Lab Test Interpretation Guide

Gabriel's Take:

Your TSH of 3.8 is "normal" by conventional standards, but functionally it suggests your thyroid is working harder than optimal. Most people feel best with TSH 1.0-2.0. Above 2.5 often correlates with fatigue, weight gain, and brain fog even when doctors say you're "fine."

Gabriel's Take:

Free T4 measures the raw material your body must convert to active T3. Being in the upper-middle range (1.0-1.5) ensures adequate substrate for conversion. Low-normal T4 with symptoms suggests production issues, not just "borderline."

Gabriel's Take:

Free T3 is THE active thyroid hormone that runs your metabolism. You want it in the upper third of range (3.0-4.0). Below 3.0, even if "normal," often means fatigue, weight resistance, and cold extremities. This is where you actually FEEL the difference.

Gabriel's Take:

Reverse T3 is your metabolic brake. High rT3 (>20) blocks Free T3 from working, even when Free T3 looks normal. This is why you feel hypothyroid with "normal labs." Caused by stress, inflammation, dieting, or illness. Functional goal: keep it low-normal.

Gabriel's Take:

This ratio is CRITICAL. Calculate: (Free T3 × 100) / Reverse T3. Need >20 for good cellular thyroid function. Below 20 = tissue-level hypothyroidism even with normal TSH. This is the metric conventional docs miss that explains why you feel terrible with "normal" labs.

Gabriel's Take:

Any detectable TPO antibodies means your immune system is attacking your thyroid. Conventional cutoff (35) means significant damage already occurred. Functional goal: <9, ideally zero. Catch and reverse autoimmunity early through diet, gut healing, and nutrient optimization before thyroid is destroyed.

Gabriel's Take:

Often elevated alongside TPO antibodies in Hashimoto's. Some people have only TgAb positive. Functional medicine aims to drive these toward zero through immune modulation, gut repair, and reducing triggers (gluten, infections, toxins).

Gabriel's Take:

T3 Uptake is old-school but helps interpret Total T4. High uptake = more free hormone (hyperthyroid or low binding proteins). Low = more binding, less free hormone. Functional range keeps binding capacity optimal, not just "normal."

Gabriel's Take:

Total T4 includes bound (inactive) hormone. Less useful than Free T4, but should be mid-range or higher (6-10). Low Total T4 suggests inadequate production. Functional medicine prefers Free T4/Free T3 for precision.

Gabriel's Take:

Total T3 reflects overall T3 production/conversion. Should be mid-to-upper range (100-180). Low Total T3 with normal T4 = conversion problem. Free T3 is more clinically useful, but Total T3 trending low flags conversion issues early.

Gabriel's Take:

Not a blood test, but essential. If antibodies are elevated or symptoms persist with normal labs, ultrasound can show early Hashimoto's changes (heterogeneous echotexture) before TSH rises. Gabriel recommends baseline ultrasound for anyone with thyroid symptoms or family history.

Gabriel's Take:

Fasting glucose of 95 is "normal" but functionally suboptimal. Above 90 correlates with increased diabetes and heart disease risk. Functional target 75-85 reflects true metabolic health. If yours is 90-99, you're on the insulin resistance path even though your doctor says you're fine.

Gabriel's Take:

This is HUGE. Conventional range goes up to 25, but anything above 6 indicates insulin resistance YEARS before glucose rises. Fasting insulin is the earliest warning sign. At 10-15, you're insulin resistant even with normal glucose. Gabriel catches prediabetes 5-10 years earlier than conventional medicine.

Gabriel's Take:

HbA1c of 5.5 is "normal" but functional goal is <5.3. Every 0.1% increase above 5.0 raises heart disease and dementia risk. Conventional medicine waits until 5.7+ (prediabetes), but damage starts earlier. Optimize now, not when you're diagnosed.

Gabriel's Take:

HOMA-IR is the gold standard for assessing insulin resistance from fasting labs. Conventional cutoff is 2.0, but functional optimal is <1.0. Between 1-2 = early insulin resistance. Above 2 = significant resistance. This catches metabolic dysfunction EARLY.

Gabriel's Take:

C-peptide tells you if your pancreas is overworking (high = insulin resistance) or failing (low = Type 1 or burnout). Functional medicine uses this to differentiate insulin resistance from pancreatic exhaustion and monitor progression.

