The Importance Of Optimum Lab Testing Values

Posted On March 16, 2021 at 9:34 am by / No Comments

The Importance Of Optimum Lab Testing Values

There are an ever-growing number of people who are seeking to prevent the diseases of aging and who wish for a longer time living and a shorter time dying. People realise the flaws in the conventional medical approach, and more and more, are seeking doctors who integrate preventative medicine to enhance their health. Conventional medicine practice follows a disease-based model, where diagnosis and treatment are often instituted when frank disease states are apparent. Typically, symptoms are managed rather than the cause.

Preventative medicine is a clinical/medical specialty and field of scientific research aimed at the very early detection, prevention, treatment, and reversal of age-related decline. It is a healthcare model promoting innovative science and research to prolong a healthy lifespan and decrease the incidences of diseases that occur with aging, for example cancer, heart disease, osteoporosis, dementia and diabetes mellitus.

Preventative medicine is well-documented by peer-reviewed medical and scientific journals and employs evidence-based methodologies to conduct patient assessments. Treatments involve natural supplements, vitamins, aminoacids, essential fatty acids, bioidentical hormones, neurotransmitter balancing, chelation therapy for heavy meal toxicity,, nutraceuticals, IV nutrient repletions and many more modalities, including gene therapies, stem cell therapies and nanotechnologies.

In order to practice medicine from an integrative point of view, OPTIMUM lab test values are essential to detect disease processes earlier (see below table).

Optimum Lab Testing Values

Cardiovascular Risk Factors

Normal Reference Range

Optimum Reference Range

Reason For Testing

Nutraceutical Or Hormone Treatment

HSCRP

1 – 3 mg/L

< 1 mg/L

  • Marker of inflammation
  • Cardiovascular risk factor
  • Disease risk factor
  • Omega 3
  • Curcumin
  • Natural anti-inflammatories

Homocysteine

< 15 umol/L

< 6.3 umol/L

  • Marker of methylation
  • Cardiovascular risk factor
  • General health risk factor
  • Cancer risk factor
  • Memory loss risk factor
  • Bone mineral loss risk factor
  • Adrenal hormone replenishment
  • Thyroid hormone replenishment
  • Methyl donors
    • B Vitamins
    • TMG
  • SAMe

Cholesterol

< 5 mmol/L

4.1 – 4.7 mmol/L

  • Cardiovascular disease prevention
  • Red yeast rice
  • Omega 3
  • Niacin
  • Betasitosterol
  • Thyroid hormone replenishment
  • Adrenal hormone replenishment
  • Steroid hormone replenishment

Ldl

< 3 mmol/L

2.1 – 2.6 mmol/L

  • Cardiovascular risk factor
  • Red yeast rice
  • Omega 3
  • Niacin
  • Betasitosterol
  • Thyroid hormone replenishment
  • Adrenal hormone replenishment
  • Steroid hormone replenishment

Hdl

> 0.9 mmol/L

1.3 – 3.1 mmol/L

  • Cardiovascular disease prevention
  • Niacin
  • Omega 3
  • Estrogen replenishment in women

LDL/HDL ratio

< 2

  • Cardiovascular disease prevention

Triglycerides

< 1.7 mmol/L

0.45 – 1.13 mmol/L

  • Cardiovascular disease prevention
  • Niacin
  • Omega 3
  • Red yeast rice

TGL/HDL ratio

< 2

  • Cardiovascular disease prevention

Lipoprotein (a)

< 200 mg/L

  • Cardiovascular disease prevention
  • Lysine
  • Proline
  • Omega 3
  • Vitamin C
  • Niacin

Fibrinogen

<4 g/L

2 – 3 m/L

  • Blood clotting prevention
  • Cardiovascular disease prevention
  • Omega 3

Ferritin

  • 20 – 250 ng/ml (male)
  • 13 – 150 ng/ml (female)

< 100 ng/ml

  • Oxidative stress prevention
  • Cardiovascular disease prevention

Iron

10.7 – 17.9 umol/L

  • Cardiovascular disease prevention

Uric acid

0.18 – 0.3 mmol/L

  • Chronic gout prevention
  • Cardiovascular disease prevention
  • Quercetin
  • Wild cherry extract

