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Posted by: | Posted on: November 12, 2019

Tylenol in Pregnancy Doubles Risk of Autism


Reproduced from original article:
https://articles.mercola.com/sites/articles/archive/2019/11/12/tylenol-during-pregnancy-causing-autism.aspx

Analysis by Dr. Joseph MercolaFact Checked  –  November 12, 2019
tylenol during pregnancy causing autism

STORY AT-A-GLANCE

  • Abnormal hormonal exposures in pregnancy can influence fetal brain development, and research published in 2014 warned acetaminophen is in fact a hormone disruptor
  • According to that 2014 study, use of acetaminophen during pregnancy was associated with a 37% increased risk of the child being diagnosed with hyperkinetic disorder, a severe form of attention deficit hyperactivity disorder (ADHD)
  • A 2019 study found that, compared to children of mothers with the lowest acetaminophen burden, children of mothers with the greatest exposure had a 286% higher risk for ADHD and a 362% higher risk for autism spectrum disorder (ASD) by the time they were about 9 years old
  • Findings published in 2016 revealed use of acetaminophen at 18 and 32 weeks of pregnancy were associated with a 42% higher risk of conduct problems and a 31% higher risk of hyperactivity symptoms in the child
  • Another 2016 investigation found children of both sexes whose mothers used acetaminophen during pregnancy were 41% more likely to present with ADHD symptoms at age 5. Boys were also more likely to have ASD

Many view over-the-counter (OTC) drugs as safe because they don’t require a prescription. Nothing could be further from the truth. Acetaminophen, for example, (also known as paracetamol and sold under the brand name Tylenol among others) is actually one of the more dangerous drugs you can get your hands on.

Despite statistics showing acetaminophen is the leading cause of acute liver failure in the U.S.,1 most people don’t think twice before downing those pills. Acetaminophen is also found in a wide variety of products designed to treat headache, fever and cold symptoms, as well as in prescription pain medications mixed with codeine or hydrocodone.2 And, most households have more than one of the over-the-counter products, which could easily lead to overdosing.

Although it was initially hailed as a safe drug for pain, by 2013 lawsuits were piling up, citing 50,000 trips to the emergency room every year, all due to Tylenol causing liver and kidney failure.3 The grim truth is that as early as 2005 scientists already knew that “severe acetaminophen hepatotoxicity leads to acute liver failure.”4

Not only that, reports also showed that unintentional overdoses accounted for hundreds of suicide attempts, deaths and liver transplants. Along that line, statistics from national database analyses in 20065 showed that acetaminophen accounted for an estimated 56,000 emergency room visits and 26,000 hospitalizations annually. The average annual death toll from acetaminophen overdose was 458.

A number of studies have also linked acetaminophen use during pregnancy with lifelong repercussions for the child, raising their risk of developing conduct disorders, hyperactivity and autism.

Acetaminophen Use Linked to Hyperactivity in Offspring

In 2014, a study in the journal JAMA Pediatrics6 revealed that “Research data suggest that acetaminophen is a hormone disruptor, and abnormal hormonal exposures in pregnancy may influence fetal brain development.” This is a significant concern, considering many pregnant women are likely to reach for an OTC pain reliever at some point during their pregnancy.

According to that 2014 study, use of acetaminophen during pregnancy was associated with a 37% increased risk of their child being diagnosed with hyperkinetic disorder, a severe form of attention deficit hyperactivity disorder (ADHD).

Their children were also 29% more likely to be prescribed ADHD medication by the time they were 7 years old. The strongest associations were observed in mothers who used acetaminophen in more than a single trimester, and the greater the frequency of use, the more likely their child was to experience behavioral problems. As reported by Forbes at the time:7

“Acetaminophen can cross the placenta, making its way to the fetus and its delicate developing nervous system. The drug is a known endocrine (hormone) disrupter, and has previously been linked to undescended testes in male infants.

Since the maternal hormone environment plays a critical role in the development of the fetus, the authors say that it’s ‘possible that acetaminophen may interrupt brain development by interfering with maternal hormones or via neurotoxicity such as the induction of oxidative stress that can cause neuronal death.’”

Similar findings were published in 2016. This study,8 also published in JAMA Pediatrics, found use of acetaminophen at 18 and 32 weeks of pregnancy was associated with a 42% higher risk of conduct problems and a 31% higher risk of hyperactivity symptoms in the child.

When the mother used acetaminophen at 32 weeks of pregnancy, the child also had a 29% higher risk of having emotional problems and a 46% higher risk of “total difficulties.”

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Tylenol in Pregnancy May Double or Triple Risk of Autism

A study9,10,11 published online October 30, 2019, in JAMA Psychiatry further strengthens the link between acetaminophen use and ADHD, while also noting an increased risk for autism spectrum disorder (ASD). According to the authors:12

“Prior studies have raised concern about maternal acetaminophen use during pregnancy and increased risk of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in their children; however, most studies have relied on maternal self-report …

In this cohort study of 996 mother-infant dyads from the Boston Birth Cohort, cord plasma biomarkers of fetal exposure to acetaminophen were associated with significantly increased risk of childhood attention-deficit/hyperactivity disorder and autism spectrum disorder.”

Compared to children of mothers with the lowest acetaminophen burden (first tertile, based on cord plasma biomarkers for acetaminophen), children of those in the second tertile had a 226% higher risk of being diagnosed with ADHD, and a 214% higher risk for an ASD diagnosis by the time they were about 10 years old (average age 9.8 years).

Those with the greatest (third tertile) acetaminophen burden had a 286% higher risk for ADHD and a 362% higher risk for ASD. As noted by the authors,13 their findings “support previous studies regarding the association between prenatal and perinatal acetaminophen exposure and childhood neurodevelopmental risk.”

More Evidence Against Taking Acetaminophen During Pregnancy

In addition to the studies already mentioned, a number of others have also documented this disturbing link between acetaminophen use during pregnancy and neurological problems in the children. Among them:

A 2013 study14 published in the International Journal of Epidemiology found “children exposed to [acetaminophen] for more than 28 days during pregnancy had poorer gross motor development, communication, externalizing behavior, internalizing behavior and higher activity levels” than unexposed children at age 3. Use of ibuprofen was not associated with these neurodevelopmental effects.

A 2016 Spanish investigation15,16 published in the International Journal of Epidemiology found children of both sexes whose mothers used acetaminophen during pregnancy were 41% more likely to present with ADHD symptoms at age 5. Boys were also more likely to have ASD. As noted by the authors:

“Prenatal acetaminophen exposure was associated with a greater number of autism spectrum symptoms in males and showed adverse effects on attention-related outcomes for both genders. These associations seem to be dependent on the frequency of exposure.”

Aside from a higher risk of neurodevelopmental problems, studies have also shown:

Use of acetaminophen during pregnancy may increase your risk of pre-eclampsia and thromboembolic diseases17

Taking the drug for more than four weeks during pregnancy, especially during the first and second trimester, moderately increases the risk of undescended testicles in boys18

Using acetaminophen in the third trimester increases your risk of preterm birth19

Acetaminophen After Birth Also Linked to Autism

The use of acetaminophen after birth may also lead to problems. In fact, some argue the increased risk of autism we see following childhood vaccinations may in fact be due to the inappropriate use of acetaminophen after the shots are given — not the vaccines.20

In my view, it seems irrational to give toxic injections a free pass, but acetaminophen administration could certainly make matters worse. A small preliminary study21 published in 2008 concluded “acetaminophen use after measles-mumps-rubella vaccination was associated with autistic disorder.”

Debunkers of the vaccine-autism connection point to statistics showing that, in the early 1980s, when the autism trend began its precipitously steep incline, vaccines were not only being added to the vaccination schedule, but pediatricians were also told to start using acetaminophen instead of aspirin, as aspirin had been linked to Reye’s syndrome.22

A 2017 study23 even claims “The use of acetaminophen in babies and young children may be much more strongly associated with autism than its use during pregnancy, perhaps because of well-known deficiencies in the metabolic breakdown of pharmaceuticals during early development.”

While parents give babies and infants Tylenol for numerous reasons, one instance in which Tylenol is routinely used is after childhood vaccinations, and according to research24 published in the journal Lancet in 2009, acetaminophen might actually render vaccinations less effective when administered together, which is yet another reason to avoid giving acetaminophen to your baby.

Infants who received acetaminophen right after getting a vaccination experienced lowered immune response, developing significantly fewer antibodies against the disease they were vaccinated against.

The vaccines used in the study were for pneumococcal disease, Haemophilus influenzae type b (Hib), diphtheria, tetanus, whooping cough, hepatitis B, polio and rotavirus. The authors concluded that:

“Although febrile reactions significantly decreased, prophylactic administration of antipyretic drugs at the time of vaccination should not be routinely recommended since antibody responses to several vaccine antigens were reduced.”

Understand the Risks Associated With Acetaminophen

Pregnant women are not the only ones that need to be careful in their use of this common pain reliever and fever reducer. Acetaminophen overdose is responsible for nearly half of all acute liver failure cases in the U.S.,25 and its use has also been linked to three serious skin reactions; two of which typically require hospitalization and can be fatal.

These problems can happen to anyone. A major problem is that while acetaminophen is considered safe when taken as recommended, the margin between a safe dose and a potentially lethal one is very small.

Provided you have a healthy liver and do not consume more than three alcoholic beverages a day, the recommended oral dose of acetaminophen is up to 1,000 milligrams (mg) every four to six hours, not to exceed 3 grams (3,000 mg) per day.26 As noted by U.S. San Diego Health:27

“To appreciate how easy it is to exceed the safe limit, consider that one extra strength Tylenol tablet contains 500 mg of acetaminophen. Take two tablets at a single dose three times a day and you are at the maximum recommended dose.

If you then inadvertently consume an acetaminophen-containing allergy medication or cold medication in addition, you risk damaging your liver … The key is to be aware of how much acetaminophen you are consuming.”

What’s more, research28 has shown taking just a little more than the recommended dose over the course of several days or weeks (referred to as “staggered overdosing”) can be riskier than taking one large overdose. So, in summary, please be aware that your risk of severe liver injury and/or death increases if you:

  • Take more than one regular strength (325 mg) acetaminophen when combined with a narcotic analgesic like codeine or hydrocodone.
  • Take more than the prescribed dose of an acetaminophen-containing product in a 24-hour period.
  • Take more than one acetaminophen-containing product at the same time — Make sure to read the list of ingredients on any other over-the-counter (OTC) or prescription drug you take in combination.
  • Drink alcohol while taking an acetaminophen product — Research29,30 suggests acetaminophen increases your risk of kidney damage by 123% if taken with alcohol, even if the amount of alcohol is small.

Why You Should Keep NAC in Your Medicine Cabinet

Given their health risks, I generally do not recommend using acetaminophen-containing drugs for minor aches and pains. There are many other ways to address acute and chronic pain that do not involve taking a medication. For a long list of pain-relieving alternatives, please see this previous article.

That said, pain relievers like acetaminophen do have their place. Post-surgical pain, for example, or other severe pain may warrant its temporary use. For those instances, I recommend taking it along with N-acetyl cysteine (NAC), which is the rate-limiting nutrient for the formation of the intracellular antioxidant glutathione.

It is believed that the liver damage acetaminophen causes is largely due to the fact that it can deplete glutathione, an antioxidant compound secreted by your liver in response to toxic exposure. Glutathione also helps protect your cells from free radical damage.

NAC is the standard of care in cases of acetaminophen overdose, approved in 1985 by the FDA as an antidote for acetaminophen toxicity.31 Mortality due to acetaminophen toxicity has been shown to be virtually eliminated when NAC is promptly administered. So, whether you are taking Tylenol in prescription or over-the-counter form, I strongly suggest taking NAC along with it.

Keep in mind, however, that there’s no data showing whether taking NAC would ameliorate the autism or ADHD risk for pregnant women, so if you’re pregnant, I would recommend just avoiding acetaminophen. If you absolutely need an OTC pain reliever, ibuprofen appears to be a safer choice. The same caveat for lack of data goes for infants.

Tips for a More Toxin-Free Pregnancy

I believe it’s imperative to be aware of, and abstain from, as many potential neurotoxins as possible during pregnancy to protect the health of your child. Our environment is saturated with such a wide variety of toxins, and you may not be able to defend yourself against each and every one of them, but you do have a great degree of control within your own immediate household.

The food and drinks you ingest, and the household, personal care and medical products you opt to use during pregnancy can have a distinct impact on your child’s development and long-term health.

ADHD and autism have both skyrocketed in prevalence the past few decades, signaling that something is going terribly wrong. Our environment is becoming overly toxic, and children are paying the price for our chemical-laden lifestyles. OTC drugs like acetaminophen are part of this toxic burden that infants have to contend with.

Avoiding any and all unnecessary drugs is one aspect you have a large degree of control over. Below are several more. Rather than compile an endless list of what you should avoid, it’s far easier to focus on what you should do to lead a healthy lifestyle with as minimal a chemical exposure as possible. This includes:

As much as you’re able, buy and eat organic produce and grass fed, pastured animal foods to reduce your exposure to agricultural chemicals like glyphosate. Steer clear of processed, prepackaged foods of all kinds. This way you automatically avoid pesticides, artificial food additives, dangerous artificial sweeteners, food coloring, MSG and unlabeled genetically engineered ingredients.

Also avoid conventional or farm-raised fish, which are often heavily contaminated with PCBs and mercury. Wild caught Alaskan salmon is one of the very few fish I still recommend eating, as well as small fatty fish like anchovies, sardines, mackerel and herring. If you don’t eat these on a regular basis, consider taking a krill oil supplement to optimize your omega-3 level.

Store your food and beverages in glass rather than plastic, and avoid using plastic wrap and canned foods to avoid exposure to plastic chemicals known to disrupt endocrine function.
Install an appropriate water filter on all your faucets (even those in your shower or bath).
Only use natural cleaning products in your home.
Switch over to natural brands of toiletries such as shampoo, toothpaste, antiperspirants and cosmetics. The Environmental Working Group has a great database32 to help you find safer personal care products. I also offer one of the highest quality organic skin care lines, shampoo and conditioner, and body butter that are completely natural and safe.
Avoid using artificial air fresheners, dryer sheets, fabric softeners or other synthetic fragrances. Relinquish the idea that fragrance equals “clean.” It doesn’t. Clean laundry need not smell like anything at all.
Replace your nonstick pots and pans with ceramic or glass cookware to avoid toxic PFOA chemicals.
When redoing your home and/or shopping for baby items, look for “green” toxin-free alternatives. Avoid plastic toys, especially teething toys, and make sure items like mattresses, car seats and nursing pillows do not contain toxic flame retardant chemicals.
Replace your vinyl shower curtain with one made of fabric, or install a glass shower door. Most all flexible plastics, like shower curtains, contain dangerous plasticizers like phthalates.
Avoid spraying pesticides around your home or insect repellants that contain DEET on your body. There are safe, effective and natural alternatives.
 Sources and References
Posted by: | Posted on: November 2, 2019

Echinacea Benefits

Written by Brenton Wight – LeanMachine, 11th November 2019
© 2019 – This article is copyrighted by Brenton Wight and BJ & HJ Wight trading as Lean Machine

What is Echinacea?

Echinacea is a flowering plant in the daisy family, also known as purple coneflower.
There are nine species, however only three are normally used as supplements:

  • Echinacea purpurea
  • Echinacea angustifolia
  • Echinacea pallida

Most commonly used as an over-the-counter remedy to build immunity for colds, allergies and flu, but also  used for inflammation, pain, migraines and blood glucose.

Native to North America but cultivated almost anywhere.
Upper parts and roots are typically used in tablets, tinctures, extracts and teas.
Beneficial Compounds in Echinacea include:

  • Caffeic acid
  • Alkamides
  • Phenolic acid
  • Rosmarinic acid
  • Polyacetylenes

Suggested health benefits include:

  • Antioxidants, including flavonoids, cichoric acid and rosmarinic acid
  • Alkamides that enhance antioxidant activity
  • Immunity to infections and viruses. In studies, Echinacea lowered risk of colds by 50% and  duration by one and a half days
  • Helps blood glucose control by suppression of carbohydrate-digesting enzymes, also increased insulin sensitivity, and helps stop glucose levels plummeting in hypoglycemia
  • Shown to help lower blood pressure, probably by helping to control blood glucose
  • Reduced anxiety due to action of alkamides, rosmarinic acid and caffeic acid
  • Anti-inflammatory, via compounds that reduce inflammatory markers
  • Reduced pain, especially in those who received no benefit from standard pain relief drugs
  • Reduced swelling
  • Improved skin hydration and reduced wrinkles with Echinacea cream
  • Acne (caused by Propionibacterium) suppressed with Echinacea cream
  • Eczema symptoms reduced by Echinacea cream
  • Shown to suppress cancer cell growth and trigger cancer cell death (Apoptosis), a benefit of  the chicoric acid component
  • Shown to increase apoptosis in pancreas and colon cancer cells

Issues with cream products: Echinacea extract is difficult to incorporate into commercial skin care products due to short shelf life.

Side Effects

Echinacea has been shown safe and tolerated well for short-term use, but long-term studies have not been carried out. Rare side effects (mainly in those with allergies to daisies, chrysanthemums, marigolds, ragweed) include:

  • Stomach pain, nausea
  • Shortness of breath
  • Rashes, hives, itchy skin
  • Swelling

Those trying Echinacea for the first time should start with a tiny dose to test for any reaction.

Who should NOT consume Echinacea

Because Echinacea stimulates the immune system, those with any autoimmune disorder, or those taking immunosuppressive drugs (such as those for transplant rejection) should avoid taking Echinacea.

Dosage

No official dosage exists, partly because studies have varied in quantity and quality of the product used, and products sometimes do not contain the amount and/or strength specified, so it is wise to purchase products from trusted brands such as those recommended by LeanMachine in this article.

Studies in the immunity properties of Echinacea suggest the following doses:

Summary

Echinacea has a long and successful history of use in many countries, with rare allergy side-effects, and may help with immunity, allergies, anxiety, skin, cancer, blood pressure, pain, swelling and more.

There are many studies on Echinacea, but results are mixed, with some showing benefits and others showing none. Most studies were mouse studies, test tube studies, petri dish studies, etc and all were of short duration. However, LeanMachine suggests that the antioxidant benefits alone are worthwhile, and long-term studies are expected to show better health outcomes for seniors because their cardiovascular system should be in better shape, and their cancer risk should be lower.

Children

Generally safe for children over age 2 to take Echinacea supplements and drink Echinacea teas, and studies show benefits to children taking Echinacea.

Pregnancy

Study:
www.webmd.com/baby/news/20001128/study-shows-echinacea-safe-during-pregnancy
This study shows Echinachea is safe, but because the study involved only about 200 women, safety cannot be guaranteed absolutely.

Drug Interactions

Risk of drug interactions is relatively low, but some medications are affected by Echinacea.
Some interactions can be a life-or-death situation, so always inform the doctor if taking any herbal products, supplements, vitamins, minerals etc.

Posted by: | Posted on: October 28, 2019

How Leucine in Whey Helps Prevent Muscle Loss


Reproduced from original article:
https://articles.mercola.com/sites/articles/archive/2019/10/28/leucine-sarcopenia.aspx

Analysis by Dr. Joseph Mercola  – Fact Checked
October 28, 2019
leucine sarcopenia

STORY AT-A-GLANCE

  • The loss of muscle mass that occurs with age is known as sarcopenia, the most obvious cause of which is inactivity
  • Your muscles need sufficient amounts of protein. Poor digestion can impede your ability to absorb protein, thereby contributing to sarcopenia
  • Whey protein has been shown to stimulate muscle protein accretion and stave off sarcopenia the best, in part due to its higher leucine content, which helps regulate the turnover of protein in your muscle
  • Whey protein also contains the master antioxidant glutathione. Glutathione is thought to play an important role in sarcopenia specifically, as patients with sarcopenia tend to have higher levels of oxidative stress
  • The type of exercise you do can also make a big difference. Blood flow restriction (BFR) training is one of the best ways to prevent sarcopenia, and is the safest form of strength training for those who are frail and elderly

The loss of muscle mass that occurs with age is known as sarcopenia, the most obvious cause of which is inactivity. Sarcopenia can progress at a rate of approximately 0.8% skeletal muscle loss per year from the fifth decade in adult life.1 It has an estimated prevalence of 10% in adults older than 60 years,2 rising to more than 50% in adults older than 80 years.3,4

Your diet also plays a role, as your muscles need sufficient amounts of protein to stay viable, as does your ability to digest and absorb protein. As noted in a 2011 paper5 in the American Journal of Nutrition:

“Sarcopenia has been attributed to a diminished muscle protein synthetic response to food intake. Differences in digestion and absorption kinetics of dietary protein, its amino acid composition, or both have been suggested to modulate postprandial muscle protein accretion.”

In other words, while you need protein to build and maintain muscle, some protein is more easily digested and absorbed than others, so eating the right kind of protein can make a difference in your risk for sarcopenia.

Whey protein, a byproduct of cheese production, has long been acknowledged as an excellent source of protein. In this 2011 study, in which whey protein was compared to casein and casein hydrolysate, whey protein was found to stimulate muscle protein accretion (and hence stave off sarcopenia) the best — in part due to its higher leucine content.

The type of exercise you do can also make a big difference. I now believe blood flow restriction (BFR) training is one of the best ways to prevent sarcopenia. Taken together, leucine supplementation through whey and BFR can go a long way toward protecting your muscles as you age.

Leucine Regulates Protein Turnover in Muscle

One of the reasons why leucine is so important for the prevention of sarcopenia is because it helps regulate the turnover of protein in your muscle. According to a 1975 paper6 in The Journal of Clinical Investigation, leucine may also “play a pivotal role in the protein-sparing effect of amino acids.” As explained in a more recent study,7 published in 2017:

“Protein ingestion produces a strong anabolic stimulus that elevates muscle protein synthesis. The ability of a serving of protein to stimulate muscle protein synthesis (MPS) is dependent on absorption and blood kinetics of amino acids, amount of protein ingested, and the amino acid composition of the protein source.

Only the essential amino acids (EAA), especially leucine, initiate an immediate increase in MPS. Being a rapidly digested protein with a high leucine content, whey has been shown to stimulate MPS more than equal amounts of casein and soy in the first hours after exercise …

At the molecular level the mechanistic target of rapamycin complex 1 (mTORC1) and its substrates … are believed to largely be responsible for the protein synthetic response to resistance exercise and protein intake, with resistance exercise potentiating the effect of protein ingestion.”

In other words, the most effective way to optimize muscle building is to use a combination of resistance training followed by a protein meal, with leucine-rich whey being one of the most efficient.

Ori Hofmekler, author of “Unlock Your Muscle Gene: Trigger the Biological Mechanisms That Transform Your Body and Extend Your Life,” is an expert on how to use food to build muscle and improve your health, and we have previously discussed the profound benefits of whey protein for muscle building in particular.

It is important to understand, though, that simply taking leucine is likely to be ineffective, as demonstrated by a recent Harvard study.8 In it, men over the age of 65 with a daily intake of 0.8 grams of protein per kilo per day were compared to men receiving 1.3 grams of protein per kilo per day. They found the higher protein group did not increase lean body mass, muscle strength or physical function, most likely because they were not exercising.

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The Importance of Glutathione for Prevention of Sarcopenia

Whey protein also contains another really important health component: glutathione. While many whole foods contain glutathione or its precursors, organic grass fed whey protein is one of the richest sources of this “master antioxidant.”

Glutathione is found in every cell of your body. It protects your cells from free radical damage, and is especially important for liver health. It differs from other antioxidants in that its intracellular and has the unique ability to optimize the activity of all other antioxidants.

It plays a crucial role in detoxification, and protects your cells form the damaging effects of radiation, chemicals and environmental pollutants. It’s also an essential factor in energy utilization and healthy immune function, and glutathione deficiency has been linked to a wide range of health problems, including Alzheimer’s9 and Parkinson’s,10 heart disease,11 autoimmune diseases,12 inflammatory conditions13 and mitochondrial dysfunction.14

Glutathione is thought to play an important role in sarcopenia specifically, as patients with sarcopenia tend to have higher levels of oxidative stress.15 As noted in the 2012 review,16 “Rationale for Antioxidant Supplementation in Sarcopenia:”

“Sarcopenia is an age-related clinical condition characterized by the progressive loss of motor units and wasting of muscle fibers resulting in decreased muscle function.

The molecular mechanisms leading to sarcopenia are not completely identified, but the increased oxidative damage occurring in muscle cells during the course of aging represents one of the most accepted underlying pathways.

In fact, skeletal muscle is a highly oxygenated tissue and the generation of reactive oxygen species is particularly enhanced in both contracting and at rest conditions.

It has been suggested that oral antioxidant supplementation may contribute at reducing indices of oxidative stress both in animal and human models by reinforcing the natural endogenous defenses …

Antioxidants are substances able to inhibit the rate of oxidation. Mainly, antioxidant enzymes (e.g., catalase, superoxide dismutase (SOD), glutathione peroxidase, glutathione reductase) work to maintain a state of balance preventing the transformation of ROS and to convert them into more stable molecules (like water and molecular oxygen).”

Prevent Muscle Wasting With BFR

While high-quality protein intake is important, to effectively build and maintain muscle you also need strength training. Unfortunately, many elderly individuals shy away from resistance training for fear of injury.

BFR is ideal in such situations, as the amount of weight you use is so low that your risk for injury is minimal. For a more detailed discussion of BFR and how it’d done, see “Build Muscle Faster, Safer and Easier With BFR Training.”

Please understand, though, that this article is a mere teaser. I will be providing a comprehensive report within the next month about how to do BFR, its history and instructional videos. I have been working on this for nearly six months now and it is nearly ready.

In the meantime it is important to know that BRF involves exercising your muscles while partially restricting arterial inflow and fully restricting venous outflow in either both proximal arms or legs.17 Venous flow restriction is achieved by using thin elastic bands on the extremity being exercised.

By restricting the venous blood flow, you create a relatively hypoxic (low oxygen) environment in the exercising muscle, which in turn triggers a number of physiological benefits, including the production of hormones such as growth hormone and IGF-1, commonly referred to as “the fitness hormones.”18

It also increases vascular endothelial growth factor (VEGF), which acts as “fertilizer” for growing more blood vessels and improving their lining (endothelium).

I believe BRF is one of the best strategies available to address the epidemic of sarcopenia,19 and for most people who are not competitive athletes it may be the only form of resistance training they need.

It’s important to realize that sarcopenia is not just cosmetic, and it’s not just about frailty. Your muscle tissue, which makes up about half of your body’s tissues, is a metabolic organ, an endocrine organ. Your muscle tissue makes cytokines and myokines, and is a sink for glucose.

Insulin resistance and Type 2 diabetes accelerate sarcopenia, and research shows glucose fluctuations are independently associated with this condition. As noted in one 2019 study,20 “glucose fluctuations were significantly associated with a low muscle mass, low grip strength, and slow walking speed.”

BFR Effectively Counteracts Sarcopenia

The effectiveness of BFR for the prevention and reversal of muscle wasting is directly addressed in an April 2019 study21 in the Journal of Cachexia, Sarcopenia and Muscle:

“Muscle wasting leads to significant decrements in muscle strength, cardiorespiratory, and functional capacity, which increase mortality rates. As a consequence, different interventions have been tested to minimize muscle wasting.

In this regard, blood flow restriction (BFR) has been used as a novel therapeutic approach to mitigate the burden associated with muscle waste conditions.

Evidence has shown that BFR per se can counteract muscle wasting during immobilization or bed rest. Moreover, BFR has also been applied while performing low intensity resistance and endurance exercises and produced increases in muscle strength and mass.

Endurance training with BFR has also been proved to increase cardiorespiratory fitness. Thus, frail patients can benefit from exercising with BFR due to the lower cardiovascular and join stress compared with traditional high intensity exercises.

Therefore, low intensity resistance and endurance training combined with BFR may be considered as a novel and attractive intervention to counteract muscle wasting and to decrease the burden associated with this condition.”

Leucine Dosage and Timing

As mentioned, leucine is a branched-chain amino acid that serves multiple functions, one of which is signaling the mTOR mechanism, which causes protein to be created and builds your muscle. However, according to Hofmekler, for optimal results you need far higher amounts of leucine than the recommended daily allowance.

The reason for this is because most of the leucine is used up as an energy substrate or building block rather than an anabolic agent. The typical requirement for leucine to maintain body protein is 1 to 3 grams daily. However, to optimize its anabolic pathway, Hofmekler insists (and research shows22) you need somewhere between 8 to 16 grams of leucine per day, in divided doses.23,24

Getting that amount of leucine from your regular diet could be pretty difficult. For example, 4.6 eggs will provide you with 2.5 grams of leucine,25 which means you’d have to eat nearly 15 eggs to reach the 8-gram minimum.

For most, that simply wouldn’t be possible and would overdose you on protein (105 grams of protein from the eggs alone). High-quality whey, on the other hand, contains about 10% leucine (10 grams of leucine per 100 grams of protein).26 So, 80 grams of whey protein will give you 8 grams of leucine.

Ideally you’ll want to consume the whey about 30 to 60 minutes before exercise, and again about an hour after your workout. This will help increase both fat burning and muscle building.

A 2010 study27 found that consuming whey protein (20 grams of protein per serving) 30 minutes before resistance training boosts your body’s metabolism for as much as 24 hours after your workout.

Other Health Benefits of Whey Protein

Whey protein has undergone extensive study, revealing an impressive array of benefits over and above its ability to support healthy muscle growth. For example, studies show whey consumption may also:

  • Help lower blood pressure and improve vascular function if you’re overweight and/or have high blood pressure28
  • Support normal blood sugar levels and boost insulin sensitivity in Type 2 diabetics29
  • Reduce inflammation,30 including inflammation associated with inflammatory bowel disease (IBD)31 — In the case of IBD, researchers have suggested its protective actions may be the due to its ability to stimulate intestinal mucin synthesis and modify the composition of the gut microbiome
  • Help normalize your weight — Not only is whey protein very filling, thereby reducing hunger pangs32,33,34 it also boosts metabolism35 (allowing you to burn more calories) and helps maintain lean muscle mass while shedding excess fat stores36

Guidelines for Buying High-Quality Whey

Whey derived from cheese manufacturing that uses raw grass fed milk is the highest quality whey you can possibly find today. One of the most important components of the whey is glycomacropeptides (GMP), which have amazing immuno components that are critically important for your gut flora.

