Measuring Results — Part Two: The Advanced
The 5 crucial lab tests for longevity & turning insights into lifestyle changes.
We previously covered how to measure results using the more basic and easily accessible tools. Today we’re doing a deep dive into more advanced methods of quantifying our health. Let’s dig in.
Going for blood tests at regular intervals provides great insight into your health at a molecular level. You can feel healthy and look fit, but without gaining insight into certain biomarkers in your blood, it’s impossible to know what’s really going on inside of your body.
Blood tests can show deficiencies and expose risks that you, as an individual, may be predisposed to. Keep in mind that, similar to a scale, many blood tests are a snapshot in time and can be impacted by various environmental factors. It’s highly recommended to obtain tests at certain intervals throughout the year, at roughly the same time of day, and with the same protocol leading up to the test.
For example, if you get a test done at 10am in January after completing a fasted workout and then another at 5pm in June after packing down a Big Mac and large fry you can’t expect to achieve meaningful and comparable results.
There are four blood tests and one non-blood test, included here for simplicity, that Dr. Peter Attia recommends, as each informs us of our certain predispositions:
Provides insight into what diseases you may be more or less at risk for. From there, you can tailor your lifestyle around mitigating risks.
LDL Particle Number via NMR*
This counts all of the LDL particles in your blood, which are primarily responsible for trafficking cholesterol to and from the heart and liver. The higher the number of LDL particles the greater the risk of cardiovascular disease.
LP(a) via NMR*
This is the most atherogenic particle in our bodies. If elevated, it’s a massive predictor of risk, particularly atherosclerosis and its related diseases, such as coronary heart disease and stroke, and something to act on.
IGF-1 (Insulin-like Growth Factor 1)
This is a strong driver of cancer. Your choice of diet can help keep IGF-1 low.
OGTT (Oral Glucose Tolerance Test)
This is performed by testing your blood for insulin and glucose at hour 0, hour 1, and hour 2. After a baseline measurement is obtained, you drink a glucose-water (sugar water) cocktail. Glucose is measured again at hour 1 and hour 2. The 1-hour mark is where you may begin to see early warning signs of elevated glucose levels which is defined as anything over 40-50 on insulin. Elevated glucose could represent hyperinsulinemia which may indicate further metabolic issues.
*NMR (Nuclear Magnetic Resonance) is a technology that can count the number of lipoproteins in your blood. Lipoproteins are substances made of protein and fat that carry cholesterol through our bloodstream. There are two main types of cholesterol: High-density lipoprotein (HDL) and Low-density lipoprotein (LDL).
I emailed my doctor about having these tests done and the response I got was something along the lines of “This is an extremely unusual request for a healthy 22-year-old man…” (I’d quote verbatim here but I deleted the email in frustration).
Sorry doctor, should I wait until you suspect that I have an illness or disease and then get a blood test to confirm I do at which point it’s far too late to take preventative or corrective action?
If you can’t tell by my sarcastic jousting, to me this response is indicative of one of the many issues with the healthcare system. Medicine is almost entirely focused on trying to cure those who have already developed an illness or disease.
Preventative medicine, or properly educating people on how to exercise, eat well, and otherwise take care of their body, is only evident to the determined seeker and is never prescribed as a way to reduce risk and cure or prevent illness.
The basics of improving health, which can reduce our risk for a bounty of diseases, help us cope with sickness better when we face it, and even cure certain illnesses, are overlooked and rarely discussed, certainly not within the confines of most doctors' offices.
Exercise, eat healthily, drink water, sleep well, practice gratitude, build a strong social circle or community, and spend time with those people. It’s simple stuff that we can all do and lead a longer and much better quality of life as a result.
Focusing on these basics is crucial and the advanced methods of analysis described here give us actionable insights that will allow us to feel better now and reduce our risk of illness in the future. A pill or drug should be our last resort, not our first option.
Back to the Tests
It seems that other than the OGTT, none of these tests are available in Canada. I’m digging deeper to figure out how to get these tests done so stay tuned.
