Blood Tests to Ask for at Your Annual Physical


A Functional, Preventive Approach to Long-Term Health

Most people leave their annual physical with a simple message:

“Everything looks normal.”

But here’s the truth I see every day in my practice:
“Normal” does not always mean optimal — and it certainly doesn’t mean preventive.

As a functional health practitioner, I don’t just look for disease.
I look for patterns, early warning signs, and silent imbalances that can quietly lead to hormone issues, fatigue, weight gain, autoimmune conditions, cardiovascular disease, and metabolic dysfunction years down the road.

This blog will walk you through:

  • Blood tests worth requesting at your annual physical

  • Why the standard panel often isn’t enough

  • What functional medicine (and experts like Dr. David Perlmutter and The Great Cholesterol Myth) recommend instead

  • How I support clients by deep-diving results through a preventive lens

Why the Standard Annual Blood Panel Falls Short

Most conventional annual labs are designed to detect established disease, not early dysfunction.

They often miss:

  • Insulin resistance before diabetes

  • Inflammation before heart disease

  • Thyroid stress before hypothyroidism

  • Hormone shifts before menopause symptoms hit

  • Nutrient deficiencies before exhaustion becomes chronic

Functional practitioners ask a different question:

“What patterns are forming — and how do we support the body before things break down?”

Core Blood Tests to Ask for Every Year

(Functional + Preventive Focus)

1. Comprehensive Metabolic Panel (CMP)

This is standard — but interpretation matters.

What I look at beyond ‘normal’:

  • Liver enzymes as detox stress signals

  • Blood sugar trends over time

  • Electrolyte balance as a clue to mineral depletion

2. Fasting Insulin (Not Just Glucose or A1C)

One of the most overlooked — and most important — markers.

  • Fasting glucose can be “normal” while insulin is chronically elevated

  • Elevated insulin = inflammation, weight gain, hormone disruption

Functional goal:
Low, steady insulin — not just “acceptable” blood sugar

3. Hemoglobin A1C

This shows your average blood sugar over 3 months.

But again — context matters:

  • I look at trends, not just one snapshot

  • Rising A1C over years is an early metabolic red flag

Rethinking Cholesterol (Inspired by The Great Cholesterol Myth)

Total cholesterol alone tells us very little.

4. Advanced Lipid Panel (If Available)

Instead of focusing on “high cholesterol,” functional medicine looks at:

  • LDL particle size

  • Triglyceride-to-HDL ratio

  • Inflammation + insulin relationship

Key insight from The Great Cholesterol Myth:
Cholesterol is not the villain — inflammation, oxidation, and insulin resistance are.

5. High-Sensitivity C-Reactive Protein (hs-CRP)

This measures systemic inflammation, a major driver of:

  • Heart disease

  • Neurodegeneration

  • Autoimmune conditions

  • Hormone imbalance

You can feel “fine” while inflammation is quietly brewing.

Thyroid: Go Beyond TSH

6. Full Thyroid Panel

Ask for more than just TSH:

  • Free T3

  • Free T4

  • Thyroid antibodies (TPO & TG)

I regularly see:

  • “Normal TSH” with clear thyroid stress patterns

  • Early autoimmune markers years before diagnosis

Nutrients That Matter More Than You’ve Been Told

7. Vitamin D

A hormone-like nutrient essential for:

  • Immune health

  • Mood

  • Bone integrity

  • Hormone balance

Most people are functionally deficient, even if technically “in range.”

8. Ferritin (Iron Storage)

This is critical — especially for women.

Low ferritin can look like:

  • Fatigue

  • Hair loss

  • Anxiety

  • Exercise intolerance

And yet it’s often not checked.

9. Vitamin B12 & Folate

These impact:

  • Energy

  • Brain function

  • Detox pathways

  • Cardiovascular health

“Normal” levels may still be suboptimal for how your body functions.

Hormones & Stress Markers (When Appropriate)

Depending on age, symptoms, and life stage, I often recommend:

  • Cortisol patterns

  • Sex hormone evaluation (blood or urine-based)

Stress physiology plays a massive role in:

  • Weight resistance

  • Thyroid suppression

  • Gut dysfunction

  • Hormone chaos

The Missing Piece: Interpretation & Pattern Recognition

Here’s where most people get stuck.

They receive their labs…
They’re told everything is “fine”…
And yet they still don’t feel well.

This is where my work comes in.

One of my core services is a deep functional review of bloodwork, where I:

  • Look at patterns across markers

  • Compare results to functional optimal ranges

  • Identify early warning signs

  • Connect labs to real-life symptoms

  • Highlight what to watch preventively over time

Not just:

“Do you have a disease today?”

But:

“What is your body asking for support with now so you can avoid disease later?”

Prevention Is Not Passive — It’s Informed

You don’t need to wait for a diagnosis to take your health seriously.

Annual blood work can be a powerful preventive tool when:

  • The right markers are tested

  • Results are interpreted through a functional lens

  • Trends are tracked year over year

If you’ve ever looked at your labs and thought:

“I feel off… but no one can explain why,”

That’s exactly the gap I help bridge.

Ready for a Functional Bloodwork Review?

If you want help understanding:

  • What your labs really mean

  • What patterns may be developing

  • What to be proactive about moving forward

I offer comprehensive blood work reviews designed to support clarity, prevention, and long-term vitality. Book with Dee DavidsonHERE

Because your health story is bigger than a reference range — and your labs have more to say than you’ve been told.

About Dee Davidson, FDN-P

Dee Davidson is a Board-Certified Functional Health Practitioner, hormone and thyroid specialist, and the creator of the Confidently Balance Your Hormones podcast. She helps women in midlife and beyond uncover the root causes of fatigue, weight gain, anxiety, gut issues, and hormonal imbalances using functional labs, science-backed strategies, and nervous system regulation.

Dee’s work centers around empowering women to finally feel safe, seen, supported, and confident in their bodies — without restriction, overwhelm, or confusion.

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