Lab tests for Metabolic Health
Some examples of healthy and not so much....
I have posted before about lab values as well as metabolic health here, here , here, here, here and finally here.
Wow!
It sure looks like I believe good metabolic health is important!!
Today I will expand on that topic with a discussion of lab interpretations and how they relate to your Metabolism and Health.
What you see written below is from my clinical observations of thousands of patients over the past decade or more. I doubt you will see this in many traditional or Evidenced Based Medicine guidelines or protocols. But as I often say, EBM is an OK place to start, but not everyone can achieve optimal individual health when trying to become part of the crowd. The crowd may be popular and loud but the crowd is not always correct.
You should always try and safely find your individual optimal lifestyle.
Perhaps work with someone who understands how to help you achieve good metabolic health???
If you are a member of the Institute for Medical Wellness and have already had your Advanced Wellness Testing, this should be a good recap of how we evaluated your results.
Let’s look at some lab tests that are all part of the Institute for Medical Wellness (IMW) Advanced Wellness Testing (AWT). All interpretations are using American lab values.
Fasting Insulin- This is the level of Insulin, a hormone made by your pancreas, in your blood. This generally tracks with how your body handles it’s response to excess dietary carbohydrates that get stored as fat for future use.
Optimal : 3-7
OK : 7-10
Needs some work: >10
Hemoglobin A1C (HbA1C or A1C)- This is a measurement of the amount of sugar that permanently attaches to your hemoglobin inside your red blood cells. Generally the higher the value the more carbohydrates and glucose that has been circulating in your blood. So lower levels are generally better.
Optimal : varies with age but usually <5.7
But the A1C can vary with health status in that some very metabolically and active people have elevated A1C’s due not from too many carbohydrates, but instead due to healthier and longer lived Red Blood Cells which contain hemoglobin. So I suggest you do NOT look at this value alone when interpreting your metabolic health.
HOMA-IR - This is a calculated value from Fasting Glucose and Fasting Insulin that evaluates how well your body is handling excess dietary carbohydrates from your diet. Lower numbers are better.
Optimal : <1
OK : 1-2
Needs some work: >2
Triglycerides - correlate with excess dietary carbohydrates, alcohol and sometimes coffee consumption. Lower triglyceride levels are generally better
Optimal : less than HDL
OK : less than 1.5X HDL
Needs some work: >1.5x HDL
HDL - correlates with the amount of fat soluble nutrients being recycled in your body. Higher HDL levels are generally better.
Optimal : > than Triglycerides
OK: > than 2/3 Triglycerides
Needs some work: < 1.5x HDL
Triglyceride/HDL Ratio - The lower the ratio the better the metabolic health.
Optimal : <1
OK : 1 - 1.5
Needs some work: >1.5
Leptin - correlates with the amount of your stored inflammatory fat. Lower Leptin levels are generally better.
Optimal : < than Adiponectin or <10
Needs some work: > than Adiponectin or >10
Adiponectin - correlates with the amount of safe fat storage remaining in your body which allows you to be metabolically healthy. Higher Adiponectin values are generally better.
Optimal : > than Leptin or >10
Needs some work: < than Leptin or <10
Leptin to Adiponectin ratio
Optimal <1
Needs some work >1
Free T3 (FT3) - the active thyroid hormone. Your cells convert another thyroid hormone Free T4 into Free T3 in a very balanced way. In a euthyroid (normal thyroid) individual the FT3 correlates closely with the amount of dietary carbohydrates eaten and burned for energy. This is what I call my dietary carbohydrate bullsh-t or BS detector. If someone is actively hypothyroid this correlation does not work as well.
Optimal : < 3.0
Needs some work: >3.0
C-peptide - correlates with the amount of Insulin produced by your pancreas.
I use a Fasting Insulin to C-Peptide ratio as a determinant of your metabolic inflammatory health.
Fasting Insulin / C-Peptide
Optimal ratio: <3.5
OK : 3.5 - 4.0
Needs some work: >4
Uric Acid - this is an interesting marker. I used to always believe this was a marker only of Gout. But it is more than that. It is also a marker of both alcohol use and dietary carbohydrates/sugars/fructose consumed. My belief is that Uric acid is one of our natural antioxidants that we make. It is interesting how we make more Uric Acid when we consume more carbohydrates, sugar and alcohol. Perhaps our body is trying to buffer the excess oxidation occurring from the excess intake and burning of carbohydrates, sugar and alcohol?? I see this correlation all the time.
Optimal : <4-6
Needs some work: >6
Very unhealthy: > 8
GGT - Liver enzyme that also correlates well with metabolic health. High levels can indicate possible fatty liver, a precursor to Diabetes. Lower levels are better.
Optimal ratio: < 20
OK : 20-30
Needs some work: >30
Ferritin - another liver enzyme that often correlates generalized inflammation as well as with fatty liver. Lower levels are better.
Optimal : 30-50
OK : 50 - 100
Needs some work: > 100
These levels can be different between Males and Females.
AST-ALT - two more liver enzymes similar to GGT and Ferritin in correlating with metabolic health and possible fatty liver. Lower levels are better.
Optimal : <20
OK : 20-30
Needs some work: >30
Urine pH - This is a new marker I have been following recently. I find that excess oxidation/inflammation from increased carbohydrate fuel burning can lower the Urine pH. This could be our way of eliminating excess oxidation thru our kidneys.
Optimal : 6-7
Needs some work <6
What about if I can not get lab tests? Is there another way to evaluate metabolic health?
Height to Waist Ratio
You need measuring tape and your height.
If your height in inches is more than double your waist measurement at your umbilicus in inches, then you are metabolically in a good place.
Another way to look at it that you want your waist to be less than half your height.
They are both the same calculation, just reversed.
EX:
If you are 5 foot 6 inches, you are 66 inches tall.
To be metabolically healthy you would want your waist to be less than half of 66.
66 divided by 2 = 33 inches.
So a healthy waist for a 5’6” tall person is 33 inches or less.
Ex:
If you are 5 ft 10 inches tall you are 70 inches tall.
To be metabolically healthy you would want your waist to be less than half of 70.
70 divided by 2 = 35 inches
So a healthy waist for a 5’10: tall person is 35 inches or less.
Ex:
If you have a waist of 34 inches, to be metabolically healthy you want to be at least twice as tall as your waist.
34 x 2 = 68 inches or 5’8” tall
So to be metabolically healthy with a 34 inch waist you want to be at least 5’8” tall
I have met very few healthcare professionals who evaluate metabolic health as I do. I encourage others to evaluate the above. I am open to discussion and constructive criticism if anyone can show where I am off in my thinking. There will always be outliers and other medical issues that make some of the above criteria not valid in individual circumstances. That is why I encourage everyone to discuss the above with someone knowledgeable in metabolic health.
As always comments and civil discussions are welcome.
This substack blog is not meant to be an echo chamber but instead a place to have common sense health and wellness discussions.
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These height weight expectations are unrealistic for most. This harsh reality makes me want to give up my efforts to lose weight, as HOPELESS. I have not been a size 33 waist since high school. I don't have ANY hope of achieving that goal ! Your meat snack tip is some solace, at least :-( Fasting until 1pm , Really? I am trying to fast from 9pm to 11am.