InsideTracker is a personalized health analytics company founded by leading scientists, physicians, nutritionists and exercise physiologists from MIT, Harvard and Tufts University. The InsideTracker platform tracks and analyzes key biochemical and physiological markers and applies sophisticated algorithms and large scientific databases to determine personalized optimal zones for each marker. InsideTracker’s expert system offers science-driven nutrition and lifestyle interventions that empower people to optimize their markers. When optimized, these marker levels have been scientifically proven to increase vitality, improve performance and extend life.
Joining me from InsideTracker is Mike Tarnapoll, who studied nutrition at Cornell University, is a soon to be registered dietitian, was a D-1 collegiate athlete, and has been active in CrossFit since age 10. Not only does Mike work with professional/elite athletes, helping them to translate biomarker results into improved performance, but he enjoys working with all individuals looking to live healthier for longer. On this episode:
- A Holistic Picture of Where Low Testosterone may be coming from
- Mobile and Therapeutic Phlebotomists
- What is the Global Inflammation Marker?
- Your Biological Age vs. Your Chronological Age
- The #1 Longevity Hormone Predictor for Women (not Estrogen or Progresterone)
- How Elite Athletes do Blood Testing
- New Science! Sex Hormone Binding Globulin Receptor Sites, plus what raises SHBG
- The Dangers of Iron and Ferritin
- The Value of Complete Blood Count
- And Much More
Download here (right click Save As)
You can also reach out to Mike directly at [email protected]
Click the link below to access the complete transcript.
[spoiler]Logan: Welcome to the Vital Way Podcast. I’m Logan Christopher from Lost Empire Herbs and Legendary Strength and I have another exciting call for you today. Definitely a big proponent of nature and doing natural things and learning to listen to your body and the flipside of that is looking at numbers is very helpful, very useful. Doing bio-hacking, being able to see quantified results, there is something very special about that and ultimately I think the best results come from really blending these two different approaches together.
So joining me today, I have Mike Tarnopol, who has studied nutrition, been an undergrad at Cornell, a CrossFitter since he was 10 years old, which is pretty cool and he’s here representing Inside Tracker, which is a personalized health analytics company founded by leading scientists, physicians, nutritionists, and exercise physiologists from MIT, Harvard and TUFTS University. The Inside Tracker platforms tracks and analyzes key biochemical physiological markers and applies sophisticated algorithms and large scientific databases to determine personalized optimal zones for each marker.
So we’ll be talking all about Inside Tracker and how it can help you and of course even if you don’t go with those services, you’ll be learning a lot about testing, about different numbers you may want to be looking at that you can talk to your doctor about and all that. And I just personally went through this myself so we’ll be talking about some personal things, looking at some of my weak points as far as what the blood test shows. So thanks for joining me today, Mike.
Mike: Yeah, thanks for having me, Logan. I appreciate it. Great intro, by the way. You’re doing my job for me. I don’t even have to talk about Insight Tracker now.
Logan: Well, I pulled that off the website so you guys did a good putting that together. It feels good.
Mike: Yeah, definitely.
Logan: So let’s just talk a little bit more. There’s a lot of junk out there when it comes to training and nutrition. How do you differentiate yourself at Inside Tracker and cut through all the clutter?
Mike: Well, you kind of said it in the intro and really what we look like, kind of at first glance is a blood-testing company. Don’t get me wrong. That is exactly what we do but for us, it’s kind of really a means to an end and that end point is the personalized guidance that we generate for an individual based off of those markers. So if you go to your physician and how often do you get blood work done, for an average individual I’d say maybe once or twice a year. What do you with that data? What does it mean? And what kind of action plan can you actually get from there?
So there are a lot of companies out there that will do genetic testing or that’ll do blood testing like we do, or will look at some other data testing variables but it kind of stops there. And that’s all well and good, except where you pay a lot of money to get those things done and the goal, the gold mine is how do you actually do anything with that data? So what we’re able to do is say okay, now you’ve tested with us; we have your biomarkers; we want to know a few more things about you. We want to look at what does your physical activity look like, what kind of training are you doing or are you just kind of a hobby jogger? Either way, we’d like to know.
