Blog | Optimal DX | Functional Blood Chemistry Analysis Software

FBCA Outside of the Doctor's Office: Improving Clients' Quality of Life

Written by Beth Ellen DiLuglio, MS, RDN, LDN | Nov 16, 2021 5:55:32 PM

This post is part 1 of a 2-part series focusing on how Functional Blood Chemistry Analysis can support not only licensed practitioners but also the growing field of allied healthcare professionals

Today's post is entitled FBCA Outside of the Doctor's Office: Improving Clients' Quality of Life.

What is a Functional Blood Chemistry Analysis

A functional blood chemistry analysis (FBCA) assesses clients’ bloodwork results within optimal ranges instead of standard lab reference ranges.

Standard ranges are based on “average” results instead of optimal metabolic function and optimal health.

The FBCA helps identify current trends in an individual’s blood work that may develop into dysfunction and chronic disease down the road. It is also valuable for monitoring improving or declining metabolic health.

A comprehensive FBCA evaluates the physiological function and how well the client is processing carbohydrates, fats, and protein. It also evaluates blood glucose regulation, lipid metabolism, acid-base balance, inflammation, vitamin and mineral status, hormone balance, and liver, kidney, thyroid, and gallbladder function.

Where does Functional Blood Chemistry land in the toolbox of a healthcare provider who is not a physician or licensed healthcare provider?

Remember, an FBCA is not diagnostic, it is informational. It is part of a bigger puzzle that is then pieced together using a client’s presentation, history, and primary concerns.

The objective for non-physician practitioners is prevention…to identify trends early and initiate healthy lifestyle interventions that can help reverse the slide toward dysfunction. We want to keep clients healthy and avoid chronic lifestyle diseases such as type 2 diabetes, hypertension, obesity, atherosclerosis, and cardiovascular disease.

Clients are often more motivated to comply with interventions and advice when they can see tangible issues and define tangible goals.

Repeating labs and monitoring changes over time is the best way to determine that interventions are working. It also helps tweak and tailor a program as a client progresses. If results worsen or are out of standard range, a possible sign of impending disease, then clients should be referred to a licensed healthcare practitioner for evaluation.

Will interventions be reflected in an FBCA?

Healthy interventions do translate into healthy metabolic changes.

One diet and lifestyle intervention used a “Health Revival Process” that promoted significant changes in blood chemistry biomarkers within six months of initiation. The study used health coaches alongside medical providers to create a comprehensive program designed to exceed the goals of the US HHS National Action Plan to Improve Health Literacy. [1]

The study defined a “four-tiered approach to health maintenance” in which steps 1 and 2 fall right into the wheelhouse of the non-physician practitioner:

  1. Prevention
  2. Mitigation of asymptomatic disease in people with elevated predictive biomarkers
  3. Mitigation upon the earliest detectable signs of early disease
  4. Advanced root-cause mitigation approaches within disease management.

Using personalized Health Revival Care Plans incorporating healthy nutrition and activity habits, researchers demonstrated an improvement in blood chemistry biomarkers and energy levels and a reduction in chronic disease risk.

Significant improvements were observed for the following biomarkers:

  • Atherogenic Index of Plasma
  • Fasting glucose
  • HbA1C
  • HDL
  • Hs-CRP
  • Insulin
  • Neutrophils
  • Neutrophil to lymphocyte ratio
  • RDW
  • Vitamin D
  • WBC

Basic proactive measures for prevention

A healthy diet is the cornerstone of good health. Patterns such as the Mediterranean diet and the DASH diet (Dietary Approaches to Stop Hypertension) are consistently associated with better health and improved biomarkers. [ii] [iii] [iv] [v] [vi] [vii] [viii]

These healthy patterns are based on an abundance of whole, unprocessed foods, fresh fruits and vegetables, high-quality protein and seafood, whole grains, legumes, nuts, seeds, herbs, and spices. Incorporating these healthy foods and encouraging physical activity is key to promoting health and reducing chronic disease risk. It’s also important to minimize highly processed foods, deep-fried foods, sugar- or artificially-sweetened beverages, smoking, excess alcohol, and a sedentary lifestyle.