Gabriel's Take:

Total cholesterol alone is OUTDATED. You can have 180 with dangerous small LDL particles, or 240 with large fluffy protective LDL. Functional medicine cares about particle size/number (NMR lipoprofile), inflammation, and oxidation—not just this number.

Gabriel's Take:

LDL cholesterol (LDL-C) is a POOR predictor of heart disease. LDL particle NUMBER (LDL-P) and ApoB are what matter. You can have low LDL-C but high particle number (dangerous) or high LDL-C with low particle number (safer). Gabriel orders advanced lipid testing, not just basic panels.

Gabriel's Take:

Low HDL (<50 men, <60 women) is a red flag for metabolic dysfunction. Functional optimal: >55 men, >65 women. HDL quality matters too—dysfunctional HDL exists. But higher HDL generally = better cardiovascular protection and insulin sensitivity.

Gabriel's Take:

Triglycerides >100 signal carb intolerance and insulin resistance. Functional goal <80, ideally <70. High TG with low HDL = metabolic syndrome. TG/HDL ratio >2 predicts insulin resistance and heart disease better than LDL alone.

Gabriel's Take:

VLDL carries triglycerides. Elevated VLDL = high TG and insulin resistance. Functional medicine targets <20 through carb reduction and metabolic optimization. High VLDL contributes to small dense LDL formation (the dangerous type).

Gabriel's Take:

LDL-P is the BEST predictor of heart disease—better than LDL cholesterol. Measures particle COUNT, not cholesterol content. You want <1000 nmol/L. Discordance (high LDL-P with normal LDL-C) is common in insulin resistance. This is what Gabriel orders instead of basic lipids.

Gabriel's Take:

Lp(a) is genetically determined and highly atherogenic. Elevated Lp(a) (>30 mg/dL) significantly increases heart disease risk independent of LDL. Can't be lowered easily—niacin helps modestly. If high, must be aggressive with other risk factors (inflammation, LDL-P, blood pressure).

Gabriel's Take:

ApoB measures the NUMBER of atherogenic particles (LDL, VLDL, Lp(a)). One ApoB per particle. Better predictor than LDL-C. Functional optimal <80 mg/dL. Gabriel uses ApoB as primary lipid target, not LDL cholesterol.

Gabriel's Take:

ApoA1 is the protein on HDL particles. Higher = better cardiovascular protection. ApoB/ApoA1 ratio is powerful: want <0.6 for optimal cardiovascular health. Low ApoA1 flags metabolic dysfunction even with normal HDL-C.

Gabriel's Take:

Homocysteine >10 increases cardiovascular and dementia risk. Conventional cutoff (15) is way too high. Functional optimal <8, ideally <7. Caused by B-vitamin deficiency (B12, folate, B6) or MTHFR mutations. Easy to fix with methylated B vitamins.

Gabriel's Take:

Uric acid >6.0 (even in "normal" range) increases gout, kidney disease, and cardiovascular risk. High uric acid = fructose overconsumption and insulin resistance. Functional target 3.5-5.5. Gabriel views elevated uric acid as a metabolic red flag.

Gabriel's Take:

Total T of 350 ng/dL is "normal" for men but functionally low. Men feel best 500-800+. Below 450, expect fatigue, low libido, muscle loss. Conventional medicine waits until <300 to treat. Women need 30-60 ng/dL for optimal energy, mood, libido. Gabriel optimizes, not just "normalizes."

Gabriel's Take:

Free Testosterone is what's actually AVAILABLE to tissues. Can have normal Total T but low Free T if SHBG is high. Functional optimal: upper third of range. Free T reflects true androgen status better than Total T.

Gabriel's Take:

Men need SOME estradiol (20-40) for bone and brain health, but >50 = estrogen dominance (fatigue, gynecomastia, ED). Women need higher levels, but E2 >200 (non-ovulatory) flags estrogen dominance. Balance is key.

Gabriel's Take:

Progesterone is crucial for women in luteal phase (>10 ng/mL Day 21). Low progesterone = estrogen dominance → PMS, anxiety, insomnia, heavy periods. Also needed for fertility and pregnancy. Gabriel optimizes progesterone through lifestyle or bioidentical supplementation.

Gabriel's Take:

DHEA-S declines with age and chronic stress. Low DHEA (<150) = adrenal exhaustion, low resilience, accelerated aging. Optimal: mid-to-upper range. Supplementing DHEA can improve energy, mood, immunity, and longevity. High in women = PCOS or adrenal tumor.

