If you are working with your family doctor or nurse practitioner, you might share this list with him/her and say something like:
"I realize you probably don't order these tests as a matter of routine care, but what I have read in the medical literature about modifiable risk factors for preventing dementia seems to substantiate having this information. I am willing to do the work to change anything that comes up out of optimal range, and I'd love for you to help me get these so that we might track the changes over time."
If you find yourself limited to only what you primary care provider can order for you (or what Medicare or Medicaid covers), get what you can and either check prices at sites like our Rupa Health site (link here) to see if perhaps you can get some of the most important missing labs on your own-- or just "double down," as Dr. Heather Sandison suggests in her new book, "Reversing Alzheimer's," on the known lifestyle inputs: strength training + aerobic (+ HIIT and/or EWOT), sleep, food, environment, (meditation or at least moments of mindfulness/gratitude throughout day).
Labs most PCPs/insurance plans will order/cover:
CBC (with differential)
Vitamin D
Thyroid panel (including reverse T3)
Hormone panel (estrogen, (progesterone), testosterone, (DHT), SHBG, Dhea, cortisol)
hs-CRP
Heavy metals test (lead, mercury, arsenic)
B vitamins (12,9 (folate); insurance unlikely to cover B1-7)
Omega-3s (or 3 & 6)
HSV1, EBV, HHV6 antibody (IgG) titers
Lyme (& associated co-infections, if possible) panel
Sleep study (can do at home these days, which is likely more useful)
(I would add Continuous Glucose Monitoring (CGM), which insurance now seems to cover, if only to rule out blood glucose instability, especially at night)
Brain MRI (or FDG PET)
Brain EEG (typically included in sleep study)
MoCA test (if only to establish a solid baseline, as MoCA is really capable only of detecting significant cognitive decline-- as opposed to subtle losses; to get less than a stellar score, you really have to be in a little trouble already!)
Tabular comparison
Test (or test panel) | DIY via Access Medical Labs | DIY via LabCorp (+ $10 phlebotomy fee) |
Heavy metals panel | $29.84 | $30.00 |
Female hormone panel | $79.00 | Still looking |
Male hormone panel | $74.00 | Still looking |
Thyroid panel | $50.39 | $25.00 |
Pregnenolone (aka the "memory hormone" | $35.00 | $56.00 |
Vitamin B12 + folate | $10.29 | $23.50 |
(Methylmalonic acid) | $75.00 | $89.00 |
Vitamin D (25-OH) | $20.58 | $20.00 |
Omega 3:omega 6 | $69.00 | $69.00 |
RBC magnesium | $17.00 | $20.00 |
RBC zinc | $26.75 | $31.50 |
RBC copper | $40.13 | $109.00 |
Lyme (Western blot) | $32.93 | $64.00 |
HSV1 IgG | $8.23 | $17.00 |
HSV1 + HSV2 IgG | $15.44 | $24.00 |
HHV6 IgG | $34.99 | $34.00 |
EBV IgG | $20.58 | ---- |
Labs if you are working with functional medicine practitioner, naturopath or some other Bredesen trained provider:
Full male/full female hormone panel (try to include pregnenolone)
A1C
Fasting insulin
Homocysteine (indirect measure of methylation status, particularly B12 and folate, but also B6, betaine/choline)
Mycotoxins testing (urine)
Chemical toxins testing (blood and/or urine)
Heavy metals testing (blood)
Antioxidant status testing (A-C-E, glutathione)
Mineral status-- especially magnesium, zinc, copper; maybe selenium, iodine, lithium
Mitochondrial function
Methylation status
Microbiome & gut status testing (stool and/or markers in blood (or blood spot) and urinary organic acids)
(I would add H pylori & Candida serology, although there are various ways to test for H pylori, and there is now a Dried Blood Spot test for candida, by KBMO)
Cortisol testing (both salivary & urine)
Test (or test panel) | DIY via Access Medical (+ $10 phlebotomy fee) | DIY via LabCorp (+10 phlebotomy fee) |
Fasting insulin | $5.15 | $16.00 |
Homocysteine | $10.00 | $20.00 |
hs-CRP | $8.23 | $11.00 |
Ferritin | $5.15 | $12.00 |
Iron panel | $9.26 | $10.00 |
Cadmium | $120 (21 Toxic/16 Nutritional) | Not found |
B6 | $89.00 | $65.00 |
B3 | $249.50 | $177.50 |
B2 | $228.00 | $299.00 |
B1 | $76.00 | $69.00 |
C | $30.00 | $50.00 |
E | $47.50 (tocopherol) | $50.00 |
A | $34.00 (retinol) | $55.00 |
RBC selenium | $35.00 | Not available |
Lithium | $20.00 | $20.00 |
Iodine | $80.00 | $80.00 |
GGT | $2.06 | $4.00 |
Glutathione | $71.00 | $89.00 |
Candida Albicans Serology (IgG, IgA, IgM) | Not found | $175.00 |
Helicobacter pylori (Ab) | $10.29 | Not found |
While some of these tests are typically covered by Medicare or private insurance, some will likely will not. In our clinic a full panel costs about $2,500. But even if you did them once a year for several years, the out-of-pocket cost dwarfs compared to what a life of cognitive disability might mean both financially & psychoemotionally to the entire extended family. Some people have even regained their businesses or ability to work (i.e., earn money) once they identified & corrected unnoticed cognitive failings or identified lab abnormalities.
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