Biohack your blood markers for thriving health!
Understanding the metrics, markers and variations on a laboratory blood test report, can be one of the most empowering skills to equip yourself with as you walk a journey of thriving with a medical practitioner that you trust. Partnering with your medical doctor to better understand your blood markers and learning more about these parameters and indicators enables you to be aware of the best functional ranges for your optimal health. Today we will share some insights with you which you can unpack further with your medical practitioner. But before we go into specifics, it’s important to have some background on blood reports, reference ranges and laboratory basics.
Understanding the base reference- The ‘mean’ range parameters
In most instances, blood biomarker reports will indicate high and low markers in comparison to the mean/ norm range of the population. This involves complex statistical analyses in relation to parabolic curves. What this means therefore, is that the report or practitioner viewing the report, may only be looking for outliers that stand out on either side of the high or low markers in relation to the average population. This may result in important nuances of readings being skirted over. This isn’t ‘wrong’ per se as it is human conditioning that we skim over graphs and readings that may be ‘green’ (or apparently ‘normal’) but hone in on those that stand out as red (or ‘concerning’). But for those of us who do want to equip ourselves with deeper knowledge of our biomechanical individuality, we can dig a little deeper. Today, we’ll share some ways to do this.
A further motivator to understand your own blood reports better, is that range reports from Labs can vary substantially. Whilst manufacturers are supposed to have their reference ranges checked by independent third parties, this may not be regulated. A report from 1 lab may indicate your vitamin D levels are perfectly normal, yet another lab may test and indicate different ranges. Knowing what the ranges mean and how to read these reports is thus vital and we will share these insights with you today.
A number is a number- absence of disease or longevity?
Often, blood marker reports will indicate ranges– but these are not always reflective of the absence of disease or on the flip side, of longevity of sustained health to live to 100 years. The blood test results or physicians interpreting them, are looking for critical outliers– that is, are there life- threatening indicators here that may affect the person right now? For example, you may test thyroid function with an evaluation of thyroid stimulating hormone (TSH) which may indicate that you don’t have full blown hypothyroidism and are therefore doing just fine… but what about turning this result on its head and asking ‘what does great thyroid function look like?’ You want to take into account the fact that maybe these reference ranges do not reflect good to great or what your potential for longevity or for health span is.
9 Key Blood Biomarkers
Blood Test 1: Red Blood Cell Magnesium
Testing Magnesium levels indicate things like insulin sensitivity, physical performance, how your sleep may be affected, your sleep architecture or potential for sarcopenia (the loss of muscle as you age).
It is important to know which type of Magnesium test the laboratory has undertaken. Most tests will provide a reading which is reflective of extracellular Magnesium levels which does not show bioavailable Magnesium– that is, Magnesium that is absorbed and available in the circulatory system. Instead you want to be sure that you have a reading showing intracellular Magnesium– that’s what an RBC Magnesium test looks for. So when you receive your blood report, it is important to ask your doctor if it is an RBC Magnesium test or an extracellular Magnesium test- the 2 are very different.
Many of my clients who are low in red blood cell Magnesium are using a Magnesium supplement in the evenings. There are many different forms and brands of Magnesium on the market but the best variants to look for would be a triplicate form of Magnesium which includes Magnesium threonate, Magnesium glycinate, Magnesium citrate. Personally, I use anywhere from 400 to 600 milligrams of Magnesium daily.
Blood Test 2: Estradiol
Estradiol is the test for the hormone estrogen. Many men believe this is a test that only women should pay attention to, but in actual fact it is something we should all be monitoring. Non optimised estradiol levels can affect:
- Bone mass
- Oxidative stress
- Anti-oxidant potential
- Nitric oxide
- Glutathione which is one of the main anti oxidants in your body
- Muscle repair and muscle strength
The problem with blood measurements of hormones is that they just provide a snapshot in time so be aware of this when receiving estradiol blood test results. Salivary tests on the other hand can provide 4 to 5 different measurements of hormones within a 24 hour period which is more accurate as your hormones are supposed to fluctuate through the day. Even more profound is something called Dutch Test, which is a dry urine test for hormones. The Dutch Test is great because it involves a urine test on a strip 5 times throughout the day providing a reading of adrenal stress over a 24 hour period.
Blood Test 3: Testosterone
Both sexes should be paying attention to testosterone- not just men. Unoptimised testosterone affects sexual performance, energy, strength, bone density, muscle mass, cardiovascular disease, and overall mortality. The big thing with hormones is that they can be bound up by proteins and testosterone can be bound up by either albumin proteins or sex hormone-binding globulin. Testosterone bound up by albumin proteins is still relatively bioavailable but if its bound by sex hormone-binding globulin, it’s not bioavailable. You’ll often find that if your cortisol is very high, your sex hormone-binding globulin is also high because it’s almost that message that nature sends your body that it doesn’t want you to make babies in times of stress. Whereas, if you have a low level of cortisol, you produce more sex hormone-binding globulin that bind up that total testosterone keeping you to be free and active, and keeping your drive elevated, or keeping you to be exceptionally active.
The ideal is to have 2% of your testosterone in free form.
Blood Test 4: hsCRP or High sensitivity C-reactive protein
High sensitivity C-reactive protein reveals information in relation to inflammation and heart function– it is vitally important when assessing these readings however, to note that high intensity, eccentric exercise can artificially elevate the readings. By eccentric exercise I mean a workout that includes the tearing out of muscles during weight lifting for example so be sure to select lower intensity exercise the day prior to an hsCRP test to enable a more accurate reading.