However, only whey produced from raw milk cheese contains GMP. Other varieties do not. Whey isolate is a clearly inferior form of whey that should be avoided, because once the fat has been removed, you lose some of the most important components of its immunological properties. So, to ensure you’re getting a high-quality product, make sure the whey you’re buying is:

Organic (no hormones or genetically engineered ingredients) Grass fed Made from unpasteurized (raw) milk
Cold processed (as heat destroys whey’s fragile molecular structure) Minimally processed Full of rich, creamy flavor
Water soluble Sweetened naturally, not artificially Highly digestible — Look for medium chain fatty acids (MCTs), not long chain fatty acids

Sarcopenia Is Not an Inevitable Outcome of Aging

While muscle loss occurs with age, it’s not an inevitable outcome — provided you take proactive measures. To summarize, the way you prevent it is by regularly engaging in some form of resistance training, and BFR has many advantages that makes it an ideal choice.

This is especially true for those who are older, frail or struggling with a condition that makes regular strength training difficult or potentially dangerous. In addition to that, you’ll want to make sure you’re getting enough high-quality protein.

Organic grass fed whey protein is ideal, as it provides high amounts of both leucine and glutathione, both of which are important for muscle growth and maintenance.

– Sources and References
Posted by: | Posted on: October 14, 2019

Health Benefits of MSM — A Powerful Sulfur Donor


Reproduced from original article:
https://articles.mercola.com/sites/articles/archive/2019/10/14/msm-health-benefits.aspx

Analysis by Dr. Joseph Mercola – Medically reviewed by Dr. Stephanie Seneff
Fact Checked – October 14, 2019
msm health benefits

STORY AT-A-GLANCE

  • Sulfur is the third most abundant mineral in your body and plays important roles in many bodily processes, including metabolism and detoxification
  • Sulfur bonds are required for proteins to maintain their shape, and these bonds determine the biological activity of the proteins. Sulfur is also required for the proper structure and biological activity of enzymes
  • Sulfur is crucial for healthy liver function and the prevention of liver disease. A derangement in sulfur amino acid metabolism is found even in mild forms of liver disease
  • Excellent sources of sulfur include homemade bone broth, organic pastured eggs, grass fed meats, seafood, cruciferous vegetables and alliums like onions and garlic. Sulfur can also be obtained through supplementation with MSM and/or by taking Epsom salt baths
  • MSM is widely used in the treatment of pain, especially pain associated with arthritic conditions. Research has shown it can significantly decrease pain and improve physical function in patients with osteoarthritis of the knee

Sulfur is a somewhat “forgotten” nutrient you don’t hear mentioned very often, but it’s very important for optimal body function and health. You get most of your sulfur from certain proteins in your diet, specifically the amino acids methionine, cysteine, cystine, homocysteine, homocystine and taurine.1

Of these, the two most important sources are methionine and cysteine. Methionine is an essential amino acid, which means it cannot be synthesized by your body and must be supplied through your diet. Cysteine is conditionally essential, because it can be synthesized from methionine but not from inorganic forms of sulfur.2

Neither of these primary sulfur-containing amino acids is stored in your body per se, although glutathione is a key storage form for sulfur.3 Glutathione is composed of three amino acids: cysteine, glutamate and glycine, and is your body’s most potent antioxidant.

Glutathione also keeps many other antioxidants performing at peak levels, and cysteine availability is thought to be a rate-limiting factor for glutathione synthesis.4

While sulfur is found in many foods, sulfur deficiency may still be quite common5 — in part due to sulfur deficiency in crops,6 and in part due to low consumption of sulfur-rich foods7 such as leafy greens, cruciferous veggies, alliums8 such as garlic and onions, seafood, grass fed meats and organic pastured eggs.

Frequent use of drugs that require sulfur for excretion and/or detoxification can also contribute to an inadequate sulfur status. Acetaminophen is one such example.9 A vegan diet can also put you at increased risk for sulfur deficiency, because plant-based foods contain fewer sulfur-containing amino acids than animal-based foods.10

The Importance of Sulfur

According to Stephanie Seneff, Ph.D., who has written several papers11,12,13,14 on sulfur and sulfur metabolism and its role in human disease, sulfur plays a role in many biological processes, including metabolism15 and the sulfonation of hormones,16 and deficiency appears to play a role in a wide range of health problems and diseases, including:

  • Obesity
  • Heart disease
  • Chronic fatigue syndrome
  • Alzheimer’s disease
  • Autism17

Required in the creation of connective tissues such as cartilage, tendons and ligaments, sulfur is also essential for healthy joints, and deficiency has been linked to joint pain and joint-related diseases.18 Other benefits, uses and sources are also noted in the paper “Sulfur in Human Nutrition and Applications in Medicine”:19

“Methylsulfonylmethane (MSM), a volatile component in the sulfur cycle, is another source of sulfur found in the human diet … Organic sulfur, as SAAs [sulfur-containing amino acids], can be used to increase synthesis of S-adenosylmethionine (SAMe), glutathione (GSH), taurine, and N-acetylcysteine (NAC).

MSM may be effective for the treatment of allergy, pain syndromes, athletic injuries, and bladder disorders.

Other sulfur compounds such as SAMe … taurine, glucosamine or chondroitin sulfate, and reduced glutathione may also have clinical applications in the treatment of a number of conditions such as depression, fibromyalgia, arthritis, interstitial cystitis, athletic injuries, congestive heart failure, diabetes, cancer, and AIDS.”

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Sulfur 101

As explained by the featured study above, sulfur is the third most abundant mineral in your body, based on percentage of total body weight.20 Sulfur bonds are required for proteins to maintain their shape, and these bonds determine the biological activity of the proteins.

For example, hair and nails consist of a tough protein called keratin, which is high in sulfur, whereas connective tissue and cartilage contain proteins with flexible sulfur bonds, giving the structure its flexibility.

With age, the flexible tissues in your body tend to lose their elasticity, leading to sagging and wrinkling of skin, stiff muscles and painful joints. A shortage of sulfur likely contributes to these age-related problems.

In addition to bonding proteins, sulfur is also required for the proper structure and biological activity of enzymes. If you don’t have sufficient amounts of sulfur in your body, enzymes cannot function properly.

A cascade of health problems may thus ensue, since your metabolic processes rely on biologically active enzymes. You can learn more about this in “Enzyme Fundamentals.” Sulfur also plays an important role in:

Your body’s electron transport system, as part of iron/sulfur proteins in mitochondria, the energy factories of your cells21
Synthesizing important metabolic intermediates, such as glutathione — one of the most important antioxidants that your body produces — SAMe, taurine and NAC22
Detoxification23 — Without sulfur, glutathione (your body’s built-in detoxifier) is rendered ineffective
Thiamine (vitamin B1) and biotin (B7) conversion, which in turn are essential for converting carbohydrates into energy
Proper insulin function24 — The insulin molecule consists of two amino acid chains connected to each other by sulfur bridges, without which the insulin cannot perform its biological activity25
Glucose metabolism — One hypothesis26 is that if a sufficient amount of sulfur is available, it will act as a decoy to glucose, effectively diverting it to reduce the sulfur rather than glycating and causing damage. This would have the beneficial effect of reducing chronic inflammation, as sugar (glucose) is highly inflammatory and wreaks havoc in your body

Sulfur for Liver Health

Sulfur is also crucial for healthy liver function and the prevention of liver disease. As noted in one study,27 “a derangement in sulfur amino acid metabolism, possibly located at various steps along the trans-sulfuration pathway” is found even in mild forms of liver disease.

Part of its influence on your liver has to do with its influence over glutathione. As noted in the 2015 paper,28 “Metabolism of Sulfur-Containing Amino Acids in the Liver: A Link Between Hepatic Injury and Recovery”:

“The transsulfuration pathway is connected to the production of glutathione (GSH), which has potent antioxidant capacity in the liver. Accumulating data show that GSH depletion renders the liver vulnerable to oxidative stress and prone to progression of liver disease.”

Similarly, the journal Nutrients reports that MSM has been shown to attenuate “cytokine expression in vivo for induced colitis … and liver injury,” and that MSM has also been shown to have a beneficial effect on liver cancer.29

Another crucial nutrient for liver health and the prevention of chronic liver disease, including nonalcoholic fatty liver disease, is choline,30 detailed in “Choline Is Crucial for Liver Health.”

MSM for Osteoarthritic Knee Pain

Methylsulfonylmethane (MSM) is known as a sulfur donor, being 34% elemental sulfur by weight.31 Many of the benefits of MSM supplementation are related to its ability to reduce inflammation, regulate the balance of reactive oxygen species and antioxidant enzymes,32 and modulate your immune response.33

As a supplement, MSM is widely used in the treatment of pain, especially pain associated with arthritic conditions. One clinical trial34 found that people with osteoarthritis of the knee who took 3 grams of MSM twice a day for 12 weeks experienced significantly decreased pain and improved physical function, compared to a placebo.

Another randomized double-blind placebo-controlled study35 found patients with mild to moderate osteoarthritis benefited from oral glucosamine and MSM, both individually and in combination. Here, the treatment groups received 500 milligrams (mg) of glucosamine and/or 500 mg of MSM three times a day for 12 weeks. According to the authors:36

“Glucosamine, MSM and their combination produced an analgesic and anti-inflammatory effect in osteoarthritis. Combination therapy showed better efficacy in reducing pain and swelling and in improving the functional ability of joints than the individual agents.

All the treatments were well tolerated. The onset of analgesic and anti-inflammatory activity was found to be more rapid with the combination than with glucosamine. It can be concluded that the combination of MSM with glucosamine provides better and more rapid improvement in patients with osteoarthritis.”

Sulfur’s Role in Heart Disease

In 2011, I interviewed Seneff about the influence of sulfur on health and disease. I’ve included that interview above for your convenience. In it, Seneff discusses the crucial connections between sulfur, cholesterol and vitamin D.

Her research suggests heart disease may actually be related to cholesterol sulfate deficiency, and in the interview, she explains how elevated LDL (low-density lipoprotein) cholesterol is a sign of this deficiency.

To summarize, high levels of LDL cholesterol is your body’s way of compensating for cholesterol sulfate deficiency. When LDL is turned into plaque, blood platelets inside the plaque produce cholesterol sulfate, which your heart and brain need for optimal function.

Seneff also explains why lowering LDL with statins can lead to heart failure. Essentially, by elevating LDL, your body is protecting itself from the harmful effects of cholesterol sulfate deficiency. When you simply remove the LDL, you remove this “backup” mechanism aimed at keeping your heart going strong. As a result, heart failure becomes a distinct possibility.

That said, high LDL is correlated with cardiovascular disease, so the question then becomes: How can your body produce cholesterol sulfate without having to create harmful LDL?

Under normal, healthy conditions, your skin synthesizes both cholesterol sulfate and vitamin D3 sulfate when exposed to sunlight. These two sulfated sterols are water soluble and can travel freely in your bloodstream.

If you have sufficient amounts of cholesterol sulfate in circulation, your body does not need to produce more cholesterol-transporting LDL. This results in less plaque buildup in the arteries of the heart, because cholesterol sulfate is plentiful.

In essence, sensible sun exposure may be an important part of heart and cardiovascular health. In fact, studies have shown that those who live in countries with abundant sunlight have a lower risk to heart disease. Vitamin D3 supplements, on the other hand, are unsulfated. This is a significant drawback, as the unsulfated form needs LDL as a vehicle of transport.

Seneff believes that vitamin D is basically a signaling molecule that informs the tissues that there is an abundant supply of cholesterol sulfate, and cholesterol sulfate is the real beneficial product of sunlight exposure to the skin. Her suspicion is that the oral nonsulfated form of vitamin D is unlikely to provide the same benefits as the vitamin D created in your skin from sun exposure, since it is not accompanied by cholesterol sulfate, and therefore provides a false signal.

Sulfur Intolerance May Be a Sign of Toxicity

As mentioned earlier, sulfur-rich foods37 include leafy greens, cruciferous veggies, alliums,38 seafood, grass fed meats and organic pastured eggs. Another excellent source, and perhaps the best one, is homemade bone broth made from organically raised animals.

Either drink the broth regularly, or use it for soups and stews. Connective tissues are sulfur-rich, and when you slow-cook the bones, you dissolve these nutrients out of the bone and into the water.

If you have poor tolerance for foods high in sulfur, it may be an indication of an overgrowth of sulfur-reducing bacteria in your gut. These bacteria, such as Desoulfovibrio and Bilophila wadsworthia, produce hydrogen sulfide gas from sulfur-based food sources, which can destroy the gut lining and cause gastrointestinal discomfort.

A defect in the enzyme that oxidizes sulfur to sulfate, called sulfite oxidase, will lead to an overgrowth of these sulfur-reducing bacteria, and toxic chemical exposures may disrupt sulfite oxidase.

Furthermore, these bacteria also convert mercury to a toxic organic form called methyl mercury. When sulfite oxidase is deficient, mercury cannot be converted to mercury sulfate, which is the nontoxic form of mercury that can be excreted by the body. Thus, disruption of sulfite oxidase results in impaired sulfation capacity and increased mercury toxicity.

Other food additives such as food dyes can also exacerbate problems in your phenol sulfur-transferase (PST) sulfation pathway by suppressing PST enzyme activity. Sulfation is a critical step in detoxification of toxic phenols.

To address this situation, it’s recommended you initially go on a low-sulfur diet and reduce your toxic exposure by eating organic and avoiding household toxins of all kinds.

As your toxicity level is reduced, you can start adding sulfur-rich foods back into your diet, one at a time. Next, it’s important to enhance your body’s detoxification process by supplying more sulfate, either through diet or supplementation.

How to Boost Your Sulfur Intake — Diet and Supplementation

Aside from sulfur-rich foods, sulfur can also be obtained through supplementation with MSM. You can learn more about MSM in my interview with Rod Benjamin.

Benjamin is the director of technical development for Bergstrom Nutrition, the largest producer of the highest quality MSM produced by distillation purification. In his interview, we discuss suggested dosages and how to identify a high-quality supplement.

The sulfur-containing amino acids cysteine and taurine can also be used, both of which are available in supplement form. The supplement form of cysteine is NAC, the benefits of which I expounded on in “The Many Benefits of NAC — One of the Most Important Supplements You’ve Likely Never Heard Of.”

Another excellent source of sulfur is taking regular Epsom salt baths. Epsom salt (magnesium sulfate) is made up of magnesium, sulfur and oxygen. While most of the benefits associated with Epsom salt baths relates to magnesium39 — such as improved sleep, stress reduction and reduced pain and muscle cramping — its sulfur content is also important for health.

Epsom salt baths are often preferable if you’re toxic, as the sulfur in Epsom salt is readily available to your body without having to be converted. As a general recommendation, use 1 to 2 cups of Epsom salt to a tub of water. The warmer the water, the more of the salt will be dissolved, and the more your body will be able to absorb as the heat opens your pores.

If you experience a negative reaction, such as irritability or hyperactivity, decrease the amount used and incrementally increase the amount based on your tolerance. Alternatively, use 1 part Epsom salt to 2 parts water for a foot bath. Soak your feet for about 30 minutes.

Toxicity data shows MSM is extremely safe and can be taken at high doses. As noted in the journal Nutrients, “As a Generally Recognized As Safe (GRAS) approved substance, MSM is well-tolerated by most individuals at dosages of up to 4 grams daily,”40 although toxicity studies have reported no observed adverse effects up to a level of 5 grams per kilo per day.41

That said, potential side effects at higher doses include intestinal discomfort, ankle swelling and skin rashes. These are likely detoxifying effects that can typically be mitigated or minimized by cutting back on the initial dosage and slowly working your way up.

 Sources and References
Posted by: | Posted on: October 7, 2019

Artificially sweetened products threaten heart health, study reveals

Reproduced from original article:
https://www.naturalhealth365.com/artificial-sweeteners-soda-3141.html

by:  

artificial-sweeteners(NaturalHealth365) Just about everyone knows that sugary beverages not only destroy weight loss plans, but also trigger negative health effects.  Unfortunately, as a replacement for sugar-laced beverages, too many people still turn to soda with artificial sweeteners – with the hope of cutting out “empty calories.”

However, there’s a growing body of scientific evidence that suggests it’s a really bad move.

Excessive sugar consumption continues to be a problem in the Western diet, contributing to health conditions like diabetes, obesity plus much more.  However, while diet soda and other diet drinks are popular, one new study published in JAMA Internal Medicine found that artificially sweetened beverages have the potential to increase the risk of heart disease and other serious health conditions.

Discover what artificial sweeteners can do to your cardiovascular system

The study looked at regular consumption of soda and found that individuals who consume soft drinks regularly have a higher risk of mortality over 16 years compared to those who drink them infrequently.  Data from more than 450,000 men and women who were a part of the European Prospective Investigation into Cancer and Nutrition (EPIC) was considered, with initial dietary assessments done on the type and number of soft drinks consumed daily, weekly and monthly when individuals enrolled.

Individuals who consumed two or more glasses of soda a day had a 17% higher risk of dying from any cause during the 16.4-year follow-up period.  For those who drank beverages with artificial sweeteners, their mortality risk was 26% greater.

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Among those who had a high intake of sweetened sodas, the risk of dying of heart disease was 27%.  Shockingly, people that drank sodas with artificial sweeteners had a 59% greater risk, far higher than in those who consumed the sugary sodas.

Beyond heart disease, drinking a glass a day of sugary beverages was also linked to a 59% higher risk of digestive diseases.

Don’t be fooled: Fruits juices can be just as bad as soda

While some people turn to fruit juices thinking they’re a healthier beverage choice, they can be just as bad as sodas. Regular consumption of commercially-produced fruit juices has also been linked to premature death.

Consuming 10% of more of your daily calories from sugary drinks increases the risk of dying from heart disease by 44%, and that includes drinking store-bought fruit juice.

Both sugary beverages and soda with artificial sweeteners come with serious health risks, and this recent study showed that drinking artificially sweetened beverages was even more dangerous than consuming the sugary ones.

And remember, artificial sweeteners don’t just show up in sodas, they’re often found in juices, coffee drinks and “diet” sweets like cupcakes and donuts.  Even some ‘healthy-sounding’ beverages contain them.

Bottom line: Instead of drinking sugary sodas, artificially sweetened beverages or fruit juices, try staying well hydrated with plenty of clean (purified) water – every day.  If you want something sweet, go for an organic apple or a bunch of blueberries.

And, if you’re having trouble with your blood sugar levels – you might want to look at the value of alpha lipoic acid.

To learn more about the dangers of artificial sweeteners, listen to this mind-blowing NaturalHealth365 Podcast with Jonathan Landsman.  You’ll never look at artificial sweeteners the same again.

Sources for this article include:

JAMANetwork.com
LifeExtension.com
NaturalHealth365.com
ConsumerReports.com

Posted by: | Posted on: September 27, 2019

5 melatonin benefits that go way beyond better sleep

Reproduced from original article:
https://www.naturalhealth365store.com/melatonin-better-sleep
Posted by Jonathan Landsman, 21st September 2019

If you suffer with occasional sleepless nights, you probably know all about the importance of melatonin.  This natural hormone is sold over-the-counter as a “sleep supplement,” and it’s listed as an ingredient in many sleep aids.

But, as you continue to read here, you may be quite surprised at how melatonin can help you – in many other ways.

Melatonin is a naturally occurring hormone that helps regulate the sleep-wake cycle.  Unfortunately, its levels can be adversely affected by smoking, drinking too much caffeine and alcohol or staying up late at night.

It’s important to understand that the pineal gland releases melatonin when you are in a dark environment – and it is suppressed by light.  In other words, checking emails or watching T.V. – late at night – will inhibit your ability to product adequate amounts of melatonin.

Melatonin helps us to maintain the circadian rhythm – the body’s internal clock.  That’s why being under artificial light during nighttime hours can adversely affect your sleep rhythms overall.

Discover the 5 surprising benefits of melatonin

Hot flashes and hormonal changes can wreak havoc on a menopausal woman’s sleep. In addition to helping them get a good night’s rest, melatonin has been shown to improve mood in menopausal women between 42 and 62 years of age.

Melatonin naturally suppresses the type of inflammation that is caused by an immune response. It is also a source of powerful antioxidants that boost the immune system to help the body protect itself from all types of unwanted health issues.

For example, the types of bladder leakage related to aging and some bladder disorders may be decreased with melatonin use.  In addition, melatonin helps prevent the rise of oxidative stress in the prostate and bladder.  Simply put, less stress means a more relaxed bladder and better control of bladder contractions.

Stomach burning may be reduced with the use of melatonin.  One study, from the Department of Gastroenterology, Medical University of Lublin, Poland, revealed that a combination of omeprazole, tryptophan and melatonin healed H. pylori-related stomach ulcers faster.

One of the most surprising benefits of melatonin may be its ability to reduce tinnitus symptoms and help those suffering with the condition to get a good night’s sleep. Tinnitus is characterized as ringing in the ears. It can be severe and nearly debilitating for some people.

Therefore, supplementing with melatonin (just 3 mg) before bedtime can reduce symptoms and improve sleep significantly.

Should you use melatonin?

Melatonin is affordable, widely available and considered safe when taken in proper (suggested) amounts.  However, before taking melatonin for something other than occasional sleeplessness, it’s a really good idea to consult your integrative healthcare provider – especially if you are experiencing any of the health concerns listed above.

Sources for this article include:

LifeExtension.com

NaturalHealth365.com

NIH.gov

Posted by: | Posted on: September 16, 2019

Why we need B12, B6, Active Folate and TMG

Written by Brenton Wight – LeanMachine, Health Researcher
Updated 2nd December 2019, Copyright © 1999-2019 Brenton Wight and BJ & HJ Wight trading as Lean Machine abn 55293601285

Vitamin B12

Vitamin B12, or Cobalamin, is part of the B group of vitamins, but is different in three respects:

  • The B12 molecule is the largest and most complex vitamin known.
  • B12, like the rest of the B-group vitamins, is water-soluble, but B12 is the ONLY water-soluble vitamin which can be stored in the liver for months, or even years
  • B12 is generally formed in the high-acid stomach, but those with low acid levels cannot form B12.

Benefits of B12

  • Protects brain cells, improves nerve growth and conduction, increasing speed of messages to and from the brain
  • Protects the myelin sheath surrounding nerve cells.
  • Protects against Alzheimer’s and other brain-degenerative diseases
  • Mental clarity, concentration, memory, nervous system
  • Circulation
  • Aids in turning food carbohydrates into glucose for energy
  • Fat metabolism, digestion
  • Helps produce DNA and RNA, the genetic material in our cells
  • Increases iron utilisation to build red blood cells, preventing anemia
  • With B9 (folate), helps the manufacture of S-adenosylmethionine to reduce depression and boost the immune system
  • With B9 (folate) and B6, B-12 inhibits homocysteine production, an amino acid linked to heart disease.
  • Adrenal hormone function
  • Energy – physical, emotional, mental

B12 is only found in animal products, apart from mushrooms, which are the only vegetable (actually a fungus) containing B12, but the B12 exists only in the skin of the mushroom which is often peeled off and discarded, and in any case, this is a poor food source of B12.
This is why vegetarians, and especially vegans should take additional B12 supplements.
The elderly are also at risk for B12 deficiency, because as we age, the level of stomach acid tends to drop, and once it drops below a certain point, this ends the conversion process that generates the B12 that can be absorbed.
Many diets recommend that we limit protein from animal products, but this is very wrong. LeanMachine has been a vegetarian for over 40 years, but regularly eats eggs and fish for B12 intake. Even so, B12 levels were low the first time they were checked at around age 64. Since then, daily B12 supplements have built B12 levels to around five times the normal amount. We cannot overdose on B12, unlike Folate and other vitamins.
Unfortunately many doctors never test for B12, and if we are deficient in B12, doctors typically misdiagnose this deficiency, resulting in prescribing drugs that do not help the condition, but may even create side effects that only make us feel worse!
Some PPI (Proton Pump Inhibitor) medications such as Nexium, prescribed for reflux, heartburn and other digestive issues, deliberately lower stomach acid, and there are many off-the-shelf antacids which do the same, and all result in knocking out our Vitamin B12. Note also that microwaving food also knocks out all B12.

Symptoms of B12 deficiency

  • Anaemia
  • Macrocytosis (larger than normal red blood cells)
  • Hypersegmented neutrophils (Nuetrophil blood cells with more lobes than normal)
  • Fatigue, lack of energy
  • Weak legs
  • Forgetfulness, mental fogginess
  • Mood swings, lack of motivation
  • Depression, paranoia, delusions
  • Yellow colour
  • Feelings of apathy
  • Loss of appetite
  • Hair loss
  • Rapid heart rate (Tachycardia)
  • Shallow breathing, short of breath
  • Unintended weight loss
  • Bleeding or bruising more than normal
  • Persistent constipation or diarrhea
  • Dizziness
  • Incontinence
  • Loss of taste and smell
  • Sore tongue or mouth
  • Bones which easily break, even if a DEXA scan says they are dense
  • Tingling in fingers or toes
  • Strange nerve sensations
  • Muscle Tenderness

Untreated, a severe B12 deficiency may lead to permanent nerve damage.
Not everyone with low B12 will have all symptoms, but having a few of these suggests testing for B12 and Folate.

Who is at Risk?

  • Those aged over 50
  • Vegans, vegetarians
  • Those taking antacids
  • Those on PPI (Proton Pump Inhibotor) medications, e.g. Nexium
  • Diabetics taking Metformin (Diabex)
  • Those having surgery where part of the stomach is removed
  • Those with Ceoliac Disease
  • Those with bacterial overgrowth, stomach and intestines
  • Alcoholics
  • Those taking some anti-seizure medications
  • Those drinking too much water

Research suggests that in the over-50 age group, more than 20% of the population are low in B12, and a fifth of those are seriously deficient.

Recommended Daily Allowance for B12

Official recommended dietary amounts (RDAs) are:

  • Infants 0-6 months, 0.4 mcg
  • Infants 7-12 months, 0.5 mcg
  • Children 1-3 years, 0.9 mcg
  • Children 4-8 years, 1.2 mcg
  • Children 9-13 years, 1.8 mcg
  • Adults: 2.4 mcg daily for ages 14 years and older
  • Pregnant Females: 2.6 mcg daily
  • Breastfeeding Females: 2.8 mcg daily
  • Adults over 50 years old: 20 mcg daily

However, LeanMachine has the opinion that these amounts are way too low. If anyone has any symptoms of deficiency, testing and subsequent supplementation may be required, but beware of cheap supplements containing cyanocobalamin (an artificial chemical made from cyanide) and only use methylcobalamin which is the active form of Vitamin B12. Even though the cyanide in cheap B12 is fairly harmless, and easily excreted into urine, the methyl version can be used directly by the body without conversion, and contributes to the important methylation process, which occurs over a billion times per second in the body.
LeanMachine recommends Active B12 1500mcg 60 vcaps

Testing Vitamin B12

It is important to test Folate at the same time as B12, because a deficiency in one can mask a deficiency in the other.
Blood Test for B12 deficiency:
For a long time, the reference range in Australia has been 135 to 650 pmol/L (pica moles per litre) but this is way too low.
In the 1980’s, Japan lifted their low end of the range to 500, and for those people with the defective MTHFR gene (up to 40% of the population), even this can be too low.
LeanMachine recommends 750 to 1500 as a more desirable range. LeanMachine uses B12 supplements, and tests at the top end of this range.
However, a high B12 reading does not always mean a satisfactory level.
When B12 is low, two enzyme substrates will increase: tHcy (total homocysteine) and MMA (methylmalonic acid). If deficiency symptoms do not go away, these should also be tested.

Treating Low Vitamin B12

Memory loss is a significant symptom, and if diet and/or supplementation is improved within one to two years, full memory can often be restored, but after two years, permanent memory damage may have occurred.
Ideally, we should look at the diet first, and if this does not improve B12, then B12 supplements are essential. If deficiency symptoms are severe, immediate supplementation or a B12 injection is advised.
Because B12 can be stored in the body, B12 injections are only required every 3 months to maintain healthy levels.
Here are some food sources of vitamin B12, arranged from highest to lowest:

Type of Food mcg of B12/serving % of RDA
Shellfish (Clams) 85g/3oz 84 1400
Liver, beef 85g/3oz 70.0 1178
Shellfish (Oysters) 85g/3oz 84 408
Crab, raw, 85g/3oz 9.8 163
Trout, rainbow, wild, cooked, 85g/3oz 5.4 90
Salmon, sockeye, cooked, 85g/3oz 4.9 80
Red Meat (Beef) 85g/3oz 5.1 85
Yogurt, plain, 1 cup 1.4 25
Haddock, cooked, 85g/3oz 1.2 20
Egg (chicken), one extra-large 0.5 20

Chicken is missing from the table above, because one egg has as much B12 as nearly half a chicken. Another case for the egg coming before the chicken!

Who should NOT take Vitamin B12
In those with Leber’s Disease (Leber Hereditary Optic Neuropathy, or LHON, a rare eye disease affecting less than 1 in 50,000) B12 can seriously damage the optic nerve, so B12 should never be taken.

Homocysteine – an inflammatory marker

Homocysteine levels in the blood are a marker of inflammation and cardiovascular disease, and low levels of Vitamin B12 and Folate can raise Homocysteine levels.
High homocysteine levels usually lead to cognitive decline in advancing years, cardiovascular disease, Alzheimer’s disease and many other ageing-related diseases.
Homocysteine is produced in the body as a result of demethylation of methionine utilisation of fats and proteins.
In Australia, doctors seldom order a Homocysteine blood test unless we ask for it. This test can also check for a rare inherited disorder called homocystinurina. The risk for homocystinurina is low, but it is best to rule it out.
If there is a family history of high homocysteine, children should be tested from birth.
The main purpose of the Homocysteine test is to determine if you have increased risk for heart attack or stroke, and a deficiency in B12 and Folate, and all should be tested at the same time.

