If you’re planning to adopt a new diet or have been following a new diet for some time, it seems sensible to know where you stand with regard to your health by means of a medical checkup/blood test.

You may ask, which tests? It turns out, the answer to this question lies with many variables.

Every person is different and what tests you should be interested in vary depending on things like your diet, lifestyle (how active you’re, stress levels, sleep, hydration, smoking & consumption of alcohol), age, gender, medical history, if you are planning to get pregnant, what medications you are on, etc.

All these variables can contribute to different potential deficiencies or areas of concern in a medical checkup. Because of this, your first step ideally is to form a relationship with a doctor who can get to know you, your lifestyle, medical and family history.

The vegan blood tests we’ve listed here may also be relevant to raw vegans, vegetarians, and plant-based diet followers as well.

Do note that certain results of medical tests could be misleading trying to interpret on your own as opposed to what it may actually indicate. For example, the levels of nutrients in your blood are not always indicative of the quantities obtained from your diet.

Calcium is a prime example, as normal levels of this in the blood may not actually indicate sufficient dietary intake. This is because calcium is so important to homeostasis and your body will maintain a sufficient level even when dietary intake is insufficient.

How does it replenish calcium in blood? When forced to, your body will draw calcium from your bones. This means that besides testing for adequate levels in the blood, your doctor may also need to take a look at other factors such as your dietary sources and other potential indicators.

This can also be true with other minerals such as zinc and magnesium, and these areas, therefore, require expert attention & input from a doctor.

Benefits of Having a Medical Checkup/Blood Test

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1) If you have a blood test before embarking on a vegan diet, you will be able to track your health status after 6-12 months of following it. This comparison can enable you to appreciate the progress of your health while identifying any areas of concern to give more emphasis.

2) Medical checkups allow you to be proactive and help you to identify any health issues before they start. This could help in treating illnesses at an early stage where your chances of restoring your health can be much easier & faster.

3) Seeing the positive results of vegan blood tests and knowing that your health is in great shape can give you an added reason to appreciate the health impact of vegan diets. As an example, your blood lipid profile can improve significantly as a result of moving to a whole food vegan diet which can minimize the risks of heart disease and strokes which are the biggest causes of death.

4) Though medical checkups can cost you, it may still not exceed the higher medical costs of treating major illnesses in the long run as a result of not being proactive.

5) Ultimately regular medical checkups may help you in improving health, prolong your life and boost your self-confidence!

How Often Should You Consider Having a Vegan Blood Test

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If you follow a vegan diet that is rich in whole foods such as vegetables, greens, grains, nuts/seeds, fruits, and a B12 supplement or B12 fortified food, your chance of having a deficiency is minimal. You’ll most probably feel great and be functioning at optimum in your daily routine, so it really isn’t necessary to have a test more than once a year at most.

If however, you are on chronic medications or have pre-existing conditions that may interfere with your body’s ability to absorb nutrients, your doctor may advise you to have more regular health tests.

This is especially true if you have previously been diagnosed with a B12 or iron deficiency, where your doctor will want to do follow-up medical exams to make sure that treatment is working.

Vegan Blood Tests

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1. CBC – Complete Blood Count Test

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This test is an excellent starting point as part of a general health examination and it indicates whether you have low red blood cell count (RBC), hemoglobin, and hematocrit which may help identify signs of anemia [1].

It can help detect underlying causes of anemia such as iron deficiency, B12 & folate deficiency, or blood loss.

In addition, this health screening can test for general immune deficiency, allergies, infections, and find the cause if you often feel weak, fatigued, or suspect an infection. If the results are normal, your general health status is quite good, and can consider it as a great relief!

2. CMP – Comprehensive Metabolic Panel Test

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This medical checkup is especially useful because it consists of 14 separate tests. This particularly means combinations of results which are problematic and can all be useful in finding the exact cause of an issue.

This one test gives the physician information on your liver, kidneys, blood sugar, blood protein levels, calcium levels, electrolyte, acid/base balance, etc. all in one go [2] [3].

Though you should not have any worries about your protein levels, if you still need to make sure, then this test will once and for all clear that for you!

It tests total protein, albumin, and globulin levels, and you’ll have enough proof to indicate whether you should have any worries over your protein levels. Total protein under 6.5 and albumin under 3.9 are indications of protein deficiency!

While it’s relatively rare for a vegan to be diabetic, this panel will also check your blood glucose. Furthermore, it’s possible for blood sugar to be too low as well which is called hypoglycemia, and this test can indicate that too.

Here’s a Full List of Indicators from a CMP Panel:

• Blood Urea Nitrogen (BUN)
• Alanine Aminotransferase (ALT)
• Alkaline Phosphatase (ALP)
• Aspartate Aminotransferase (AST)
• Potassium
• Sodium
• Calcium
• Glucose
• Carbon Dioxide (Bicarbonate)
• Chloride
• Creatinine
• Total Protein
• Total Bilirubin
• Albumin

3. Vitamin B12 Test

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If there’s one health checkup no vegan, vegetarian, or anyone over the age of 60 should miss, it’s this one.

