Chemistry Panel, Complete Blood Count and Lipid Panel

The Chemistry Panel and Complete Blood Count (CBC) is the best place to begin your disease-prevention program.This low- cost panel will give you and your physician a quick snapshot of your overall health.This test provides a broad range of diagnostic information to assess your vascular, liver, kidney, and blood cell status.The Complete Blood Count measures the number, variety, percentage, concentration, and quality of platelets, red blood cells, and white blood cells, and thus is useful in screening for infec- tions, anemias, and other hematological abnormalities.

The Chemistry Panel provides information on the status of your cardiovascular system by testing for total cholesterol, HDL (high-density lipoprotein), LDL (low-density lipoprotein), triglycerides, and the total cholesterol/HDL ratio.1

The Chemistry Panel also measures blood glucose, which is critically important for detecting early-stage metabolic syndrome, diabetes, and coronary artery disease. In light of the rapidly growing epidemic of diabetes and other related metabolic syndromes, monitoring your fasting glucose levels is as important as knowing your cholesterol.

Also included in the Chemistry Panel is an assessment of critical minerals such as calcium, potassium, iron, and we also add magnesium which is not included in standard Chemistry Panels.


An important contributor to blood clotting, fibrinogen levels increase in response to tissue inflammation. Since the development of atherosclerosis and heart disease are essentially inflammatory processes, increased fibrinogen levels can help predict the risk of heart disease and stroke.

FM Comp Blood panel

High fibrinogen levels not only are associated with an increased risk of heart attack, but also are seen in other inflammatory disorders such as rheumatoid arthritis and glomerulonephritis (inflammation of the kidney).

In a recently published study from the University of Hong Kong Medical Center, researchers identified increased levels of fibrinogen in the blood as an independent risk factor for mortality in patients with peripheral arterial disease.When left untreated, peripheral arterial disease increases the risk of heart attack, stroke, and death.This 2005 study followed 139 men and women with peripheral arterial disease for an average of six years. Death from all causes increased with elevated fibrinogen levels: 80% of patients with a fibrinogen level above 340 mg/dL survived for less than three years. Researchers concluded that increased fibrinogen was an independent risk factor for mortality in this patient population.2

In the February 2006 issue of the Journal of Thrombosis and Haemostasis, researchers reported an association between increased levels of fibrinogen and risk for venous thrombosis (blood clots).3 A recent study from Greece found an association between higher fibrinogen levels and the presence of multiple coronary lesions in patients who had suffered an acute myocardial infarction.4

A combination of lifestyle and behavioral changes—such as quitting smoking, losing weight, and becoming more physically active—may help to lower fibrinogen levels to the optimal range. Nutritional interventions may also help to optimize fibrinogen lev- els.You and your physician may wish to discuss the use of fish oil, niacin, and folic acid, along with vitamins A and C.

Hemoglobin A1C

One of the best ways to assess your glucose status is testing for hemoglobin A1C (HbA1c).5 This test measures a person’s blood sugar control over the last two to three months and is an independent predictor of heart disease risk in persons with or without diabetes.6 Maintaining healthy hemoglobin A1C levels may also help patients with diabetes to prevent some of the complications of the disease.7

According to a study published in the New England Journal of Medicine in 2005, type I diabetes patients who monitored their hemoglobin A1C (HbA1c) levels were able to achieve tight glucose control, thereby significantly lowering their risk of a cardiovascular disease event.7 Long-term elevation of blood sugar, a hallmark of diabetes, is associated with an increased risk of heart disease and stroke.

The American Diabetes Association recommends testing HbA1c levels every three to six months to monitor blood sugar levels in insulin-treated patients, in patients who are changing therapy, and in patients with elevated blood glucose levels. Since HbA1c is not subject to the same fluctuations that normally occur with daily glucose monitoring, it represents a more accurate picture of blood sugar control.

In a recent study, 1,340 type I diabetic patients were followed for a total of 17 years. Patients were randomly assigned to either intensive or conventional diabetic (blood glucose) control. In the group receiving intensive treatment, hemoglobin A1C levels were significantly lower and the risk of nonfatal myocardial infarction, stroke, or death from cardiovascular disease decreased by 57%.The decrease in HbA1c values was “significantly associated with most of the positive effects of intensive treatment on the risk of cardiovascular disease.”7

Nutritional therapies may help to optimize hemoglobin A1C levels.You and your physician may wish to discuss the use of chromium, cinnamon, and coffee berry extracts.