Fasting glucose

< 6.1 mmol/L

< 5.6 mmol/L

  • Diabetes prevention
  • Cardiovascular disease prevention
  • Chromium
  • Alpha lipoic acid
  • EGCG
  • Bitter melon
  • Magnesium
  • Vitamin D3

Fasting insulin

< 15 uU/ml

3 – 8uU/ml

  • Diabetes prevention
  • Cardiovascular disease prevention
  • Chromium
  • Alpha lipoic acid
  • EGCG
  • Bitter melon
  • Magnesium
  • Vitamin D3
  • Irvingia

HBA1C

< 6 %

< 4.6%

  • Diabetes prevention
  • Cardiovascular disease prevention
  • Chromium
  • Alpha lipoic acid
  • EGCG
  • Bitter melon
  • Magnesium
  • Vitamin D3
  • Irvingia

Hormones

Normal Reference Range

Optimum Reference Range

Reason For Testing

Nutraceutical Or Hormone Treatment

Fasting insulin

< 15 uU/ml

3 – 8uU/ml

  • Diabetes prevention
  • Cardiovascular disease prevention
  • Chromium
  • Alpha lipoic acid
  • EGCG
  • Bitter melon
  • Magnesium
  • Vitamin D3
  • Irvingia

Free testosterone female

20.82 – 31.23 nmol/L

  • Libido
  • Skin tonicity
  • Well-being
  • Mood
  • Bio-identical testosterone
  • Bio-identical DHEA

Free testosterone male

6000 – 9000 pg/ml

  • Libido
  • Cardiovascular disease prevention
  • Prostate cancer prevention
  • Diabetes prevention
  • Bio-identical testosterone
  • Prostate protection formula™
  • Nettle root

Free estradiol female

Varies according to day of cycle

200 – 450 pmol/L

  • Post-menopausal bio-identical HRT
  • Bio-identical estrogen
    • Estradiol
    • Bi-est
    • Tri-est

Free estradiol male

< 207 pmol/L

30 – 60 pmol/L

  • Prostate cancer prevention
  • Prostate protection formula™
  • Chrysin X
  • Anastrazole

SHBG

  • 4 – 52.3 nmol/L(male)
  • 8 – 122 nmol/L (female 18 – 50 years)
  • 14.1 – 68.9 nmol/L (female > 51 years)
  • Maximise free hormone values
  • Bio-identical hormone balancing
  • Cancer prevention
  • Nettle root improves free hormone values

DHEA

  • 1 – 13.5 umol/L (male 20 – 24 years)
  • 8 – 13.9 umol/L (male 25 – 44 years)
  • 1 – 9.9 umol/L (male 45 – 54 years)
  • 1 – 8.6 umol/L (male >55 years)
  • 9 – 11.5 umol/L (female 20 – 24 years)
  • 5 – 10.8 umol/L (female 25 – 44 years)
  • 8 – 8.7 umol/L (female 45 – 54 years)
  • 0.4 – 6 umol/L (female > 55 years)

6 – 8 umol/L

  • Immune system health
  • Fat metabolism
  • Cortisol balancing
  • Bone strength
  • Cancer prevention
  • Bio-identical DHEA

Cortisol

  • 142 – 651 nmol/L (08:00 – 10:00)
  • 51 – 424 nmol/L (16:00 – 20:00)
  • < 50 nmol/L (00:00)

DHEA:Cortisol > 15 (08:00)

  • Adrenal stress management
  • Anti-aging hormone balancing
  • Weight management
  • Cardiovascular disease prevention
  • Cancer prevention
  • Pregnenolone
  • Herbal adaptogens
  • Vitamin C
  • Phosphatidyl Serine
  • Cortico steroid replenishment where needed
  • B vitamins where indicated
  • Progesterone where indicated

Pregnenolone

  • Cortisol balancing
  • Brain health
  • Hormone balancing
  • Adrenal stress management
  • Bio-identical pregnenolone

TSH

0.27 – 4.2 mIU/L

< 2 mIU/L

  • Thyroid abnormalities
  • Cardiovascular disease prevention
  • Thyroid support formula™
  • Iosol drops™
  • Bio-identical thyroid hormones

