Facilitated

The Dashboard of Your Health: Why Baseline Testing Matters More Than You Think

• The Facility Denver • Episode 1

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We bring real stories, strategies, and science from functional medicine to help you understand how lab testing and interpretation can transform your approach to health.

In this episode:

• Getting proper lab tests and understanding what they mean gives you power to take control of your health
• Functional medicine uses conventional labs but with different optimal ranges than standard medicine
• Establishing your baseline when feeling well creates a personal health dashboard to track changes
• Insurance-billed lab tests can cost 50-100 times more than direct cash pay options
• The four pillars we use for clinical decisions: patient history, presenting symptoms, lab results, and response to interventions
• Functional ranges (like insulin 3-6) are much tighter than standard ranges (insulin 2-24)
• Direct access testing is now available without doctor gatekeeping
• You deserve access to your health data without waiting for problems to become severe



Thanks for tuning in to Facilitated! If you enjoyed this episode, hit subscribe because, let's be honest, you'll forget otherwise. And if you really loved it, please leave us a review. Not only does it make Mitchell feel warm and fuzzy inside, but it also helps more people find functional medicine without falling into a Google rabbit hole.

Want to take the next step with functional medicine? Learn more about our new patient process and lab testing at www.thefacilitydenver.com

For more insights, tips, and behind-the-scenes content, follow us on Instagram @thefacilitydenver

Stay curious, stay proactive, and we’ll catch you next time!

Mitchell:

Welcome to Facilitated, where we bring you real stories, strategies and science from the world of functional medicine. I'm Dr Mitchell Rasmussen, a functional medicine practitioner.

Kate:

And I'm Kate Daugherty, a certified nutritionist. We are the owners of the Facility, a functional medicine clinic here in Denver, Colorado.

Mitchell:

We help people improve their biology and get out of their own way. In my view, our work is about getting to know the person with the condition much more than it's about understanding which condition the person has. As I always say, diagnose the biology, not the disease.

Kate:

On this podcast. We break down complex health topics, share real patient cases anonymized, of course and explore cutting-edge wellness strategies so you can make informed decisions about your health. Quick heads up before we dive in this podcast is for education and general information only. We're here to share insights, not to diagnose or treat. So if you're dealing with a health issue, chat with a qualified healthcare provider before making any changes. All right, let's get into it. That's our action. We're ready. We're doing it again. This is probably the third or fourth time we've recorded and we just got to roll with it. This podcasting thing is harder than we thought it was going to be.

Mitchell:

Well, we have so much we want to say, but you're dealing with an unmedicated man with ADHD who doesn't know how to keep it on the straight and narrow. First and foremost, we're doing this because the world needs another podcast really no one of our mentors. I said that to her and she said the world needs more good information and you can be a counter to some of the bad information, and I think that was what really sealed it for me that you know what. We do have something to say, and I think I know that education is a core value, and it's why you and I built a practice together was we both value educating ourselves and educating our community, and this is a way that we can reach more people who maybe don't yet know how or why to advocate for themselves and they don't understand how much power they have to take control over their health, and that's, I think, one of my goals with this.

Kate:

I like that. I think we're going to do our best to give you an arc and a takeaway and a lesson. It might not always come out that way. It might become all these little sidebars and complex conversations, but that's who we are. If you've ever been in a visit with us, you know we've got our personalities and we kind of balance each other out in the middle. So you'll start to get to know that. And just stick with us as we navigate this new platform.

Mitchell:

Some of the concepts that we'll eventually talk about will be things like specific labs and how to get that information for yourself, and how to think about prevention. I think today's goal is just more of a high-level view of why we believe labs matter, how to interpret, track labs over time, why trends are important when it comes to blood work which is why you should recheck, probably more than once a year and then even how to get labs done on your own. Eventually, we will go into maybe more specifics on that, maybe even next time. We'll go into maybe more specifics on that, maybe even next time. But let's just jump into this idea of lab testing and why it's important.

Kate:

Yeah, so we are. We call ourselves a functional medicine practice. I think probably most people at this point know or have an idea of what that means, but we're definitely not all the way in the woo-woo. We're using real conventional medical labs and it's just our interpretation of it or our action of it, or maybe sometimes our comprehensive view of it. How things are connected is a little bit different, but the labs are the exact same.

Mitchell:

The exact same as you'd get in a yearly physical. Exact same, the exact same as you'd get in a yearly physical, with the exception of we add a lot more color and information to them. You know, a standard blood panel might be 15 to 20 markers in a yearly physical and you've probably often left with no action steps or even no thought about how it's all connected. So we run those labs and then we use this idea that everything is connected, everything matters and everybody's different. And if we can not just look for what's out of range here or out of range there, but we can really step back and see the the entire picture together, that's when we can really start to establish issues that will pop up in the future and then create an action plan to avoid those diseases or conditions that might crop up later on in life.

