Tag Archives: Lab Tests

Post #59 – What are our lifestyle choices for maximizing health and lifespan?

11 Sunday Feb 2018

Posted by in Life-Span, Living to 120, meditation, Mental Health, Nutrition, Optimal Exercise, Optimal Health, Optimal Nutrition, Puposely Living, Quality of Life, Stress, Supplements, TM, Uncategorized, Vitality, wellness, Yoga

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Lifestyle Choices for Maximizing Health and Lifespan

Unless you have been living under a rock on an isolated island, I am sure you have heard that lifestyle choices have big impact on the both your health and how long you live.

Living longer means not dying sooner.  And, to not die sooner, you must take actions that eliminate the various ways one dies.

Living healthy, means taking actions to prevent all the ways one loses their abilities to enjoy day-to-day activities of life. Or, at least postpone the time as far into the future as possible before developing disabilities.

In both case, i.e., living longer and living healthy, lifestyle choices play crucial roles. But what are these life choices, besides the ones you hear all the time:  Eat Better and Exercise.

When I started to systematically pursue this topic of living optimal lifespan possible (my goal being 120 years), with optimal health span (my goal being no disabilities), I started enumerating all areas of life in which one can take some action to make this impact.

Of course, not everything is in our control. We did not come to this earth with guarantees. Unforeseen, random event, or events that are not in our control can ruin all our goals and plans. But the objective is to not let the possibility of events not in our control prevent us from taking actions that are indeed in our control.

So, here are all 12 dimensions of lifestyle that I have discovered so far that impact health span and life span. Each subject is a very extensive topic by itself.  I just very briefly summarize my personal take on these and may be an example of how I am attempting to address them in my lifestyle and where you can read about further in these blog posts.

1. Benchmarking Health: Knowing where you are is where I believe it has to all start. You go to doctor’s office and they take your physical measurements (height, weight), you vitals (pulse, blood pressure), order some measurements from the lab and then compare those with what should be “normal” for you. In Post #7 – Can biomarkers help in the quest for vitality and longevity?, I discuss the various measurements you can use as biomarkers for health. These days I measure:

Daily: Weight, waist, fat near navel and thigh, BP, SPO2, pulse, my over-all subjective state of my physical, emotional and mental health

Weekly: pH, Nitric Oxide, fasting glucose

Quarterly: Bloodwork through my primary physician – CBC (complete blood count), typical chemistry panel, Lipids (Cholesterol total, HDL, LDL, VLDL, Triglysrides), TSH, T3, T4 (Thyroid hormones), Male Hormones (Total and Free Testosterone, Estrogen, LH, FSH), Hydroxy-D, fasting glucose, A1c, PSA (for prostrate tumor screening), CRP, (for inflammation), Homocysteine (for heart condition)

Annually or Biennially: Telomere Measurements (DNA strands that dictate how long cells live), X-Rays of joints if I suspect arthritis etc., Ultrasound Study of Carotid and Aorta arteries, MRI’s to detect any tumors, eye-exam, hearing test, EKG.

Every 5 years: Colonoscopy, Stress-test.    

2.  Nutrition – That is everything that crosses our lips, what we eat or drink. I discussed the topic of nutrition in a series of eight blog posts on this subject of Optimal Nutrition, Posts #22 through #29.  additionally, Post #15, #31 and #32 discuss the topic of how and when to complement the nutrition with supplements.

 3. Exercise – Exercise is indispensable for building and maintaining muscle strength, flexibility, balance, endurance. There is also abundant proof that it helps with the metabolism, overall health and health of specific organs. I discussed this topic of exercise in blog post #30 – How much and what type of exercise do you need for optimal health?

 4. Maintaining Musco-skelatal Integrity: Pains in the back, knees, hips, shoulder, wrists and other various joints creep up. We may think that these pains just come out of nowhere. After all, we often notice that “yesterday it did not hurt and today it hurts”. So, it got be a random event. Right?

Reality is that unless there was a trauma caused by an accident, most of these are the result of repetitive movement in un-aligned joints. The underlying cause could be neglect of the muscles, ligaments and tendons surrounding joints or prolonged asymmetrical movements, e.g., always carrying a bag on the same shoulder, or playing games such tennis or golf that inherently require asymmetrical movement.

