Episode 70: Functional Blood Test Analysis with Andrea Nakayama

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Reading Lab Results with a Functional Medicine Eye

When we think of functional medicine testing, we often think of expensive tests not covered by insurance. But there’s actually a lot we can learn from the regular bloodwork commonly ordered through our conventional doctor’s office. Andrea Nakayama is a world-renowned Functional Nutritionist, educator and speaker, whose mission is to change the way we do healthcare by empowering patients to reclaim ownership over their own health. In today’s podcast episode, she walks us through two blood tests that are very common: a CBC with Differential and a Complete Metabolic Panel, and tells us how she interprets these from a functional perspective.

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Show Notes

  • Intro (0:00)
  • Thank You to Our Podcast Sponsor – Paleo on the Go (2:32)
    • A frozen meal delivery service, they have a large menu of items for the paleo autoimmune protocol (AIP).
    • Use the code PHOENIX for 10% off your first order.
  • Meet Andrea (3:45)
    • Andrea Nakayama works directly with clients through her company Functional Nutrition Alliace (formerly Replenish PDX), and she also trains thousands of practitioners every year through her Full-Body Systems Class.
    • She’s regularly consulted by world-renowned doctors as the nutrition expert for some of their toughest cases. She’s also been honored with both the Impact and Service Awards from the National Association of Nutrition Professionals.
    • To hear her personal story of being diagnosed with Hashimoto’s disease, listen to Episode 27. Today she shares an update to her healing story. She was diagnosed back in 2011, and while she’s been in remission a long time now, she prefers to call it “management”, because it’s directly due to her self-care efforts that she’s able to keep her symptoms minimal.
    • Functional medicine looks at Antecedants (genetics), Triggers (things that potentially contributed to the development of autoimmune disease), and Mediators (the things we can control on a daily basis in the management of our disease like diet, sleep, stress management, etc.) As long as Andrea stays tuned in with her body and makes healthy choices (her Mediators), she manages her autoimmune health well.
  • Self-Assessment Before Lab Testing – The 3 Tiers of Epigenetic Mastery (9:40)
    • Don’t underestimate the power of tuning into your body. There’s so much we can learn and improve before ever turning to a lab test.
    • Andrea teaches a 3-Tier approach to working with clients (listed below). Often, doctors and patients want to jump straight to Tier 3, when those interventions will be much more successful (and sometimes aren’t even needed), when the other tiers are addressed first:
  • Andrea’s Baseline Lab Testing Wish List (Tier 2) – (24:52)
    • Complete Blood Count (CBC) with Differential
    • Complete Metabolic Panel
    • Complete Thyroid Panel: TSH, Free T3, Free T4, Reverse T3, TPO antibodies and TgAB antibodies
    • C-Reactive Protein and Sedimentation Rate (inflammation markers)
    • 25-Hydroxy Vitamin D
    • Homocysteine (provides information on folate levels)
    • Methylmalonic Acid (provides information on B12 action)
    • Complete Lipid Profile: Cholesterol (LDL & HDL) and Triglycerides
    • Complete Iron Panel: Iron saturation, Ferritin, Transferrin and TIBC
    • If possible, serum MTHFR
    • *These are all blood tests, and many are common ones ordered by doctors and covered by insurance. You can request the other tests, and if your doctor refuses, you can still gain a lot of information from the most basic bloodwork. If you want the full wish list, you can order those extra tests independently through Direct Labs.
  • What Is Functional Analysis? (36:53)
    • Looks at the whole person and how systems interact.
    • Seeks to find root causes of illness.
    • Works in partnership with the patient.
    • On a lab report, you’ll see an H or an L if the lab has identified something as pathologically out of range. These lab ranges actually vary based on the location of the lab and what is “average” for that area. So, you could get a “high” result from one lab and a “normal” result from another. These are the results that will get your doctor’s attention.
    • In functional analysis, practitioners look at how the results reflect optimal health or hint at imbalances. It’s as much an art as a science. Andrea cannot teach us all that she’s learned in years of practice, but she can give us an overview. The functional lab ranges she is sharing don’t mean a diagnosis. Instead, they’re information that can help guide your healing journey. Lab tests are just a snapshot in time, and they’re nothing to fear; trends that continue to show up on these tests over time are more powerful indicators than one elevated result. A skilled practitioner looks at these results in combination with your health history to prioritize treatment. Andrea uses these results to choose specific functional medicine tests unique to each patient, rather than ordering a battery of tests for all patients.
  • CBC with Differential (39:43)
    • The Complete Blood Count (CBC) looks at your white blood cells (immune cells) and red blood cells (information carriers). The Differential breaks this down into different types.
    • White blood cells (WBC): a healthy functional range is between 5 and 8. Higher then that indicates a possible infection. Lower than that indicates a depressed or suppressed immune system.
    • We have 5 different kinds of white blood cells. They perform unique functions and are meant to exist in our body in certain percentages. Neutrophils are the highest percentage and their functional range is between 40-60%. Higher than that can indicate acute infection or acute inflammation.  Lymphocytes’ functional range is 25-40%. Higher than that can indicate either acute or chronic issues, such as viruses, autoimmunity or detoxification challenges. Monocytes’ functional range is between 0-7%.  Higher than that can indicate liver dysfunction, prostate problems, or the process of recovering from an infection.  If they stay elevated for an extended period of time, that’s a possible indication of Epstein Barr virus. Eosinophils’ functional range is between 0-3%. Higher than that can indicate food sensitivities, environmental allergies, or parasites. Basophils’ functional range is 0-1%. Higher than that can indicate histamine intolerance.
    • Unusual red blood cell results can sometimes indicate dehydration, and drinking more water might normalize those results.
  • Complete Metabolic Panel (49:29)
    • Fasting glucose functional range is between 76-88. Higher than that can indicate blood sugar issues.
    • BUN speaks to protein metabolism.
    • AST and ALT (or SGOT/SGPT) are your liver enzymes. Their functional range is between 15-26. Lower than that can indicate magnesium or B6 deficiency. Higher than that can indicate liver inflammation or detoxification challenges.
  • Outro (1:00:38)
    • If you’re interested in learning more about the functional nutrition counseling that Andrea and her team offer, you can learn more through her website: Functional Nutrition Alliance. She also has a free gift for anyone interested. It’s her Food Mood Poop ebook, which teaches you all about personal tracking and self-assessment. Andrea also loves to teach. If you’re a practitioner who would like to expand your knowledge or someone who wants to learn more about functional nutrition as a career, check out Functional Nutrition Certification Program.  Another free gift is a primer for the 3 Tiers paradigm she shared on today’s podcast.
    • Eileen (your podcast host) is the author of multiple books, written to help people thrive with autoimmune disease. Learn more on the Books Page.
    • If you like this podcast, follow or subscribe through your favorite podcast app. You can also subscribe to Eileen’s biweekly newsletter.
    • Check out the entire archive of podcast episodes.