What is Homocysteine?

Homocysteine is an amino acid, one of the building blocks of proteins. We can not get homocysteine from the diet.
Homocysteine can only be made from methionine, another amino acid that is found in meat, fish, and dairy products, and this reaction can only happen with enough Vitamin B6 (pyridoxine), Vitamin B12 and folate.
Foods containing methionine are transformed into homocysteine in the blood, and then Vitamin B6 helps convert homocysteine to cysteine. Vitamin B12 related enzymes can also recycle homocysteine back into methionine.
Cysteine is a very important protein, involved in how proteins in cells are folded, maintain their shape, and link to each other, and cysteine is a source of sulfide, taking part in metabolism of iron, zinc, copper and other important minerals. Cysteine also acts as an anti-oxidant. If homocysteine cannot be converted into cysteine or returned to the methionine form, levels of homocysteine in the body increase. Elevated homocysteine levels have been associated with heart attack, stroke, blood clot formation, and perhaps the development of Alzheimer’s disease.

Homocysteine Test

Laboratories generally say that normal homocysteine serum levels are between 4 and 15 micromoles per litre, with anything above 15 considered high.
However, the OPTIMAL level of homocysteine is less than 10 or 12 in good labs, but many doctors will ignore readings unless they are flagged on the report (above 15).

CRP  (c-Reactive Protein)

C-Reactive Protein is another important marker for inflammation and risk for strokes, and should be tested if homocysteine results are inconclusive.
Healthy people should ask for the High-Sensitivity test, hs-CRP.
Those in poor health should ask for the regular CRP test, which is not as sensitive, but has a much wider range of values.

Folate, Folic Acid, Folinic Acid, Active Folate

These all sound similar, but most forms have to be converted in the body to the active form that the body can use: MTHF or (6S)-5-MethylTetraHydroFolate, commonly calles Active Folate.
Up to 40% of the population have a MTHFR gene polymorphism. The MTHFR gene helps make  methylenetetrahydrofolate reductase, an enzyme involved in processing amino acids, the building blocks of proteins.
Unfortunately, consumption of Folic Acid can aggravate this MTHFR gene polymorphism, making the problem worse, blocking the real folate, increasing cancer risk and causing other health problems.

Treating High Homocysteine

Because homocysteine is missing CH3 (the methyl group), the best way to lower homocysteine is to add a methyl donor, which will aid the breakdown of homocysteine into methionine.
The following are all methyl donors:

Studies

In a 2-year study of people aged over 70 with elevated Homocysteine levels over 11.3 micromoles/litre, patients were given either a placebo or Folic Acid 800mcg, Vitamin B12 500mcg, and Vitamin B6 20mg daily.
Most of those on the placebo showed distinct cognitive decline. Those on the supplements showed no decline or much more moderate decline.

  • A 2-year study of people aged 60 to 74 with symptoms of depression using smaller doses and only Folic Acid 400mcg and Vitamin B12 100mcg taken twice daily, showed small but significant improvements in short-term and long-term memory
  • An 8-year study of several hundred people in their seventies showed that those having the lowest levels of B12 in their blood (under 257 pmol/l), 40% of the group, had the highest rates of cognitive decline. Formerly, the official danger point for B12 was set at 148 pmol/l (picomoles per litre), but this study confirms that this level is too low, and that most people aged 50 or over should either consume foods fortified with B12 or take supplements
  • A 2-year study showed that B12 and Folic Acid supplements significantly reduced the risk of Alzheimer’s Disease
  • A study found that although bone density remained the same in the B12 and Folate group as well as the placebo group, the number of bone fractures was 80% less in the supplement group.
    It appears that high homocysteine levels interfere with the way collagen works to strengthen bone

Food Sources of B Vitamins

All B-group vitamins come primarily in meat and eggs, the only exception being mushrooms as the only “vegetable” with B-group vitamins).
ALL vegetarians and especially vegans should supplement with Active B12 and Active Folate.
Almost all seniors need B12 because of reduced stomach acid as we age, and anyone taking statin drugs (e.g. Simvastatin, Lipitor, etc for Cholesterol) or heartburn medication (Nexium) (or off-the-shelf remedies) MUST supplement with B12 because stomach acid will not be strong enough for the body to produce any B12 at all.

As we age, we also lose our ability to absorb B12, B6 and Folate from foods, so most people over 50 should supplement.
Many younger people are also deficient in B-group vitamins due to diet, health, lifestyle, genetic makeup or illness, so annual blood tests are recommended for everyone.

Around 20% of the population suffer from Folate deficiency, but too much Folate (over 1000mcg or 1mg daily) can be toxic to the liver.
However, we cannot overdose on B6 or B12. No side-effects have ever been observed at extremely high doses.

TMG – TriMethylGlycine

The TMG molecule consists of three methyl groups (CH3) and one glycine group (C2H5NO2).

The advantage of TMG is that it can donate all three methyl groups, leaving pure glycine.

Glycine is very important for body functions, including:

  • Build lean muscle mass
  • Preventing sarcopenia (muscle loss, muscle wasting)
  • Producing human growth hormone
  • Improving memory and mental performance
  • Reducing risk of strokes and seizures
  • Protecting skin from aging and cell mutations
  • Increasing collagen in joints, reducing joint pain
  • Improving flexibility and range of motion
  • Lowering blood glucose, reducing risk of type 2 diabetes
  • Improving sleep quality
  • Reducing inflammation and free radical damage
  • Increasing glutathione production
  • Reducing risk for some cancers
  • Building gastrointestinal tract lining
  • Producing bile salts and digestive enzymes
  • Reducing allergic and autoimmune reactions
  • Increasing energy levels, fighting fatigue
  • Increasing red blood cell production
  • Reducing stress,  anxiety
  • Controlling symptoms: seizures, schizophrenia, mental disorders

The following are my recommended supplements:

LeanMachine Supplements

Disclaimer

LeanMachine is not a doctor, and everyone should consult with their own health professional before taking any product to ensure there is no conflict with existing prescription medication.
LeanMachine has been studying nutrition and health since 2011 and has completed many relevant studies including:
Open2Study, Australia – Food, Nutrition and Your Health
RMIT University, Australia – Foundations of Psychology
Swinburne University of Technology, Australia – Chemistry – Building Blocks of the World
University of Washington, USA – Energy, Diet and Weight
Johns Hopkins Bloomberg School of Public Health, USA – Health Issues for Aging Populations
Johns Hopkins Bloomberg School of Public Health, USA – International Nutrition
Johns Hopkins Bloomberg School of Public Health, USA – Methods in Biostatistics I
Johns Hopkins Bloomberg School of Public Health, USA – Methods in Biostatistics II
Johns Hopkins Bloomberg School of Public Health, USA – Principles of Human Nutrition
TUFTS University, USA – Nutrition and Medicine
TUFTS University, USA – Lipids/Cardiovascular Disease I and Lipids/Cardiovascular Disease II
Technical Learning College, USA – Western Herbology, Identification, Formulas
Bath University, England – Inside Cancer
WebMD Education – The Link Between Stroke and Atrial Fibrillation
WebMD Education – High Potassium: Causes and Reasons to Treat
Leiden University Medical Center, Netherlands – Anatomy of the Abdomen and Pelvis
MIT (Massachusetts Institute of Technology) – A Clinical Approach to the Human Brain

LeanMachine has now examined thousands of studies, journals and reports related to health and nutrition and this research is ongoing.

Updated 2nd December 2019, Copyright © 1999-2019 Brenton Wight and BJ & HJ Wight trading as Lean Machine abn 55293601285

Posted by: | Posted on: August 9, 2019

Blood Tests – How to read the results

By Brenton Wight – LeanMachine, Health Researcher, updated 29th November 2019

Blood Tests – They May Save Your Life!

Blood tests should be carried out with your annual checkup, or any time you have a medical condition

Urine tests are also common, but many are inaccurate, because they only tell us what has left the body, not what is currently available in the body to feed our cells and keep us in good health.
Urine tests are included here where appropriate and where the results can be useful.
Important:
ALWAYS get a printed copy of your tests. The Doctor cannot refuse as the results belong to you.
Unfortunately, Doctors often only look at results outside the “normal range” and disregard everything else.
There are several problems here.

  • There can be potential problems buried within the “normal range”
  • The “normal range” is an average range for a person of the same age and sex as you, not accounting for weight, height, body fat, muscle mass, and general physical condition
  • The “normal range” given does not indicate if the low end, middle or high end of the range is optimal
  • The “normal range” does not always inform you of changes over time within the range which may indicate a better or worse diet, health or impending sickness, etc
  • The “normal range” includes a lot of sick people, skewing the results

For example, the “normal range” for vitamin D3 is 60 to 160 nmol/litre for most Australian labs (some labs now say 75), but the OPTIMAL range is 125 to 175 nmol/litre, with the preference at the high end of the range.
When the results come in at 61, the lab says you are fine, the doc says you are fine, but your immune system is nowhere near the optimum level!
Another example is TSH (Thyroid Stimulating Hormone). The “normal range” is 1.0 to 4.0 but anything over 2.0 is certainly undesirable, and may indicate a hypothyroid condition, going un-diagnosed because the lab and the doc both agree “you are fine”.

Reference Ranges

Some labs indicate “Reference Range”, other labs may indicate “Normal Range”, “Reference Intervals”, “Desirable Range”, “Healthy Range”, Target Range”, “Average Range”, “Suggested Range”, “Optimal Range” which all sound similar, but actual values may vary.
Reference ranges are calculated by the lab as what 95% of the “normal” population conform to (2 standard deviations for you mathematicians).
However, in the 95% of the population who are considered “normal”, we have some sick, healthy, athletic, frail, obese, slim, old, young people of different ethnic backgrounds, occupations, environments, exposure to toxins, which can skew the test results, along with many other factors such as male or female.
Just because we fit into the reference range, it does not mean that we are in the best physical condition.
And for the 5% (or 1 in 20 people) who are outside this range, but still considered “normal” their results are questionable, whether they are at the healthy or unhealthy end of the reference range, which can be a high or a low number, depending on the test.
In some tests, a small margin over or under the reference value can indicate a problem, and in other tests, we can be several hundred times the reference range before we have a serious condition.
The labs will do their best job to calculate the reference range for our age and sex, sometimes weight, sometimes our medical condition, but that is all.
Every lab uses their own terminology, their own test equipment and their own numbers, so typical results may vary.
USA labs often use different units for measurement compared to Australian and other countries, so we must always look at the units as well as the numbers.
Many labs are now trying to standardise in SI (Standard International) units.
It is a good idea to use the same lab each time so that any changing numbers over time can be used as clues to various medical conditions or changes in health.
Many labs who upgrade their equipment and/or software will give two sets of results, pertaining to old and new systems.

Some Conditions Diagnosed by a Blood Test

Malnutrition

Even though we eat much more than our ancestors, modern foods are often devoid of nutrients due to repetitive farming practices, over-processing, over-heating, and the addition of toxic chemicals, trans fats, sugars, etc which all contribute to bad health and a reduced ability for the body to absorb nutrients from food.
Many prescription medications, especially antacids and PPI’s (Proton Pump Inhibitors like Nexium) make this problem even worse by REDUCING stomach acid.
The body NEEDS stomach acid to absorb nutrients AND to make vitamin B12, an important part of the digestion process.
We can have a full stomach, but be starved of nutrients without adequate stomach acid.
People with lap-band or similar surgery, or who have part of the stomach or intestines removed due to disease or cancer, or who have damaged gut bacteria from antibiotics or other prescription medication,
or who have taken antacids or PPI (Proton Pump Inhibitors), or who have a diet poor in nutrition, will have poor absorption of vitamins, minerals, amino acids, etc and can easily suffer from malnutrition.
Malnutrition itself can skew the results of other blood tests, and doctors do not always take this into account, as most assume malnutrition cannot exist in modern society.

Cardiovascular Disease

High LDL cholesterol with low HDL cholesterol, combined with high triglycerides is a warning sign of future heart attack or stroke, and diet must be improved to reverse this condition.
These tests are not part of a normal blood workup so we should ask the doctor for a “lipid study”.

Tumours or Cancer

Cancer tests are described under the Cancer Tests heading near the bottom.

Abnormal White Blood Cell Count and/or Platelet Counts

May indicate Leukemia, with early treatment promoting better recovery.

Diabetes

Diabetes, or even pre-diabetes, can be caught early with a simple blood glucose test.
This condition is easily controlled with some very basic changes to the diet, combined with regular exercise.
Left unchecked, diabetes can lead to blindness, amputations, heart attack, stroke or death.

Allergies or Parasites

Blood tests can reveal these problems, and simple steps are required to correct these conditions.

Infections

Infections can spread, causing a lot of damage, but are easily treated if diagnosed with a blood test.

Anemia

Can be caused by many things including internal bleeding, kidney disease, malnutrition, vegan diet, etc but can usually be simply treated.

Thyroid Problems

The thyroid controls many other hormones in the body, but problems can be found easily with a blood test.
This test must be asked for, as it is not included in a typical blood workup.

Symptoms requiring a blood test

  • Unexplained Tiredness
  • Unexplained weight gain
  • Unexplained weight loss
  • Fever
  • Unexplained pain
  • Changes in bowel habits
  • A long time since the previous test

Preparing for the test

Your Doctor will arrange the test. Ensure that you ask the following:

  • Do I have to fast?
  • Can I drink water?
  • Do I continue my prescription medication?
  • Do I continue my supplements, vitamins, minerals?
  • If I am on blood-thinning medication, what precautions are required?
  • Have I donated blood recently, or can I soon?
  • Please give me a printed copy for my opn records when the results are available.

If the test is a fasting test, arrange a time early in the morning for the test so you can follow up with a nourishing breakfast afterwards.
Do not drink alcohol for 24 hours before the test.
Avoid fatty foods at the last meal before the test.
If all of the results are “within the normal range” it does not mean you can now forget everything.
Compare all results with previous tests, and keep results to compare with the next tests.
If you still have some unexplained condition, there may be repeated tests, new tests, ultrasound, x-rays, CT, MRI or other tests required.
Even if you are feeling fine, look up your previous test results.
If you do not have these results, ask the Doctor – previous records should be on their database, as they are generally e-mailed from the lab.
Compare the results line by line to check if any levels are getting better or worse. Some results will give a higher or lower number,
but check details below on each individual test to work out if this means getting better or getting worse.
Discuss all results with your Doctor, and if you cannot get useful answers, find another Doctor!

Some of the many different Blood Test Measurements and abbreviations

Some Australian (SI), some USA measurements.

  • cmm – cells per cubic millimeter
  • g/L – grams per liter
  • g/dL – grams per deciliter (1/10 of grams per liter)
  • IU/L – international units per liter
  • mEq/L – milliequivalent per liter
  • mg/dL – milligrams per deciliter
  • mL – milliliter
  • fL – femtoliter, 10-15 Liter, or one thousand trillionth (one quadrillionth) of one liter.
  • mmol/L – millimoles per liter
  • ng/mL – nanograms per milliliter
  • pg/mL – picograms (one-trillionth of a gram) per mL (milli-litre)

The standard CBE (Complete Blood Exam), also called CBC (Complete Blood Count) or FBE (Full Blood Exam)

This is the most common test ordered by the Doctor – by no means complete, but can isolate many common problems.
This test determines red blood cells, various white blood cells, and platelets in the blood.
Do not consider these figures absolute, as different labs and different countries and different ages and sexes of patients have different ranges.
Not all labs do all of the tests.
Not all doctors ask for all of the tests.
Many of the tests are for specific diagnosis or monitoring of some disease or condition.

The Red Blood Cell Test Group

Hb or Hgb (Haemoglobin)

Normal values for adult males: 130 to 170 g/L (13.0 to 17.0 g/dL), adult females: 120 to 150g/L (12.0 to 16.0 g/dL)
OPTIMUM values for adult males: 140 to 150 g/L (14.0 to 15.0 g/dL, adult females: 135 to 145g/L (13.5 to 14.5 g/dL)

Adult males after middle age: 124 to 149 g/L (12.4 to 14.9 g/dL), adult females after middle age: 117 to 138 g/L (11.7 to 13.8 g/dL)
This is the iron-containing component of red blood cells which carries oxygen from the lungs to every part of the body, and gives the red cells their bright red colour.
Low Haemoglobin levels often indicate Anaemia.
Hemoglobin must be evaluated with HCT (hematocrit), RBC and MCV to determine if there is fact anemia and the type of anemia.
Low Haemoglobin can be caused by:

  • Low production of red blood cells in the bone marrow
  • Low iron intake
  • Low folate and/or vitamin B12
  • Internal or external bleeding
  • Blood cell destruction
  • Chronic illness
  • Low testosterone
  • Vegan, vegetarian or low-carbohydrate diet

High Haemoglobin can be caused by:

  • Dehydration (as in prolonged or severe diarrhea)
  • Emphysema, severe asthma, or other respiratory disease
  • Macrocytosis (enlargement of red blood cells, often caused by hypothyroid or liver disease or deficiency of B6, B12, folate)
  • Adrenal cortex over-activity
  • Polycythemia vera (bone marrow makes too many red blood cells)
  • Living at high altitude
  • Splenic hypofunction
  • Immune suppression
  • Testosterone supplementation

RBC (or RCC, R.B.C.,R.C.C.) – Red Blood Cell Count or Erythrocyte Count

Normal range: Adult males 4.5 to 5.5 x 1012/L, adult females 3.8 to 4.8 x 1012/L.
OPTIMAL range: Adult males 4.7 to 5.25, adult females 4.0 to 4.5.
Units are trillions (1012) per litre, or millions (106) per cubic mm (mm3) which both give the same result.
An estimate of the number of red blood cells per mm3 of blood.
Low RCC may indicate:

  • Anaemia
  • Blood loss, internal or external
  • Bone marrow failure
  • Iron deficiency
  • Copper deficiency
  • Over-hydration
  • Leukemia
  • Multiple myeloma (cancer of plasma cells in bone marrow)
  • Malnutrition
  • Cell damage
  • Iron deficiency (with a low MCV)
  • Vitamin B6, B12, and/or Folic Acid deficiency (with a high MCV )
  • Chronic Disease
  • Liver dysfunction
  • Kidney dysfunction (also abnormal chemistry tests, BUN, creatinine)
  • Hereditary anemia
  • Free radical pathology
  • Toxic metals
  • Catabolic Metabolism
  • Pregnancy
  • Erythropoietin deficiency, typically those with chronic kidney disease
  • Hemolysis, or RBC destruction caused by transfusions and blood vessel injury
  • Thyroid disorders
  • Adrenal dysfunction
  • Cortisol production dysfunction
  • Chronic bacterial infections

High RCC may indicate:

  • Lung disease
  • Emphysema
  • Pulmonary fibrosis
  • Cigarette smoking
  • Sleep Apnea
  • Living at a high altitude
  • Cystic fibrosis
  • Adrenal cortical hyperfunction (either too much cortisol or too much aldosterone)
  • Anabolic Metabolism (testosterone supplementation)
  • Congenital heart disease
  • Cardiovascular dysfunction
  • Dehydration
  • Kidney disease
  • Renal cell carcinoma (kidney cancer)
  • Immune suppression
  • Transplant rejection drugs
  • Gentamicin and Methyldopa drugs
  • Performance enhancing protein injections and anabolic steroids
  • PV (Polycythaemia Vera) – genetic disease where bone marrow makes too many red blood cells

May help indicate the lifespan of the cells, and indicate problems, but may not indicate the actual problem, so other tests will be required.

Haematocrit, also called HCT or PCV – Packed Cell Volume

Normal Range: Adult males: 40 to 50%, adult females: 36 to 46%.
OPTIMUM Range: Adult males: 42 to 48%, adult females: 39 to 45%
Percentage of red blood cells in the total blood volume.
Low PCV/HCT may indicate:

  • Anaemia
  • Blood loss
  • Low RBC
  • Bone marrow failure
  • Abnormal breakdown of Red Blood Cells
  • Increased production of WBC
  • Leukaemia
  • Adrenal dysfunction
  • Low thymus function
  • Multiple myeloma (cancer of plasma cells in bone marrow)
  • Over-hydration
  • Malnutrition
  • RA (rheumatoid arthritis

High PCV/HCT may indicate:

  • Shock
  • Immune supression
  • Excess RBC
  • Dehydration (typically burns or diarrhoea)
  • Eclampsea (a serious pregnancy condition)
  • Polycythaemia vera – bone marrow makes too many red blood cells
  • Spleen hyperfunction

MCV (Mean Cell Volume or Mean Corpuscular Volume)

Normal adult range: 83 to 101 fL (femtoliters).
OPTIMUM adult range: 87 to 92 fL
Some labs give results in cubic microns, which is identical to the range in femtoliters.
An estimate of blood cell volume, or average volume of red blood cells, or the average amount of space taken by each red blood cell.
May help determine the type of anaemia and/or chronic fatigue syndrome.
Low MCV can indicate:

  • Copper deficiency
  • Iron deficiency
  • Low stomach acid
  • B12 and/or Folate deficiency
  • Rheumatoid arthritis
  • Vitamin deficiency
  • Vitamin B6 deficiency
  • Pregnancy
  • Chronic disease
  • Lead or other toxins
  • Hereditary anemia such as thalassemia or sideroblastic
  • Hemolytic anemia
  • Haemoglobin disorder
  • Blood cell destruction
  • Bone marrow disorder

High MCV can indicate:

  • Hereditary anemia
  • Alcoholism
  • Liver disease
  • Malnutrition
  • Bone marrow problems
  • Chronic lung disease
  • Problem with prescription medication
  • Megaloblastic Anemias (pernicious, folic acid deficiency, B12 deficiency)
  • Reticulocytosis (acute blood loss response. Reticulocytes are immature cells, relatively large in size compared to a mature red blood cell)
  • Artifact (aplasia, myelofibrosis, hyperglycemia, cold agglutinins)
  • Hypothyroidism
  • Anti-convulsant drugs
  • Zidovidune treatment (for AIDS)

MCH (Mean Corpuscular Haemoglobin or Mean Cell Haemoglobin)

Normal range: 27 to 32 picograms
MCH is a calculation determining the amount of oxygen-carrying haemoglobin inside the Red Blood Cells.
Results too high (usually Macrocytic anemia), often caused by too little vitamin B12 and/or folate, in turn often caused by low stomach acid or antacid use.
Macrocytic Red Blood Cells are larger than either normal or microcytic RBCs, tending to have higher MCH values.
The larger cells mean that there are fewer cells, and less haemoglobin is then available.
Results too low (usually Microcytic) may indicate Iron Deficiency Anemia, or a nutritional deficiency.
Normally MCH is elevated or depressed when MCV is elevated or depressed, and usually for the same reasons as MCV.

MCHC (Mean Corpuscular Haemoglobin Concentration)

Normal range: 315 to 345 g/L or often specified as 28% to 36%
OPTIMUM range: 32% to 35%
A calculation of the concentration of haemoglobin inside the Red Blood Cells.
Decreased MCHC values (hypochromia) are when haemoglobin is abnormally diluted inside the red blood cells.
Indicates anemia if the count is low, or possible nutritional deficiencies if high.
Typical causes are iron deficiency anaemia and in thalassaemia.
Increased MCHC values (hyperchromia) are seen in conditions where the haemoglobin is abnormally concentrated inside the red blood cells.
Typically seen in burn patients.
MCHC is increased or decreased in the same conditions as MCV is increased or decreased, except:
1. In spherocytosis (a fairly rare congenital disorder), MCHC is elevated
2. In pernicious anemia, MCHC is normal.

RDW (Red Cell Distribution Width or Random Distribution of red cell Width)

Normal range: 11% to 15%
OPTIMAL Range: 13%
Tests for the shape and size of red blood cells, but the term “width” refers to the distribution, rather than the size of cells.
Liver disease, anemia, nutritional deficiencies, and many health conditions can cause high or low RDW tests.
RDW can be increased in:

  • B12 and Pernicious anemia
  • Folic acid anemia
  • Iron deficiency anemia combined with other anemia
  • Hemolytic anemia
  • Transfusions
  • Sideroblastic anemia
  • Alcohol abuse

RDW can be decreased in:

  • Iron deficiency anemia (blood loss, parasites, poor iron absorption)
  • Vitamin B6 anemia
  • RA (Rheumatoid arthritis)

ESR (Erythrocyte Sedimentation Rate)

Also known as SED (Sedimentation Rate).
A measure of how Erythrocytes (Red Blood Cells) sink in a pipette. The faster the blood cells sink, the higher the inflammation we have.
Inflammation creates proteins that make red blood cells fall faster, giving a higher test result.
The test reports the distance (mm) between the clear liquid (plasma) at the top of the tube and the red blood cells after 1 hour.
The normal range:
Males: 0 to 15 mm/hour
Females: 0 to 20 mm/hour
Seniors may have slightly higher readings.
High ESR can be caused by:

  • pregnancy
  • inflammation
  • infection
  • anemia
  • kidney or other cancer
  • rheumatoid arthritis
  • polymyalgia rheumatica
  • giant cell arteritis (swelling in blood vessel lining)
  • systematic vasculitis (inflammation in blood vessels)
  • multiple myeloma
  • lupus (SLE or systemic lupus erythematotus)
  • IBS (Inflammatory Bowel Disease)

Low ESR can be caused by:

  • polycythemia
  • sickle cell anemia
  • hereditary spherocytosis
  • congestive heart failure

The ESR test is recommended for patients with symptoms of headaches, stiff joints, pain in shoulders, neck or pelvis, appetite loss, unexplained weight loss.

Platelets

Most adults have between 150,000 to 450,000 platelets per mcL (microlitre) of blood.
1mcL is the same as 1 cubic millimetre (mm3).
The OPTIMUM values are 230,000 to 400,000 per mm3.
Platelets are small portions of cells involved in blood clotting, continually made by the bone marrow, as each platelet survives only around 10 days.
Platelets stick together when we cut ourselves to form a clot to stop bleeding.
Too many or too few platelets can affect clotting in different ways, and the number of platelets may also indicate a health condition.
Low platelets (thrombocytopenia) can be caused by:

  • Bleeding
  • Alcoholism
  • HIV
  • Toxins
  • Inherited disorders like Wiskott-Aldrich or Bernard-Soulier
  • Bacterial infections
  • SLE (Systemic Lupus Erythematosus)
  • RA (Rheumatoid Arthritis)
  • Pernicious anaemia
  • Megaloblastic anemia (B12 and/or folic acid deficiency)
  • Hypersplenism (spleen takes too many out of circulation)
  • Leukaemia
  • Chemotherapy
  • Marrow depression (aplastic anemia, radiation, drugs)
  • Marrow infiltration (acute leukemia, carcinoma, myelofibrosis, multiple myeloma)
  • Prescription medications like heparin, quinidine, quinine, sulfa-containing antibiotics, interferon, anticonvulsants and gold salts
  • Immunologic (ITP, infectious mononucleosis (EBV), SLE, Lymphoma, CLL)
  • Dilution due to overhydration (drinking too much water)
  • Coagulation disorders (DIC, septicemia, hemolytic-uremic syndrome, TTP, large hemangiomas, heart valve, eclampsia)
  • Hypersplenism (over-active spleen, removing old blood cells too soon)
  • Platelet aggregation or large platelets
  • Rubella
  • Liver dysfunction (cirrhosis)

Idiopathic Cytopenic Purpura (ITP), a condition possibly related to viral infection, autoimmunity or chemical toxin.

High platelets (essential thrombocythemia) can be caused by:

  • Thrombocythemia (bone marrow makes too many platelets)
  • Gene mutations (Janus kinase 2 [JAK2] gene)
  • Infections
  • Iron deficiency
  • Hemolytic anemia (abnormal breakdown of red blood cells)
  • Acute blood loss
  • Splenectomy (surgical removal of the spleen)
  • Tissue damage, chronic inflammation, surgery
  • Disseminated carcinoma (a condition where cancer cells are spreading)

Mean Platelet Volume (MPV)

Normal range: 7.5 to 11.5 femtoliters
This test measures and calculates the average size of platelets.
Higher MPVs mean the platelets are larger, which could put an individual at risk for a heart attack or stroke.
Lower MPVs indicate smaller platelets, meaning the person is at risk for a bleeding disorder.

The White Blood Cell Test Group

WBC – White Blood Cells (or leukocytes, or sometimes leucocytes)

Normal Range: 4,500 to 11,000 WBC per mcL (micro-litre) of blood, average person around 7,000 (USA labs 4,300 to 10,800 cmm).
A high number can be an indicator of disease.
Part of the immune system which defends against infectious, disease and foreign bodies.
WBC’s live for three to four days in the body, and are found throughout the blood and lymphatic system.
WBC’s make up around 1% of the total blood volume in a healthy adult, and help fight infections. A high white blood cell count may help identify infections.
It may also indicate leukemia, which can cause an increase in white blood cells.
Too few white blood cells may be caused by some medications or health problems.
This test measures the numbers, shapes and sizes of various types of white blood cells.
The WBC differential count (percentage) shows if the numbers of different cells are in proper proportion to each other.
Irregularities may indicate infection, inflammation, autoimmune disorders, anaemia, or other health conditions.

High leukocytes (leukocytosis)

Typically caused by a bacterial or viral infection, the body responding my making more WBC’s.
Typical is bone marrow disease, leukemia, myelofibrosis, smoking, stress, tuberculosis, rheumatoid arthritis, whooping cough.
Also can be caused by reaction to some medications such as antibiotics, diuretics, corticosteroids, epinephrine and others.

