Why Understanding Your Labs Should Be Your New Year’s Resolution
It’s 2024: it’s time to ditch the idea that weight loss for everyone looks the same. In reality, every single person is unique, and with today’s technology, there’s a lower barrier than ever to getting clear insight into what’s going on in your body.
For many patients, simply getting validation via lab work that there is a very clear reason why weight is a struggle can change everything. That’s why I always start with doing lab work before anything else with my patients.
Here’s a breakdown of the best labs to get from your doctor—or to test on your own with the Weight Biology Kit—and how to understand them.
Fasting insulin levels are a sensitive marker for insulin resistance, which is a key driver of obesity and type 2 diabetes. Even though its probably the best tool we have for detecting early insulin resistance, most doctors do not test for it!
Insulin resistance is a problem because it can lead to various health complications and increase the risk of several chronic diseases. Here are some of the key reasons why having insulin resistance is a concern:
Elevated Blood Sugar Levels: Insulin resistance means that the body's cells do not respond effectively to insulin, causing higher-than-normal blood sugar levels (hyperglycemia). Prolonged hyperglycemia can damage various organs and tissues throughout the body.
Risk of Type 2 Diabetes: Insulin resistance is a major precursor to the development of type 2 diabetes. When the pancreas can no longer produce enough insulin to compensate for the reduced effectiveness of insulin, blood sugar levels continue to rise, eventually leading to diabetes. Uncontrolled diabetes can result in serious health complications, including heart disease, kidney problems, nerve damage, and vision issues.
Cardiovascular Disease: Insulin resistance is strongly associated with an increased risk of cardiovascular disease. High insulin levels can contribute to atherosclerosis (hardening and narrowing of the arteries), high blood pressure, and abnormal lipid profiles (elevated triglycerides and decreased HDL cholesterol), all of which are risk factors for heart disease and stroke.
Weight Gain and Obesity: Insulin resistance can make it more difficult to lose weight and easier to gain weight. It promotes fat storage, particularly in the abdominal area, and hinders the body's ability to use stored fat for energy. This can contribute to obesity, which is itself a risk factor for various health problems.
Fatty Liver Disease: Insulin resistance can lead to the accumulation of fat in the liver, a condition known as non-alcoholic fatty liver disease (NAFLD). In some cases, NAFLD can progress to more severe liver conditions, such as non-alcoholic steatohepatitis (NASH) and cirrhosis.
Polycystic Ovary Syndrome (PCOS): Insulin resistance is often associated with PCOS, a hormonal disorder that affects reproductive health in women. PCOS can lead to irregular menstrual cycles, fertility issues, and other health problems.
Increased Inflammation: Insulin resistance is linked to chronic inflammation in the body, which is a key factor in the development of many chronic diseases, including heart disease, cancer, and neurodegenerative disorders.
- Risk of Other Health Issues: Insulin resistance has also been associated with an increased risk of certain cancers, sleep apnea, and cognitive decline.
Insulin resistance is best caught early, which is why it’s important for you to be proactive in getting your fasting insulin tested via your doctor or in the Weight Biology Kit.
This biomarker alone can be very validating and helpful for those who have struggled with getting answers to their weight struggles, since insulin resistance is a primary reason many people cannot lose weight.
Fasting glucose levels indicate how well your body is managing blood sugar. Elevated levels may suggest impaired glucose metabolism, which can lead to weight gain and diabetes. This is commonly tested by doctors, but the real gold comes from using this number, along with your fasting insulin number, to calculate your insulin resistance.
So, once you have these two numbers you can easily see exactly how insulin resistant you are by calculating something called your HOMA-IR score.
The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) score is a mathematical formula used to estimate insulin resistance in the body. It provides a numerical value that helps assess how well the body is responding to insulin, a hormone responsible for regulating blood sugar levels.
You can use our HOMA-IR calculator to see exactly how insulin resistant you are. When interpreting your results:
A score of less than 1.0 means you’re insulin sensitive. This is optimal!
A score above 1.9 indicates early insulin resistance. If you do nothing to manage blood sugar, your metabolic issues are likely to progress and get worse.
- A score above 2.9 indicates significant insulin resistance. This is where many people who struggle to lose weight see their score.
