Bio Markers Your Doctor Likes Because It Can Be Managed.
Many of my patients are calling up as it’s the new year and asking to have a biometric screening at the request of their employer’s insurance company and ‘corporate wellness program.’ The request often includes: Total Cholesterol, HDL, LDL, Triglycerides, Blood Glucose, BMI Composition, and Blood Pressure. I’m happy to satisfy the request to help them satisfy requirements for work.
The problem is that those biometric markers are poor at best at predicting quality and quantity of life. For decades insurance companies and traditional healthcare practices have put cholesterol and its counterparts as king of the priority list to ‘manage.’ The result is that as a nation, we’re at historically low cholesterol levels, yet record high heart disease rates. We’re not that Heart Smart so before trying to lower cholesterol, read this first.
Blood pressure is no different. It is something good to check but they look it as a cause of heart disease when it’s more an effect of a deficient and toxic lifestyle, physically, chemically, emotionally, socially, and spiritually.
What’s wrong with tracking blood glucose? Nothing, except that it’s too variable. There are too many factors that can influence that value, even when you do fast. BMI composition is ok, but just because someone is skinny, it doesn’t make them healthy. They can still be inflamed and ignorant. Or if someone is ultra muscular and short, they may show as obese on the measurement.
In traditional healthcare, these values are great because there are drugs and surgeries to control them all. If you haven’t figured it out by now, Big Pharma, Big Insurance, and Healthcare Policy makers have a symbiotic relationship. You would think that insurance companies would want to limit non-effective healthcare practices but they get a kickback when the system is used. I don’t understand how those economics work.
And because insurers generally earn a profit by charging a premium on claims they pay, they don’t necessarily have an incentive to crack down on excess spending.
The government insurance program is legally barred from considering a treatment’s benefits when deciding how much to pay doctors for doing a certain procedure. – Wall Street Journal
With that said, I’m happy to satisfy your employer’s request for the standard biometric screening. Just remember, there are better biomarkers that will quantify your quality and quantity of health more appropriately.
Bio Markers You Should Track That Your Doctor Often Doesn’t
If I were an insurance company assessing your risk for disease and how much I would have to pay out for your usage of the system, I would make sure these 5 factors were tested.
Homocysteine:
I have already written on homocysteine. Homocysteine has been called the single best indicator of your longevity and quality of life. It’s not just an indicator of many disease processes like cardio-vascular disease, Alzheimer’s, Parkinson’s, Auto-Immune disease, diabetes, Hypothyroid, Osteoporosis, liver disease, hormone imbalance, autism, and anemia, but a massive contributor to disease.
One of the biggest reasons it contributes to virtually any chronic illness is that elevations can indicate a defect in a process called methylation. Methylation is one of the top biochemical reactions in the body. The roles of methylation aid in protecting DNA translation, hormonal control, neurotransmitter regulation, liver detoxification, and nutrient activation.
I like to see a range between 4-8 umol/L. Your traditional lab value don’t usually flag it until over 15. Elevations for too long contribute to the diseases I mentioned above. Ranges too low have some implications and indications of malnourishment or malabsorption problems (especially in the sulfur containing amino acids), glutathione deficiency (a massively powerful antioxidant that you produce), hyperthyroidism, medication use (antibiotics, birth control, and tamoxifen to name a few), liver disease, and kidney disease.
CRP (C-reactive Protein):
CRP is a protein produced in the liver in response to inflammatory cytokine production in the body. Cytokines are messengers used by the immune system to trigger for help. Inflammation is a helper. The problem is that when we make poor decisions, we are constantly pulling the fire alarm. If it’s good to have 3 fire trucks to put out a fire, let’s have a lot more…just in case. Inflammation likes to party.
CRP is very sensitive but not very specific as to what the cause of inflammation. With that said, it doesn’t necessarily rise in all causes of inflammation. It is synthesized from stimulation of antigen-immune complexes (autoimmune conditions), bacteria, fungi, injury, and tissue damage such as heart attacks and stroke.
Persistent, mild elevations of CRP have been clearly linked to cardio vascular disease risk. Since vascular compromise to tissues in heart and brain lead to chronic low levels of inflammation, CRP is a great tool to detect and monitor health improvement. Idealistically, there is no safe limit in the body. If it’s elevated, then there is something happening. Realistically, in today’s toxic and deficient world, I expect to see it elevated in lab work. If 0 mg/L is ideal, I will give it some buffer until 0.5 mg/L. Then I want to investigate deeper.
Vitamin D:
Although most often categorized as a vitamin, vitamin D is actually a hormone. Vitamins cannot be produced by the cells in your body and thus must be obtained via consumption from dietary sources. Vitamin D, however, can be made by the cells in your body in a process that involves the conversion of cholesterol derivatives into vitamin D using sunlight. See, cholesterol is not a bad thing.