Yoga, myofascial massages, Rolfing, rolling with foam rollers, visiting a chiropractor for body alignment, weight bearing exercises for join strengths, e-cise routines designed by Pete Egoscue are methods I have learned for maintaining musco-skeletal integrity.  I discuss some of these in Post #30 – How much and what type of exercise do you need for optimal health? And Post #49 – What is the role of massage therapy in Optimal Health? Also, I discuss how you can use foam rolling for body alignment in Post #39 – Ever heard of foam rolling.

 5. Maintaining Mind-body Connection: Our mind and body are inherently connected. Maintaining the connection between the two is essential for optimal health. Yoga, Tai Chi, Qigong, are some ways to develop and maintain mind-body connection.  I have very limited experience with Tai Chi and Qigong. I do, however, perform Yoga as part of my lifestyle.  In Post #11 – My first year of experience with Bikram Yoga, Post #12 – My second year of experience with Bikram Yoga, I describe how I incorporated Bikram Yoga into my lifestyle.

 6. Enhancing and Maintaining Brain: If we lose vitality of the brain, the quality of life suffers dramatically. Alzheimer and other forms of Dementia can often be very painful way of living. Evidence is mounting that for optimal brain health, we must keep the brain stimulated with right activities. All my life, I have been very focused on left brain type of activities. As I was turning 60, I decided to do something about it and started taking piano lessons to stimulate my right brain and prevent any premature aging of the brain. I discuss the activities for maintaining optimal health in Post #57 – Optimal Mental Health – what is it and how to achieve it?

 7. Stress Management: Stress is a root cause of many diseases. We have all experienced how stress can bring about disturbances in the digestive systems, back pain, high blood pressures, even heart attacks and strokes. Yoga and Meditation are two of the ways to manage stress. Perspective management is another powerful method. I got initiated in Transcendental Meditation over 30 years ago and I have been doing TM ever since with good benefits. I tackle the subject in Post #16 – What is stress really and why is it bad for longevity and health and Post #17 – Is meditation an effective antidote to stress.

8. Adequate Sleep: There is more and more evidence every day that inadequate sleep can cause all sorts of ailments. 7 to 9 hours of restful sleep is considered optimal. All my life, I thought the object of the game was to get away with as little a sleep as possible. Sleeping more than 6 hours every night is still a challenge for me. Although I am working on it to extend sleeping hours during the week and may be do some catch up sleeping during the weekends. Maybe I will tackle this topic in a future post.

 9. Social Engagement: World-wide Study of Blue Zones, i.e., geographical areas where longest living people are clustered, showed a very surprising factor that contributed to long healthy life of people living there. Researchers found that people in Blue Zones are socially very engaged. Centenarians in these areas are engaged with tight knit groups of friends and family. So, the conclusion is that social engagement is an important factor in living longer and healthier.

 10. Purposeful Living: It is well known that death rates spike after the holidays and after major life events. Researchers deduce from studies of such phenomena that people live only as long as they find life meaningful.

Of course, it is needs an ongoing effort to figure out what one can derive meaning from. One may find meaning in raising kids or grand kids, contributions to society, being the best spouse one can be or from “slaying some dragon”. Some people find meaning in their faith and service to God. Others find meaning in being of service to mankind. Yet others can find meaning in their job or career.

Viktor Frankel explores this topic beautifully in his book: Man’s Search for Meaning.

11. Make Full-use of All Modalities of Medical Care: Modern medicine has developed amazing and miraculous treatments. By making use of the modern medicine one can live much healthier and much longer..  In general, the earlier you are able to catch a disease and the sooner you start treatment, better your chances of a cure or at least minimum damage. Mantra for modern medicine is “early detection, early cure”

 Alternative schools of medicine, such as Ayurvedic, Homeopathy, Aquapuncture, Naturopathy, offer valid means for preventative care and whole-person healing.  Leveraging these modalities of medical care as appropriate can offer means for optimal healing and living. Here the rule is the age old wisdom: An ounce of prevention is better than a pound of cure.

I was even able to eliminate my severe seasonal allergies by working with doctors for Naturopathy and totally change the vector of my health as I discuss in Post #8 – So, did I you tell you the story of my allergies. Also strengthening your immune system can have major consequences on how your body deals with diseases as I discuss in a series of Posts #51 – 54 – How to Optimize Your Immune System – Part I through Part IV

12. Make use of Genetics Science: There is of course the truth of genetics. Genes do play a role in how long we will live and what diseases we may have the tendencies to develop. Over the last few years, however, scientists are finding that inherited genes don’t determine your destiny, it is the lifestyle that can either turn those genes on or off. This is the exciting field of epigenetics.

