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Acute vs Chronic Lab Values


Do you like bad news or would you prefer to avert it?

In our current medical system, your doctor draws some blood and, generally, two things result when you get your lab tests back:

  • All your markers are normal, or

  • You have a marker or markers that are considered too high or too low and are prescribed a drug to fix it.

 

Our healthcare system is reactive rather than a pro-active system. My mother-in-law recently went to her doctor and fortunately my wife went along. The doctor proclaimed that her blood tests were all normal.


Her A1C was 6.4 and the threshold for diabetes is 6.5. Thus she was just 1 tick away from being classified a diabetic. At an A1C of 6.4, the medical playbook does NOT call for a drug but at 6.5 it does.


The entire purpose of today’s laboratory reference ranges are to determine if you have a diagnosable medical condition. However these ranges completely ignore the fact that health and disease is a continuum. Diabetes happens when your A1C is 6.5% or above. However, to be truly healthy, that value should be <5%. At <5% your body is completely “insulin sensitive.” That means the hormone insulin is 100% efficient at escorting glucose into a cell that requires energy. Any value above an A1C of 5% infers some degree of the actually underlying disease of type 2 diabetes - insulin resistance.


Wouldn’t you prefer to know where you are on the diabetes / insulin resistance continuum and avoid being diabetic rather than wait to be classified as type 2 diabetic and be put on drugs?

 

Understanding Lab Values Other Than A1C

The A1C value is arguably the most familiar blood marker value and many of us know that we don’t want to be pre-diabetic (A1C 5.7 - 6.4%). However, there are many other markers, that are far more impactful to our current (acute) and future (chronic) state of health and we need to know what is a good “pre-disease” level as opposed to the level that classifies us as either sick or high risk.


Here is a short list of biomarkers that you should know as well or better than A1C:

  • C-Reactive Protein (vessel inflammation)

  • Homocysteine (risk marker for heart disease and Alzheimer’s)

  • Fibrinogen (Signal molecule that is a measure of the amount of repair occurring in your vessels)

  • ESR (Indication of the electrical charge on cell membranes - particularly red blood cells)

  • Uric acid (an indicator for kidney function, hypoxia, and Gout)

  • GFR (a measurement of kidney filtration efficiency)

  • Insulin (the true metric for insulin resistance and diabetes - both type 1 and type 2)

  • Triglycerides (the measure of fat storage and utilization balance)

  • HDL (the measure of essential fat demand and sufficiency)

  • RDW (red blood cell distribution width - a measure of how inflamed the lining of your capillaries are)

  • WBC with differential (The measure of chronic infection like Lyme disease and other infections that have a significant impact on human health - but is largely ignored by the medical community.)