What follows is a long, roundabout attempt at qualifying the quantification of biomarkers. This post is designed to help bring some of the unarticulated, unexamined reasoning out of the woods of my mind. (SPOILER: I do eventually get there in the last section — briefly)
The testing odyssey
I started out with WellnessFX. Dave promoted them fairly heavily in 2013 and it looked like a nice way to visually scope out your progress over time. I stopped using WFX for a year when I realized that the test packages I was buying didn’t quite satisfy what I wanted from testing. (Also, they switched completely to Quest, who had impractical hours for me.)
My stated impetus for blood testing was to quantify my baselines, in order to gain insight and a direction to take my health in. With the Baseline package, I scored well on pretty much everything tested. (There were a few things I ignored since I couldn’t find any clear ideas about them.) I was a bit crestfallen at the lack of direction it provided me.
Since the Baseline package didn’t cover any hormones, I decided to ‘level up’ and test my hormone levels. I got a membership to LEF and got some relatively inexpensive tests on things like testosterone, DHEA, thyroid panel, SHBG, etc (they usually have a big sale in the Spring; WFX has a sale in January). Well, I had low testosterone and DHEA. Not surprising given the nasty habit I developed in high school of staying up way too fucking late on the computer. I got an ASI, too. Not surprisingly, I had depressed cortisol, suggesting end stage ‘adrenal dysfunction’.
So now I had a problem to fix. That’s good. Unlike in my previous testing packages, I was no longer perfect on paper. Progress. However, there are dozens of reasons for each of those things to be out of whack. Likewise, dozens of ways to fix them with no real winning protocol in sight. Direction to take my health focus? Check. Insight? Hardly.
Testing hormones is a good diagnostic method. Actually, pretty much any blood test is great for diagnostics. That’s obvious enough when you consider that’s what blood tests are used for — ferreting out problems. It did not satisfy my full aspiration for quantifying my biomarkers, though.
With scant guidance granted by blood tests of lipids, hormones, electrolytes, and proteins, I became drawn to hair tissue mineral analysis. HTMA is a little unusual when compared to other methods of testing. It has its own unique culture built right into the testing and diagnostics. I liked the idea of HTMA because it’s cheap yet has broad implications and it focuses on minerals (I have a micronutrient fetish). The affordability of HTMA makes it easy to pay for regular updates on your health status (a test once a year is too low of sampling frequency). Micronutrients are the essential elements that make all the myriad enzymes in our bodies work. Therefore, learning about the micronutrient status in your body can provide a lot of explanatory power.
I wanted to do an HTMA quarterly, but the turnaround times for the tests are too long to make that feasible. It took over a month to get my test back. So one out of three months is spent waiting for feedback to act on. I think this is common place with boutique testing; my ASI also took a good month to process. In both instances, I began to wonder if something was lost in the mail, or something happened to my enclosed check after 3 weeks of silence. With blood tests, you can sometimes see results in a week.
Rumination
After I started reading Jack Kruse’s Leptin series, I became enamored with the idea of innocuous blood tests being used to discern hidden realities about one’s body. For instance, Jack claims that Reverse T3 can be used to gauge leptin sensitivity. Around the same time, I happened to catch an article from WFX. I also chanced upon Russell Jaffe’s talk about his top 8 biomarkers. Jack Kruse also has a list of labs that he likes. This created a perfect storm for me to muse on the idea of a cadre of blood tests that would probe multiple aspects of one’s health and spit out a scorecard. A stalwart six or so.
When it comes to testing, it’s easy to throw in everything but the kitchen sink. I like minimalism — for the sake of wallet and mind. What I envisioned was not a dense diagnostic panel, but a chart of biomarker progression that I could proudly watch. It should include some unusual biomarkers and some mundane biomarkers. It should allow an informed person a broad view of one’s health.
An ideal testing suite?