Low leukocytes (leukopenia)

Caused by cancer, viral infections of the bone marrow, congenital disorders, autoimmune diseases which attack WBC’s, major infections which use up WBC’s faster than they can be produced, chemotherapy, AIDS, lupus, malnutrition, lack of vitamins, radiation, parasites.
Volume, conductivity, and granularity can change due to activation, presence of immature cells or malignant leukocytes in leukemia.

Five Major Types of White Blood Cells

  • Neutrophils – making up around 62% (can be 40% to 80%) of White Blood Cells, neutrophils attack bacteria and fungi, and live from a few hours to a few days.
    If given as the number of cells instead of a percentage, divide the number by the WBC (White Blood Cells) to get the percentage.
    The bone marrow makes neutrophils and stores them, to be released into the blood in response to physical stress or infections.
    Neutrophils contain enzymes which can break down bacteria, and also contain glycogen and protein for their own energy.
    High neutrophils increase the body’s requirement for protein to replace that used by the bone marrow to make more nuetrophils.
    High Neutrophils (Neutrophilia) can be caused by infection, inflammation, pregnancy, or physical stress (intense exercise).
    Low Neutrophils (Neutropenia) can be caused by B12 and folate deficiency, infections that destroy neutrophils, aplastic anemia, leukemia, autoimmune disease, hypersplenism (spleen enlargement), dialysis, some medications.
  • Eosinophils – making up 2.3% (can be 1% to 4%) of White Blood Cells, eosinophils attack parasites and allergens.
    High eosinophils normally indicate parasitic infections or allergic reactions.
    Low eosinophils can be caused by alcohol intoxication or excess cortisol production.
  • Basophils (also called basophiles, basophilic leukocytes, basocytes, basophilocytes, mast leukocytes) – making up 0.4% (can be up to 1%) of White Blood Cells, basophils release histamine for inflammatory allergic responses.
    High basophils may be caused by bone marrow disease, Chrohn’s disease, removed spleen, when inflammation is healing, asthma, chronic dermatitis, hypothyroidism, Hodgkins lymphoma.
    Low basophils can be caused by hyperthyroidism, allergies, pregnancy, ovulation, immune-suppressing drugs.
  • Lymphocytes – making up 30% (can be 20% to 40%) of the White Blood Cells, living for years as memory cells, months for other types.
    Normal range (adults): 1,000 to 4,800 lymphocytes in 1 microliter (µL) of blood.
    Normal range (children): 3,000 to 9,500 lymphocytes in 1 microliter (µL) of blood.
    Unusually high or low lymphocytes may cause no symptoms or problems on their own,
    and may be the body’s normal response to infection, inflammation or other condition, and often return to normal after some time.
    If there are other tests with unusual results, the doctor should look at all these tests together to determine if further invesatigation is required.
    If levels do not retern to normal, or keep progressing high or low, further investigation is required,
    as this may be diagnosed as lymphocytopenia or lymphocytosis, with symptoms from mild to severe, and the duration depends on the cause.Low lymphocytes (lymphocytopenia) may indicate:

    • Poor immune system
    • Lymphocyte cells are trapped in the spleen or lymph nodes
    • The marrow cannot make enough lymphocytes
    • Something is destroying the lymphocytes

    Some acquired causes of Low Lymphocyte Count:

    • Typhoid fever
    • Viral Hepatitis
    • HIV/AIDS
    • Tuberculosis
    • Aplastic Anemia
    • Myelofibrosis
    • Systemic Lupus Erythematosus (SLE)
    • Hodgkin’s Lymphoma
    • Dengue
    • Radiation and Chemotherapy

    Some inherited causes of Low Lymphocyte Count:

    • Wiskott–Aldrich syndrome
    • Ataxia-telangiectasia
    • DiGeorge Syndrome
    • Severe Combined Immunodeficiency

    High lymphocytes (lymphocytosis) may indicate cancer, autoimmune disorder or severe viral infection.
    Lymphocytes are white blood cells that help defend the body from illness, consisting of three major types: B cells, T cells, and NK (Natural Killer) cells:

    • B cells – release antibodies that fight bacteria and toxins, also assist in activation of T cells
    • T cells attack cells that have been infected by viruses or malignancies, and consist of 4 sub-types:
      • CD4+ (Th or T helper cells) – activate and regulate B and T cells, release T cell cytokines to aid the adaptive immune system to recognise foreign invaders
      • CD8+ (cytotoxic T cells) – tumour cells and virus infected cells
      • γ δ (gamma delta) T cells – bridge between innate and adaptive immune responses (phagocytosis)
      • Regulatory (supressor) T cells – return the immune system to normal functioning after an infection, preventing auto-immune disease
    • NK (Natural Killer) cells – part of the innate immune system, also assisting the adaptive immune system, important in cancer therapy, helping reject tumours and cells infected by viruses,
      killing invaders by releasing small cytoplasmic granules of proteins that literally reprogram the target cells to self-destruct
  • Monocytes – making up 5.3% (can be 2% to 8%) of the White Blood Cells, monocytes migrate from the blood into other tissues as macrophages,
    also into the liver where they become Kupffer cells.

Blood Biochemistry, or Blood Chemistry

Electrolytes

Electrolytes are electrically charged chemicals (ions) that are vital to normal body processes, such as nerve and muscle function.
Electrolytes help regulate fluid in the body and maintain the acid-base balance.
The important electrolytes: Sodium, Potassium, Chloride and Bicarbonate (HCO3).
Normally bundled with the electrolytes are the important mineral tests: Phosphorus, Calcium, Iron, Zinc and Magnesium. Magnesium not normally tested as only about 1% of the body’s Magnesium is in the blood, but very important, as 90% of the population has lower than optimal Magnesium intake. Zinc also seldom tested, but equally important.

Sodium

Normal range: 135 to 145 mmol/L (or mEq/L) depending on the lab.
An essential electrolyte.  Essential for the body to balance water volume and pressure in thee body tissues, carry nutrients into cells and wastes from cells,  for nerve impulses and muscle contractions, automatic functions in the intestinal tract.
Irregularities in levels may indicate dehydration, disorders of the adrenal glands, excessive salt intake, corticosteroids, painkiller medications, liver or kidney problems.
The body keeps sodium levels in the normal range by excreting more or less through the kidneys into urine.
High sodium may raise blood pressure, and/or cause leg swelling in some people.
Many factors affect levels. Shock or trauma may increase levels. Some prescription diuretics, anti-depressants and blood pressure medications deplete sodium.
Drinking too little water can increase levels, drinking too much water can deplete levels.
Excessive sweating or vomiting can reduce sodium levels.
Too much sodium (Hypernatremia) or too little sodium (Hyponatraemia) cause many problems.

Sodium above the range may suggest:

  • Water retention, weight gain (water weight!)
  • High Blood Pressure
  • Dehydration
  • Diabetes
  • Dysfunction of Adrenal Glands

Sodium below the range may suggest:

  • Addison’s Disease (Damaged Adrenal Glands)
  • Severe Diabetes
  • Liver Cirrhosis
  • Kidney damage
  • Diuretic medications
  • Congestive heart failure
  • Excessive sweating
  • Diarrhea
  • Hypothyroidism

Urine Sodium

The amount of Sodium in urine, which is excreted by the kidneys.
Used with other electrolyte tests, and to help determine kidney function.
Reference Range: 20 mmol/L as a random urine test, or 28-272 mmol/L as a 24-hour urine test.
The excretion of sodium varies with dietary intake, and excretion is greater in daytime than at night.
Medications known to interfere with the results:
Corticosteroids

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Prostaglandins (used to treat conditions such as glaucoma or stomach ulcers)
  • Water pills (diuretics)

Low urine levels may be due to:

  • Congestive heart failure
  • Excessive sweating
  • Diarrhea
  • Pyloric obstruction
  • Malabsorption and primary aldosteronism
  • Excess water consumption

Increased urine levels may be due to:

  • Increased salt intake (typically from processed foods)
  • Failure of adrenal glands
  • Diabetic acidosis
  • Salt losing renal (kidney) disease
  • Water deficient dehydration

Potassium

Normal range: 3.6 to 5.2 mmol/L (or mEq/L) depending on the lab.
* A critical level is 5.5 mmol/L and over 6.0 mmol/L can be life-threatening.
An essential electrolyte, required for relaying nerve impulses, maintaining proper muscle functions, and regulating heartbeats. Without Potassium, the heart cannot beat!
The body must keep potassium and sodium levels in balance with each other for correct cell function and nerve transmission. High Potassium may cause a pounding heart, especially when lying down, and increases heart attack risk if high levels maintained over a long time,

High potassium (Hyperkalemia) issues:

  • Kidney disease
  • Adrenal exhaustion
  • Some blood pressure drugs (ACE inhibitors, ARB’s, some Beta blockers)
  • Potassium sparing diuretics
  • Diabetic ketoacidosis
  • Primary aldosteronism
  • Cushing’s syndrome
  • Heavy alcohol use
  • Drug use
  • Anything causing muscle breakdown (which releases potassium into the blood), e.g.Statins
  • Possible false score if the blood specimen is mis-handled

Low potassium levels (Hypokalemia) issues:

  • Irregular heart beat
  • Diuretics (mainly “Loop Diuretics”)
  • Blood pressure drugs (if they include loop diuretics)
  • Loss of body fluids
  • Exhaustion
  • Swollen ankles and fingers
  • Worse menopause symptoms
  • Stress
  • Asthma drugs (such as Abuterol)
  • Antibiotics
  • Diarrhea
  • Anorexia
  • Laxatives
  • Partial paralysis in legs, hands

Constipation can be a symptom of high or low potassium.
Low potassium is a major cause of cardiac arrhythmia, which can be a life-threatening condition.

Chloride

Normal range: 98 to 106 mEq/L (USA labs).
An essential electrolyte, and the body must keep chloride levels in the normal range.
Often will increase (hyperchloraemia) or decrease (hyporchloraemia) with changes in sodium levels (from salt – Sodium Chloride).
Some medications or a diet high in salt can cause high chloride.
Excess chloride may indicate an acidic environment in the body, or dehydration, multiple myeloma, kidney disorders, or adrenal gland dysfunction.

Bicarbonate (total HCO3, total CO2)

Normal Range: 24 to 30 mmol/L (Australia) or mEq/L (USA)
Most of the carbon dioxide in the body is in the form of bicarbonate (HCO3).
An essential electrolyte, part of a standard blood electrolyte panel, and part of a renal (kidney) function test, lung test or metabolic test.
Normally taken from a vein (in the crook of the elbow), but for some lung tests, it is taken from an artery, usually in the wrist, for an ABG (Arterial Blood Gas) test.

ABG (Arterial Blood Gas)

Taken from an artery to test for various gases which may indicate problems with the heart, lungs, metabolism or kidneys.
Not normally tested unless there is a serious illness.

Serum Anion Gap

Anion Gap (AG or AGAP) is the difference between measured cations and measured anions in serum.
This difference does not reflect a true disparity between positive and negative charges,
because serum is actually electrically neutral when all serum cations and anions are measured.
Rather, the anion gap is a measurement artifact resulting from the fact that only certain cations and anions are routinely measured.
Cations are ions with a positive electric charge. Anions are ions with a negative electric charge.
Anion gap metabolic acidosis is secondary to the addition of endogenous or exogenous acid.
Anion Gap can be calculated in different ways, but commonly the sum of common cations less the sum of common anions:
Serum Anion Gap (AG) = Sodium (Na+) + Potassium (K+) less the sum of (Chloride Cl) and Bicarbonate HCO3)
Sometimes the potassium is ignored, as it is comparatively small compared to Sodium, giving different results:
Reference range for serum Anion Gap is 8 to 16 mmol/L or mEq/L (without potassium)
Reference range for serum Anion Gap is 12 to 20 mmol/L or mEq/L (with potassium)
Normal Anion Gap is specific to laboratory and equipment used.
Newer technology and equipment have been shown to measure “low” Anion Gap in otherwise normal, healthy people.
Because there are other chemicals with anions in the body, a test below 11 is considered normal.
If test results are unexpected, the doctor may ask for a test repeat, as errors in any of the electrolyte tests will give an incorrect Anion Gap calculation.
A high Anion Gap, typically over 20, can indicate:

  • Lactic Acidosis (high blood lactic acid level), e.g. from over-exercising
  • Diabetes where ketones break down causing diabetic ketoacidosis
  • Starvation causing ketoacidosis
  • Alcoholic ketoacidosis
  • Poisoning, e.g. methanol, aspirin, carbon monoxide, cyanide, anti-freeze (ethylene glycol)
  • Toluene poisoning
  • Paracetamol (Acetaminophen) overdose
  • Paraldehyde overdose
  • Iron overdose
  • Kidney failure, when kidneys cannot take in bicarbonate which is then lost in the urine
  • Uremia (urea in the blood)

A low Anion Gap can be caused by:

  • Hyponatremia (decreased sodium in the blood)
  • Multiple myeloma (cancer of plasma cells in bone marrow)

Other causes of low Anion Gap, although less common:

  • Bromide (negatively charged) intoxication, from some sedative drugs, medication for myasthenia gravis, and some herbal medications.
    High bromide can lead to neurologic or dermatologic symptoms. Bromide can interfere with chloride calculation, giving a false low Anion Gap.
    Bromide is often used in heated spas as a disinfectant, where it is readily absorbed through the skin, also blocking thyroid uptake of Iodine
  • Lithium is positively charged, often prescribed for bipolar disorder, and high concentrations may lower Anion Gap
  • Increase in positively charged ions such as calcium and magnesium can also lower the Anion Gap

Urine Anion Gap

The Urine Anion Gap test where the ammonium ion (NH4+) is the main positive ion (Cation).
However, Urine NH4+ is difficult to measure directly, but its excretion is normally accompanied by the anion chloride,
So the Urine Anion Gap is calculated by the sum of Urine Sodium plus Urine Potassium less Urine Chloride (Na+ + K+ – Cl)
Bicarb is omitted in this formula because urine is generally acidic, and Bicarbonate is generally negligible.
Note that urine values are different from serum values, so these results cannot be interchanged in the formula.
Typical values of Urine Anion Gap:
0 to 10 mmol/L (or mEq/L), and values over 10 mean the body is more acidic (undesirable).
Urine Anion Gap result over 20 indicates metabolic acidosis, usually when the kidneys cannot excrete ammonia, e.g. in renal tubular acidosis.
A negative Urine Anion Gap can be used as evidence of increased NH4+ excretion.
A zero or negative Urine Anion Gap while the Serum Anion Gap is positive, suggests a high urinary NH44+ (probably caused by gastrointestinal, e.g. diarrhea or vomiting).

Glucose

The amount of glucose in the blood at the time of the test. A relatively constant level of glucose must be maintained in the blood.
For a more helpful test, see the HbA1c test.
Should always be a fasting test, minimum 2 hours after a meal, but preferably fasting overnight after at least 6 hours without food or drink other than water.
Normal range is around 3.2 to 5.5 mmol/L (70 to 100 mg/dL in USA labs).
Results below this range is hypoglycaemic (low blood glucose) and urgent medical attention is required.
Elderly people generally test higher, even if they are healthy.
Levels are affected by food or drink recently ingested, recent exercise, stress levels, medications, hydration and the time of day.
Ranges above 5.5 are hyperglycaemic (high blood glucose).
5.5 to 6.9 is considered pre-diabetic, and over 6.9 is diabetic.
Doctors normally prescribe Metformin (with nasty side-effects) rather than refer to a nutritionist who can advise elimination of sugar,
high-carbohydrate and processed foods from the diet, and use magnesium supplements,
which in nearly every case will eliminate diabetes as well as reduce excess weight and improve cardiovascular health and reduce risk of dementia.

Random Glucose Level

Also called RBC (Random Blood Glucose) or CBG (Casual Blood Glucose). A recent meal is assumed, so has a higher reference range than the fasting glucose test above.
Typical range for a normal adult is 4.4 – 7.8 mmol/L (Australia) or 79 – 140 mg/dl (USA).
Results above this may not indicate diabetes (could also be a recent high sugar or carbohydrate meal), but a fasting glucose test should then be carried out to confirm if diabetes is suspected.

The Kidney Function Group of Tests

Note that kidney issues often show no symptoms until they are both working as low as 10% capacity,
so regular testing is advised to capture problems early while changes to diet, medications and lifestyle can correct the issues.
Some symptoms of kidney dysfunction include fatigue, swelling and hypertension.
The Kidney Panel usually consists of the following tests:
Electrolytes, –

Minerals include:

Phosphorus, vital for energy production, muscle and nerve function, bone growth and as a buffer to maintain the acid-base balance.
Calcium, essential for the proper functioning of muscles, nerves, and heart, also for blood clotting and bone formation.

Protein
Albumin – a protein that makes up about 60% of protein in the blood. Roles include keeping fluid from leaking out of blood vessels, and transporting hormones, vitamins, drugs, and ions like calcium throughout the body.
Waste products
Three calculated values may also be reported with a renal panel:
Estimated Glomerular Filtration Rate (eGFR) – a calculated estimate of the actual glomerular filtration rate (GFR, the amount of blood filtered by the glomeruli in the kidneys per minute) derived from creatinine levels in the blood; the formula takes into account the person’s age, gender, race, and sometimes height and weight.

Urea, or BUN (Blood Urea Nitrogen)

Urea, or BUN (Blood Urea Nitrogen) is a nitrogen-containing waste product that forms from metabolism of protein.
Released by the liver into the blood and is carried to the kidneys, where it is filtered out of the blood and eliminated in the urine.
Normal Range: 2.5 to 7.1 mmol/L or 10 to 20 mg/dL (USA labs). Not always tested in Australia.
High levels indicate poor kidney function, and results should be looked at in combination with the creatinine test.
May also be influenced by function.
Many medications and/or a high-protein diet can also raise BUN levels.

BUN/creatinine ratio

Urea (BUN)/creatinine ratio is a comparison of urea (nitrogen) to creatinine content in the blood.
Normal Range: Ratio of BUN to creatinine: 10:1 to 20:1 (men and older individuals may be somewhat higher)
Shows if kidneys are eliminating waste correctly.
High levels of creatinine, a by-product of muscle contractions, are excreted through the kidneys and suggest reduced kidney function.

Creatinine (Serum)

To determine if kidneys are functioning normally.
This test is used in conjunction with Urea and eGFR tests.
This is a waste product, disposed of by the kidneys, so any elevation may indicate kidney problems.
Creatinine is not re-absorbed or recycled, so if the kidneys cannot eliminate creatinine through the urine, levels will continue to rise.
High levels may also be caused by muscle problems, such as rhabdomyolysis (breakdown of muscle) often caused my statin medication.
Body builders may take Creatine supplements (not the same thing as creatinine) which is a natural product made by the body, but breaks down into creatinine,
and will increase the creatinine test results. Creatine has been shown to increase water retention in some people, causing swollen ankles,
but this mainly occurs in those with poor kidney function, and the doctor should order a series of kidney tests.
Certain chemicals can cause analytic interference of Creatinine measurements.
Ketoacids (such as occurring in diabetic ketoacidosis) and 5-aminolevulinic acid (sometimes administered for photodynamic therapy) interfere with the alkaline picrate (Jaffé) assay of creatinine, giving falsely high readings and the incorrect impression of kidney dysfunction.
The issue does not arise with enzymatic creatinine measurements, so different labs using either the Jaffé assay or the enzymatic method will give different results.
Note also that Amlodipine and some similar blood-pressure medications, cause increased Creatinine, often resulting in swollen ankles, indicating kidney dysfunction, especially for those who are male, over 60 years old, and also take the drug Furosemide, and also have high cholesterol.
Other drugs such as Cimetidine, Trimethoprim, Corticosteroids, Pyrimethamine, Phenacemide, Salicylates, and active Vitamin D metabolites, can also increase plasma Creatinine without influencing glomerular filtration, thought to be through inhibition of Creatinine secretion, so a urine creatinine test would perhaps show a reduced level of creatinine compared to the increased serum results.
This is the blood (serum) test. See also the Creatinine Urine test below.
Normal range:
Men (18 to 60 years): 80 – 115 umol/L (Australia) or 0.9 to 1.3 mg/dL (USA)
Women (18 to 60 years): 53 – 97 umol/L (Australia) or 0.6 to 1.1 mg/dL (USA)
The elderly may test a little lower.
Men (60 to 90 years): 71 – 115 umol/L (Australia) or 0.8 to 1.3 mg/dL (USA)
Women (60 to 90 years): 53 – 106 umol/L, some labs say 45 to 90 umol/L (Australia) or 0.6 to 1.2 mg/dL (USA)

Creatinine (Urine)

Kidneys filter creatinine from the blood, excreting it through urine. The creatinine urine test may detect kidney malfunctioning.
This test is normally performed as a 24-hour urine test.
All urine is collected for 24 hours, stored in the refrigerator (not frozen), mixed and the result poured into a small sample bottle and labelled as such.
If a 24-hour test cannot be performed, a mid-stream urine sample from the first morning urination can be used, but results will not be as accurate, as urine creatinine levels change normally throughout the day.
Creatinine is a metabolic waste product of muscle metabolism and meat consumption, so those with a high protein diet, or very muscular, or have muscle damage, will have higher levels.
Urine creatinine levels may fluctuate depending on race, muscle mass, diet and certain medications.
Labs usually do not specify a normal range, as results can vary, and the test is generally used in conjunction with other tests to determine kidney function.
Normal range (subject to many factors, check with your doctor or laboratory if results appear out of range):
Men: 1.7 to 28 mmol/L (20-320 mg/dL USA labs)
Women: 1.7 to 24 mmol/L (20-275 mg/dL USA labs)

Creatinine Clearance

How fast creatinine is cleared by the kidneys, another way of estimating kidney function.
Low test results may mean kidney problems such as tubule damage, kidney failure, restricted kidney blood flow, kidney filtering unit damage, dehydration, obstructed bladder outlet, heart failure.
Normal Range:
Men: 97 to 137 ml/min. (all labs)
Women: 88 to 128 ml/min. (all labs)

eGFR (Glomerular Filtration Rate)

Used to screen for early kidney damage and to monitor kidney status. Performed by the creatinine test and calculating the estimated Glomerular Filtration Rate.
The creatinine test is ordered as part of a routine metabolic panel, or along with a Blood Urea Nitrogen (BUN) test to evaluate the kidney status,
or to monitor those with known chronic kidney disease and those with diabetes and hypertension which may lead to kidney damage.
A low rate means some kidney damage has occurred.

KIDNEY DAMAGE STAGE DESCRIPTION GFR OTHER
1 Normal/minimal kidney damage with normal GFR 90+ Protein or albumin in urine are high, cells or casts seen in urine
2 Mild decrease in GFR 60-89 Protein or albumin in urine are high, cells or casts seen in urine
3 Moderate decrease in GFR 30-59
4 Severe decrease in GFR 15-29
5 Kidney failure under 15

Related test: Cystatin C

Often used as an alternative test to eGFR.
Kidney damage can cause gynecomastia in men due to decreased testosterone levels, leading to greater estrogen/testosterone ratio.

Cholesterol (total)

A fairly meaningless test – see Cholesterol (Lipid) Testing below.
Labs use around 0.0 to 5.4 nmol/L for a normal range, but very low levels, or rapidly dropping levels can indicate a higher risk for cancer, anxiety, depression, and if pregnant, premature birth and low birth weight.
High levels are a signal for doctors to prescribe statin drugs, when the cause should be investigated
(inflammation, which causes the body to make more cholesterol to repair the damage caused by inflammation).
Many smarter doctors are now agreeing with the science: Cholesterol is not bad, and unless levels go into the 8.0 area and above, there is not a huge problem as long as HDL levels are high enough.

Urate (Uric Acid)

Produced by the breakdown of purines. Normal range, Men: 0.208 to 0.416 mmol/L (3.5 to 7.0 mg/dL), desired range less than 0.36mmol/L (6.0 mg/dL)
Sometimes units given as µmol/L which is mmol/L / 1000, e.g. 0.416 mmol/L = 416 µmol/l.
Excess uric acid (Hyperuricemia) is excreted by the kidneys and disposed in the urine and faeces.
It is normal to have some Uric acid in urine.
High uric acid causes crystals to form in the joints – a painful condition known as gout, often in the big toe joint,
although not everyone with high uric acid has a problem. Some with levels up to 0.571 mmol/L (9.6 mg/dL) still have no gout.
Men are much more likeley to have gout than women up tp ages 50 to 60,
probably because testosterone aggravates gout, and men lose a large amount of testosterone and often gain excess body fat in senior years.
High Uric acid can increase risk of diabetes, cardiovascular disease and ammonium acid urate kidney stones.
High Uric acid (Hyperuricemia) can be caused by:

  • Obesity or excess body fat
  • High purine foods
  • Thiazide diuretics (hydrochlortiazide)
  • ACE inhibitors and beta blockers
  • Loop diuretics (including Furosemide or Lasix®)
  • Anti-TB (Tuberculosis) drugs
  • Chemotherapy drugs
  • Immune suppressing drugs
  • Other drugs including:
    • Acitretin
    • Didanosine
    • Filgrastim
    • L-dopa
    • Omeprazole
    • Peg-interferon + ribavirin
    • Sildenafil
    • Teriparatride
    • Ticagrelor
    • Topiramate
  • Vitamin B3 (niacin), mainly high doses
  • Insulin resistance (type 2 diabetes)
  • Fasting or rapid weight loss, usually temporary
  • Low dose Aspirin (60 to 300mg daily)
  • Fructose (generally from fruit juices or foods sweetened with HFCS – High Fructose Corn Syrup)
  • Apples, peaches, pears, plums, grapes, prunes, dates all contain fructose, but OK in moderation
  • Yeast containing foods: Vegemite, Marmite, bread
  • Xylitol, a natural sweetener
  • Glycerol
  • Sorbitol
  • Testosterone
  • Recent surgery or trauma

Low uric acid (Hypouricemia) may indicate, cause or be caused by:

  • Hyperthyroidism
  • MS (Multiple Sclerocis)
  • Fanconi Syndrome (Kidney disease, genetic, from some drugs or heavy metals),
  • Myeloma (Cancer of blood plasma cells in bone marrow)
  • Nephritis (Kidney inflammation)
  • Wilson’s Disease (genetic, causing copper accumulation)

Phosphate (Phosphorus)

Normal range: 0.8 to 1.4 mmol/L (2.5 to 4.3 mg/dL)
Phosphorus is important for bone health, energy storage, nerves and muscles, and related to calcium levels, which should be read in conjunction.
High phosphorus (Hyperphosphatemia) may indicate kidney or parathyroid problems, alcohol abuse, long-term antacid use,
excessive diuretics, malnutrition or high/low vitamin D.
Meat, dairy products and other foods contain phosphorus, so insufficiency (Hypophosphatemia) is rare.
Liver disease and low vitamin D can cause high or low phosphorus levels.
Low phosphate (Hypophosphataemia) can be caused by poor nutrition, low vitamin D3, poor absorption.
Extra-low (less than 0.4 mmol/L) may be caused by redistribution into cells, kidney losses or low intake.
Often accompanies other electrolyte deficiencies.
The test results will not determine the cause of high or low readings, so more tests are then required.

Total Calcium

The amount of calcium circulating in the blood, normal range 2.10 to 2.55 nmol/L (USA labs 9.0 to 10.5 mg/dL). Elderly people usually test a little lower.
Calcium levels over 3.0 (Hypercalcaemia) are a cause for further investigation, as high levels can increase risk of blood clots, and may indicate other problems.
Possible causes are Sarcoidosis, too much or too little Vitamin D, kidney problems, over-active thyroid or parathyroid, some cancers (such as lymphoma, parathyroid, and pancreatic).
This test does not tell us how much calcium is in the bones and teeth, where most of the calcium is stored, only the amount in the blood.
If out of range, additional tests may be required for ionised calcium, urine calcium, phosphate, magnesium, vitamin D and PTH (parathyroid hormone).
Normally, the Parathyroid hormone (PTH) and vitamin D control blood calcium levels within a narrow range of values. See the PTH section for more info.
Low calcium (Hypocalcemia) may be caused by low vitamin D3, poor intestinal absorption, the amount of phosphate in the blood, anorexia or poor nutrition.
Low calcium may cause cramps and twitching.

Calc.IC – Ionised Calcium

Normal Range 1.10 to 1.25 nmol/L
Usually included in the standard tests.
This test result in normal people is inversely related to PTH (parathyroid hormone) so the PTH test is required if Ionised Calcium is out of range.

The Liver Function Group of Tests

These tests should be called “Liver Damage Tests” instead of “Liver Function Tests” as they only report problems when damaged liver cells leak enzymes into the blood, and the
liver can lose significant function before abnormalities show up in these tests: Bilirubin, CGT, AST, ALT and ALP.
These tests are looked at in conjunction with the blood proteins: Globulins, Albumin and Fibrinogen.

Albumin

Normal range: 37 to 48 g/L. USA labs often say 3.9 to 5.0 g/dL (39 to 50 g/L)
A protein made by the liver. Helps stop blood from leaking out. A high number indicates good health.
Results at the low end of this range indicates poor health. Possible causes of low numbers are:

  • Liver or kidney disease
  • Malnutrition
  • Malabsorption in the intestines

The doctor may then order a prealbumin test and other tests to determine the nature of the problem.

Urine Albumin

Reference range: 0 to 25.0 mg/L (Australia and USA)

Albumin/Creatinine Ratio – Urine

Reference range: 0 to 3.5 mg/mmol

Globulins

Simple proteins found in the blood. Range depending on many factors: 21 to 41 g/L
Globulins are a family of globular proteins with a higher molecular weight than albumins. They are insoluble in pure water, but dissolve in dilute salt solutions.
Some are produced in the liver, others are made by the immune system.
There are four different globulin groups: gamma (immune system), beta (hormone transport), alpha-1 and alpha-2 (clotting function).
Individual groups may be tested if further diagnosis is required.
Low test results may indicate liver disease, IBS (Irritable Bowel Syndrome) or inability to digest or absorb proteins, celiac disease, cancer, anaemia, kidney disease, poor immunity and more.
High test results may indicate a chronic or infectious disease, leukemia or other bone marrow disease, autoimmune disease like lupus or rheumatoid arthritis, kidney or liver disease, or carcinoid tumours.

