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#21 Dean Pomerleau

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Posted 06 September 2015 - 05:49 PM

I'm still really loving my recumbent bike desk. I was playing around with making GIFs from burst photos, and figured I'd make one of my exercise desk in action to give people a feel for how nicely it works. Here it is:

 

nwIAjUH.gif

 

Its SO MUCH more stable than my treadmill desk. Here is the post with details.

 

--Dean


There will never be peace in the world while there are animals in our bellies.

#22 Zeta

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Posted 07 October 2015 - 10:50 AM

Four quick questions. I'm in Massachusetts, and want to get some bloodwork done without going to a doctor or leaving Massachusetts.

 

1. Is my only option the Life-Extension Foundation?

 

2. If I'm particularly interested in advanced lipid testing (LDL particle number and size, etc., and oxidized LDL), how much of a difference would it make if I test after a feast day, as opposed to after my fasting day? (For those who don't know: I eat nearly 4000 calories of ~65% fat, mostly from nuts and avocado, two days in a row, then low-fat ~500 calories on the third day.) I will have fasted at least 12 hours either way.

 

3. For advanced lipid testing, what would be more useful, NMR, or VAP?

 

4. Any other tests I might want to get while I'm at it, tests that are particularly relevant for gauging the effects of a high-fat (well, 2 out of 3 days) diet? Blood glucose I can do at home, and HbA1C is irrelevant since I'm anemic. Fasting insulin, perhaps.

 

Zeta


Edited by Zeta, 07 October 2015 - 11:33 AM.


#23 Dean Pomerleau

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Posted 07 October 2015 - 11:50 AM

Four quick questions. I'm in Massachusetts, and want to get some bloodwork done without going to a doctor or leaving Massachusetts.

 

1. Is my only option the Life-Extension Foundation?

 

2. If I'm particularly interested in advanced lipid testing (LDL particle number and size, etc., and oxidized LDL), how much of a difference would it make if I test after a feast day, as opposed to after my fasting day? (For those who don't know: I eat nearly 4000 calories of ~65% fat, mostly from nuts and avocado, two days in a row, then low-fat ~500 calories on the third day.) I will have fasted at least 12 hours either way.

 

3. For advanced lipid testing, what would be more useful, NMR, or VAP?

 

4. Any other tests I might want to get while I'm at it, tests that are particularly relevant for gauging the effects of a high-fat (well, 2 out of 3 days) diet? Blood glucose I can do at home, and HbA1C is irrelevant since I'm anemic. Fasting insulin, perhaps.

 

Zeta

 

Hi Zeta,

 

I'll take a shot at some answers:

 

#1) No, LEF isn't your only option for doctorless blood testing. I've been quite pleased over the years with privatemdlabs.com. They have many different testing packages that are often less expensive than LEF for the same or greater numbers of tests. Very quick service - order the test (via credit card), they send you the prescription the next day, you take it to a local LabCorp to get blood drawn, and in a couple days you get notified to log in to download your PDF with results. Here is just one good one (for $272) that has a lot of useful tests, including VAP lipid testing. I usually go with the Deluxe Male Anti-Aging Panel, but it doesn't include VAP or NMR lipid testing.

 

#2) If you've fasted for at least 12 hours, I shouldn't think it would make too much difference whether you do it after a feast or fast day.

 

#3) I'm not an expert on either VAP or NMR, but privatemdlabs.com offers both.

 

#4) Definitely fasting insulin. And (obviously) triglycerides, especially if you are going to try very low fat subsequently and retest. A liver panel would be informative as well, to see what if any impact your high fat diet has had on your liver function.

 

--Dean


There will never be peace in the world while there are animals in our bellies.

#24 Zeta

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Posted 07 October 2015 - 01:59 PM

Dean, thanks for the useful reply!

 

Unless there's a "wink wink" read between the lines option ("Due to state laws, we cannot provide services for RESIDENTS in NY, NJ, MA, MD or RI," we read), Private MD Labs does not provide services in Massachusetts. The allcaps on "residents" made wonder whether there might be some work-around, but I called and they said: Nope. 1) Can't be a MA resident (I'm not), and can't go to a lab in MA. It's a long drive to New Hampshire, so I lean towards LEF.

 

Yes, triglycerides will be important! (And I'll remember not to take my EPA supplement before the test. As a probable APOE-epsilon-4 carrier this is particularly important. (1).)

 

The liver function test is cheap, and I think you're right that it would be good to check liver function.

 

While I'm at it I might as well get a CBC and see whether my pancytopenia has improved. (A new test noted in the other thread on that showed that it had worsened even further still.)

 

Zeta

 

#2) If you've fasted for at least 12 hours, I shouldn't think it would make too much difference whether you do it after a feast or fast day.

 

#3) I'm not an expert on either VAP or NMR, but privatemdlabs.com offers both.

 

#4) Definitely fasting insulin. And (obviously) triglycerides, especially if you are going to try very low fat subsequently and retest. A liver panel would be informative as well, to see what if any impact your high fat diet has had on your liver function.

 

--Dean

 

 

 

(1) "'Probable'? Didn't you do 23andMe?" Yes, but after some family discussions all I can say is the "probable" bit.


Edited by Zeta, 07 October 2015 - 02:43 PM.


