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What do you thnk about these blood results?

Answered on August 19, 2014
Created May 19, 2011 at 10:22 PM

Got a couple blood panels, and here are the results. Doctor wants me to followup with a VAP because she's concerned with my cholesterol results (go figure). I actually wanted them to do the VAP right away, but they wanted me to take the metabolic panel first. The practice is low-carb friendly, but I get the impression that they're not too well versed with paleo despite this.

Any thoughts from the paleo crowd? Age 31 male, ~160lb, 6'2".

Testosterone, Free-tot, LC-MS-MS

Testosterone, Total, LCMSMS     598
Testosterone, Free              87.9

TSH* W/Free T4 RFX

TSH             1.72

CBC (includes DIFF-PLT)

White Blood Cell Count      6.4
Red Blood Cell Count        5.18
Hemoglobin                  15.6
Hematocrit                  46.6
MCV                         90
MCH                         30.0
MCHC                        33.3
Platelet Count              170
RDW                         13.6
MPV                         10.3
Absolute Neutrophils        3834
Absolute Lymphocytes        2150
Absolute Monocytes          314
Absolute Eosinophils        83
Absolute Basophils          19
Neutrophils                 59.9
Lymphocytes                 33.6
Reactive Lymphocytes        0.0
Monocytes                   4.9
Eosinophils                 1.3
Basophils                   0.3

Hemoglobin A1C

Hemoglobin A1C              5.3

C-Reactive Protein

C-Reactive Protein          <1

Vitamin D, 25-hydroxy, LC-MS-MS

Vitamin D, 25-OH Total      55
Vitamin D 25-OH, D3         55
Vitamin D, 25-OH D2         <4

Comp Metabolic Panel W-eGFR

Sodium                      140
Potassium                   5.1
Chloride                    103
Carbon Dioxide              26
Glucose                     88
Urea Nitrogen               16
Creatinine                  1.19

Calcium                     10.2
Protein, Total              7.3
Albumin                     5.1
Globulin, Calculated        2.2
A/G Ratio                   2.3
Bilirubin, Total            1.0
AST                         17
ALT                         21
Alkaline Phosphatase        38
Non-African American eGFR   81
African Amerucab eGFR       94

Lipid Panel

Cholesterol                 320
Triglycerides               69
HDL Cholesterol             87
LDL Cholesterol, Calculated     219
Cholesterol/HDL Ratio           3.7

Update (06/07/2011):

VAP Cholesterol Test

Total LDL           207
Total HDL           78
Total VLDL          17
Sum Total           301
Triglycerides       55

Total Non-HDL       223
LP(a)               8.0
LDL                 14
Sum Total LDL-C     207
Real-LDL Size       Pattern A

Remnant Lipoproteins    24
No constellation of lipid risk.
HDL-2                   27
HDL-3                   51
VLDL-3                  10
Total APOB100 Calc      135

Da8e709acde269e8b8bfbc09d1737841

(1906)

on August 19, 2011
at 01:49 PM

For those interested, my CIMT results came back and there is no evidence of atherosclerosis. In fact, my "arterial age" is 21, and the doctor stated that my scores were the lowest she's ever seen, on par with the "control" group which is some sort of hunter-gatherer group (she believed it was native Inuit).

Da8e709acde269e8b8bfbc09d1737841

(1906)

on June 07, 2011
at 05:23 PM

Updated with VAP results. Doctor indicated that everything is likely fine, but suggested a CIMT test to verify that the cholesterol levels are indeed benign. Thoughts?

3864f9a2af09b1b447c7963058650a34

(3703)

on May 23, 2011
at 05:33 PM

BTW avoid ketosis -- eat some carbs throughtout unless you don't tolerate starches (which might indicate SIBO). Ketosis further stresses the adrenals provoking higher cortisol and worse depletion of cortisol... When the adrenals are stressed, they will refuse to KICK IN to bring up natural testosterone [which makes boys into grrrrrls]

3864f9a2af09b1b447c7963058650a34

(3703)

on May 23, 2011
at 05:31 PM

Ahh. makes sense. When you up the T naturally and lower the estrogens (metals, pesticides, liver gunk, soy, etc) then you won't be a hard-gainer any longer. Hofmekler advises a lot of veggies for obvious benefits (contains aromatase inhibitors). However my observation is that everyone has poor digestion directly attributed to SAD damage. As Robb Wolf advises, consider the extremely high value of digestive enzymes, betaine HCL and glutamine/GI support. Liver support wouldn't hurt (silymarin). Melatonin, vit D, lipoic acid and herbs (parsley, cilantro, etc) are ALL natural metal chelators.

