Fit Fail – Bloodwork Breakdowns

Summary:

From my recent yearly physical, I received a poor grade on my blood work. My “health consultant” (doctor’s PA) prescribed a statin (Crestor) for my pre-CVD (CardioVascular Disease) “high” cholesterol and an anti-diabetic (Metformin) for my pre-diabetes high fasting blood glucose and elevated HbA1c. I have 90 days before I am to be re-tested. I’m going to get a much better (i.e. healthier) grade by NOT using “health consultant’s” prescriptions, but by using self-discipline, support and my critical thinking skills.

Details (story):

I got back the results of my bloodwork on Wednesday (blood drawn on Aug/23) and got some pretty undesirable news. Given the figures and my MD’s PA’s interpretation was that my cholesterol is bad (LDL is too high and my HDL is too low), my fasting blood glucose and HbA1c is too high. Ugh! Here are those undesirable numbers (where they are over or under the end of the recommended range / over or under change from last year’s numbers):

  1. Cholesterol, Total: 214 (+14/+57)
  2. LDL-C: 162 (+62/+57)
  3. HDL-C: 39 (-1/+2)
  4. LDL-P: 2984 (+1984/)
  5. Small LDL-P: 2414 (+1887)
  6. LDL Size: 19.9 (-0.6)
  7. Large HDL-P: <0.7 (-4.1)
  8. HDL Size: 8.3 (-0.9)
  9. LP-IR Score: 46 (+1)
  10. Glucose, Serum: 107 (+8)
  11. Hemoglobin A1c (HbA1c): 5.6 (+0 – top value of range – 6.4 or higher is considered diabetic)

There are some desirable numbers (measurement / over or under change from last year’s numbers):

  1. Triglycerides: 66 (-9)
  2. Vitamin D, 25 Hydroxy: 40.2 (first time measured)
  3. C-Reactive Protein, Quant: 0.5 (0.0)

What does all those numbers actually mean?

It turns out it largely depends up on who you ask. For example, my doctor’s PA interpreted these numbers to mean I have high cholesterol and need to be on a statin. And I have high blood sugar and HbA1c which means I am pre-diabetic. And if you ask the pharmaceutical industry, you would find they are the ones who funded the studies and marketing material my doctor and his PA have read, accepted and promote. And given the average person’s lacking taking responsibility for their personal health, it means that most of their patients just willing accept their newly diagnosed disease state and just begin popping the problem solving pills.

However, I am choosing to interpret them a slightly different way. I am choosing to see them as opportunities to make some adjustments to my list of the most important areas of managing  and maintaining healthy happy longevity (i.e. fun filled active old-age). They are listed in order of importance; i.e. their degree of influence in over-all fitness and health:

  1. Attitude – reducing stress and projecting a free, happy and successful possible future
  2. Sleep – repairing and growing basic physiological and neurological building blocks
  3. Breathing – maximizing and generating excess capacity in immune system function
  4. Diet – fuel for both the body and the brain
  5. Exercise – hormonal and neuro-chemical factory activation and pumping system

While I have listed them in order of influence, they all intricately depend upon the others. Having an effective (empowered and non-victimized) attitude is pretty moot if one has crappy sleep patterns and diet, regardless of how good the breathing and exercise patterns might be.

How did I get to this (blood work) state?

My numbers this time last year were awesome (according to my doctor) compared to those from this year.

  1. Did I really lose that much ground in one year?
  2. On my list of “Happy Longevity Influencers”, where did I go wrong to produce this bloodwork state?
  3. How can I feel confident about disregarding the “profession” (and pharmaceutical conglomerate marketing) advice I have received and just “do my own thing”?

1) Did I really lose that much ground in one year?

The answer isn’t simple, but can be summed up as probably. The first assumption to challenge is the objectivity of the numbers themselves. It turns out that even though the blood is taken from me in a fasting state, that does not mean the resulting measurements are precise. In other words, if I were to go in the next day in a fasted state, have blood drawn and the same numbers produced, some of the measurements could be substantially different (first 10 of the 11 listed above). Some would have very small differences (HbA1c, C-Reactive Protein and Vitamin D).

This same effect can be experienced by getting on the bathroom scale to measure my weight and body fat percentage. I can get up one morning, get on my scale 10 times in a row, and receive a different weight and body fat percentage every time. Granted, the measurement would fall in a range. For example, my weight might be 205.1, 205.7, 204.9, 205.2, etc. So, what’s my actual weight? The bathroom scale cannot tell you accurately. It can only give you an approximate answer with a +/-1.1lbs accuracy. To get a scale with an accuracy that has a smaller approximate range, you have to pay substantially more for it. And you have to frequently calibrate it with a known weight quantity just prior to using the device. It’s very accurate. And pretty darn inconvenient. And expensive too boot.

