Are you actually healthy? A doctor explains how to know for sure

You probably know that you should have an annual physical exam, but does that mean you’re healthy? It depends, says Robin Berzin, MD, the CEO of the functional medicine practice Parsley Health. She believes that certain tests give a stronger idea of an individual’s overall health—and can help health care providers and patients work better together.  Here, the Well+Good Council member outlines the top markers of good health, plus shares her advice on getting your own health evaluated.

You work out at least four days a week, eat clean most days, and are all about that self-care. But are you actually healthy? So many people come to my practice, Parsley Health, asking this question, and the answer really differs for everyone. Regardless of how healthy you think you are, the best way to measure your health is through specific lab tests that are reviewed by a doctor. The problem is, most doctors only test the basics. To truly get a full picture of your health, it’s best to work with a doctor who is trained in advanced medical testing and will know how to interpret your results.

These are the top markers of good health that everyone should be tested for at least annually.

Low inflammation

Chronic inflammation has been linked to everything from depression and poor sleep quality to heart disease and cancer, so keeping inflammation levels low is crucial. Two good inflammatory markers to get checked are hsCRP and homocysteine.

Moderate levels of hsCRP are associated with cardiovascular disease, while high levels could be related to an acute sickness like a cold or flu—or could be a more serious sign of an autoimmune disorder or other inflammatory process. Scientists have linked elevated levels of homocysteine to dementia and vascular disease.

A healthy thyroid

Your thyroid produces hormones that are involved in regulating cell metabolism, so when your levels of these vital hormones are off, it can have a ripple effect throughout the body. Thyroid diseases and sub-optimal levels of these hormones are associated with weight gain, fatigue, constipation, and even miscarriage.

Traditional lab work looks at your TSH, or thyroid stimulating hormone levels, but usually doesn’t include total T3, free T3, reverse T3, free T4, and anti-thyroglobulin and anti-TPO antibodies. I recommend getting these tested as well. I like to see my patients in the clinically “optimal ranges” for these rather than the “normal ranges.” For context: Just because something is “normal” (meaning within a few standard deviations of the mean), that doesn’t mean it’s optimal (meaning ideal for you and your body).

Ideal nutrient levels

Nutrient deficiencies are more common than you might think, but most people don’t know they have them. These deficiencies could show up as symptoms like fatigue, brain fog, and irritability. Usually they are a sign of a deeper problem or might be caused by another medication, so it’s necessary to address not just the deficiency, but also the underlying cause. I recommend getting tested for some of the most common deficiencies: vitamin D, magnesium, B12, iron, and iodine. Again, aim for “optimal ranges.”

A normal cortisol pattern

A four-point cortisol test measures the stress hormone cortisol and how your levels fluctuate over the course of the day. Ideally, they are high in the morning when you wake up and naturally drop throughout the day to the lowest point at night. If your levels follow a different pattern, it can explain things like high blood pressure, weight gain, and insomnia.

Balanced sex hormones

Whether or not you’re taking hormones like the birth control pill, checking up on on your sex hormones is essential. A hormonal imbalance might be a sign of PCOS, or it could be the reason you have irregular periods, acne, weight gain, hair loss, fatigue, or infertility. Ask your doctor to check your levels of estrogen, progesterone, DHEA-S, and testosterone. We typically look at female hormones on day 21 of the menstrual cycle in pre-menopausal women, but if you don’t have a regular cycle, are post-menopausal, or are specifically checking markers of fertility, other days might be preferable.

Cholesterol under control

You’ve probably had your cholesterol taken many times, and for good reason—cholesterol levels are important! But most doctors only order a basic lipid profile, which measures total cholesterol, LDL and HDL cholesterol, and triglycerides. I check the NMR profile of my patients, which, in addition to those measures, looks at lipoprotein particle number and size. Research shows that looking at numbers of specific particles is more indicative of cardiovascular risk than basics like total cholesterol and total LDL. Most people can manage their cholesterol levels by adjusting their diet and exercise, but it’s important to take preventative action before serious damage is done.

Remember, just getting these tests done is not enough. You need the guidance of a doctor or health coach to interpret the results, like we do at Parsley Health. Then, you need to make changes in your life that will help optimize anything out of the ordinary. Once you make changes—such as those made through diet, exercise, and supplementation—get follow-up tests done to make sure you’re on track.

Robin Berzin, MD, is the founder and CEO of Parsley Health, an innovative primary care practice with offices in New York, Los Angeles, and San Francisco. Dr. Berzin attended medical school at Columbia University. She is a certified yoga instructor and a meditation teacher.

What should Robin write about next? Send your questions and suggestions to [email protected].