We get pretty specific with that, too. What’s the relative time domain of your work out, the intensity, if you’re tracking heart rate data, things along those lines? Then we want to look at your food frequency and your dietary pattern, what you are eating, how much of that and then how often. For example, are you eating fish once or twice a month, or a couple of times a day, or something in between? And then if you’re taking supplements, we also want to know again what you’re taking, how much and how often. We go ahead and take a look at your goals. Are your goals to prevent injuries? You have recovery. Are they to fight aging? Are they to reduce inflammation or build strength and power? Something along those lines. And once your results come in, we can say okay, based on the 20,000 things you could probably do tomorrow for your health, here are the 20 interventions across nutrition, supplement, exercise and lifestyle categories that are going to help optimize your biomarkers the most and help you achieve that goal, whether it be the wellness goal, or an aesthetic goal or a performance goal. So for us, it’s the recommendations that really differentiate us in this whole kind of quantified self-market, so to speak.
Logan: Right, because I’ve done other tests before and you get this piece of paper or something with the results and it’s like I don’t know what any of these mean. Sometimes, there are reference ranges included but even with that, you’re really not—Is this really optimal or where is this reference coming from? So you guys are going a step beyond that, right?
Mike: Yup, we’re definitely going a step beyond that. We’re a team of registered dieticians, MDs and PHDs and really our goal is to kind of sift through all the bullshit road signs that’s out there and give individuals an evidence-based action plan. All of our recommendations therefore we’re pulling from peer-reviewed scientific literature. We have a database of over 1,600 publications that we’ve all read individually and kind of interpreted and generate recommendations from that so we can tag pretty specifically to an individual what is going to work for them, all things considered from their current nutrition, or current lifestyle or current supplementation.
Logan: Very cool. So first of all, Inside Tracker offers a whole bunch of different types of tests so one of the things that I guess stops a lot of people is well the cost of testing. So maybe we can talk of that but also the convenience of testing. So is it ordered by a doctor? How does that work? And there are some tests that can be done at home versus what requires you going into the lab.
Mike: Yes. So to kind of break that down, we do offer a variety of plans and they range from $99 or $499 and really the only difference between them being how many biomarkers are tested in each plan. The more biomarkers we test, the more expensive it is. It’s just kind of plain and simple. But what that allows us to do is have a little bit more insights into what’s going on biochemically when we have a little bit more biomarkers. So for example, let’s say somebody has low testosterone. That in itself could come from a whole slew of different areas. It can come from training. It can come from nutrition. It can come from poor sleep.
We’ll certainly give recommendations based on that and what we might think be occurring but if we know that your testosterone low, and that may have a bunch of related markers, let’s say we’re looking at your HSBG, your free testosterone, maybe some cortisol levels, creatine kinase and we still know how you’ve been training because you told us, we know how you’ve been eating because you told us and we know how you’re supplementing, now we have a much more clear, a little bit more clear picture to where that low testosterone might be coming from. So the recommendations that we can generate are of a much higher level of specificity. So that’s really kind of the difference between each plan. That’s not to say the most expensive plan is the best for everybody. It really depends on what your goals are. Are your goals optimizing your performance or are they overall health, something along those lines? And each plan kind of has a different angle or different target that it’s trying to hit for those different goals.
The way the testing works is there’s kind of two options. The first is purchase a plan through us online then we get you to fill out your profile, go over all the frequency data that I just touched on and then we generate a PDF lab slip. You just download it, print it and take that with your photo ID to the closest Quest location to you. We partnered with a company called Quest Diagnostics and they are a national, very reputable company. You’ll show up there, most of them accept walk-ins. You’ll give them the lab slip, the photo ID, and normally it takes about 10 minutes total for the whole process. And you’ll get your blood results back within three to five days. We’ll send you an email saying your results are in, log back into your profile and your analysis and recommendations will be all ready to go.