As a result, I do not put near the value in measurements 1-10 (or Triglycerides) as they have too much day-to-day fluctuation. If my insurance company paid for it, I am sure my doctor would be more than happy to take a series of measurements to get a tighter feel for the actual numbers. My insurance company won’t pay for it more than once a year (unless it’s for diagnosing an unusual problem). So, the single measurement is used with too much weight compared to it’s actual value accuracy.

And that leads use to the second assumption to challenge; that high LDL is “bad” or “undesirable”. And I don’t hold that assumption. I choose to imagine that nature wouldn’t have put a “bad” thing in us. The immune system is not “bad” just because a person has an auto-immune disorder (i.e. allergy). It’s just indicating there is some systemic issue that needs to be addressed that until address the immune system is going to react to a particular way. Said slightly differently, when one solves the root cause in the system, the “allergy” goes away because the immune system no longer has to “make do” with it’s current more stressful and undesirable response.

If one makes the assumption LDL is desirable and good, then one has to investigate why the liver choose to generate so much of it? In other words, rather than reduce my LDL directly using a statin, why not try to find other causes which might actually be responsible for the liver’s pathological response of producing high levels of LDL (and that’s assuming that I am not genetically predisposed to high levels of LDL in the first place which is a whole different tangent)? Back to this in a moment.

The next assumption to challenge is that lowing one’s LDL leads to a reduction in all-cause mortality, not just lowering one’s CVD risk. It turns out that there are a number of studies showing while statin use does seem to reduce CVD risk in middle aged males (not females), all-cause mortality goes UP. Translated, it appears that statins have a very limited affect on preventing CVD in a small age range of males while actually increasing non-CVD types of death to INCREASE!

If we return to the original question, “Did I really lose that much ground in one year?”, I want my answer to be based on the variables that have a longer term profile. And HbA1c seems to be the better candidate. And that variable did go up. And that variable is being found to have a strong correlation to all-cause mortality, not just the onset of Type 2 diabetes. So, I’m drawing the conclusion that I’m worse off than last year regarding my longevity goals.

2) On my list of “Happy Longevity Influencers”, where did I go wrong to produce this bloodwork state?

I was fine with my attitude and sleep. However, prior to the last 12 months, I did breathing exercises daily, played soccer once a week, practicing Yoga 2-3 times a week, went to CrossFit Plano 5 times a week, was on a pretty strict version of the Zone diet, did not eat mammal meat and was off of caffeine (no diet coke or iced tea). And then basically stopped all of that in the last 12 months. I just enjoyed a relaxing time not worrying about any of these areas strongly (large change in my personal life). I shifted to a low-carb-ish diet with at least one exception a week. And I didn’t work out more than once or twice a month, if that. It was not accidental. I chose to let go of all my old patterns. I wanted to restructure my life and wanted my patterns to re-emerge according to my new life priorities.

As a result, my insulin sensitivity dropped substantially. However, because I was eating large amounts of protein, I never lost much in the way of muscle tone or muscle mass. I just grew a nice large belly. I went from my comfortable size 34 pants to my comfortable 36 pants. And of course started sporting an additional 10-15lbs of weight almost exclusively in my mid-section. And then I didn’t really do anything special prior to my physical. Hence, my bloodwork being indicative of my imprecise diet combined with almost no exercise.

3) How can I feel confident about disregarding the “profession” (and pharmaceutical conglomerate marketing) advice I have received and just “do my own thing”?

In my research on statins, I was not please to see so many side-effects. And some of the side-effects have long term consequences related to physically intense activities. I am not willing to live with some of those possible consequences.

Additionally, I have been able to alter my numbers in these areas prior to now. So, I am convinced I can change them again using similar techniques that have worked for me previously.

Lastly, I have skin in the game and a deadline. I have to do the work to produce results within a relatively short time frame. That is very motivating to me.

What am I doing to do now?

I have continued my intermittent fasting and that seems to be having positive results in stopping my weight gains. However, it does not seem to be taking the weight off (even using my low-carb approach). And I find my current fasting schedule to be pleasing from an eating standpoint.

However, while I will continue with my intermittent fasting plan, I am now making some very large adjustments. More about these in my next post…

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One Response to “Fit Fail – Bloodwork Breakdowns”

  1. Fit Fail – Diet Designs « Chaotic3quilibrium's Weblog Says:

    […] Chaotic3quilibrium's Weblog Jim O'Flaherty, Jr.'s structured random thoughts and feelings… « Fit Fail – Bloodwork Breakdowns […]

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