T4

12 – 22 pmol/L

15 – 18 pmol/L

T3

3.95 – 6.8 pmol/L

4.3 – 6 pmol/L

Progesterone male

0.7 – 4.7 nmol/L

> 2 nmol/L

  • Prostate cancer protection

Bio-identical progesterone (1 – 1.5%)

Progesterone female

Varies according to cycle

Prog/Est ration > 20 post-menopausal

  • Breast cancer prevention
  • Hormone balancing
  • Bio-identical progesterone (2 – 10%)

IGF-1

> 100 ng/ml

175 – 250 ng/ml

  • Lipolytic effects
  • Muscle anabolic effects
  • Anti-aging effects
  • Bio-identical human growth hormone
  • Growth hormone secretagogues
  • IGF-1
  • Somatorelin

Tumor Markers

Normal Reference Range

Optimum Reference Range

Reason For Testing

Nutraceutical Or Hormone Treatment

CEA

0 – 5 ng/ml

0 – 5ng/ml

  • Colon cancer prevention
  • Invisible fibre™
  • I3Complex™
  • Vitamin D3
  • Omega 3
  • Folate

CA19-9

0 – 37 U/ml

0 – 37 U/ml

  • Biliary tract cancer prevention
  • Pancreas cancer prevention
  • Quercetin
  • Omega 3
  • Vitamin D3
  • I3Complex™

CA15-3

0 – 34 U/ml

0 – 34 U/ml

  • Breast cancer prevention
  • Breast protection formula™
  • I3Complex™
  • Vitamin D3
  • Omega 3
  • Melatonin
  • Ubiqunol CoQ10

CA125

0 – 35U/ml

0 – 35U/ml

  • Ovarial cancer prevention
  • I3Complex™
  • Vitamin D3
  • Omega 3

PSA

0 – 4 ng/ml

0 – 4 ng/ml

  • Prostate cancer prevention
  • Prostate protection formula™
  • Vitamin D3
  • Omega 3

Other Anti-Aging Tests

Normal Reference Range

Optimum Reference Range

Reason For Testing

Nutraceutical Or Hormone Treatment

Vitamin D3

33 – 100 ng/ml

> 55 ng/ml

  • Skeletal health
  • Cancer prevention
  • Cardiovascular disease prevention
  • Multiple sclerosis prevention
  • Overall health improvement
  • Bio-identical D3 treatment

Red blood cell magnesium

> 1.7 mmol/L

  • Magnesium is involved in more than 300 metabolic reactions
  • Magnesium glycinate

NTX

  • 110 – 2450 Units
    (female 10 – 12 years)
  • 5 – 65 Units
    (female pre-menopausal mean age 39)
  • 18 – 38 Units
    (female post-menopausal 1.4X higher risk for bone loss)
  • 38 – 51 Units
    (female post-menopausal 2.5X higher risk for bone loss)
  • 51 – 67 Units
    (female post-menopausal 3.8X higher risk for bone loss)
  • 67 – 188 Units
    (female post-menopausal 17.3X higher risk for bone loss)

< 40 in post-menopausal women

  • Detect post-menopausal bone-loss
  • Vitamin D3
  • Minerals
  • Bio-identical hormones
  • Strontium
  • Bone Mix™

Free Radicals/ Malondialdeahyde urine

0 – 5 measurement on urine

< 3

  • Free radicals are associated with all disease states and accelerated aging
  • Anti-oxidants

Telomere Length

  • Reflection of biological age of cells
  • Omega 3
  • Anti-oxidants
  • Vitamin D3
  • Folate
  • Alpha tocopherol
  • NAC
  • Ginkgo biloba
  • TA-65

Anti-oxidant Status

  • Free radical opposition
  • Anti-oxidants

Nutritional Status

  • Optimum nutrition essential for health
  • Guided by lab results

P300 Brain Score

  • Brain health
  • Guided by lab results

Bone Density

  • T-score 0 – -2.5 – osteopenia
  • T-score > 2.5 – osteoporosis

T score – 0

  • Bone mineral loss is associated with
    • Frailty
    • Fractures
    • Morbidity
    • Mortality
  • Vitamin D3
  • Minerals
  • Bio-identical hormones
  • Strontium
  • Bone Mix™