Gabriel's Take:

Morning cortisol should be 10-18 μg/dL (upper-mid range). Low AM cortisol (<10) = adrenal dysfunction or HPA axis suppression → fatigue, dizziness, low resilience. Very high = Cushing's or acute stress. Single AM cortisol doesn't capture full picture—4-point better.

Gabriel's Take:

4-point salivary cortisol (morning, noon, evening, night) shows your cortisol RHYTHM. Healthy = high morning, low night. Flattened curve or reversed rhythm = HPA axis dysfunction ("adrenal fatigue"). This is FAR more useful than single AM cortisol for assessing chronic stress.

Gabriel's Take:

SHBG binds testosterone and estrogen, reducing free (active) levels. Low SHBG (<25) = insulin resistance, PCOS. High SHBG (>60) = low free testosterone despite normal total T. SHBG is the key to interpreting Total vs Free testosterone.

Gabriel's Take:

LH stimulates testosterone (men) and triggers ovulation (women). High LH + low testosterone = primary hypogonadism (testicular failure). Low LH + low testosterone = secondary (pituitary/hypothalamic). LH:FSH ratio >2 in women = PCOS red flag.

Gabriel's Take:

FSH stimulates sperm (men) and egg development (women). High FSH in women >40 = approaching menopause. High FSH + low T in men = testicular failure (primary hypogonadism). FSH:LH ratio helps diagnose reproductive issues.

Gabriel's Take:

Prolactin >20 (men) or >30 (women, non-pregnant) can suppress testosterone/libido, cause ED, and signal pituitary tumor (prolactinoma). Many medications raise prolactin. Functional optimal: mid-range. High prolactin is often missed cause of sexual dysfunction.

Gabriel's Take:

Pregnenolone is the precursor to ALL steroid hormones (cortisol, DHEA, testosterone, estrogen, progesterone). Low pregnenolone = upstream hormone production issue. Supplementing pregnenolone can improve cognition, memory, mood, and downstream hormone production. Often low in aging and chronic stress.

Gabriel's Take:

Aldosterone regulates sodium retention and BP. High aldosterone = hypertension, low potassium (Conn's syndrome). Low = adrenal insufficiency → salt cravings, low BP, dizziness. Functional medicine checks aldosterone in resistant hypertension or adrenal dysfunction.

Gabriel's Take:

IGF-1 reflects growth hormone (GH) status. Low IGF-1 (<150) = GH deficiency → low muscle, high fat, poor recovery, accelerated aging. Functional optimal: mid-to-upper range (180-250). Optimize naturally via sleep, resistance training, fasting.

Gabriel's Take:

GH is pulsatile (released in bursts), so random GH testing is not useful. IGF-1 is a better marker of GH status. GH stimulation testing (insulin tolerance test) is gold standard for GH deficiency diagnosis. Functional medicine focuses on IGF-1 and optimizing natural GH secretion.

Gabriel's Take:

Vitamin D of 35 is "normal" but functionally insufficient. Optimal 60-80 ng/mL for immune function, mood, bone health, autoimmunity prevention. Most people need 4,000-8,000 IU/day to reach this. Conventional "sufficient" (>30) is just enough to prevent rickets, not optimize health.

Gabriel's Take:

B12 of 250 pg/mL is "normal" but neurological damage can occur below 400. Functional optimal 500-800. Vegans, elderly, PPI users at risk. Methylcobalamin (not cyanocobalamin) preferred. Low B12 + high homocysteine = functional deficiency even if B12 looks "okay."

Gabriel's Take:

Folate should be mid-to-upper range (8-15). Low folate + high homocysteine = cardiovascular and cognitive risk. Use methylfolate (5-MTHF), especially if MTHFR gene variants. Folic acid (synthetic) may not convert well in 40-60% of people.

Gabriel's Take:

Serum magnesium is useless (only 1% of total body Mg). RBC magnesium shows intracellular stores. Most people are deficient (<5.0). Optimal 5.0-6.4. Magnesium deficiency causes anxiety, insomnia, cramps, migraines, arrhythmias. Gabriel ALWAYS orders RBC Mg, never serum.