A/G ratio (albumin/globulin ratio)

Healthy ratio: A little over 1.0, which means more albumin than globulin.
The blood contains two types of protein: albumin and globulin.
The A/G ratio test compares levels of these proteins with one another.

Serum Protein

Typically total proteins are the sum of albumin and globulin.
Normal Range 64 to 83 g/L
High levels can be caused by dehydration or other factors. See the notes on Albumin and Globulin.
Low protein is when Albumin and/or Glogulin levels are low, and indicates poor health.

Total Bilirubin

Bilirubin is the yellow-coloured pigment in the bile, produced as the liver breaks down heme from hemoglobin in old red blood cells,
and gives stools the normal brown colour as it is excreted.
Bilirubin is a lipophilic antioxidant, reducing lipid peroxidation (oxidative degradation of lipids),
where free radicals steal electrons from lipids in cell membranes, causing cell damage.
Low bilirubin is associated with an increase in all-cause mortality, but most doctors do not know this,
they say that low levels mean better health!
Range (Total): 2 to 20 umol/L or USA Labs: 0.3 to 1.9 mg/dL.
Range (Direct) 1.0 to 5.1 umol/L or USA Labs: 0 to 0.3 mg/dL.
Different ranges apply for babies and between labs.
High levels can indicate poor function of liver and kidneys, problems in bile ducts, and anaemia, and usually indicate the need for further tests.
However, if further tests reveal no issues with liver or other organs, high bilirubin is a good thing, leading to higher glutathione and a longer, healthier life.
Bilirubin in the blood circulates in two forms:
Indirect (unconjugated) bilirubin – insoluble in water – changed in the liver to a soluble form.
Direct (conjugated) bilirubin – soluble form – made in the liver from indirect bilirubin.
Total bilirubin and direct bilirubin levels are measured directly in the blood, while indirect bilirubin is calculated from the total less the direct bilirubin.
High bilirubin (hyperbilirubinemia) cause skin and/or whites of the eyes to appear yellow (jaundice),
caused by liver disease (hepatitis), blood disorders (hemolytic anemia), or blockage of the bile ducts from the liver to the small intestine.
Hyperbilirubinemia in a newborn baby may cause brain damage (kernicterus), hearing loss, problems with eye movement muscles,
physical abnormalities, and even death.
Babies who develop jaundice can be treated with phototherapy (special lights or a “light blanket”) or a blood transfusion
to lower their bilirubin levels.
When the liver is mature enough to control bilirubin, all symptoms disappear and no further treatment is required.
Standard blood tests only test for total bilirubin and other tests are prescribed only if results or symptoms determine the need for more tests.

GGT (Gamma-Glutamyltransferase)

A very sensitive enzymatic indicator of liver disease.
Common reasons for elevated values can indicate alcoholic cirrhosis (from heavy drinking, or consumption of other liver-toxic substances).
A healthy liver can only detox one alcoholic drink in two hours, so those people who consume two drinks in one hour have a quadruple liver-overload condition.
Used to determine if raised alkaline phosphatase is due to skeletal disease (normal range GGT) or indicate hepatobiliary disease (raised GGT).
Normal range varies – small children approx 7 to 19 U/L (male), 6 to 29 U/L (female) with the high side increasing with age to 50 and above for the elderly.
Adult level range usually around 0 to 45 U/L but always check with the lab and the doctor for your appropriate range.
(GGT) activity is seen in any and all forms of liver disease, although the highest elevations are seen in intra- or post-hepatic biliary obstruction.
Excess alcohol consumption will increase CGT.
High GGT combined with high ALP indicates some form of hepatobiliary disease.

ALP (Alkaline Phosphatase)

Normal range: varies from 45 to 115 U/L (adult male) and 55 to 142 U/L (adult females). USA labs often say 44 to 147 U/L.
OPTIMAL range: depends on age. Adolescents have a much higher ALP when rapidly growing compared to a fully grown adult because the osteoblasts are laying down bone very rapidly.
For adults, 50 to 75 is considered a reasonable optimal range.
Children and female ranges are very varied so always check with the lab for the correct range for your age and sex.
The SI units IU/L are the same as the US units U/L.
ALP is a group of enzymes present mainly in liver (isoenzyme ALP-1) and bone (isoenzyme ALP-2), with lesser amounts in the intestines (isoenzyme ALP-3),
the placenta, the kidneys (in the proximal convoluted tubules) and in white blood cells.
When any of these cells are damaged, ALP is released into the bloodstream.
The ALP enzyme is synthesised in the hepatocytes adjacent to the biliary canaliculi.
Elevations typically indicate problems with bone disease, the liver or obstruction.
Obstruction can be in the biliary tract, which may occur within the liver, the ducts leading from the liver to the gallbladder,
or the duct leading from the gallbladder through the pancreas that empty into the duodenum (small intestine). Any of these organs (liver, gallbladder, pancreas, or duodenum) can be involved.
High ALP can indicate:

  • Liver, Obstruction or Congestion:
    • Cholestasis (decrease in bile flow)
    • Obstructive jaundice (the liver responds to biliary obstruction by synthesising more ALP)
    • Oral contraceptives
    • Obstructive pancreatitis
    • Hepatitis/Mononucleosis/CMV
    • Congestive heart failure
    • Parasites
    • Malignancy involving liver
    • Giant Cell Arteritis, especially with Cholestasis
  • Bone / Skeletal issues involving osteoblast hyperactivity and bone remodeling:
    • Paget’s disease
    • Rickets
    • Shingles (Herpes Zoster virus)
    • Osteomalacia
    • Osteogenic sarcoma
    • Fractures
    • Osteoporosis treatment
    • Adrenal cortical hyperfunction
  • From other conditions:
    • Pregnancy (late, as the placenta produces ALP)
    • Hyperparathyroidism
    • MEN II (Multiple endocrine neoplasia)
    • Leukemia
    • Lymphoma
    • Amyloidosis
    • Granulation tissue
    • Gastrointestinal inflammation (Inflammatory Bowel Disease, Ulcerative colitis, Crohn’s, ulcers)
    • Systemic infections (sepsis)
    • Sarcoidosis
    • Rheumatoid arthritis
    • Hodgkin’s Lymphoma, gynecologic malignancies and some other cancers
    • Acute tissue damage in the heart or lungs (myocardial or pulmonary infarctions)

Low ALP can indicate:

  • Zinc deficiency
  • Hypothyroidism
  • Vitamin C deficiency or Scurvy
  • Folic acid deficiency
  • Excess Vitamin D intake
  • Low phosphorus levels (hypophosphatasia)
  • Celiac disease
  • Malnutrition with low protein assimilation (including low stomach acid production/hypochlorhydria)
  • Insufficient Parathyroid gland function
  • Pernicious anemia
  • Vitamin B6 insufficiency
  • Hypophosphatasia
  • Protein deficiency
  • Wilson disease

ALT (Alanine Aminotransferase)

Also known as Serum Glutamic Pyruvic Transaminase, or SGPT
Normal range: adult males: 7 to 55 U/L, adult females: 7 to 45 U/L depending on age and lab.
Some USA labs say 8 to 37 U/L, some Australian labs say 0 to 54 U/L.
OPTIMAL Range: 20-30 U/L
This test checks for elevated liver enzymes. Note that if the patient is taking high-dose
Niacin, it is normal to have elevated ALT.
Of course, it is NOT normal to have VERY high ALT, and medical advice should be sought, but a little over the normal range can be contributed to Niacin,
and this is not a problem by itself, but should be taken into account if there are other abnormal liver tests.
The other common cause for high ALT is drinking too much alcohol. A healthy liver can detox one alcoholic drink in around 2 hours.
If the patient has 4 drinks in 4 hours, then the liver is double-overloaded and suffers accordingly.
The solution? Stop drinking alcohol!
Diagnosis of liver disease associated with hepatic necrosis (hepatic = liver, necrosis = cell death).
When the liver is fine, results are within range, the lower the better.
High ALT is seen in parenchymal liver diseases where hepatocytes are destroyed, with values often ten times above normal, sometimes as high as one hundred times the upper reference limit.
In some liver infections or inflammatory conditions, ALT is usually higher or as high as AST, and the ALT/AST ratio (normally less than 1), becomes greater than 1.
ALT increases usually occur prior to appearance of symptoms of disease. The liver can lose a lot of function before symptoms appear.
High ALT results can be from other causes, such as:

  • Liver damage such as viral hepatitis
  • Acute lymphocytic leukemia (ALL)
  • Lead poisoning
  • Drug reactions
  • Carbon tetrachloride exposure
  • Large tumor necrosis (decay)
  • Shock
  • Mononucleosis
  • Excessive alcohol consumption
  • Panadol, Parecetamol, Acetaminophen, Tylenol
  • Rapidly growing children
  • Cirrhosis
  • Liver cancer
  • Heart attack
  • Thyroid disease
  • Polymyositis
  • Severe burns
  • Pancreas, Kidney or muscle injury
  • Strenuous exercise
  • Antibiotics, statins, chemotherapy, aspirin, narcotics, and barbiturates
  • Herbs such as echinacea or valerian
  • Injections into a muscle
  • Recent cardiac catheterization or surgery
  • Hemochromatosis
  • Liver ischemia (Lack of blood flow to the liver)
  • Taking high strength Niacin

ALT values are normally compared to ALP (alkaline phosphatase) and AST (aspartate aminotransferase) to diagnose which form of liver disease is present.

AST (Aspartate aminotransferase)

Also called SGOT, Serum Glutamic-Oxaloacetic Transaminase, GOT, Aspartate Transaminase

Normal range: around 8 to 48 U/L, some labs say 0 to 45 U/L, some USA labs say 10 to 34 U/L
An enzyme found in the liver, heart, skeletal muscle and kidneys, in both the cytoplasm and mitochondria of cells.
Not always related to the liver. Elevated values typically mean disease of the heart, muscle, liver, or all.
Mild tissue injury caused the main form of AST to be the cytoplasm form, and major tissue damage results in higher mitochondrial enzyme.
High AST may be found in myocardial infarction (heart attack), acute liver cell damage, viral hepatitis and carbon tetrachloride poisoning.
More moderate rise in AST can be caused by muscular dystrophy, dermatomyositis, acute pancreatitis and crushed muscle injuries.

LD or LDH (Lactate Dehydrogenase)

Normal range: Approx 110 to 230 U/L depending on the lab.
Lactate dehydrogenase is an enzyme, found in almost every living cell, but mostly in the heart, liver, muscles, kidneys, lungs and blood (erythrocytes).
LDH catalyzes the conversion of lactate to pyruvic acid and back, as it converts NAD+ to NADH and back.
A dehydrogenase is an enzyme that transfers a hydride from one molecule to another.
Used to monitor changes in tumour burden after chemotherapy.
High LD is common in cancer patients but results are too erratic to formally diagnose cancer.
High LD generally means that mitochondrial function is compromised, meaning that newly diagnosed cancer patients will have a poor outlook.
High LD is also seen in:

  • Megaloblastic anemia
  • Untreated pernicious anemia
  • Hodgkin’s disease
  • Abdominal and lung cancers
  • Severe shock
  • Hypoxia (reduced oxygen)

Moderatly high LD is seen in:

  • Myocardial infarction (heart attack)
  • Pulmonary infarction
  • Pulmonary embolism
  • Leukemia
  • Hemolytic anemia
  • Infectious mononucleosis
  • Progressive muscular dystrophy
  • Liver and kidney disease

Other tests outside the standard blood tests

Vitamin D3 (25-hydroxycholecalciferol) Testing

Not normally tested unless it is asked for, but given that two-thirds of Australians have less than the minimum vitamin D3,
and nearly 98% have less than optimum levels, and almost 97% of all cancer patients have less than optimal vitamin D3, this test should be mandatory.
Those most at risk include:

  • Those who shower every day, as showering washes off the pre-vitamin D compounds absorbed from sunlight the day before
  • Those with dark skin or wear clothing covering most of the body
  • Those who slip, slop, slap, which is the WRONG thing to do except on cloudy days
  • Those who live further from the equator, where the sun is seldom high in the sky
  • Those who are aged 50 or older, because as we age, we lose the ability to synthesise vitamin D from sunlight
  • Those who work nights and sleep in the day, restricting sunlight exposure
  • Those taking statin medications for cholesterol, as these medicationss prevent the liver from making the ingredients to manufacture vitamin D

Most of the labs say we need from 60 to 160 nmol/L, some medical institutions say we need 20 to 95, and most doctors accept the lab results.
Some labs are now revising their optimal range upwards: 75 to 250 nmol/L.
What we REALLY need is: For healthy bones, we need minimum 90, up to 175.
The OPTIMAL range for IMMUNITY to all disease including most cancers is 125 to 175 nmol/L, preferably in the high end of this range.
For short-term treatment of cancer or other serious illness, we should aim for levels in the 160 to 250 range.
While it is true that vitamin D can be toxic in very high doses, the average dose sold in most stores is 1000 IU which is nowhere near enough.
LeanMachine recommends 5000 IU Vitamin D3, typical cost approx. $20 for 360 gelcaps (almost a year’s supply) at 5 times normal strength.
No cases of toxic overdose of vitamin D3 has been recorded at less than an intake of 40,000 IU.
LeanMachine also gets a lot of sunlight, but still needs this dosage to maintain levels of around 150 to 160 nmol/L.
The body’s organs have the ability to turn Vitamin D into Calcitriol, which goes to work repairing damage from infections, diseases and cancers.
Vitamin D, D2 or D3 – vitamin D3 is the ONLY vitamin we should take as a supplement.
Avoid products “fortified with vitamin D” as these almost always contain vitamin D2, a cheap, synthetic version of natural D3, which not only do not do the same job as real D3,
they actually block absorption of real D3, leaving us D3 deficient.
For the full article on vitamin D3 go to Vitamin D3 fact sheet.

Vitamin B12 (Cobalamin)

Unlike other B group vitamins which are flushed away in urine daily, B12 can last for months in the body, even though it is also water-soluble.
People who have problems taking supplements can get a B12 injection every 3 months.
Normal Range 148 to 616 pmol/L depending on the lab and other factors.
Low levels may be caused by malabsorption in the small intestine, low stomach acid, taking antacids, hyperthyroidism, parasites, pernicious anaemia or dietary insufficiency.
Vegans and vegetarians do not get B12 from plant foods except small amounts in mushrooms.
High levels may be caused by liver disease (cirrhosis or hepatitis), some types of leukemia or taking too many B12 supplements.
Health Departments recommend 2 to 5 mcg daily, but LeanMachine takes 1000 mcg daily, with test results more than double the maximum normal blood range at around 1500 pmol/L.
High doses of B12 do no harm, unlike folate – see next section.
Note: Cheap B12 supplements contain a small amount of cyanide, which is flushed away completely harmlessly in the urine.
Of course, no one should take several bottles at once, and any excess probably offers no extra benefit.
LeanMachine only recommends the
active methyl B12 which has no cyanide.
Essential as we age, because we get older, we produce less stomach acid, so produce less B12.
Up to 30% of people over 50 cannot correctly absorb and make B12 and are deficient, so supplementation is essential in the elderly.
Studies show that over 3% of people over 50 are SEVERELY deficient in B12.
Not normally tested unless we ask for it, but very important for most people over 45 or for vegans and vegetarians.
B12 is chemically the most complex vitamin, and the only water-soluble vitamin that is stored in the body for months or years, but vegetarians and especially vegans as well as most people over 50 should supplement.
Essential for anyone taking PPI (Proton Pump Inhibitors) like Nexium, which reduce stomach acid – giving short-term relief for heartburn, but impacting B12 production and adequate nutrition.
The only effective way to treat heartburn is to eat less, and only eat nutritious food.
Should always be tested along with folate, as high folate can mask B12 deficiency and vice versa – see folate test below.
Recommended : Active B12

Folate (Vitamin B9) – Testing

NOTE: Folic Acid is a cheap substitute for folate, but is not the same thing. Read more below…
Range: Folate in plasma: 7 to 30 nmol/L, folate in Red Blood Cells: 317 to 1422 nmol/L.
High folate may mask a B12 deficiency as B12 is used to process folate. Low B12 means folate is not used and builds up in the blood.
Low folate can be caused by eating disorders, alcoholism, liver disease, celiac disease, chrohn’s disease, malabsorption issues, or low vitamin C intake.
Some sources say excess folate is not a problem, but LeanMachine recommends a maximum intake of 1000 mcg daily from all sources.
One source is our Active Folate
Folate is famous for helping prevent neural tube defects in the developing foetus (e.g. Spina Bifida) when given to pregnant women.
Also helps with limb deformities, nerve problems, tumours and some birth defects.
Mothers should take Folate and B12 before, during and if breastfeeding, after pregnancy.
Because foetus problems from folate deficiency occur at just 3 weeks into the gestation period, this can be too late to start taking folate, so every woman of child-bearing age should supplement with folate.
Not so famous is the fact that most healthy people reaching 100 years of age are high in folate.
Folate benefits both sexes, helping to reduce levels of homocysteine (a marker of cardiovascular disease), especially in conjunction with B6 and B12.
Folic Acid and Folate are NOT the same thing.
Folate comes naturally from various foods such as spinach, asparagus, chickpeas, beans, and broccoli.
Folic Acid generally comes from cheap supplements.
Note: Many people have a defective MTHFR Gene which prevents the partial or full conversion from folate to the active form, MTHF ((6S)-5-MethylTetraHydroFolate) or Active Folate
This gene can be inherited or due to lifestyle, and up to 40% of the population have varying forms, producing very mild to very severe symptoms.
We can ask for a MTHFR (also known as MethylTetraHydroFolate Reductase) test, or simply use the Active Folate.
Low folate produces symptoms such as high homocysteine, hypothyroidism, lethargy, impaired cognitive function, and mood disorders.
LeanMachine recommends only the active form of Folate.
For those with the MTHFR issue, taking ordinary folate or folic acid will often make the problem worse.

NOTE: Out of range B-12 can mask testing results of Folate and vice versa, so BOTH need to be tested at the same time.

Homocysteine Testing

Range: 4 to 17 mcmol/L (normally higher in men than women)
Deficiencies in Folate and B12 cause high homocysteine, an amino acid.
High homocysteine can be caused by low folate and/or B12, too much alcohol, hypothyroidism, kidney disease, Alzheimer’s disease, homocystinuria, or cancers.
Low homocysteine can be caused by some medications, or excess folic acid, B12 or Niacin.
Read more about B-12, B-6, Active Folate and Homocysteine here.

Iron Testing

There are three different iron test ranges:
Serum Iron: Men: 12.5 to 31.3 nmol/L, Women: 8.9 to 26.8 mcmol/L
TIBC (Total Iron Binding Capacity) Men and Women: 45 to 76 mcmol/L.
Transferrin Saturation: Men 10% to 50%, Women 15% to 50%.
A test to see how well iron is metabolised in the body, often tested in conjunction with the Ferritin test – see below.
Out of range values can be diet, lead poisoning, liver, kidney, rheumatoid arthritis, hemochromotosis, anaemia, bleeding, supplement overdose.

Ferritin Testing

Normal Range: Men 18 to 270 mcg/L, Women 18 to 160 mcg/L, but some labs say 15 to 350 for men, 15 to 300 for women.
However, LeanMachine recommends levels between 20 and 80, preferably between 30 and 60. Anything outside this range can cause problems.
Ferritin is a protein that binds to iron in the blood, often tested in conjunction with the Iron test above.
High iron in the blood, pancreas or heart can cause many health problems, and eventually death.
High ferritin may be caused by:

  • hemochromotosis (over 1000 mcg/L)
  • Liver disease (cirrhosis or hepatitis)
  • Hodgkin’s disease
  • Leukemia
  • Infection
  • Arthritis
  • Lupus
  • Iron-rich diet
  • Receiving blood transfusions

Low ferritin can be caused by:

  • Bleeding (externally or internally)
  • Heavy menstrual periods
  • Pregnancy
  • Iron-deficient diet (such as vegan or vegetarian)
  • Blood donations
  • Loss through the skin (psoriasis)
  • Loss by excretion through the urine

High Iron/Ferritin has two basic treatments: Blood-letting (donating blood at the Red Cross), or taking
IP6 to chelate excess iron.
Many supplements can help chelate heavy metals from the body, but IP6 appears to be the ONLY way of effectively chelating iron with supplements.
Blood donations may be undesirable (e.g.religious reasons) or not allowed (e.g. if the donor has HIV or other disease, has recently been to an undesirable country, or is too old or otherwise ineligible).
Prescription drugs can be used, such as:

  • Deferoxamine (Desferal®), administered by subcutaneous (under the skin) infusion using a small portable pump, worn for 8-12 hours daily, usually while sleeping.
  • Deferasirox, either as:
    • Exjade®, a tablet dissolved in juice or water and taken orally once daily
    • Jadenu®, a tablet taken daily with water or other liquids
  • Deferiprone or L1 (Ferriprox™)

Side effects can be unpleasant or even damaging to health using prescription drugs. No all drugs are approved in all Countries.
IP6 appears to be the safest and most effective, and also helps treat cancer, diabetes, depression, osteoporosis, heart disease, and kidney stones.
Parkinson’s patients can improve because of reduction in excess iron, reducing neuronal degradation.

See LeanMachine’s article on Ferritin
Do NOT take iron supplements or use any method to increase or decrease iron without a full “Ferritin Study”, and watch for iron in multivitamins or other supplements.

HbA1C

Normal range: 4% to 5.6%
Pre-diabetes range: 5.7% to 6.4%
Diabetic range (controlled): 6.5% to 7%
Diabetic (uncontrolled): over 7%
HbA1C is a measure of how many glucose (sugar) molecules have “stuck” to red blood cells.
As red blood cells die in around 3 months, this gives doctors an insight into how well (or not) the patient’s blood glucose is under control,
as it effectively gives an average for the last 3 months, rather than a simple glucose test which only gives the result based on a moment in time when the blood was drawn.
As such, the HbA1C test SHOULD be given to everyone suspected of being diabetic or pre-diabetic, as this is the best screening method we have.
Unfortunately, our “smart” Australian Government only allows HbA1C testing in patients already diagnosed with diabetes, eliminating the best screening tool for diabetes available!
The reasoning behind this decision is to keep track of how many confirmed diabetics we have in Australia,
but surely it is more important to prevent diabetes in the first place by improving diet and lifestyle before real diabetes damage happens?

Note: People with iron deficiency anemia or other forms of anemia may have distorted results, giving higher than normal HbA1c when there is no high blood glucose.
Some other factors with people having unusual haemoglobin may have distorted high or low results.

Cholesterol Testing

Typical test is a “lipid study” which includes total cholesterol, LDL, HDL and triglycerides.

Total Cholesterol

This is a fairly useless test, but doctors wrongly prescribe statins for anyone with cholesterol over around 5.2 or who are over 50 years old or who have diabetes or heart conditions.
Statins cause depletion of the body’s co-Enzyme Q10, resulting in side-effects such as muscle pain, diabetes, osteoporosis, a weaker heart and more.
Patients on statins may have a slightly less chance of dying from cardiovascular issues, but an INCREASED risk of dying from all other causes.
The result is a poorer quality of life, and most people will not live one day longer.
For instance a woman on statins for over 2 years has double the risk of breast cancer, and other cancer risks are substantially increased.
Anyone on statins has a higher risk of cataracts, muscle and joint pain and many other conditions. Most of these problems are due to the low vitamin D levels caused by statins.
Statins also prevent the liver from producing cholesterol sulfate, which supplies oxygen, sulfur, cholesterol, energy and a healthy negative charge to every cell in the body.
CoQ10 and vitamin D3 supplements are essential for anyone taking statins.
Eat an organic apple a day instead of taking a statin and you may really “keep the doctor away”.

LDL – Low Density Lipoprotein

Desirable range under 2.0 mmol/L but not as important if HDL levels are high.
Often known as “bad” cholesterol, but has several important jobs in helping create hormones and other beneficial body components.
For decades, LDL has had a bad reputation as the bad cholesterol, when in fact high LDL levels are blamed simply because they are present whenever the body needs repairing,
for example an inflamed artery, where LDL goes to patch up the damage by helping to form a clot and preventing a rupture of the artery.
Obviously we need LDL for this and many other bodily functions, so high LDL is simply a warning sign of inflammation, and inflammation is better reduced by exercise and a healthier diet, rather than taking statin drugs,
which force the liver to produce less LDL, and NOT margarine (trans fat) which appears to reduce LDL but INCREASES deadly trans fats which cause cardiovascular disease and DOUBLE the risk of breast cancer
as well as most other cancers.

HDL – High Density Lipoprotein

Desirable range is over 2.0 mmol/L, with most labs stating the reference range 1.0 to 2.2 mmol/L.
Known as “good” cholesterol – High Density Lipoprotein
The main job of HDL is to assist in clearing LDL, triglycerides, trans fats, and other unwanted components from the blood by returning them to the liver for processing.
The liver then converts LDL to bile and most unwanted body products are then eliminated.
Without our “garbage collectors”, the human body would die in 24 hours.
A healthy diet free from sugar, processed foods, trans fats, etc is essential for adequate levels of HDL.
No prescription drug can raise HDL, only exercise and a healthy diet and supplements such as Niacin (Prolonged Release).
Many things can affect HDL test results such as pregnancy, serious illness, stress, accident, heart attack, etc so the patient should wait until 6 weeks after recovery for an accurate result.

VLDL (or VLDL-C) – Very Low-Density Lipoprotein Cholesterol

Desirable range: Less than 0.77 mmol/L or 30 mg/dL.
This is the only “bad” cholesterol, mainly when oxidised, generally caused by a bad diet of sugars and bad fats (Canola oil, margarine, etc).
Can be reported as part of a lipid study to determine risk of coronary heart disease, but not often asked for.
In fact, most regular labs do not test for this at all, instead estimating VLDL as a percentage of Triglycerides (see below).
Because a true test for VLDL is expensive and time-consuming, only a few research labs have the equipment and time to carry out a true test.
High levels of VLDL-C are believed to indicate the presence of lipoprotein remnants (intermediate particles on the pathway of conversion of VLDL to LDL).
High levels of VLDL slow the conversion of VLDL to LDL and may contribute to development of atherosclerosis and coronary heart disease.
Exercise, weight loss, and a healthy diet are the most effective ways to reduce triglycerides and in turn reduce VLDL.

Triglycerides

Healthy adults should have triglycerides less than 1.5 mmol/L.
The amount of fats (lipids) circulating in the bloodstream.
Exercise, weight loss, and a healthy diet are the most effective ways to reduce triglycerides.

CRP – C-Reactive Protein

Lab range: Less than 8mg/L, but 90% of all healthy people are below 3.0 and 99% below 12 mg/L, and a level below 0.8 mg/L is best.
CRP is a protein produced by the liver in response to inflammation.
High CRP (over 3mg per mL) can mean inflammation, infection, trauma and tissue necrosis, malignancies, or autoimmune disorders.
Often caused by inflammation in the arteries and veins, and can be a marker for possible cardiovascular disease.
High CRP can be caused by so many things that alone it cannot diagnose any particular disease, but only indicate further studies, and the test may be repeated after 2 weeks.
Obesity often causes elevated CRP levels, as fat cells produce signals for the liver to generate more CRP.
Doctors do not normally test for this in Australia (but do so commonly in the USA) so the patient should insist if there are other risk factors for cardiovascular disease
or other unexplained symptoms.
Low levels (below 1mg per mL) are considered normal.

Testing for Lyme Disease

Doctors have long insisted that Lyme Disease noes not exist in Australia.
This has been proven incorrect as there are countless Australians suffering from this disease, of which there are at least 14 known variants.
There is only one testing laboratory for Lyme Disease in Australia which has not been accredited, so most testing is carried out in the USA.
Lyme disease is generally transmitted through a tick bite, often going un-noticed, as a small tick can be no larger than a full stop on this page.
Tick bites are more common at latitudes North of Sydney, but can happen anywhere. People working or living among tall grass have a higher risk.
For more information, go to www.lymedisease.org.au

PSA (Protein Specific Antigen)

PSA testing has been used for a long time to check for prostate cancer.
However, this test does not always point to a problem, as many men have a high reading and no prostate cancer, while others have prostate cancer but a low PSA reading.
For men in a high-risk category – those on a bad diet, over 60 years of age, overweight, those with a family history of prostate cancer: should be tested on a regular basis.
Although a low PSA result is preferred, we aim to look for any change in the number between tests, say at least 3 months apart.
A significant increase in the value is more important than the actual number.
This PSA test has nothing to do with BPA (Benign Prostate Enlargement) which is not cancerous, but often affects quality of life by urgent and frequent urination.
Prostate cancer in men and breast and ovarian cancer in women are all known as estrogen-related cancers. Excess weight is a high risk factor, as every fat cell produces more estrogen, and the problem gets worse as men and women age, with ever-increasing weight gain bringing a higher cancer risk.