The second way is we can send a mobile phlebotomist to you. Now there are some states where this is a requirement just due to some state laws. Those states are New York, New Jersey, Rhode Island, Maine, North Dakota and South Dakota. Just those states are a little more strict with how individuals have access to their own health data and you just can’t walk into a Quest Diagnostics like you can in other states where that’s kind of the primary option. So we’ll send a phlebotomist to you. It could be at your work. It could be at your office. It could be at your gym. Hell, if you want to do it in a local coffee shop and you want to piss too many people off, you can do it there, too. So once the phlebotomist gets there and draws the blood, it’s the same process. They’ll have your lab slip and everything set up already. They’ll confirm directly with you over the phone, the date and time and once they draw the blood again, it will be 3 to 5 days. Once the results are up, you’ll get an email the same as the first option. So you can do the mobile phlebotomy option in any state but again those states that I mentioned are a necessary evil so to speak and that is also an additional $80 fee.
Logan: I was thinking about doing that because I was imagining there wouldn’t be a place that close so I was like that’s probably worth it, but then I found there was a Quest Diagnostics only 10 or 15 minutes away from my house. They’re kind of everywhere, aren’t they?
Mike: That is a good point there but I definitely should have mentioned it. There are a few dead zones. If that happens, then we can certainly work with individuals kind of on an individual basis. They contact me directly but they’re coverage is nationwide and it’s pretty strong. In most states, you’d be hard-pressed to not find one within you know 10 to 15 minutes from your house as you just said. They are everywhere and it is pretty convenient, given the fact they do accept walk-ins. In most locations, you can just go ahead, show up. At 8:00 AM, they open. You’re likely to be the first one there. You’ll be in and out in 10 minutes. So it’s definitely the primary choice if you can do it and it’s feasible just from a kind of cost perspective.
Logan: And what about some of the in-home tests, what can be done? What doesn’t need a phlebotomist involved?
Mike: So we have two testing options that you can do at home and both of them are a finger prick. We have the basic version and then we also have the advanced home kit. The different between the two is the advanced just has the cortisol high-sensitivity C-reactive protein, which is kind of the global measure of inflammation in your body. It doesn’t necessarily pinpoint where the inflammation maybe coming from but it tells you that it is there, as well as vitamin D. So the basic really only includes glucose, cholesterol, LDL, HDL and triglycerides, which are all energy and metabolism markers and it will give you a good idea of how optimized or not your metabolism is. And the advanced include those as well plus the additional few.
And the way that process works is again, you purchase the test through us online and we would ship the kit to you and then you would ship the results back to our lab, which is again a partner of Quest. They’ll be the ones that are analyzing the blood itself and then we will analyze the actual results. The price point there, the basic would be $109 and the advanced would be $299. I don’t know if you have any international listeners but the advanced plan is available worldwide.
Logan: Okay, that’s good to know. Well let’s start diving into some more details about the biomarkers. You guys also have something called Inner Age. Maybe describe that and what five biomarkers make that up.
Mike: Yeah, kind of briefly Inner Age is a nice kind of either one, introductory service or two, an add-on service that measures five key biomarkers that kind of our science team feels are most directly related to aging and longevity, but also on the flipside of that can be modulated through some sort of nutrition and supplement, lifestyle, and exercise intervention. So that’s how we generate which ones are most pertinent. Then from there, based on those five biomarkers we can calculate your Inner Age or your biological age versus your chronological age. Just like a car, age is certainly one consideration if you’re buying a used car but mileage is also kind of what’s most telling, how much wear and tear is on vehicle and how much work you might have to put into it.
So really what it is, it’s kind of as we move from analyzing individual biomarkers in the blood, we need some sort of summary tool where you can have a number that reflects the current state of health and performance as we move into trying to be truly data driven. It’s just another kind of objective measure for an individual to use to kind of simplistically look at okay, here are the interventions I’m following and here’s how my Inner Age is trending over time.