Gabriel's Take:

Zinc should be mid-to-upper range (90-120 μg/dL). Low zinc (<80) = poor immune function, low testosterone, hair loss, skin issues. Zinc deficiency is common (poor soil, vegetarian diets). Must balance with copper (Zn:Cu ratio important).

Gabriel's Take:

Copper should be mid-range (85-120). Excess copper (>130) = oxidative stress, anxiety, estrogen dominance. Deficiency = anemia. Copper competes with zinc, so balance matters. Birth control pills raise copper. Copper IUD can raise serum copper.

Gabriel's Take:

Ideal Zn:Cu ratio is 0.8-1.2. Low ratio (<0.7) = copper excess → anxiety, estrogen dominance, inflammation. High ratio (>1.5) = possible copper deficiency. Gabriel targets the ratio, not just individual values. Common issue: birth control pills raise copper and lower zinc.

Gabriel's Take:

Ferritin of 15 is "normal" but causes crushing fatigue, hair loss, restless legs, and brain fog. Women need 50-100, men 100-200 for optimal energy and thyroid function (T4→T3 conversion needs iron). Above 300 = inflammation or iron overload (hemochromatosis). Gabriel won't accept ferritin <50.

Gabriel's Take:

Serum iron should be mid-range (80-130). Low = anemia. High = overload. Serum iron alone is insufficient—must check ferritin, TIBC, and saturation for full picture. Iron is highly variable (time of day, meals).

Gabriel's Take:

TIBC rises in iron deficiency (body trying to grab more iron) and falls in iron overload. Should be mid-range (300-400). Interpret with ferritin and iron saturation for complete iron status assessment.

Gabriel's Take:

Iron saturation <20% = iron deficiency. >45% = possible hemochromatosis (genetic iron overload). Functional optimal 30-40%. This is the most sensitive early marker for hemochromatosis (before ferritin rises high). Check fasting.

Gabriel's Take:

Iodine deficiency is common (iodized salt avoidance, low seafood). Low iodine = hypothyroid symptoms, goiter, fibrocystic breasts. Urinary iodine <100 = deficiency. Optimal 150-200 μg/L. Caution: high-dose iodine can trigger Hashimoto's flares in susceptible people. Test before supplementing.

Gabriel's Take:

Selenium is CRITICAL for T4→T3 conversion and thyroid antibody reduction. Low selenium (<100) = poor thyroid function, weakened immunity, increased cancer risk. Optimal 110-140 μg/L. Selenium 200 μg/day can lower TPO antibodies in Hashimoto's.

Gabriel's Take:

Vitamin A should be mid-range (45-70). Low (<40) = immune dysfunction, night blindness, dry skin. Many vegetarians are deficient—beta-carotene from plants converts poorly to retinol. Functional medicine uses preformed vitamin A (retinol) from animal sources or supplements.

Gabriel's Take:

Vitamin E should be mid-range (8-15 mg/L). Deficiency is rare but causes oxidative stress and neuropathy. Use mixed tocopherols (natural vitamin E), not synthetic alpha-tocopherol alone. Gabriel checks Vitamin E in oxidative stress or cardiovascular cases.

Gabriel's Take:

Omega-3 Index <8% doubles cardiovascular and sudden cardiac death risk. Optimal >8%, ideally 10-12%. Most Americans are 4-6% (deficient). Requires high-dose fish oil or fatty fish consumption (2-3 servings/week). This is one of the BEST longevity biomarkers.

Gabriel's Take:

RBC fatty acid profile shows your membrane composition. Key metric: omega-6:omega-3 ratio. Modern diets are 15-20:1 (inflammatory). Functional optimal <4:1. High omega-6 (from seed oils) + low omega-3 = chronic inflammation, heart disease, depression. Gabriel uses this to personalize fat intake.

Gabriel's Take:

hs-CRP (high-sensitivity) is a MAJOR cardiovascular risk factor. Conventional says <3.0 is normal, but functional goal is <0.5 mg/L. Between 1-3 = moderate inflammation and 2-3× increased heart disease risk. Gabriel treats inflammation as aggressively as high cholesterol.

Gabriel's Take:

hs-CRP >1.0 mg/L = 2× cardiovascular risk. >3.0 = 3× risk. Functional optimal <0.5. Caused by obesity, poor diet, gut inflammation, infections. Gabriel treats hs-CRP as aggressively as cholesterol. Lowering hs-CRP with lifestyle reduces heart attack and stroke risk by 30-50%.