Kate:

Yeah, it's that. Preventative lens. It's that, hey, sally, we see this coming, we see this changing. You have the power to change your diet, your lifestyle, your habits, correct deficiencies and change the course of whatever disease might be looming, based on those lab markers.

Mitchell:

Yeah, and lab testing is vitally important, but it's only one piece of a puzzle that we like to help people put together. When I think about where that fits in, it's one of four pillars that we use to help figure out what a person needs to feel better, work better and have a better arc of their future. We think about a patient history, if anybody. When you come in and sit with us, you know you've already spent an hour filling out an intake form that we read, so please don't do it the day of, please. We read that and we plan and we think about you. You are considered before you ever walk in the door. You are thought about, you are already investigated into what might be culprits and then we use that first visit to really establish that history further.

Mitchell:

To give you that second piece of the puzzle, which is what are you currently presenting with? We use labs as that third piece. Lab information helps guide one of four areas that we use for clinical decision making and the fourth one being highly valuable, which is how do you respond to a series of thoughtful, low-risk interventions? So that's our four pillars. Really, it's patient history, presenting illness, results of tests and responses to interventions, and we teach that to every single person. Today is more going to be focused on why your lab testing matters.

Kate:

Yeah, and I think a big thing is a lot of times we start to not feel good. Yeah, and I think a big thing is a lot of times we start to not feel good. We might that might be the time that we go and and seek some data or diagnostics. And one thing we want our community to understand is Go get your labs when you feel well. If you can establish a baseline for feeling well or feeling off, that is going to serve you so much better than waiting to get your testing done, and you mentioned a few minutes ago how we use different ranges.

Mitchell:

What are some examples of that?

Kate:

So we call them a functional range. I think insulin is one that we commonly see, so a fasting insulin normal range could be anywhere from 2 to 24. So above 24 is diagnostic for diabetes. Our range, we like a number, something more like 3 to five, three to six maybe. Uh, so way, way tighter, way, way smaller, and I think that's one that surprises people a lot. They'll be feeling pretty good coming in their insulin's 10. Well below normal, I'm sorry, well below normal, well within normal.

Kate:

Thank you, but that's, we'll kind of talk them off the ledge Like I don't know.

Mitchell:

We got to do something about this, or I guess we talk them to the ledge of why this matters. And I think oftentimes we'll send you your labs before we meet with you and people will only zoom around looking for what's read on their lab report and they'll come to be surprised when I'll actually spend more time talking about things that never even flagged. And I think that's one of the essential parts of lab testing is. Keep in mind, on a medical lab, the ranges are established based on an unwell population. That is not normal. That is common but not normal. So if you're waiting for something to actually flag, that is a signifier that something is much more serious. That's going on oftentimes and we want to get on top of that well before that happens.

Kate:

Yeah, it's funny we rarely use the wait and see approach, the oh, this is looking a little out of range. We better wait and retest it in six months and see what happens.

Mitchell:

Yeah, I think a perfect example is thyroid function. We hear that all the time. Well, your TSH was 4.5. It doesn't flag till 4.551. What did your doctor mention about this? Well, they said we'll come back in six months and check. Did they talk to you about eating enough protein? Did they talk to you about how this might be correlated to your constipation or your depression? No, they just said they would look at it again in six months.

Mitchell:

And that is so frustrating to me, because now I'm fighting a battle on behalf of this patient Number one, against their conventional wisdom, what they've always been taught trust your doctor. And number two, to almost wake up to the idea that they were in some ways gaslit or not supported to get resources that they need now that can vastly change the course of their history, of their, of their future, and that's one of the things that we find the most value in is helping see these trends before they become a bigger issue. So that's a big thing is interpreting and tracking labs. Over time needs to be taken into account. What's an optimal range for things, and I think we've beaten that dead horse.

Kate:

But it does kind of open up this can of worms of access, access. So with these labs that you want run more frequently or keep an eye on how can we get them done?

Mitchell:

Yeah, we are all about patient access.

Mitchell:

In fact, we are in the process of creating our own testing website for people where you can have access to direct order labs right to your house, and I will even send you a quick summary within that lab test. That helps break down simple things. And then let's say there is something that's a little bit more concerning. Then we can talk about what that looks like. But again, if you are taking these labs while you're still well, now you're creating this, almost this personal health dashboard where you know what's normal for you and what your labs look like when you feel well, so that you can now establish your normal when you get these labs done. We can literally have a kit sent to your house. You can have a phlebotomist show up at your house and take your blood for you and spin it down and send it to the lab, and it's so easy and it doesn't require making an appointment, and that's kind of the new age of of direct access medicine is you can get this information without having to sit in a cold waiting room.