So the biomarkers that we look for in this plan are glucose, vitamin D, testosterone, HS-CRP, and ALT. That’s for the male panel. For the female panel, instead of testosterone we look at DHEAS. And don’t get me wrong. Testosterone is definitely important for females as well as males but the levels that are in females or the normal ranges are so low that it’s hard for kind of our algorithm to take a look at small changes that might be made over time by following these interventions. So instead, we look at DHEAS for women, which is a precursor to sex hormones including testosterone as well as estrogen. So we’ll look at those as a predictor for women for longevity. So those are the biomarkers that it assesses.
But again, what we’re doing here at Inside Tracker is saying okay, now that we have these data, what does it mean? So we put the number on it, which is an objective form for you to measure what’s really going on in your body, your biological clock versus the number on your driver’s license. But then also, what we’re doing is providing you with simplistic input. What we wanted to do is make sure that we can provide you with some action plan by extracting all the complexity from science and then presenting it in some sort of elegant form that is a great target goal for every individual, not just the elite athlete but anybody looking to make progress. The way we do that is with personalized focus foods, kind of our tag line or what we call. You can kind of think of like super foods and the notion that super foods are healthy because they have antioxidants, vitamins and minerals, and fiber, etc. so they can kind of label it as healthy for the population as a whole.
So what we’ve done is said okay, the focus foods that we’re going to generate for you are the five most potent food options that are going to deliver kind of the most nutritional bang for your buck in terms of they’re going to have the largest magnitude of effect on the biomarkers that are related to your Inner Age, and based on their micro- and macronutrient profile we’re going to drive them in the positive direction so you can lower your Inner Age as far as possible. By doing so, what you’re doing is improving and furthering your health. It’s the general idea behind the Inner Age product.
Logan: Very cool. I haven’t got my score back on that so I’d be curious to see how that is. But I thought it was interesting also just cruising through your website one of the blog posts on there, a recent one was How Burning Man Aged Me 21 Years which I thought was very interesting. Could you speak to that a little bit?
Mike: Yeah, I could. What we often see a lot of the time is that when individuals get their results back for the first time, they are often let’s say less than satisfied with the results, and he included it with the nutritional background that I do have from six-plus years of studying it, a few years of working with it directly kind of in a field with athletes and everyday individuals, I thought that hell, I probably have a good knowledge on what’s going inside of my body. When I got my results back, at the time I was 23 but I tested at 31. So that’s kind of a shocker as it is for any individual. It’d be like hey, I tested almost 8 years older than I actually am.
So to speak to these endpoints, these physiological markers of how we’re actually doing with our health are very hard to predict without actually seeing that. If I told you that I was eating brown rice, chicken breast every day, you’d probably tell me hey, that sounds pretty healthy, pretty clean, whatever your definition of that may be. But maybe for me, what I needed to be doing was eating more cod, more whole wheat pasta and more spinach, also very “clean,” very healthy but the micro nutrient profile is just that much different to have more effects for me on the biomarkers that were off, given my current training, given my current lifestyle, things along those lines.
With that being said, what we’re looking for more with the Inner Age versus just a single testing point in time is that trend line over multiple tests. What we’re able to do and what Inside Tracker Inner Age itself also provides are graphs for you to trend your Inner Age versus your chronological age. So you might have a good test and stay on point for a few tests and then you might fall off and have a poor testing results. But what we want to see over time is a positive trend line, an absolute positive trend in the right direction there in a “race against time” to avoid the cheesy line there.
But it’s true. Sometimes, we definitely pull ahead and become internally younger and then sometimes we fail. But it doesn’t end there and with Aaron’s results, it’s kind of one end of the extreme, right? You can only imagine the physical toll with something like Burning Man that has on this individual but it’s highly likely that a few weeks down the road when she retests, her Inner Age will be back to where it was originally, if not younger again. It’s all about knowing that and how quickly can she apply some of the nutrition and some of the lifestyles and the exercise recommendations that come with her regular Inside Tracker profile and then of course the focus foods that she had with the Inner Age add-on to kind of decrease the time it takes for her to return to the baseline.