#25 Dean Pomerleau

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Posted 07 October 2015 - 05:42 PM

Bummer that privatemdlabs.com doesn't service Massachusetts. I didn't realize they had such geographic restrictions. I guess the medical industry lobby is particularly strong in Massachusetts...

 

--Dean


There will never be peace in the world while there are animals in our bellies.

#26 Dean Pomerleau

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Posted 08 October 2015 - 03:51 AM

Zeta,

One other test to consider is IGF-1. It is the best candidate we have (IMO) for a marker of the "CR state" and since you've recently change from continuous CR to a somewhat higher calorie diet with intermittent fasting, it would be interesting to see what if any effect this has had on your IGF-1 level.

Dean
There will never be peace in the world while there are animals in our bellies.

#27 Michael R

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Posted 08 October 2015 - 11:04 AM

All (mostly Zeta):
 

Unless there's a "wink wink" read between the lines option ("Due to state laws, we cannot provide services for RESIDENTS in NY, NJ, MA, MD or RI.") Private MD Labs does not provide services in Massachusetts. The allcaps on "residents" made wonder whether there might be some work-around, but I called and they said: Nope. 1) Can't be a MA resident (I'm not), and can't go to a lab in MA. It's a long drive to New Hampshire, so I lean towards LEF.


I'm afraid LEF is going to tell you the same thing. I've lived in and adjacent to the designated states: they have well-intentioned laws against direct-to-consumer blood testing. You're going tot have to go out-of-state (or LEF will set you p with a PITA and IMO likely medically unreliable alternative: hire your own phlebotomist and they'll send you the vials and instructions for sending them to Labcorp).
 
On the NMR testing: You will not be surprised to learn that this has been a question in Paleo and other communities. LDL particles have 3-5 day half-life, so LDL-P counts should be basically stable for 36 hours or so (which is I take it as long as you go without eating). You may get some variation on VLDL subclasses, but I take it you're not trying to read those tea leaves.

 

I fully agree with Dean that IGF-1 testing is important (though it's only really informative when combined with IGFBP3), and that I would expect to vary significantly with extended fasting. Actually, however, the importance of IGF-1 metabolism for CR is driven by mechanistic hypothesis more than data: per Luigi Fontana, the most reliable marker of the CR state in humans is absolute lymphocyte count.



#28 Michael R

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Posted 08 October 2015 - 07:25 PM

Sorry, Zeta: I seem to have missed most of your questions!
 

2. If I'm particularly interested in advanced lipid testing (LDL particle number and size, etc., and oxidized LDL), how much of a difference would it make if I test after a feast day, as opposed to after my fasting day? (For those who don't know: I eat nearly 4000 calories of ~65% fat, mostly from nuts and avocado, two days in a row, then low-fat ~500 calories on the third day.) I will have fasted at least 12 hours either way.

 
I'm less sure on oxLDL. High-phenolic EVOO lowers oxLDL both chronically and acutely, but I'm not sure about an effect over 24+ vs. 12 hours. Do I take it, though, that you never actually go a day without eating (you're doing something close to Michael Mosley's thing)?
 

3. For advanced lipid testing, what would be more useful, NMR, or VAP?

 
VAP is really pretty useless — no better than knowing LDL-C plus HDL, TG, and markers of metabolic syndrome. Particle number is the key. NMR LipoProfile is good, but FWIW (and I have done no digging beyond this point) a meta-analysis done by the American Association for Clinical Chemistry Lipoprotein and Vascular Diseases Division Working Group on Best Practices on the relative merit of NMR LipoProfile vs. apoB in predicting cardiovascular and other outcomes and found them to be roughly equivalent; an article written in response, one of whose two lead authors is a LipoScience employee, could only point at suggestive trends favoring the LipoProfile in a non-systematically selected subset of those studies favoring their test.
 
If the cost were equivalent, I'd go with NMR, but LEF (eg.) charges $149.00 for NMR LipoProfile but only $55 for ApoA-1 + apoB + their molar ratio.
 

4. Any other tests I might want to get while I'm at it, tests that are particularly relevant for gauging the effects of a high-fat (well, 2 out of 3 days) diet? Blood glucose I can do at home, and HbA1C is irrelevant since I'm anemic. Fasting insulin, perhaps.


(Your 500 Cal day isn't high-fat?). Definitely do fasting glucose and insulin no matter what your fat intake is. If you can't do HbA1c, you might do Glycomark, which is apparently a pretty good marker of chronic postprandial glucose excursions. However, as you know, having such is characteristic of intense CR that lowers IGF-1, and hasn't yet been nailed down to insulin resistance in such folks (if that's what you were thinking), so I'd not attribute the latter to fat intake or insulin resistance absent direct experiment.
 

Yes, triglycerides will be important! (And I'll remember not to take my EPA supplement before the test. As a probable APOE-epsilon-4 carrier this is particularly important. (1).)


I'm not sure that makes sense ... are you chronically taking EPA? If so, you presumably want your on-treatment value to assess your actual risk. You could also do a repeat test (just of basic lipids, not fancy stuff) off-treatment, tho' that's a big PITA if you're having to go out-of-state for it.

 

I take it that you have repeated measures of free and total T (by LC MS/MS) already?



#29 Zeta

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Posted 10 November 2015 - 06:01 PM

It's a long drive to New Hampshire, so I lean towards LEF.


