Our bodies speak long before a diagnosis shows up on a Western lab panel.

Traditional blood work is designed to catch disease, not dysfunction — which is why so many people are told “everything looks normal” even when they feel exhausted, inflamed, anxious, shedding hair, breaking out, gaining weight unpredictably, and disconnected from their hormones.  

Functional testing looks deeper. It asks:

• What’s inflamed?
• What’s shifting?
• What’s imbalanced?
• What can we support today,  long before something becomes a diagnosis?

This is why I’ve always gravitated toward functional blood work. It sees the body holistically, the same way I see beauty: in layers, rhythms, and interconnections.

Below is the ultimate checklist to bring to your practitioner. Use it as a guide to understand what your body is really asking for. You do not need every test at once, but knowing what to ask for is everything.

1. Cancer & Inflammation Markers

These are almost never included in a basic panel, but they’re essential for understanding underlying inflammation or early dysfunction.

Markers to Request

• hs-CRP
• ESR
• Homocysteine
• LDH
• CEA
• CA-125
• CA 19-9
• AFP
• PSA (for men)

Persistent inflammation is often the first sign something is off — even when traditional tests are “normal.”

2. Complete Thyroid Panel (Not Just TSH)

Thyroid dysfunction is one of the most undiagnosed contributors to fatigue, weight changes, anxiety, and hair shedding.

The Full Thyroid Panel

• TSH
• Free T4
• Free T3
• Reverse T3
• TPO antibodies
• Thyroglobulin antibodies
• TSI (for Graves’ disease)

A normal TSH means almost nothing without the rest of these markers.

3. Complete Sex Hormone Panels

Western hormone testing is extremely basic, often done at random times and without context. A functional approach looks at timing, ratios, and metabolism.

Female Hormone Markers

• Estradiol
• Progesterone
• LH
• FSH
• Total testosterone
• Free testosterone
• DHEA-S
• SHBG
• Prolactin

Male Panels

• Total testosterone
• Free testosterone
• SHBG
• Estradiol (E2)
• Prolactin
• DHEA-S

Advanced Testing

• DUTCH urine hormone metabolites
• DUTCH adrenal panel (for cortisol rhythm)

These give insight into estrogen dominance, perimenopause, adrenal burnout, and androgen-driven symptoms.

4. Adrenal Health & Cortisol Rhythm Testing

If you feel wired but tired, anxious upon waking, or unable to regulate stress, your adrenals may be dysregulated.

Ask for:

• 4-point cortisol curve (morning, midday, afternoon, night)
• DHEA-S
• Cortisone + cortisol metabolites
• ACTH

Cortisol rhythm patterns tell you more about your nervous system than a single cortisol reading ever could.

5. Advanced Cardiovascular Markers

Cholesterol alone is outdated. These markers catch risk decades earlier.

Most Important:

• ApoB (most predictive marker of cardiovascular risk)
• Lp(a) (genetic, not lifestyle driven)
• ApoA1
• NMR lipoprotein particle size testing

Additional Insightful Markers

• hs-CRP
• Fibrinogen
• Homocysteine
• Oxidized LDL

These are crucial for anyone with inflammation, fatigue, stubborn weight changes, or a family history of heart disease.

6. Nutrient Status & Methylation Markers

So many “mystery symptoms” come from nutrient depletion.

Ask for:

• Vitamin D (25-OH)
• B12
• Methylmalonic acid
• Homocysteine
• RBC folate
• Ferritin
• Serum iron, TIBC, transferrin saturation
• Zinc + copper (and ratio)
• Selenium
• RBC magnesium

These directly impact:

energy, collagen production, hair, skin, nails, mood, metabolism, and detox.

7. Gut, Detox & Liver Function Markers

The gut influences everything from hormones to immunity to nervous system regulation.

Blood-Based Markers

• GGT
• ALT, AST
• Bilirubin
• Albumin
• Pancreatic enzymes

Advanced Stool or Urine Tests

• GI-MAP or comprehensive stool analysis
• Calprotectin
• Secretory IgA
• Pancreatic elastase
• OAT (organic acids test)

These reveal malabsorption, dysbiosis, yeast overgrowth, and leaky gut patterns.

8. Heavy Metals

Essential for anyone experiencing chronic fatigue, unexplained inflammation, neurological symptoms, hair changes, or detox challenges.

