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Chemical pillar
Chemical Pillar
The human body is basically a large chemical engine. When we have all the chemicals needed, we call them nutrients, to run the body we are healthy and when we do not have the proper chemicals we are unhealthy. This is why at the end of the day, from a chemical standpoint, health can be summed up as good chemicals in vs bad chemicals out. Blood tests are very helpful in assessing some of the data we need for the chemical pillar. Here are some of the usual suspects that you may have heard about.
Testosterone: Testosterone is the healing hormone. It is responsible for bone density, muscle creation and maintenance, mental clarity, energy, sex drive, orgasm function, ligament and tendon healing, mood, and is one of the best tools against depression outside of exercise. One of the biggest things people notice when they get their levels back up is that they are not as tired or sore anymore. This is because you can create more energy and your joints and muscles can heal leaving them feeling younger and less damaged.
When looking for this we need to look at total testosterone, free testosterone, and Sex Hormone Binding Globulin or SHBG. Total testosterone allows us to see how much is registering in the blood. Free testosterone tells us how much of the testosterone we have is available for use in the body. SHBG is often a major player in reducing the free testosterone available for use.
Estrogen: True testosterone converts easily into estrogen which can be good for women who have low testosterone and have hot flashes night sweats and or vaginal dryness. However, this conversion happens in men as well. When it happens in men we see water retention, puffiness, joint pain and emotional issues. Estrogen therapy as well as excess estrogens have been linked to serious cancer issues in women so monitoring these levels is very important. Very often women are given testosterone along with estrogen and progesterone, all of which will convert into estrogen which can cause significant issues.
Insulin: Insulin is rarely pulled by medical personnel, which is troubling. Insulin is the key to diabetes, insulin resistance, fat accumulation, metabolic function, brain health, and other critical systems. You cannot understand a person's metabolic health without pulling insulin. It is very possible to see metabolic issues like diabetes coming if you understand insulin and fasting insulin levels. This is a critical lab to pull, however, because of the lack of understanding of how it works medical doctors will not generally pull this lab.
Cholesterol Panel: In 2009 UCLA medical research studied 136,000 people in the hospital for heart attacks. The vast majority 75% of these people had cholesterol levels in the normal range. What this means is that heart attacks are not linked to the amount of cholesterol in your blood, rather they are caused by the Reactive Oxidative Stress (ROS) that damages the cholesterol and the blood vessels that leads to plaque. While the study, funded by pharmaceutical companies, came to the conclusion that we should just lower the threshold at which we can prescribe statin medication, the obvious answer is that total cholesterol needs to stop being looked at as the indicator for heart issues and we should start looking elsewhere. This is a good lab to pull to get an overview of metabolic function and health. If you are worried about heart attacks it is important that you get imaging of the heart and blood vessels. A calcium CT, and echocardiogram, or a dye based CT (a CT angiogram), are going to be the most important option for you. https://www.uclahealth.org/news/most-heart-attack-patients-cholesterol-levels-did-not-indicate-cardiac-risk
Cortisol: Cortisol has gotten a very bad rap, that it does not deserve, due to misunderstanding of how the mind controls the physical body. Cortisol is a stress hormone that is released when we are stressed out. When it is lower than it should be in people that are chronically stressed, we see adrenal fatigue and or failure. Cortisol is more like bubble wrap for your physical body when under stress. If you are healthy these levels should be high if you have above average stress. All of the issues associated with cortisol being bad are actually from being in a sympathetic state from the psychological stress, not from cortisol.
Thyroid Panel: I see thyroid panels pulled all the time, however, most often the labs pulled, even if medications are prescribed due to them, are the wrong labs to pull for thyroid. What you need pulled is:
Free T3: This is the amount of unbound ready to use T3 in the body. T3 is the active form that our body actually uses.
Free T4: This is the amount of unbound ready to use T4 in the body. T4 is made in quantities 4 times more than T3, while it is inactive it converts into T3 while in the body.
