Bloodtest Results - 11.5 years mild CR

[drewab]

Hi All,

I thought I would share my blood test results after 11.5 years of mild CR and feeling incredibly vibrant and energetic. The only two changes I've noticed are that my ferritin is low (albeit just a little) for the first time ever and my thyroid appeared to be considerably more active than normal. My test choices are limited by what can be ordered and covered by the Canadian medical system for a healthy individual without paying out of pocket. Sometimes they seem comfortable to order more, sometimes less... Just though I'd share for anyone interested. I tend to be very consistent with my regime day after day, month after month, year after year. So I have found a sustainable way of living for me. 

Test	Result	Range	Flag
Vitamin B12	329 pmol/L	>=160 pmol/L
Triglycerides	0.58 mmol/L	0.00 - 1.70 mmol/L
Cholesterol, Total	3.45 mmol/L	mmol/L
HDL Cholesterol	1.17 mmol/L	mmol/L
Low Density Lipoprotein Cholesterol (Calculated)	2.02 mmol/L	0.00 - 3.40 mmol/L
Non High Density Lipoprotein Cholesterol	2.28 mmol/L	0.00 - 4.20 mmol/L
Prostate Specific Antigen (PSA), total	0.3 ug/L	<2.6 ug/L
Hemoglobin A1c	5.0 %	4.3 - 5.9 %
Glucose, Fasting	4.5 mmol/L	3.3 - 6.0 mmol/L
Ferritin	28 ug/L	30 - 500 ug/L	Low
Potassium	4.4 mmol/L	3.6 - 5.2 mmol/L
Sodium	140 mmol/L	135 - 145 mmol/L
Creatinine	79 umol/L	50 - 120 umol/L
eGFR (mL/min/1.73m2)	109	>59 mL/min/1.73m2
Alanine Aminotransferase (ALT)	19 U/L	<60 U/L
Auto WBC	3.7 10*9/L	4.0 - 11.0 10*9/L	Low
RBC	4.93 10*12/L	4.30 - 6.00 10*12/L
Hemoglobin	165 g/L	135 - 175 g/L
Hematocrit	0.46 L/L	0.40 - 0.52 L/L
MCV	94 fL	80 - 100 fL
MCHC	358 g/L	310 - 360 g/L
RDW	15.8 %	<16.0 %
Platelets	129 10*9/L	140 - 400 10*9/L	Low
Thyroid Stimulating Hormone (TSH), Progressive	0.92 mIU/L	0.20 - 6.50 mIU/L
C-Reactive Protein (CRP)	<0.5 mg/L	<8.0 mg/L

[mccoy]

I would say that the healthy CR regime is paying off.

[Saul]

Hi drewab!

Low WBC is normal for CR; also, for mem, low ferritin (which is a lot better than high ferritin)

  --  Saul

[mccoy]

Anyway, a vegan regime should cause no problems for iron intake, I remember when vegan I used to have 300% of RDI, of course absorption might not be optimal. I would just eat more spinach, sesame seeds and Fe-rich food.

Vegans say that relatively low amounts are better than relatively high amounts of Fe, but there is always the middle ground, I would not be happy with a value equal to the lower bound, just for safety I would aim at something higher. Also, relatively low ferritin AND relatively low WBC may be a warning, although preliminary, of a trend to be avoided.

Unless otherwise specified by credible CR authorities like Fontana or very few others

[Dean Pomerleau]

It is rare that I have the opportunity to say this, but Saul is correct. Low WBC and low ferritin are pretty common for CR folks. Both of mine have been at or below the bottom of the reference range for the last 20 years.

--Dean

[mccoy]

7 hours ago, Dean Pomerleau said:

It is rare that I have the opportunity to say this, but Saul is correct. Low WBC and low ferritin are pretty common for CR folks. Both of mine have been at or below the bottom of the reference range for the last 20 years.

--Dean

Dean, I stand gladly corrected since I consider you among the very few others credible CR authorities, but do we have a more than anecdotal reference on this issue?

[Dean Pomerleau]

3 hours ago, mccoy said:

Dean, I stand gladly corrected since I consider you among the very few others credible CR authorities, but do we have a more than anecdotal reference on this issue?

See this Fontana paper [1] for low WBC on CR without compromised immune response. Studies [2] and [3] are suggestive about the benefits of keeping ferritin near the bottom of the reference range.

--Dean

 

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[1] Long-term moderate calorie restriction inhibits inflammation without impairing cell-mediated immunity: a randomized controlled trial in non-obese humans.

