How to read lab results and a blood analysis

Howdy Show Upper’s! I’m excited to have my friend and MD, Doctor Chris Perry guest blog today. He’s been a great resource for Show Up Fitness to consult with in terms of contraindications for different medical issues. He’s recently developed an AMAZING sports supplement for endurance athletes that our trainers and clients LOVE. Ultra 26 is the perfect recipe of caffeine, carbs, and protein to help push you through those tough workouts and/or endurance events.

I’ve always been a fan of clients getting their blood analysed every 6-12 months. It’s a great way to monitor what you’re putting into your body, how your heart and organs are functioning, and how exercise affects everything. It’s not about how “healthy” you look on the outside, it’s about how well the engine and oil levels are working inside. I challenge you to schedule an appointment to get your blood lipid profile, liver functioning, inflammatory markers, kidneys, and testosterone / hormone levels checked out. If you’re approaching menopause or over 50, throw in a bone-mineral density test (BMD) to see how strong your bones are (which will only get stronger from lifting HEAVIER weights.) Doesn’t hurt to get an STD / STI check as well. They say it’s best to keep it in your pants, but that ain’t fun, is it? So do the world a favor and make sure your juicy parts aren’t jaded. Mine came back all positive which is a great thing. Wait a second, I mean NEGATIVE right? I’m kidding, you want all your results to be NEGATIVE, just as mine were. Instead of turning a blind eye, take responsibility for your actions by getting your blood analyzed bi-annually. You’ll be setting realistic goals and it’s a great way to CRUSH 2017. Without further ado, I want to introduce you to a qualified professional who can analyze my lab results.

Really stoked that my buddy Chris at Show-Up Fitness asked me to do a guest post for his blog. Love what he and his trainers do out there, applying sound training principles and science in helping people meet their personal fitness goals. And most of all, always emphasizing that the first and hardest step is just showing up!

Chris asked me to write about his blood work from his recent physical, in the hopes that I could further explain it. With his permission, his recent results were as follows:

Hb A1C 5.2%

Alkaline Phosphatase 60 U/L

Total Bilirubin 1.8 mg/dL

Alanine Aminotransferase 33 U/L

Lipid Panel

Cholesterol 164 mg/dL

triglyceride 92 mg/dL

HDL 80 mg/dL

LDL Calculated 66 mg/dL

Testosterone 613 ng/dL

To begin with, let's take a look at the Hemoglobin A1c (or HbA1c for short). The HbA1c is a common test that healthcare professionals use to screen for diabetes or, if you are already a known diabetic, to see how well your diabetes is being controlled. It is useful because it gives a good idea of what your blood sugars have been running over the previous several months, as opposed to just what it is at this very moment. Sort of like a baseball player's batting average gives a better indication of how good his season going, rather than just judging him by his last at-bat. A HbA1c below 5.7% is normal, and values between 5.7 to 6.4% are considered to be “pre-diabetic”. A value of greater than 6.5% is considered to be diagnostic of diabetes (1).

Next, let's look at the liver tests: the alkaline phosphatase, the total bilirubin, and the alanine aminotransferase. The liver is an incredibly complex organ, so obviously these tests are by no means comprehensive. But they do act as a good screening test to alert us that something could be wrong.

Alkaline phosphatase is an enzyme found in many parts of your body, but primarily concentrated in the liver, the bones, and (for pregnant women) in the placenta. With regards to the liver, alkaline phosphatase is an important part of the biliary system, so a raised level could indicate an obstruction. Similarly, the total bilirubin also will go up if the biliary system is obstructed. However, there are many other causes of elevations in these lab values, so often they just need to be repeated or to be followed up with an imaging test, such as an ultrasound. For Chris, both levels are normal, so no issues there!

Like alkaline phosphatase, alanine aminotransferase (ALT) is also an enzyme found throughout your body but concentrated heavily in liver cells. If your liver is damaged from hepatitis or any of a number of other causes, the cells release ALT into the blood stream causing the blood levels to rise. A level above 60 is generally considered abnormal and warranting further evaluation. Chris's value of 33 is entirely normal.

Chris also seems to be good with his lipid panel. The lipid panel is in general a very important part of our screening blood work to identify those at risk of developing heart disease. Interpreting and applying the results can depend on a variety of factors, such as whether or not you have other risk factors (e.g. diabetes or high blood pressure), but a total cholesterol under 200 and a low-density lipoprotein (LDL) cholesterol under 100 is acceptable for an average adult. Chris's triglyceride level is also great, being well under the goal of less than 150. With high-density lipoprotein, a higher number is actually desirable, preferably above 60. So Chris's value of 80 puts him in a low-risk category for cardiovascular disease.

Chris's testosterone levels are also within normal range, although this represents a bit of a more controversial topic. Testosterone levels generally go down with age, leading to many of the physiological effects you normally see as you get older. As a result, many have sought testosterone replacement therapy to overcome this normal decline. However, this approach is controversial as there do exist risks, most concerning of which is a potential increase in prostate cancer (2). Granted, the topic is very controversial, but with regards to over the counter testosterone replacement, the FDA specifically directs manufacturers of such products to state these products are only approved for men with low testosterone due to known causes (3). My personal recommendation is to only consider testosterone replacement in conjunction with your physician.

Anyways, looks like Chris is okay until his next check-up. I hope this information is useful to all of you. Be sure to check out my blog at www.ultra26sports.com/blog and follow me on social media (@ultra26sports) for more of my articles and info. Happy holidays and remember to take care of yourself and keep up showing up!

Chris Perry, MD, CISSN, CNSC

Founder/Owner Ultra 26 Sports Nutrition® Products, LLC

www.ultra26sports.com

Facebook/Instagram/Twitter: @ultra26sports

1. Chamberlain JJ, Rhinehart AS, Shaefer CF Jr, Neuman A. Diagnosis and Management of Diabetes: Synopsis of the 2016 American Diabetes Association Standards of Medical Care in Diabetes. Ann Intern Med. 2016 Apr 19;164(8):542-52.

2. Huggins C, Hodges CV. Studies on prostatic cancer: I. The effect of castration, of estrogen and of androgen injection on serum phosphatases in metastatic carcinoma of the prostate. 1941. J Urol. 2002 Jul;168(1):9-12.

3. Nguyen CP, Hirsch MS, Moeny D, Kaul S, Mohamoud M, Joffe HV. Testosterone and “Age-Related Hypogonadism”–FDA Concerns. N Engl J Med. 2015 Aug;373(8):689-91.