Reverse T3: Think of this like “anti” T3. As if it negates the ability for T3 to work. If this is higher than normal it explains why a “normal” T3 level is not working well enough.
TSH Thyroid Stimulating Hormone: This is actually not a thyroid level, even though lots of doctors seem to think it is. This is a brain hormone that tells your thyroid to make more T3 and T4. If this is high and your free T3 and T4 are low you have a thyroid issue. If this is low and your thyroid levels are low it could be a brain based issue.
While getting large lab panels can be expensive it is extremely important to get the full understanding of what is going on. For a more extensive list of labs often pulled please look here.
Glucose: This is the amount of sugar that is in your blood. You want a fasting glucose to be under 100. If it is 1 or 2 points high don’t worry about it. If you had eaten the day that you had blood taken, thus not fasting, don’t use this number. If this is consistently high, for instance 110+ for 2 or more blood draws you need to start looking at diabetes. Cut your glycemic intake, not necessarily carbs, but get the glycemic index of your foods under 60. So cut back on sugars. If you need to eat sweets look at the keto sweets as those will not affect your blood sugar. These labs are only a part of the picture though. You need to look at them with insulin to get a full picture of metabolic health. See Insulin for more.
BUN Blood Urea Nitrogen: This test shows us that your kidneys are under undue stress. This can show everything from dehydration, which is what it commonly shows, however, it can also be indicative of kidney damage or disease. Drink more water. For most people 70% of their body weight in ounces is enough. If you are an athlete move that up to 100% of your body weight in ounces. If you’re an athlete outside, in the summer, in Texas then make it 125% of your body weight in ounces. So 100lbs you drink 100ounces.
Creatinine: This also shows pressure on the kidneys. What happens when you use your muscles is you break them apart a little bit and they drop creatinine into the blood. Your kidneys then take it out and everyone is happy. However, if your kidneys have issues you will have more creatinine in your blood. HAVING said that. If you exercise, especially if it is hard workouts, these levels will be higher, because you are working the muscle harder and thus it drops a lot more creatinine into the blood. Water will still kinda help but if it’s a little high and you work out hard don’t freak out.
EGFR Estimated Glomerular Filtration Rate: This is how well your kidneys are working. You want this above 60. Under 60 and we start to worry about kidney disease and lower kidney function. If it is under 15 that is a sign of kidney failure.
BUN / Creatinine Ratio: This is amount of BUN to creatinine. When it is high the worry is blood flow to the kidneys and thus they are not filtering enough fast enough. Also dehydration, or very hard physical activity. I hope your catching the theme of dehydration, lets drink some more water everyone. When high check with your doc.
Sodium: This is the amount of sodium in your blood. Too low and you become hyponatremic. This can be very serious and can mimic heat stroke in athletes. You start to lose function of your body as your nerves can not conduct properly. This can cause your brain to start to shut down and pass out as well. This can happen from hyperhydration or drinking too much water at one time. Most of the time if this is too high it means that you need more water, again with the dehydration.
Potassium: Most of the time this can only be caused by acute kidney failure. Sudden onset of kidney issues. If this is high make sure to get it checked.
Chloride: This is how much chloride you have in your blood. This can be indicative of heart, lung, and respiratory issues. It can also show up with Addisons disease. Again if this is 1 or 2 points off don’t freak out about it. If low get checked for HCL tolerance and take some extra HCL.
Carbon Dioxide, Total: When we see this high we worry about respiratory issues or metabolic acidosis, that isnt ketosis BTW.
Calcium: Its how much calcium is in your blood. If it is high or low you have a high risk for a hormone issue. Either way high or low you need to get your hormones checked. It is also bad for kidneys so make sure you get those checked as well. This is one of those that if your .1 over don’t worry about it. Often if you are way over on this one and you feel ok go ahead and get it retested as it could be a mistake. So don’t freak out but get it checked. You should feel this one.
