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What about the role of lab tests in the pursuit of recovering health? What does one do when they feel better but the lab values are moving in the wrong direction?
After a few years of paleo-ish and low-carb-ish, I had an annual physical and requested an NMR LipoProfile and Hgb A1c, in addition to the usual tests.
The results were very good. My LDL-P number was higher than I wanted (in the “Moderate” range), but the other values were almost universally excellent — low triglycerides, high insulin sensitivity, good A1c, low HDL-P, Large (Pattern A) LDL, immeasurable VLDL, and so forth.
Being in my mid-40s, I decided more exercise would be better. In addition to the regular walking and hiking, I bought a mountain bike, started sprinting several times a week, lifting heavy and measuring time under tension, swinging kettlebells, doing push-ups and pull-ups, and whatever else I could imagine. All while low-ish carb.
(Like many of us, I’m prone to an all-or-none personality.)
Eventually, while on a moderate hike I completed several times before, I reached a level tired I’ve never before experienced. One I hope I never reach again. I felt tired on a cellular level. Fortunately, I had a friend with me that helped me back to the car.
Being sufficiently freaked-out, I decided to go to the Emergency Room (ER). Although not the first time, I had some chest pain, too. They performed various blood and urine tests and concluded I was fine and sent me home. I understand the ER is a place to rule-out urgent, life-threatening issues, so I felt better knowing there was nothing obvious. But, of course, I knew *something* was off.
Over the next few months, my energy continued to flag. I had random, wandering muscular and joint pain of varying degrees. Finally, I decided to ramp-up the carb intake — especially fruit. I also added legumes, despite my lingering phobias from paleo/low-carb. I was on the fence with grains. I still avoided seed oils, hydrogenated fats, fried foods, chemicals, etc.
Even while deep in the throes of paleo/low-carb, I read and listened to other groups like raw, vegan, vegetarian, fruitarian, Weston A. Price, ketogenic, Gerson Therapy, Hippocrates Health Institute, and more. Of all those, I always liked Dr. Joel Fuhrman the best. He seemed pretty reasonable. He wasn’t afraid of fat, allowed for some animal foods, and believed in eating lots of vegetables. Nothing wrong with more vegetables, right?
So, I decided to move in that direction, thinking more carbs would be better. Besides, I’ve always loved fruit and Dr. Fuhrman was giving me a prescription to eat it!
Before investing in a Vitamix, I bought a NutriBullet (or, as Matt calls it, a ?NutriBullshit?) to see if I would commit to the program. I blending like a madman. Lots of varieties of greens, lots of varieties of fruit, avocado, sprouted grain protein powder, flax seeds, chia seeds, sprouted beans, broccoli sprouts, coconut milk, and coconut water. They really tasted excellent.
Next, I hardly ate any animal meats and completely avoided eggs. Protein would come from the sprouted grain protein powder, beans, nuts, and whatever was contained in the plant material. I would drink one for breakfast, and, most days, would have another later in the day. Because I was using a lot of frozen fruit, the smoothies were COLD. Also, I filled the 32 oz. blender to capacity. So, I was freezing and had to pee a lot.
During this time, approximately three months, I did virtually no exercise. Just a few short, gentle walks on flat terrain, if I had the energy.
I then went for another annual physical. Again, I requested the NMR LipoProfile and Hgb A1c, in addition to the standard tests. Honestly, I expected an improvement in my numbers, even if only slightly. Well, much to my surprise, just about every marker was worse. And, most were quite a bit worse. My A1c went up a little, triglycerides more than doubled, HDL went down, Chol/HDL Ratio declined, LDL/HDL Ratio declined, HDL and LDL particle sizes got smaller, and LDL-P went from ?Moderate? to ?Borderline-High.
Truly, I was floored. Looking at the results, visually, was alarming. As many of you likely know, there is a horizontal scale with green on the left and graduating through yellow and red as one moves through the scale to the right. Previously, most of my numbers were in the green on the left. Now, the numbers were at the far right in the red. This was quite a reversal.
One of the cited lipid experts in the low-carb world is Thomas Dayspring, M.D. When asked about how to lower the LDL-P number, Dr. Dayspring’s simple answer is ?lower carbs. Plain and simple, in his mind. Yet, there seems to be many populations eating high-carb with little-to-no heart disease. That’s the problem, I guess — there’s always some exception to be highlighted.
I finally decided to get off the diet merry-go-round and bought four of Matt’s e-books and the corresponding audio books. I’m glad I did. It was as if he wrote them specifically for me. So, I’m now working on BEING healthy, rather than just LOOKING healthy.
Which brings me back to the original question:
What about the role of lab tests in the pursuit of recovering health? What does one do when they feel better but the lab values are moving in the wrong direction?
Anyone? Anyone?
Hello again,
Here’s the short version of my post:
“What about the role of lab tests in the pursuit of recovering health? What does one do when they feel better but the lab values are moving in the wrong direction?”
Sorry for the original, long-winded post. Looking at it again, it’s even too much for me. : )
Thanks for any feedback.
Jeff
Hmmm… I’ll take a stab.
I think lab results are interesting and can tell you how you’re doing – especially when you have trends in the results. (I’m an engineer, so I LOVE having data that I can put on a chart!)
But… Doctors are still ‘practicing’ medicine. Biology is complex. What’s “average” or “normal” for one person could be “out-of-range” for someone else (on either side of the spectrum).
So… I guess I do like lab results, and I think you should pay attention to them (and listen to your Doc, too) – but I would treat them secondary to what your body is telling you. I think the key is figuring out how to “hear” what your body is saying.