Common Metals to Test

• Mercury
• Lead
• Arsenic
• Cadmium
• Aluminum

Typically tested via blood, urine (provoked or unprovoked), or hair mineral analysis.

9. Mold & Mycotoxin Testing

Mold is one of the most overlooked triggers of chronic illness. It affects hormones, inflammation, nervous system stability, detoxification, and even EBV reactivation.

Environmental Testing

• ERMI
• HERTSMI-2
• Professional air quality + swab testing

Human Mycotoxin Testing

• Ochratoxin A
• Aflatoxin
• Gliotoxin
• Trichothecenes
• Zearalenone
• Mycophenolic acid

Supportive Labs for Mold Illness

• C4a
• TGF-β1
• VEGF
• MMP-9
• VIP
• ADH + osmolality
• IgE, IgG, IgA patterns

These markers uncover chronic inflammatory response syndromes (CIRS) that Western medicine rarely recognizes.

10. Viral Reactivation: EBV, Mono & Other Chronic Viruses

EBV can stay dormant for years and reactivate under stress, mold exposure, hormone shifts, or gut dysfunction.

Full EBV Panel

• EBV VCA IgM
• EBV VCA IgG
• EBV Early Antigen (EA-D) IgG (key for reactivation)
• EBNA IgG

Additional Viral Panels

• CMV
• HHV-6
• Parvovirus B19

Reactivation can drive fatigue, anxiety, joint pain, hair shedding, and chronic inflammation.

11. Autoimmune Screening Panels

Autoimmunity often appears years before symptoms get severe. A basic Western panel rarely screens for this.

General Autoimmune Tests

• ANA
• ENA panel
• Complement C3, C4
• CRP, ESR

Thyroid Autoimmunity

• TPO antibodies
• Thyroglobulin antibodies
• TSI

Other Autoimmune Markers

• RF
• Anti-CCP
• Anti-dsDNA
• SSA (Ro)
• SSB (La)
• Parietal cell antibodies
• Intrinsic factor antibodies

Immune Function

• IgG, IgA, IgM
• IgG subclasses
• NK cell function

These clarify whether the immune system is overactive or under-functioning.

12. Food sensitivity (IgG)

Tests across:

Dairy, gluten, eggs, nuts, legumes, seafood, fruits, vegetables, additives

Measures:

Delayed immune reactions to food

Why this matters:

These reactions are not immediate allergies. They show up as bloating, inflammation, skin changes, and fatigue

Where to Get These Tests

(New York, Miami, Los Angeles + Remote Options)**

New York

• New York Center for Integrative Health – Comprehensive functional testing including hormones, thyroid, autoimmune, viral panels, and detox pathways

• Rahav Wellness – Full-spectrum functional diagnostics with an emphasis on gut, hormones, trauma physiology, and chronic illness

• Genesis Health NYC – Metabolic, thyroid, nutrient, adrenal, immune, and inflammation-focused panels

• Quest Diagnostics / LabCorp – Broad access for standard + advanced markers with physician ordering

Miami / South Florida

• Covalent Health – IFM-certified physician offering root-cause testing including hormones, immune panels, mycotoxins, heavy metals, and gut diagnostics

• South Florida Integrative Health Center – Full functional lab testing for gut, detox, metabolic markers, and chronic inflammation

• Dr. Carlos Vaca (In-House Blood Testing) – Convenient in-office blood draws with access to specialty labs

• Dr. Ivan Rusilko – Advanced functional diagnostics with a focus on hormones, metabolic health, longevity medicine, and personalized therapeutic interpretation

Los Angeles

• Vitalife MD – Offers complete hormone panels, thyroid, adrenal testing, nutrient status, mycotoxins, heavy metals, gut panels, and longevity diagnostics

• Dr. Lehman – Functional and regenerative medicine practitioner known for deep diagnostics including viral reactivation, autoimmune panels, mold testing, and hormone optimization

• IHS Medical Group – Comprehensive functional medicine testing including cardiovascular markers, thyroid, hormones, and chronic illness evaluation

• LaboratoryAssist – Self-pay testing with direct access to a wide range of blood and specialty labs without a doctor’s referral

Remote (Nationwide)

• Dr. Will Cole – One of the leading functional medicine practitioners in the world; offers fully remote testing and consultations, including hormones, thyroid, gut, autoimmune, detox, viral panels, mold/mycotoxins, heavy metals, and advanced inflammation markers. Ideal for deep root-cause investigations from anywhere.