Why won't your MD run my lab panels?

Patrick Krupka, DC, CFMP:

So a question I get regularly from patients is, can they get their family practice doctor, or gynecologist, or endocrinologist, whomever, to run our lab panels instead of us running them? Which I don't mind. I tell the patients regularly, I don't care who orders it. As long as it's got the components that I need, it'll work for us. So that comes up regularly.

Well, there are several reasons why we've had very little success getting other doctors to run our lab panels. So I just want to run through this real quickly. It's, again, something I answer pretty regularly during an average week at the office.

So number one, understand that I do functional medicine, and the lab panels that we've put together are specifically geared toward finding underlying mechanisms. Looking for problems before they are so far down the road that they're diagnosable. Looking for indications that there's dysfunction even if there's not disease at this point.

That's, to a large...

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Stop fasting for your labwork? Maybe...

Patrick Krupka, DC, CFMP:

So I was listening to another clinician talk recently about getting lab work done in a non-fasted state. And you guys know, things like cholesterol and blood sugar and things like that, when we send you to the lab for those, we generally want you to be fasting when you go into the lab. 6, 8, 10 hours without eating, you can certainly have water, but we want a decent amount of time without food consumption before you go into the lab and have those drawn. So there's a little bit of a push now to say, look, why don't we just do labs in the condition in which people live? Most people don't spend most of their time in the fasted state. Yes, you wake up that way, but then you eat, and then later you eat, and then later you eat again, and you snack a little bit, and then you exercise, and then you eat again, and then you go back to bed.

So most of your time is not spent in the fasting state, most of your time is spent in some version of what we loosely call the...

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