These are the blood tests I recommend to friends.

High Sensitive CRP (C-reactive protein)

When: when you hit 40 and every few years thereafter if the results are OK.
Why: indication of inflammation which is a strong risk factor for heart disease

Cholesterol

When: every time you do a blood test
Why: it’s cheap and provides some useful information on your risk for heart disease. However, interpretations of the results are often WRONG and used to support unnecessary drug intervention. If you are told you need statins, don’t just agree to it. Do your homework. Especially for women where high LDL has little if any correlation to heart disease.

The ratio of HDL, LDL and Triglycerides are more important than total cholesterol unless they are sky-high (300+) which may be indicative of genetic risk.

Homocysteine

When: At least once if you have never done it before. Repeat regularly if score >8
Why: It’s a risk factor for heart disease and may indicate a genetic incapacity to properly metabolise some B vitamins.

If your levels are high, consider taking 5-MTHF aka Metafolin which is an activated form of B which does not need to be metabolised to be effective. If you have the genetic issue with metabilising B (it is common) you can take regular B ’till the cows come home with no benefit.

If you are really dying to know if you have the “MTHFR mutation”, you can get a DNA test “DNA Methylation Analysis” aka DNA “MTHFR” but in Singapore this is not available as a stand-alone test. Easiest way to get this done is a 23-and-me DNA analysis which is a few hundred bucks.

HbA1c

When: useful to do this regularly (annual) to set a baseline. More often if you become pre-diabetic.
Why: it’s indicative of diabetes risk and your ability to process sugar. As diabetes is a common condition on the SAD diet, it is good to know this number and be sure it remains in check. For best results, use in combo with fasting glucose test.

CA-125

When: women > 40.
Why: indicative of some cancers and endometriosis

Thyroid function

When: weight issues, sleep issues, lethargy
Why: can indicate why all your efforts to achieve optimum health are failing. Ensure that the thyroid function test includes Free T3.

Wishlist

Great tests not available in Singapore

Lipoprotein subfraction analysis

When: when you hit 40 and every years thereafter if the results are OK.
Why: This is the gold standard lipid test ie cholesterol test. While the regular cholesterol test does have some useful info, high LDL readings may not mean health issues likewise low LDL does not mean a clean bill of health. This test (also known as NMR Lipoprofile) will definitely say how much bad cholesterol you have leading to risk of arterial plaque, inflammation and heart disease. It can also give you a very, very early indication of metabolic syndrome.

25-hydroxy Vitamin D

When: Over the age of 35 and/or you rarely get sun exposure
Why: Our ability to process sunlight to vitamin D drops off with age. Optimum D levels have many beneficial health effects. Low levels correlate with many health conditions including cancer.

Optimum range is around 70 ng/mL. Supplement with D3 if levels are lower than 40.

Note: Test not available in Singapore but can be obtained through internet here.

One more for the road. Not a blood test but…

Cardiac Calcium Score

When: If you are at high risk for heart disease
Why: This is a type of CT scan (ie involves radiation) which will let you know if you have accumulation of arterial plaque. If you do, do NOT freak out before reading this blog… There are steps you can take to reverse your condition. It does not need to be a one-way street.

UPDATE: This test is now available in Singapore and is often paired with a CT angiogram (which is non-invasive however you need to be injected with a radioactive dye so it is not advisable as an elective screening). Calcium scoring alone does not require injection of a contrast.

Post Script

Just came across this list by Dr. Davis which is very similar to my own but he adds in Omega 3…

What tests are MORE important than cholesterol?