Thyroid Testing

The Hypothalamus gland releases TRH (thyrotropin-releasing hormone, which triggers the pituitary gland to release TSH (Thyroid Stimulating Hormone).
Most doctors only ask for a TSH (Thyroid Stimulating Hormone) test, but this test alone is insufficient for an accurate diagnosis.
Generally, doctors only order tests for other thyroid hormones if TSH (Thyroid Stimulating Hormone) is less than 0.5 mIU/L (hyperthyroidism, too much thyroid hormone)
or greater than 4.0 mIU/L (hypothyroidism, not enough thyroid hormone) when actually the top end of the range (hypothyroidism) should be 2.0 rather than 4.0
USA labs often say 3.0 as a top reading, but even this is too high, and some Australian labs say 4.5 is the top end which is way too high.
Note: Supplemental Biotin (part of the B-group vitamins) over 5 5mg daily should stop biotin supplementation at least 36 to 48 hours before blood collection.
These results are just a guide, and the doctor should evaluate results based on each individual’s health, symptoms, history and other factors, including results of other tests required.
Values outside those listed here may still be normal for each individual or laboratory.
Labs can measure TSH, total T4, FT4 (free T4), total T3, FT3 (free T3), T3U (uptake T3) FTI (Free Thyroxine Index), and T3R (Reverse T3) and others.
Almost all of the T4 in the blood is bound to a protein called thyroxine-binding globulin, leaving less than 1% unattached (free).
Total T4 blood tests can measure both bound and free T4. Free T4 affects body functions, but bound T4 does not.
Range for FT4 is approx 9 to 19 pmol/L but varies with the lab and the age of the patient.
FT4 (Free thyroxine) can be measured directly (FT4) or calculated as FTI (Free Thyroxine Index), which indicates the level of free T4 compared to bound T4.
Abnormal amounts of thyroxine-binding globulin is indicated by FTI.
Most T3 in the blood is also attached to thyroxine-binding globulin, and again, less than 1% of T3 is unattached.
Total T3 blood tests measure both bound and free T3 (triiodothyronine).
T3 is usually in much smaller amounts than T4, but T3 has a greater effect on the body’s metabolism than T4.
T4 is considered to be more of a “storage” thyroid hormone, where the body converts T4 to T3 as required.
This area is a huge subject and is discussed in greater detail here: Hyperthyroidism
Hypothyroidism is very common in older adults, and symptoms such as low energy can be attibuted to being a little overweight, or just an off day.
Thyroid tests are not part of the standard blood panel, but may be ordered if the patient reports fatigue and weight gain (hypothyroidism), or weight loss with nervousness or hyperactivity (hyperthyroidism).
Many doctors dismiss low or high test results if they are borderline, but these tests can indicate early thyroid problems.

TSH (Thyroid-stimulating hormone) Range 0.4 to 4.0 uIU/mL (same as mIU/L) Optimal range: 1.0 to 1.5 mIU/L
Total T4 (total thyroxine) Range 12 to 22 pmol/L (4.5 to 12.5 mg/dL) Optimal range: Top half
Free T4 (free thyroxine) Range 9 to 19 pmol/L (0.8-1.8 ng/dL) Optimal range: Top half
Total T3 (total triiodothyronine) Range 80 to 200 ng/dL Optimal range: Top half OK, very top quarter best
Free T3 (free triiodothyronine) Range 2.6 to 6.0 pmol/L (80-200 ng/dL or 2.3 to 4.2 pg/mL) Optimal range: Top half OK, very top quarter best
THBR (Thyroid hormone binding ratio) Range 0.9-1.1

A low TSH indicates hyperthyroidism.
If T3 and T4 shows below the minimum, hypothyroidism may be indicated.
If T3 and T4 is high, hyperthyroidism (over-active thyroid) may be indicated.
Hyperthyroidism is a common cause of gynecomastia in men because it increases the estrogen to testosterone ratio.

Copper Testing

Humans have efficient mechanisms to regulate copper stores, normally protecting from excess dietary copper levels.
Copper tests can help to diagnose some diseases such as Wilson’s disease or Menkes disease.
We should monitor total copper, free serum copper, 24-hour urine copper, and liver biopsy copper concentrations.
Some symptoms of excess copper are similar to those of a copper deficit, often making diagnosis difficult.
Serum ceruloplasmin is used to determine free serum copper.
Note that some infections or inflammation may temporarily increase copper levels.
Also, supplementation of zinc and/or magnesium will complete with copper for absorption, leading to a copper deficiency.

Copper reference ranges:
Free serum copper: 1.6-2.4 μmol/L (10-15μg/dL)
Total copper: 10-22 μmol/L (63.7-140.12 μg/dL)
Serum ceruloplasmin: 2.83-5.50 μmol/L (18-35 μg/dL)
24-hour urine copper 0.3-0.8 μmol (20-50 μg)
Liver copper 0.3-0.8 μmol/g of tissue (20-50 μg/g of tissue)

Normal copper values indicate normal dietary intake, physiology, absorption and excretion of copper.
Food sources of copper:
Many foods including seeds, organ meats, nuts, seafood, liver.
Copper is also found in the water supply.
Average daily copper intake in men: 1.54-1.70 mg/day, in women 1.13-1.18 mg/day.
The wide food sources make copper deficiency fairly rare.
Copper deficiency may be from:

  • Dietary insufficiency of copper (rare)
  • Malabsorption in the duodenum where most copper is absorbed.
  • Nephrotic syndrome
  • Those with Menkes disease (low serum copper, low serum ceruloplasmin, low liver biopsy levels)
  • Overcorrection of treatment for Wilson disease

High total copper may be from:

  • Ingesting too much copper
  • Eating acidic foods cooked in uncoated copper cookware
  • Poor excretion secondary to underdeveloped biliary systems, more common in infants
  • In Wilson’s disease, liver biopsy shows high levels of copper, the criterion for diagnosis
  • Elevated urinary copper (24-hour urine study) can also indicate Wilson disease
  • But low serum ceruloplasmin and serum copper are common in Wilson’s disease

Symptoms of copper deficiency include:

  • Fatigue and weakness
  • Frequent illness
  • Weak and brittle bones
  • Memory, learning and walking difficulty
  • Cold sensitivity
  • Pale skin
  • Premature grey hair
  • Low haemoglobin count
  • Too much Zinc and Magnesium supplements which fight Copper for the same cell receptors

Symptoms of excess copper include:

  • Mood swings, irritability, depression, fatigue
  • Excitation, difficulty focusing, feeling out of control
  • Vomiting, Hematemesis (vomiting of blood)
  • Hypotension (low blood pressure)
  • Melena (black “tarry” faeces)
  • Coma
  • Jaundice (yellowish pigmentation of the skin and/or whites of eyes)
  • Gastrointestinal distress
  • Those with glucose-6-phosphate deficiency may have greater risk of hematologic effects of copper
  • Hemolytic anemia from burn treatment with copper compounds (rare)

Chronic (long-term) copper exposure may damage the liver and kidneys.

Gene Testing

Testing for the BRCA1 and BRAC2 gene for Breast Cancer Risk

Angelina Jolie had a double masectomy as a result of a positive BRCA1 test, which is not the right thing to do.
Some Doctors claim that a positive result means a 95% chance of developing breast cancer.
In fact, the true figures are more like 80% increased risk, but the risk of breast cancer can be REDUCED by 80% or more in most women by:
– A healthy diet free of toxins, chemicals, processed foods, eating organic foods wherever possible.
– Elimination of sugar, especially fructose in the diet, including sugar hidden in processed foods.
– A teaspoon of Turmeric every day, preferably as a tea in a mug of hot water, with freshly ground black pepper (containing Bioperine) to substantially increase the release of cancer-fighting curcuminoids.
– Or alternatively, a Curcumin capsules, the active ingredient in turmeric).
– Adequate supplements of Vitamin D3,
Selenium and
Lycopene.
– Building the immune system by exercise and keeping off excess weight.
In other words, anyone with the BRCA1 gene can reduce their cancer risk to that of a normal person, and considerably less risk if the above recommendations are carried out from an early age and strictly adhered to.
If you still want the test, fine, but LeanMachine maintains that the above recommendations can help prevent ALL types of cancer, as well as maintaining a healthy heart, and preventing “modern” diseases like Alzheimer’s, MS, Parkinsons, Diabetes, etc.
Still want a double masectomy?
Remember that as soon as the surgeon starts cutting, any existing cancer cells will go into the bloodstream and circulate through every organ in the body.
Also we have the usual risks for any surgery – anaesthetics, infection, wrong drugs, side effects, incorrect dosage given, etc.

Testing Alzheimer’s gene

Yes, tests can now show if we have a high risk of Alzheimer’s Disease.
I did consider this myself. I watched my father slowly wither away and die from Alzheimer’s disease, deeply affecting my mother, friends, family and myself.
However, I declined to have the test because regardless of the outcome, the same diet I recommend for cancer and cardiovascular disease is also effective for reducing risk of Alzheimer’s.
The only extra thing to add is two to four tablespoons of Coconut Oil every day, because Alzheimer’s is often known as “Diabetes of the Brain” when glucose sometimes cannot get into the brain because the brain becomes “insulin resistant”.
The brain uses more glucose than the rest of the body, however, we can feed the brain with coconut oil effectively as it feeds the brain via a different pathway,
delaying or even eliminating the onset of Alzheimer’s.
Most Alzheimer’s patients will improve their symptoms on coconut oil. Countries with the most Junk food, e.g. the USA have an Alzheimers death rate of 24.8 per 100,000 while Phillipines, Malaysia, Maldives and other tropical countries where coconut oil is an important part of the diet, rates are around 0.2 per 100,000.
Of course, Alzheimers deaths are very much under-reported, as the patient normally dies from pneumonia or organ failure, which is often the cause reported on the death certificate.
Turmeric is also important as the active ingredient
Curcumin helps to dissolve amyloid plaques which are present in Alzheimer’s patients.
Drug companies have tried for years to get rid of amyloid plaques, but the have made no difference to Alzheimer’s, because the plaques are the body’s way of protecting neurons for damage caused by high blood glocose, high insulin, toxic metals like mercury, aluminium from vaccinations, food and the environment.
Wise old men are sometimes referred to as a “Sage” and the reason is simple – eating sage leaves every day can help halt Alzheimer’s.

Immunology

The range of tests below can help determine the risk or check the progress of treatment of many infections and autoimmune diseases.
Diagnosis can be complex, and should always be under the guidance on an Immunologist who specialises in this area.
Some tests also relate to allergies and these should be under the guidance of an Allergist.

RH – Rheumatoid Factor

Normal range is less than 14 IU/ml, the lower the better.
Results over 14 can indicate Rheumatoid Arthritis, or some other auto-inmmune disease, where
For further diagnosis of Rheumatoid Arthritis, the doctor may order a CCP (Cyclic Citrullinated Peptide Antibody) test.
Other tests may include a Synovial Fluid Analysis, where synovial fluid (which lubricates the joints) is drawn from the space between joints by a needle (not a blood test).

CCP (Cyclic Citrullinated Peptide Antibody)

This test helps diagnose Rheumatoid Arthritis, often confirming a diagnosis months before symptoms appear.

Immunoglobulins A, G and M

These are three tests associated with the immune system.
Immunoglobulins are protein molecules that contain antibody activity. They are produced by terminal cells of B-cell differentiation known as “plasma cells”.
There are five immunoglobulin (Ig) classes: IgG, IgM, IgA, IgD and IgE.
In normal serum, approximately 80% is IgG, 15% is IgA, 5% is IgM, 0.2% is IgD and a trace is IgE. IgD and IgE are not tested as often.
Total immunoglobulin levels are normally considered the total of the three most common: IgG + IgM + IgA, ignoring IgD and IgE.

IgG – Immunoglobulin G

Normal serum range (adults) varying between labs, is 62 to 140 g/L (620 to 1400 mg/dL in USA, some labs say 767 to 1,590 mg/dL).
Babies (Newborn to 5 months) is 10 to 33 g/L (100 to 334 mg/dL in USA), increasing with age to level out at adulthood (18 years +).
IgG is a major antibody type in blood, and can enter tissues and fight infection.
IgG has 4 forms, all providing most antibody-based immunity against invading pathogens.
IgG is also the only antibody that can cross the placenta to provide passive immunity to the fetus.
– High IgG – may indicate a chronic infection such as AIDS.
High IgG is found in IgG MGUS, IgG multiple myeloma, chronic hepatitis, and MS (multiple sclerosis).
With multiple myeloma (cancer of plasma cells in bone marrow), tumour cells make only the monoclonal type of IgG antibody (IgM), and reduced levels of IgG and IgA are found.
Other conditions make polyclonal IgG antibodies.
Electrophoresis is required (a lab technique) to separate macromolecules based on size. A negative charge is applied causing proteins to move towards a positive charge.
Used for both DNA and RNA analysis, and to differentiate the monoclonal from the polyclonal cells.
– Low IgG – can be found in patients with congenital deficiencies.
Low IgG occurs in Waldenstrom’s macroglobulinemia, where high IgM antibodies inhibit growth of B-cells that make IgG.
Low IgG can also indicate some types of leukemia and nephrotic syndrome (kidney damage).
Rarely, some people are born with insufficient IgG antibodies, and have a greater risk of infections.
Low IgG levels in adolescents or adults are classified as:

  • Mild to moderate 30 to 60 g/L (300 to 600 mg/dL)
  • Significant 10 to 29.9 g/L (100 to 299 mg/dL)
  • Profoundly reduced – under 10 g/L (under 100 mg/dL)

Adolescents and adults should have a total immunoglobulin (IgG + IgM + IgA) level greater than 60 g/L (600 mg/dL),
with confirmed normal antibody responses, to exclude humoral deficiency.
Total immunoglobulin levels of 40 to 60 g/L (400 to 600 mg/dL) or IgG levels of 20 to 40 g/L (200 to 400 mg/dL) may contain adequate amounts of antibody,
but this is unlikely if total immunoglobulin levels are under 40 g/L (400 mg/dL) or serum IgG levels are under 20 g/L (200 mg/dL).
A specialist should decide if a patient should start immunoglobulin replacement therapy, based on clinical history, physical findings, laboratory variables,
serum immunoglobulin levels, history of infections, concomitant diseases, antibody response to proteins and vaccines, radiographic studies, and pulmonary function tests.
Patients with profoundly or significantly reduced IgG levels and impaired antibody response are usually treated with replacement immunoglobulin
starting at 100 mg per kg of body weight per week, given either intravenously or subcutaneously.
Prophylactic antibiotics may also be needed in some patients.
Dosage and frequency is aimed to maintain serum IgG level greater than 60 g/L (600 mg/dL), and over 80 g/L (800 mg/dL) has potential to improve pulmonary outcome.
Serum IgG levels should be checked four to six month intervals to ensure that adequate trough levels are maintained.
Patients with mild-moderate reductions in IgG levels 30 to 60 g/L (300 to 600 mg/dL) and normal antibody responses generally do not require immunoglobulin replacement therapy,
but should be carefully monitored by a knowledgeable specialist.

IgA – Immunoglobulin A

Normal serum range (adults) is 8 to 35 g/L (80 to 350 mg/dL in USA, some labs say 61 – 356 mg/dL).
Babies 0 to 5 months: 0.7 to 3.7 g/L (7 to 37 mg/dL in USA), quickly increasing to age 2 to 4 years, then gradually increasing to stable adulthood (18+)
Sometimes a lumbar puncture is performed to test for IgA in Cerebrospinal Fluid (the fluid that bathes the brain and spinal cord) but this is uncommon as it has a higher risk.
Protects from infections of mucous membranes, typically in the lining of the mouth, airways, digestive tract, urogenital tract, preventing bacteria colonization.
Also found in fluids such as saliva, tears, and breast milk – see Secretory IgA below.
– High IgA – may indicate MGUS (IgA Monoclonal Gammopathy of Unknown Significance) or IgA multiple myeloma (cancer of plasma cells in bone marrow).
IgA may be higher in some autoimmune diseases, e.g. RA (rheumatoid arthritis) and SLE (Systemic Lupus Erythematosus), and in cirrhosis, chronic hepatitis and other liver disease.
– Low IgA – may indicate some types of leukemia, nephrotic syndrome (kidney damage), intestinal problems (enteropathy), and ataxia-telangiectasia (rare inherited disease
affecting muscle coordination). Increases risk of autoimmune disease, and risk of severe reactions to receiving blood products.

SIgA – Secretory IgA (Subclass of IgA)

Normal Range (saliva): 118 to 641 mg/L (118 – 641 µg/mL in USA)
Optimum Range (saliva): 130 to 471 mg/L (130 – 471 µg/mL in USA)
Normal range (fecal): 5.1 to 20.4 g/L (51 – 204 mg/dL in USA) (Genova Lab range).
​Secretory Immunoglobulin A (SIgA) is a subclass of Immunoglobulin A (IgA), tested in saliva or feces,
although also found in mucous secretions of tear glands, mammary glands, respiratory system, genito-urinary tract, and the gastrointestinal tract.
SIgA is not synthesized by mucosal epithelial cells or derived from blood but is produced by B-lymphocytes adjacent to the mucosal cells, then transported through the cell interiors, and released into the secretions from the cells.
SIgA protects the oral cavity, lungs, gut and other mucosal areas from invading pathogens.
SIgA has highest levels in the morning and lowest levels in the evening, but is dependant on flow rate.
IgA levels in saliva are affected by Concentrations normally decrease as flow rates increase, so flow rate is measured to express SIgA secretion as a function of time.
To maintain healthy SIgA levels, increase intake of Choline, EFA’s, glutathione, glycine, phosphatidylcholine, Vitamin C and zinc, all essential for SIgA production.

Anti tTg IgA, tTG Antibodies IgA, Tissue Transglutaminase (tTG), Tissue Transglutaminase Antibodies IgA

Serum test, a subclass of IgA, for monitoring adherence to gluten-free diet in patients with dermatitis herpetiformis (cutaneous manifestation of Coeliac disease) and celiac disease.
Reference Range:
Less than 4.0 U/mL (negative)
4.0 to 10.0 U/mL (weak positive)
Greater than 10.0 U/mL (positive)
These tests are not sensitive to age.
Usually tested along with IgG to help evaluate certain autoimmune conditions, commonly celiac disease.
If testing for celiac disease, the patient must eat gluten-containing foods up to 7 days before the test, otherwise no antibodies may be evident in the test result.
In celiac disease, the body produces IgA and IgG that attack tTG: immunoglobulin A (IgA) and immunoglobulin G (IgG).
Measuring the IgA form of tTG antibody in the blood is more useful in detecting celiac disease as tTG is made in the small intestine, where gluten causes inflammation and irritation in sensitive people.

IgM – Immunoglobulin M

Normal serum range (adults) is 0.45 to 2.5 g/L (45 to 250 mg/dL in USA).
Some labs say 0.37 to 2.86 g/L (37 to 286 g/dL).
Babies 0 to 5 months: 0.26 to 1.22 g/L (26 to 122 mg/dL in USA) gradually increasing to adult range (18+)
Women usually have higher IgM levels than men.
Often discovered by investigation of other conditions.
There are two types: Natural IgM and Immune IgM.
Natural IgM occurs in the body at all times, and Immune IgM responds to invaders in the body.
IgM is a large molecule and in non-specific in it’s attack role, and is the first line of defense to invaders, followed by IgG which is slower to respond,
but has a better targeting role for an individual invader.
Antibody measurements assist diagnosis of conditions, such as infections, immunodeficiency, autoimmune disease, and certain types of cancer.
Insufficient immunoglobulins increases susceptibility to infections. High immunoglobulins may indicate an overactive immune system (auto-immune condition).
Found mostly in blood and lymph fluid, and the first the body makes to fight new infections.
Expressed on the surface of B cells (monomer) and in secreted form (pentamer) with very high avidity (forms multiple binding sites with antigen).
Eliminates pathogens in early stage B-cell mediated (humoral) immunity before there is enough IgG.
– High IgM – may indicate a new infection, IgM MGUS, Waldenstrom’s macroglobulinemia, early viral hepatitis,
mononucleosis, rheumatoid arthritis, nephrotic syndrome (kidney damage), or parasite infection.
– Low IgM – occurs in multiple myeloma, some kinds of leukemia, and some inherited immune diseases.
Causes of Low IgM:

  • Smoking with alcohol consumption
  • Endurance exercise and over-training
  • Rheumatoid arthritis
  • Hashimoto’s thyroiditis
  • Lupus
  • Celiac disease
  • Crohn’s disease
  • Immune thrombocytopenia
  • Diabetes
  • Selective immunoglobulin M deficiency, a rare and sometimes hereditary disorder
  • Wiskott-Aldrich syndrome, a rare immune deficiency disorder
  • Lymphoid nodular hyperplasia
  • Leukemia

Smoking alone or alcohol consumption alone has little effect on IgM, but together they signigicantly reduce IgM.
Some patients have no symptoms, others may develop serious recurring infections.
Supplements shown to increase IgM:

  • Lycopene shown beneficial in human and animal studies, from red foods such as tomatoes and watermelon
  • Ginseng shown beneficial in animal studies
  • Astragalus shown beneficial in animal studies

Causes of High IgM:

  • Viral and/or bacterial infections
  • Some autoimmune disorders, including:
    • Type 1 diabetes
    • Multiple sclerosis
    • Primary biliary cirrhosis
  • Kidney damage, where proteins such as albumin and IgG are lost through urine (nephrotic syndrome), but serum IgM conversely increases
  • Hyper-immunoglobulin M syndromes, genetic immunodeficiency disorders with high IgM and low levels of other immunoglobulins
  • Louis–Bar syndrome (ataxia-telangiectasia), a rare genetic neurodegenerative disease
  • Cancers, such as multiple myeloma and Waldenstrom’s macroglobulinemia (a type of non-Hodgkin’s lymphoma)

Health Effects of High IgM:
1: Metabolic Syndrome, a condition characterized by three or more of: fat around the stomach, high blood pressure, high blood glucose, high triglycerides, and low HDL-C levels.
2: High IgM Levels Increase All-Cause Mortality Risk
To decrease IgM levels, work on resolving underlying health issue with a health care professional.

IgD – Immuglobin D

Normal range (adults) is 0.003 to 0.03 g/L (.3 to 3.0 mg/dL in USA). Some labs say anything less than 10 mg/dL is normal.
Many normal, healthy people have undetectable levels of IgD.
IgD fights bacteria, functioning as an antigen receptor on B cells that have not been exposed to antigens.
Shown to activate basophils and mast cells to produce antimicrobial factors.
– High IgD – can indicate IgD multiple myeloma, not as common as IgA or IgG multiple myeloma.
– Low or absent IgD – does not appear to increase infection risk. Not well-researched, so rarely tested.

IgE – Immuglobin E

Normal range (adults) is only a trace amount, .0002 to .02 g/L (or 200 to 20000 ug/L or 83 to 8333 U/mL) or (.002 to .2 mg/dL in USA).
Binds to allergens, triggers histamine release from basophils and mast cells.
Involved in allergic reactions, and protects from parasitic worms.
Frequently increased in parasitic infestations and atopic inviduals (with allergic hypersensitivity).
– High IgE – may indicate parasitic infection.
Also found in those with allergic reactions, asthma, atopic dermatitis, some cancers or certain autoimmune diseases.
Rarely, high IgE may mean multiple myeloma.
– Low IgE – may indicate ataxia-telangiectasia (rare inherited disease affecting muscle coordination).

Complement Tests

Nine major complement proteins, important for the innate immune system, are numbered C1 to C9.
These nine proteins help the body recognise foreign disease-causing cells. Certain health issues may cause deficiencies in these proteins or vice versa.
The numbering generally represents the order in which they react in a cascade of events (except C4).
There are three separate reaction pathways:
1. The the Classical activation pathway
2. The Alternative activation pathway
3. The Membrane attack pathway
Those with low early complement proteins (C1 to C4) are more prone to infections.
Low complement levels can also be a factor in development of autoimmune diseases.
Those with low late complement proteins (C5 to C9) can have a higher risk of infections caused by Neisseria (a type of bacteria that colonise mucosal surfaces).
Neisseria has two forms in humans, one causing ghonorrhea, the other causing bacterial meningitis which can lead to meningococcal septicaemia.
Some people inherit deficiencies in these proteins, some acquire deficiencies, others have these proteins “used up” by some disease, usually an autoimmune disease.
Normal immunology testing is only for C3 and C4, with other tests required if there appears to be an inherited or aquired deficiency in one or more complement proteins.
Reference range (those older than 16 years):Total hemolytic complement (CH50): 30 to 75 U/mL (41 to 90 hemolytic units).
Total complement (CH50) is used to screen for suspected complement deficiencies before ordering individual C1 to C9 complement tests,
as a deficiency of a single individual component of the complement cascade can result in an undetectable total complement level.
High levels of CH50 combined with high C3 and C4 indicate systemic inflammation, connective-tissue diseases including, but not limited to, SLE (systemic lupus erythematosus),
RA (rheumatoid arthritis), severe bacterial and viral infections, and others like cancer, diabetes mellitus, and myocardial infarction.
Also hypermetabolic states such as hyperthyroidism and pregnancy can be linked to high CH50 levels.
Low results may be a consequence of infectious or autoimmune processes.
Complement component activity varies. Those with rheumatoid arthritis can have high complement serum levels but low complement levels in joint fluid.
Normal C3 levels combined with undetectable C4 levels can indicate congenital C4 deficiency.
Congenital deficiencies of C1, C2 or C4 results in an inability to clear immune complexes.
Undetectable C1q levels combined with zero total complement (CH50) and normal C2, C3, and C4 suggests a congenital C1 deficiency, however inherited C1 deficiency is rare.
Absent (or low) C2 levels in the presence of normal C3 and C4 values are consistent with a C2 deficiency.
Low C2 levels with low C3 and C4 levels can indicate a complement-consumptive process such as infectious or autoimmune disease.
Low C2 and C4 levels with C3 levels may indicate C1-INH (C1 esterase inhibitor) deficiency.
Note: This test is different from C1q binding, which is an assay for circulating immune complexes.

C1, C1Q Complement Level

Reference range: 1.2 to 2.2 g/L (12 to 22 mg/dL USA)
Normally tested when Total Complement (CH50) level is undetectable, to diagnose congenital C1 deficiency.
Also to diagnose acquired deficiency of C1-INH (C1 Esterase Inhibitor).
Complement C1 is composed of 3 subunits: C1q, C1r, and C1s. C1q level indicates the amount of C1 present.
C1q recognises and binds to immunoglobulin complexed to antigen, initiating the complement cascade.
Like the more common C2 deficiency, C1 deficiency is associated with increased risk of immune complex disease such as SLE (systemic lupus erythematosus),
polymyositis, glomerulonephritis, and Henoch-Schonlein purpura.
Low C1 levels have also been reported in patients with abnormal immunoglobulin levels (Bruton’s and common variable hypogammaglobulinemia and severe combined immunodeficiency),
likely due to increased catabolism.

C2 Complement Level

Reference Range: 25 to 47 U/mL.
Normally tested when the patient with a low or absent (undetectable) hemolytic complement (CH50).
If the C2 result is under 15 U/mL, then C3, C4, and C2AG levels will be tested.
C2 deficiency is the most common inherited complement deficiency, although rare.
Homozygous (two of the same allele) C2 deficiency has an approximate prevalence ranging from 1 in 10,000 to 1 in 40,000.
Heterozygotes (specific genotypes with 1 each of different alleles) C2 deficiency has an approximate prevalence ranging from 1 in 50 to 1 in 100).
Around half of the homozygous patients are clinically normal, but in one third,
SLE (systemic lupus erythematosus) or discoid lupus erythematosus occurs.
People with both SLE and a deficient C2 level frequently have a normal anti-ds DNA titer.
Many have lupus-like skin lesions and photosensitivity, but immunofluorescence studies can fail to demonstrate immunoglobulin or complement
along the epidermal-dermal junction.
Diseases associated with deficient C2 level include dermatomyositis, glomerulonephritis, vasculitis, atrophodema, cold urticaria, inflammatory bowel disease
and recurrent infections.
Test results suggesting C2 deficiency include zero or undetectable hemolytic complement (CH50), with normal C3 and C4 values.

C3 Complement Level

Reference range Males: 8.8 to 25.2 g/L (88 to 252 mg/dL USA)
Reference range Females: 8.8 to 20.6 g/L (88 to 206 mg/dL USA)

C4 Complement Level

Reference range Males: 1.2 to 7.2 g/L (12 to 72 mg/dL USA)
Reference range Females: 1.3 to 7.5 g/L (13 to 75 mg/dL USA)
Complement C4 plays an important role in eliminating certain infections.
– High C4 – may indicate cancer or ulcerative colitis.
– Low C4 – may indicate:

  • Autoimmune disorders and collagen vascular diseases, e.g. lupus and rheumatoid arthritis
  • Bacterial infections
  • Hepatitis
  • Malnutrition
  • Rejection of a kidney transplant
  • Systemic lupus erythematosus (autoimmune disease affecting skin, joints, kidneys and other organs
  • Lupus nephritis (kidney disorder as a result of systemic lupus erythematosus
  • Cirrhosis (liver damage)
  • Glomerulonephritis (kidney disease)
  • Hereditary angioedema (rare but serious autoimmune disease, causes swelling in various body parts

C5 to C9 Complement Level

Reference range (C5): 29 to 53 U/ml.
Reference range (C6): 32 to 57 U/ml.
Reference range (C7): 36 to 60 U/ml.
Reference range (C8): 33 to 58 U/ml.
Reference range (C9): 37 to 61 U/ml.
Deficiencies of the late complement proteins (C5, C6, C7, C8, and C9) are unable to form the MAC (lytic membrane attack complex) and have increased susceptibility to neisserial infections.
Absent C5 to C9 levels with normal C3 and C4 levels are consistent with C5 deficiency.
Absent C5 to C9 levels with low C3 and C4 levels suggest complement consumption (Used up by an autoimmune disease).
Normal results indicate normal C5 to C9 levels and normal functional activity, although in rare cases, although C5 to C9 levels seem OK,
the protein can be non-functional, and further tests are required to determine correct function of C5 to C9.
See notes above under the heading Complements.
Additional notes re C7:
Most cases of C7 deficiency have neisserial infections, but rarely cases of SLE (Systemic Lupus Erythematosus), RA (Rheumatoid Arthritis),
scleroderma or pyoderma gangrenosum.
Additional notes re C9:
In the Japanese population, C9 deficiency is common, almost 1%.
Lytic activity of C9-deficient serum is decreased, but assembly of C5b-C8 complexes will result in a transmembrane channel with lytic activity,
although lytic activity is reduced.
Many C9-deficient patients show no symptoms, but may still present with invasive neisserial infections.

