Using blood tests to personalise your health program
The world of health and fitness has never been awash with more information than it is today. This information, while much of it true, can often be misleading, this is due to a need for information to be presented in the context it originated. When data is presented out of context, it becomes what I call a half-truth which is tantamount to a full lie on most occasions. This is not a purposeful ploy; in many cases, just a lack of understanding, and often stems from an excitation to share what they have learnt with the world.
Health is a very complex subject with many moving parts; high levels of fasting glucose blood test, for example, can be caused by a large number of health complications. Enter blood tests, the use of blood tests to reveal additional markers such as cholesterol, triglycerides and specific enzymes will go a long way to understanding the true cause of increased fasting glucose blood test. Before we get into the details of how blood test can be used to define personalised strategies to improve health, let us first look at how individual markers are scored and how the standard ranges are decided.
A reference range for a blood test is determined by looking at what 95% of the healthy population falls into, the word healthy is relative to if they have a recognised clinical condition. This term healthy dose not take into account optimal or those that are well on the way to poor health but not yet diagnosable. These ranges can be specific to the lab performing the blood test, may include many unhealthy individuals, resulting in wider ranges that are not indicative of optimal health or functionality but only the avoidance of clinical conditions. These ranges also do not take into account any links between specific ranges and mortality or disease risk.
One example of a blood test marker, often hotly debated, is TSH (Thyroid-stimulating hormone) which is released by the pituitary gland in the brain to control the amount of thyroid hormone produced (T4 & T3) in the thyroid gland. Thyroid hormones control the number of calories you burn so the amount we produce is essential to maintain proper energy balance and impacts temperature regulation also. Many standard lab ranges are as wide as 0.4-6 mlU/L despite much tighter ranges being suggested in researchers of 0.4-3 mlU/L due to increased risk of developing hypothyroidism and other adverse health conditions for those above this upper limit. (1, 2, 3, 4)
As well as the use of tighter ranges for specific markers, the use of known patterns that present in particular health conditions is vital to making use of blood tests. A great example is how aspects of the red blood cell (RBC) can give a strong indication for B12 and B9 need. Patterns seen in blood tests such as this can often provide a better indication of functionality then assessing the nutrients themselves, as when considering a blood test it is crucial to not only look at nutrient availability but the practical actions those nutrients should have. For example, one can have optimal ranges of vitamin B12 & B9 yet still have issues with RBC size due to reduced vitamin B2 or B7. Without looking at wholistic patterns rather than individual markers, we may miss a key piece of information.
So how do you decide what blood test markers to assess?
Many reading this will probably have been to the doctor's office at some point with symptoms or a notion that something isn't right in your body only to have the blood test results come back all clear. This can be incredibly frustrating, especially if you do not have a supportive physician or health care professional at your side. Now, this may be due to issues noted above in regard to reference ranges being too large to pick up conditions at early stages, but it may also be that the wrong test is being performed or the test is being performed at the wrong time. Symptoms do not happen for free; there is always a reason.
The first step to any personalised wellness program is the proper assessment of symptoms; this gives us the base at which we can start creating a theory or theories of what could be occurring in the body. To make this base theory, grouping symptoms into sections such as the upper gastrointestinal tract or the liver and gallbladder will help determine a potential hierarchy of needs. This base will also guide us on what blood tests to order and if any specific pre-test conditions need to be adhered.
Once We have our blood test results and symptoms analysed, we can start to look at patterns not only between the blood test markers, but the symptoms experienced also. This cross-analysis reveals where the most considerable efforts are needed and how to personalise your efforts.
X symptoms = X blood test = X intervention
So why is this/blood tests important?
Let's take a look at one of the most common blood test markers to be out of range, fasting glucose blood test and walk through a real-life case study.
Optimal levels are between 4.16-4.77 mmol/L, which in my experience is very rare to find someone in this range. Standard ranges are 3.61-5.50 mmol/L, and even this, I will often see people regularly in the 6 mmol/L range on a daily basis. This is a simple blood test that can be done routinely from home or in a full panel and as mentioned at the beginning of this post can have many different causes. So fasting glucose blood test is not impacted by what you ate last night and is a reflection of basal stress status. Hydration status can significantly impact RBC health, kidney and liver markers as well as fasting glucose blood test.
In this case study patient X has a fasting glucose regularly over 6 mmol/L, wakes up thirsty every morning, shows signs of dehydration in their full blood test panel and has energy dips after consuming anything with excessive sugar or salts but drinks 3 L of water every day without fail. These are classical signs of dehydration and are occurring even though enough water is being consumed. Blood glucose also seems to be elevated, although not to any alarming levels. Client X was taking 5 supplements to improve glucose sensitivity and reduced carbohydrate intake but saw no improvement.
When a full blood test was assessed, a pattern showing problems with protein integration and electrolytes was found. A dietary program of eating 4 meals per day with 40% of each meal consisting of complex carbohydrates, electrolytes and glutamine supplementation was taken in the morning and evenings as well as a reduction in water intake to 2 L per day; all other supplements were paused.
Client X saw an increase of energy throughout the day, improved mood, improved cognition, increased tolerance to sugary and salty, no more thirst upon waking, meals all blood test markers related to hydration improved to optimal ranges and fasting glucose blood test average reduced to 5.2.
Client X assumed they had a problem managing glucose; in reality, they were suffering from not enough water getting inside the cells, which was triggering a stress response. The stress response was creating changes in glucose metabolism and exacerbating the hydration issue they were experiencing. Without complete analysis, this problem could have lead to real glucose tolerance issues over time.
Blood tests are a vital part of personalised health, and choosing where to start can seem overwhelming. To help things along visit my website to download my symptom analysis questionnaire. This is a free service to help you decide which blood tests will be most suitable to reveal your ideal path. https://www.christianthomson.co.uk/symptom-analysis-signup/
- Hamilton TE, Davis S, Onstad L, Kopecky KJ. Thyrotropin levels in a population with no clinical, autoantibody, or ultrasonographic evidence of thyroid disease: implications for the diagnosis of subclinical hypothyroidism. J Clin Endocrinol Metab. 2008;93(4):1224‐1230. doi:10.1210/jc.2006-2300
- Tan ZS, Beiser A, Vasan RS, et al. Thyroid function and the risk of Alzheimer disease: the Framingham Study. Arch Intern Med. 2008;168(14):1514‐1520. doi:10.1001/archinte.168.14.1514
- John P. Walsh, Alexandra P. Bremner, Peter Feddema, Peter J. Leedman, Suzanne J. Brown, Peter O'Leary, Thyrotropin and Thyroid Antibodies as Predictors of Hypothyroidism: A 13-Year, Longitudinal Study of a Community-Based Cohort Using Current Immunoassay Techniques, The Journal of Clinical Endocrinology & Metabolism, Volume 95, Issue 3, 1 March 2010, Pages 1095–1104, https://doi.org/10.1210/jc.2009-1977
- Langén, VL, Niiranen, TJ, Puukka, P, et al. Thyroid‐stimulating hormone and risk of sudden cardiac death, total mortality and cardiovascular morbidity. Clin Endocrinol (Oxf). 2018; 88: 105– 113. https://doi.org/10.1111/cen.13472