28 Most Commonly Ordered Lab Tests For Naturopathic Doctors

Patients frequently report feeling unwell despite receiving “normal” results on standard laboratory panels. This clinical disconnect highlights the limitations of conventional reference ranges in capturing subclinical imbalances or early dysfunction. 

As a result, many individuals turn to integrative and naturopathic care, which emphasizes personalized assessment and functional lab interpretation to gain additional insights into symptoms that may not be fully explained through conventional testing alone.

Understanding the Role of Lab Testing in Naturopathic Medicine

The practice of naturopathic medicine emphasizes identifying the root causes of illness rather than merely alleviating symptoms, and laboratory testing is a valuable tool in uncovering imbalances in the body. 

By integrating lab results with clinical evaluation and patient history, naturopathic doctors (NDs) can create personalized treatment plans that address the root causes of disease for lasting health improvements.

Moving Beyond Symptom Management

Naturopathic medicine acknowledges that illness arises from a combination of genetic, environmental, and lifestyle factors. NDs utilize lab tests as part of a comprehensive assessment to help identify underlying contributors to symptoms.

Conventional diagnostic tests are typically designed to confirm a disease after symptoms have emerged. Functional tests offer an additional perspective on health that complements conventional diagnostic methods.

Personalized, Preventive, and Predictive Healthcare

One of the key tenets of naturopathic medicine is the focus on prevention. 

NDs use lab tests to track biomarkers that can predict potential health issues before they become pathological diseases. For example, identifying trends in rising insulin and blood sugar levels can predict future risk for diabetes and allow time for early interventions through diet and lifestyle changes before the disease actually manifests.

Integrating Lab Results into Patient-Specific Treatment Plans

Lab results are not seen in isolation. Instead, NDs integrate lab findings with detailed patient histories, lifestyle factors, and symptom patterns to develop personalized treatment plans. This whole-person care approach moves away from the ‘one-size-fits-all’ healthcare model and embraces a patient-specific philosophy.

Most Commonly Ordered Lab Tests by Naturopathic Doctors

Let’s discuss some of the most commonly ordered lab tests by NDs. 

Core Blood Testing Essentials

Here are commonly ordered core blood tests.

Complete Blood Count (CBC)

The CBC is one of the most commonly ordered lab tests, as it provides a broad overview of a patient’s general health. It measures various components of blood, including red blood cells (RBCs), white blood cells, and platelets. This test can help detect infections, anemia, nutritional deficiencies, clotting disorders, and cancer.

Comprehensive Metabolic Panel (CMP)

The CMP provides a broad overview of metabolic function by measuring blood sugar, electrolyte levels, kidney health, and liver function. Abnormal results can indicate a wide range of conditions, including dehydration, blood sugar dysregulation, kidney disease, liver disease, and malnutrition. 

Lipid Panel

A lipid panel measures different types of cholesterol and triglycerides as one component of assessing cardiovascular risk. While a basic lipid panel is standard in routine health screenings, NDs often recommend advanced panels, which include novel biomarkers being explored for their potential role in cardiovascular risk assessment.

Blood Sugar

Insulin resistance plays a central role in the development and progression of chronic diseases, such as type 2 diabetes mellitus, CVD, and fatty liver disease, by promoting high blood sugar, abnormal lipid levels, and chronic inflammation. 

Because metabolic dysfunction exists on a spectrum, measuring multiple markers of blood sugar regulation—insulin, blood glucose, and hemoglobin A1c (HbA1c)— is helpful to screen for, diagnose, and monitor glycemic instability.

Hormonal Testing

Here are some commonly ordered hormone tests.

Thyroid Panel 

The thyroid gland is the master regulator of metabolism, and even slight imbalances in function can tip the metabolic scale to negatively impact energy, weight, digestion, and mood. Using thyroid-stimulating hormone (TSH) as the only screening marker for thyroid disease may miss about 7% of patients with overt thyroid dysfunction. 

A comprehensive thyroid panel assesses multiple thyroid markers simultaneously, providing a more complete understanding of the complex cascade involved in thyroid hormone production, conversion, and signaling.

Reproductive Hormones 

Sex hormones (estrogen, progesterone, and testosterone) influence tissues throughout the body, playing key roles in reproduction, mood, bone health, skin and hair integrity, cardiovascular function, metabolism, and the immune system. 

Hormone panels may provide insight into physiological patterns that are associated with symptoms such as menstrual irregularities, menopausal symptoms, changes in mood, sexual dysfunction, infertility, acne, hair loss, fatigue, and osteoporosis.