Your doctor is unlikely to bring up the HOMA-IR. You not be diabetic or even pre-diabetic but still have significant insulin resistance, which is why it’s important to get this number. Left alone, significant insulin resistance can lead to type 2 diabetes.
% Hemoglobin A1C (HbA1c)
A Hemoglobin A1C test evaluates average blood sugar levels over the past 2-3 months. It is used as a screening tool for type 2 diabetes and its precursor, prediabetes. In general, these are the ranges for A1C that are evaluted in blood work:
Normal/Healthy A1c: An A1c level of less than 5.7% is typically considered normal and indicates good blood sugar control. This range is associated with a lower risk of developing diabetes.
Prediabetes: A1c levels between 5.7% and 6.4% indicate prediabetes. People with prediabetes have elevated blood sugar levels but have not yet reached the threshold for a diabetes diagnosis. It's a warning sign that intervention and lifestyle changes may be needed to prevent the development of diabetes.
- Diabetes: An A1c level of 6.5% or higher is generally indicative of diabetes. This level indicates chronic high blood sugar levels and suggests the need for ongoing management and treatment to control blood sugar and reduce the risk of complications.
Even if you have a healthy A1c, you can be insulin resistant, which is why this is important to measure alongside other measures.
Thyroid Stimulating Hormone (TSH)
Thyroid Stimulating Hormone (TSH) is produced by the pituitary gland and signals the thyroid to make two main hormones that are delivered to the body, T3 and T4. High TSH can be a sign of an underactive thyroid (hypothyroidism) and low TSH can be a sign of an overactive thyroid (hyperthyroidism).
Specifically, an underactive thyroid (hypothyroidism) can lead to weight gain and make it challenging to manage weight effectively. A TSH under 4.5uIU/mL is considered within a healthy range, but for optimal function, sometimes its best to aim for less than 2uIU/mL.
Adequate vitamin B12 is essential for energy metabolism and overall well-being. Deficiencies can lead to fatigue and hinder physical activity, making it harder to control weight. Our bodies do not produce B12, so it’s obtained by consuming animal products or via supplementation.
Triglycerides are a type of fat that stores excess energy from dietary sources.
Elevated triglycerides can be a sign of insulin resistance, type 2 diabetes, low thyroid levels and metabolic syndrome, a constellation of conditions that are associated with insulin resistance, high blood pressure and too much fat around the waist.
It can also be associated with excess alcohol consumption, certain medications, and less commonly, high levels can indicate acute inflammation of the pancreas (pancreatitis).
The recommended triglyceride levels can vary slightly depending on the guidelines used by different medical organizations, but here are general guidelines:
Normal/Healthy Triglyceride Levels: Typically, triglyceride levels are considered normal when they are below 150 milligrams per deciliter (mg/dL) of blood. This level is associated with a lower risk of cardiovascular disease.
Borderline High Triglycerides: Triglyceride levels between 150 mg/dL and 199 mg/dL are considered borderline high. It's a warning sign that indicates a moderate risk of heart disease.
High Triglycerides: Triglyceride levels between 200 mg/dL and 499 mg/dL are considered high. High triglycerides can increase the risk of cardiovascular disease, especially when combined with other risk factors such as high LDL cholesterol or low HDL cholesterol.
- Very High Triglycerides: Triglyceride levels of 500 mg/dL or higher are considered very high and are associated with a significantly increased risk of pancreatitis (inflammation of the pancreas), as well as cardiovascular complications.
The good news is, in most cases, elevated triglycerides can be normalized! Regular exercise, carbohydrate reduction (especially refined carbohydrates like sweets, pasta and bread), alcohol reduction, and, if needed, a 5% total body weight loss, can significantly reduce elevated triglycerides.
HDL is known as "good" cholesterol, because it helps prevent LDL from building up as plaque in coronary arteries.
Low HDL is a component of metabolic syndrome, a constellation of conditions that are associated with insulin resistance, elevated triglycerides and high blood pressure and too much fat around the waist. Metabolic Syndrome increases risk of heart disease, stroke, and other inflammatory disease. Thus, it’s important to try to increase this number!
