Introduction

9 Important Blood Tests to Order on Keto

Don’t guess, test! The more data you have, the more metrics you can analyze for progress and necessary tweaks. I am going to share with you 9 blood tests. Not only will I share them with you, but I will also explain what they mean and the optimal numbers to aim for.

The first thing I want you to realize is that the reference ranges on your lab report is not the same as the healthy ranges you should aim for. Lab companies such as LabCorp, Quest and many others, are factoring in your countries entire population who have done these labs before. We live in a sick world of unhealthy people, so why would we aim to be the average of unhealthy people? Instead, I encourage you to aim for the functional reference range. Functional medicine lab ranges are usually much narrower than standard lab ranges. They are labeled “optimal lab values,” meaning anything outside of those optimal values can show patterns and markers that spot trends toward disease. When I give you the suggested reference ranges to hit with the following labs, these are functional medicine lab ranges.

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Here are the 9 markers!

Hemoglobin A1C. How gummed up with sugar are your blood cells? Hemoglobin A1C (hbA1c) measures your average blood sugar from the past 3 months. Your red blood cells carry oxygen to your tissues using a protein called Hemoglobin A. The higher your blood glucose, the more glucose sticks to the hemoglobin A1c protein.

How glycated is your hemoglobin?

Glycation is a spontaneous non-enzymatic reaction of free reducing sugars with free amino groups of proteins, DNA, and lipids that forms glycated residues. Sugar is sticky (think of cotton candy sticking to your fingers) and this sugar can gunk up your arteries and cells.

 Our red blood cells keep a record of your behavior. The answer hides in your red blood cells – specifically, your hemoglobin. A1C measures average blood sugars by detecting the glucose stuck to the hemoglobin protein.  The higher A1C, the more glucose glycated your protein.

Test your hemoglobin A1C to learn your average blood sugar. You can request this test from your doctor. There are also companies who have created A1C test kits to do at the comfort of your own home.

A “normal” A1C level is below 5.7%, a level of 5.7% to 6.4% indicates prediabetes, and a level of 6.5% or more indicates diabetes. Within the 5.7% to 6.4% prediabetes range, the higher your A1C, the greater your risk is for developing type 2 diabetes.

The functional medicine range of A1C is 5.2% or lower.

C-Peptide. C-peptide is a substance that is created when the hormone insulin is produced and released into the body. The insulin C-peptide test measures the amount of this product in the blood. The pancreas makes insulin, but not directly. The beta cells in the pancreas first produce a protein called “proinsulin.” Each proinsulin breaks down to one molecule of insulin and one molecule of C–peptide. Both are released when blood sugar levels get high.

The more your beta cells get stimulated for insulin production, the faster you gain weight and create inflammation. While moderate levels lower inflammation, even slightly higher levels have been linked to insulin resistance, metabolic syndrome, heart disease, and cancer.

C-peptide can give you a good idea if you’ve been overworking your beta cells.

The functional medicine range for C-peptide is 0.8 – 3.8 ng/mL.

Levels below 0.6 ng/mL (0.2 nmol/L) are a sign of possible beta cell failure and type 1 diabetes. High C-peptide levels indicate that the body is producing too much insulin.

Fasting Insulin. This is a great compliment to the C-peptide test. Testing your insulin can reveal hidden problems in the way your body controls your blood sugar, years before they escalate to more serious issues, such as diabetes. In many cases, your blood sugar levels might not change for 10+ years, meanwhile you are getting closer each day to developing diabetes. This is because insulin is working so hard to keep those sugar levels “normal”. After a period, insulin cannot keep up with the demand. At this point blood sugars start to rise, and a diagnosis of prediabetes or diabetes is made. A fasting insulin test allows you to see if you are insulin resistant or on the road to insulin resistance.

The standard reference range for a fasting insulin is less than 25 uIU/mL.

The functional medicine range for fasting insulin is 3 – 7 uIU/mL.

25-Hydroxy Vitamin D. Vitamin D is a fat-soluble vitamin (and hormone) the body needs to build and maintain strong bones. It helps absorb calcium in the gut, keeping calcium and phosphorus in balance to mineralize bones. Vitamin D also helps support immune balance. Most people are deficient in Vitamin D.

