Blood Work Analysis and Optimization Part 2
As previously discussed in Blood Work Tracking and Optimization Part 1, my new year’s resolution for 2023 was to optimize my bloodwork. I am becoming increasingly conscious of the importance of preventative healthcare, especially considering my family’s history of chronic diseases. I am also reaching an age where I will be considering starting a family in the next few years, and I want to ensure I am in peak physical condition to optimize the chances of healthy pregnancies and children.
Optimizing Pre-Conception Health for Women
Optimizing Pre-Conception Health for Men
To benchmark my results, I use InsideTracker to track my bloodwork against optimal ranges backed by the latest scientific research. The last time my blood was tested, I obtained the blood requisition from my doctor and manually uploaded the results to InsideTracker. I ordered a more extensive blood test this time through InsideTracker, so some indicators will not have previous data to compare.
Lifestyle Factors
In my last blood test, a few blood markers were not optimized and required some work. I was in the “At Risk” category for Vitamin D, HDL Cholesterol, and Hematocrit and in the “Needs Work” category for Triglycerides, Ferritin, Hemoglobin, and Vitamin B12.
Some lifestyle factors to note since my first blood test are as follows:
I maintained a vegetarian diet.
I did not take any vitamin supplements.
I increased my consumption of grass-fed dairy and pastured eggs to increase vitamin D.
I continued to exercise regularly to keep HDL levels from worsening.
I increased my consumption of chlorella to help raise hematocrit, ferritin, and hemoglobin levels. Also, I stopped consuming tea with meals to avoid inhibiting the absorption of non-heme iron. I also paired leafy greens with lemon juice to enhance iron absorption.
Results
Vitamin B12 (Optimized)
Improved
Nov 25, 2022: 255 pg/ml
Jan 23, 2023: 317 pg/ml
My vitamin B12 is now in the optimized range - previously, my B12 levels were in the “Needs Work.” I attribute this to the increased consumption of eggs, butter, and chlorella, all with good levels of B12.
Vitamin D (At Risk)
Worsened
Nov 25, 2022: 18 ng/mL
Jan 23, 2023: 13 ng/mL
During the period of November to January, my vitamin D levels have dropped even further. This is to be expected as it is winter in Canada. I have become a little more concerned with my vitamin D levels and intend to monitor them closely for the rest of the year. While still avoiding vitamin D supplementation, my strategy is to increase my regular sun exposure and vitamin-D food sources.
I took a two-week trip to Panama in March, where I surely got a good dose of vitamin D from the equator sun. I also started incorporating meat in my diet again after a decade and have included fish once to twice a week, which should help boost my vitamin D levels. Now that the weather has begun to warm up in May, I aim to get sunlight exposure daily at noon or early afternoon when I can make vitamin D from UVB rays.
Iron Group
In my first blood test, some of my Iron Group markers were low (ferritin, hemoglobin, hematocrit), and some were optimized (red blood cells, red blood cell volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and red cell distribution width). Some Iron Group indicators were not measured in my first blood test but were measured in my second test.
I was surprised to see that in my most recent blood test, some of my iron group indicators were above the optimal range, and some were below. On Dr. Matt Angove’s site, Dr. Wholeness, I read an article about the combination of high serum iron and low ferritin, which I have.
He suggests that this ratio can be caused by underlying infections, oral contraceptive use and thyroid disorders. He also suggests considering testing based on history for heavy metals (especially lead). The use of cast iron pans can also cause elevated serum iron if taken before a blood test - and at the time of testing, my cast iron was the only pan I used. 5 While not immediately concerning, I will continue to monitor my iron group levels for the rest of the year to ensure that there are no worrying trends.
Since my most recent blood test, I have begun incorporating meat into my diet. I expect that the red meat will help boost my iron levels further. I have also started taking a 100% grass-fed heart, spleen and liver supplement containing good amounts of heme iron.
Hematocrit (Optimized)
Improved
Nov 25, 2022: 34.9%
Jan 23, 2023: 40%
My previous bloodwork put me in the “At Risk” range for hematocrit, so I was pleased to see my results jump into the “Optimized” range. I expect this was influenced by my consumption of chlorella, pairing of leafy greens with lemon juice, and being more mindful about the timing of my tea consumption.
Ferritin (Needs Work)
Improved
Nov 25, 2022: 36 ng/mL
Jan 23, 2023: 38 ng/mL
My ferritin levels have slightly improved since my last blood test - not yet putting me in the “Optimized” range where I want to be. My increase in ferritin levels can likely be attributed to the same habits that raised my hematocrit - both indicators are associated with optimal iron intake.
Transferrin saturation (TS) (Needs Work)
Nov 25, 2022: not tested
Jan 23, 2023: 41%
Transferrin saturation is serum iron divided by total iron binding capacity. This indicator is currently higher than the optimal range.
Iron (Needs Work)
Nov 25, 2022: not tested
Jan 23, 2023: 117 ug/dL
My serum iron levels are currently higher than the optimal range.
HBA1C (Needs Work)
Worsened
Nov 25, 2022: 5%
Jan 23, 2023: 5.2%
I am on high alert for any trends that indicate increasing insulin resistance, as I have a long family history of diabetes. (at least as far back as my paternal great-grandmother) My latest HBA1C is still very low compared to typical normal ranges and just .2% above InsideTracker’s optimal range. Even so, I want to ensure that I closely monitor any developing trends so that I can correct them with lifestyle changes.