Da8e709acde269e8b8bfbc09d1737841

(1906)

on May 23, 2011
at 01:09 PM

I've been paleo for about six months. Most of my diet before that was relatively paleo-ish, with the exception of grain intake. I'm definitely a hard-gainer, and have had < 10% body fat most of my life, regardless of what I eat. Since going paleo, I've mostly removed sugars from my diet. I occasionally cheat when going out to dinner, and share a dessert with the spouse, but otherwise only have some occasional honey (like when making jerky or tea). As far as carbs go, I have sweet potatoes a couple times a week. If I don't, I believe I'm going into ketosis and get the associated bad breathe.

Da8e709acde269e8b8bfbc09d1737841

(1906)

on May 20, 2011
at 01:57 PM

Thanks! I'm not supplementing with creatine, but admit I could use more sleep; I'm averaging about 6.5 or 7 hours a night. I don't monitor how much water I drink, but don't typically drink a lot beyond the bare minimum to quench my thirst.

Da8e709acde269e8b8bfbc09d1737841

(1906)

on May 20, 2011
at 01:52 PM

Nope, never had kidney-related problems.

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5 Answers

3
Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on May 19, 2011
at 10:55 PM

High LDL in the presence of high HDL and low triglycerides simply isn't indicative of a risk for heart disease, at least with regards to the lipoproteins and their propensity to be oxidized. Elevated LDL can be caused by a bunch of things. It could be inflammation and insulin, but you look good for that. It could be genetic, or it could be that you are deficient in cholesterol in your cells. If your cells become damaged you need cholesterol to help fix them, that's a huge part of what LDL does. Eating a diet that uses a lot of cholesterol due to damage and not supplying the body with all of the substrate it needs to produce cholesterol leads to a chronic deficiency and poor health, and when people start eating a lot of good fat their LDL tends to go up. But as they get healthy and need less cholesterol, their levels eventually go down. The solution isn't to eat "cholesterol-lowering diet but to eat a cholesterol raising diet to provide the cholesterol you need AND reduce damage to the body. Paul Jaminet points out that a deficiency in copper can cause damage to the arteries and increase the need for cholesterol. http://perfecthealthdiet.com/?p=2547 So make sure to get enough copper and all nutrients for that matter. Just keep doing what you're doing and striving to be as healthy as you can and don't worry about cholesterol, if you do everything fairly well it will go down, and if all of your other markers are excellent and you have enough of all nutrients then you are commanded to forget about it. There is no evidence that high pattern A LDL predicts CHD disease risk or that high LDL causes any disease, quite the opposite actually.

2
Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on May 20, 2011
at 11:01 AM

The labs on absolute numbers are fine. But to point out some finer points.....Your Testosterone for a 31 yr old male is not optimal. Your free T is also not optimal. Neither is your Vitamin D. My bet is you have a very mild case of Pregnenlone steal likely from higher levels of cortisol.....I would suggest you get salivary cortisol checked to see what that is doing. Clinically tracking your sleep will tell you if the cortisol is a problem. If I am correct then fixing that will autocorrect the T and D issues. The reason is cortisol T and D are made from the same precursor and evolution dictates that we make cortisol first before T and D because its more important to be able to run away from a Tiger than have sex or protect you bone or immune system.

Your kidney function is low and that is likely secondary to volume depletion and dehydration. So I suggest you drink more water too. If you are supplementing creatine I would back off a bit

Da8e709acde269e8b8bfbc09d1737841

(1906)

on May 20, 2011
at 01:57 PM

Thanks! I'm not supplementing with creatine, but admit I could use more sleep; I'm averaging about 6.5 or 7 hours a night. I don't monitor how much water I drink, but don't typically drink a lot beyond the bare minimum to quench my thirst.

1
3864f9a2af09b1b447c7963058650a34

(3703)

on May 20, 2011
at 08:59 PM

How long have you been paleo?

I'd agree the SCr (kidney) test is mildly high which could be temporarily high from dehydration or if you have more muscle mass compared to the average person. You seem skinny from your stats but are you a hard gainer or is your BF (body fat) < 10%? High muscle mass translates to higher SCr which is innocuous.