I’m still not positive how to describe the exact characteristics of my ideal testing suite, but maybe that’s because each test shouldn’t be the same. I like hs-CRP and LDH because they’re nonspecific and provide a good way to gamify your health. With those two, lower is better. I also think that 25-hydroxy D and Mag RBC should constantly be tested. There are hundreds of studies showing the positive effects of Vitamin D on dozens of conditions. Likewise, magnesium is a mineral that is involved in over 300 enzymatic reactions in your body. Whatever ailment you have, it’s likely that magnesium plays a role in it. While Vitamin D and magnesium may not be center stage for whatever specific illness you’re targeting, insufficient levels of either ruin the integrity of your health structure.
Those are my top four. What are some other things to watch? Total cholesterol and TSH. While ideally, you would get a full cholesterol breakdown (VAP or NMR) and diagnose thyroid function with a full and precise panel, these two markers will give you an idea of your potential of steroid (hormone) production. You need cholesterol and a functioning thyroid to produce pregnenolone, the mother hormone. (You also need preformed Vitamin A.) Having good levels of these does not mean you won’t have hormone problems, though. There are a lot of other things impacting your hormone status. This is just a way to to get an idea about your potential for steroid production in a cheap, crude fashion.
Other panels to check out are a full anemia panel as well as a profile of your omegas.
If you’re paying for this out of pocket, I would suggest cycling through the four aforementioned panels (thyroid, VAP/NMR, anemia, omegas) with each regular round of testing. Baseline+thyroid, Baseline+anemia, Baseline+omegas, Baseline+VAP/NMR.
What I plan to do
In December 2015, my plan for 2016 was to grab two of WFX’s “Performance Package”, tack on an omega profile, maybe VAP/NMR, and try out some more exotic biomarkers like TNF-alpha. However, when I sat down to write this section, and looked over the WFX packages again, I realized this might not be the most cost effective option given my current philosophy.
Broadly speaking, the advantages that “Performance” has over “Baseline” is magnesium RBC, full anemia panel, and a good handful of hormones. Performance costs over twice as much as Baseline. A Mag RBC test costs $50 and an anemia panel costs $79 (member price). The rest of the cost is going into all the hormones. It’s a great deal if you value all those hormones. However, I’ve had many of them tested before and I feel like they’re not worth the extra cost. I will try to articulate why.
Are you shimmering with energy and joy? If not, your hormones are out of whack. If you shell out the cash, that’s what a hormone panel will tell you. If you’re going to adjust your hormone levels with exogenous hormones, then a test would be helpful (or rather, required). However, if you intend to apply lifestyle and diet fixes… I point out again that you can preclude any money spent on blood tests with an assessment of your energy and mental state. Hormones will take care of themselves.
Having said that, I may tack on DHEA-S and Testosterone to a testing round in order to chart progress and aging. That brings me to the ultimate reason why I’ve opted for Baseline: flexibility. Instead of paying for DHEA-S, Testosterone, and an anemia panel twice — like if I got the Performance package — I can pay for them once.
Amusingly, this means I’ve come full circle. I went bearish on Baseline in 2014, and now I think it’s the best overall option for myself.
Conclusion
I find writing to be an effective form of self-education. It’s rare that I set out to discuss a topic without learning something as I go. It forces me to carefully delineate my line of thinking, and in the process I uncover new trains of thought and unexamined loopholes. It is a form of exploration for me. The act of writing, the implied permanence, enhances verbal reasoning and awareness. It makes one laboriously hone their logic and word choice. For this reason, I find writing to be extremely exhausting (but rewarding).
I’ve started and stopped this post multiple times and I still haven’t answered myself. At this point, I should probably rewrite the whole thing. There’s a lot to cut out, and a re-write would be more cohesive after all of the thinking I’ve done to get here. To be frank, there are at least three separate posts in here. This should’ve never left my personal journal.