To keep my blood glucose levels and HBA1C in check, I aim to manage my circadian rhythm by keeping a consistent wake and sleep time and trying to keep a 12-hour maximum eating window. I also exercise every weekday morning, except for the first few days of my menstrual cycle when I prioritize rest. I have also incorporated exercise after meals when possible to help absorb glucose into the blood by walking or quick large muscle movements like squats and lunges. Since my latest blood test, I have also incorporated meat back into my diet, making it easier to balance carbs and protein in meals, which I expect has had a positive effect on my blood glucose levels.
Lipid Group
As heart disease runs in my family and is the second leading cause of death in my country, I also want to be mindful of my cholesterol and triglyceride levels. Since my last blood test, I have increased my exercise frequency and incorporated more high-intensity aerobic exercise into my routine.
I haven’t focused on targeting cholesterol and triglycerides through my diet. Still, I have made significant diet changes since my last blood test- from being vegetarian to eating meat - and I am very interested to see how that reflects in my next blood test. My lipid group will likely become my next focus area if my levels are still not optimal.
LDL Cholesterol (Needs Work)
Worsened
Nov 25, 2022: 76 mg/dL
Jan 23, 2023: 85 mg/dL
My LDL, also known as “bad cholesterol,” has jumped from the top of the “optimal” range to “needs work”
HDL Cholesterol (Needs Work)
Improved
Nov 25, 2022: 45 mg/dL
Jan 23, 2023: 50 mg/dL
HDL, also known as “good cholesterol,” has risen but is still below the optimal range.
Triglycerides (Needs Work)
Improved
Nov 25, 2022: 101 mg/dL
Jan 23, 2023: 87 mg/dL
I am pleased to see that my Triglycerides levels have gone down, although they still fall in the above-optimized range.
Testosterone Group
Sex Hormone Binding Globulin (SHBG) (Needs Work)
Nov 25, 2022: not tested
Jan 23, 2023: 52 nmol/L
My SHBG is a bit lower than the “Optimized” range. Low SHBG levels are associated with an increased risk of type 2 diabetes. SHBG can also be an early indicator of insulin resistance - when SHBG is low, HBA1C levels tend to be high. 1
As mentioned previously, my family has a history of diabetes that goes back generations. As such, I would definitely like to see my SHBG become optimized. Some studies have noted improvements in SHBG levels with aerobic exercise, which I have increased since my last blood test. I am eager to see if there will be any impact on my SHBG level.
DHEAS (dehydroepiandrosterone-sulfate) (Needs Work)
Nov 25, 2022: not tested
Jan 23, 2023: 137 ug/dL
My DHEAS level is in the below-optimal range. DHEAS levels peak around age 20-30 and then decline steadily over time, so this is one of the indicators that InsideTracker uses to calculate InnerAge. Lower levels of DHEAS are associated with an increased risk of cardiovascular disease, decreased immunity, and blood sugar instability. 3
One study found that vegetarian women had lower levels of DHEAS levels than omnivores. I am interested to see if my change in diet will help me elevate my DHEAS level into the optimal range. 2
Testosterone: Cortisol ratio
Nov 25, 2022: not tested
Jan 23, 2023: 59
My testosterone/cortisol ratio falls between the “Needs Work” and “Optimal” ranges. A low score may indicate high stress, insufficient sleep, or poor recovery after exercise. My testosterone levels are currently optimized, but my cortisol levels are slightly higher than the top of the optimal range. 4
I have since implemented a fairly strict waking and sleeping schedule during the weekdays since my last blood test, so I am interested to see if there will be a difference next time I test. If my results still indicate that I can improve, I will look to see what other areas I can adjust to reduce my cortisol levels.
Disclaimer:
The information on Better Health Project is intended for educative and informational purposes only and is not intended to serve as professional or medical advice. The content of this site is not written by a medical professional. Always seek the advice of a trusted and qualified healthcare professional before making health changes.
Sources
Wallace, I.R., McKinley, M.C., Bell, P.M. and Hunter, S.J. (2013), Sex hormone binding globulin and insulin resistance. Clin Endocrinol, 78: 321-329. https://doi.org/10.1111/cen.12086
Karelis AD, Fex A, Filion ME, Adlercreutz H, Aubertin-Leheudre M. Comparison of sex hormonal and metabolic profiles between omnivores and vegetarians in pre- and post-menopausal women. Br J Nutr. 2010 Jul;104(2):222-6. doi: 10.1017/S0007114510000619. Epub 2010 Mar 9. PMID: 20211044.
Shanahan, E., By, & Shanahan, E. (2023, April 28). Using DHEAS as a biomarker of aging in women. The InsideGuide. https://blog.insidetracker.com/using-dheas-as-a-biomarker-of-aging-in-women
Nguyen, R., By, & Nguyen, R. (2021, November 5). The science behind testosterone biomarkers. The InsideGuide. https://blog.insidetracker.com/the-science-behind-testosterone-biomarkers
Angove. (2020, December 1). What does it mean when serum iron is high but ferritin is low? Dr Wholeness. https://drwholeness.com/blog/what-does-it-mean-when-serum-iron-is-high-but-ferritin-is-low/