The amino acid homocysteine is formed in the body during the metabolism of methionine. High homocysteine levels have been associated with increased risk of heart attack, bone fracture, and poor cognitive function.

Incremental increases in the level of homocysteine correlate with an increased risk for coronary artery disease. Data from the Physicians’ Health Study, which tracked 14,916 healthy male physicians with no previous history of heart disease, showed that highly elevated homocysteine levels were associated with a more than threefold increase in the risk of heart attack over a five-year period. 2H3 homocysteine has also become recognized as an independent risk factor for bone fractures. In a recent study of 1,267 men and women with an average age of 76, investigators in the Netherlands concluded that high homocysteine levels and low vitamin B12 concentrations were significantly associated with an increased risk for bone fracture.24 This mirrors data from two previous studies published in 2004 in the New England Journal of Medicine, in which elevated homocysteine levels were shown to be an important and independent risk factor for osteoporotic fractures, including hip fractures.25,26

Elevated homocysteine levels have recently been linked to other disorders. In three recent studies, investigators found an association between elevated homocysteine levels and age-related macular degeneration.27-29 In Japan, increased homocysteine levels were found to be associated with the presence of gallstones in middle-aged men. Investigators suggested that this association “may partly explain the reported high prevalence rate of coronary heart disease” in persons with gallstones.30

A study from the Netherlands has shown that among normal individuals aged 30-80, elevated homocysteine concentrations are associated with prolonged lower cognitive performance.31

Natural therapies may help to optimize homocysteine levels.You may wish to discuss with your doctor the use of vitamin B12, vitamin B6, folic acid, and trimethylglycine

C-Reactive Protein

Increasingly, medical science is discovering that inflammation within the body can lead to a range of life-threatening degenerative diseases such as coronary heart disease, diabetes, macular degeneration, and cognitive decline. By measuring your body’s level of inflammation through regular C-reactive protein testing, you can devise a strategy of diet, exercise, and supplementation to halt many of these conditions.

C-reactive protein (CRP) is a sensitive marker of systemic inflammation that has emerged as a powerful predictor of coronary heart disease and other diseases of the cardiovascular system.32 The highly sensitive cardiac CRP test measures C-reactive protein in the blood at very early stages of vascular disease, allowing for appropriate intervention with diet, supplements, or anti-inflammatory therapy. The cardiac CRP test detects much smaller levels of inflammation than the basic CRP test, so is therefore able to identify at-risk patients earlier, even among apparently healthy persons.

A review of epidemiological data found that high-sensitivity cardiac CRP was able to predict risk of incident myocardial infarction, stroke, peripheral arterial disease, and sudden cardiac death among healthy individuals with no history of cardiovascular disease, as well as predict recurrent events and death in patients with acute or stable coronary syndromes. This inflammatory marker provided prognostic information that was independent of other measures of risk such as cholesterol level, metabolic syndrome, and high blood pressure. Investigators concluded that greater levels of cardiac CRP are associated with higher cardiovascular risk.33

According to a recently published article in the journal Circulation, “In older men and women, elevated C-reactive protein was associated with increased 10-year risk of coronary heart disease, regardless of the presence or absence of cardiac risk factors. A single CRP measurement provided information beyond conventional risk assessment, especially in [men and women at intermediate levels of risk].”3

Increased levels of C-reactive protein have previously been strongly linked with a greater risk of developing type II diabetes.35 These results were confirmed in a more recent study from the Harvard School of Public Health. In a prospective study of 32,826 healthy women, elevated CRP levels were a strong independent predictor of type II diabetes. According to investigators, these data support the role of inflammation in the pathogenesis of type II diabetes.36

C-reactive protein is also an independent risk factor for the progression of age-related macular degeneration, according to recent research published in the Archives of American Ophthalmology.37 This follows a study by the same authors, in which elevated CRP levels were shown to be an independent risk factor for age-related macular degeneration, implicating “the role of inflammation in the pathogenesis of [age-related macular degeneration].”38

Elevated levels of CRP have also been associated with the loss of cognitive ability in seemingly healthy people.39 Furthermore, elevated CRP levels have been strongly associated with major depression in men.40

High-sensitivity CRP testing likewise reveals systemic inflammation that is associated with disease activity in patients with rheumatoid arthritis.41

Natural therapies may help to optimize high-sensitivity CRP levels.You may wish to discuss with your doctor the use of fish oil, L-carnitine, and soluble fiber before meals.