Adrenal Hormones

The adrenal glands produce cortisol and dehydroepiandrosterone (DHEA), hormones involved in stress response, energy levels, and inflammation. 

Chronic stress may influence the hypothalamic-pituitary-adrenal (HPA) axis function, which is being explored in connection with altered cortisol and DHEA levels and a range of symptoms, including fatigue, mood swings, and sleep disturbances, while also contributing to conditions like metabolic syndrome, CVD, and chronic fatigue.

Nutritional Testing

Here are some commonly ordered nutritional tests.

Vitamin D (25-Hydroxyvitamin D)

Vitamin D is a fat-soluble vitamin that, unlike other vitamins, functions as a hormone. It plays numerous important roles in the body, from supporting bone health via calcium absorption to modulating the immune system. 

Vitamin D deficiency has been associated with multiple disease states, which is why NDs consider optimizing body stores an important aspect of preventive medicine.

Vitamin B12

Vitamin B12 is involved in DNA synthesis and cellular energy production. Marginal deficiency is relatively common, affecting 15% of adults aged 20-59 and more than 20% of those over 60. 

Treating B12 deficiency has been linked to improved neurological function, hematological parameters, and cognition. 

Iron Studies

Iron is a structural component of hemoglobin, the protein in RBCs that carries oxygen throughout the body. Insufficient iron levels, therefore, lead to a state of deoxygenation. 

Left untreated, iron deficiency can progress to iron deficiency anemia, which has wide-ranging consequences, including increased fatigue, depression, weakened immune function, developmental delays in children, heart problems, and pregnancy complications. 

Inflammatory Markers

Here are some commonly ordered inflammatory markers.

C-reactive Protein (CRP)

The liver produces CRP in response to inflammatory stimuli. Levels rise and drop quickly, making it a reliable marker for detecting and monitoring any type of inflammation. 

High-sensitivity CRP (hs-CRP) is a more sensitive test that can detect minor elevations in CRP. NDs often utilize it to quantify low-grade inflammation and estimate cardiovascular risk.

Erythrocyte Sedimentation Rate (ESR)

ESR measures the rate RBCs settle at the bottom of a test tube. Faster sedimentation (higher ESR) occurs when inflammation, such as that caused by autoimmune disease or infection, causes RBCs to clump together, become heavier, and settle more rapidly.

Homocysteine

Homocysteine is an amino acid, and while it doesn’t directly measure inflammation, high levels (a condition called hyperhomocysteinemia) are known to induce inflammation in the cardiovascular and nervous systems. 

Functionally, homocysteine is also used to assess vitamin B12 and folate status and the efficiency of methylation pathways. 

Specialty Functional Lab Testing to Uncover Hidden Imbalances

Specialty lab testing includes taking blood, stool, urinary, salivary, or hair samples to analyze biomarkers not routinely measured through conventional labs.

Advanced Gastrointestinal Health Sssessments

Gastrointestinal (GI) disease ranks among the most prevalent chronic health conditions. 

However, because the gut is closely connected to the immune system and other bodily functions, imbalances in gut health can extend beyond digestion, contributing to the development and progression of conditions such as CVD, arthritis, autoimmunity, mood disorders, and skin diseases.

This is why, even in cases where digestive symptoms are not a patient’s primary concern, NDs may recommend investigating digestive function and the state of the gut microbiome through functional tests like: 

• Comprehensive stool analysis 
• Small intestinal bacterial overgrowth (SIBO) breath test

Expanded Food Sensitivity and Allergy Testing

Here are some examples of expanded food sensitivity and allergy tests.

Allergy Testing 

A food allergy occurs when the immune system identifies a food protein as foreign and immediately mounts an IgE-mediated inflammatory immune response, triggering gastrointestinal, cardiovascular, and respiratory symptoms minutes to hours after exposure. 

Cow’s milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat account for about 90% of all food allergies. Food allergies can be diagnosed by skin-prick tests (performed by an allergist) or an IgE food allergy blood test (which can be ordered by an ND). 

Food Sensitivity Testing

Food sensitivities, while also mediated by the immune system, involve the IgG pathway and can be more difficult to identify based on symptoms alone, as symptoms can be nonspecific and manifest up to 72 hours after ingestion. 

An IgG food sensitivity blood test may be ordered as part of a comprehensive gastrointestinal assessment, as some researchers hypothesize that food sensitivities may be linked to changes in intestinal permeability, sometimes referred to as ‘leaky gut.’