That is the same thing let’s say if somebody did an intense couple of weeks of training. That is going to have a pretty significant impact on your biomarkers and it’s not necessarily a negative but keeping in mind of how it did affect you, now we know okay, what new thing should you be doing for your nutrition and can we tinker with your training a little bit to kind of keep you performing at that high level, given the fact that you just wrecked yourself the previous four weeks? So it’s really looking at that map over time and making adjustments and changes from there.
Logan: Right. I think I’s very important that people see aging as a process. So if you’re doing certain things that are just additionally stressing your body beyond normal then that is going to accelerate the aging process. But if you’re doing things well then you can slow down, perhaps even reverse that aging process. I’m curious; with the recommendations that are being made, how big of shifts in these biomarkers can people see and how quickly?
Mike: That is a good question. Really that is both individual-dependent as well as biomarker-dependent. Different biomarkers are affected more strongly by different categories of recommendations than the others. For example, training affects testosterone a little bit more quickly than nutrition does. Is nutrition important? Definitely, but you might see day-to-day swings in testosterone levels, all things considered, from a training perspective than you would from let’s say you got a little less zinc in your diet one day to the next. You’re not really going to see a large swing there. So for certain markers, nutritional ones, to kind of see a large kind of baseline improvement, normally it’s two to three months which is no coincidence as to why we recommend quarterly testing. One, to generate that map and two, to really see the effects of those nutritional and lifestyle changes that take effect after two to three months.
Now with the kind of strength and endurance markers, you will see changes a little more quickly. Again, that’s why it’s very important to test over time. You could test right after coming off of a pretty intense week of training. Maybe your testosterone is a little bit low from that. You can think of testosterone kind of as a gas tank and if driving or putting your foot on the gas of a car drains the gas tank then continually working out hard drains your testosterone tank. As you recover with proper rest or proper recovery, things like active recovery-based things, along those lines, proper nutrition, then your testosterone will come back. But if you don’t do that correctly then you’re going to compound the effects and you’re going to end up with a slightly depleted levels of testosterone. However a week later, if now you decide that you’re going to recover properly, your testosterone levels might come up. So over time, what we want to see is either one, level is going to stay the same or the levels improved but we definitely don’t want that map to decrease. So we kind of cover all angles there from all biomarkers perspective by testing quarterly.
And some of our elite athletes do test more than that. I work with a few individuals across a variety of different sports. For example, I work with a couple of CrossFitters who will test quarterly as baseline tests and then they will draw the blood test right around any sort of time they are trying to test their training and their performance. So let’s say they’re running a quick CrossFit competition, they might draw a blood test right after that or if they’re doing a test to measure their aerobic capacity or look at their strength and power improvements then I might draw the test in after that. That’s just adding another objective data point and to say okay, here’s how their biomarkers look, here’s how they feel subjectively with their training data, here’s how they’re actually improving on their performance tests and let’s look at all things considered. So I definitely got a little off-track there because sometimes I’m excited.
Logan: No, that’s good. So we were talking a little bit about this before but as I mentioned, I just got my results back and I’m happy to report that as far as the blood test that I’ve done my total testosterone was the highest it’s ever been at 782 nanograms per dekaliter. But something I have right now and I’ve seen this in the past is my sex hormone-binding globulin is pretty high. Now not a lot of people are familiar with that but basically the name kind of says it, sex hormone-globulin so it’s a globulin and protein that binds to things like testosterone but other androgens and estrogens as well. It basically renders them inert. So could you talk about sex hormone-binding globulin and what are some lifestyle, or nutrition, training factors that may be causing that to be high in me and what I can do about it?