ANA – Anti-Nuclear Antibodies Screen

ANA tests identify serum antibodies that bind to autoantigens in cell nuclei.
Most of these antibodies are IgG, with IgM and IgA also sometimes detected.
The ELISA (Enzyme-Linked ImmunoSorbent Assay) method is mostly used.
Normal Range: Less than 1.0 U (or less than or equal to 1:40 dilution) is classed as a negative result.
Positive range:
1.1 to 2.9 U is weakly positive.
3.0 to 5.9 U is positive.
Greater than or equal to 6.0 U is highly positive.
A positive result normally indicates presence of an autoimmune disease where the body attacks connective tissue, and may indicate:

  • Mixed connective tissue disease
  • Drug-induced lupus erythematosus
  • Systemic lupus erythematosus
  • Sjögren syndrome
  • Scleroderma
  • Polymyositis-dermatomyositis
  • Rheumatoid arthritis

Some labs give results as 1:40 (good) while a result of 1:640 suggests an autoimmune condition. This is a measure of how much dilution of the blood specimen is required before the antibodies can no longer be observed.
Other tests will be required to diagnose a specific autoimmune condition.
Note that insufficient Vitamin D3 can cause some autoimmune conditions. Although Vitamin D3 increases immunity, it also moderates an immune system running out of control.

Allergy Testing

If the Eosinophil test (see under Haematology) is high, allergies may be the cause.
There are many allergy tests. Some are serum (blood) tests, and the sample may be tested in vitro exposed to a mixture of various allergens.
Allergens may be pollen, mould, animal fur or saliva, dust mites, birds, and various foods, the common culprits being:

  • Eggs
  • Peanuts
  • Cows Milk
  • Soy
  • Barley
  • Rice
  • Wheat (gluten)
  • Seafoods
  • Nuts
  • Antibiotics

When allergic reactions occur, levels of IgE are tested, and in some cases IgA

Anaphylactic Foods

These are foods which may cause enough swelling around the mouth, tongue and throat that breathing is difficult, and choking may occur.
Peanuts are perhaps the most famous food for causing breathing difficulties.
Usually overlooked by doctors: Lack of vitamin D, lack of sunlight, lack of very small exposure to these foods as a fetus or as a newborn are significant factors in these conditions.

Other Testing

The doctor may order many other types of tests, depending on results of previous tests combined with previous medical history, age, sex, current symptoms, family history, etc.

Sex Hormone Testing

Doctors can order an Androgen Study or Sex Hormone Profile, and may include any or all of the below tests and more:

Estrogens including E2 (estradiol), E1 (estrone), E3 (estriol)

E1 and E2 are the main active estrogens, as E3 is generally the pregnancy estrogen.
The enzyme aromatase converts testosterone to estradiol, and converts androstenedione to estrone.
Many other steroids can stimulate the estrogen receptor independent of aromatase.
This includes xenoestrogens such as BPA (Bisphenol A) and other plastics in the environment and unfortunately in the diet (microwave dinners, etc).
This is why LeanMachine recommends glass containers for all foods. BPA free plastics are just as bad. BPA has been replaced with BPS, and
although BPS is not taken up as much by estrogen receptors, once in the body it is very hard to excrete, so can easily build up to harmful levels.
E2 is mainly produced in ovaries and testes by aromatization of testosterone
High estrogen may come from estrogen secreting tumours, medications, exposure to BPA, pthalates and other toxins in plastics, from obesity (every fat cell can produce estrogens), and many other factors.
High estrogen may be a result of unusually high levels of testosterone, from testosterone replacement therapy or testicular tumour, which converts to estrogen by the enzyme aromatase.
Aromatase inhibitor drugs such as anastrozole (Arimidex), letrozole (Femara) and exemestane have largely replaced the older tamoxifen to help treat breast cancer in post-menopausal women.
Anti-estrogenic foods and supplements include cruciferous vegetables (broccoli, cauliflower brussel sprouts, cabbage), onions, garlic, healthy fats
(coconut oil, extra virgin olive oil, avocados, raw nuts), chrysin (passionflower),
DIM (diindolylmethane),
citrus bioflavonoids (diosmin, hesperidin,
rutin, naringin, tangeretin, diosmetin, narirutin, neohesperidin,
nobiletin, quercetin),
turmeric,
Curcumin,
fermented foods (sauerkraut, kimchi, fermented soy, fermented raw dairy, apple cider vinegar, kombucha).

Progesterone

I will omit the reference range here, as there are too many variables.
Progesterone levels are influenced by the time through the monthly cycle, age, pregnancy status, menstruating or post-menopusal, whether uterus and/or ovaries have been removed, if there are cysts on the ovaries, problems with the adrenal glands, and many other factors.
The test can help determine the cause of infertility, track ovulation, assist diagnosis of an ectopic or failing pregnancy, monitor pregnancy health, monitor progesterone replacement therapy, or assist diagnosis of abnormal uterine bleeding.
Men also have small amounts of progesterone.
If supplementation is recommended, see a doctor who can prescribe natural progesterone from a compounding chemist.
Most doctors will simply prescribe Progestin, an artificial and incomplete copy of real progesterone, with side effects perhaps worse than any benefit.
Women pregnant with twins, triplets, etc will usually have higher progesterone than those with a single fetus.
High progesterone levels can be seen sometimes with:

  • Some types of ovarian cysts
  • Non-viable pregnancies (molar pregnancies)
  • A rare type of ovarian cancer
  • Adrenal overproduction of progesterone
  • Adrenal cancer
  • CAM (Congenital Adrenal Hyperplasia)

Low progesterone levels can be associated with:

  • Toxemia late in pregnancy
  • Poor function of ovaries
  • Amenorrhea (Lack of menstruation)
  • Ectopic pregnancy
  • Fetal death or miscarriage

Testosterone

Required by men and women. Women have much less testosterone, but are more sensitive to it. Most testosterone is bound to SHBG (Sex Hormone Binding Globulin) which makes the molecule so large, it can no longer have any effect. Free Testosterone (not bound to SHBG) is the only effective testosterone.
Many labs will only measure total testosterone, and calculate free testosterone by measuring SHBG.
There are many causes of low testosterone, including disease, obesity, stress, insomnia and medications.
If blood tests show low testosterone and high LH, it may indicate a testicular problem in men, such as testicular failure or Klinefelter’s syndrome.
If blood tests show low testosterone and normal or low LH, it may indicate a problem with the pituitary gland.

SHBG (Sex Hormone Binding Globulin)

Attaches to other hormones to regulate their effectiveness when the body produces more hormones than we require.
This is a natural part of the self-regulation body system to prevent skyrocketing or insufficient hormones.

LH (Luteinizing Hormone)

Luteinizing hormone (LH), also called lutropin or lutrophin, British spelling luteinising hormone.
An acute rise of LH (“LH surge”) in women triggers ovulation and development of the corpus luteum (a hormone-secreting structure developed in an ovary after an ovum (egg) has been discharged, but degenerates after a few days unless pregnancy has begun.
LH is secreted by the gonadotropic cells in the anterior pituitary gland in the brain.
This signals the testes (in men) or the adrenals (in women) to produce testosterone.

DHEA

Often called the “Mother of all hormones” as levels can be a thousand times higher than other hormones.
DHEA is mainly made by the adrenal glands, and used to make testosterone and many other hormones.
Unusually high levels of DHEA can be caused by adrenal cancer or hyperplasia, and are aromatised into estrogen or other hormones.

Cortisol

Commonly called the “stress hormone”, or the “fight or flight hormone”.
We all need some cortisol, but long-term high cortisol, usually caused by chronic stress, is very bad for the body.
Cortisol levels vary considerably through the day, so testing is usually carried out at multiple intervals through the day.

Prolactin

Prolactin is a peptide hormone produced by the anterior pituitary gland in the brain.
Primarily associated with lactation, and vital in breast development during pregnancy and lactation.
Doctors test for prolactin in women with galactorrhea (unexplained milk secretion) or irregular menses or infertility, and in men with impaired sexual function and milk secretion.
If prolactin is high, a doctor will test thyroid function and ask first about other conditions and medications known to raise prolactin secretion.
Prolactin is downregulated by dopamine and is upregulated by estrogen.
Hyperprolactinaemia (abnormally high serum prolactin levels) may cause galactorrhea (production and spontaneous flow of breast milk)
and disruptions in the normal menstrual period in women, and hypogonadism, infertility and erectile dysfunction in men.
High levels of prolactin (sometimes due to a prolactin secreting tumour) inhibits the release of gonadotropin releasing hormone,
resulting in reduced LH (Luteinizing hormone, a gonadotropin) secretion, leading to reduced testosterone production.
Normal prolactin levels:
Women: Less than 500 mIU/L (20 ng/mL or µg/L)
Men: Less than 450 mI U/L (18 ng/mL or µg/L)

Beta-HCG

Also known as β-HCG, Human chorionic gonadotropin (HCG), quantitative blood pregnancy test, quantitative hCG blood test, quantitative serial beta-hCG test.
This Serum Quantitative test is the sum of human Chorionic Gonadotropin (hCG) plus the hCG beta-subunit, for early detection of pregnancy.
hCG consists of alpha (α) and beta (β) chains associated to the intact hormone.
The α-chains in all four of these glycoprotein hormones are virtually identical, while β-chains have greatly differing structures,
responsible for the respective specific hormonal functions.
Reference values change during pregnancy, and can double every 2 to 3 days.
Generally a level below 5 indicates no pregnancy, while a level over 25 confirms a pregnancy.
Results between 6 and 24 are a grey area, best re-tested later, or confirmed by ultrasound after 5 to 6 weeks from gestation.
Note: This is a much more accurate and useful test than hGC Urine tests available over the counter.

Range (mIU/mL)
Weeks of pregnancy is defined as completed weeks beginning with the start of the last menstruation phase.
Male 0−3
Female
nonpregnant 0−5
postmenopausal 0−8
pregnant
Weeks Gestation
3 6−71
4 10−750
5 217−7138
6 158−31,795
7 3697−163,563
8 32,065−149,571
9 63,803−151,410
10 46,509−186,977
12 27,832−210,612
14 13,950−62,530
15 12,039−70,971
16 9040−56,451
17 8175−55,868
18 8099−58,176

Levels are high if there is a testicular tumour in men, or pregnancy in women. Often used as a pregnancy test.

MSH (Melanocyte-Stimulating Hormone) Blood Test

MSH is an anti-inflammatory, regulatory hormone made in the hypothalamus, controlling hormone production, modulating the immune system and controlling nerve function.
Also caled: Alpha-Melanocyte-stimulating Hormone, α-MSH.
It is made when leptin is able to activate its receptor in the POMC (Proopio-MelanoCortin) pathway.
If the receptor is damaged by peripheral immune effects, such as the release of too many pro-inflammatory cytokines, then the receptor doesn’t work right and MSH isn’t made.
Leptin controls storage of fatty acids as fat, so MSH and leptin are a major source of interest for obesity control.
MSH controls hypothalamic production of melatonin and endorphins. Without MSH, deficiency creates chronic non-restful sleep and chronic increased perception of pain, respectively.
MSH deficiency causes chronic fatigue and chronic pain. MSH also controls many protective effects in the skin, gut and mucus membranes of the nose and lung.
MSH also controls the peripheral release of cytokines. When there is insufficient MSH, peripheral inflammatory effects are multiplied.
MSH also controls pituitary function, with 60% of MSH deficient patients not having enough antidiuretic hormone, causing patients to be constantly thirsty,
urinate frequently and often have unusual sensitivity to static electrical shocks.
40% of MSH deficient patients will not regulate male hormone production, and another 40% will not regulate proper control of ACTH (AdrenoCorticoTropic Hormone) and cortisol.

ACTH (AdrenoCorticoTropic Hormone)

Normal range: 9 to 52 pg/mL or 10 to 60 pg/mL depending on the lab.
Always tested early morning, as ACTH is highest 6 to 8 am and lowest around 11 pm. No ranges are specified for later in the day.
Normally tested in conjunction with a Cortisol test.
ACTH is a hormone produced in the anterior (front) pituitary gland in the brain, and regulates levels of cortisol (the steroid hormone),
which is released from the adrenal glands
Also known as:

  • Highly-sensitive ACTH
  • Corticotropin
  • Cosyntropin (drug form of ACTH)

Used to detect diseases associated with too much or too little cortisol, possibly caused by:

  • Adrenal or pituitary malfunction
  • Pituitary tumour
  • Adrenal tumour
  • Lung tumour

General

Some of the hormone tests above are blood tests, some are urine tests, some are saliva tests.
I have chosen not to discuss these tests in detail here, as it would fill an encyclopaedia.
These tests vary enormously with age, sex, pre or post menopause, time of the month for women, and so many other factors.
Doctors specialising in this field are best, as typical GP’s often do not have a great understanding of this complex problem.

Other general health tests

Body Mass Index (BMI)

BMI = weight (kg) divided by (height in metres squared).
Note: BMI does not allow for the amount of muscle compared to body fat, so a professional weight-lifter may have a BMI in the obese range, but still have a healthy body composition (more muscle than fat).

Underweight < 18.5 kg/m2
Normal 18.5 – 24.9 Caucasian
Overweight 25.0 – 29.9
Obesity class I 30.0 – 34.9
Obesity class II 35.0 – 39.9
Obesity class III (extreme, morbid) ≥ 40.0

 

Blood Pressure (Systolic / Diastolic)

At doctor’s office (average 5 measurements with lowest and highest readings discarded) < 140 / 90 mmHg
Ambulatory BP monitor < 130 / 85
With diabetes or stroke or cardiac risk < 130 / 80

Heart Rate (HR) or Pulse

Bradycardia < 60 beats per minute
Normal 60 – 80
Tachycardia > 100

Respiration Rate (RR)

Bradypnea < 12 breaths per minute
Normal (eupnea) 12 – 18
Tachypnea > 18

Body Temperature

Fever > 37.5 ° C
Normal 36.5 – 37.5 ° C (approximate)
Hypothermia < 35.0 ° C

Five Blood Tests for Everyone Over 50

Hepatitis C

Hepatitis C probably kills more people than any other virus, and 2014 data from the CDC in the USA shows hepatitis C–related deaths are at an all-time high.
Because this liver disease usually shows little or no symptoms, around half of those infected do not know they carry the virus.
Left untreated, Hepatitis C can lead to cirrhosis, liver cancer, and liver failure, all contributing to about 20,000 deaths in the USA alone.
A simple blood test can diagnose Hepatitis C, and if the test is positive, Hepatitis C is effectively treated before the liver damage becomes life-threatening.
For those born between 1945 and 1965, the USPSTF (U.S. Preventive Services Task Force) recommends a single hepatitis C test.
For those born before 1945 or after 1965, USPSTF reccomend testing only for high risk people, such as those
who had blood transfusions before 1992, injection drug users, or health care workers who have been stuck with a patient’s needle.

Blood glucose

For those overweight, or have have high blood pressure, or a family history of diabetes, there is a high risk for diabetes.
If blood glucose tests normal repeatedly, then once a year is often enough to repeat the test.
If pre-diabetes is diagnosed, immediate action is required to prevent the condition turning into full-blown diabetes.
The best way to prevent full-blown diabetes is to eliminate sugar, carbohydrates and processed foods from the diet.

Lipid panel

The lipid panel tests for LDL and HDL cholesterol and triglycerides.
See notes above.

STI (Sexually Transmitted Infections)

The doctor may ask if any sexual activity has changed (you or your partner).
Although STI’s are unusual among older adults, they are increasing.
Get tested if there are any doubts, as most STI’s can be easily treated and cleared up quickly.

Cancer Tests

Many tests are available, For example, abnormal levels of liver enzymes may indicate liver tumours before any symptoms are evident, allowing early surgery intervention, reducing other dangerous treatments and improving chance of recovery.

CA 15-3 (Cancer Antigen 15-3

This test is used mainly to monitor the treatment for metastatic (spreading) breast cancer.
CA 15-3 is a protein shed by tumour cells, often increased in breast cancer, indicating how the cancer has progressed or how the treatment has reduced the cancer.
CA 15-3 can be elevated in healthy people and in those with other cancers, so is not accurate enough to screen for early breast cancer.
Negative results do not mean there is no cancer, and positive results do not mean there is cancer.
CA 15-3 may be elevated by some other cancers, or by other non-cancerous conditions.
Related tests are Tumour markers, CEA, HER-2/neu, hormone receptor status.

<h3>HER-2, also called HER2/neu, is the acronym for Human Epidermal growth factor Receptor 2</h3>

Tests for HER-2:

FISH (Fluorescence In Situ Hybridization) test uses fluorescent probes, looking at the number of HER2 gene copies in a tumor cell.
More than two copies of the HER2 gene indicatesthat the cancer is HER2 positive.​

IHC (ImmunoHistoChemistry) test measures tumour production of the HER2 protein, ranked as 0, 1+, 2+, or 3+.
If results are 3+ the cancer is HER2-positive.
If the results are 2+, a FISH test determines if the cancer is HER2-positive.
If the HER 2 test is positive, it indicates that cancer can be treated with Herceptin (trastuzumab, an immune treatment), also Perjeta and Kadcyla.
A HER2 positive result also means that the cancer is most likely aggressive, so it is advised to start treatment as soon as possible to improve  survival and help prevent recurrence.

CA 19-9 (Cancer Antigen 19-9)

High CA 19-9 levels are usually caused by pancreatic cancer, but also by other cancers and by infections in the liver, gallbladder, and pancreas.
Related tests: Bilirubin, CEA, liver function tests, tumour markers

CA-125, also known as Cancer antigen 125

CA-125 is a protein produced by ovarian cancer cells, but also in some healthy women, and used as a marker for ovarian cancer.
CA-125 levels may be high in non-cancerous conditions such as pelvic inflammatory disease, excessive abdomen fluid (ascites), liver disease, pregnancy and menstruation.
Related tests: Tumour markers, BRCA-1 and BRCA-2

BRCA-1 and BRCA-2

See info above under the Gene Testing heading.

Calcitonin, also called Thyrocalcitonin

The Calcitonin test helps diagnose and/or monitor:

  • C-cell hyperplasia, a benign condition that may or may not progress to MTC
  • MTC (Medullary thyroid cancer), a malignant condition
  • Screen risk for MEN2 (multiple endocrine neoplasia type 2)

Age, pregnancy, lactation and food can influence calcitonin concentration in healthy people.
Reference ranges for some calcitonin chemiluminescent assays:
Males: Less than 8.8 pg/mL (ng/L)
Females: Less than 5.8 pg/mL (ng/L)
Athyroidal (without a functioning thyroid gland) people: Less than 0.5 pg/ml (ng/L)
Calcium Infusion test raises calcitonin levels.
Peak calcium infusion (IMMULITE 2000 calcitonin assay) test:
Males: Less than or equal to 130 pg/mL
Females: Less than or equal to 90 pg/mL
Normal range for peak calcitonin following calcium infusion is 100 to 200 ng/L
Specific reference intervals have not been established, so must be interpreted by the doctor along with other tests.
A high level of calcitonin should lead the doctor to perform a thyroid biopsy, scan and ultrasound to confirm the diagnosis.
About 25% of MTC cases relate to an inherited mutation in the RET gene, leading to MEN2.
Only 1 copy from either parent increases risk of MTC, occurring mostly in the 40 to 60 age group, but can occur at any age, more prevalent in women.

AFP (alpha-fetoprotein)

There are different AFP tests for different reasons, performed on a blood sample, urine sample, or amniotic fluid sample.
Other names for the test: Total AFP, MSAFP (Maternal Serum AFP), and Alpha-Fetoprotein-L3 percent (%)
Tested between the 14th and 22nd week of pregnancy as a screen for neural tube defects and chromosomal abnormalities.
Elevated AFP in maternal serum or amniotic fluid during pregnancy may indicate:

  • Spina Bifida
  • Anencephalia
  • Atresia of the oesophagus
  • Multiple pregnancy

Down Syndrome markers:
Maternal AFP levels, together with Beta-HCG, gestational age, maternal weight and other parameters, risk of Trisomy 21 (Down Syndrome) is calculated.
In Trosomy 21, maternal serum AFP concentration is decreased, while maternal serum Beta-HCG is about double the normal level,
and Pregnancy-Associated Plasma Protein A (PAPP-A) is reduced.
If a woman was screened for Down’s syndrome or open neural tube defects in a previous pregnancy,
the levels of the screening markers in that pregnancy can be used to adjust the marker levels in the current pregnancy.
Women with a false positive in one pregnancy is likely to have a false positive again in a subsequent pregnancy.
Twin / Down Syndrome markers:
Serum marker levels are raised in twin pregnancies, so twin pregnancies pose problems as one fetus may be affected and the other may not.
About 2% of pregnancies affected by Down’s syndrome are twins. If the twins are dizygotic (Fraternal, non-identical),
the risk of Down’s syndrome for each baby individually is the same as for a single baby (around 1 in 800 pregnancies).
If the twins are monozygotic (identical), the risk to both of having Down’s syndrome is also around 1 in 800.
A combination of Nuchal Translucency scanning and Serum screening may aid in risk assessment of Down’s syndrome for twin pregnancies.
Fetal Nuchal Translucency (FNT) screening uses ultrasound to measure size of the nuchal pad at the nape of the fetal neck,
performed between 11 weeks + 2 days and 14 weeks + 1 day.
Increased nuchal translucency reflects fetal heart failure, typically seen in any serious anomaly of the heart and great arteries,
and strongly associated with a chromosomal abnormality. In one study,
84% of karyotypically proven trisomy 21 fetuses had a nuchal translucency >3 mm at 10-13 weeks of gestation (as did 4.5% of chromosomally normal fetuses).
The greater the extent of FNT, the greater the risk of abnormality.
FNT is a straightforward test but will have a 20% false positive rate (FPR) if the thresholds are set to detect 85% (if used alone and maternal age adjusted).
Adding nasal bone screening during the same examination may increase sensitivity further and reduce the FPR.
One study concluded that an absent nasal bone should be considered as a highly predictive marker of Down’s syndrome.
Afro-Caribbean women have different marker levels than Caucasian women, heavier wome have different markers than lighter women, and those who skoke have different markers again.
Conclusion: These markers only pose a risk level, and do not guarantee a result one way or the other.

AFP also tests for cancer.
The Quantitative test, reporting the concentration of AFP in the sample, is the normal AFP test,
but a less expensive Qualitative test may be used sometimes, reporting only a normal or high concentration.
AFP is made by the liver and yolk sac of a fetus, and is the main protein in the first three months of development,
but decreases by age 1 to the very low levels found in adults.

However, AFP is a tumour marker for hepatocellular carcinoma (liver cancer), germ cell tumours (testicular, ovarian cancers),
also the rare nonseminomatous germ cell tumors usually found in the pineal gland of the brain.
AFP can also be elevated in some forms of biliary tract, stomach or pancreas cancers.
AFP may also elevated in Cirrhosis or chronic active hepatitis.

Reference range:
Non-pregnant adults, high blood levels, over 500 ng/ml (nanograms/milliliter) of AFP are seen in only a few situations, such as:

  • Hepatocellular carcinoma (HCC), a primary cancer of the liver
  • Germ cell tumors (a type of cancer of the testes and ovaries, such as embryonal carcinoma and yolk sac tumors)
  • Ataxia Telangiectasia, a severely disabling and rare genetic neurodegenerative disease

Moderately elevated values are found in:

  • Alcohol-mediated liver cirrhosis
  • Acute viral hepatitis
  • Carriers of HBsAg (surface antigen of the hepatitis B virus), indicating current hepatitis B infection

Amniotic Fluid AFP (alpha-fetoprotein)

Info to follow later…

Pregnancy Tests

See also AFP test above.

pregnancy-associated plasma protein A (PAPP-A)

To be advised…

Rare Tests

Protein C and Protein S

Other names for these tests:
– Protein C Antigen and/or Functional Blood Test
– Protein C, Functional or Antigen Test
– Protein S, Functional or Antigen Test
Protein C and Protein S are separate blood tests, often performed together. The tests are meant to assess either the functioning or the abundance of these proteins.
Protein C is an anticoagulant and anti-inflammatory enzyme. It requires both Protein S, a coenzyme, and Vitamin K to function.
It is similar to aspirin in its “blood-thinning” effects.
Protein C is made in the liver, while Protein S made in the inner (endotheliel) lining of blood vessels.
Both proteins circulate in the bloodstream.
Blood clotting is essential to minimise blood loss if injured, but it is regulated, because if the bood is too thin, we can bleed out and die,
but if blood is too thick, it can form clots when we do not need them, and restrict or block off blood supply, potentially causing loss of a limb or organ, and sometimes life.
About 1 in 300 people have protein C deficiency, which is classed as a hereditaty condition, although more people aquire it from taking Warfarin.
Most people with this deficiency have few problems with clotting, as long as diet and lifestyle factors are kept in a healthy manner, and any sudden clotting is attended to promptly.
If two people, both with Protein C deficiency, have offspring, then that child is more likely to have a very severe case of clotting.
Protein C is activated during the clotting process, to prevent too much clotting, by removing blood clotting factors,
and stimulating plasmin, a protein that degrades blood clots (fibrinolysis).
Deficiencies in these proteins can cause hypercoagulable blood (abnormal blood coagulation) and internal blood clotting (thrombosis).
There are several classifications, characterized by Protein C and S deficiencies:
– Type I is caused by insufficient quantity.
– Type II is caused by defective function.
– Type III (Protein S only) is caused by a low amount of active-form Protein S, but normal levels of total Protein S.
If there is a thrombotic (clotting) episode, then the test has to be performed only after a period of 10 days.
Low Levels of Protein C and Protein S may indicate:

  • Serious infections
  • Kidney disorder
  • Liver disorder
  • HIV
  • Pregnancy
  • Chronic high blood pressure (hypertension)
  • Disseminated intravascular coagulation (DIC)
  • Various cancers
  • Vitamin K deficiency

High Protein C and Protein S levels are rarely of concern.
Note: Test results are NOT to be interpreted as a “stand-alone” test.
Results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information.
Factors that may interfere with the results include surgery, oral contraceptives and chemotherapy.
Up to 15% of Caucasians carry a genetic mutation in a clotting factor that makes it resistant to Protein C’s effects, leading to similar symptoms as Protein C deficiency.
Tourniquet placement for extended periods of time can cause veins to pool with blood, altering Protein C and Protein S levels and affecting the test results.
Protein C and Protein S are being considered for use in therapy for individuals with hypercoagulation or Sepsis (whole-body inflammation).
LeanMachine advises finding a specialist experienced in these disorders, as these conditions can be easily mis-diagnosed.

More tests to follow here soon…

There are many more tests available, but the ones included here are among the most common.
To get accurate readings, be sure to follow instructions in preparing for tests.
We may be asked not to eat and to drink only water for anywhere from a few hours to 12 hours beforehand.
Follow these instructions, or results may be skewed, requiring additional tests or even unnecessary medications or procedures.
Remember that you have the right to ask questions!
No matter how busy the Doctor is, you are entitled to the information and explanation.
If the Doctor cannot provide it, ask the nurse. If you still cannot get a reasonable explanation, find another doctor!
This information is not meant to replace advice from the doctor, but to assist us to understand what the results mean, and allow us to ask the doctor any appropriate questions related to the test results, and understand the health, medication, treatment and prognosis implications.
And if the doctor says “All of your results are fine” then ask if any are “in range, but not optimal” and “what changes should I make to progress toward optimal results”.
Always get a printed copy of your results, and refer to this site to check if the doctor is really telling the truth, bluffing, or has no idea.

LeanMachine Supplements: Health Supplements, Body Building, Immunity, Diabetes, Cardiovascular, Weight Loss and more

Updated 6th September 2019, Copyright © 1999 Brenton Wight and BJ & HJ Wight trading as Lean Machine abn 55293601285

Reproduction by any means absolutely prohibited, however links to this site are allowed from other web sites after permission granted, email sales@leanmachine.com.au for link requests.

 

Posted by: | Posted on: August 8, 2019

Flesh eating bacteria attacks those with excess iron

Analysis by Dr. Joseph Mercola Fact Checked – July 30, 2019
Reproduced from original article:
https://articles.mercola.com/sites/articles/archive/2019/07/30/necrotizing-fasciitis.aspx

Story at-a-glance

  • Flesh-eating disease (necrotizing fasciitis) can be caused by several different organisms. In cases where the infection is contracted through contact with seawater, the culprit is typically Vibrio vulnificus, a particularly dangerous Vibrio species that occurs naturally in warm seawater
  • Having liver disease increases your risk of V. vulnificus infection by 800% and your risk of death from it is 200 times higher than those with healthy livers
  • Having diabetes, HIV, thalassemia or cancer also raises your risk of Vibrio infection, as does taking antacids
  • Iron overload may be a key factor in life-threatening Vibrio infections. High iron provides prime growth conditions for V. vulnificus, and minihepcidin, an iron-lowering drug, has been shown to cure the infection by inhibiting the bacteria’s growth
  • Vibrio bacteria have a high affinity for attachment to human skin. In one study, all participants had Vibrio bacteria on their skin after swimming in seawater

The very idea of flesh-eating bacteria is horrifying and the real-world effects can indeed be devastating, necessitating the removal of large portions of flesh or amputation of limbs. Its effects can also be lethal.

July 15, 2019, WGN9 News reported the case of a woman being infected with flesh-eating bacteria after a quick swim at Norfolk’s Ocean View beach in Virginia the week before.1

She started feeling ill the very next day, and noticed symptoms of infection in her leg. It spread rapidly, and within a couple of days, she could no longer walk. Treating doctors suspect the bacterium made its way into her body via a small cut. She’s currently recovering from leg surgery. Another Florida woman who contracted the infection is also on the path to recovery.2

Two other recent cases did not end as well. A man crabbing at Magnolia Beach in Texas, and another who went for a swim in the Gulf, contracted infections that led to their deaths.3

“Health officials urge swimmers to avoid swallowing water and taking a dip after a heavy rainfall. Don’t swim if you are ill or have a weakened immune system and swim away from fishing piers, pipes, drains and water flowing from storm drains onto a beach Once you get out of the water, health officials say you should shower with soap,” WGN9 reports.4

What WGN9 does not cover is evidence suggesting flesh-eating bacteria are ubiquitous in the ocean and on human skin after swimming in saltwater, and that the difference between those who come into contact with the bacteria and remain unaffected and those in whom the bacterium unleashes a dangerous infection is strongly related to their iron levels.