I'm afraid LEF is going to tell you the same thing.

 

Yup, they did. Sigh....

 

So it's off to New Hampshire in a couple days. I had to wait for my weight to stabilize.

 

In fact, I probably should wait even longer, but my hematologist (located elsewhere) says I really need to repeat the CBC pronto, and I don't want to have to drive to New Hampshire twice, so.... Take a look at the weight change in the attached image, and tell me whether the weight gain has been slow and, recently, stable enough. 

 

weight.png

 

(Day 1 is July 1, last day is today. All morning weights, kgs.)

 

Sorry, Zeta: I seem to have missed most of your questions!

 

And I'm sorry for not thanking you for your responses, and for not continuing the dialogue. Have many balls in the air right now.

 

 

 2. If I'm particularly interested in advanced lipid testing (LDL particle number and size, etc., and oxidized LDL), how much of a difference would it make if I test after a feast day, as opposed to after my fasting day? (For those who don't know: I eat nearly 4000 calories of ~65% fat, mostly from nuts and avocado, two days in a row, then low-fat ~500 calories on the third day.) I will have fasted at least 12 hours either way.

 
I'm less sure on oxLDL. High-phenolic EVOO lowers oxLDL both chronically and acutely, but I'm not sure about an effect over 24+ vs. 12 hours. Do I take it, though, that you never actually go a day without eating (you're doing something close to Michael Mosley's thing)?

 

Yes: 2 feast days, 1 470-calorie day. Repeat. Never a day without eating.

 

 

3. For advanced lipid testing, what would be more useful, NMR, or VAP?

 
VAP is really pretty useless — no better than knowing LDL-C plus HDL, TG, and markers of metabolic syndrome.

 

Well, except it breaks down HDL into HDL2 and HDL3. That is looking important for dementia risk.

 

FWIW (and I have done no digging beyond this point) a meta-analysis done by the American Association for Clinical Chemistry Lipoprotein and Vascular Diseases Division Working Group on Best Practices on the relative merit of NMR LipoProfile vs. apoB in predicting cardiovascular and other outcomes and found them to be roughly equivalent.

 

Thanks for this. I looked into that further and have started to think the simple apoB test (or ApoA-1 + apoB + their molar ratio) might be a good choice for many reasons: one is that there is greater standardization across labs.

 

Glycomark: Hadn't heard of that -- thanks!

 

 

Yes, triglycerides will be important! (And I'll remember not to take my EPA supplement before the test. As a probable APOE-epsilon-4 carrier this is particularly important. (1).)


I'm not sure that makes sense ... are you chronically taking EPA? If so, you presumably want your on-treatment value to assess your actual risk. You could also do a repeat test (just of basic lipids, not fancy stuff) off-treatment, tho' that's a big PITA if you're having to go out-of-state for it.

 

I take it that you have repeated measures of free and total T (by LC MS/MS) already?

 

No, I take EPA sporadically -- a 2-3 times/week, max, on days when I don't get a lot of plant omega-3s.

 

And yes, I've had T tested repeatedly. Always low (slightly below, sometimes slightly above, bottom of ref. range).

 

Zeta

 

 



#30 Dean Pomerleau

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Posted 21 December 2015 - 02:18 PM

I got my bloodwork back from the yearly physical I had a week ago, during which I got a clean bill of health from my doctor. He said I appear to be doing great. But the truth is in the numbers, so here goes.

 

For those of you who want to check out the details, I'vd updated table with the history of my bloodwork since age 35, when I started CR 16 years ago. Note - I added an "Age" row at the top of the table, so it is easy to figure out how far back a test was.

 

For those of you who don't want to see all the gory details, the upshot is that I continue to show the typical biomarkers of CR, at least those which I was able to convince my insurance company to pay for...  I'll get a more comprehensive set of tests again in six months, when I pay out-of-pocket to get this suite of tests offered by Private MD Labs.

 

For those who want details and color commentary, here are the highlights from my latest round of tests:

  • Diet & Exercise Routine - Here is how I describe my current diet and exercise routine in footnote 18 of the table: "Very stable diet, exercise & weight for at least 4 months. Diet detailed here. ~3400kcal/day. 58C / 33F / 9P.  High fruit, vegetables & nuts/seeds. One BIG meal per day (breakfast). Daily Exercise: 90 miles stationary biking, 2 miles running, ~1h resistance training per day, 7d/wk. Feeling really good, high energy."
  • Weight - Despite eating a lot of healthy calories (~3400kcal/day), my weight is the lowest it has been in several years at 115lbs (BMI 17.3), due to LOTS of low- and some moderate-intensity exercise.
  • Blood Pressure - 100/60. Very stable and good. This was in doctor's office - no 'white coat' syndrome for me!
  • Resting Heart Rate - 43 BMP, measured with my Fitbit before getting out of bed in morning. Quite low. My cardiovascular conditioning is pretty good.
  • Fasting Glucose - 81 mg/dL. Quite consistent with my old days of 'low calorie' (aka 'real') CR, despite currently eating 500+ grams of carbs / day. Note: I did my usual 3h of pre-breakfast exercise prior to blood draw, which usually raises my glucose level a bit from its fasting level immediately upon waking, which is after 19h fast.
  • Cholesterol - Continues to be extremely good, in fact arguably the best I've ever had, with total chol only 133, HDL well above LDL, and triglycerides low despite high carb diet. Perhaps not quite as good as Saul's 'legendary' (at least in his own mind  :)xyz) cholesterol numbers.
    • ​Total Cholesterol - 133 mg/dL
    • HDL - 64 mg/dL
    • LDL - 59 mg/dL - my topical coconut oil use as a moisturizer does not seem to have negatively impacted my LDL cholesterol level, despite concerns some have expressed in this thread.
    • Triglycerides - 49 mg/dL
    • Tot / HDL - 2.08 - my lowest ratio ever.
  • White Blood Cell Count (WBC) - 2.2 (RR 4.0 - 10.5). About 1/2 the bottom of the reference range. Ties for my lowest WBC ever. Absolute lymphocyte and monocyte counts below RR as well. No inflammation here, despite copious exercise! In fact I did my usual 3h of pre-breakfast exercise prior to blood draw. Very typical of CR practitioners. Haven't had a cold or flu in many years.
  • Red Blood Cell Count (RBC) - 3.37 (RR 4.14 - 5.8). Well below the reference range. Also seemingly not unusual for CR practitioners, or for me during my history of CR.
  • Hemoglobin - 12.3 (RR 13.2 - 17.1). Also below the reference range, despite 400% of RDA of dietary (non-heme) iron and 300% of RDA from supplemental iron. Zeta take note. Could be low iron bioavailability from vegan sources. But thankfully no physical symptoms of anemia, which I've found from my two prior bouts of anemia don't kick in for me until my hemoglobin drops below around 11.
  • Ferritin - 19 (RR 20-380). Also below reference range, despite all that dietary/supplemental iron. My body just refuses to store iron (note: I do give blood every 3 months - but haven't given in over a month).
  • MCV - 106.6 (RR 80-98). 
  • MCH - 36.4 (RR 27-34) - Both MCV and MCH are well above reference range, as most long-term CR practitioners report - see poll results on the topic.
  • Miscellaneous Other Tests:
    • ​Serum B12 - 437 (RR 200-1100) - Supplementation doing the trick to keep B12 at healthy level despite vegan diet.
    • Homocysteine - 9.2 (RR 0-15) - Serum B12 isn't always good measure of B12 status in vegans, so I got homocysteine tested just in case. Looks good. Homocysteine level below 10 is thought to be healthy.
    • Vitamin D 25-Hydro - 33 (RR 30-100) - Always just above the lower bound of the reference range, despite supplementing ~2000 IU / day. Not much sun this time of year in Pittsburgh.
    • PSA - < 0.01 - No sign of prostate cancer. Worth keeping an eye on for me, since lots of biking appears associated with modest increase in prostate and testicular cancer risk
    • Fecal Immunochemical Test (FIT) - Based on Michael's insights on colorectal cancer screening, I convinced my doctor to prescribe a FIT test. It actually wasn't easy - he argued pretty hard for occasional colonoscopy as 'gold standard', but I eventually prevailed. FIT test was very easy to perform. I highly recommend it (yearly). Still waiting on results. Will update if anything interesting comes from it.

 

​Overall, I was very pleased with these latest test results. My paradoxical (some would say non-sensical :)xyz) experiment with a 'high calorie CR' regime (i.e. lots of calories but net calorie deficit from exercise) appears to be continuing to go well from the perspective of biomarkers, not to mention from the perspective of perceived health, vitality and quality of life.

 

Comments / questions welcome, as always!

 

--Dean


There will never be peace in the world while there are animals in our bellies.

#31 Dean Pomerleau

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Posted 01 July 2016 - 05:34 PM

OK Folks,

 

As anyone who's been following along knows, for almost a year now I've been trying out a rather unusual approach to a CR-ish diet & lifestyle, eating a ton of calories (~3400+ per day) but remaining slim as a result of lots of exercise and (for the last six months) nearly continuous cold exposure.

 

The big question in my mind (and others) has been whether Dean would be able to maintain the blood markers of the "CR Response" despite eating so much and burning it off to create a net calorie shortfall rather than the kind of absolute calorie shortfall typically associated with a 'traditional' low-calorie CR diet & lifestyle. So in some sense this set of blood work represents the moment of truth...

 

But before we get to the results, a little more background to set the context.

 

I considered my weight to have been too low (115lbs, BMI 17.3) at the time of my last comprehensive blood test (7 months ago, 12/16/2015), particularly to support the development of brown adipose tissue (BAT) via cold exposure I've been shooting for. So I've endeavored to and succeeded in gaining some weight in the intervening time. My weight at the time of these latest blood tests was up 10 lbs since that last test 7 months ago, and is now 125lbs (BMI 18.7). It was stable at 125 ± 1 lbs for over a month before the time of this set of blood tests. 

 

More info on the tests - I ordered this set of tests from Life Extension Foundation (LEF.org) during their annual blood test sale, rather than my usual Private MD Labs, so you'll notice there are a few tests which are different from those I've had done before. It cost me $575 out of pocket. The things I do for science...

 

For anyone who wants to see all the gory details of this suite of tests, along with the history of all my bloodwork over the last 16 years since starting CR, here it is in tabular form. This latest set of tests is in the rightmost data column. But rather than make you try to parse out all the numbers, I'm going to highlight and discuss the significant changes below, as I did in the post above from December when I discussed my previous comprehensive suite of blood tests.