Low HDL Cholesterol: HDL cholesterol levels below 40 milligrams per deciliter (mg/dL) for men and below 50 mg/dL for women are typically considered low. Low HDL levels can be a risk factor for heart disease.
Borderline HDL Cholesterol: HDL cholesterol levels between 40 mg/dL and 59 mg/dL are generally considered borderline. While not considered high, these levels are still better for heart health than lower levels.
- High HDL Cholesterol: HDL cholesterol levels of 60 mg/dL or higher are considered high and are associated with a lower risk of heart disease.
Genetics play an important role in determining HDL levels, but it isn’t everything.
HDL can be raised by increasing physical activity and focusing on a whole-foods, low refined carbohydrate and low trans-fat diet. Weight loss, when indicated, also helps improve HDL markers.
LDL is known as "bad" cholesterol, because it carries cholesterol to the arteries, potentially leading to plaque build-up and coronary artery disease. Therefore, lower levels of LDL are optimal for cardiometabolic health.
- Optimal LDL Cholesterol: An optimal or healthy LDL cholesterol level is typically considered to be less than 100 milligrams per deciliter (mg/dL) of blood. This level is associated with a lower risk of heart disease.
Near Optimal/Borderline High LDL Cholesterol: LDL cholesterol levels between 100 mg/dL and 129 mg/dL are generally considered near optimal or borderline high, depending on an individual's risk factors.
High LDL Cholesterol: LDL cholesterol levels of 130 mg/dL to 159 mg/dL are considered high. This level may indicate an increased risk of heart disease, particularly if other risk factors are present.
- Very High LDL Cholesterol: LDL cholesterol levels of 160 mg/dL or higher are considered very high and are associated with a significantly increased risk of heart disease.
LDL can be kept at healthy levels through regular aerobic physical activity, and focusing on a diet low in refined and processed carbohydrates, and maintaining a healthy weight.
Do You Have Metabolic Syndrome?
You can use the labs above to get an idea of if you may have metabolic syndrome, which increases your risk of developing heart disease, stroke, and type 2 diabetes. And yes, makes it harder to lose weight.
Metabolic syndrome is typically diagnosed when an individual has three or more of the following five key components.
Abdominal Obesity: Excess fat accumulation in the abdominal area, often measured by waist circumference. The specific cutoff values for waist circumference may vary by region and ethnicity. Generally, abdominal obesity is defined as a waist circumference greater than 40 inches (102 cm) in men and greater than 35 inches (88 cm) in women.
Elevated Blood Pressure: Blood pressure equal to or higher than 130/85 mm Hg (millimeters of mercury). Hypertension, or high blood pressure, is a common risk factor for heart disease and stroke.
High Fasting Blood Sugar: Fasting blood sugar (glucose) levels equal to or greater than 100 mg/dL. Elevated blood sugar levels can indicate insulin resistance and an increased risk of type 2 diabetes.
High Triglycerides: Triglyceride levels equal to or greater than 150 mg/dL. Triglycerides are a type of fat found in the blood, and high levels are associated with an increased risk of heart disease.
- Low HDL Cholesterol: High-density lipoprotein (HDL) cholesterol levels lower than 40 mg/dL in men and lower than 50 mg/dL in women. Low levels of HDL cholesterol are associated with an increased risk of heart disease.
Managing metabolic syndrome typically involves making lifestyle changes to address the underlying risk factors. Using medication to manage blood sugar and cholesterol can help, as well as diet and exercise.
As far as excess belly fat goes, there are specific compounds like the berberine in GetSoBALANCED that are clinically shown to help reduce waist circumference.
Putting It All Together
Using the biomarkers listed above, you’re able to get a good picture of what could be holding you back.
Within your Weight Biology Kit results portal, you’ll get a complete explanation of your personal indicators. Once you have them, it’s best to connect with your doctor to create a game plan, which could include:
- Thyroid medication to treat low TSH levels
- B12 supplementation for low B12 levels
- A GLP-1 medication to treat metabolic syndrome or obesity
- Cholesterol medication to treat high cholesterol
- Specific diet modificatons like adopting a low-carb diet for insulin resistance
Knowledge is power. Don’t let another year go by without getting a grasp on your metabolism! Buy the Weight Biology Kit here.