However, food sensitivities can also be tied to low-grade systemic inflammation and immune dysregulation, contributing to symptoms like chronic fatigue, joint pain, and headaches.

C3 Complement Activation Testing

The complement system is a group of proteins, including C3, that mount an inflammatory immune response to fight infection. IgG complexes can activate the complement system, and measuring C3d (a fragment of C3) levels alongside IgG antibodies to food antigens offers additional insights into managing the inflammatory response associated with food sensitivities.

Organic Acids and Metabolic Testing

Organic acids are cellular byproducts produced through metabolic processes that can be measured through the urine. An organic acids test (OAT) serves as a wide-cast health assessment, as patterns in OAT results can indicate various imbalances, including:

• Microbial dysbiosis
• Mitochondrial dysfunction
• Neurotransmitter imbalances
• Nutritional deficiencies
• Slowed antioxidant and detoxification pathways

Deep Inflammation and Oxidative Stress

Oxidative stress is an imbalance between the production of reactive oxygen species (ROS) and the body’s ability to neutralize these reactive intermediates or repair the resulting damage. This imbalance leads to cellular and tissue damage and is implicated in the pathogenesis of chronic diseases, including cardiovascular diseases, diabetes, neurodegenerative disorders, and cancer.

8-Hydroxy-2′-Deoxyguanosine (8-OHdG)

8-OHdG is a reliable indicator of oxidative stress and DNA damage because it’s formed when ROS attack guanine residues in DNA.

Inflammatory Cytokine Panels

Inflammatory cytokines (TNF-α, IL-1, or IL-6) are signaling proteins released by immune cells that play a key role in initiating and propagating inflammation linked to chronic disease.

Environmental Toxin and Heavy Metal Testing

Environmental medicine is a multidisciplinary field that focuses on the connection between environmental factors and human health, specifically how exposure to chemicals, pollutants, and other environmental hazards can contribute to disease. Diagnostic urine, blood, and hair tests are available to identify and quantify toxic exposure to:

• Heavy metals (mercury, lead, cadmium, aluminum)
• Environmental chemicals (bisphenol A, phthalates, glyphosate)
• Mycotoxins (ochratoxin A, aflatoxin, zearalenone)

Genetic and Neurotransmitter Profiling

Genetic and neurotransmitter profiling may be appropriate in certain populations.

Genetics Panels

Genetic tests using blood or saliva samples screen for variations in the genetic code that can influence susceptibility to various health conditions and how an individual might respond to certain treatments or lifestyle interventions.

Neurotransmitter Tests

Neurotransmitters are chemical messengers that help regulate mood, cognition, muscle movement, digestion, and sleep. Urine tests measure neurotransmitter precursors and metabolites as indirect markers of neurotransmitter levels. 

They are commonly utilized in diagnostic workups related to neurocognitive, sleep, mood, pain, and fatigue disorders, especially when patients have not responded to conventional approaches. 

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Interpreting Lab Results Through a Naturopathic Lens

After ordering lab tests, NDs will interpret the results and integrate them into a personalized treatment plan tailored to the patient’s unique needs.

Understanding Optimal Versus Normal Lab Ranges

Using standard reference ranges, lab results are often assessed as “normal” or “abnormal.” These ranges are typically set to reflect the central 95% of the population, meaning that if you fall within the middle of this range, your results are considered “normal.” However, this approach doesn’t always reflect an individual’s ideal state of health.

NDs focus on “optimal” rather than “normal” ranges. Optimal ranges are based on what’s considered ideal for long-term health and disease prevention rather than simply the absence of disease.

For example, a normal fasting insulin is often considered anything under 25 μU/mL. However, research suggests that fasting levels under 7 μU/mL are associated with a reduced risk of metabolic syndrome and type 2 diabetes.

Quest lab results on Fullscript include these ranges in a visual report that makes it easy for provider’s to quickly spot suboptimal or out of range values, and help patients understand their results.

For an additional resource to help you get started, check out Fullscript’s provider’s guide to optimal biomarker ranges. 

This guide, developed by the Fullscript Medical Advisory Team, utilizes medical research and advanced technology to refine optimal ranges through large datasets from trusted sources like ScienceDirect and PubMeb. 

Incorporating the Whole Person Care Context

Lab results do not exist in a vacuum. They must be interpreted within the context of the whole person—their symptoms, health history, lifestyle, and genetic predispositions. 

For example, a high level of cortisol might be an indicator of Cushing’s disease, but an ND will also consider if the patient has a history of chronic illness, corticosteroid use, or a stressful job when interpreting this result.