Kate:

And plea with your doctor just to get a $10 marker run.

Mitchell:

Well, actually this isn't what we planned on talking about today, but you were just sharing with me from when you were pregnant and you got rear-ended and you went to the ER and you showed me your hospital services. Can you just talk about that for a second, Because I was livid.

Kate:

Yeah, this is crazy. It really paints the picture of insurance versus cash pay. So I was in the hospital and I got an itemized bill and they did run some chemistry, some lab tests. They did a comprehensive metabolic panel. Total amount $917.84. So I decided, wow, let me compare that to the LabCorp price list.

Mitchell:

Guess how much a comprehensive metabolic panel on its own, which we run on every patient, every single patient $9 and 65 cents.

Kate:

with a blood draw it's $16 and 60 cents. So my insurance great. I got to use my insurance and I got to pay $917 and 84 cents versus. Let me just pay out of pocket $16.60.

Mitchell:

And no wonder why people don't go to the doctor. I recently heard that one of the top causes of bankruptcy in America is unforeseen health care costs. Insurance is through the roof and people often ask us can I use my insurance for this? And we can totally give you a super bill that you submit, but oftentimes that cost that you just discussed, that's the cost that gets billed. If you're on a high deductible plan, you're almost always on the hook for that thousand dollars, for000, for a $20 blood test. So we often explain that to them and well, why do I have insurance? Well, that's a deeper philosophical question. If you have a horrific injury or a hospitalization required illness, that's where insurance can be amazing. We have the most insane, the most insanely competent healthcare system in the world. In my opinion, when it comes to acute care, emergency services, surgeries, diagnostic imaging, we have an amazing system set up for acute care. The problem is cost and access to it and access to it.

Kate:

Yeah, it's incredibly frustrating. So we just recognize that frustration and our answer to it is let's be as transparent as possible and let's give as much access as possible. So if there is a lab that a patient wants run, we are not going to be the ones gatekeeping them from it. We are not going to be the ones telling them no, I'm not going to order that. If you want to pay for it, we will order whatever you want. It's your health data. You absolutely deserve to have access to it.

Mitchell:

I think that's one of the coolest realizations we had and one of the benefits of COVID. Now that we see so many clients all across the country via telehealth, we can even get access to lab services all over the country for people and even imaging centers, and that's one of the ways that I can advocate and I do it for people all over the country. You are in Henderson, nevada, I can find an imaging center. I just did it for a cash pay ultrasound or MRI or CT scan and the cash pay service is about 15% the cost of what it would be through health insurance and even though I'm out of state I only have a license in Colorado we are still able to order that for people. You have access to your information. It is not gatekept. I will educate you on why.

Mitchell:

I think it might not be so important to spend money here or there. I think a big one is like stool testing. Everyone wants a stool test, everyone wants a methylation genetics panel and that's good information, but oftentimes we use that other arm of our clinical decision making, which is response to thoughtful interventions, and those aren't necessary. That being said, if you want a stool test, I will order you a stool test I don't care, it's fine.

Kate:

So many claps we just keep clapping and restarting anyway. Um, yes, you always have access to your labs, but we we also don't expect you to be your own doctor. So our new patient process we have built out a very custom, what we believe to be the best annual blood testing. It's something we'll run as a new patient, but it's also something we encourage current patients to run once a year just to again get that tracking, see what's changing over time. Make sure we're staying on top of wellness, on top of feeling your best, and that starts with information, education.

Mitchell:

That sounds good. Yeah, this was a quick one today. Just get it in the can and then next time I do want to talk more specifically about labs. It'll tie in nicely to the end of this conversation.

Kate:

Great, I like where that's going.

Mitchell:

And someday we'll have good closing jokes or lines. Wait wait, wait.

Kate:

Just had to test our sound effect. More to come, and that's a wrap for this episode of Facitated. If you enjoyed it, hit subscribe because, let's be honest, you'll forget otherwise. And if you really loved it, please leave us a review. Not only does it make mitchell feel warm and fuzzy inside, but it also helps more people find functional medicine without falling into a google rabbit hole. For more about what we do at the facility, check out our website, wwwthefacilitydenvercom. You can also follow us on Instagram at the facility Denver for extra tips behind the scenes fun and updates on new episodes. Thanks for listening. Now go facilitate your own health and we'll see you next time.