This is because B12 is the only vitamin for which it is difficult to find reliable ‘whole food’ vegan sources, though there are other options such as plant milk, fortified foods, or supplements to obtain B12.

Although it is only needed in truly minuscule amounts, it’s incredibly important. Both B12 and folate are required for normal red blood cells production to maintain nerve health, tissue and cellular repair and synthesis of DNA.

Normal values are generally considered to be between 200 and 900 picograms per milliliter (pg/mL), and a value less than 200 is a possible indicator of deficiency [4]. This range is given only as a guide, but the normal range may differ from lab to lab and your doctor will determine what constitutes a normal range for you.

Do note that along with a B12 test, the most reliable evaluation of a B12 deficiency is MMA testing (methylmalonic acid serum test), and homocysteine test which we discuss next [4] [Vegan Society Ref].

Discuss with your doctor to decide whether you should take an MMA test first, being a reliable form of B12 diagnosis, and to follow up & compare with other tests such as homocysteine blood test and/or vitamin B12 test for a complete diagnosis.

People with this deficiency are likely to have or develop symptoms such as general weakness, tiredness, loss of balance, heart palpitations, tingling in the arms & legs, numbness, pale skin, and mental issues.

If the results of this test are either low or borderline low, your doctor may also request what is called a holotranscobalamin, or ‘active’ B12 test. This shows how much of the biologically active form of the vitamin you have in your blood.

Love to know more about vitamin B12 health benefits? Check it here

4. MMA – Methylmalonic Acid, Serum Test

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This test, along with the homocysteine test which we will discuss next, is often useful to diagnose the early stages of a vitamin B12 deficiency. If levels in both the MMA and homocysteine tests are elevated, it is a good indicator that less B12 is available to the cells and tissues.

It helps to differentiate where the problem may actually be. If it’s a folic acid issue rather than B12 itself, this would be indicated by a higher homocysteine level. That would indicate either folic acid being low or not being metabolized adequately. If both are normal, the likelihood of a B12 deficiency is unlikely.

5. Homocysteine Test

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As described above, this test can indicate the B12 levels or a folate deficiency.

Higher levels of this test are also associated with atherosclerosis, where arteries are getting hardened due to the deposits of cholesterol, plaque, and other substances.

Narrowing of the arteries can pose a serious threat, as it is associated with an increased risk of strokes and Alzheimer’s disease, blood clots, and potential heart attacks.

Raised levels of homocysteine (above ten micromoles/liter) are of concern, so the levels should be at least lower than 9 micromoles/liter and ideally less than 6 micromoles/liter.

6. 25-Hydroxy Vitamin D Test

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Vitamin D deficiency is associated with skeletal issues like weak bones, malformation, or abnormal calcium metabolism.

While we can, of course, obtain this vitamin from exposure to sunshine, vegans who spend most of the time indoors or in areas of extended winters should seek other sources of vitamin D. This is due to the fact that we as vegans, avoid oily fish, red meat, liver, and egg yolks which are food sources of vitamin D.

Thus if you’re not getting enough vitamin D from sunlight, it is advisable to consider other vegan sources of vitamin D such as fortified plant milk, other vitamin D fortified products, mushrooms pre-exposed to sun, or supplements.

Because vitamin D is fat-soluble, those on extremely low-fat diets may also be slightly more at risk. Other conditions which may cause deficiency include cystic fibrosis, Crohn’s disease, IBS (irritable bowel syndrome), and celiac disease, which may interfere with the intestine’s ability to absorb fat and as a result disrupt vitamin D absorption.

7. Iron – TIBC (Total Iron Binding Capacity) Test

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While there are many options for vegans to get all the iron they need from dark leafy greens, legumes, and nuts, there could be situations in which having this medical screening can be a good idea.

Heavy physical activities like long-distance running can deplete iron levels as can heavy menstruation in women. People who are prone to depression, fatigue, or women of childbearing age should also find it useful to have their iron levels checked.

8. Ferritin Test

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While the TIBC tests for iron levels in the blood, the ferritin test helps assess how good the iron stores in your body. When an iron deficiency is suspected, this test is often used in combination with the TIBC test to evaluate the severity of the deficiency.

9. Omega-3 Index Test

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Omega-3 levels can be problematic in many people, not just where consumption of omega 3 itself is too low, but the consumption of omega 6 fatty acids is too high, as it interferes with the levels of omega 3.

According to observational findings, a significant number of American adults are not meeting recommendations for omega-3 fatty acid intake, so vegans and vegetarians should definitely be just as vigilant to avoid a deficiency.

There are three different types of omega 3 which are of particular importance – ALA, DHA, and EPA, (alpha-linolenic acid, docosahexaenoic acid, and eicosapentaenoic acid respectively).