 Studies from the filed of epigenetics do  give us opportunites to leverage genes.  Through genome mapping, we can find out what might be our tendencies and to what aspects of our life, therefore, we should pay particular attention. Over the last few years, I have gotten my telomeres measured – these are tips at the ends of genes that are considered to act like our lifespan clocks.  I discussed this in Post #50 – How to optimize your health by maximizing your telomeres. More recently, I have sent for genetic testing to be able to receive personalized genetics bases lifestyle coaching. I will share results of that experiences in a future post.

The percent of role of genes that we cannot do anything about is constantly shrinking all the time. Now it is believed that only between 5% to 15% of lifespan and health span is determined by genes that we have no control over.

Bottomline:

In summary, researchers have shown again and again that health span and life span depend upon one’s lifestyle choices. A holistic look at lifestyle choices means many different and distinct areas of life.

I shared my take on these dimension of lifestyle and some of my experience. Also, gave references to where you can find more information, whenever, I have already discussed that topic in more detail in my blog posts.

  1. Benchmarking Health
  2. Nutrition
  3. Exercise
  4. Maintaining Musco-skelatal Integrity
  5. Maintaining Mind-body Connection
  6. Enhancing and Maintaining Brain
  7. Stress Management
  8. Adequate Sleep
  9. Social Engagement
  10. Purposeful Living
  11. Making full-use of all modalities of medical care
  12. Make use of Genetics Science

What do you think?

Do you think there is another dimension of lifestyle that I did not care is also important?

I would love to hear from you and learn from you.

Please click on Comment to leave your comments or question so others can benefit from your input. 

 

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Post #38 – What are some basic lab tests for monitoring optimal health?

20 Monday Apr 2015

Posted by in Optimal Health

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When I turned 40, I decided to visit my doctor and asked him to give me a 40,000 mile checkup. So, the doctor ordered some blood work, an EKG, and scheduled a full physical. On my scheduled physical, he asked me some questions about my lifestyle and if I had any issues. He checked my vitals, listened to my heart and lungs, and did a rectal exam to verify I did not have enlarged prostates. He reviewed my lab results and EKG. And, told me “everything was normal”. So I assumed I was in perfect health.

I repeated that same process every few years.

Few years ago, I started questioning, whether that process of physicals was sufficient for living an Optimal Health. As I started to study this subject, I learned that was not the case.

First of all, and as we discussed in my last blog post, that “everything is normal” does not necessarily mean I am living an Optimal Health. If my cholesterol or fasting glucose numbers are within the “reference range”, it does not mean that they are the best that may be desired for an optimal health.

Next, I started questioning whether the tests that my primary physician was conducting were adequate for optimal health. And, the answer came out be: no, it was not. For living an optimal health, my objective is to detect any issues at the earliest possible moment in time, which the physicals alone were not accomplishing.

Sooner I can detect an issue, I believe easier it is for me to do something about it. As my flight instructor drilled in my head when I was learning flying, “It is easier to make small corrections sooner than big corrections later”. I believe the same is definitely true for health as well.

So, what other tests should I undergo to detect any issues early? As I studied this topic some more, here is what I learned are the basic numbers I should know.

I am sure everyone is already well aware of measuring Total Cholesterol, HDL, LDL and Triglycerides, which most physicians very faithfully measure these days.

Hemogloblin A1c

Excess blood sugar is a huge issue for health. It has so many different implications to health.

Fasting Glucose level often measured by primary physicians is not adequate for early detection of blood sugar and insulin issues. Commonly called A1c, measured as percent of A1c or glycated blood cells is a very important to know to really understand if one is diabetic or pre-diabetic.

Last year, when for the first time I measured my A1c, I found that it was elevated and was in the pre-diabetic range. I had no data to compare with since none of my labs during physicals in the last twenty years had measured A1c. My physicians did not feel the need to measure it since my fasting glucose has always been and still is under 90 which is within the reference range and is considered “normal”.

Having tested it multiple times during the last 15 months, I noticed it is going up and I have been further investigating its root cause and aggressively treating it with further changes in my lifestyle.