Symptoms of vitamin D deficiency may include:

-            Fatigue

-            Not sleeping well

-            Bone pain or achiness

-            Depression or feelings of sadness

-            Hair loss

-            Muscle weakness

-            Loss of appetite

-            Getting sick more easily

-            Pale skin

 Is the solution to take Vitamin D supplements? Not really. I am not opposed to taking a fat-soluble complex supplement, but it isn’t until you lower insulin that you’ll be able to change your Vitamin D numbers for the better. High insulin levels block the production of Vitamin D! You can take all the vitamin D in the world, and get sunshine every day, but you will not optimize your vitamin D levels until insulin is optimized. The great news for you, this book will teach you how to do this.

The standard reference range on your lab report is typically 30-80 ng/mL.

The functional medicine range for Vitamin D is 60-80 ng/mL)

Homocysteine. High homocysteine has been linked to many health problems including heart disease, dementia, and Alzheimer’s. When homocysteine cannot be converted to other compounds, it builds up in the body and may cause damage. B vitamins play a very important role in this balance.

The standard reference range for homocysteine is under 14.5 umol/L.

The functional medicine range for homocysteine is 5 – 7 umol/L.

High Sensitivity C-Reactive Protein. An important marker of systemic inflammation. While this protein helps you fight infections, it is also a marker of low-grade inflammation and a predictor of your heart disease risk. People with higher hs-CRP values have a more elevated risk of cardiovascular disease and those with lower values have less risk.

Standard reference range for hs-CRP is 0 – 3.0 mg/L.

Functional medicine range for hs-CRP is 0.5 mg/L or under.

Let’s talk about lipids! The most common questions I get asked on social media is about cholesterol.

Here are the markers I suggest you get done to assess if you are risk for heart disease.

You will not see total cholesterol on here because this marker is close to meaningless.

High Density Lipoprotein Count (HDL-C). HDL (high-density lipoprotein) is often referred to as the “good” cholesterol because it helps to remove the “bad” cholesterol from the body and is required for many vital processes within the body. Having high levels of HDL cholesterol has been shown to decrease your risk for heart disease.

Cholesterol transported by HDL is known as “good” cholesterol because it is being removed from artery walls, which helps prevent, reduce, and even reverse hardening of the arteries (atherosclerosis) and heart disease [2].

HDL also plays a role in reducing oxidative stress and inflammation, improving cell and immune function, enhancing insulin sensivity, and may protect against neurodegenerative disorders [5, 6, 7].

The standard reference range for HDL for men is 35 – 65 mg/dl, for women is 35 – 80 mg/dl.

The functional reference range for HDL for men and women is 60-90 mg/dl.

Triglycerides. High levels of triglycerides can increase your risk of obesity, heart disease, diabetes, and other chronic health conditions.

Triglycerides can be stored in fat tissue, or can be used as energy.

For example, the body can release stored fats into the bloodstream as fatty acids when you don’t eat for a prolonged time. These fatty acids travel back to the liver, which transforms them into triglyceride-containing very low density lipoproteins (VLDL) that are returned into the blood.

On the other hand, your body stores more triglycerides when you overeat or have an unhealthy diet, such as the good ol’ standard American diet.

The standard reference range for triglycerides is under 150 mg/dL.

The functional medicine range for triglycerides is under 90 mg/dL.

Triglycerides to HDL ratio (TG:HDL). Your Triglyceride/HDL ratio helps offer a lifelong metric for your health.

TG:HDL is one of the criteria for the diagnosis of metabolic syndrome, which was briefly known as Reaven’s syndrome, named after Gerald Reaven, MD, of Stanford University. He and his colleagues around the world pioneered much of the research on TG:HDL ratio that indicates cardiovascular risk. TG:HDL is a strong marker of lifestyle factors—Your TG:HDL ratio offers a way to see whether you have a metabolism that naturally has cardiac protection or whether you need to earn it.

To calculate your TG:HDL ratio, you simply take your total triglycerides and divide this by your total HDL.

The standard reference range for TG: HDL is below 3.5

The functional medicine range for TG: HDL is below 1.5.

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Disclaimer: This podcast is for information purposes only. Statements and views expressed on this podcast are not medical advice. This podcast including Ben Azadi disclaim responsibility from any possible adverse effects from the use of information contained herein. Opinions of guests are their own, and this podcast does not accept responsibility of statements made by guests. This podcast does not make any representations or warranties about guests qualifications or credibility. Individuals on this podcast may have a direct or non-direct interest in products or services referred to herein. If you think you have a medical problem, consult a licensed physician.

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