Metabolic Health Assessment
As a functional medicine health coach, I'm excited to share how specific lab tests can provide profound insights into your metabolic health. These tests are particularly important if you experience symptoms of blood sugar dysregulation.
The tests we’ll explore today are so much more than just numbers – they're crucial indicators of your body's intricate metabolic balance.
Let’s dive in!
Unpacking BLOOD SUGAR MARKERS
Fasting Glucose: This marker gives us a snapshot of your blood sugar status. This one-time marker is easily influenced by your cortisol awakening response, which can hide or amplify the real status of ongoing fasting glucose through a 24-hour period. Optimal glucose levels range from 80 - 88 mg/dL from the functional medicine perspective. Since fasting glucose is a one-time marker, I do recommend assessing additional blood sugar markers if there are any symptoms of blood sugar dysregulation.
Hemoglobin A1c (HbA1c): This marker reveals the impact of blood sugar on hemoglobin in red blood cells (RBCs). Since RBCs have a lifespan of 3-4 months, HbA1c provides a longer-term picture of your blood sugar levels, making it a more consistent indicator than fasting glucose. However, it's important to note that HbA1c can be influenced by insulin resistance and becomes less accurate if you have anemia. Ideal HbA1c levels are typically 5.0% or less, with levels above 5.3% indicating potential insulin resistance. Levels reaching 5.7% and higher are often used by physicians to diagnose pre-diabetes.
Fasting Insulin: This hormone, produced by the pancreas, plays a pivotal role in regulating blood sugar by signaling cells to absorb glucose. Elevated insulin levels can indicate your body’s resistance to its effects, often a precursor to metabolic dysfunction, and can lead to increased blood sugar levels. From my perspective, this is one of the most valuable markers to assess to understand your true blood sugar management status. The optimal functional range is typically 4 - 5mIU/L, and measurements outside of this range suggest the need for immediate functional intervention to stop the cascade of metabolic dysfunction and disease development.
These markers don't just tell us where you stand health-wise; they guide us in charting a path toward addressing your unwanted symptoms.
LIPID PANEL assessing liver health
Assessing a lipid panel offers many valuable insights into cardiovascular health, cholesterol uptake and utilization, steroid hormone synthesis, and more; however, in regard to metabolic health, my focus is on assessing your triglyceride levels.
Triglycerides: When we consume more glucose than our body immediately needs, it first gets stored as glycogen in the liver and muscles. Glycogen acts as a short-term energy reserve. However, the storage capacity for glycogen is limited. Once these reserves are full, additional excess glucose is converted by the liver into triglycerides for longer-term fat storage. From the functional lens, the optimal range of triglycerides lies within 60 - 100 mg / dL.
When this process of converting glucose to triglycerides happens frequently due to consistently high glucose intake, it leads to elevated levels of triglycerides in the blood. This is a key aspect of metabolic dysfunction and a vital area to assess if you eat a high glycemic diet and are struggling with stubborn weight.
LIVER ENZYMES measured in a metabolic panel
The liver plays a central role in managing glucose levels. When there's an overflow of glucose, the liver steps in to convert this excess into a form that can be stored. It acts like a regulatory hub, ensuring the body's glucose levels remain balanced.
ALT, AST & GGT:
Assessing liver enzymes is crucial for evaluating liver tissue turnover rate. Abnormal liver enzymes can suggest impaired glucose and lipid metabolism. While elevated liver enzymes may indicate liver damage or hepatic biliary congestion, low liver enzymes may suggest a poor tissue turnover rate due to nutrient deficiencies required for optimal liver health.
A comprehensive THYROID PANEL
Thyroid hormones directly influence the body's metabolic rate, influencing the speed and efficiency of energy utilization, weight management, energy levels, body temperature, and overall metabolic health.
An underactive thyroid (hypothyroidism) can lead to a slower metabolism, causing symptoms like weight gain, fatigue, and cold intolerance. Conversely, an overactive thyroid (hyperthyroidism) can cause weight loss, anxiety, and heat intolerance. Even in the absence of overt symptoms, a thyroid panel can detect subclinical thyroid disorders.
COMPONENTS OF A THYROID PANEL
TSH (Thyroid-Stimulating Hormone): TSH is produced by the pituitary gland and regulates the production of thyroid hormones. From the functional perspective, levels above 2.0 IU/L suggest some sluggishness within TSH levels, typically indicating an underactive thyroid, which may have many downstream implications on cellular metabolism and metabolic status.
Free T4 (Thyroxine): T4 is the primary hormone produced by the thyroid gland. Free T4 refers to the portion of T4 not bound to proteins in the blood, thus available for use by the body.
Free T3 (Triiodothyronine): T3 is the more active thyroid hormone converted from T4. It's more potent and impacts metabolic processes more directly. Assessing free T3 levels helps understand how effectively the body converts T4 to T3.
Reverse T3 (rT3): This is an inactive form of T3 and can increase in response to stress, illness, or other metabolic changes. Elevated rT3 can indicate issues with thyroid hormone metabolism.
Thyroid Antibodies (such as TPO antibodies): These are assessed to determine if thyroid issues are caused by an autoimmune response, as seen in conditions like Hashimoto's thyroiditis.
Assessing a comprehensive thyroid panel helps us to assess the complex interactions of the thyroid and its downstream impact on other symptoms, including adrenal health, reproductive hormones, and insulin regulation.
UNDERSTANDING THE COMPLEX INTERPLAY
As we've explored, these lab tests are much more than mere numbers; they are windows into the unique workings of your body. Understanding your fasting glucose, HbA1c, fasting insulin levels, lipid panel, liver enzymes, and thyroid panel is crucial in grasping the full picture of your metabolic health. Neglecting the early signs of metabolic dysfunction can create a snowball effect, where symptoms worsen and become increasingly difficult to manage. When left unchecked, these early warning signs can cause various detrimental effects, setting the stage for diagnosable disease.
The truth is that from the conventional perspective, these markers are often overlooked and left unchecked until completely out of range, allowing for complete disease development (diabetes, hypothyroid, fatty liver, cardiovascular disease) where the main option offered is medication. The hardest part of this dynamic is that often, the medication is simply a bandaid with a wide range of side effects and nutrient depletions and doesn’t address the upstream drivers contributing to the imbalance.
Proactively managing your metabolic health now can prevent this cascade of complications.
In the realm of functional medicine, it's essential to not only understand the importance of these health markers but also to translate this understanding into actionable steps that seamlessly integrate into your daily life. By assessing these markers in this way, we focus on clearly explaining their implications in a relatable manner and helping you grasp the impact of your lifestyle choices on your health.
This understanding is pivotal in developing personalized and actionable strategies that cater to your specific needs. These strategies aren't just generic advice; they are tailored interventions encompassing lifestyle modifications, supplement recommendations, dietary adjustments, and other personalized measures designed to address the issues identified through your health markers effectively.
This complete metabolic lab work assessment is included in our inital functional assessment.