A 10-year follow-up study of 1514 men and 1528 women confirmed that moderate adherence to a Mediterranean diet could reduce the risk of diabetes by 49% and high adherence could reduce risk by 62%. Researchers noted that the diet correlated with improvements in several markers including homocysteine, TNF-alpha, and total antioxidant capacity. [ix]

FBCA Dos and Don’ts for the non-physician practitioner

Do

  • Explain that an FBCA provides the client with information about how close to optimal their lab results are.
  • Explain that the optimal range for biomarkers reflects healthy physiological function and that being outside the optimal range does not mean they have a disease.
  • Look at the whole client and the whole picture.
    • Get a full history and list of medications and supplements the client is on as these can affect FBCA results.
    • Inquire about hydration and extreme exercise prior to blood draw as these can influence results.
  • Work within your own scope of practice, this may vary from state to state or country to country
  • Consult with or refer the client to an appropriate licensed practitioner if results are consistently out of standard range.
  • Refer to a physician if signs or symptoms of a disease are present.
  • Provide regular FBCA follow-ups, preferably using the same laboratory.

Don’t

  • Don’t diagnose unless you have a medical license to do so.
  • Don’t make assumptions based on one set of blood work. An FBCA is most valuable when analyzing trends over time.
  • Don’t present an FBCA or a single biomarker result as a standalone assessment, it must be interpreted within the context of each client’s history and health status.

Remember that it is very important to not function outside your scope of practice or licensure. Note that the scope of practice can vary between different healthcare professions.

These are commonly licensed and unlicensed practitioners: [x]

Licensed:

  • Physicians (naturopathic, chiropractic, osteopathic, allopathic), physician’s assistants, nurses, nurse practitioners, pharmacists, dentists
  • Nutritionists, dietitians (many states require licensure)
  • Acupuncturists (most states require licensure)

Unlicensed:   

  • Health coaches
  • Nutrition coaches
  • Nutritional therapists
  • Personal trainers

Next Up:

The Medical Practitioner's Guide to Functional Blood Chemistry Analysis (FBCA)

References

[1] Lewis, Thomas J et al. “Reduction in Chronic Disease Risk and Burden in a 70-Individual Cohort Through Modification of Health Behaviors.” Cureus vol. 12,8 e10039. 26 Aug. 2020, doi:10.7759/cureus.10039 This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

[ii] Ahmad, Shafqat et al. “Assessment of Risk Factors and Biomarkers Associated With Risk of Cardiovascular Disease Among Women Consuming a Mediterranean Diet.” JAMA network open vol. 1,8 e185708. 7 Dec. 2018, doi:10.1001/jamanetworkopen.2018.5708

[iii] Soltani, Sepideh et al. “The effect of dietary approaches to stop hypertension (DASH) on serum inflammatory markers: A systematic review and meta-analysis of randomized trials.” Clinical nutrition (Edinburgh, Scotland) vol. 37,2 (2018): 542-550. doi:10.1016/j.clnu.2017.02.018

[iv] Kucharska, Alicja et al. “The impact of individualised nutritional therapy according to DASH diet on blood pressure, body mass, and selected biochemical parameters in overweight/obese patients with primary arterial hypertension: a prospective randomised study.” Kardiologia polska vol. 76,1 (2018): 158-165. doi:10.5603/KP.a2017.0184

[v] Phillips, Catherine M et al. “Relationship between dietary quality, determined by DASH score, and cardiometabolic health biomarkers: A cross-sectional analysis in adults.” Clinical nutrition (Edinburgh, Scotland) vol. 38,4 (2019): 1620-1628. doi:10.1016/j.clnu.2018.08.028

[vi] Sureda, Antoni et al. “Adherence to the Mediterranean Diet and Inflammatory Markers.” Nutrients vol. 10,1 62. 10 Jan. 2018, doi:10.3390/nu10010062

[vii] Whalen, Kristine A et al. “Paleolithic and Mediterranean Diet Pattern Scores Are Inversely Associated with Biomarkers of Inflammation and Oxidative Balance in Adults.” The Journal of nutrition vol. 146,6 (2016): 1217-26. doi:10.3945/jn.115.224048   

[viii] Casas, Rosa et al. “The effects of the mediterranean diet on biomarkers of vascular wall inflammation and plaque vulnerability in subjects with high risk for cardiovascular disease. A randomized trial.” PloS one vol. 9,6 e100084. 12 Jun. 2014, doi:10.1371/journal.pone.0100084

[ix] Koloverou, E et al. “Adherence to Mediterranean diet and 10-year incidence (2002-2012) of diabetes: correlations with inflammatory and oxidative stress biomarkers in the ATTICA cohort study.” Diabetes/metabolism research and reviews vol. 32,1 (2016): 73-81. doi:10.1002/dmrr.2672

[x] License Finder. CareerOneStop.org