After a little over three months since I stopped working as a shift worker and fixed a lot of my sleep issues and settled into a fairly regular routine, I thought it would be a good idea to check some of my labs to see where I stood.  I checked my NMR Lipoprofile, Apo B100, Lp-PLA2, Ferritin, fasting Insulin, CRP, Vitamin D, Thyroid Panel, and Testosterone.  Before going into the health test results, here is a brief bit of background.

My last series of tests was in October 2014 when I was trying another round of strictly following the Carb Nite protocol. Here is what I wrote about the various tests I had:

• NMR Lipoprofile and Cholesterol, CRP, Fasting Insulin and HbA1c
• Thyroid Panel with Reverse T3
• Vitamin D

In December 2014 I also did an isolated thyroid panel because I was experimenting with Keifer’s T3 Fuel supplement and wanted to see if it had any effect on my own numbers.  After 6 weeks of taking T3 Fuel I wrote about my results here:

• Review of Kiefer’s T3 Fuel with a Before and After Thyroid Panel

From December 2014 to March 2015 the main changes I made in my life were:

• New job with regular schedule and sleeping 6.5 to 8 hrs regularly.  No more shift work.
• Regular BJJ training, 3-5 times per week
• Weight training 1-2 times per week
• Increased my carb intake to around 100 gm on average.  I did this because of my increased physical activity.
• Decreased saturated fat intake to around 60 gm on average.  When doing Carb Nite, my saturated fat intake averaged 80-90 gm.  This was one of Dr. Daysprings recommendations to someone else in a similar situation.
• The only supplements I took were Creatine Monohydrate, Magnesium Glycinate, and Upgraded Collagen to help with muscle recovery.  I hadn’t trained this much, this regularly in a long time and was constantly plagued with delayed onset muscle soreness.
• I also regularly took the Athletic Greens Vitamin D supplement because the winter was terrible and I didn’t get any sun.

If you want to see exactly what I ate during this time period you can check out my diary on MyFitnessPal here.

I exported the data as a tabulated excel spread sheet for easier viewing here.

These are my averaged daily macros from January 1, 2015 to March 15, 2015.

• Calories: 2085.7
• Carbs: 99.73 gm
• Fat: 119.77 gm
• Protein: 134.74 gm
• Saturated Fat: 57.14 gm

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On March 16, 2015 I went to the lab and got my blood test.  Here are the results:

 

 

 

Cholesterol

Here is my cholesterol data in a tabulated format including all of my historic values.  You can click on it to make it bigger:

 

It really appears as if all the changes I made a difference.  There were improvements in my total cholesterol, LDL-C, Apo-B, and LDL-P.  This is in line with all the research out there showing how detrimental shift work can be to cardiovascular health (here are two studies for example from 2006 and 2011).

My triglycerides went up a bit, likely reflecting my increased carb intake during this period.

My Small LDL-P went up to it’s highest level yet which seems like a bad thing, and I can’t say that I really know what to make of this.

My HDL-C again was stubbornly immovable (the drop from 55 to 48 was likely due to simple variation).

Fasting Insulin

It looks like the increase in carbs caused a bump in my insulin from 1.1 to 4.8, which is similar to the 4.6 value in April 2014 when I was doing Carb Back-Loading.

Inflammatory Markers – CRP and Ferritin

My CRP has been pretty stable whenever I’ve checked it, almost always measuring less than 1.0, and this time was no different.

This was the first time checking Ferritin which is something that Igor Cummins likes.  It looks like mine is a little high at 442 ng/ml with the normal range from 30 – 400 ng/ml.  I have my doubts of this reference range because everything I’ve read seems to indicate that 300 ng/ml should be considered the upper limits of normal.

In any case, a high Ferritin can mean that there’s an underlying inflammatory process going on or I might have hemochromatosis or it could just be related to my increased level of exercise.

At this point all that is warranted is some additional testing.  I’ll probably need a complete iron panel including a transferrin saturation test, to get a better understanding of what’s going on.  According to MedScape:

Serum ferritin levels elevated higher than 200 mcg/L in premenopausal women and 300 mcg/L in men and postmenopausal women indicate primary iron overload due to hemochromatosis, especially when associated with high transferrin saturation and evidence of liver disease…

Transferrin saturation corresponds to the ratio of serum iron and total iron-binding capacity (TIBC). The screening threshold for hemochromatosis is a fasting transferrin saturation of 45-50%. If transferrin saturation is greater than 45%, the presence of the C282Y or H63D mutation may be evaluated to confirm the diagnosis of hemochromatosis…

High transferrin saturation is the earliest evidence of hemochromatosis; a value greater than 60% in men and 50% in women is highly specific.

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Lp-PLA2

I first heard of this test from a reader who e-mailed me about his own markers.  The Lp-PLA2 test is used for assessing cardiovascular risk.  It’s an inflammatory marker that is thought to be specific to inflammation within the blood vessels.  According to labtestsonline.org:

An Lp-PLA₂ test may sometimes be used along with an hs-CRP test to evaluate a person’s level of underlying inflammation associated with CVD risk. However, unlike hs-CRP, the Lp-PLA₂ test is not affected by conditions other than CVD that can cause general inflammation, so it may be used when someone has an inflammatory condition, such as arthritis.

According to the company that offers the test, which they call the Plactest:

High PLAC activity is found in plaque deposits that are unstable. Because they are unstable, they are more prone to rupturing. Studies show that a PLAC Test for Lp-PLA₂ Activity result ≥225 nmol/min/mL points to an increased risk of CHD events. These coronary heart disease, or CHD, events can include heart attack, revascularization (such as stent placement or coronary artery bypass grafting), or death from a cardiac event, even in patients with normal cholesterol levels.

If you want to learn more about the mechanism of this test there’s a nice video here and a good handout here.

So it looks like my Lp-PLA2 of 244 ng/ml is high and puts me in the high risk category.

I’m not sure what this means in the face of all of my other data and have to admit that this is way out of my element.  I’ll definitely need to talk to someone with more expertise.

Vitamin D

It looks like the use of the Athletic Greens Vitamin D supplement did a good job of keeping my levels up.  Now that the sun is out I won’t be using the supplement as much because I’ll be making a more conscious effort to expose my skin and get Vitamin D the old fashioned way.

Thyroid Hormone

 

It looks like all of the changes I made did the trick because everything here is tip top!  This was the first time I was able to get my Reverse T3 levels down and my Free T3: rT3 Ratio up into the normal range.

Testosterone

I last checked my testosterone levels in March 2013 when it measured 776.2 ng/dL and December 2013 when it measured 860.2 ng/dl.

My testosterone seems to have taken a hit in this last round of testing at 673.2 ng/dl.  I’m not sure if this is simple variation or if something else is going on.  I would have expected this to improve now that I’m sleeping better, but who knows.  I’ll keep an eye on this and retest later on in the year.

Final Thoughts

At this point I’m not sure what to make of my cardiovascular risk.

Am I inflamed?  My CRP seems to say no… but my Lp-PLA2 and Ferritin seem to say yes.

Is my cholesterol getting better?  My total cholesterol, LDL-C, Apo-B, and LDL-P say yes… but my Small LDL-P says no.

Clear as mud.

*Image found here.