In addition, and mainly to keep things simple, I’m planning to use InsideTracker to measure key biomarkers and better understand how to optimize my health. I’ll do a follow-up post on my experience, what I learned, how I applied it to my lifestyle, and whether I’d recommend the service.
Continuous Glucose Monitors
This one may sound a little extreme, especially for use by someone who isn’t diabetic. But bear with me, these do serve a purpose for diabetics and nondiabetics alike. A Continuous Glucose Monitor (CGM) is a wearable device that tracks your blood glucose (sugar) every couple of minutes throughout the day. The readings are then transmitted back to an app or device that can be read by the user.
CGMs are generally worn by those who have Type 1 Diabetes (T1D) which is a condition in which your pancreas doesn’t secrete insulin at all or makes too little insulin. Insulin plays a crucial role in regulating blood glucose levels. For those with T1D, it is essential to monitor these levels to prevent an episode of either low (hypoglycemia) or high (hyperglycemia) blood glucose – both of which are bad.
For those interested in enhancing their nutrition practices, CGMs can be useful in gauging how our bodies respond to certain foods by measuring the size of the spike in blood glucose that occurs after eating something. From a longevity standpoint, keeping our blood glucose as low as possible and avoiding wide fluctuations or spikes throughout the day is probably one of the most beneficial things we can do to extend our lifespan.
“The unadjusted numbers tell the real world story, which is once your blood sugar goes up, and this happens monotonically from a very low level, your rate of mortality skyrockets. That’s the take home message here.” — Peter Attia
Having high blood glucose, a condition called hyperglycemia, and wide variances in blood glucose throughout the day can cause serious health issues if left unattended. This is due to the damaging effect that elevated glucose levels will have on your pancreas, the insulin-producing organ, over time.
Hyperglycemia can damage blood vessels that supply blood to our organs thus increasing our risk of heart disease, stroke, kidney disease (ever tried dialysis?), and a host of other issues ranging from cancer to erectile dysfunction (men – if this doesn't motivate you to eat healthily, exercise, and sleep well, I don’t know what will).
This is where the CGM comes in. Since our bodies are all so different, the same potato that increases your glucose a regular or healthy amount could send mine through the roof. As we try different foods and monitor how our blood glucose responds to each, we can build a portfolio of foods we know that we respond well to and those which we should avoid.
If wearing a CGM isn’t something you’re interested in yet, check out this list of foods that are unlikely to spike your blood glucose. But remember, our bodies are all unique which means we can’t be certain of how we’re actually reacting to different foods unless we measure our body’s response at a molecular level. A CGM does just that.
The Longevity Minded Lab
I hope this article changed your framing as to how you approach and think about health. To become well-rounded in our approach, we have to think about how the things we do impact our bodies on a cellular level. You don’t need to become a scientist – I’m certainly not – to reframe your thinking towards how the things you do impact your overall health, not just your physique.
Even if you’re not ready to proactively get some bloodwork done or stick a CGM on your arm, some of the concepts in this article should shed light on key indicators you may want to start thinking about, look out for, or discuss with your doctor.
In the future, I’ll be experimenting with both blood tests, first through InsideTracker, and a CGM to gain molecular insights into my current health and the actions I can take through modifying exercise, sleep, and nutrient and supplement intake to improve it.
Join me on this journey by following along on Twitter.
I’m on a mission to help others take control of their health so they can live better, for longer. Help me help others by sharing Longevity Minded.
And, as always, please give me feedback on Twitter or by hitting reply to this email.
I have a good friend who has used CGMs for tracking as you mention here. She was showing me the report and there was this clear spike where she ate some tortilla chips-- super fascinating. I have a thing with needles, and while I can deep breathe my way through some bloodwork at a lab I don't think I can stomach installing the CGM (though I have heard it isn't really that bad). Anyway, looking forward to hearing more about what you discover, fascinating stuff.