Gabriel's Take:

ESR >20 flags inflammation but is non-specific (infections, autoimmune, cancer). Slower/older test than hs-CRP. Functional optimal <10. Very high ESR (>50) warrants urgent workup for temporal arteritis, infection, or malignancy.

Gabriel's Take:

Fibrinogen >400 increases clotting risk (stroke, heart attack, DVT). Also a marker of chronic inflammation. Functional optimal 250-350. High fibrinogen = cardiovascular risk even with normal cholesterol. Lowered by anti-inflammatory diet, exercise, fish oil.

Gabriel's Take:

IL-6 is a key inflammatory cytokine. Elevated IL-6 (>5) = systemic inflammation → cardiovascular disease, diabetes, autoimmunity, aging. Functional optimal <3. Reduced by weight loss, anti-inflammatory diet, omega-3s, exercise.

Gabriel's Take:

TNF-alpha drives chronic inflammation in autoimmune diseases (RA, IBD, psoriasis). Elevated TNF-alpha (>8) = systemic inflammation. Biologics (anti-TNF drugs) target this. Functional optimal <5. Lowered naturally by omega-3s, curcumin, weight loss.

Gabriel's Take:

ANA is a screening test for autoimmune disease. Positive ANA (especially >1:160) warrants further workup. Low-positive titers (1:40-1:80) can be false positives. High titers + symptoms = likely autoimmune disease. Gabriel checks ANA in unexplained inflammation, fatigue, joint pain.

Gabriel's Take:

Low C3 = autoimmune disease (lupus, vasculitis) consuming complement. High C3 = acute inflammation. Should be mid-range (100-160). Gabriel checks C3/C4 in suspected autoimmune cases.

Gabriel's Take:

C4 parallels C3. Low C3 + low C4 = autoimmune disease (lupus, vasculitis). Low C4 alone = hereditary angioedema. Should be mid-range (15-35). Functional medicine checks complement in autoimmune workups.

Gabriel's Take:

IgG is the main antibody for long-term immunity. Low IgG (<700) = immunodeficiency → recurrent infections. High IgG (>1600) = chronic infection or autoimmune disease. Should be mid-range (800-1500).

Gabriel's Take:

IgA protects mucous membranes (gut, lungs, sinuses). Low IgA (<70) = recurrent infections (sinusitis, UTIs, gut issues). IgA deficiency is the most common immunodeficiency. High IgA (>400) = IgA nephropathy or chronic infection. Gabriel checks IgA in gut and sinus issues.

Gabriel's Take:

IgM is the initial antibody response to infections. Low IgM (<40) = immunodeficiency. High IgM (>230) = acute infection or lymphoproliferative disorder (Waldenström's). Should be mid-range (60-200).

Gabriel's Take:

IgE mediates allergic reactions. Elevated IgE (>100) = allergies, asthma, eczema, or parasites. Functional optimal <50 IU/mL. High IgE flags atopy and histamine issues. Gabriel checks IgE in allergy and histamine intolerance cases.

Gabriel's Take:

Comprehensive stool testing (GI-MAP, GIMAP, etc.) reveals infections (H. pylori, parasites, yeast), dysbiosis (imbalanced bacteria), inflammation, and digestive function. Gabriel uses this to guide gut healing protocols. Conventional medicine rarely orders this—huge missed opportunity.

Gabriel's Take:

Zonulin regulates tight junctions in gut lining. Elevated zonulin (>30) = leaky gut → food particles, bacteria, toxins leak into bloodstream → autoimmunity, inflammation, food sensitivities. Triggered by gluten, dysbiosis, infections. Gabriel treats high zonulin with gut repair protocols (remove gluten, heal with L-glutamine, probiotics).

Gabriel's Take:

Calprotectin >50 μg/g = intestinal inflammation (IBD likely). <50 = IBS (functional, not inflammatory). This test DIFFERENTIATES IBD from IBS without colonoscopy. Calprotectin >200 = active IBD. Gabriel orders this before colonoscopy in gut symptoms.

Gabriel's Take:

Secretory IgA is the gut's immune defense. Low sIgA (<500) = weakened gut immunity → infections, leaky gut, dysbiosis. Often low in chronic stress ("adrenal fatigue"). High sIgA (>2000) = acute gut infection. Functional optimal 800-1800. Gabriel optimizes sIgA with stress management, probiotics, colostrum.