Thermography scan

  • Detection of inflammation
  • Detection of cancer
  • Detection of pathology
  • Guided by test results

Endopat

  • Endothelial function assessment
  • Arterial stiffening
  • Cardiovascular disease prevention
  • Vitamin D3
  • Vitamin K2
  • Omega 3
  • Arterial cleanse and defence™
  • Address cardiovascular risk factors
  • Bio-identical hormone replenishment

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To give some examples :

  1. If insulin resistance is diagnosed, like in the metabolic syndrome, nutraceuticals such as chromium, alphalipoic, egcg and bitter melon can be used to restore insulin sensitivity and prevent the dreaded diabetes mellitus with all its devastating consequences
  2. Enlargement of the prostate and prostate cancer are caused by metabolites of testosterone (estradiol / estrogen by aromatization of testosterone) and DHT (dihidrotestosterone) by 5alpha reductase metabolism of testosterone. Using nutraceuticals like chrysin, betasitosterol and indole 3 Carbinol, one can reduce these dangerous metabolites and protect from disease
  3. Neurotransmitter abnormalities such as depression (norepinephrine, serotonin, dopamine deficiency) can be corrected by phenylalanine, 5-htp, Acetyl L Carnitine, SAMe/S-Adenosylmethionine,  and tyrosine resectively, as well as cofactor supplementation, without the necessity for prescription drugs.
  4. Other neurotransmitter abnormalities like attention deficit, anxiety, insomnia and behavioural disorders can also be addressed
  5. Heavy metal toxicity and neurotoxicity can be addressed by chelation therapy
  6. One of the major reasons we age is due to hormone decline (hormones such as DHEA, growth hormone, sex hormones, thyroid hormones, melatonin, etc). Restoring these hormones to more youthful levels retards the aging process and all the diseases associated with aging like cancer, diabetes, heart disease, dementia, osteoarthritis, osteoporosis, etc
  7. Using nutraceuticals such as I3C and DIM can help one metabolize estrogen to 2 rather than the dangerous 16 OH estrone, lowering the risk for breast and prostate cancer
  8. Nutraceutcals can be used with pharmaceuticals, and often may be required to replenish the micronutirnet deficiencies that pharmaceuticals cause.  To give an example, statin drugs deplete the body of CoQ10, and this can result in muscular pains and even rhabdomyolysis and heart failure later on. All people on statins should be supplementing with Co Q10.

The importance of maintaining youthful blood readings

A growing number of people are taking prescription drugs to treat chronic medical conditions.  Many of these drugs have toxic side effects that result in the deaths of more than 100 000 americans for example every year. In fact, according to the American Medical Association, adverse reactions to prescription drugs are between the fourth and sixth leading causes of death in the USA!

When physicians review a patient’s blood test results, their only concern is when a particular result is outside the normal laboratory “referance range”. The problem is that standard reference ranges usually represent “average” populations, rather than the optimal level required to maintain good health. It now appears that most standard reference ranges are too broad to adequately detect health problems or prescribe appropriate therapy on an individual basis.

 

For example here follow some “normal” lab values, followed by optimal levels

Insulin fasting : “normal” 6-27uIU/ml

Optimal : <6

TSH : “normal” 0.35-5.5 mU/L

Optimal <2, latest evidence even less than 1.5

Homocysteine male : “normal” 6.3- 15umonl/l

Optimal : under 7 umol/l

Homocysteine female : “normal” 4.6-12.4umol/l

Optimal : under 7

In conclusion here is an excerpt from The Life Extension Revolution, by Dr Phillip Lee Miller:

“Antiaging (preventative) medicine is the fastest growing medical specialty in the USA. This reflects more than merely a change in attitude and philosophy.  It reflects the enormous advances that have been made in our understanding of the causes and treatments for aging. It also recognizes the economic and social imperative we face as senior citizens become the largest sector of our society. Dwindling government resources and a crippled medical safety net, the pursuit of antiaging therapies is a matter not of vanity but of survival.

