Hello, I'm a longtime lurker, first-time asker.
15 months ago, as I was starting my experiment with Paleo, I had some labs done; figured I was overdue for a follow-up.
Here are the highlights, or anything Out Of Range (OOR), either then or now. (I can share any other numbers if requested.):
3/20/2011 (11:30 am) -> 6/7/2012 (10:00 am) (Both fasted at least 14 hours.)
Glucose 84 -> 91
BUN 10 -> 10 Creatinine 0.84 -> 0.87 eGFR >59 -> 114 Calcium 9.6 -> 9.6
Phosphorus 3.5 -> 4.7 (OOR)
Bilirubin 1.3 (OOR) -> 1.6 (more OOR)
AST 25 -> 30 ALT 15 -> 27
Cholesterol, Total 150 -> 263 Triglycerides 53 -> 52 HDL 45 -> 92 LDL Calc 94 -> 161
TSH 7.76 (OOR) -> 3.6 ... T4, T3 Uptake, FTI all within range both times, but just a tick lower now.
Thyroxine (T4) 6.4 -> 6.1 T3 Uptake 38 -> 36 Free Thy Index 2.4 -> 2.2
Urine Ketones 3+ (OOR) -> 3+ (To be expected, I think.)
Vitamin D 28.6 (OOR) -> 25.4 (more OOR!)
C-Reactive Protein, Cardiac 0.74 -> 0.16
Hemoglobin A1c 5.5 (111 est. avg) -> [didn't test]
Iron w TIBC All in range -> [didn't test]
All else was and is within range.
LDL 164 (OOR) HDL 81 VLDL 14
T Cholesterol 259 (OOR) Triglycerides 56 Non HDL Chol 178 (OOR)
apoB100-calc 111 (OOR)
LDL-R (Real)-C 139 (OOR) Lp(a) C 16.0 (OOR)
IDL C 9 Remnant Lipo 17 Probably Metabolic Syndrome No
HDL-2 30 HDL-3 52 VLDL-3 8
LDL1 A 20.8 LDL2 A 55.1 LDL3 B 57.2 LDL4 B 5.7
LDL Density Pattern A
Male 6' 32yo 140lbs (yes, pretty thin, but have always been towards the bottom of BMI scale, but newly determined to put on weight.)
Any general/specific feedback is appreciated. Just wondering if there's anything one can infer from these results. Any advice? Lab tests to consider in the future? Symptoms, etc., to watch out for?
Particularly in regards to:
Thyroid. I think TSH is still OOR by Paleo standards, but I assume improvement without medication or much iodine to speak of (as it exacerbated acne) is a good sign, or not?
Liver Enzymes. I think elevated by Paleo standards. Worth further examination? Any ideas why Paleo would increase them? Gallstones?
Kidney. What's up with elevated Phosphorus? A fluke? My records show I've been getting ~90% of RDA, and I don't supplement.
Glucose. I bought a glucose meter and will be testing fasted and postprandial numbers in the coming days.
Balanced approach going further. Given results, current ailments (particularly acne) and objective of gaining weight, what's my best course of action to balance all these things?
After a few weeks' transition into Paleo, and as of a few days before 3/2011 labs, I was basically full-fledged Paleo, consuming:
- 1900 calories
- 40g carbs
- 100g of protein
- 150g of fat (mostly cream, chicken, 4x egg yolks; 40g saturated)
- BP: ~112/72
Between 3/2011 and 3/2012
There was plenty of experimentation (in many cases for the worse), but roughly averaged:
- 1900 calories
- 75g carbs (mostly banana, berries, coconut milk, veggies, leafy greens)
- 80-100g protein (primarily from 8oz GF beef, 4x pastured egg yolks)
- >190g (65%) fat (mostly coconut milk (~1 can/day), coconut oil, egg yolks; 2-3g O3; <8g O6; >90g saturated)
- 4,0000 IU Vitamin D
- B Complex (Vitamin Shoppe liquid, probably not best quality)
- Fermented Cod Liver Oil
- No: nightshades, dairy, mushrooms, egg whites
- started drinking a few cups of coffee in January; stopped in March
As of 3/2012 (last three months)
- 2500 calories
- 75g carbs (mostly white rice; got rid of FODMAPs)
- 80-100g protein (primarily from 8oz GF beef, 6x egg yolks, some chicken)
- >200g (75%) fat (mostly coconut oil, egg yolks, beef; 2-3g O3; <7g O6; >130g saturated)
- strength training 3x/week; 30min noontime walks a few times a week
- stopped: coconut milk (replaced with more coconut oil via homemade mayo)
- added: homemade bone broth (from chicken feet), 4oz beef liver/week and water kefir, vitamin c, magnesium citrate, zinc picolinate
- 2,000 IU Vitamin D (I thought I might've been overdoing it, but apparently not.)