Vitamin D3 is produced in the skin of humans (and other vertebrates) after exposure to ultraviolet B light (uVB). Vitamin D3 only becomes biologically active after two conversions; one in the liver (primarily) to 25-hydroxyvitamin D(25 OHD), the circulating form of vitamin D, and then in the kidney to 1,25-dihydroxyvitamin D (1,25 (OH)2D), the biologically active hormone form which is also known as calcitriol. Calcitriol or biologically active vitamin D is often considered the most potent steroid hormone in human physiology.
Many cells have Vitamin D receptors and many genes are influenced by the action of Vitamin D. In fact, it has been estimated that the human genome has over 2700 binding sites for Vitamin D. This is why being deficient in Vitamin D can lead to increased risk of many diseases, and, conversely why being sufficient in Vitamin D is essential for wellness and prevention.
Typical lab ranges will have an ocean of normal between 30-100 ng/ml. The Vitamin D council suggests a level of 50 ng/ml.
Something to think about is that if you are deficient, it doesn’t always mean that you have a lack of consumption or a lack of sun exposure. Those Vitamin D compounds have to be chemically altered through the liver and kidneys to become active. Deficiencies could mean that you have to look deeper at a dysfunctional liver or kidney. The fastest way to trash your liver and kidneys is creating an internal environment of insulin resistance.
Hemoglobin A1C (HA1C or A1C):
A1C is known as Glycosolated Hemoglobin. Glycosolation is when a sugar attaches to another molecule. In this case, a sugar has attached to the protein hemoglobin from your red blood cells. The more sugar is available, the more it will bind to proteins. This test serves as a couple red flags.
The first is that your red blood cells live approximately 120 days. This test serves as a good indication of your blood sugar levels over the past 120 days. Your body will store excess sugar in a number of places before it requires the storage capacity of proteins like hemoglobin. If your body is having a hard time storing in other areas, it means you either have a massive influx of sugar or you have used up the usually storage areas.
The other red flag is that once glycosylation happens, it’s irreversible. It’s like toasting bread. Once you create toast, you can’t reverse it back to normal bread. In the body this becomes damaging in itself. Since it’s not reversible, the body has to attack it to remove the body of it. This will spark the immune system, which will spark the need for inflammatory factors like CRP and homocysteine and the system is on 5 alarm fire.
“Normal” lab ranges will be 4.8 – 5.6% as healthy, 5.7 – 6.4% as pre-diabetic, and >6.4% as diabetic. I get nervous over 5.4%. The labels mean nothing to me. In fact, obtaining a label of pre-diabetic or diabetic is often times worse for 2 reasons. The first, is that you are then referred to a Registered Dietician that has an education sponsored by the people that make the food pyramid. What nutritional science went into composing the plate or pyramid? Not much, just the lobby money from the grain and dairy association. What are the US’s two largest food subsidiary? The grain and dairy industries.
Now you’re getting nutritional advice (low fat foods, no-low calorie foods, or artificially sweetened foods) that will make your blood sugar and insulin response worse. All those no-low calorie foods are made of carbs or chemicals. All those low fat foods like dairy have a high insulin response. The artificially sweetened stuff? Your body has no idea what that is.
The second reason you may be worse off is that your drug of choice is insulin. You already have an insulin problem, your pancreas is pumping out as much as possible so your cells will listen. The solution is to give you more? Insulin acts as both a growth and a mitogenic hormone. You get bigger and cells divide more rapidly. You just got fatter and set yourself up for cancer.
If you’re in the low ranges, under 4.7%, you may have other issues going on like: hypoglycemia (low blood sugars), adrenal insufficiency (Cortisol’s main action is to regulate blood sugar levels); anemia (if anemic, hemoglobin A levels can be low in addition to the red blood cell life span shorter and not having enough opportunity for glycosylation to occur); antioxidant insufficiency (if glutathione is deficient, red blood cell life span is shortened, creating less hemoglobin A to be glycosylated, giving low false values).
Fasting Insulin:
If you can control insulin, you can control lifespan and quality of life. There isn’t an illness that doesn’t have roots in poor insulin regulation. Anything from obesity, diabetes, heart disease, Alzheimer’s, autism, degenerative disc disease, chronic pain, PCOS, breast cancer, restless leg syndrome, chronic fatigue, osteoporosis, fatty liver disease, thyroid disorders, high cholesterol, and hypertension.
Why would you want a fasting insulin if you already have good levels of A1C and glucose? It’s because your pancreas may be working overtime to make sure those other values (A1C and Glucose) are fine. Your pancreas can only keep up for so long before burnout. A fasting insulin gives context to how hard your body is working to maintain your sugar load.
Some labs report that “you’re all good” when your levels are lower than 25 mIU/L. Waiting until your fasting insulin is 25 before taking action is like waiting until you’re 84 years old to start saving for retirement. You need to start praying for miracles. Healthy decision making is putting yourself in a position where you don’t need the miracle.
Other labs report 8 mIU/L is at the high range. In the book Grain Brain by Dr. David Perlmutter, being able to top out at 3 mIU/L is ideal but a decent range is 2 – 5. Remember, you don’t want it too low or that means you have burned out your pancreas or have an auto-immune condition that doesn’t allow your pancreas to produce enough insulin.
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