Mike: Yeah. So sex hormone binding-globulin definitely got its name for its ability to bind sex hormones, testosterone and estrogen-like compounds in the bloodstream and it binds it with a pretty high affinity. The bond is very strong between them. Testosterone also binds other products in the blood as well but the bond is less strong. So what we look for here and why we’re looking at it is because one theory, and this works out to kind of a certain point, is that when SHBG is bound to testosterone, that means they are not bioavailable. They’re not readily available for testosterone to be able to—
Logan: Exert its effects.
Mike: Yeah, exactly. There it is.
Logan: It can’t bind to the androgen receptor sites if it’s bound up by sex hormone-binding globulin.
Mike: Exactly. So it’s not going to be able to do that anabolic reaction, whether it be bone and muscle health or protein synthesis or sometimes it’s related to endurance and heat load as well. So it’s not going to be available for those reactions. And it’s certainly the case up until specific points. What we have found with some more research is that some tissues also had SHBG receptors. So up until a certain point of SHBG level, they might actually kind of improve the absorption in the testosterone in a tissue-specific manner. This is kind of the newer, emerging research. The testosterone being not bioavailable because of its bound state to SHBG was something that was found out through research in the 1980s or so. They did tests in test tubes and they used kind of random cells, whatever, they were able to get ahold of at the time and those cells happen to not have SHBG receptors on them so when testosterone was bound to SHBG, it couldn’t perfuse into the cell. Therefore the extrapolation was made that if it’s bound to the bloodstream then it’s not going to make its way through bloodstream and perfuse into the cellular tissues for those metabolic or anabolic reactions. And that is the case still.
Now that I’ve muddied the waters, what does it actually mean? Well again, it goes back to testing over time. So things that you have to keep into account are okay, what does the SHBG look like for you at baseline, how do you establish that baseline and then what happens over time as you either one, change your training or two, take a look at your nutrition? And what we want to see is okay, maybe slightly elevated as yours is. It’s not too high so we wouldn’t be like oh whoa, you could have done a couple of endurance workouts for your higher level, which is 63 by the way. Kind of the cut-off for clinically okay is 50 so it’s not too high. Let’s say you were doing two weeks of increased endurance volume for you. This is something that we definitely can see happen. We can definitely also see it happen from a nutritional perspective, if you’ve lost any weight significantly recently. We’re talking kind of a half-pound of muscle, it’s very miniscule, we’ll see SHBG rise there as well. Or if you’re kind of along the same lines a little bit calorically restricted, we can call SHBG to go high.
But what we want to do is keep it stabilized, keep it in a stabilized zone for you. So I wouldn’t be worried if you’re SHBG on your next test kind of trends downward a little bit. Again, it is so relatively high and that’s okay because again we’re looking for over time what does the trend look like. And if it’s trending downwards, then we’re fine. If it’s staying the same, which is still kind of okay, we just need to take a look at what you’re doing training-wise and making sure that your caloric intake and your protein intake are on par. And if it goes up, then we’d just need to take a step back and definitely reconsider; okay, what are you doing? Are you doing too many MetCons and then going off for long runs afterwards, things along those lines? Then we say okay, instead of doing a MetCon, today you’re going to maybe do some maximal lifts or maybe some heavier kettlebell work madness over that run. But maybe it’s the combination of MetCons and runs that causing it to rise. Maybe you’re not sleeping well enough, things along those lines. We can start to tease out over time where exactly it’s coming from but then again you need those multiple testing points to start to really delve into it.
Logan: Right, very useful. I have not heard about the sex hormone-binding globulin receptors. That’s interesting.
Mike: Yeah, it is. It’s hard because there’s a lot of things that go into SHBG and what we know and what we don’t know about it but there is a good amount of research that there’s a multitude of different functions that SHBG has that kind of compounds the results more so than just simply saying hey, testosterone is not available now. That’s currently the case but there’s also a lot of other things that we have to consider when we’re looking at different fluctuations of these biomarker in context of everything that you’re doing. If Joe has an SHBG level of 50 and Jeff has one at 30 and both have the same plasma testosterone concentration, that doesn’t necessarily mean that Jeff is better off because of his higher free testosterone test because tissue-specific distribution of SHBG definitely matters. So you have to look at what is Jeff doing and what is Joe doing because they can be equally as good off or Jeff could be better than Joe even though he has a slightly lower SHBG level.