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4 comments on “Episode 70: Functional Blood Test Analysis with Andrea Nakayama”

    1. Eileen

      Hi Rita. It really varies based on your insurance policy, your doctor’s willingness to order tests, which tests are ordered, and whether the lab is in your insurance network. The blood tests Andrea discusses are usually covered (although it’s always best to confirm with your insurance company to be sure). Conventional autoimmune tests ordered by MD’s are also usually covered. Functional medicine autoimmune antibody tests are less likely to be covered (like the Cyrex Array 5) – that is usually paid out-of-pocket. Eczema isn’t officially an autoimmune disease. My understanding is that there is an immune system component, but it’s not autoimmune activity necessarily. However, other autoimmune diseases might have eczema as a symptom.

      Reply
  2. Diana

    Hi Eileen,

    I wonder how you think about this functional approach in relation to medication. Does Andrea seek to help her clients totally heal from autoimmunity and get off all meds? Or is it just to feel better? I struggle with what I believe about what’s possible without medication, as I have been using functional medicine for 3 years and spent lots and lots of money but still have very active disease (I’m at my rock bottom). I just recently went on a pretty serious medication to prevent more joint damage, and I feel like I failed, essentially because I ran out of money to continue with functional medicine. I’ve done all the gut tests, the organic acids, the genetic stuff, the AIP, tons of supplements and protocols, and I am very ill (and to be honest, quite bitter about functional medicine!).

    Anyway, I’d love to know your thoughts on functional medicine’s place and whether you think it is capable of reversing autoimmune disease. Every time I hear a talk like this I wonder, should I keep going down the functional path until I am symptom-free without medication? The implication in many conversations about functional medicine is that that’s the goal (not in this podcast, but in many!).

    Thank you!

    Reply
    1. Eileen

      Hi Diana. I can relate to this post so much. Let me try to address your questions one at a time. One of the things I love about Andrea is that she is not anti-medication. Her goal is to help people reclaim a vital life, with all the tools at their disposal. While some people can achieve that without medication, others do much better with medication. And let me say this clearly: it isn’t a personal failure. Some autoimmune diseases are simply more aggressive than others. There’s a big difference between reversing autoimmune disease and a cure, and it’s been a journey of acceptance for me as well. Reversing autoimmune disease is when we reduce symptoms, reclaim abilities we thought were lost forever, and find joy in life again. But we still have autoimmune disease. Last year, I went on medication myself. It was a huge decision for me emotionally and spiritually, but in the end, it was absolutely the right choice for me. Even though the AIP has made a huge difference in my health, I never achieved remission before I went on medication. If you haven’t listened already, I recommend checking out my Medication Decisions podcast, where people with a wide variety of medication experiences share their decision-making process. My view of functional medicine is that it’s goal is to reduce obstacles to healing, which in turn allows diet, lifestyle and medication interventions to all work better. But it doesn’t necessarily replace those things. Even though we wish it would. I agree with you that sometimes practitioners make promises they shouldn’t. The best practitioners don’t do that. Gentle hugs coming your way, and I hope the medication lifts you from rock bottom quickly and effectively.

      Reply

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