Pull out your magnifying lens and become your own health detective! Real health is about self empowerment, patient education and applying and understanding principles and strategies that work for you. Healthcare should be about “health” more than just managing disease. Understanding how to interpret your own blood chemistry test can provide you with a tremendous amount of very valuable insight, which ultimately can be used to develop powerful nutritional strategies for improving your health.
This 4 part series of articles will teach you how to do just that: provide you with the basic data necessary to understand what your blood test results mean, and how to use them to develop effective nutritional strategies.
This series of articles is based upon my experience of having interpreted hundreds of blood test results over a 4 year period, as well as the accumulation of knowledge I have acquired from my mentors during this 4-year period of time.
This series of articles is going to cover many of the basic components of blood chemistry. It should be known that blood chemistry interpretation can become quite complex. Therefore this series of articles is only going to cover the fundamental material.
Advantages & Disadvantages of Using Blood As A Biopsy
The blood has been called the river of life. In it contains the properties that are used by the cells, tissues, glands and organs of the body. I do not view any one laboratory test as being absolute. I view and use use laboratory data as a way to obtain evidence and information. There are a number of valuable laboratory tests, which each in their own right has something unique to share.
Every lab test provides a unique “snapshot” into a particular system or function of the body. These snapshots are limited by time, function, and effect. A hair tissue mineral analysis reveals deposition of minerals and metals into the soft tissue over a 3-4 month period of time. A blood test reveals many immediate variables, and some longer-term variables.
Since much of what is in the blood is very “homeostatic” (always attempting to keep certain factors within a certain range for balance), it can be argued that the blood is not a very reliable biopsy. Example: if the body takes calcium from bones in order to keep levels high enough in the blood and cells, how can blood calcium be a valid assessment of calcium metabolism? Since blood steroidal hormones are bound to certain proteins and therefore many cannot make it to cell receptor sites, how can one accurately assess adrenal function in the blood?
These are 2 of several similar questions which effectively question the efficacy of blood as a valid biopsy.
In answer to the 2 proposed questions above, let’s look closer at these issues:
Consider that calcium activity can be assessed not by looking only at serum calcium alone, but by multiple factors that are involved in calcium activity such as phosphorous, albumin and Vitamin D. Or even more interesting, consider that serum calcium levels can actually be used to identify the function of other systems of the body such as thyroid activity and digestive functions.
In answer to the second question regarding steroidal hormones (like the adrenal hormone cortisol), saliva hormone levels are indeed the best biopsy to obtain a more accurate “free-fractioned” and “bio-available” profile of steroidal hormone numbers than blood. However, in a similar way to how calcium can be used to identify function of other systems of the body, there are indirect ways to assess hormone synthesis and adrenal activity in the blood without looking specifically at hormone levels in the blood.
What these series of articles will address is what is called “Functional Analysis of Blood Chemistry”. Since the blood contains so many elements of the chemistry of the body, there are endless blood tests that are available. We will discuss the “Functional” interpretation of the fundamental blood test:
- The Metabolic Panel
- The Lipid Panel
- The CBC (complete blood count)
Replace Conventional Laboratory Reference Ranges With Functional Ranges
Laboratory reference ranges are statistical averages, not ideal values. If you want to really get to the origin of your health issues, this is point #1 that must be addressed. Laboratory reference ranges are created from a mean taken from an increasingly unhealthy population of people. In fact, each lab director sets his/her own reference range based upon the population of people tested for that lab. I have seen completely different reference ranges from 2 different labs. What passes for “normal” on a laboratory reference range I find to be very abnormal in many instances.
The working reference ranges that I use are based upon the experience of having reviewed hundreds of blood tests, as well as through the correlation with other colleagues in the field of functional nutrition, who have interpreted tens of thousands of blood tests. No reference ranges are absolute, but I find the ranges that I use to be much tighter and valid than the statistical averages used by various labs.
3 Quadrants of Functional Blood Chemistry Analysis
There are 3 quadrants of functional blood chemistry analysis which allow for the most effective assessment and nutritional strategies.
- Identifying Function/Self Assessment
- Subjective Correlations When Possible
- Implementation of Strategy
1. Identifying Function & Self Assessment
There are many, many different bodily functions that can be assessed on a blood test. In fact, there is a dizzying array of different functions. Many of these functions cannot be discussed without proper understanding of the assessment of more basic functions. Take for example adrenal function. While we can get a fairly accurate assessment of adrenal function, we absolutely must view the relationship between electrolytes and the adrenals. In fact, adrenal function is directly influenced by electrolyte homeostasis.
This series of articles is going to address primarily the identification of 5 fundamental bodily functions through a blood test:
- Glucose Homeostasis
- Liver & Detoxification
- Adrenal Balance
These 4 pillars are arguably the most fundamental for understanding the nature of function of other more complex functions and systems. Its very important to also grasp that none of these functions or systems should be considered as separate, functioning independently of other systems. The body functions truly as a holistic organism, and when viewed as such, there is an open possibility of making correct assessments.
2. Subjective Correlations When Possible
Understanding what your symptoms and signs mean is an art in itself. Being able to get subjective correlation with numerous blood chemistry factors is invaluable and essential in many instances. Applicable subjective correlations is also essential because there is always the possibility of laboratory error. If a person has elevated liver enzymes and there is also “pain between the shoulder blades” and/or temporal headaches, liver dysfunction of some sort is likely.