 

Here are the highlights, comparing my current results to 7 months ago where available:

 

  • Diet & Exercise Routine - Here is how I describe my current diet and exercise routine in footnote 20 of the table: "Very similar diet/lifestyle to (18) above, except I've gain 10 lbs in 7.5 months since (18), BMI 17.3 → 18.7. Diet detailed here. ~3400kcal/day. 58C / 33F / 9P.  High fruit, vegetables & nuts/seeds. One BIG meal per day (breakfast). Daily Exercise: ~90 miles stationary biking, 3-4 miles running, ½ mile swimming, ~1h resistance training per day, 7d/wk. Feeling really good, high energy. Feel like I'm firing on all cylinders both physically and mentally."
  • Weight - Intentionally gained 10 lbs since last comprehensive blood work. 115 → 125 lbs. BMI 17.3 → 18.7. See above for motivation.
  • Resting Heart Rate - 52 BPM, measured with my Fitbit before getting out of bed in morning. Up 9 BMP since 7 months ago, when it was 43 BPM.  Increased RHR virtually certainly a result of increased catecholamines and thermogenesis from cold exposure. Note my cardiovascular endurance has never been better. About a month ago I ran a 5K in 20:40 - pretty quick for an old guy like me. Came in second in the race to a fleet-footed 14 year old, but beat several high school x-country runners and all the other adults (~150) in the race.
  • Fasting Glucose - 77 mg/dL (RR 65-99). Down slightly from last test, when it was 81, but probably within the margin of error. I consider this a quite good number - no sign of diabetes for this guy.
  • HgA1c - 5.5% (RR 4.8 - 5.6). Didn't get this tested last time, but within the reference range, and within the range of values I've seen before while on CR.
  • Insulin - 0.4 (RR 2.6 - 24.9) - Very low. This ties for the lowest insulin level I've ever had measured. Far below reference range. I appear to be keeping glucose down without much insulin - my insulin sensitivity is apparently very good, as would be expected with all my cold exposure.
  • Cholesterol - Continues to be extremely good, with very low total, LDL and triglycerides, despite all those calories and 10lbs of weight gain:
    • ​Total Cholesterol - 140 mg/dL
    • HDL - 59 mg/dL
    • LDL - 72 mg/dL
    • Triglycerides - 44 mg/dL
    • Tot / HDL - 2.4
  • White Blood Cell Count (WBC) - 3.9 (RR 3.4 - 10.8). Up from 2.2 reading it was 7 months ago, which I consider a good thing. Actually down from 4.5 at an intermediate blood test I had done 4 months ago. The bottom RR seems to have gone down from 4.0 to 3.4. By the old standard I'd still be just below the bottom of the reference range - like other CR folks. No inflammation here, despite copious exercise! In fact I did my usual 3h of pre-breakfast exercise prior to (fasting) blood draw. Haven't had a cold or flu in many years.
  • Red Blood Cell Count (RBC) - 4.03 (RR 4.14 - 5.8). Below the reference range, but up from 3.37 at last comprehensive blood test. Also seemingly not unusual for CR practitioners, or for me during my history of CR.
  • Hemoglobin - 14.2 (RR 13.2 - 17.1). Near the lower end of reference range despite continued iron supplementation. Just about where I want it to support cardiovascular endurance and allow me to donate blood without worrying about anemia, or being rejected for too low hemoglobin, since the FDA mandated cutoff is going from 12.0 to 13.0 this summer. Up from 12.3 at last full test.
  • Ferritin - 46 (RR 20-380). Up from a close-to-anemic 19 last time. Comfortably within the reference range now, but still close to the low end, despite iron supplements. Like hemoglobin, this is about where I want it. Not unusual for a vegan CR practitioner to have low iron stores.
  • MCV - 105 (RR 80-98). 
  • MCH - 35.2 (RR 27-34) - Both MCV and MCH are well above reference range, as most long-term CR practitioners report - see poll results on the topic. Both are down a tiny bit since 7 months ago.
  • AST - 41 (RR 0-40)
  • ALT - 46 (RR 0-45) - AST and ALT are just barely above reference range (by 1 point each). Liver working hard processing all those carbs. But these aren't levels that I'm concerned about. Have been higher in the past. But worth keeping an eye on. Alkaline phosphatase, another liver marker, was well within normal range. I may add milk thistle back to my supplement regime for its liver support benefits.
  • Lactate Dehydrogenase (LD/LDH) - 284 (RR 121-224). This one was well above the reference range. The one and only time I've had this test before was in 2002, when it was 187. For a 'normal' person elevated LDH might be cause for concern, as it may indicate the presence of HIV, cancer, meningitis or encephalitis. But I'm not a normal person (obviously) and elevated LDH is a sign of lactic acid metabolism, which can also result from endurance exercise - See this post below & PMID 7072633.  I mentioned above that I'd done my usual 3h pre-breakfast exercise routine prior to getting the blood drawn for these tests - which could very well explain this elevated reading.
  • C-reactive Protein (CRP) - < 0.1 (RR 0.0-3.0) - No inflammation here!
  • Homocysteine - 7.0 (RR 0-15) Looks good for a vegan. I'm getting my B12 and folate.
  • Free T3 - 2.6 (RR 2.0 - 4.4) - Towards the lower end of the RR, indicating reduced thyroid activity, as you'd expect for someone on CR.
  • Reverse T3 - 11.7 (RR 9.2 - 24.1) - First time I've had this particular thyroid hormone test. Not sure what it means. Towards the low-end of the RR.
  • Testosterone, Total - 352 (RR 348-1197) - Barely above the low-end of the RR. Typical of CR person.
  • Testosterone, Free 3.4 (RR 6.8-21.5) - Up from 2.2 at my last blood test, but still only half the lower bound of the RR. Again, very typical for CR.
  • Sex Hormone Binding Glob (SHBG) - 77.2 (RR 13-71) - Also high as expected for CR.
  • Estradiol - < 5.0 (RR 8-35) - Low, as it has always been for me since starting CR. Down from 6.6 at last test.
  • Progesterone - 0.2 (RR 0.2-1.4) - First time tested. At low-end of RR.
  • DHEA-S - 58 (RR 72-375) - Low, as it has always been for me since starting CR.  Up from 50 at last test.
  • IGF-1 - 83 (RR 61-200) - Remains nice and low as expected for CR person. But up a bit from last time (71) which is probably a good thing, for brain, bone and cardiovascular health.
  • IGF-BF3 - 2276 (RR 2251-5808) - Right near the low end of the RR. First time tested.
  • Copper, Serum - 74 (RR 72-166) - Very close to the low end of the RR, despite very high dietary copper intake, especially from 8oz of mushrooms I eat per day. I supplement w/ zinc to compensate (see below).
  • Zinc, Serum - 89 (RR 56-134) - Close to the middle of the reference range, despite fact that I get plenty from my diet and also supplement w/ 2x the RDA (25mg/day). Competes with copper. Overall my serum copper & zinc balance look pretty good. That's why I got these two checked.

