From the Guidelines
For chronic body aches all over, I recommend a comprehensive laboratory workup including complete blood count (CBC), comprehensive metabolic panel (CMP), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), thyroid-stimulating hormone (TSH), vitamin D level, creatine kinase (CK), and antinuclear antibody (ANA) test, as these tests help identify common causes of widespread pain such as inflammatory conditions, autoimmune disorders, thyroid dysfunction, vitamin deficiencies, and muscle disorders 1.
Key Laboratory Tests
- Complete blood count (CBC) to detect infections or blood disorders
- Comprehensive metabolic panel (CMP) to assess organ function and electrolyte balance
- Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) to measure inflammation levels in the body
- Thyroid-stimulating hormone (TSH) to screen for thyroid disorders which commonly cause muscle pain and fatigue
- Vitamin D level, as deficiency frequently causes generalized pain
- Creatine kinase (CK) to identify muscle damage
- Antinuclear antibody (ANA) test to screen for autoimmune conditions like lupus or fibromyalgia
Additional Considerations
- Rheumatoid factor (RF) and cyclic citrullinated peptide (CCP) antibodies to evaluate for rheumatoid arthritis
- Lyme disease serology if living in an endemic area
- Electromyography (EMG), imaging (MRI), and/or biopsy on an individual basis when diagnosis is uncertain and overlap with neurologic syndromes is suspected 1
- Paraneoplastic autoantibody testing for myositis and neurologic conditions, such as myasthenia gravis, if clinically indicated 1 It is essential to discuss specific symptoms, medical history, and risk factors with a healthcare provider, as they may recommend additional specialized tests based on the clinical presentation.
From the Research
Labs to Check for Chronic Body Aches
To diagnose the cause of chronic body aches, several laboratory tests can be considered:
- Complete Blood Count (CBC) to rule out infections or inflammation
- Erythrocyte Sedimentation Rate (ESR) to measure inflammation
- C-reactive protein (CRP) to measure inflammation
- Vitamin D levels, as deficiency has been linked to musculoskeletal pain and rheumatoid arthritis 2, 3, 4, 5, 6
- Parathyroid hormone levels to assess calcium and vitamin D regulation
- Rheumatoid factor and anti-cyclic citrullinated peptide antibody to diagnose rheumatoid arthritis
Vitamin D and Rheumatoid Arthritis
Studies have shown that vitamin D deficiency is common in patients with rheumatoid arthritis and may be associated with disease severity and activity 2, 3, 4, 5, 6.
- Vitamin D levels were found to be negatively correlated with disease activity and inflammation markers such as CRP and ESR 2
- Vitamin D insufficiency and deficiency were highly prevalent in patients with rheumatoid arthritis, with 84% and 43% of patients having insufficient and deficient levels, respectively 3
- The relationship between vitamin D and rheumatoid arthritis is complex and requires further evaluation, but vitamin D supplementation may have therapeutic potential in reducing disease activity and improving quality of life 4, 5, 6