Lab Tests - What are 'Healthy' Ranges?

Most 'nutrition' programs are designed solely with weight loss as the goal. Even if successful, they leave people exhausted, hormonally deficient, and primed to revert back to their old selves. While weight loss is indeed a goal for many people, we believe excess weight should not be the diagnosis but a symptom of a more dire metabolic ailment. Healing a malfunctioning metabolism sets the stage for achieving lasting weight loss nearly effortlessly. You can reach your goal weight with astonishingly few hunger pangs while simultaneously improving your hormone levels.

Another disservice from a fixation on weight is a ‘healthy’ BMI doesn’t automatically signal metabolic excellence. Many slim people are often ‘hangry’ before meals, get hit with afternoon drowsiness, or struggle with acne and other skin conditions. Like extra weight, these are all signs of an impaired metabolism.

While we can get a great approximation of your metabolic health merely based on how you’re feeling throughout the day, a simple set of blood work and other tests* can help paint a surprisingly complete metabolic picture.

Unfortunately, the reference ranges that determine if your numbers are ‘healthy’ are typically determined by nothing more than recent averages from the general population. Given that a measly 7% of American adults are truly metabolically healthy, trusting the reference range on any specific test isn’t a great barometer.

Below is what we deem to be the most important basic labs to request and fantastic goals to aim for:

Fasting glucose: < 85 and ideally < 75 

Fasting insulin: < 5 uIU/mL

HOMA-IR: Determines insulin resistance: < 1 would be fabulous! Under 2 is still a celebratory feat.

This requires a fasted insulin test, plus your fasting glucose results. Plug both numbers in here.

Fasting triglycerides: < 100 and ideally < 70

Triglycerides to HDL cholesterol ratio: < 1/1, aka lower than 1

HDL cholesterol: (> 60 for men, > 65 for women) 

CAC (Coronary Artery Calcium): Measures arterial calcium buildup and indicates cardiovascular disease risk, 0

CTCA (CT Coronary Angiogram): Measures soft plaque buildup

Note: There are other soft plaque tests available with varying levels of invasiveness and resolution

Hemoglobin A1C: < 5.3%

Blood Pressure: < 120/80 & > 90/60

Additional Notes on cholesterol:

• While LDL cholesterol alone provides little indication on cardiovascular risk (higher levels are actually associated with better health outcomes), if you truly want to determine your LDL levels, ApoB is a much more precise test for cardiovascular disease risk.

• Lp(a) is another advanced test to determine CVD risk. Lp(a) is a molecule similar to LDL with addition of a 'tail'. Lp(a) increases blood clotting - evolutionarily helpful in the case of significant injury, but possibly detrimental for those at risk of CVD. Lp(a) is largely genetically determined, though lifestyle can decrease the clotting potency of Lp(a) present.

*You can likely ask to include all these tests during an annual physical, which should be covered under most insurance plans.