Fasting Insulin and HOMAIR

Fasting serum insulin is used as an index of insulin sensitivity and resistance. Insulin resistance, estimated by homeostasis model assessment (HOMAIR), has been shown to increase accuracy over the traditional test.62 HOMAIR is determined by multiplying fasting blood glucose level by fasting insulin level and then dividing by 22.5. The lower the number, the better.

Insulin resistance (when the body does not respond to the insulin that it produces) is a common finding in metabolic disorders, including glucose intolerance, dyslipidemia, hyperuricemia, and hypertension,62 and is associated with an increased risk of symptomatic coronary artery disease.63 Furthermore, approximately 25% of persons with insulin resistance will go on to develop type II diabetes.

According to Bonora et al, the prevalence of insulin resistance estimated by HOMA is 66% in patients with impaired glucose tolerance, 84% in NIDDM (non-insulin-dependent diabetes mellitus) subjects, 54% in persons with hypercholesterolemia, 84% in hypertriglyceridemia patients, 88% in patients with low HDL cholesterol, 63% in patients with hyperuricemia, and 58% in hypertensive patients. In patients with a combination of glucose intolerance, dyslipidemia and/or hypertension, the prevalence of insulin resistance was 95%.62

Data also show that HOMA-estimated insulin resistance is an independent predictor of cardiovascular disease in patients with type II diabetes.64

Insulin resistance may also be an indicator and likely cause of kidney disease in persons with type I diabetes, according to a study at the University of Pittsburgh. Investigators also found that because insulin resistance predicts heart disease, “it may explain the longstanding observation that in type I diabetes, kidney disease predicts heart disease. In other words, insulin resistance may be the ‘common ground’ for both complications.”65

Early detection of insulin resistance may, therefore, help prevent potentially serious complications that may result from metabolic disorders, including type I and II diabetes, dyslipidemia, hyperuricemia, and hypertention.

Vitamin D

We use the 25(OH)D measurement in that the other form of vitamin D (1,25(OH)D) will decline after 25(OH)D depletion is virtually complete, and it has a longer half life of about 3 weeks.Vitamin D regulates calcium and phosphorus absorption/resorption to maintain bone health.Vitamin D deficiency is linked to depression and Seasonal Affective Disorder (SAD).Vitamin D is important in autoimmune neurological processes life MS and helps prevent ongoing inflammatory cycles that could damage tissues.42

1. Haq IU, Ramsay LE, Jackson PR,Wallis EJ. Prediction of coronary risk for primary preven- tion of coronary heart disease: a comparison of methods. QJM. 1999 Jul;92(7):379-85.

2. Cheuk BL, Cheung GC, Lau SS, Cheng SW. Plasma fibrinogen level: an independent risk factor for long-term survival in Chinese patients with peripheral artery disease? World J Surg. 2005 Oct;29(10):1263-7.

3. Diez N, Montes R, Alonso A, et al. Association of increased fibrinogen concentration with impaired activation of anticoagulant protein C. J Thromb Haemost. 2006 Feb;4(2):398-402.

4. Zairis MN, Lyras AG, Bibis GP, et al. Association of inflammatory biomarkers and cardiac troponin I with multifocal activation of coronary artery tree in the setting of non-ST- elevation acute myocardial infarction. Atherosclerosis. 2005 Sep;182(1):161-7.

5. Geberhiwot T, Haddon A, Labib M. HbA1C predicts the likelihood of having impaired glucose tolerance in high-risk patients with normal fasting plasma glucose. Ann Clin Biochem. 2005 May;42(Pt 3):193-5.

6. Selvin E, Coresh J, Golden SH, Brancati FL, Folsom AR, Steffes MW. Glycemic control and coronary heart disease risk in persons with and without diabetes: the atherosclerosis risk in communities study. Arch Intern Med. 2005 Sep 12;165(16):1910-6.

7. Nathan DM, Cleary PA, Backlund JY, et al. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med. 2005 Dec 22;353(25):2643-53.

8. Available at: ppl_1/s33.pdf. Accessed March 2, 2006.

23. Stampfer MJ, Malinow MR,Willett WC, et al.A prospective study of plasma homocyst(e)ine and risk of myocardial infarc- tion in US physicians. JAMA. 1992 Aug 19;268(7):877-81.

24. Dhonukshe-Rutten RA, Pluijm SM, de Groot LC, et al. Homocysteine and vitamin B12 status relate to bone turnover markers, broad- band ultrasound attenuation, and fractures in healthy elderly people. J Bone Miner Res. 2005 Jun;20(6):921-9.