It is no longer acceptable or responsible for doctors to dismiss a gradual deterioration of function and wellness as “what happens as you get older”.    It is also not good enough to medicate symptoms as they arise, using pain relievers, antacids, arthritis drugs and cholesterol medications. We must find a way to remain healthy, vital and productive as we enjoy the longer lifespan that modernity has made possible.

Antiaging/preventative medicine will allow you to grow older without becoming aged. It will maximize your chances of not only a long life, but a long and healthy life. Antiaging medicine is more than just a medical specialty. It is the future of medicine and the future of humankind.”

Pitfalls in laboratory Testing

Below are parts of an article written by  Pat Phillips, Senior Director, Endocrinology Unit, The Queen Elizabeth Hospital, Adelaide

Reference ranges : Quoted reference ranges depend on the method used in the laboratory, and the population from which the reference range was derived. The  results from one method may be systematically different from those of another and therefore the reference ranges will be different.

Some laboratories give the range quoted by the manufacturer of the test or derived from an easily accessible population such as blood donors. Others give ranges in terms of age, sex or biological phase.

For example, the ranges quoted for female sex hormones are related to pre- and post-menopausal status and the phase of menstrual cycle. Some important biological influences, such as seasonal effects on 25-hydroxyvitamin D, are often not included in the reference ranges. Perhaps this is because users would find it harder to interpret results if the reference ranges were changing all the time and because of the logistics and laboratory workload needed to derive such specific reference ranges.

The ideal reference range would relate to the individual being tested while healthy, at the same age, biological phase and in the same season. Clearly this is not possible, but sometimes one gets insights from looking back through previous results (ideally reported by the same laboratory using the same method).

By tradition, laboratories quote a reference range including 95% of the reference population. If results are normally distributed, this includes results within approximately two standard deviations above and two standard deviations below the mean value. The reference range therefore covers four standard deviations. Some results vary so much within the population that the laboratory may quote a reference range that includes a smaller proportion of the population. For example, the reference range commonly quoted for serum insulin may only include results within one standard deviation above and one standard deviation below the mean value. This includes 68% of the reference population. In this case, 16% of normal people will have ‘abnormal’ high insulin and 16% will have ‘abnormal’ low insulin according to the quoted reference range. Serum insulin is therefore not a useful test for assessing ‘insulin resistance’.

Results have to be interpreted in terms of the particular laboratory reference range. When monitoring results over time, clinicians also need to be aware that different laboratories will have different  reference ranges. As reference ranges are population-based, a patient might have a result near the top or bottom of the normal range. Clinically significant changes could then occur, without the results moving out of the population reference range. For example, if an elderly patient’s plasma creatinine concentration is usually near the bottom of the reference range but then rises to the upper end of that range, the patient may have had a significant deterioration in renal function. Similar considerations apply to a haemoglobin concentration falling from a high normal to a low normal value.

Remember, the more tests you do the more likely you are to get at least one ‘false positive’ outside the laboratory reference range. Aim to limit the number of tests to those that are relevant to the clinical situation rather than requesting a screening battery. When assessing the effects of treatment, consider how long the treatment will take before the therapeutic effect reaches a steady state (e.g. 4-6 half-lives of a drug) and how long the biological  response will take before the measurement you make reaches a steady  state. Trying to assess therapeutic effects before treatment and response have reached a steady state can seriously underestimate the therapeutic effect.

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References for last article:

  1. Phillips P, Beng C. Electrolytes – ‘fun with fluids’. Check  (Continuous Home Evaluation of Clinical Knowledge) program of self  assessment. No. 323. South Melbourne: Royal Australian College of General Practitioners; 1999.
  2. Cooper GR, Myers GL, Smith SJ, Schlant RC. Blood lipid measurements. Variations and practical utility. JAMA 1992;267:1652-60.
  3. Phillipou G, Phillips PJ. Variability of urinary albumin excretion in patients with microalbuminuria. Diabetes Care 1994;17:425-7.
  4. Irwig L, Glasziou P, Wilson A, Macaskill P. Estimating an individual’s true cholesterol level and response to intervention. JAMA 1991;266:1678-85.
  5. Phillipov G, Phillips PJ. Components of total measurement error for haemoglobin A(1c) determination. Clin Chem 2001;47:1851-3.

http://www.australianprescriber.com/magazine/32/2/43/6

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