Vitamin D, 25-Hydroxy

Although, called a Vitamin, it is really a hormone. When I leaned that every single cell in the body has receptors for Vitamin D, I really finally understood Vitamin D’s significance. It is implicated in so many health issues and is responsible for turning on/off as many as 500 different genes. Although, many labs don’t consider your Vitamin D deficient until below the reference range minimum of 30, many studies support a value of 50 to 60 as the optimal range.

TSH

Thyroids, either underactive or over-active, can be an issue and cause of a wide variety of symptoms. The thyroid-stimulating hormone (TSH) test is often the test of choice for evaluating thyroid function and/or symptoms of a thyroid disorder, including hyperthyroidism or hypothyroidism. TSH is good screening test and if noted abnormal doctors will want to further investigate by examining free T3 and T4.

Homocysteine

Homocysteine is an amino acid and breakdown product of protein metabolism that, when present in high concentrations, has been linked to an increased risk of heart attacks, strokes and Alzhiemer’s disease. High Homocysteine level also indicate deficiency in B12 and folic acid. There are no immediate symptoms associated with high levels of Homocysteine. So, it is useful to know your levels and make necessary adjustments in lifestyle if needed to prevent future issues.

C-Reactive Protein (CRP)

CRP is a protein made by the liver. The level of CRP rises when there is inflammation throughout the body. So, the CRP test is a general test to check for inflammation in the body. It is not a specific test. That means it can reveal that you have inflammation somewhere in your body, but it cannot pinpoint the exact location. Many consider a high CRP level to be a risk factor for heart disease. However, it is not known whether CRP is merely a sign of cardiovascular disease or if it actually plays a role in causing heart problems. Some researchers assert that Homocysteine and CRP are more important to monitor for cardiovascular health than cholesterol.

Testosterone

Both men and women have testosterone. In men, testosterone plays a key role in the development of male reproductive tissues such as the testis and prostate as well as promoting secondary sexual characteristics such as increased muscle, bone mass, and the growth of body hair. In addition, testosterone is essential for health and well-being as well as the prevention of osteoporosis. Low Testosterone (Low-T) can cause issues such as losing muscle mass, pre-maturely developing “man boobs”, losing “get-up and go”, erectile dysfunction, and low libido or sexual desire.

There is controversy over what the “normal” range should be as testosterone tends to decline as men age. Often, receiving testosterone through hormone replacement therapy can restore “get-up and go” and sexual desires and performance and other youthful traits. It is not only important to measure Total Testosterone, but also even more importantly Free Testosterone, which is the testosterone available for use by the body.

DHEA-Sulphate

DHEA-sulfate is a weak male hormone (androgen) produced by the adrenal gland in both men and women. DHEA is a pre-cursor of both Testosterone and Estradiol. A shortage of DHEA can lead to shortage of testosterone in men or estradiol in women.

Estradiol

Estradiol is a human sex hormone and the primary female sex hormone. It is named for and is important in the regulation of the estrous and menstrual female reproductive cycles. Estradiol is essential for the development and maintenance of female reproductive tissues but it also has important effects in many other tissues including bone. While estrogen levels in men are lower compared to women, estrogens have essential functions in men as well.

 So, how do you get these tests done?

First stop to get these tests should be your primary physician. Mark Hyman, M.D. has a very helpful report on his website:  How to work with your doctor to get what you need?  That report may be useful to read and bring along.

Your doctor may be reluctant to order these test even after you express your desire to have these test done. That was the case with my primary physician. So, I went ahead and found a place that will run these tests in the U.S.: Life Extension Foundation. You can order a variety of tests from them, but their Male Panel and Female Panel include all of the tests mentioned above. Additionally, these tests include metabolic panel with lipids (i.e., Cholesterol), Complete Blood Count and PSA (for men) and Progesterone (for women)

From Life Extension Foundation, you can order these tests online or over the phone. Your will then go to a local lab for blood draw and then receive results on hardcopy, email or online. They even have folks you can call to discuss the results.

Having studied these basic tests and their implication to optimal health, I even asked our twenty three year old twin boys to do their blood work for full male panel. They don’t have any health issues, but I thought it was important for them to have this information as their baselines when they are in top health and establish what is “normal” for them.