Another important angle to note in relation to increased inflammation is its relationship to cholesterol. We are encouraged to consume fatty acids in the forms of good cholesterol in eggs, avocados, and fatty cuts of fish but the problem is that elevated inflammation levels can cause oxidation of that cholesterol so its important to accompany a CRP reading with a look at blood glucose because these are 2 factors that can cause cholesterol. It is however important to ensure that one doesn’t have high total cholesterol, elevated CRP and elevated blood glucose as that is not a good combination.
There are other inflammatory marker tests that can be done (fibrinogen and cytokines) but CRP is a low-hanging fruit and such an easy blood test to get.
Blood Test 5: Triglyceride to HDL ratio
As I noted above, when looking for cholesterol markers, its important to review CRP and blood glucose in parallel. It is also very important to pay attention to the triglyceride to high density lipoprotein (HDL) ratio as this has been shown to be far more important in terms of determining your risk for cardiovascular disease and your true cardiovascular health- far more important than total cholesterol or low density lipoprotein (LDL) cholesterol.
Both health span and lifespan are influenced by this triglyceride to HDL number. Ideally, if you’re looking at trends as you change your diet, triglyceride should generally go down over time and HDL should generally go up over time. For your triglyceride to HDL ratio, lower is better and an ideal marker should be below 1.
An indicator below 1 could mean:
- low triglycerides or
- high HDL
To increase your HDL levels, it is important to consume omega-3 fatty acid sources, such as fish oil for example. Some nutritionists will advise that whole grains such as quinoa, oats, and whole wheat bread increase HDL but the problem is that some of these foods have the same glycemic index as a Snickers bar. So, whilst you may increase your HDL, your blood glucose is similarly elevated so this isn’t a good balance. Dark leafy greens and adequate fiber intake are preferable to favouring an increase in HDL.
To ensure lower triglyceride levels, exercise and control of consumption of processed oils and sugars, is key. If you can stay away from processed starch whilst exercising, your triglyceride levels will decline.
It is also important to look at your HDL to total cholesterol ratio. Lower is better and a ratio of HDL to total cholesterol of 0.24 is ideal. This ratio is often not provided on your report but is easy to calculate off the back of the HDL and total cholesterol numbers on the report.
Blood Test 6: A full lipid panel
To get an overarching view of health functioning, a full lipid panel is a must as it is a key indicator for cardiovascular risk and inflammation. A full lipid profile will give you an indicator of the size of your cholesterol particles and provides an indicator of your particle health. In short, the ideal is for your particles to be large, fluffy particles and not small atherogenic particles.
It is important to ask your medical doctor further information on the size and number of LDL particles. Dr Mark Houston is a specialist integrative cardiologist who notes that the field of lipidology has gone through incredible transformation. The industry has moved from measuring total cholesterol counts to a focus on rather looking at LDL and HDL and more recently there are proponents who support subfractions of the above. The bottom line is that advanced lipid testing is developing so quickly that we potentially don’t know as much as we thought we did. Dr Houston further notes that one consistent that can be relied upon, is that the particle never loses its predictability. The particle can be modified and/or changed by inflammation and oxidative stress but the predictability remains constant.
You may also have read about the importance of lowering LDL particle numbers– but as Dr Houston notes, total levels of LDL (or HDL for that matter) may actually be non- useful information as readings cannot predict anything about risk and a drive to lower LDL levels could mean an interference with one’s biomechanical pathways. We have LDL for a good reason and striving for enormously low LDL levels could see concerning changes in vitamin D levels and steroid hormones for example.
Blood Test 7: Insulin Like Growth Factor (IGF-1)
There is a lot of talk at the moment about IGF-1 and the importance of keeping levels low by not eating too much dairy and not eating too much protein in red meat to ensure your body is not in a constant state of growth activation as this may assist with bulking and strength but may not be supportive of longevity. I do believe however that there is a good balance that can be obtained by pairing heavy weight sessions and hard exercise with the reward of your much loved ribeye steak or cheese board if this is your indulgence. Then, over days where you are recovering from intense exercise, you may choose to enjoy salmon over a read meat option.
Blood Test 8: Insulin
For the same reasons as listed above for IGF-1, it is important to pay attention to insulin in addition to IGF-1. Insulin will help partition nutrients that you eat or specifically things like glucose that you consume, into fat in your liver or into muscle. Constant circulation of insulin through one’s bloodstream may result in your receptors eventually becoming insensitive which creates what we know as insulin resistance or insulin insensitivity.
This is why its vital important to pay attention to your insulin levels. Many times, a normal blood test may not show insulin readings, but be sure to have this tested in addition to your blood glucose.
Blood Test 9: Iron
Iron has recently received a lot of attention- particularly in the endurance athletic industry with athletes who have a very high red blood cell turnover. Adenosine triphosphate (ATP) is a complex organic chemical that provides energy to drive many processes in living cells. The problem is that in the production of ATP by your mitochondria, you produce what are called lipid peroxides. In many cases, this can result when they interact with iron in the production of hydrogen peroxide, which can essentially happen to rust inside your body. This is a bigger issue with men, in particular, who don’t work out with weights every month, or who aren’t endurance athletes going through a lot of iron. It’s fixable if your iron levels are constantly elevated or, in particular, for some people ferritin is constantly elevated, or GGT, that’s gamma-glutamyl transferase. This is an enzyme that can indicate that you have low iron turnover. If those two numbers, GGT and ferritin, are constantly elevated and iron is constantly elevated, a lot of times men just need to give blood a couple times a year, quarterly and that fixes the issue. You do not want your iron constantly elevated, especially if you’re a man as this can lead to increased risk of cancer, heart disease, diabetes, Alzheimer’s, Parkinson’s.