Published: 07/13/16

Full paper

Abstract

Calorie restriction (CR) inhibits inflammation and slows aging in many animal species, but in rodents housed in pathogen-free facilities, CR impairs immunity against certain pathogens. However, little is known about the effects of long-term moderate CR on immune function in humans. In this multi-center, randomized clinical trial to determine CR's effect on inflammation and cell-mediated immunity, 218 healthy non-obese adults (20-50 y), were assigned 25% CR (n=143) or an ad-libitum (AL) diet (n=75), and outcomes tested at baseline, 12, and 24 months of CR. CR induced a 10.4% weight loss over the 2-y period. Relative to AL group, CR reduced circulating inflammatory markers, including total WBC and lymphocyte counts, ICAM-1 and leptin. Serum CRP and TNF-α concentrations were about 40% and 50% lower in CR group, respectively. CR had no effect on the delayed-type hypersensitivity skin response or antibody response to vaccines, nor did it cause difference in clinically significant infections. In conclusion, long-term moderate CR without malnutrition induces a significant and persistent inhibition of inflammation without impairing key in vivo indicators of cell-mediated immunity. Given the established role of these pro-inflammatory molecules in the pathogenesis of multiple chronic diseases, these CR-induced adaptations suggest a shift toward a healthy phenotype.

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[2] Clin Chem. 2014 Nov;60(11):1419-28. doi: 10.1373/clinchem.2014.229013. Epub 2014 Aug 25.

Total and cause-specific mortality by moderately and markedly increased ferritin concentrations: general population study and metaanalysis

Christina Ellervik 1, Jacob Louis Marott 2, Anne Tybjærg-Hansen 3, Peter Schnohr 2, Børge G Nordestgaard 4
Affiliations expand
PMID: 25156997 DOI: 10.1373/clinchem.2014.229013
Full text linksCite
Abstract
Background: Previous population-based studies of plasma ferritin concentration have not revealed a relationship with total mortality. We tested the possible association of increased ferritin concentrations with increased risk of total and cause-specific mortality in the general population.

Methods: We examined total and cause-specific mortality according to baseline plasma ferritin concentrations in a Danish population-based study (the Copenhagen City Heart Study) of 8988 individuals, 6364 of whom died (median follow-up 23 years). We also included a metaanalysis of total mortality comprising population-based studies according to ferritin quartiles or tertiles.

Results: Multifactorially adjusted hazard ratios (HRs) for total mortality for individuals with ferritin ≥200 vs <200 μg/L were 1.1 (95% CI 1.1-1.2; P = 0.0008) overall, 1.1 (1.0-1.2; P = 0.02) in men, and 1.2 (1.0-1.3; P = 0.03) in women. Stepwise increasing concentrations of ferritin were associated with a stepwise increased risk of premature death overall (log rank, P = 2 × 10(-22)), with median survival of 55 years at ferritin concentrations ≥600 μg/L, 72 years at 400-599 μg/L, 76 years at 200-399 μg/L, and 79 years at ferritin <200 μg/L. The corresponding HR for total overall mortality for ferritin ≥600 vs <200 μg/L was 1.5 (1.2-1.8; P = 0.00008). Corresponding adjusted HRs for ferritin ≥600 vs <200 μg/L were 1.6 (1.1-2.3; P = 0.01) for cancer mortality, 2.9 (1.7-5.0; P = 0.0001) for endocrinological mortality, and 1.5 (1.1-2.0; P = 0.01) for cardiovascular mortality. The metaanalysis random effects odds ratio for total mortality for ferritin upper vs reference quartile or tertile was 1.0 (0.9-1.1; P = 0.3) (P heterogeneity = 0.5).

Conclusions: Moderately to markedly increased ferritin concentrations represent a biological biomarker predictive of early death in a dose-dependent linear manner in the general population.

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[3] Clin Chem. 2018 Feb;64(2):374-385. doi: 10.1373/clinchem.2017.276055. Epub 2017 Oct 16.

Increased Plasma Ferritin Concentration and Low-Grade Inflammation-A Mendelian Randomization Study

Ingrid W Moen 1, Helle K M Bergholdt 1 2, Thomas Mandrup-Poulsen 1 3, Børge G Nordestgaard 1 4 5 6, Christina Ellervik 7 2 8 9
Affiliations expand
PMID: 29038157 DOI: 10.1373/clinchem.2017.276055

Abstract
Background: It is unknown why increased plasma ferritin concentration predicts all-cause mortality. As low-grade inflammation and increased plasma ferritin concentration are associated with all-cause mortality, we hypothesized that increased plasma ferritin concentration is genetically associated with low-grade inflammation.

