Let’s look at laboratory testing. Why do this?
You cannot manage what you don’t measure, whether it be your blood pressure, your weight, your body fat, bone density or other labs.
It is important to discuss that basic labs being “normal” in isolation do not assure that you are in good health. The typical patient I see in the ER who has a heart attack or stroke would have had “normal” basic labs the day before. However, with focused lab testing and a comprehensive view of that same individual by someone with my training, I’d have raised red flags and treated things that often go unmeasured and unmanaged until it is too late.
Labs can be expensive! However, I can order labs cost effectively. For example:
CBC $3.49, Comprehensive Panel $7.90, HbA1C$5, Vitamin D $20, Thyroid panel (TSH, FT4, FT3) $25, Lipid Panel $5, Fasting insulin $16, HsCRP $11, Testosterone Free/Total/SHBG $27.50, Vitamin B12/Folate$23.50, Homocysteine $20, Uric Acid $4, Cortisol $6, Omega 3/6 Fatty Acids $69. There is also a lab drawing fee (usually $10 or $12 depending upon what lab we use).
For most individuals, it is better to just pay out of pocket, as insurance coverage, if you have a deductible, still yields higher costs, even for most “covered” tests. The critical issue to understand, is that insurance usually denies many of the tests. Guess what happens when that occurs? The lab charges their maximum charge for the labs which can be 10-15 times the price you'd have paid cash! You’ll get slapped with a surprise bill, which can be $2000+ for a standard lab panel that would have cost $200 with cash pay.
So what about simply self-ordering labs? You can do this through Ulta Labs(and others); we find UltaLabs to be the best option. You self order, and get your labs drawn at Quest. You’ll pay ~50-60% more than getting them ordered by our practice.
So what labs are typical for a anti-aging and regenerative medicine intake?
CBC & Comprehensive Panel, Cystatin C, GGT
Lipid panel, Lipid particle sizes/numbers by NMR, ApoB, HsCRP, Lp(a)
HgbA1C, Fasting Insulin
Vitamin D, B12, Folate, Magnesium, Homocysteine, Uric Acid
TSH, Free T4, Free T3
Estradiol/Progesterone/DHEAS/SHBG/Testosterone/Free Testosterone
Ferritin, Iron, TIBC,Transferrin saturation
Omega 3/6 Fatty Acids
Apolipoprotein E
Urine microalbumin
Renin/Angiotensin
Selected Patients
PSA (Male Only)
Estone, Estriol, Urinary metabolites of estrogens (usually Female Only)
Cycle map for females for Estradiol/Progesterone x 28 days
C-peptide
Urine Heavy Metals
Cortisol Salivary x 4/DHEA/Melatonin for curve
Thyroid APO-Anti-thyroid Abs
Dihydrotestosterone
Prolactin, FSH, LH
Micronutrient Testing
CardiaX if premature family history of coronary artery disease
TruDiagnostic OMIC Age, Dunedin Pace, DNA Methylation
TMAO
CPK
GI Testing: Genova Effects, KBMO 176 Fit test, tTG-Iga, Immunoglobulin A
IGF-1
ANA, Rheumatoid Factor, Circulating Immune Complexes
Osteocalcin, Osteopontin
Total IgG, IgM, IgA
Organic Acids
Tick borne illnesses/other screening with Vibrant Infectious panel
EBV/HSV/Coxsackie
Vibrant Tox Panel
PFAs (Forever Chemicals)
There are so many other tests we can order, but these would be most of our laboratory medicine orders. Many of these tests are not available at standard labs and they are ordered at specialty labs which generally require a physician order.
Hopefully this is a helpful review of how we approach laboratory testing and gives you some insight into the economics and best workflow to minimize costs.
