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.)

Current Reference Ranges

Here is an excerpt from labtestsonline.org:


Some lab tests provide a simple "yes" or "no" answer. For instance, was the test positive for the bacteria that cause strep throat? Many other tests, however, are reported as numbers or values. Laboratory test results reported as numbers are not meaningful by themselves. Their meaning comes from comparison to reference values. Reference values are the values expected for a healthy person. They are sometimes called "normal" values.

Three important things to know about reference ranges:


1. A normal result in one lab may be abnormal in another: You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits." While accuracy of laboratory testing has significantly evolved over the past few decades, some lab-to-lab variability can occur due to differences in testing equipment, chemical reagents used, and analysis techniques. Consequently, for most lab tests, there is no universally applicable reference value. This is the reason why so few reference ranges are provided in the test information on this website, Lab Tests Online.

2. A normal result does not promise health: While having all test results within normal limits is certainly a good sign, it's not a guarantee. For many tests, there is a lot of overlap among results from healthy people and those with diseases, so there is still a chance that there could be an undetected problem. Lab test results in some people with disease fall within the reference range, especially in the early stages of a disease.

3. An abnormal result does not mean you are sick: A test result outside the reference range may or may not indicate a problem. Since many reference values are based on statistical ranges in healthy people, you may be one of the healthy people outside the statistical range, especially if your value is close to the expected reference range. However, the abnormal value does alert your healthcare provider to a possible problem, especially if your test result is far outside the expected values.

Summary:

  • A normal result varies from lab-to-lab - for the same test!

  • A normal result does not promise health (remember my mother-in-law - just 0.1% away from being diabetic).

  • An abnormal result does not mean you are sick.


So which of the 3 above are you for any given lab value? Unfortunately, you are not provided guidance to know for sure. Maybe I'm off, but this feels like a very inadequate system.

I gave an example of someone on the verge of being diabetic yet they were classified as normal. Here is an example of someone who is perfectly healthy who is classified as "out of range."


Fasting Insulin LabCorp Test Result - Dr. Lewis

The above result is for my fasting insulin from 2018. Having a low** fasting insulin is one of the most important measures of overall health. Insulin is the "fat hormone." It's REAL job is to keep your blood sugar between 65 - 80 mg/dL - because too much glucose in your blood stream creates chronic vessel inflammation leading to a myriad of diseases. A perfectly healthy person has a fasting insulin of 2.0 - 4.0 uIU/mL .


Look at the "reference interval." Labcorp considers a fasting insulin of 24.9 uIU/mL NORMAL?! Sure, it's normal today compared to the average American, because most of us are insulin resistant, pre-diabetic, or diabetic.


When you base your health on reference intervals like this, you're bound to be chronically ill later in life.


Summary: My fasting insulin value is absolutely optimal yet it is consider "abnormal" when compared to other people having their fasting insulin drawn by labCorp.


My wife, Jazz, has a simple expression for this type of health assessment.


Here is a mortality study on insulin:

Fasting insulin was determined to be an independent risk factors for heart disease mortality. Increase in risk of death is shown to become relevant at a fasting serum insulin of > 9.7 uIU/mL. https://tinyurl.com/yydx2rvf


If you have a significant risk of heart disease death at 9.7, what is your risk at 24.9 uIU/mL, which is still considered normal?


** A fasting insulin below 2 may be indicative of type 1 diabetes.

A BETTER WAY

Can we all agree on one thing - we all want to live a long healthy life - true?

Translation: We want our risk of early mortality to be as low as possible.

Doesn’t it make sense then that “reference intervals” be based on early mortality risk? Doesn’t it also make sense that the ranges be a scale rather than high risk or no risk at all?

Here is why mortality risk is important to you…


To Live a Long Healthy Life - You Must Live a Long Life!

A brilliant study by National Geographic on centenarians showed that people who live longer live healthier as well. The graph indicates that someone who lives to 100 enjoys 30 years of extra good health compared to someone who lives to 80.

Translation: Long Lifespan = EVEN GREATER Healthspan

https://www.nationalgeographic.com/magazine/2013/05/longevity/

Your Chronic Disease Temperature:

Your Chronic Disease Temperature is a panel of 55 biomarkers with detailed focus on the early mortality predictive capability of 16 markers. Your “Temperature” is a combination of the 16 markers into a single mortality risk score - based on the 98.6 (core temperature) scale. What your thermometer tells you about how well or sick you feel today, your chronic disease temperature value tells you about how well or sick you are towards future early mortality.

Specifically, your chronic disease temperature provides the following:

  1. Your risk for early mortality

  2. Your risk for chronic disease

  3. WHERE you are on the health continuum

  4. In what disease categories your risks lie

  5. Action plan to reverse chronic disease and mortality risk trends

Chronic disease accounts for 80% of medical visits and 85% of the cost of healthcare in America. Our current medical testing is for acute disease and existing conditions. I assume it makes sense to all of us that we should finally adopt a way to measure chronic disease and risk.

Get your chronic disease temperature taken and remove all doubt about you current and future health status.

Be Well...




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-Ecclesiastes 9:16-17

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