25. McLean RR, Jacques PF, Selhub J, et al. Homocysteine as a predictive factor for hip fracture in older persons. N Engl J Med. 2004 May 13;350(20):2042-9.

26. van Meurs JB, Dhonukshe-Rutten RA, Pluijm SM, et al. Homocysteine levels and the risk of osteoporotic fracture. N Engl J Med. 2004 May 13;350(20):2033-41.

27. Kamburoglu G, Gumus K, Kadayifcilar S, Eldem B. Plasma homocysteine, vitamin B12 and folate levels in age-related macular degenera- tion. Graefes Arch Clin Exp Ophthalmol. 2005 Sep 15;1-5.

28. Seddon JM, Gensler G, Klein ML, Milton RC. Evaluation of plasma homocysteine and risk of age-related macular degeneration.Am J Ophthalmol. 2006 Jan;141(1):201-3.

29.Vine AK, Stader J, Branham K, Musch DC, Swaroop A. Biomarkers of cardiovascular disease as risk factors for age-related macular degeneration. Ophthalmology. 2005 Dec;112(12):2076-80.

30. Sakuta H, Suzuki T. Plasma total homo- cysteine and gallstone in middle-aged Japanese men. J Gastroenterol. 2005 Nov;40(11):1061-4.

31.Teunissen CE, Blom AH,Van Boxtel MP, et al. Homocysteine: a marker for cognitive performance? A longitudinal follow-up study. J Nutr Health Aging. 2003;7(3):153-9.

32. Koenig W, Sund M, Frohlich M, et al. C- Reactive protein, a sensitive marker of inflam- mation, predicts future risk of coronary heart disease in initially healthy middle-aged men: results from the MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Augsburg Cohort Study, 1984 to 1992. Circulation. 1999 Jan 19;99(2):237-42.

33. Bassuk SS, Rifai N, Ridker PM. High-sen- sitivity C-reactive protein: clinical importance. Curr Probl Cardiol. 2004 Aug;29(8):439-93.

34. Cushman M, Arnold AM, Psaty BM, et al. C-reactive protein and the 10-year incidence of coronary heart disease in older men and women: the cardiovascular health study. Circulation. 2005 Jul 5;112(1):25-31.

35. Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA. 2001 Jul 18;286(3):327-34.

36. Hu FB, Meigs JB, Li TY, Rifai N, Manson JE. Inflammatory markers and risk of developing type 2 diabetes in women. Diabetes. 2004 Mar;53(3):693-700.

37. Seddon JM, George S, Rosner B, Rifai N. Progression of age-related macular degenera- tion: prospective assessment of C-reactive pro- tein, interleukin 6, and other cardiovascular bio- markers. Arch Ophthalmol. 2005 Jun;123(6):774-82.

38. Seddon JM, Gensler G, Milton RC, Klein ML, Rifai N. Association between C-reactive protein and age-related macular degeneration. JAMA. 2004 Feb 11;291(6):704-10.

39.Teunissen CE,Van Boxtel MP, Bosma H, et al. Inflammation markers in relation to cogni- tion in a healthy aging population. J Neuroimmunol. 2003 Jan;134(1-2):142-50.

40. Ford DE, Erlinger TP. Depression and C- reactive protein in US adults: data from the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2004 May 10;164(9):1010-4.

41. Dessein PH, Joffe BI, Stanwix AE. High sensitivity C-reactive protein as a disease activi- ty marker in rheumatoid arthritis. J Rheumatol. 2004 Jun;31(6):1095-7.

42. Grant,WB and MF Holick (2005). “Benefits and requirement of vitamin D for optimal health: a review.” Altern Med Rev 10(2): 94-111.

62. Bonora E, Kiechl S,Willeit J, et al. Prevalence of insulin resistance in metabolic disorders: the Bruneck Study. Diabetes. 1998 Oct;47(10):1643-9.

63. Arad Y, Newstein D, Cadet F, Roth M, Guerci AD. Association of multiple risk factors and insulin resistance with increased prevalence of asymptomatic coronary artery disease by an electon-beam computed tomographic study. Arterioscler Thromb Vasc Biol. 2001 Dec;21(12):2051-8.

64. Bonora E, Formentini G, Calcaterra F, et al. HOMA-estimated insulin resistance is an independent predictor of cardiovascular disease in Type II diabetic subjects. Prospective data from the Verona Diabetes Complications Study. Diabetes Care. 2002 Jul;25(7):1135-41.

65.Available at: media/pcc020916/sciInsulinResistant.html. Accessed March 10, 2004