrients (deep panel)
Serum is a snapshot. RBC and intracellular markers tell us what is actually inside your cells.
- 25-OH Vitamin D Optimal 50 to 80 ng/mL for most adults.
- RBC magnesium The form that matters. Serum magnesium is almost always “normal.”
- Zinc and copper Always paired. Ratio is what matters.
- Iron studies Ferritin, serum iron, TIBC, transferrin saturation.
- B12 and folate Plus MMA for true B12 status.
- Omega-3 index Anti-inflammatory reserve.
06
Gut and microbiome
“IBS” is rarely the answer. The gut workup is where root-cause investigation really pays off.
- GI-MAP DNA stool analysis PCR-level detail on pathogens, dysbiosis, digestion, inflammation.
- SIBO breath test Hydrogen and methane. Three-hour collection in clinic.
- Food sensitivity panel IgG to 96 foods plus candida.
- Zonulin Intestinal permeability marker.
- Calprotectin Bowel inflammation marker, rules out IBD.
07
Toxic burden
Run when symptoms point to environmental load, mold exposure, or stubborn chronic issues that other panels do not explain.
- Heavy metals (HMA) Mercury, arsenic, lead, cadmium via hair analysis.
- Mycotoxin panel Mold exposure markers.
- Glyphosate Standalone urine test.
- Environmental toxin panel (Great Plains) Phthalates, parabens, benzene metabolites.