Not enough sleep!!! Sleep makes people bionic -- and grows GH and T (growth hormone and T) and lowers cortisol as others have mentioned above.

Don't worry about the LDL --- as Dexter mentioned likely the $99 VAP will just verify how great the labs otherwise are. FH (famililar hypercholesterolemia) is common among northern Chinese and northern European descendants. It indicates apo E status, that is all. Your body may absorb more cholesterol from the GI than normal (and toxic chemicals and toxic metals). Avoid heavy metals, contaminated tuna/seafood, scented products, petroleum products etc (which increase estrogenic effects anyway). These are all neolethal and best to avoid but specifically in those apoE4/E4 (aluminum is associated with Alzheimers in these folks studies show).

I think the liver tests are mildly high -- > 15 for guys (> 12 for women) is sometimes suggestive of mild NASH/fatty liver. How much fructose and carbs do you consume? consider < 100 grams daily if you are eating a ton. I think there is some mild insulin resistance and possibly estrogen dominance from the T, lack of sleep and ALT/AST status.

Have you ever read Ori Hofmekler? Read him. He's the author of the warrior diet -- he has good info on how to up the T and lower the estrogens...

Would love to hear about the improvements later!

Da8e709acde269e8b8bfbc09d1737841

(1906)

on May 23, 2011
at 01:09 PM

I've been paleo for about six months. Most of my diet before that was relatively paleo-ish, with the exception of grain intake. I'm definitely a hard-gainer, and have had < 10% body fat most of my life, regardless of what I eat. Since going paleo, I've mostly removed sugars from my diet. I occasionally cheat when going out to dinner, and share a dessert with the spouse, but otherwise only have some occasional honey (like when making jerky or tea). As far as carbs go, I have sweet potatoes a couple times a week. If I don't, I believe I'm going into ketosis and get the associated bad breathe.

3864f9a2af09b1b447c7963058650a34

(3703)

on May 23, 2011
at 05:31 PM

Ahh. makes sense. When you up the T naturally and lower the estrogens (metals, pesticides, liver gunk, soy, etc) then you won't be a hard-gainer any longer. Hofmekler advises a lot of veggies for obvious benefits (contains aromatase inhibitors). However my observation is that everyone has poor digestion directly attributed to SAD damage. As Robb Wolf advises, consider the extremely high value of digestive enzymes, betaine HCL and glutamine/GI support. Liver support wouldn't hurt (silymarin). Melatonin, vit D, lipoic acid and herbs (parsley, cilantro, etc) are ALL natural metal chelators.

3864f9a2af09b1b447c7963058650a34

(3703)

on May 23, 2011
at 05:33 PM

BTW avoid ketosis -- eat some carbs throughtout unless you don't tolerate starches (which might indicate SIBO). Ketosis further stresses the adrenals provoking higher cortisol and worse depletion of cortisol... When the adrenals are stressed, they will refuse to KICK IN to bring up natural testosterone [which makes boys into grrrrrls]

1
06d21b99c58283ce575e36c4ecd4a458

(9948)

on May 19, 2011
at 10:43 PM

I think you should be happy, very happy. Everything looks good and your VAP more than likely will show you are mostly Pattern A, large bouyant particles.

Your HDL/LDL 87/219 = .39 is excellent. Anything above .3 is great and preferable over .4

More paleo eating will keep you and your lipid panel happy. If your VAP show a distribution of 50/50, just keep on trucking with paleo as you have practiced.

Vit D3 level is fine. The Quilt wants his clients to be 70-100ng/ml. You could be a little higher here by a little more sun during the day or a bit more supplementation.

0
3c6b4eed18dc57f746755b698426e7c8

on May 20, 2011
at 04:35 AM

For a 31 year old guy, your creatinine seems a bit high and, as a result, your GFR is low. Have you have kidney-related problems? Your calcium is also high normal. Based on just your GFR only, you could be taken for someone at Stage 2 of Chronic Kidney Disease, CKD (unless you're African American) ... not to worry, very mild. I would get your Parathyroid Hormone (PTH) tested with calcium and redo the GFR, as they all could have been faulty.

Da8e709acde269e8b8bfbc09d1737841

(1906)

on May 20, 2011
at 01:52 PM

Nope, never had kidney-related problems.

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