TinaT,
Thank you for the feedback. My degree is also in Engineering, but I work in Healthcare I.T., so I’m doubly OCD about data, charts, lab values, etc. :)
Jeff
Hi Jeff,
I LOVED your post, and have been meaning to comment (I’m surprised more people haven’t chimed in).
Great, great observations, and I so don’t know how to answer your question about feeling better but having less than ideal lab results; however, I think this issue is worth exploring. I was talking about this with a friend the other day who feels better when she is a little heavier and, subsequently, her blood pressure runs a little too high. Her doctor is telling her to lose weight, or go on medication for her elevated bp. Now what is she supposed to do? I don’t know how to answer that. I think that you absolutely have to at least consider lab results. Are they everything? No, of course not. But they have to play some role, however large or small. I’m sure some are more important than others, and I also understand that people can be completely healthy while having their labs fall outside of the reference range. Also, I think that quality of life is vital, and if someone feels better and more vibrant with messy labs, that absolutely must be considered when weighing everything out. It’s that whole cost/benefit–risk/reward thing.
Regarding your particular situation. Maybe, you just swung the pendulum to far in the other direction? I suspect you will be able to find a happy medium. Hell, one day, maybe you will feel terrific and have labs to support it!
If not, I don’t know what the answer is. Thanks for the terrific post, Jeff!
Jeff, I’ve been around these forums for a bit, so I think I can offer some insight into what Matt would say, and I think he’s probably right. Apparently, when you begin restricting (in any way) health markers generally improve. This can be on low-fat, vegan, low-carb, or just plain old starvation from a famine. Blood pressure drops, blood sugar drops, etc. But, longterm things are less rosy. After a famine ends, blood pressure across the population skyrockets, for example. After you’ve been on low-carb for awhile, insulin sensitivity is increased and fasting blood sugar actually rises. So, yes, labs can be helpful, but you have to consider longterm, not just short-term. Short-term, PUFAs are excellent for lowering cholesterol. But in the longrun, they are not increasing health.
You’re not kidding when you say you do things all the way! It sounds to me like you abused your body with low carb and too much exercise, got adrenal fatigue and the prevented your body by really healing by going to another deprivation type of diet. If I may recommend anything, it would be to practice moderation for awhile (balanced diet, 3 meals a day; sleep 8-9 hours/night on a regular schedule; don’t do things that will exhaust you, listen to your body), and then have labs in 6 months to see what’s what (Unless your doctors think you have some immediate health threat that needs to be monitored by lab tests).
People have been eating carbs for millions of years, and unless your ancestors were eskimos or something, you’ll probably be fine with them. Most of us are. Give yourself some time to heal.
Leighton,
The Real Amy,I stopped following health blogs and podcasts for a while, so please forgive my delayed response. I do appreciate and value your responses.
For now, I’m working on “tuning-in” to the signals from my body. This is taking a considerable effort on my part, due to decades of mindless eating, paired with all the alarmism in Paleo/Low Carb.
Here is a response I recently submitted to a blog post on another site:
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“I share your feelings about knowing whom/what to believe. There are populations that have thrived on a variety of diets, so I believe the key is customizing a diet to the individual.
After a few years of trying different dietary and exercise approaches, I cannot deny the importance of how I feel and what my body seems to be telling me.
As an example, I do not feel well eating large meals or large portions of meat. I tend to do better eating ‘lighter’ foods with meat being a condiment, if at all. Again, this is my experience and is completely anecdotal.
For me, I’ve found more value in what foods I AVOID, versus what foods to include. If the ‘food’ has a ingredient list or nutrition label, it’s probably not really food. If it can be found in nature, then I feel there’s a good argument for it being food. (Assuming it’s not poisonous, of course.)
Again, this is non-scientific and is where I ended-up, due to the analysis paralysis of trying to eat ‘perfect.’ I started to avoid more and more food and became obsessive about finding ‘THE’ diet.
But, as I alluded already, I don’t personally feel there’s only one diet. How could that be the case, with so many different people living in varied climates?
Could those in a desert environment be fruitarians? Could those in arctic climates be vegetarians? Maybe they could, but it doesn’t seem like a possibility, given my limited knowledge.
I once read something that really made me laugh. In effect, the person wrote that humans are the only species that can’t seem to figure-out what to eat. Generally speaking, that seems true, especially here in the U.S.”
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Along those lines, eating lots of potato chips, pizza, ice cream, cereal, etc. just doesn’t feel right for me — mentally or physically. I thought it would be fun, but it wasn’t. It made me feel terrible AND apparently made my pants shrink.
Now, I do enjoy a small amount of ice cream from time-to-time, but I also find satisfaction in blueberries and strawberries. So, I don’t see the value in (re)habituating myself to junk food.
For me, I feel that I need to focus on food quality first. I’m less concerned (now, finally) about macronutrient ratios and tend to think that calories will more-or-less be regulated appropriately, if I eat quality, nutrient-dense food, listen to my body’s signals, and take care of the other big items like sleep, stress management, relaxation, and moderate exercise, like most every other site parrots.
Wow, that’s a serious run-on sentence.
Finally, given any discordance between lab values and how I feel, it now seems clear that how I feel is much more important to me. My suspicion is that, if I’m feeling better, sleeping better, and my pants are fitting better, it’s likely my lab values will also be better.
I have more faith in my body as a whole than I have in science looking at its parts in isolation.
My best wishes to everyone in their journey.
Jeff
Please keep us updated Jeff! I am interested in this too as I too have been dealing with the numbers being different from what they used to be. It is really bothering me and I keep telling myself I can’t let it stress me out. That is counter productive to overall well being.
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