Gabriel's Take:

SCFAs (especially butyrate) are produced by gut bacteria fermenting fiber. They fuel colon cells, reduce inflammation, and regulate metabolism. Low butyrate = dysbiosis, increased colon cancer risk, inflammation. Gabriel optimizes SCFAs with fiber, prebiotics (potato starch, inulin), and diverse microbiome.

Gabriel's Take:

Candida is a normal gut yeast but overgrows with antibiotics, high sugar, or immune suppression. Positive Candida antibodies (especially IgG) = systemic yeast overgrowth → fatigue, brain fog, digestive issues, thrush. Gabriel treats with antifungal diet and antimicrobials. Conventional medicine often dismisses this.

Gabriel's Take:

H. pylori infects 50% of population but only causes symptoms in some. Causes ulcers, gastritis, and increases stomach cancer risk 6×. Gabriel tests via stool antigen (active infection) or breath test. Treatment: antibiotics or natural antimicrobials (mastic gum). Retest after treatment to confirm eradication.

Gabriel's Take:

IgG food sensitivity testing is controversial (not IgE allergies). Gabriel uses it to identify foods triggering inflammation in leaky gut. Common reactions: gluten, dairy, eggs, soy, corn. Remove reactive foods, heal gut, then reintroduce. Critics say IgG = exposure, not sensitivity. Gabriel finds clinical utility when combined with gut healing.

Gabriel's Take:

Heavy metals accumulate from environment (fish, water, air, occupational). Mercury (>5 μg/L) = neurological damage. Lead (>2 μg/dL) = cognitive and cardiovascular harm. Arsenic = cancer risk. Cadmium = kidney disease. Gabriel tests in unexplained neurological, cognitive, or chronic fatigue cases. Chelation therapy removes metals.

Gabriel's Take:

Mercury (especially methylmercury from fish) is neurotoxic. Hair/blood mercury >5 μg/L or urine >10 μg/L = toxicity. Symptoms: tremor, cognitive decline, neuropathy. Sources: large fish, amalgam fillings, environment. Gabriel reduces fish exposure, removes amalgams, chelates, supports with selenium and glutathione.

Gabriel's Take:

Lead is neurotoxic and cardiotoxic. No safe level. Blood lead >5 μg/dL in adults = harm (cognitive, cardiovascular, kidney). Children: >3.5 μg/dL = developmental harm. Sources: old paint, water pipes, occupational. Gabriel chelates lead >5 and investigates sources. Lead is vastly under-tested in conventional medicine.

Gabriel's Take:

Arsenic is carcinogenic (skin, bladder, lung cancer). Urine arsenic >10 μg/L = elevated exposure. Sources: contaminated water, rice, seafood. Gabriel recommends reverse osmosis water filtration, limit rice, and chelation if severely elevated.

Gabriel's Take:

Cadmium causes kidney disease, osteoporosis, and lung cancer. Blood cadmium >1 μg/L = toxicity. Main sources: smoking (primary), shellfish, contaminated food. Chelation is less effective for cadmium. Gabriel focuses on stopping smoking and supporting kidney function (hydration, antioxidants).

Gabriel's Take:

Aluminum is neurotoxic. Elevated aluminum (>10 μg/L urine) linked to cognitive decline and possibly Alzheimer's. Sources: aluminum cookware, antiperspirants, antacids, vaccines (trace). Gabriel recommends avoiding aluminum sources and detox support (silica-rich water, malic acid). Evidence for Alzheimer's link is debated but precautionary principle applies.

Gabriel's Take:

Glyphosate (Roundup) is the most widely used herbicide. Disrupts gut microbiome (it's an antibiotic), linked to leaky gut, cancer (NHL), endocrine disruption. Urine glyphosate >1 μg/L = significant exposure. Sources: non-organic grains, soy, oats. Gabriel strongly recommends organic diet to minimize glyphosate. WHO classified it as "probable carcinogen."

Gabriel's Take:

Mycotoxins from mold exposure cause chronic illness: fatigue, brain fog, respiratory issues, immune dysfunction. Testing: urine mycotoxin panel. Positive = mold exposure. Must remediate environment (home inspection, ERMI test). Treatment: binders (cholestyramine, charcoal), support detox. Conventional medicine often misses mold toxicity. Gabriel tests in unexplained chronic illness.

