Why Optimal DX Does Not Feature Certain Pathology-Based Biomarkers

At Optimal DX, our mission is to provide cutting-edge Functional Blood Chemistry Analysis (FBCA) to help practitioners optimize patient health through early detection of functional imbalances and preventive care.

Occasionally, we receive inquiries about why our platform does not feature certain biomarkers commonly used in pathology and hematologic diagnostics.

Recently, we were asked why we do not include the following biomarkers:

• Nucleated Red Blood Cells (NRBC, %)
• Metamyelocytes (%)
• Myelocytes (%)
• Megakaryocytes (%)
• Other, Lineage Uncertain (%)

These markers are primarily used to detect acute infections, bone marrow disorders, and hematologic malignancies. While they play a vital role in diagnosing disease in clinical pathology, they do not align with the functional and preventive focus of OptimalDX.

Let's explain why.

Pathology vs. Functional Blood Chemistry: Understanding the Difference

Pathology-Based Biomarkers: Detecting Disease

The biomarkers mentioned above are part of bone marrow and hematologic diagnostics, typically ordered when a serious illness, blood disorder, or bone marrow dysfunction is suspected. For example:

• NRBC (%) is used to assess severe bone marrow stress, hypoxia, or blood cancers. In Functional Blood Chemistry, RBC indices (MCV, MCH, RDW) and reticulocytes offer more actionable insights into red blood cell health.
• Metamyelocytes, and Myelocytes (%): These immature granulocytes indicate acute infections or bone marrow response, but they are not standard functional medicine markers. Instead, we assess Neutrophil-to-Lymphocyte Ratio (NLR) and other white blood cell trends for systemic inflammation.
• Megakaryocytes (%) are precursors to platelets and are used to assess bone marrow failure. Platelet count and mean platelet volume (MPV) provide adequate platelet function insights for functional health.
• Other, Lineage Uncertain (%) is used to classify unusual or abnormal blood cells, typically in leukemia or myeloproliferative disorders.

These markers are not typically found in routine blood chemistry panels and are more aligned with hematologic and oncologic diagnostics rather than functional health optimization.

Functional Blood Chemistry: Optimizing Health

In contrast, Functional Blood Chemistry Analysis (FBCA) focuses on identifying subclinical imbalances, trends, and patterns that indicate dysfunction before disease develops. We prioritize markers that provide insights into systemic inflammation, immune function, oxygenation, and overall hematopoiesis, such as:

• White blood cell differentials (Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils, and the NLR)
• RBC indices (MCV, MCH, RDW, Reticulocytes)
• Platelet function markers (Platelet Count, Mean Platelet Volume - MPV)
• Inflammatory markers (CRP, ESR, Fibrinogen)

These markers are more useful for Functional Medicine practitioners looking to detect dysfunction early and implement preventive strategies.

Should Pathology Biomarkers Be Included in FBCA?

While some practitioners may find these pathology-based markers useful in certain clinical scenarios, their routine inclusion in Functional Blood Chemistry would shift the focus from optimization to disease diagnosis.

If a bone marrow disorder, leukemia, or acute infection is suspected, a patient should be referred for specialized hematologic testing rather than relying on a Functional Health Report. Our goal at Optimal DX is to support functional assessment and prevention, not replace hematologic diagnostics.

That said, we are always open to discussing potential custom integrations for practitioners who require pathology-based markers in specific workflows.

Final Thoughts: Keeping the Focus on Functional Health

At Optimal DX, we believe in delivering the most relevant, functional, and preventive biomarker assessments to help practitioners guide their patients toward optimal health and longevity. While pathology-based markers have their place in disease diagnostics, our platform is dedicated to Functional Blood Chemistry and its ability to transform patient care before disease manifests.

For practitioners looking to enhance their approach to blood test analysis, functional assessments, and personalized treatment planning, Optimal DX offers a comprehensive, data-driven platform to support your practice.

Want to learn more about the biomarkers we do have in Optimal DX? Check out our Ultimate Biomarker Guide today!