Blood Work/Laboratory Testing

Heath markers are important tools in the assessment of clinical practice. Naturopathic Doctors are trained to assess patients with a baseline, initiate a protocol to optimize health or treat a symptom and then reassess our protocol.
Laboratory testing is used for diagnostic purposes, assessment of organ function, looking at inflammatory markers and assessment of protocol success.
Health markers have been found in the research about frailty. Fragility is a complex idea that includes a decline in biological function that will lead to deterioration of physiological function, a decline in the ability to respond to stress and an associated increase in vulnerability.
Fragility indexes have been postulated for many years using data from people and then seeing how that data changes though time. The data sets are usually multifactorial and based on current health status, medical findings such as pulse and heart rate, mood, living situations and current ability to manage the world around them. Many factors, up to 70, are used in creating a fragility index. One of the main fragility indexes was created in Canada. This index is used to compare the accuracy of other fragility indexes.

New research has just revealed a way to assess the fragility via laboratory blood tests using metabolites of known areas of energy pathways. Metabolites are the direct readout of functional activity. Metabolomics is the emerging field of comprehensive profiling of metabolites.12 metabolites present within four metabolic pathways (the carnitine shuttle, peroxisomal degradation, the kynurenine pathway and vitamin E metabolism) and were statistically significant compared to a fragility index.

Fragility index was then shown to have similar accuracy when using a set of simple blood laboratory tests:

  • Blood fibrinogen (increased in inflammation)
  • Total blood cholesterol, total blood HDL, and total blood LDL (higher HDL levels overall healthier)
  • Blood ferritin level (low to track anemia and high to track inflammation)
  • Blood CRP (increased in inflammation)
  • Blood DHEAs level (lowered levels of testosterone for men and women increase fragility)
  • Blood insulin-like growth factor (Igf-1) (age-related decline in Igf-1levels promotes the pathogenesis of intracerebral hemorrhages)
  • Fasting blood glucose (lower levels are healthier)
  • Blood HbA1C (lower levels are healthier)
  • Blood hemoglobin (to fully assess iron/anemia levels)
  • White blood cell count (to look at inflammation or infection)
  • Blood mean corpuscular hemoglobin (to fully assess anemia)

2 SNPs were also shown to increase fragility and have a relationship to carnitine, SLC16A9 (solute carrier family 16 member 9) (rs12356193) and SLC22A4 (solute carrier family 22 member 4) (rs419291) genes.

Fragility markers in simple blood tests can be helpful to assess health and efficacy of naturopathic protocols. Vitamin E and carnitine are supplements that should be considered in those with inflammation and in those who are over 50.


Rattray NJW et al. Metabolic dysregulation in vitamin E and carnitine shuttle energy mechanisms associate with human frailty. Nat Commun. 2019 Nov 5;10(1):5027.