Bloodwork & Panels...the final word?
Team, hoping you can give some guidance that can be a takeaway here for the newer Boomers. I have seen mention of "managing blood sugars and insulin sensitivity" and "lipid panels" along the way, but what would you recommend would be the Baseline stuff to track and the Gold Standard?
Bullet point answers are fine, but your input / experience is appreciated!
~ Coach P
@Sheila Leard @Al Truscott @Gary Lewis
Bullet point answers are fine, but your input / experience is appreciated!
~ Coach P
@Sheila Leard @Al Truscott @Gary Lewis
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It looks at such things as:
Lipids (HDL, LDL etc.)
Inflammatory/Oxidation (hs-CRP, etc.)
Vitamins (D, Bs etc,)
Renal (Creatinine)
Sterol Absorption Markers
Glycemic Contol (Glucose etc.)
Insulin Resistance
Insulin
Electrolytes
Liver function
Anemia (iron, ferritin, etc.)
WBC/RBC and other blood markers
PSA
Fatty Acids - Omega 3s, Omega 6s
With all the markers, I get my numbers from the current and past tests as well an appropriate/healthy range.
A lot of these things are interrelated and since I'm not a doctor I'd hate to throw out my numbers or ranges for someone like me on an open forum for fear of giving out bad medical advice.
@Al Truscott and @Coach Patrick, I'm happy to share this with you if you are looking for ideas.
Tom
@Coach Patrick You ask what would be the baseline stuff and gold standard?
When it comes to testing for cardiac risk factors and metabolic disease, I follow the guidelines of the Cleveland Heart Lab. Advanced lipid testing or Gold Standard, is not the norm in most conventional medical practices.
Here is an example of a scenario I see too frequently.
A person walks in and is ‘apparently healthy’. For the most part they are endurance athletes. They ride recreational, compete in stage races, triathlons, ultra-running group centuries and MTB races. Many report feeling sluggish, gut issues and can’t improve body composition. When I look at their standard lipid panel I often see slightly elevated cholesterol, LDL’s (bad ones) on the border, fasting glucose on the upper end of normal. Their doctor tells them everything is fine, continue to exercise and watch what you eat.
I will then get a family history and timeline of when symptoms began. Based on this information is when I may advise to have advanced lipid testing done, Gold Standard. What I am looking for is an in depth look at LDL. What are the particle size and numbers? I also want to see LP(a) which is the fraction of LDL that has a strong genetic component. LDL is a contributor to building plaque and inflammation within the arteries. The alarming part to this scenario is that I see labs that clearly put the athlete at risk for a stroke. But the standard test is all they have, and it will not flag this high-risk athlete. The athlete that succumbs in a swim, or sits down at the side of the road having a cardiac event.
The connection to managing blood glucose and insulin to lower LDL’s is often not addressed. Some people are more carbohydrate sensitive and need to work harder at managing carb intake to balance blood sugars. In Functional Medicine it is said there is no such thing as pre-diabetes.
The Cardio-Metabolic test I use and has some good education is Spectracellhttps://www.spectracell.com/patients/patient-cardiometabolic-and-diabetes-testing/
Cleveland Heart Labs - http://www.clevelandheartlab.com/test-menu/
Standard Baseline Labs:
Gold Standard Labs:
CBC
Cardio-Metabolic Lipid Panel.
Iron panel with ferritin
Vit B12
Vit D
Thyroid panel – TSH, T4, free T3
This is really a general summary of what we should be asking our doctors.
There is more to keep an eye on as we age such as testosterone, bone density, muscle mass.
Paul - did you ask you ask your Doctor to write the lab request for standard blood work? This step is sometimes a deterrent for folks to get it done.
You got on it!!
Rather than go into any detail in this thread, I'll link to two blog posts I put up about cardiac concerns, first on my own experience with getting the Echo (Teaser: "...an article from Australia and Belgium (European Heart Journal, Dec 6, 2011, by La Gerche, Burns, Mooney, et al.) It’s specific to long-course triathletes, studied pre and post [immediate and 1 week later] races that showed an increased risk [relative to other IMers] for evidence of cardiac fibrosis who met the following criteria: competing for longer (20 yrs vs 8 years), had greater predicted VO2 max for age, and were older (50+).":
http://bikrutz.org/triblog/?p=1140
And one on Atrial Fibrillation:
http://bikrutz.org/triblog/?p=1604
This is all great information folks. I have been thinking recently about doing this. I typically get a 'wellness' check through work but would love to have an advanced series after doing my first full this year at IM Texas (13:18). I Have the best coach around (@Coach Patrick ) now I just need to work on the diet a little more and bring that time down.👍️
@Keith Shireman I'm glad you resurrected this post. In light of Paul Sherwen's untimely passing of heart failure at 62 yo, it's worth paying attention to our health if we want to continue doing what we love.
@Al Truscott ... thanks for the links. Very timely to read again.
@Sheila Leard there's a lot to be said about our health when training. I meet people who don't do all the training required and don't follow a diet their body should be following to be competitive. Thank you @Al Truscott for posting this link as well. It motivates me to keep doing better not just for my own health but for my family as well.
Interesting blog post @Al Truscott I have SVT (Supra ventricular tachycardia) and have had for years, likely since I was a kid. I only have a couple of episodes a year that require intervention, but I’ve definitely noticed a tendency towards a lower heart rate...ambient and resting...in recent years. My max hr while exercising seems to be the same (I’m 59 yo) for the past decade, maybe only a slight drop. I have an Apple Watch which will give high and low hr alerts. Somehow, during an update about 6 wks ago, I turned on the low hr alert. I get an almost daily message that my hr has dropped below 40 bpm for 10 consecutive min (how the alert is triggered) while sleeping. My avg RHR is 43 and seems to be steady month to month for the past year. And since this alert is a new variable, it’s hard to know whether this is a new “thing” or not. I hesitate to follow up with a dr. The person I was seeing has left the practice, and even she would occasionally freak out at my test results. I hate to break in a new person. I feel like most drs in tradional general practice are not used to treating “healthy” people my age, and I hesitate to put myself through a battery of tests that aren’t necessary or useful. Can’t tell you how many times the general message I’ve received from a medical professional for whatever issue, has been, “Exercise is bad for you.”