Educating and Empowering Patients About Their Health Data

Another of the naturopathic guiding principles is “Doctor as Teacher (Docere).” NDs take the time to explain what each test measures, why it’s important, and how it fits into their overall health picture. 

This is important as research demonstrates that patient education enhances therapeutic compliance, reduces complications, and improves health outcomes. 

Identifying Clinical Patterns for Early Intervention

One of the greatest benefits of functional and naturopathic lab testing is its ability to detect early signs of imbalance, even before symptoms appear. NDs are trained to recognize subtle shifts in lab markers that may suggest early physiological changes, though more research is needed to confirm the predictive value.

Early insights from lab testing may support proactive wellness strategies, such as through dietary changes, lifestyle adjustments, herbal remedies, dietary supplements, or other natural therapies that can help prevent the development of more serious health problems in the future.

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Overcoming Common Challenges in Naturopathic Lab Testing

Despite the important role of testing in healthcare, providers often face challenges in navigating cost barriers and securing patient follow-up.

Navigating Insurance and Cost Barriers

One of the most significant challenges for patients seeking naturopathic care is navigating insurance coverage for functional lab testing. Because insurance plans may not cover these tests, this can create financial barriers for patients seeking a comprehensive lab evaluation.

NDs can assist by helping patients:

• Confirm insurance coverage
• Find affordable alternative testing options
• Choose labs with cash-pay discounts, sliding-scale pricing, or payment plans

Promoting Patient Understanding, Compliance, and Follow-Through

For lab testing to be effective, patients must understand the results and be willing to follow through with the necessary treatment plans. Naturopathic medicine is a slow medicine, often requiring patients to break old habits and adopt health-promoting habits. Sometimes, this approach can take months to years to restore health.

NDs can improve their patient’s chances of success by:

• Setting realistic expectations
• Explaining the importance of each recommendation they make
• Utilizing digital health tools and reminders to help patients keep track of follow-up testing and appointment schedules

Staying Abreast of Evolving Lab Testing Innovations

The field of lab testing is rapidly evolving, with new biomarkers, technologies, and methods emerging regularly. 

To provide the most accurate care, naturopathic doctors stay current through continuing education, conferences, and collaborations with laboratories. This ensures that patients benefit from both proven and innovative diagnostic tools that are not always available through conventional care.

Getting Started with Lab Testing

Integrating lab testing into your practice requires careful consideration of providers, legal guidelines, and client education. Taking the right steps ensures you offer reliable, ethical, and effective support.  

Choosing the Right Lab Testing Provider

Selecting a reputable lab provider is essential for accurate and reliable results. Consider the following when choosing a provider: 

• Quality and accreditation: Ensure the lab meets industry standards and certifications.
• Test offerings: Choose a provider that offers functional tests relevant to your coaching focus.
• Ease of access: Look for labs that allow client-direct testing or offer practitioner-authorized options.
• Support and interpretation tools: Some labs provide educational resources or practitioner support for interpreting results.  

Choosing Fullscript as your lab testing provider

An industry leader and trusted partner, labs on Fullscript gives you easier access to high-quality diagnostic testing and the valuable patient insights they deliver, so you can provide better care with greater confidence, without the additional administrative burden.

Fullscript brings together industry-leading lab partners on one platform so you can access your favourite lab tests all in one place. 

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Strategic Best Practices for Ordering and Interpreting Lab Tests

NDs will follow best practices to ensure effective, personalized care, including:

• Aligning tests with patient symptoms and prevention, prioritizing the tests that will provide the most relevant information for diagnosis and treatment
• Customizing test panels by selecting specific tests based on the patient’s individual health history, lifestyle, and risk factors rather than using generic panels
• Interpreting results holistically by considering them within the broader context of the patient’s overall health
• Using “optimal” reference ranges for health optimization and disease prevention
• Discussing lab results with patients in an accessible and transparent way, ensuring they understand the significance and potential impact on their health
• Empowering patients to actively participate in their health journey

Key Takeaways

• Comprehensive lab testing plays a critical role in uncovering root causes and optimizing whole-person health in naturopathic medicine. 
• The tests most commonly ordered by lab naturopathic doctors go beyond symptom management, focusing on prevention, early intervention, and preserving long-term wellness. 
• By providing a deeper understanding of the body’s biochemical and metabolic processes, laboratory tests assist NDs in crafting personalized, holistic treatment plans that address the root cause of illness and disease.

This article is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. Always consult a qualified healthcare provider before making changes to your health routine or interpreting lab results.