Protein, Total: Total number of proteins in the blood. This helps show kidney function. Too high and the kidneys are not filtering things properly. Too low and you're not going to be able to heal. If this is high it can be a sign of multiple myeloma, however, if it is a point or 2 high do not freak out. Keep track of it or get it checked, however if it is 5 points high get it checked.
Albumin: Lower levels of these show issues with liver, kidneys, or in some cases low protein. If this is high it is typically a strong indication of dehydration. Drink more water. For most people 70% of their body weight in ounces is enough. If you are an athlete move that up to 100% of your body weight in ounces. If you’re an athlete outside, in the summer, in Texas then make it 125% of your body weight in ounces. So 100lbs you drink 100ounces.
Globulin, Total: High levels are indicative of cancer, autoimmune issues, and some infections. If these are high get them checked.
A/G Ration: This shows the ratio of albumin vs globulin. When these are high we worry about the liver, kidney, and intestines. This usually also makes people tired, and can cause swelling, especially in the extremities like feet and ankles. Get these checked if they are high.
Bilirubin, Total: This is a liver health check. Often if these levels get to high we see jaundice or a yellowing of the skin. This happens often during birth however, it typically isnt harmful and clears up on its own.
Alkaline Phosphatase: Alkaline phosphatase or Alk Phos, helps identify issues like liver, bones, intestinal, and kidney damage.If it is high we see bone and liver, often times common bile duct so bile congestion, typically.We see these levels often higher in children and pregnant women.If this is elevated we need to get it worked on.
AST (SGOT): Aspartate transferase, these are levels of amino acids in the blood. If this is high we often think of liver cirrhosis and tissue damage. Until this is 150% higher than the lab range you don’t need to worry. Again you can bring these down by cleaning the liver.
ALT (SGPT): Alanine transaminase, these are levels of amino acids in the blood. If they are slightly high it can be from exercise. If they are very high typically it means that we need to clean the liver. When this has been high for a couple of tests we worry about cirrhosis and liver damage. This isnt really a concern until it has been over 150% of the high point of the range for 2 consecutive blood tests, so over 6 months. However, it is always a good time to clean the liver.
WBC: A count of the total white blood cells in the body. When these are high it is typically showing your body is actively fighting an infection. If these levels are too low it can mean that you have immune system issues. When the white blood cells are low we call this being immunocompromised.
RBC: A count of how many red blood cells you have. If it is high it can be dehydration, bone marrow issues, heart disease, polycythemia get this checked if it is high. If it is low most often it is an iron issue. Take iron supplements with vitamin C to increase uptake of the iron. Low RBC can be a number of things as well such as significant heart, kidney, lung and liver issues.
Hemoglobin: When this is low the body does not have the ability to carry oxygen as well. This leads to fatigue, and brain fog. This is a sign of anemia as well as being indicative of several other issues.If it is too high it can create pressure on the blood vessels.This is also one of the levels we need to watch out for when on testosterone therapy.Again if this is too high do not worry just make it in and donate blood and you will be fine.
Hematocrit: Measures the proportion of red blood cells in your blood. Too few and you cant carry oxygen too many and your blood gets too thick. If your blood gets too thick it can increase the blood pressure and that can increase your chances of heart attack and stroke. This is one of the things you need to watch for with testosterone therapy. Testosterone can make this go up. If this is high, at all, and you're on testosterone therapy you need to go donate blood. Don’t worry about it just donate blood. That will obviously decrease the amount of blood in the blood vessels and eliminate the pressure issue.
MCV: Low MCV meansthat the red blood cells are smaller than normal and can indicate microcyticanemia issues. I would also check yourpulse ox and make sure your getting proper oxygen stat levels. You want to be 97-100% and heart rate of60-75. If you are not get that checkedas well. When we have anemia it cancreate fatigue, headaches, and feel out of breath with light exercise. If it ishigh that means the red blood cells are too large. If you have high MCV and high MCH you need tolook for macrocytosis. Either way ifthey are elevated or too low get it checked.