- Body Temp (sublingual): ~36.35/97.43 waking; ~36.61/97.89 daytime average (random times/days); high of 36.9/98.42
In the last three months, I've gained back 1lb/wk after realizing I was quite underweight (127 lbs) due to not wanting to overdo anything. Now planning to maintain this trajectory (3x/wk workouts, 500 addition calories per day) until I hit 180lb, hopefully.
In the last week, I have:
- day before blood draw:
- started a targeted ketogenic diet; ~20g carbs four times a week; 55g (difference from honey pre-workout) on workout days
- eliminated: fermented cod liver oil; white rice replaced with fewer carbs via leafy greens, carrots, garlic
- after blood draw:
- added: 1/2tsp dulse to get 100% iodine; i will proceed with caution from here without a full thyroid panel, but so far pretty good
- upped: Vitamin D to 2x 5,000IU doses
- BP: 124/75
I've since seen my body temp jump a notch: 36.9/98.42 (+0.55/0.9) waking (only measured once so far), high of 37.05/98.69; 37/98.6 daytime average from three random readings.
Ailments (motivators to try Paleo) and results thus far
- acne (with rosacea perhaps?) - drastically improved and diminished, but still a nuisance and healing; worse with more carbs, fruit or dairy
- dandruff - gone, but reappears, likewise, with more carbs, fruit or dairy
- brittle, yellow big toenails, esp. left - much healthier, stronger; ridged, but improving still
- also some neuropathy in left leg (at least partially caused by benign brain thing and sedentary lifestyle) - much improved with workouts and walks
Thanks for reading! If you didn't, that's OK. If you have a question, just ask if you don't want to hunt down a possible answer above.
asked byPaul_18 (10)
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on June 13, 2012
at 05:48 PM
Great improvement of the lipids!
Although your total cholesterol has increased and the doctor will regard it 'high, 200-~260mg/dl is actually best for all cause mortality risk (see: http://3.bp.blogspot.com/-pttFtp8eZx0/T3IFYTDzEwI/AAAAAAAAAQ8/Grmm-gHD1yI/s1600/CholesterolMortality.jpg)
Your LDL is also considered 'high' or 'OOR', but looking at your VAP test we see that it pattern A; that is your LDL are nice and fluffy. This LDL is not dangerous, even when the number is a little high, in fact as sex hormones are made from LDL, this is ideal.
Your HDL has increased greatly, due to your increased saturated fat intake. This is great.
Your triglycerides are nice and low, this is good too.
Regards thyroid, you need to ensure adequate selenium as well as iodine. Best sources for selenium are brazil nuts (no more than 2/day), and kidneys. The RDA for both selenium and iodine are a joke, they are the bare minimum to avoid goitre; much better is 200-300ug selenium, and up to 14mg iodine (which the Japanese get). Seaweeds are hard to digest (the Japanese have enzymes others don't), you may find using something like lugol's solution more effective.
You are right thinking 3.6 TSH is a little high, under 1.5 is ideal. But it is much improved from last time and may still be decreasing. Keep an eye on it.
on June 13, 2012
at 04:35 AM
Your phosphorus is high but not that high. How's your calcium? I don't think it's due to kidney failure but you should check your BUN, creatinine and calculate GFR. I wouldn't be surprised if your BUN is >25 and your creatinine >1 given your heavy meat intake but you shouldn't have any CKD at your age.
Vit D could also be involved, too. But the bioavailability and absorption of Vit D is highly individual. What were your levels before?
Your TC and LDL increase could be due to your thyroid and/or your genetic factor (Apo E4). But in your case, you seem to have low inflammation (CRP) and high HDL that was achieved via exercise, I assume, so I would think your CVD risk is not very high. But you could further assess CVD risk by testing your BP, other inflammation markers, blood stickiness, and LDL particle size.
Your liver enzymes are just a little bit high given your very low CRP but the increase could just be a snapshot, just like your FBG. Your slight FBG increase could be due to physiological insulin resistance, which shouldn't affect your insulin resistance long-term. Get another HbA1C if you think your BG control is failing.
In short, you seem pretty healthy except your thyroid (need T3, T4, RT3 levels and might want to test for HT antibodies). Cut down on protein to your lean body mass level (or about 90% of your LBM in kg) if your BUN is too high and GFR too low. I think your undercounting your total protein intake.