However, I’m very particular (religious, even) about the precious, non-repeatable nature of human thought. This is why I take my time reading books. Each paragraph is pregnant with potential directions for my mind to take. Sometimes a single minute of reading will result in five minutes of exploratory note-taking. Why do I savor books this way? The next time I read a given book I will have different thoughts, I will have a different experience. (Aside: this is why several of my favorite films I have only seen once.) I must capture my current thoughts now or else I may never see them again. Thoughts are delicate and precious. They are effervescent. Countless times I have been too lazy to scribble a note immediately, and when I go back an hour later, the idea has evaporated. There was a chain of thoughts that led up to that lost idea (the meta-thinking that occurs while reading), and I forgot the key thought necessary to regenerate the lost idea. Sometimes there are clues in the preceding sentences or paragraphs; sometimes not. Then you must look to the environment of your mind or your external environment for clues.
That is why you are getting all of this mess. A rewrite would have an entirely different composition. I strongly tend towards concise phrasing, and it’s very likely that some of the logic that I’ve enumerated here would not be recorded in a rewrite. In fact, I’ve already excised some of the logic due to verbosity. (Yes, I know.)
Also, I’m lazy, a rewrite wouldn’t be finished in time for you to take advantage of WellnessFX’s Loyalty program, and it’s an informal blog. So suck on my verbose ponderings. Even though this section was supposed to be the conclusion, I went on a monstrous tangent, so now I will have to write the real conclusion.
The real conclusion
Let’s go back to the beginning, where I talked about pulling the unexamined reasons out of my mind. I inadvertently dropped myself hints about the unexamined reasons throughout this entry, the biggest of which was the word “gamify” after my mind had been primed by the phrase “biomarker progression”.
You could say that ‘gamification’ is about compressing real world progress into a single dimension. (As far as I know, nobody has tried to create a game with progression in two dimensional space. There’s nothing like U-curve response, everything is entirely linear. What would a U-curve progression game even look like? Someone make that.)
Anyway, games have one dimensional progress (your character’s experience points, XP), so gamification is just simplifying something to a single, directional metric (it always proceeds in one direction, up or down). Another way to explain this is: it excludes homeostasis. This definition excludes markers that are interpreted with ranges. They’re relative, and the ranges are determined indirectly (population averages, clinical experience, etc) as opposed to being determined by a physical law. The reason testosterone has such a large reference range (aside from the very nature of sampling sick people) is because some men do just fine on lower amounts of testosterone than other men. Testosterone would make a poor candidate for gamification, and so would cholesterol (for other reasons).
The only biomarkers that could be used for gamification are ones that don’t obey ranges, like hs-CRP. There isn’t an optimal range for hs-CRP: zero is best. These are admittedly pretty rare in biology; biology doesn’t have bad guys. Let me explain. For instance, every health advocate would agree that inflammation is bad and we should minimize it, but what if your interference in the inflammation process with anti-inflammatory molecules actually prolonged, shrouded, or even advanced disease? Inflammation is important, even if it is connected with disease. Biology doesn’t have bad guys.
On second thought, since biology is all about ratios and homeostasis, it’s probably a foregone conclusion to say that you can’t really gamify blood markers. So I just wasted your time with this crazy idea about gamification.
I think that my inability to finish this post is indicative of how inconclusive my thoughts currently are. This whole entry was instigated by a question from a friend that I answered satisfactorily in 400 words. That was probably more helpful than the 2400 words I’m dumping in your lap right now.
I need to get the hell out of here.
Essentially
If you want to track your health progress over the years (not diagnose disease states), test biomarkers like LDH, TNF-alpha, ESR, hs-CRP, LPS.
If you want to gauge your ability to resist disease, test biomarkers like Vitamin D, Mag RBC, bicarbonate, among many others.
If you want to diagnose a health condition, please take out a loan at your nearest credit union.
In the future, I will write on this topic again. (Astute readers will have noticed I haven’t provided any reasoning for the markers I chose. It’s a hunch at this point.) For now, you can grab a couple of Baseline packages at WellnessFX, or opt to save your money for the smorgasboard of random indicators I listed above (only two are in Baseline).
Test something now so that you’ll have those results in the future. The value in quantification is the progress you can see. I get giddy just thinking about being able to look at all my results ten years in the future.
zmkd 