Gabriel's Take:

The OAT (Great Plains Lab, Mosaic, etc.) is a urine test analyzing 70+ metabolites. It reveals: mitochondrial function (Krebs cycle), neurotransmitters (dopamine, serotonin), yeast/bacteria overgrowth, oxalates, detox capacity, nutrient status (B vitamins, CoQ10, carnitine). Gabriel uses OAT to get a metabolic snapshot and guide personalized interventions. Conventional medicine doesn't use this test—huge missed opportunity.

Gabriel's Take:

WBC differential is critical. Neutrophilia = bacterial infection. Lymphocytosis = viral infection or leukemia. Eosinophilia = allergies or parasites. Monocytosis = chronic inflammation. Low WBC (<4) = immunosuppression. Functional optimal WBC 5-8 k/μL, balanced differential. Gabriel interprets patterns, not just total WBC.

Gabriel's Take:

CBC is foundational. Gabriel interprets functionally: RBC/Hgb should be mid-to-upper range for optimal oxygen delivery (not just "above minimum"). Low-normal Hgb (13.0 men, 12.0 women) = suboptimal energy. MCV <85 = iron deficiency, >95 = B12/folate deficiency. WBC 5-8 ideal (not 4-11). Platelets 175-350 optimal (extremes = clotting/bleeding risk).

Gabriel's Take:

BUN reflects protein breakdown and kidney filtration. Should be mid-range (10-18). Very high = kidney dysfunction or dehydration. Very low = liver issues or inadequate protein intake. Functional medicine interprets in context with creatinine.

Gabriel's Take:

Creatinine reflects muscle mass and kidney filtration. Should be mid-range (0.8-1.1). Used to calculate GFR. High creatinine = reduced kidney function (GFR <60 = chronic kidney disease). Gabriel monitors trends over time.

Gabriel's Take:

GFR <60 = chronic kidney disease. Functional optimal >90. GFR 60-90 = reduced reserve, warrants monitoring. GFR declines with age, but shouldn't drop below 60 until very old age if kidneys are healthy. Protect kidney function early.

Gabriel's Take:

ALT >30 flags fatty liver even if "normal" by conventional standards (up to 56). Functional optimal <25. Elevated ALT = liver inflammation, often from insulin resistance, obesity, or alcohol. Gabriel treats fatty liver aggressively to prevent progression.

Gabriel's Take:

AST is found in liver and muscle. Less liver-specific than ALT. AST/ALT ratio >2 suggests alcoholic liver disease. AST/ALT <1 suggests NAFLD. Functional optimal <25 for both. Elevated together = liver inflammation.

Gabriel's Take:

GGT is the MOST sensitive liver enzyme for oxidative stress and alcohol use. GGT >30 (even in "normal" range) predicts diabetes and cardiovascular disease. Functional optimal <25. Elevated GGT = liver distress, often before ALT/AST rise.

Gabriel's Take:

ALP should be mid-range (50-100). Very high ALP with elevated GGT = bile duct issues. Very high ALP with normal GGT = bone disease. Low ALP = zinc deficiency. Functional medicine monitors for bile flow and nutrient status.

Gabriel's Take:

Mildly elevated bilirubin (1.0-2.0) often = Gilbert's syndrome (benign genetic variant, actually protective). Very high = liver disease or hemolysis. Should be mid-range (0.3-1.0) for optimal liver conjugation and bile flow.

Gabriel's Take:

Albumin should be mid-to-upper range (4.0-5.0). Low albumin (<3.5) = poor protein status, liver dysfunction, or chronic inflammation. Gabriel monitors albumin as a nutritional and liver health marker.

Gabriel's Take:

Electrolytes must be balanced. Functional optimal: mid-range for all. Na 138-142 (not 136-145), K 4.0-4.5 (not 3.5-5.0). Low K (<4.0) = arrhythmia risk, muscle cramps, fatigue. High K (>5.0) = dangerous arrhythmia risk. CO2 (bicarbonate) reflects acid-base balance: low = acidosis, high = alkalosis. Gabriel monitors electrolytes in fatigue, heart issues, and adrenal dysfunction.

Gabriel's Take:

CMP is a metabolic snapshot. Gabriel interprets functionally: glucose 75-85 (not 70-99), electrolytes mid-range (Na 138-142, K 4.0-4.5, not extremes). Calcium 9.5-10.2 optimal. Low calcium + high PTH = vitamin D deficiency. High calcium = hyperparathyroidism or malignancy. Tight electrolyte control = better health.