Overall, I was very pleased with these latest blood test results. While a few things have normalized a bit from the extreme state I was in 7 months ago when I was 10 lbs lighter, I consider the changes to generally to have been in a positive direction. The two exceptions are the liver markers ALT & AST, which I'll want to keep an eye on to make sure they remain ok despite high calories & carbs in my diet.

 

In short, despite my calorie-replete diet and my intentional weight gain of 10lbs since last time, I appear to still be in the "CR Zone", based on all the key biomarkers CR folks typically exhibit, including:

  • low fasting glucose
  • low insulin
  • low IGF-1
  • Great serum cholesterol levels
  • Low testosterone
  • Low thyroid hormone
  • Low WBC
  • Low RBC
  • High MCV/MCH
  • Low inflammation (CRP, PSA)

My paradoxical (some would say crazy ☺) experiment with a 'high calorie CR' regime (i.e. lots of calories but net calorie shortfall from exercise and more recently, cold exposure) appears to be continuing to go well from the perspective of biomarkers, not to mention from the perspective of perceived health, vitality and quality of life.

 

Comments / questions welcome, as always!

 

--Dean

 

P.S. In case anyone thinks I may have gotten fat gaining 10 lbs, here is a photo collage of my current appearance. Be warned, I don't have a shirt on, and I don't claim to be attractive. Just still pretty skinny despite my weight gain.


Edited by Dean Pomerleau, 05 July 2016 - 02:47 AM.
Edited to fix Resting Heart Rate (56 → 52) Also added copper & Zinc test results. Added LDH test results.

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#32 Mechanism

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Posted 01 July 2016 - 06:27 PM

Hi Dean, I got some of the labs above from LE, and will be getting some more.  You make an interesting comparison since we are about the same age, build, & BMI.

 

I'll review your post carefully, but in the meantime, I'm wondering whether you have previously obtained or researched having bloodwork labs from directlabs.com before?  I have not used "Private MD Labs," which you have used in the past, and this is my first round with Life Extension and I have been satisfied.  I also have used an independent lab to select my own labs previously.

 

Of all these vendors, I have found directlabs my number one choice, and will probably return to them after this set of labs from LE.  LE is great, but directlabs uses Quest as the primary source ( in contrast, LE uses Labcorp) and there are more Quest labs in my neighborhood. 

 

Moreover, although LE has let me call for specialized labs not directly accessible ( and were also great to work with), I have found the most consistent training at directlabs so far, and their core offerings are robust.   At the link provided to the left, I have found clicking on the "sample report" hyperlinks corresponding to each lab somewhat helpful too.  I have not done a side-to-side cost comparison.


Edited by Mechanism, 01 July 2016 - 06:30 PM.


#33 Mechanism

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Posted 01 July 2016 - 06:38 PM

FYI, LabCorp ( used by LE) & Quest (used by my favorite, directlabs) have pretty similar normal laboratory testing normal ranges and results.  Check out the chart in this interesting article that also touches upon the accuracy of testing at Theranos.  The original manuscript is here but the first link is worth reading in full. 


Edited by Mechanism, 01 July 2016 - 06:40 PM.


#34 Dean Pomerleau

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Posted 01 July 2016 - 06:47 PM

Mechanism,

 

I'll be curious to see our comparison as well. Many years ago I used DirectLabs.com. I'm not sure why I switched to Private MD Labs, probably price. I've got both Quest and LabCorp facilities quite close to me, and I've never found a reason to prefer one over the other. I've been satisfied with LEF so far, and liked the somewhat wider range of tests included in their deluxe package that I got, although it was somewhat more expensive (even with the yearly sale price) than the (nearly) equivalent package from Private MD Labs.