MCH: This is looking more at the iron fraction or portion of your red blood cell the hemoglobin. When this is low you need more iron. Always take iron supplements with Vitamin C as the C will help the iron get absorbed by the body. If these levels are high we often times see macrocytic anemia this means the cells are bigger than they should be. This is often an issue with low B vitamins, specifically folic and B12. If you are going to supplement with those vitamins make sure they are fully methylated or l-5-methyltetrahydrofolate, and methylcobalamin. It can also be an issue with intrinsic factor as well. Many older people and lots of vegetarians and vegans have issues with this chemical. Intrinsic factor is critical to the uptake and use of B12.
MCHC: Mean corpuscular hemoglobin concentration. When these levels are low it shows that the red blood cells do not have enough hemoglobin, the iron part that makes it able to carry oxygen, this is also called anemia. When it is high this means that your blood is getting too thick and you need to donate blood. If you are on testosterone therapy this is one of the things you need to keep track of. If you are not on testosterone therapy you should have this looked at.
RDW: This test is usually very good for anemia. This means that your blood is not going to be able to carry enough oxygen. If you get winded, or light headed, when you exert yourself with small tasks like climbing a few stairs this is a concern. If this is high and you have a history of heart issues, like heart attack, this can be a precursor to a second event. Get this checked.
Platelets: This shows total number of platelets. If you have too few, or it is low, its called thrombocytopenia, and it can cause bleeding issues as clotting becomes more difficult. If it is too high then you can get thrombocytosis and that can make your blood clot too quickly and too easily and we worry about clots and strokes. This being high is also problematic for DVT. So as we age and we have lower testosterone the risk of blood vessels partially closing and producing clots is higher. This is why they tell you to get up and move around while on an airplane as sitting too long can be an issue with this.
Neutrophils: Number of neutrophils in the body. When these are high it is most often a bacterial infection, however you are fighting something. When these are outside the range either higher or lower you need to contact your doctor.
Lymphs: Number of lymphocytes.
Monocytes (Absolute): This measures the amount of a specific white blood cell. High levels can be caused by some medication, however, this is also indictive of chronic illness, things like mononucleosis or autoimmune issues. If this is high you need to get it checked out.
EOS: These are white blood cells that are called eosinophils. These show up with allergies but they also show up for a host of other issues. Typically if this level is high and you don’t have any allergies make sure to mention this to your doc.
Basos: Number of basophils.
Neutrophils (Absolute): When these are high it is most often a bacterial infection, however you are fighting something. When these are outside the range either higher or lower you need to contact your doctor.
Lymphs (Absolute): This is a total number of lymphocytes a type of white blood cells. This is most often seen with inflammation and infection. Youre typically fighting something when these are high.
Monocytes (Absolute): This measures the amount of a specific white blood cell. High levels can be caused by some medication, however, this is also indictive of chronic illness, things like mononucleosis or autoimmune issues. If this is high you need to get it checked out.
EOS (Absolute): These are going to show up in almost every immune response but we see them in allergies and some rare parasitic issues.
Baso (Absolute): These are the part of the immune system that battles allergies they release histamine. When these are high we are looking at allergic reactions. Remember foods are allergies for a lot of people if these are high it could be your diet. If this is higher than .9 contact your doctor immediately.
Immature Granulocytes: This is a count of granulocytes that have not been fully formed. Typically, the bone marrow completely forms and matures the granulocytes before they drop into the blood stream. If these numbers are high this may show an issue with your bone marrow and your immune system. This number should be 0.0 or really close to it. If you just had an infection, whether you felt it or not, this may be a touch higher.
Immature Grans (Abs): This is a count of granulocytes that have not been fully formed. Typically, the bone marrow completely forms and matures the granulocytes before they drop into the blood stream. If these numbers are high this may show an issue with your bone marrow and your immune system. This number should be 0.0 or really close to it. If you just had an infection, whether you felt it or not, this may be a touch higher. This needs to be looked into if the number is .5 or higher.
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