Understanding the right questions to ask is sometimes even more important than a test result!
What is recommended is to complete some basic intake data before or adjacent with your blood test. This will provide you with a strong foundation helping you to get correlation with the results of your blood test.
3. Implementation of Strategy
The purpose of the blood test interpretation is to provide you with enough objective and subjective information so that you can develop an effective nutritional strategy to improve function. This is very different than disease diagnostics and symptom treatment. If a person has a particular health issue, I am most concerned with how to improve the function of their body and its systems, rather than treating their health issues symptomatically or even directly.
When the body is supplied with what it needs to function, it functions as it is supposed to, or at least much better than previously.
Look For Clues & Investigate
Figuring out what is wrong with you is about putting all of the pieces together. You need to analyze the different objective and subjective variables. Having a good, basic functional understanding of blood chemistry is very important, but so is understanding what your symptoms may be pointing to. I recommend using your symptoms, intake data and blood test results as a gateway to understanding what your best strategy should be.
Of major importance is to recognize that your body and its nutritional needs are highly individual. Even certain blood chemistry reference ranges may be individual. If a reference range for fasting glucose is between 80-90, and a diabetic patient is typically functioning at 180, he or she may feel worse when their blood sugar drops to 120, including a sense of panic and anxiety. This is because their body has become so accustomed to functioning with a glucose level that high for so long, that it is as if the body begins to panic once the pattern shifts.
Even though the diabetic needs desperately to get glucose under 100 consistently, it may take a while to get there. And so it may be necessary to consider that for a diabetic who consistently has a glucose level of 180, getting it down to 120 consistently is a major improvement in function and should be seen as such.
Fasting Blood Tests Versus Postprandial
Most blood tests are 12-hour fasting blood tests. There is another type of blood test called “postprandial”. Postprandial blood tests are taken 2-4 hours after a meal. A 12-hour fasting blood test can show what the blood chemistry reveals after not having eaten food, whereas the postprandial blood test can be used to monitor the body’s metabolic response to food in the previous meal.
I have used and recommended both of these types of blood tests. To keep matters easier, let us first analyze the standard 12-hour fasting blood test.
Functional Assessment #1: Glucose Homeostasis
I’ll begin with the assessment of glucose and its related blood chemistry factors. I will provide the reference ranges I consider most important for each factor and then discuss them more indepth.
- Glucose 80-90
- Insulin 0-5
- Hemoglobin A1C 4.1-5.6
Related Blood Tests: Triglycerides
Glucose is sugar in the blood that is the primary source of energy burned by all cells of the body. Glucose is strongly influenced by the liver’s breakdown of glycogen, which is a stored form of energy in the tissues. When glucose enters the blood, the pancreas is called on to produce insulin.
Insulin functions to deliver the glucose in the blood to the cells so that energy can be made. Thus, insulin is a primary blood sugar-lowering hormone. The higher the amount of glucose in the blood, the more insulin gets released. If insulin levels continue to rise, the cell receptor sites become de-sensitized, and “insulin resistance” ensues. The result is high levels of insulin and glucose in the blood, but the glucose never gets into the cells where it needs to go.
This is the primary pattern in Type II, Insulin-Resistant Diabetes. Hemoglobin A1C is a 2-3 month indicator for the amount of glucose that red blood cells have been exposed to during their 3-month life span. The higher the Hemboglobin A1C the greater the exposure to glucose.
Glucose levels are regulated by the liver’s production of glycogen, the pancreas’ production of insulin (lowers glucose) and glucagon (raises glucose) as well as the autonomic nervous system. Consider that there are numerous ways the body can raise glucose, but only one way to lower it (insulin).
The body has numerous mechanisms for raising glucose: glucagon, adrenaline, cortisol, thyroxine, growth hormone, ACTH and somatostatin.
A diet that is non-harmonious for one’s individual metabolic needs is a primary cause of de-regulated glucose homeostasis. Dietary sources of sugars and carbohydrates are primary sources for elevated levels of glucose for many people. However, certain forms of protein foods can cause hyperglycemic reactions with certain Metabolic Types as I’ve observed.
It is possible for hyperglycemia to result from excessive adrenal output due to the fact that both cortisol and adrenaline are capable of raising glucose.
Ideally a person’s insulin level is as low to zero as possible. The higher the insulin, the greater the diabetic risk, and the greater the risk for cardiovascular disease.
Low blood sugar is typically used interchangeably with “Hypoglycemia”. Yet my definition of hypoglycemia is “low energy production from blood sugar”, not necessarily “low blood sugar”. A Type II Diabetic can still have hypoglycemic symptoms as described in the examples from earlier. Low blood sugar typifies inefficient energy production in the cells. It may be the case that low blood sugar is the first step in the progression towards insulin resistance.
In any event, glucose levels less than 80 indicate inefficient energy production, could possibly be seen with excessive parasympathetic functions such as low blood pressure, poor hormone synthesis and electrolyte inefficiencies.
To get a fuller, more complete picture of what glucose and related blood chemistry may be revealing, please stay tuned in the coming weeks for the next parts in this series.