Another sad note is that this woman may have undergone needless surgery as this infection, and similar diabetic leg infections, are relatively easily treated in a hyperbaric oxygen chamber.5,6

These types of infections typically require higher pressures with a hard-shell chamber7 and 100% pure oxygen with greater than two atmospheres of pressure — a treatment approved8 by the FDA for necrotizing infections, certain other wounds and gangrene. A soft-shell chamber would not likely be an effective treatment.

Necrotizing fasciitis

Flesh-eating disease (necrotizing fasciitis) can be caused by several different organisms, although group A Streptococcus are responsible for a majority of cases. Group A Strep is also responsible for strep throat, rheumatic fever and scarlet fever.9

Death is typically related to sepsis and subsequent organ failure. Due to its rapid spread, it’s important to seek medical attention as quickly as possible. According to the U.S. Centers for Disease Control and Prevention, early symptoms of necrotizing fasciitis include:10

  • Redness and/or swelling that rapidly spreads
  • Severe pain in the area and beyond (pain is typically described as worse than would be expected by the look of the wound)
  • Fever

In particular, be on the lookout for skin discoloration such as black spots, ulcers or blisters on the skin, and/or oozing pus. Dizziness, fatigue, nausea and diarrhea are symptoms associated with heightened infection.

According to the CDC’s active bacterial core surveillance system, which tracks necrotizing fasciitis cases caused by group A Strep, the U.S. has averaged between 700 and 1,200 such cases per year since 2010.11

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Flesh-eating Vibrio infections are also common

Now, in cases where the flesh-eating disease is contracted through contact with seawater, the culprit is typically the bacterium Vibrio vulnificus, a particularly dangerous Vibrio species that occurs naturally in warm seawater.12 For this reason, it’s not a good idea to go swimming if you have open cuts, sores or fresh tattoos.13

According to the U.S. National Oceanic and Atmospheric Administration,14 the Vibrios species prefer salty water above 59 degrees Fahrenheit (15 degrees Celcius). In fact, 93% of the time, the water temperature and salinity can correctly identify V. vulnificus hotspots. Iron- and nitrogen-rich dust settling in seawater has also been shown to fuel the bacteria’s growth.15

According to the CDC, Vibrio infection (by all species) causes 80,000 illnesses and kills 100 people in the U.S. each year.16 Aside from seawater exposure, raw or undercooked seafood are other common routes of exposure.

Liver disease increases risk of V. vulnificus infection

Importantly, having liver disease dramatically increases your risk of V. vulnificus infection. CDC findings reveal people with liver disease are a whopping 80 times more likely to contract V. vulnificus infection from raw oysters than those without liver problems, and 200 times more likely to die from it.17

Having diabetes, HIV, thalassemia (an inherited blood disorder that I actually have, which is associated with both anemia18 and iron overload19) or cancer also raises your risk of Vibrio infection, as does taking antacids.20 These risk factors are worth considering when swimming in the ocean as well.

Preliminary, as-yet unpublished research presented at the 2019 annual meeting of the American Society for Microbiology and reported by Medicine Net21 revealed all participants had the Vibrio genus of bacteria on their skin after swimming in the ocean and then air drying.

Vibrio was also found to have “specific affinity for attachment to human skin,” Medicine Net reports,22 as the presence of Vibrio on the swimmers’ skin was tenfold greater than in water samples.

Iron overload increases your vulnerability to V. vulnificus

I’ve mentioned iron a couple of times already, and iron may actually be a key factor in these life-threatening Vibrio infections. Not only does iron-rich water dramatically boost the growth of V. vulnificus, having excess iron in your blood may also predispose you to flesh-eating disease when exposed to the bacteria.23

In 2015, the University of California, Los Angeles (UCLA) published an article on this important finding, noting that:24

“People with a weakened immune system, chronic liver disease or iron overload disease are most at risk for severe illness. Vibrio vulnificus infections in high-risk individuals are fatal 50 percent of the time. Now, researchers at UCLA have figured out why those with iron overload disease are so vulnerable.

People with the common genetic iron overload disease called hereditary hemochromatosis have a deficiency of the iron-regulating hormone hepcidin and thus develop excess iron in their blood and tissue, providing prime growth conditions for Vibrio vulnificus.

The study25 also found that minihepcidin, a medicinal form of the hormone hepcidin that lowers iron levels in blood, could cure the infection by restricting bacterial growth … [R]esearchers compared the fatality of Vibrio vulnificus infection in healthy mice with mice that lacked hepcidin, modeling human hereditary hemochromatosis.

The results showed that the infection was much more lethal in hepcidin-deficient mice because they could not decrease iron levels in the blood in response to infection, a process mediated by hepcidin in healthy mice. 

Giving minihepcidin to susceptible hepcidin-deficient mice to lower the amount of iron in the blood prevented infection if the hormone was given before the Vibrio vulnificus was introduced. Additionally, mice given minihepcidin three hours after the bacterium was introduced were cured of any infection.”

The links between iron levels and liver health

Hemochromatosis, a hereditary disorder that causes your body to accumulate damaging levels of iron, affects 1 in 300 to 500 Caucasians.26 However, you don’t have to have a genetic disorder to have high iron.

In fact, most all adult men and non-menstruating women have damaging levels of iron, as the primary way to lower your iron level is through blood loss. Even women with hemochromatosis are relatively protected in their youth thanks to regular blood loss through menses.27 The primary therapy for hemochromatosis, and the easiest way to normalize your iron level if it’s high, is by regularly donating blood.28

Your liver is the primary organ responsible for regulating your iron level. Provided your liver is healthy, your ferritin level is likely to be healthy as well. As explained in a 2013 paper:29

“Iron is an essential nutrient that is tightly regulated. A principal function of the liver is the regulation of iron homeostasis. The liver senses changes in systemic iron requirements and can regulate iron concentrations in a robust and rapid manner.

The last 10 years have led to the discovery of several regulatory mechanisms in the liver which control the production of iron regulatory genes, storage capacity, and iron mobilization. Dysregulation of these functions leads to an imbalance of iron, which is the primary causes of iron-related disorders …

During conditions of excess iron, the liver increases iron storage and protects other tissues, namely the heart and pancreas from iron-induced cellular damage.

However, a chronic increase in liver iron stores results in excess reactive oxygen species production and liver injury. Excess liver iron is one of the major mechanisms leading to increased steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma.”

Crucial nutrients for liver health

Two nutrients crucial for liver health and function are methionine — a sulfur containing amino acid30 — and choline. Research31 shows a methionine and choline deficient diet causes rapid onset and progression of the clinical pathologies associated with nonalcoholic fatty liver disease (NAFLD) in rodents, and other researchers have suggested choline may be an essential nutrient for patients with liver cirrhosis.32

Researchers have also shown that iron overload triggers inflammation and necrosis of the liver in animals with methionine/choline‐deficiency induced NAFLD.33

According to Chris Masterjohn, who has a Ph.D. in nutritional science, choline deficiency actually appears to be a far more significant trigger of NAFLD than excess fructose and, in his view, the rise in NAFLD is largely the result of shunning liver and egg yolks. Masterjohn explains:34

“We now know that choline is necessary to produce a phospholipid called phosphatidylcholine (PC) … a critical component of the very low density lipoprotein particle, which we need to make in order to export fats from our livers.

The amino acid methionine can act as a precursor to choline and can also be used to convert a different phospholipid called phosphatidylethanolamine directly into PC. Thus, the combined deficiency of choline and methionine will severely impair our abilities to package up the fats in our livers and to send them out into the bloodstream.”

Best sources of choline and methionine

A single egg can contain anywhere from 113 milligrams35 (mg) to 147 mg36 of choline, or about 25% of your daily requirement, making it one of the best choline sources in the American diet.37 Only grass fed beef liver beats it, with 430 mg of choline per 100-gram serving.38 As noted in the Fatty Liver Diet Guide:39

“Eggs rank very high on the list of foods that are high in either lecithin, which converts to choline, or in choline itself. Note that this is the egg yolks only, not egg whites, which only have traces of this micronutrient.

Choline is essential in the production of phosphatidylcholine, a fat molecule called a phospholipid. But wait! Isn’t all fat bad? No — especially if it is essential to overall health and in particular, liver health. Simply put — if you don’t have enough choline, your liver can’t move out fat. It instead begins to collect within your liver, creating fatty liver.”

This is one of the reasons I eat about six eggs a day — typically raw in my two smoothies. This gives me about 900 mg of dietary phosphatidyl choline. Other healthy choline sources include:40

  • Wild-caught Alaskan salmon41
  • Krill oil — One 2011 study42 found 69 choline-containing phospholipids in krill oil, including 60 phosphatidylcholine substances, which helps protect against liver disease (including hepatitis and cirrhosis in alcoholics), reduce digestive tract inflammation and lessen symptoms associated with ulcerative colitis and irritable bowel syndrome
  • Organic pastured chicken
  • Vegetables such as broccoli, cauliflower and asparagus
  • Shiitake mushrooms

As for methionine, this amino acid is found in animal protein such as fish, poultry, pork and beef. High amounts are also found in Swiss cheese and provolone.43 When it comes to beef, eating “nose-to-tail,” opposed to steak exclusively, is the best way to optimize your methionine intake, as this will provide you with a healthy methionine to glycine ratio.

How to minimize your risk of flesh-eating disease

To try to tie this all together, here’s a quick summary of the key points and take-home messages presented in this article:

Chronic liver disease raises your risk of V. vulnificus infection. Optimizing your methionine and choline intake will help prevent liver disease, thus lowering your susceptibility to flesh-eating disease as well. Pastured eggs are the best source of choline, while animal protein of all types will provide varying amounts of methionine.44

Addressing insulin resistance — which may affect as many as 8 in 10 Americans45,46 — is another important strategy to protect your liver health and avoid fatty liver disease.47

Having a healthy liver is key for iron homeostasis in your body.

Excess iron — which affects most men and menopausal women — significantly raises your risk of flesh-eating disease when exposed to V. vulnificus, either from eating raw/undercooked seafood or swimming in seawater with an open cut or scrape, allowing the bacteria entry into your body.

Normalizing your iron may thus be an important way of preventing this life-threatening infection. To do that, simply donate blood a few times a year. If your ferritin level is over 200 ng/ml, a more aggressive phlebotomy schedule is recommended.

Ideally, your serum ferritin should be somewhere between 20 and 80 ng/ml. As a general rule, somewhere between 40 and 60 ng/ml is the sweet spot for adult men and non-menstruating women.

V. vulnificus is ubiquitous in seawater, and risk of infection rises along with water temperatures, as warm water spurs growth, and the bacteria adheres well to skin. To limit your risk, avoid swimming if you have open cuts or scrapes on your body, and avoid taking water into your mouth.

Sources and References
Posted by: | Posted on: August 5, 2019

How Functional Genetics Can Help You Take Control of Your Health

Analysis by Dr. Joseph Mercola  – Fact Checked – May 12, 2019

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Story at-a-glance

  • Functional genetics looks at the single nucleotide polymorphisms (SNPs, pronounced “snips”) of genes
  • When you have SNPs (genetic variants or defects on the genes), enzymes may not be working effectively, or the gene may be upregulated or downregulated
  • While traditional genetics often looks for potential disease states, functional genetics looks for potential impairment of function and helps find the best nutritional intervention to bring your body back into balance
  • People with genetic weaknesses that hamper detoxification who are exposed to high amounts of environmental toxins can be struggling with health due to their limited ability to detoxify
  • NutriGenetic Research Institute is devoted to functional genomic testing, training health professionals to help people understand the results and how to apply it to improve their health

Functional genomics is a gene testing modality with enormous value that many are completely unaware of. Bob Miller1 is a certified traditional naturopath specializing in genetic-specific nutrition. He’s the founder of the NutriGenetic Research Institute,2 devoted to testing and helping people understand the results of their functional genetic testing and how to apply it to improve their health.

“As a traditional naturopath, we’re not licensed medical doctors, so we don’t diagnose, treat or prescribe,” Miller explains. “We look at the functional approach of, ‘How is the terrain off in the body?’ … [W]hen the body is toxic or inflamed, that’s when pathogens have a better opportunity to thrive.

Many years ago, I learned about how homocysteine has pathways that clear it that may be impaired by genetic variants. I became very fascinated by it. I started looking at the enzymes that clear it, and then the genetics behind it.

My whole naturopathic and holistic practice is [now] dedicated to helping clients measure their functional genomics, which is quite a bit different than traditional genetics that looks for disease patterns, and trying to find out how we can make interventions to bring the body back into balance …

Our goal is to be able to make a contribution to functional practitioners, so they can do their job a lot better and improve the lives of those who are suffering with some of those things that nobody can seem to figure out …

To sum up what we’re finding is that those with genetic weakness in detox pathways are exposed to environmental factors we weren’t dealing with 50 to 75 years ago; their ability to detox is overwhelmed. I think this is a whole new paradigm that we have to look at in wellness.

Those who don’t have a specific disease, so to speak, but are just totally overwhelmed by all of the epigenetic factors, such as pesticides, electromagnetic fields (EMFs) … excess iron … plastics … mold … [and] sometimes even oversupplementation with things like folate and glutamine … that no matter what they try, it doesn’t work …

That’s why we need to move to personalized care, based upon the individual. Fortunately, we now have tools to do that.”

What Is Functional Genetics?

Certain genes are known to predispose you to, or raise your risk of, certain diseases. That’s not what we’re talking about here. Functional genetics looks at the single nucleotide polymorphisms (SNPs, pronounced “snips”) of genes related to function.

You’ve probably seen representations of the DNA ladder. On the end of each rung is a molecule from each of your parents. These molecules can either make your DNA optimal or, if you have a SNP, meaning a defect, that gene will not work at optimal efficiency. Miller explains:

“To make this simple, we eat fats, carbohydrates and proteins. We drink water, breathe air and are exposed to sunlight. What an absolute miracle it is that all of that turns into us: our blood, our skin, our nails, our organs and our thought processes. All of that is one enzymatic process after another.

So, an enzyme takes substance A; pulls in what we call cofactors and makes substance B. That continually happens throughout your body — one process after another. It’s your genetic makeup that [provides] the instructions on how to make these enzymes.

When we have genetic variants, SNPs, on the genes, sometimes those enzymes either aren’t as effective … or might be upregulated or downregulated. Therefore, that substance A to substance B [conversion] may not occur as it should.

Now, people get all excited about whether they have genetic variants or not, but there’s something else just as important. That’s the cofactor. Remember, substance A plus cofactors turns into substance B. You could have absolutely perfect genetics, that enzyme is made perfectly, but if you’re missing the cofactors, that A to B [conversion] is not going to work …

Where people really get hit hard is when they’ve got genetic weakness and cofactor weakness. Then there’s a third piece. Sometimes there are things that interfere. For example, lead, mercury and other things may suppress that enzymatic function …

Now, interestingly, we have all kinds of backups. One pathway may not be working, but another one might kick in. But what we’re observing … is that those who are struggling usually have multiple pathways blocked. Plus, they get multiple epigenetic exposures … When you get those epigenetic and genetic factors going together, that’s when things really start going awry.”

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The Relationship Between mTOR Pathway and Autophagy

Autophagy means “self-eating” and refers to your body’s process of eliminating damaged and defective cellular parts that are targeted for lysosome, which then digests them. The mammalian target of rapamycin (mTOR) is a molecular signaling pathway responsible for either growth or repair, depending on whether it is stimulated or inhibited.

I’ve often stated that to upregulate maintenance and repair (which will boost longevity and reduce your risk for cancer), you need to suppress the mTOR pathway. One of the most efficient ways to do this is to limit your protein intake, but it’s not the only way. Autophagy and mTOR are two processes that work together, but are inverse to each other. Miller likens mTOR to a construction crew, whereas autophagy refers to the cleanup crew.

“One of the ways you can tell if your autophagy is not working is when you get those age spots, sun spots, liver spots, whatever you’d like to call them,” Miller says. “That’s when the old cell is not cleared away and it becomes oxidized, it becomes senescent. It actually becomes a free radical-giving reactive oxygen species.

Now, we need a balance between [mTOR and autophagy]. We need a time to build and we need a time to clean. One of the things our research institute [found] in some of our studies on those with chronic Lyme disease [is] that we are being exposed to more epigenetic environmental factors that stimulate mTOR … ”

Factors That Activate mTOR Versus Those That Support Autophagy

Examples of environmental factors that activate mTOR include:

Xenoestrogens (chemicals in plastic) EMFs
Insulin Excess protein
Excess iron Excess folic acid, folate or methyl folate
Excess glutamate Amino acids such as leucine, isoleucine and valine

When mTOR is activated, it inhibits autophagy and, according to Miller, many of the health challenges people face these days appear to be related to excess mTOR activation.

This is also one way by which a cyclical ketogenic diet helps improve your health, as it inhibits mTOR and activates autophagy. When mTOR is chronically activated, it will not only inhibit autophagy but also impair apoptosis (cell death), and if that’s impaired, your risk for cancer will significantly increase as well.

“We have identified the genes that are involved with autophagy,” Miller says. “They’re called Unc-51 like autophagy activating kinase 1 (ULK1), serine/threonine-protein kinase (ULK2), 5’ AMP-activated protein kinase (AMPK) and AuTophaGy related 1 (ATG1).

Those all stimulate autophagy. We’re finding that when people have a lot of genetic variants, especially when they inherit it from both parents, this is where their autophagy’s weakened. They’re 45 years old and covered with age spots. They can’t detox.

Ketogenic diet, intermittent fasting and nutrients [such as] lithium and berberine support autophagy. Resveratrol and curcumin slow down mTOR.

When you put the three together — the caloric restriction mimetics (CRM) [editor’s note: supplements that mimic the antiaging effects of calorie restriction] … along with the keto diet, along with some form of intermittent fasting — you’re able to bring balance to mTOR and autophagy.”

If Ketogenic Diet or Intermittent Fasting Fails for You, This Could Be Why

While intermittent fasting is an excellent strategy for a majority of people, it doesn’t work as expected for everyone. As explained by Miller, members of his research team have discovered having a functional heme pathway is extremely important when you’re on a ketogenic diet and/or intermittently fasting.

Heme protein is created through an eight-step process beginning with succinyl coenzyme A (succinyl CoA), glycine and amino acids. Heme protein in turn is a component of hemoglobin, but it’s also involved in the making of nitric oxide, catalase, superoxide dismutase (SOD) and sulfite oxidase (SUOX), which is your sulfide to sulfate conversion.

“It’s involved in so many processes that I didn’t even realize until we started to research,” Miller says. “This [heme] pathway may be impaired by … glyphosate [which impacts glycine] … lead … and genetic variants in the heme pathway.

If any of those happen, you don’t make adequate heme, so you’re going to be a very poor detoxer. Now, what’s interesting … [is that] if porphyrins [glycoproteins responsible for pore formation in cell membranes] are not transferred one to another, they will block the gamma-aminobutyric acid (GABA) receptor sites. GABA is the ‘Don’t worry. Be happy. Sleep. Relax’ [neurotransmitter]. Clearly, there are problems with anxiety in the world today.

If this heme pathway gets disturbed, people oftentimes crave carbohydrates. If they try to go keto, it doesn’t work. If they try to do intermittent fasting, it doesn’t work … It’s a small amount of people, but for some individuals who just crave carbohydrates, they’ll get hangry if they don’t have their carbohydrates. They’re actually feeding that heme pathway.

If someone’s ever tried keto and is like, ‘This just does not work for me,’ there’s a potential that the heme pathway could be impaired. You have to keep those carbohydrates coming in on a regular basis to feed it, or else you feel horrible. I remember in the past people telling me, ‘Whenever I try to eat healthy, I feel horrible. When I eat junk, I feel better.’

I used to think, ‘Yeah. I’m not sure I buy that.’ But now that you understand this heme pathway and how carbohydrates and simple sugars can feed it, it starts to make sense that that is a potential scenario for some people.”

Even if You’re Anemic, You May Be Overabsorbing Iron

As mentioned earlier, iron stimulates mTOR. Clearly, iron is crucial for optimal health. Without sufficient amounts of iron, you cannot make sufficient amounts of hemoglobin, which carries oxygen through your body. However, in excess, iron is incredibly destructive.

“Here’s one of the interesting things we found through our research. There are many people who have genetic predisposition to overabsorbing iron, yet they’re told all their life they’re anemic. It just seems like such a dichotomy; how can you be anemic if you’re overabsorbing iron?

One of the things that we … find in many who are struggling and can’t get answers anywhere else is that they overabsorb iron. There’s an enzyme called ferroportin, [which] is what takes iron out of the cells. SNPs there, or genetic defects, inhibit the removal of the iron. Through something called the Fenton reaction … iron may combine with hydrogen peroxide to make hydroxyl radicals.

This can then go on to make another nasty free radical called peroxynitrite. Consequently, the person is anemic because they are measuring what’s in the blood, but the iron can be in excess and inside the cells, causing massive inflammation.

As that iron bangs around inside the cell, it creates fatigue, because the mitochondria are having a hard time making energy. These are the people who if someone gives them iron, many times, they feel considerably worse, because they’ve just fed the fire.

In our consulting, one of the things we probably do the most is identifying the Fenton reaction going on and taking remedial action to, for example, help turn the hydrogen peroxide into water through an enzyme called catalase; supporting enzymes and antioxidants called glutathione and thioredoxin that turn the hydrogen peroxide into water, [and] using homeopathics to make the iron behave itself.”

Hydrogen water can be helpful here, Miller notes, because it helps decrease the excess hydroxyl radicals. “Quite simply, H2O2 plus iron equals hydroxyl free radical (OH-), which is one of the most highly reactive and damaging free radicals,” Miller explains.

I’ve previously interviewed Tyler LeBaron, one of the leading experts on molecular hydrogen, and he believes the benefits may be related more to the upregulation of antioxidant pathways, such as the nuclear factor erythroid 2-related factor 2 (Nrf2). Either way, whatever the mechanism, it seems clear hydrogen water has the ability to neutralize free radicals.

Situations in Which NAC or Methyl Folate May Backfire

I’ve previously written about the benefits of N-acetyl cysteine (NAC), the rate-limiting factor for glutathione, which is a master antioxidant made by your body. However, in order for this to work, you must have the required enzymes. What’s more, if you have an iron problem, the cysteine you take can combine with the iron to create hydroxyl radicals — essentially worsening your situation.

“It goes back to the fact that we’ve got to get away from the cookie cutter, ‘Oh, you’re inflamed. Take NAC.’ NAC can be the perfect thing for you, or it can make you worse, depending on your genomic make up,” Miller says.

Miller has developed a hierarchical pyramid of different variables and his approach to treating them. Interestingly, many who superficially look at functional genomics think that the methylation defect is one of the most important. It is important, but according to Miller there are many others that supersede it in terms of importance.

nutrigenetic hierarchical pyramid

“[Methylation] is about how we take folic acid or folate from our diet and turn it into methyl folate, which is a very important molecule. For a woman who’s pregnant, you’ve got to have it for a good pregnancy. We’re not saying it’s not a good thing … Now, one of the interesting things about methyl folate is you need it for pregnancy because it supports mTOR.

If someone’s already in mTOR dominance and they take methyl folate, they’re going to get more anxious and more inflamed. I’ve talked to so many people who’ve said, ‘Oh, yeah. I have MTHFR. Somebody put me on methyl B12, methyl folate. I felt great for two weeks, and then I crashed.’

The reason they may have crashed is because they started to stimulate mTOR, weakening their autophagy even more, driving more inflammation … As we dug deeper, we realized that methyl folate is important, but it has to be done at the right time. That’s why I developed my pyramid.

At the very bottom we have things we have to address first, such as, is iron becoming a free radical? Is hydrogen peroxide not being cleared? Is there nitric oxide synthase (NOS) uncoupling? — where rather than making nitric oxide, we make more peroxynitrite.

And then we look at how we’re making antioxidants. How’s our glutathione pathways? How’s our superoxide dismutase? How are we making NADPH? … For the most part, I believe that when people are massively inflamed, you need to address that first.

If someone is massively inflamed, if their iron is creating hydroxyl radicals, if they have weakness in their antioxidants … and you throw methyl folate in there … there’s a very good chance it will make the situation worse.

By and large, if someone’s massively inflamed, I’d like to think about methyl folate six to eight months down the road, two to three days a week. We tend to think, ‘If a little’s good for us, a lot must be good for us.’ I’m now thinking need to be pulsing things.”

I totally agree pulsing is a key component that should not be overlooked, whether you’re taking supplements, fasting or doing a ketogenic diet. It’s important to go through cycles of buildup and tear-down.

For example, during a partial fast, you’re stimulating autophagy through caloric restriction. At that time, you would not want to take anything that stimulates mTOR (such as methyl folate or any of the other items listed above), as by stimulating mTOR you effectively interrupt the autophagy process.

Mast Cells Could Be Wreaking Havoc With Your Health

Glutathione rapidly loses electrons, making it useless unless recharged by nicotinamide adenine dinucleotide phosphate hydrogen (NADPH). As explained by Miller, the “NADPH steal,” a term he coined, may also be at play in many of the health issues people face today.

It’s becoming more widely known that you can have excess mast cells. Miller estimates about 80 percent of his clients have excess mast cell activation triggering histamine reactions. One of the signs of this is redness of the face due to heat intolerance. Sensitivity to touch is another, as are frequent, red, raised rashes.

Mast cells are white blood cells that come to the rescue when there’s a pathogen or a foreign invader that needs to be eliminated. While overfiring mast cells can cause problems, they’re not inherently bad, and strategies that inhibit them can backfire. Instead, Miller recommends determining why your mast cells are overactive.

His team presented research at the International Lyme and Associated Diseases Society’s 19th Annual Conference in November last year, identifying epigenetic factors that stimulate mast cells. He explains the relationships between mast cells, NADPH, NOX and glutathione:

“In simple terms, glutathione … has one chance to give a free radical an electron. Once it does that, it becomes oxidized. Then we need to donate that electron back. There’s this substance called NADPH that donates that electron back.3 It takes that oxidized glutathione and turns it back into reduced. That’s a good thing.

Now, NADPH has a dual role. There’s also an enzyme called NOX (NADPH oxidase). Its only purpose is to take this NADPH and turn it into a free radical … Now, they’ve done studies on animals. When they knock out that NOX enzyme, the animal dies from infection because it doesn’t have the ability to kill the pathogen.

Again, NOX and free radicals are not bad. But there are multiple factors that are now overstimulating NOX. One of them is sulfite. Sulfite needs to turn into sulfates. If we have deficiency of heme, we may not turn sulfites in sulfates … If sulfites don’t turn into sulfates, the sulfites may tell the NOX enzyme, ‘You need to make inflammation.’

Dopamine stimulates it [NOX], so stress will cause it. Glutamate stimulates it. Iron stimulates the NOX enzyme, and so does excessive mTOR … The NADPH steal is when NADPH gets stolen away from recycling glutathione, recycling thriodoxine, making nitric oxide, and potentially making excess mast cells.

There are a lot of people struggling with excess mast cells firing. They’re really sick. They don’t know what to do … Mold will also stimulate mast cells …

To sum it up, NADPH is critical for recycling your antioxidants. I believe the nicotinamide adenine dinucleotide (NAD+) and the NADPH are some of the most important things we can have adequate levels of for longevity and good health. We’re using up a lot of it because we’re exposed to so many toxic substances. Then, if another set of substances are stealing it to stimulate NOX to make mast cells, then we’ve just doubled the problem.”

Molecular hydrogen serves a role here as well, as studies have shown molecular hydrogen is an effective inhibitor of NOX,4 and can increase your concentration of NADPH. Curcumin also inhibits NOX, as does luteolin, apigenin and olive leaf. Aldosterone, on the other hand, stimulates NOX, Miller says.

More Information

This interview is quite loaded with information, not all of which has been covered in this article. For even more side notes and fascinating tangents, I recommend listening to the interview in its entirety.

Health practitioners interested in learning more about functional genomic analysis and how to apply it in your own practice, see the NutriGenetic Research Institute’s website, where you can sign up for their 30-hour, 14-module online certification course to become a nutritional genetic consultant.

Webinars for health practitioners are held every other Thursday. They also hold an annual conference in Hershey, Pennsylvania. The next one is scheduled for November 2019. In September, they’re also holding a seminar on environmental toxicity, detoxification and methylation mapping.

Patients interested in more information are directed to the yourgenomicresource.com which includes a listing of doctors who have completed the training and are qualified to provide nutritional guidance based on your SNPs. Up until last year, Miller could guide patients based on the genetic data provided by companies such as 23andMe. Now, he has developed his own DNA testing, which is capable of identifying some 300,000 SNPs.

Importantly, NutriGenetic Research Institute will never sell your private DNA or health data to anyone, which is one of the reasons why 23andMe is so inexpensive — they make their money by selling your DNA results to drug companies.

“I have pledged to everyone in writing that this data will never be sold to anyone. The other thing people can do, if they’re still worried, you can just change your name. Just come up with a fake name. It doesn’t matter. We don’t care. You just have to remember what it is,” Miller says.

“The [DNA] data from Brooks at Rutgers gets loaded into my software, which is in Chambersburg, Pennsylvania — a huge database. Then it crunches the data and gives a report, including the pyramid …

If you’re sick, you’ve been everywhere and you’re not getting better, this is certainly an option … Our whole goal is to help people get well. And to make a little bit of a dent in functional medicine — to help functional practitioners have tools that they can help, because functional medicine doctors see the tough cases. We want to give them some tools so that they can do a better job …

One of my favorite sayings is, ‘Genetics is never a diagnosis, but it tells you where to start looking.’ It’s like shining a light. ‘Think about looking here. Investigate whether this is a problem.’ Sometimes the SNPs show a problem, sometimes they don’t, but it can really give you clues to look where you may never have thought to look before.”

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