 

Speaking of extra tests, I forgot to include in my original post to al la carte tests I had done - serum zinc and serum copper. Here are the results (which I've added to the above post as well):

  • Copper, Serum - 74 (RR 72-166) - Very close to the low end of the RR, despite very high dietary copper intake, especially from 8oz of mushrooms I eat per day. I supplement w/ zinc to compensate (see below).
  • Zinc, Serum - 89 (RR 56-134) - Close to the middle of the reference range, despite fact that I get plenty from my diet and also supplement w/ 2x the RDA (25mg/day). Competes with copper. Overall my serum copper & zinc balance look pretty good. That's why I got these two checked.

--Dean


There will never be peace in the world while there are animals in our bellies.

#35 drewab

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Posted 01 July 2016 - 07:36 PM

Thanks Dean for sharing your lab results and detailed analysis.  I (and I'm sure everyone else here) really appreciate it.  Neat to see that your CR bio markers still indicated that you are CR'd. I was about to ask about your BP and vitamin D status, but I see you've included those in the table too.  What's the rational for keeping vitamin D where it is?



#36 Dean Pomerleau

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Posted 02 July 2016 - 04:19 AM

Drew,

 

I didn't post about every one of the plenitude of blood tests I had done, focusing only on these that were either weird and/or CR-relevant. From my full blood work table, you noticed my latest vitamin D level was up a bit from last time (33 → 36 ng/mL). I thought that was small change not worth mentioning. It is within the 30-40 ng/mL range I consider most healthful based on extensive discussions here and elsewhere. In short and from my recollection, Michael has argued pretty convincingly that the nadir in all-cause mortality is around 30 ng/mL.

 

--Dean


There will never be peace in the world while there are animals in our bellies.

#37 Dean Pomerleau

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Posted 02 July 2016 - 03:15 PM

All,

 

One other test I overlooked in my translation from the the LEF blood test report to my blood work table was Lactate Dehydrogenase, which LEF / LabCorp labelled LDH. I'd only had this test done once before many years ago, and at that time it was labelled LD, so I didn't make the connection, and left LDH off my table. Here is an update, which I've also included in an edit to my full report above. It is actually pretty interesting:

  • Lactate Dehydrogenase (LD/LDH) - 284 (RR 121-224). This one was well above the reference range. The one and only time I've had this test before was in 2002, when it was 187. For a 'normal' person elevated LDH might be cause for concern, as it may indicate the presence of HIV, cancer, meningitis or encephalitis. But I'm not a normal person (obviously) and elevated LDH is a sign of lactic acid metabolism, which can also result from endurance exercise - See below & PMID 7072633.  I mentioned above that I'd done my usual 3h pre-breakfast exercise routine prior to getting the blood drawn for these tests - which could very well explain this elevated reading.

Regarding elevated LDH as a result of endurance exercise, study [1] tested the blood of well-trained runners (training up to 75 miles per week) both before and after a 13-mile run. Before the run, the average LDH of the runners was on average near the top of the reference range at 174 (RR 100-190), and 21% of them had LDH values above the upper end of the reference range. After the run, their mean LDH went up to 220, which is well above the top of the RR and 86% of the runners had values above the upper end of the RR, like I did. 

 

I can hear all you exercise bashers chomping at the bit now - saying lactic acid is a harmful metabolic waste product. Dean's killing himself. Sorry, you're wrong. From this NY Times review of the evidence regarding lactic acid (my emphasis):

 

Everyone who has even thought about exercising has heard the warnings about lactic acid. It builds up in your muscles. It is what makes your muscles burn. Its buildup is what makes your muscles tire and give out...

 

But that, it turns out, is all wrong. Lactic acid is actually a fuel, not a caustic waste product. Muscles make it deliberately, producing it from glucose, and they burn it to obtain energy. The reason trained athletes can perform so hard and so long is because their intense training causes their muscles to adapt so they more readily and efficiently absorb lactic acid.
 
The notion that lactic acid was bad took hold more than a century ago, said George A. Brooks, a professor in the department of integrative biology at the University of California, Berkeley. It stuck because it seemed to make so much sense.
 
"It's one of the classic mistakes in the history of science," Dr. Brooks said....
 
Through trial and error, coaches learned that athletic performance improved when athletes worked on endurance, running longer and longer distances, for example.
 
That, it turns out, increased the mass of their muscle mitochondria, letting them burn more lactic acid and allowing the muscles to work harder and longer...
 
The understanding now is that muscle cells convert glucose or glycogen to lactic acid. The lactic acid is taken up and used as a fuel by mitochondria, the energy factories in muscle cells...
 
Just before a race, coaches often tell athletes to train very hard in brief spurts.
 
That extra stress increases the mitochondria mass even more, Dr. Brooks said, and is the reason for improved performance.
 
Mitochondria even have a special transporter protein to move the substance into them, Dr. Brooks found. Intense training makes a difference, he said, because it can make double the mitochondrial mass.
 
I strongly suspect an increase in mitochondria mass and an increase my mitochondria's ability to metabolize lactic acid for fuel as a result of my exercise and cold exposure routines are what enables me to run, bike and/or swim almost indefinitely (9+ hours per day) without getting tired or run out of energy, and also explains my elevated LDH.
 
