What is the single most important health marker your doctor looks at when you do annual blood work? Let me guess- good old CHOLESTEROL. Cholesterol is always that nasty guy, always guilty for your overall bad health.
Cholesterol is essential for our body function- it is crucial for biosynthesis of steroid hormones, bile and vitamin D. Of course, too much cholesterol floating around can be detrimental to your health, but we should look at a bigger picture and consider other very important factors, often overlooked and not even requested by your doctor.
There are other very important tests that should be done along with cholesterol and triglycerides levels. Some of them doctors order routinely but some are overlooked or their importance for vitality and longevity is undermined. Some of the tests you should ask your doctor to look at are the following:
A1c is a single number that shows blood sugar control over the last 3-4 months. It shows the number of glycolyzed red blood cells since the molecules of glucose bind to hemoglobin, protein in the erythrocytes. The higher glucose levels you had in recent few weeks, the higher A1C will be. According to medical community good A1C range is 4.3 to 5.7, if you are between 5.7-6.5 you are already in prediabetic state and everything above 6.5 is considered diabetic. But let me tell you, reality is that anything ABOVE 5 is a RED FLAG and a warning to change your eating habits. A1C above 5 is connected to ongoing inflammation process in your body, developing coronary heart disease, risk of ischemic and hemorrhagic stroke, and developing cancer. A1C is very important to have a right picture of your blood glucose levels and the amount of carbs you consume. But A1c alone is not enough, it can be faulty since life span of erythrocytes varies in each person so it can give false high or false low readings. Also, it is not accurate in anemic person who has deficit of hemoglobin or in some people with kidney and liver disease.
Experts recommend including at least 3 parameters in blood glucose control assessment: fasting blood levels, A1C and very important post meal readings, which show how well your body actually responds and brings glucose level to normal after a meal.
· Triglyceride/HDL ratio and calcium score test
If you want to know what your coronary arteries status is and if you are at risk of future heart failure, you must ask your doctor about these two parameters. When checking your lipid panel doctors look at total cholesterol, HDL or “bad cholesterol” and triglyceride but single number doesn’t tell much. What usually goes under the radar is triglyceride/HDL ratio and calcium score test. The triglyceride/HDL ratio should be under 2, ideally under 1 to be sure that you at a low risk of developing heart problems in the future.
Calcium score test is basically a scan of coronary arteries that lead to heart. It tells you how much of calcium build up you have in your coronary arteries and is a great tool in heart attack risk assessment. If your result is high, maybe it is time to adjust your diet and get necessary supplements to support your heart’s health.
· Ferritin test
Ferritin is intracellular protein that stores iron and the lack of it can cause body ache, irritability, anxiety and poor ability to oxidize fat. Low ferritin is not the same thing as anemia, but you can think of it as a precursor of anemia. In order to improve your ferritin levels your diet should include more green vegetables, fish and beef and some iron supplements, if necessary.
· Thyroid hormones
When testing for thyroid hormones, doctors usually order just TSH and in some cases free T4 levels. TSH is a hormone of a small gland called pituitary gland which stimulates thyroid gland to release T4 and T3 which is the most biologically active thyroid hormone responsible for normal growth and development, metabolism and heart rate.
Very important test that is widely overlooked when it comes to thyroid health is Reverse T3. Production of Reverse T3 is typically triggered when the body is under significant stress. Reverse T3, the inactive mirrored form of T3, inhibits T3 function and around 20% of T4 is converted into Reverse T3. In a time of significant stress, conversion rate is higher- it may go up to 50% of T4 becoming Reverse T3. That significant change in ratio can have great impact on hormonal balance since T3 and Reverse T3 are competing for the same cell receptors. The abundance of Reverse T3 blocks active T3 from reaching the cells and it slows down metabolism causing cortisol, one of “fight or flight” hormone to kick in and to give a little boost and increase of energy.
Too much cortisol along with increased Reverse T3 over time leads to long-lasting fatigue, chronic inflammation, acute illness and low iron.
Even if your TSH and free T4 are normal and you experience symptoms of hypothyroidism, ask your doctor about Reverse T3. According to a study in The Journal of Clinical Endocrinology & Metabolism, TSH and T4 levels alone are poor indicators of one’s thyroid function and if doctors neglect high levels of Reverse T3, many of the patients can be left suffering from untreated thyroid disfunction.
· Vitamin D
Vitamin D is a fat-soluble vitamin that helps your body absorb phosphorus and calcium. The common sense in accumulating enough of vitamin D is to get out and soak up the sun. When your skin is exposed to sunlight, it makes vitamin D from cholesterol. Vitamin D is essential for our health, it is important for healthy bones and teeth, protects from infections and flu, helps prevent diabetes, reduces risk of cancer and getting autoimmune disease. The lack of vitamin D can cause low moods, high blood pressure, insulin resistance, obesity.
If you have deficiency of vitamin D, including supplements may be a necessary step in order to ensure you are getting enough of this essential vitamin.
LIVER ENZYMES and DHEA test are additional tests that could be done if you find yourself eating right but not able to lose any weight. DHEA is a steroid hormone made from cholesterol in adrenal glands. It is a precursor to the sex hormone estrogen and testosterone both in women and men. It is our youth hormone also responsible for weight loss and often touted as anti-aging therapy.
These are some of the tests I like to see done by my clients and make sure they don’t have any health issues that can interfere with their weight loss and body healing while on well-formulated keto diet.