Methods: We investigated whether increased plasma ferritin concentration is associated with low-grade inflammation [i.e., increased concentrations of C-reactive protein (CRP) and complement component 3 (C3)] in 62537 individuals from the Danish general population. We also applied a Mendelian randomization approach, using the hemochromatosis genotype C282Y/C282Y as an instrument for increased plasma ferritin concentration, to assess causality.

Results: For a doubling in plasma ferritin concentration, the odds ratio (95% CI) for CRP ≥2 vs <2 mg/L was 1.12 (1.09-1.16), with a corresponding genetic estimate for C282Y/C282Y of 1.03 (1.01-1.06). For a doubling in plasma ferritin concentration, odds ratio (95% CI) for complement C3 >1.04 vs ≤1.04 g/L was 1.28 (1.21-1.35), and the corresponding genetic estimate for C282Y/C282Y was 1.06 (1.03-1.12). Mediation analyses showed that 74% (95% CI, 24-123) of the association of C282Y/C282Y with risk of increased CRP and 56% (17%-96%) of the association of C282Y/C282Y with risk of increased complement C3 were mediated through plasma ferritin concentration.

Conclusions: Increased plasma ferritin concentration as a marker of increased iron concentration is associated observationally and genetically with low-grade inflammation, possibly indicating a causal relationship from increased ferritin to inflammation. However, as HFE may also play an immunological role indicating pleiotropy and as incomplete penetrance of C282Y/C282Y indicates buffering mechanisms, these weaknesses in the study design could bias the genetic estimates.

[Todd Allen]

On 9/20/2022 at 7:26 AM, Dean Pomerleau said:

Low WBC and low ferritin are pretty common for CR folks.

One more anecdotal data point.  After about 2 years of CR my WBC and ferritin both dropped to the bottom of their reference ranges.  After shifting from a plant heavy diet to mostly red meat but still fairly low in calories my ferritin has rebounded to 201 ug/L but WBC is unchanged.  

 

[mccoy]

Thanks to Dean for the articles.

I've just read Fontana's. One point seems to be clear, that CR lowers the markers of inflammation, without impairing immune response (which remains the same as AL even if WBC is in the lower percentiles of the distribution of the general population).

About WBC, it is not clear which is the optimum range. All right, too high a count is associated with inflammation and metabolic diseases and cancer, but too low is probably associated with impaired immune response. Which is the optimum range for the AL group, and which is for the CR subgroup? Maybe the former (but not the latter) is explained in the cited articles.

I was initially nonplussed because I mistook WBC for RBC, which worried me not a little.

Edited September 22, 2022 by mccoy

[mccoy]

By the way, this topic prompted me to consult my latest analyses.

WBC is slightly below the optimum range, with 3.9 units*10^3/uL (optium 4-10 according to the lab). Please note that my regime is one of dietary, but not caloric restriction.

Ferritin is 64 ng/ml, which is in the relatively low percentiles but above the lower normality threshold (30-350 for men).

I'll express my consideration in ferritin after having read the other articles cited by Dean.

Edited September 22, 2022 by mccoy

[Dean Pomerleau]

1 minute ago, mccoy said:

WBC is slightly below the optimum range, with 3.9 units*10^3/uL (optium 4-10 according to the lab)

Ferritin is 64 ng/ml, which is in the relatively low percentiles but above the lower normality threshold (30-350 for men).

Sounds like you are in our club Mccoy! 

--Dean 

[mccoy]

21 minutes ago, Dean Pomerleau said:

Sounds like you are in our club Mccoy! 

--Dean 

MMmmmm..., right, maybe dietary restriction in this aspect is similar to caloric restriction...

[mccoy]

I'm reading the first article linked by Dean on ferritin hazard. 

The range chosen as a HR=1 is <200 ug/L, so there is a wide enough 'safe' range from the lower thresholds indicated by the lab. HR values start to be dangerous with values = >600 ug/L, which are values higher than the usual upper bound of the normal range, also apparently men are less sensitive to the hazard of high ferritin.

 

[mccoy]

Continuing the above considerations. There is a pretty huge difference in median survival between the <200 subgroup and the = > 600 subgroup (79 versus 55 years)

 

[mccoy]

Last, the dose-response plots, I drew a red line in correspondence of 50 ug/L of ferritin, which sounds a representative value for the CR subgroup. THe confidence interval of the linear regression in the CV mortality plot is pretty wide (high uncertainty of HR values). The plot all say loudly that the lower, the better, but plausibly zero ferritin may not be optimal.

Edited September 22, 2022 by mccoy