Fascinating...

 

--Dean

 

[Update: Even more fascinating, subsequent to this post I discovered evidence not only that exercise and cold exposure increases lactate / lactic acid levels, but also that lactate results in the browning / beiging of subcutaneous white fat. See here for discussion.]

 

------------

[1] Am J Clin Pathol. 1982 Mar;77(3):285-9.

 
Exercise-induced changes in common laboratory tests.
 
Priest JB, Oei TO, Moorehead WR.
 
 
Examination of 19 serum biochemical and hematologic parameters in a group of
white male runners, ranging in age from 23 to 47 years, just prior to and
immediately after a 13-mile "mini-marathon," demonstrated a significant increase,
by paired Student t-test, in mean values of: K+, BUN, creatinine, CK, LDH, AST
(SGOT), alkaline phosphatase, bilirubin, uric acid and leukocyte counts.
Prevailing environmental conditions were such as to produce no significant
hemoconcentration. Using this group's statistics and this hospital laboratory's
upper limits of normal, the percentage of values above two SDs are, for the
resting state: K+ 7%, BUN 7%, creatinine 0%, CK 21%, LDH 21%, AST 0%, alkaline
phosphatase 0%, bilirubin 7%, uric acid 7%, and leukocyte count 0%.
Post-exertional values above normal limits are: K+ 7%, BUN 21%, creatinine 21%,
CK 93%, LDH 86%, AST 0%, alkaline phosphatase 0%, bilirubin 14%, uric acid 36%,
and leukocyte 71%. Consequently, abnormally high values for K+, BUN, creatinine, 
CK, LDH, bilirubin, uric acid, and leukocyte counts can often be expected in some
patients who exercise heavily. The degree of the abnormality will depend on the
level and length of exercise as well as the elapsed time between exercise and
testing.
 
PMID: 7072633

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#38 Mechanism

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Posted 04 July 2016 - 12:59 PM

Hi Dean,

 

Thanks for sharing.

 

Have you considered tracking periodic telomere length along with the biomarkers?  Obviously it will decline over time, but if you get it done annually, you can probably z-score standardize each year to normalize for monitoring progress.  This would permit not only establishing the direction of progress, but also the rate of change by year, which may vary depending in part on how effective the various different health-promoting initiatives may be, year to year.

 

How did you determine the best method of sharing your lab data was via a link to dropbox, versus say, google drive and other options ( I know you are a big fan of Google innovation)?  I imagine you can share it in a variety of forms too but made the effort to convert it to a tabular data format as opposed to maintaining it in the original Microsoft Excel, OpenOffice, etc. - was that so that the file could not be compromised or modified by others?

 

If any of the major players is better than the rest for the ability to share data anonymously, for example no way to link to your DropBox login or Gmail ID, that may give it the edge for some users here.


Edited by Mechanism, 04 July 2016 - 01:02 PM.


#39 Dean Pomerleau

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Posted 04 July 2016 - 02:00 PM

Mechanism,

 

Have you considered tracking periodic telomere length along with the biomarkers?

 

I'm still not convinced there is any metric for telomere length that accurately reflects anything health or longevity related. From what I understand average telomere length isn't very useful, so you have to start measuring more nuanced measures like number of short telomeres, etc. It doesn't seem worth the cost, given the amount of information it seems to provide.

 

How did you determine the best method of sharing your lab data was via a link to dropbox, versus say, google drive and other options ( I know you are a big fan of Google innovation)?

 

I am a fan of Google and it's services. But in this case I've been using Dropbox for many years, long before Google Drive came on the scene. So I know the interface etc. 

 

 I imagine you can share it in a variety of forms too but made the effort to convert it to a tabular data format as opposed to maintaining it in the original Microsoft Excel, OpenOffice, etc. - was that so that the file could not be compromised or modified by others?

 

Actually there you are incorrect. I keep my blood test results in a simply HTML file. That file I link to is it - no Excel spreadsheet that it is extracted from. I edit it using a very simple and now very old, but still quite functional, freely-available WYSIWYG HTML editor called Nvu (PC & Mac version available). I bet today I could keep it in Excel (or OpenOffice) spreadsheet and export it to an HTML file for viewing on the web. But when I started the file (~15 years ago), it wasn't so easy. So I went for the lowest common denominator - HTML and a simple HTML editor. It has served me fine so far.

 

If anyone would like to use it as a template for preserving their own blood test data, simply right click on the web page of my blood work table and hit "Save As". Store it to your own computer and then edit it using Nvu or some other HTML editor.

 

--Dean


There will never be peace in the world while there are animals in our bellies.

#40 Mechanism

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Posted 05 July 2016 - 05:52 AM

Interesting Dean. Thanks for the tips on your WYSIWYG editor - for those unfamiliar, this stands for What You See is What You Get and let's you directly edit webpages without the requirement you know how to code the HTML code behind them although many do both and use it as an enhancement and/or time saver. Brings back memories, I remember using one through Netscape Navigator I believe back in the early or mid 90s. What features does it have that make you apparently favor it over Microsoft, OpenOffice, Google or other alternatives for maintaining your spreadsheet?

Edited by Mechanism, 05 July 2016 - 05:52 AM.






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