Gabriel's Take:

Liver panel is critical. Gabriel's functional ranges: ALT/AST <25 (not 40-56). Elevated enzymes flag fatty liver EARLY. ALT>AST = NAFLD (non-alcoholic fatty liver). AST/ALT >2 + elevated = alcoholic liver disease. GGT most sensitive. Albumin should be mid-to-upper range (4.0-5.0) for optimal liver protein production.

Gabriel's Take:

Kidney function is vital. GFR >90 optimal (not just >60). GFR 60-90 = reduced reserve, monitor. GFR <60 = CKD. BUN/Creat ratio: <10 = liver issue or low protein, >20 = dehydration or high protein catabolism. Functional medicine monitors kidney trends to catch decline early.

Gabriel's Take:

Comprehensive hormone panels reveal the full picture. Gabriel orders Total/Free Testosterone, Estradiol, Progesterone, DHEA-S, SHBG, LH, FSH. Men need balanced T and E2. Women need cycle-appropriate levels. SHBG determines free hormone availability. Optimize hormones for energy, mood, libido, longevity.

Gabriel's Take:

Cortisol/DHEA ratio reflects stress resilience. High ratio (>10:1) = chronic stress, "adrenal fatigue," accelerated aging. Low DHEA or high cortisol both problematic. Functional optimal ratio ~5-7:1. Optimize with stress management, adaptogens (ashwagandha, rhodiola), and DHEA supplementation if low.

Gabriel's Take:

Insulin resistance is THE root of metabolic disease (diabetes, heart disease, Alzheimer's, cancer). Gabriel's comprehensive panel: fasting glucose, fasting insulin, HOMA-IR, HbA1c. Fasting insulin is the EARLIEST marker (catches insulin resistance 5-10 years before glucose rises). HOMA-IR <1 = excellent insulin sensitivity. Above 1.5 = early resistance. Treat aggressively with low-carb diet, exercise, intermittent fasting.

Gabriel's Take:

Gabriel's cardiovascular panel goes BEYOND basic cholesterol. Includes: LDL particle number (LDL-P), ApoB, Lp(a), hs-CRP, homocysteine. These predict heart disease BETTER than LDL cholesterol. Target LDL-P <1000, ApoB <80, Lp(a) <30, hs-CRP <0.5, homocysteine <8. Treat inflammation (hs-CRP) as aggressively as lipids. This is precision cardiology.

Gabriel's Take:

Gabriel's autoimmune panel screens for: Hashimoto's (TPO, TgAb), celiac (tTG, DGP), RA (RF, anti-CCP), lupus (ANA, dsDNA). Catching autoimmunity EARLY (positive antibodies before disease) allows intervention. Optimize vitamin D, heal gut, remove gluten, reduce stress, treat infections. Functional medicine REVERSES early autoimmunity; conventional medicine waits for organ destruction.

Gabriel's Take:

Gabriel's comprehensive nutrient panel covers: Vitamin D (60-80), B12 (500-800), Folate (8-15), RBC Magnesium (5-6.4), Zinc (90-120), Copper (85-120), Ferritin (50-100 women, 100-200 men), Iron Saturation (30-40%), Selenium (110-140), Vitamin A (45-70), Vitamin E (8-15), Omega-3 Index (>8%). Most people are deficient in multiple nutrients. Optimize ALL of them for health and longevity.

Gabriel's Take:

Gabriel's gut panel: Comprehensive Stool Analysis (microbiome, pathogens), Zonulin (leaky gut), Calprotectin (inflammation), Secretory IgA (immune defense), H. pylori, Candida antibodies. Gut is the ROOT of health. Fix the gut, fix the body. Protocol: remove infections/triggers, heal leaky gut, restore microbiome. This is THE foundation of functional medicine.

Gabriel's Take:

Gabriel's comprehensive tox panel: Heavy Metals (Hg, Pb, As, Cd, Al), Glyphosate, Mycotoxins, Organic Acids Test. Environmental toxins drive chronic illness: fatigue, brain fog, neurological issues, autoimmunity, cancer. Test, identify sources, remove exposure, support detox (chelation, binders, glutathione, saunas, activated charcoal). Conventional medicine ignores toxins. Functional medicine prioritizes detox for longevity.