So, when they are 60 year old or if an issue arises they have baselines to compare against. They will not have to wonder like was the case for me, “How do my current testosterone levels or A1c compare to what I had when I was twenty three and in top shape?”

So, there you have it – the basic information you may want to know for optimal health.

What are your thoughts?

Is there something else basic that is important to measure to live optimal health?

I would love to hear from you!

Post #37 – When the doctor says “Everything is normal”, what does it mean?

12 Sunday Apr 2015

Posted by in Functional Medicine, Optimal Health

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The following paragraph is from a handout I saw in the office of Ben Gonzales, M.D.:

“Everything is Normal” … said the doctor to you. You went to your doctor because you haven’t been feeling yourself in a while. Something is not quite right. You feel a bit “off” but can’t quite put your finger on it. You may be gaining weight despite working out and eating right, your energy levels have been dropping, sex drive is decreasing or you simply are losing your ability to focus. Yes, you have the usual and may be unusual stresses at home, job, financially, relationships perhaps. Your sleep patterns are changing and you do not know why. The doctor did an exam, got some basic labs and tells you, “Everything is normal” But you don’t feel normal. What is “normal” when it comes to labs? Why is it that results vary in “normal ranges” from lab to lab?

Or, maybe it is the opposite scenario, as described below an excerpt from Labs Online website:

“Your test was out of the normal range,” your doctor says to you, handing you a sheet of paper with a set of test results, numbers on a page. Your heart starts to race in fear that you are really sick. But what does this statement mean, “Out of the normal range”? Is it cause for concern?

Doctors may use the words “normal” informally, but labs these days more often than not use the word reference range.

For example, blood work for Cholesterol may look like this:

(If the figure is legible, just click on it)

Figure

In this above example, Total Cholesterol, Triglycerides, HDL, VLDL are all within their corresponding Reference Ranges. While LDL Cholesterol, which is a calculated value from other measurements is outside the range, marked here with bold font and also with letter H (for High) in the next to the reference range.

First of all, where do these Normal or Reference Ranges come from and what does it mean to be within the range or outside the range – doctors and you may refer to as Normal or Not-Normal after a quick review of the lab results?

For some tests, guidance may come from National Institute of Health (NIH) or some expert panel of the corresponding physician’s association. For example, in the case of Cholesterol, the reference range is taken from the NIH Heart, Lung, and Blood Institute publication called Third Report of the Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults, or Adult Test Panel III or ATP III. NIH has developed this publication by organizing expert panels of medical professionals and researcher to review all the literature and then develop recommendations.

For some other tests, ranges are derived by collecting data for a large enough group of people and then performing some statistical analysis to derive what is “normal” for them

The first step in determining a given reference range is usually to define the population to which the reference range will apply, for example, healthy females between 20 and 30 years old. A large enough number of individuals from this category are tested for a specific laboratory test. The results are then averaged and a range (plus or minus 2 standard deviations of the average) of normal values is established.

And that becomes the reference range, based on which, you may be told “Everything is normal” or the opposite of it.

So, given this background, what should you be watching out for or questioning in this process? Here are some questions to ask, that may lead you to dig further into your labs:

  1. Does the lab data correspond to how I feel?
  2. Do I belong to the category from which the reference range was derived?
  3. What is the optimal range, not just normal range?

There is an intriguing story of a woman who during her pregnancy felt awful but her doctor kept telling her that everything was normal and she even had a miscarriage. She eventually figured out that she was suffering from Hypothyroid and found the right doctor to work with, thus totally transforming her life. She became a crusader in educating women on this thyroid issue and launched HypothyroidMom website.

Then there is even a bigger question: Are the lab tests that are being used for screening issues the right tests?

Dr. Gonzalez in his flier concludes:

“Many basic labs are left out in an initial general physical workup. Understanding what labs to obtain in evaluating your physiologic function is not a basic skill seen in many primary care clinics. Again, simply because most clinics are looking for disease results in your labs, not optimal results as they relate to your long term good health. This is an issue in our current health care system. Finding a provider who understands optimal ranges in your labs and how nutrition fits into managing your health can be challenging. Seek that provider.

Because everything may not be “normal”.”

In my next post I will share some more information about what are some overlooked labs that your primary physician may be reluctant to order but are these days considered vital for managing optimal health.

So, what are your experience on this subject.

I would love to hear and learn.