If you’re not testing, you’re not learning.
In college, I lost my grandmother to colon cancer. She’d spent a lifetime eating the Standard American Diet—the SAD—and smoked in her adult life, which are both huge risk factors for cancer. Still, her death was totally preventable. She never got the screening that could have saved her life.
Her story became the lens through which I saw my medical training.
Preventative testing is a pillar of functional medicine and key to helping us live our healthiest possible lives. Not only do preventative screenings help halt and reverse disease progression, they also help us optimize our health.
People always ask me “How do I know if my supplements are working?” and “How can I tell if my workouts are really improving my metabolism?” My answer is simple: if you’re not testing, you don’t know.
Lucky for you, I’ve put together a complete checklist of the tests you should be getting at least every year and ideally every six months (unless otherwise noted).
More good news: Parsley now tests 84 biomarkers as part of the The Parsley Functional Lab Panel offered to all members.* We use those insights to order advanced specialty tests tailored to your biology.
Use this checklist like a Bible and refer back to it often with your doctor to keep tabs on your health, track progress, and test whether the interventions you’ve adopted are working. A lot can change in your body in six months—make sure those changes are positive.
The research says
Only 8% of people annually get the preventive screenings they should. That is insane to me, considering early onset cancer is on the rise globally—by as much as 79% between 1990 and 2019, according to one study.
Rates of chronic disease like metabolic syndrome and diabetes, autoimmune conditions, and deaths from cardiovascular disease, meanwhile, are also on the rise.
The best way to treat chronic disease is to prevent it. And the best way to prevent it, is to stay up to date with the annual labs and preventative health screenings below.
What I’m doing for my own body
Last year I shared my personal lab results. Two big takeaways for me were that I needed to increase my protein intake and increase free testosterone levels by supplementing with zinc.
As a woman in my 40s, I’m currently paying special attention to:
- Sex hormones: I don’t have symptoms of perimenopause yet but at 43, I know it’s coming. Getting a baseline now will be incredibly empowering when it’s time to optimize my treatment.
- Body composition: The time to build lean muscle and bone density is now so I’m paying very close attention to my DEXA results. I want to know what my bone health and body composition look like while I still have the ability to meaningfully build—by the time I’m 53, it will be much harder.
- Metabolic health: Because I eat Parsley-approved, I’ve always had great blood sugar control and heart health. But regardless of how well we eat, blood sugar control starts to weaken in our 40s, so I’m paying close attention to changes in my hemoglobin A1c this year.
What I recommend for you
At minimum, you should be testing the following every year. (Ideally, every six months.) Take this list to your doctor at your next well visit. And schedule one if you haven’t seen your provider in the past 12 months!
- Complete blood count (CBC) A measure of overall health that screens for anemia, infections, and certain chronic conditions.
- Comprehensive metabolic panel (CMP) Tests liver and kidney function, electrolyte balance, and measures blood glucose and protein levels.
- Electrolyte panel Includes all the electrolytes tested in a CMP plus magnesium, key for brain and cardiovascular function.
- Comprehensive cardiovascular panel Assesses heart health by measuring levels of lipoprotein(a), ApoA, ApoB, high-sensitivity CRP (hs-CRP), and oxidized LDL.
- Lipid panel Part of a comprehensive cardiovascular panel, a lipid panel measures cholesterol levels including triglycerides, LDL, HDL, and total cholesterol.
- Inflammatory markers C-reactive protein measures inflammation in the body, which can be a sign of infection or indicate an autoimmune disorder.
- Hemoglobin A1c A measure of your blood glucose levels over the past few months used to diagnose diabetes and pre-diabetes.
- Fasting insulin Assesses the body’s resistance to insulin, which is the earliest indicator of metabolic syndrome and diabetes.
- Thyroid panel Includes several markers such as TSH, Free T3, Free T4, Reverse T3, and thyroid antibodies (TPO and TGAb) which are used to evaluate thyroid function and diagnose several autoimmune conditions.
- Core nutrients Measures key nutrients including zinc, vitamin D3, B vitamins (B12, folate), ferritin (iron), magnesium, and omega-3 fatty acids.
- Sex hormones Measures estrogen (total and metabolites), progesterone, testosterone (free and total) and DHEA-S.
- Liver and kidney function Biomarkers including GGT, homocysteine and AST, ALT, and ALP evaluate liver function while GFR indicates how well kidneys filter waste.
- Heavy metals Tests for the presence of metals like mercury, lead, and arsenic in the blood, which can affect everything from neurodegeneration, to cancer risk, to fertility.
Ideally, I’d love to see more people going beyond the basics with specialty tests to make sure they’re not just living well but living optimally. Those tests include:
- Urine hormones Help us understand how your body is processing hormones, and how they are interacting—not just the topline level of hormones you have.
- 5-point cortisol test A saliva test administered at five points throughout the day gives us a full diurnal cortisol curve and better insight into adrenal function.
- Total body DEXA scan Measures bone, muscle, and fat composition for a more comprehensive picture of bone and metabolic health.
- Total body skin examination (TBSE) The first line of defense against skin cancer and especially important given melanoma rates are up more than 40% over the past 30 years.
- Pap smear and HPV screening So important for preventing cervical cancer, yet nearly 30% of women aren’t up to date with screening. I’m getting mine done this week.
- Cologuard colorectal cancer screening Detects abnormal DNA or blood markers in the stool that may indicate cancer. Colonoscopies are now recommended for people over 45, but I did my first Cologuard screening at 40 given my family history.
And if you want to go really above and beyond:
- Full body MRI Elective MRIs are becoming more accessible; I had one done last year and discovered a thyroid nodule that I can now track closely for cancer progression through my yearly labs.
- GRAIL Galleri multi-cancer early detection test Detects DNA fragments in the body that originate from cancer cells and uses an algorithm to predict what type of cancer is the most likely cause before symptoms appear.
These ultra-proactive scans aren’t for everyone—I have plenty of patients for whom these early screenings would be potentially overwhelming and lead to unnecessary testing. I recommend these tests for people who are comfortable with a) being very proactive and b) the ambiguity of an uncertain treatment path. The TL;DR, talk to your doctor before undergoing either of these tests.
What to do with all this health data
A lot of these tests are now available direct-to-consumer via companies like Function (tracks 100+ biomarkers), Ezra and Preneuvo (full-body MRI), BodySpec (DEXA scan), Lingo (continuous glucose monitor) and Parsley.
If you’re willing to pay out of pocket, you can get almost any information about your current and future disease risk, which is awesome. But, what do you do with it?
The number one thing is to work with a functional medicine specialist who can take the results and create a personalized protocol. Take A1c for example. Hemoglobin A1c below 5.7 is considered normal—if your labs come back with an A1c at 5.5, a traditional medicine doctor probably wouldn’t flag it. But an A1c of 5.5 is not optimal. Putting this number in context might prompt you to use a continuous glucose monitor for a few weeks to better understand how your body responds to food and adjust your diet accordingly to lower your risk of becoming pre-diabetic down the road.
(BTW, I advocate sharing data from fitness trackers—especially CGMs—with your doctor.)
Set up a free consult call with my team at Parsley today and take $150 off your membership when you sign up with the code RBMDCREW.
Let’s chat live! I’ll be going deep on all things longevity at Luminescence, a one-day summit in LA on Feb.1. Use code ROBIN20 for 20% off your ticket.
*The Parsley Functional Lab Panel is currently available to all members except those in NY, NJ and RI, though those states are rolling out soon!