How the laboratory work is handled

Most of the Measura suite is performed in the office with non-invasive equipment. Where blood work is part of the plan, it is drawn at the same visit and processed by a clinical laboratory.

Which blood tests are ordered, and why not a fixed panel?

Panels are selected to the clinical question rather than ordered as a standard bundle. Someone being assessed for burning feet needs glycemic markers and vitamin B12; someone being assessed for a stalled nutrition plan needs insulin, glucose and a lipid particle analysis. Ordering everything on the menu produces incidental findings that generate work and answer nothing.

The laboratory panels page lists the available groups.

What does a standard annual blood panel leave out?

Fasting insulin, alongside glucose and hemoglobin A1c. Insulin rises for years before glucose does, so measuring only glucose describes a late stage of the process.
C-peptide and fructosamine, which characterize the same process differently.
Inflammatory markers including high-sensitivity C-reactive protein, ferritin and homocysteine.
Lipid particle analysis and oxidized LDL rather than total cholesterol alone.
A full thyroid panel — free T3, T4, reverse T3 and TSH, rather than TSH in isolation.
Vitamin B12, red cell magnesium, zinc and the omega ratio. B12 deficiency alone can produce both neuropathy and cognitive change, and it is correctable.

Do you need to fast before blood work?

Glucose, insulin, triglycerides and every index derived from them are shifted by a recent meal. The fasting state is documented rather than assumed, because a non-fasting sample reported as fasting is worse than no sample. Water is allowed and encouraged.

Draw time is recorded too. Cortisol, testosterone and thyroid markers all vary through the day, so a comparison between two draws at different times is not really a comparison.

Can I bring my own recent lab results?

Bring them. Recent outside laboratory work is reconciled rather than duplicated wherever it answers the same question. That is one of the more common ways to shorten a visit.

How are the blood test results interpreted?

Against the in-office measurements, not separately. An abnormal sudomotor result with a low B12 points somewhere quite specific; the same result with a raised hemoglobin A1c points somewhere else. Neither on its own tells you which. How to read your report.

Frequently asked questions

Where is the blood work done?

Most of the Measura suite is performed in the office with non-invasive equipment. When blood work is part of your plan, it is drawn at the same visit, so there is no separate trip, and the sample is processed by a clinical laboratory. Recent outside results are reconciled rather than repeated wherever they answer the same question.

Can I drink water before fasting blood work?

Yes. Water is allowed and encouraged. What matters is food, because glucose, insulin, triglycerides and every index derived from them are shifted by a recent meal. The fasting state is written down rather than assumed, since a non-fasting sample reported as fasting is worse than no sample at all.

Does the time of day matter for a blood test?

Yes, for some markers. Cortisol, testosterone and thyroid markers all change through the day, so the draw time is recorded with every sample. Comparing two draws taken at different times of day is not really a comparison, which is why the time is kept alongside the result.