While the body can produce EPA and DHA from ALA, it cannot make its own ALA, and this must therefore come from the food we eat. How efficiently the body has converted ALA to EPA & DHA can be gauged by taking this blood test (if you’re purely relying on ALA to obtain EPA & DHA without supplements, since EPA & DHA are mostly found in fish and other seafood)

From this test, the quantity of EPA and DHA present in the membranes of the red blood cells can be measured.

According to the general medical consensus on this test, a percentage score of 8% or greater is optimal, 4 – 8% being an intermediate risk and below 4% placing people at high risk.

To learn more about omega 3 and vegan food sources click here.

10. Folic Acid Test

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While folic acid deficiency in vegans and vegetarians is highly unlikely due to the abundance of this nutrient from plant sources, an excessive amount of folic acid can mask a vitamin B12 deficiency to exacerbate the situation. The causes of such high levels of folic acid could be due to pernicious anemia, digestive disorders, intestinal surgery, or a high dosage from supplements.

The most important outcome of this test for vegans is to make sure their folic acid levels have not elevated to a level of concealing a B12 deficiency to go unnoticed and untreated.

11. Lipid Profile Test

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This is the most common test used to determine the risk of heart disease and its associated risks. It measures four components in the blood – total cholesterol, LDL, HDL, and triglycerides.

Cholesterol tends to get a bad reputation in general, but it’s actually essential for life. It is used as the basic building block to produce hormones (such as testosterone & estrogen), cell membranes, and required for general health. The body produces it from raw materials found in our food, but levels which are too high because of excessive dietary intake can be hazardous.

While the majority of vegans and vegetarians fare much better on this test than those on a standard diet, vegetarians could be at risk for high cholesterol (above 200mg/dL) if they eat a lot of eggs and high-fat dairy products. The same risk can apply to vegans if they are consuming a lot of vegan processed food or oily foods.

However good our diet is, high cholesterol has a genetic component, hence this test can be recommended for everyone.

12. Urinary Iodine Test

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Iodine is required for normal functioning of the thyroid and is of particular importance for pregnant and breastfeeding women. If you’re a vegan who does not use iodized salt or if you’re planning on having a baby, it’s a good idea to have this test done, since iodine content in plant-based food is lower compared to food of animal origin [5].

Conclusion

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Tests Recommended for Vegans & Vegetarians

1. MMA Test – Methylmalonic Acid, Serum Test (for B12 diagnosis)
2. CBC – Complete Blood Count (for iron & B12 deficiency)
3. Iron – TIBC (Total Iron Binding Capacity) Test
4. 25 Hydroxy Vitamin D Test
5. Omega-3 Index Test

Other Tests to Consider for Optimal Health

1. Homocysteine Test / Vitamin B12 Test
2. Lipid Panel Test
3. CMP – Comprehensive Chemistry/Metabolic Panel
4. Ferritin Test
5. Folic Acid Test
6. Urinary Iodine Test

As your doctor is the best person to interpret the results, make sure to take the time to discuss all the results of your vegan blood tests.

If you don’t have a family doctor, a great resource to find a doctor who understands your particular needs is plantbaseddoctors.org, or try an online search for doctors in your area.

Your doctor will be able to make recommendations based on any areas of concern or just congratulate you on your excellent results!

If something appears lacking, your doctor can give you expert advice about additional tests that might be required or what foods or supplements you should incorporate additionally.

But if you center your diet around whole foods and make sure to have vegan fortified foods and dietary supplements where required to supplement your nutrition, then there’s a good chance of you getting a clean bill of health!

References:

1 https://www.ncbi.nlm.nih.gov/pubmed/12710004

2 https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024503/

3 https://www.nhlbi.nih.gov/health-topics/blood-tests

4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142735/

5 https://pubmed.ncbi.nlm.nih.gov/12748410/

Disclaimer: 

While every attempt has been made to verify the information provided here, the content in this post is for informational purposes only and not to be considered as professional advice. By providing the information contained herein we’re not diagnosing, or treating any type of disease or medical condition. Before beginning any regimen it is advisable to seek the advice of a licensed healthcare professional.

Dr. Alessandra Glaser Bio:

Alessandra Glaser, is a primary care physician at Williamson Medical Group, Tennessee, USA. Dr. Glaser is board certified in family medicine. After majoring in biology at the University of Illinois at Urbana-Champaign and getting her medical degree from the University of Illinois College of Medicine at Chicago, she did her residency at Mayo Clinic in Rochester. She has a special interest in the benefits of plant-based eating and she enjoys learning from Dr. McDougall & Dr. Essylstein who are advocates of a plant-based diet.

Dr. Heni Joshi MBBS, M.D. (internal medicine), DNB (nephrology) Bio:

Dr. Joshi has a broad command over health topics in the medical field. As a general physician, he has experience over 10 years and he is a specialist in nephrology. He is practicing at GMERS Medical College, Gujarat, India.

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