Logan: Right. That brings up interesting points. Science is ever evolving and things that we know for sure now, we will figure out we’re wrong ten years from now, as has happened in the past. So maybe when you’re working with people, because you talk about looking at science and that’s something we do at Lost Empire Herbs as well, but there’s not always complete science available on something. For example, our number one pine pollen supplies androgen to the body, really helps with that but there’s really no science behind it, not yet. Hopefully, someday we’ll get there. So how do you kind of balance, looking at the science to see what’s kind of proven or highly suggested that it works versus maybe trying some stuff that isn’t necessarily backed by science?
Mike: Yes, it is a definitely interesting and valid point or argument. It really comes down to these days how do you interpret the science and how do you interpret things that work? From our recommendations perspective, everything has—we’re looking at a multitude of different factors to determine whether something is we feel strongly backed by science or not. First of all if it’s not, then it’s not a recommendation of ours; we don’t put it in. Second, we’re looking at things like how reputable a journal is, that the article or the study is published in, what type of study it is, how many individuals were enrolled in the study, what were the outcomes, what were the intended outcomes, who were the authors behind the study. All these things are going in, or how many studies there are behind this specific recommendation are going in to how strongly we feel the strength of evidence behind it is. So that’s one perspective. And of course those are getting tagged to individuals based on things that we know about them, etc. such as their age, weight, their height, whether they’re doing CrossFit, or whether they’re doing some endurance running, or maybe they’re a triathlete, or maybe they’re a rower. Those are all being tagged to different individuals.
But then also basic question okay, somebody comes to me and says, I want to do intermittent fasting. Research on that is still definitely muddy, whether or not it’s beneficial or not. I don’t necessarily have an opinion on it yet. More evidence is definitely suggesting that it might be beneficial in terms of kind of overall health and wellness and lowering blood glucose levels, lowering LDL levels and improving lipid panels but in terms of athletic performance on the other hand, there’s no consensus statement. But I say okay, this is an individual that wants to try this; let’s go ahead and see if it works. If their blood glucose improves and their lipid panels improve from a biomarker perspective, that’s great. Then we subjectively ask how are you feeling on this new dietary plan? Let’s make sure you’re doing it correctly. And if your performance is improving, and you feel good, and your biomarkers are in line, then great. This is what works for you as an individual right now. Given your current training, given your current lifestyle, this is what’s going to work with you.
It all comes down to the interpretation of science. You might take a look a consensus statement that’s published off of some peer-reviewed scientific literature off of their aggregate data, so taking a look and saying hey, we’re publishing this paper based off of an average. We took 60 people and applied some sort of intervention and 40 of them had no response to the intervention so therefore we say okay, this intervention has no response. But we can’t ignore the fact that maybe the other 20 people had a high response and for whatever reason their average or metrics or whatever it is given the study, that group of individuals does respond to that intervention. So maybe when I’m talking to an individual on the phone or maybe they want to look at their results in a little bit more detail, I can gather that hey, they might be an individual in that group. So it’s definitely important to consider even though the consensus statement says X, maybe they’re a part of Y and I’ve got to make sure that I implement Z correctly, given those factors.
Logan: That’s the important reason to not just test one time because that might be useful to some degree but it’s really the trends and you can see how interventions, whether science-based or not, how those affect everything that you’re doing.
Mike: Of course, 100%. It’s all about the re-testing. Definitely.
Logan: Right. So another thing that came up on my test which is very interesting is my ferritin levels are a bit high. I was just hearing about this from a doctor at a conference I attended. He was talking about the dangers of having too much iron in the blood and recommending that people either give blood or something that I haven’t heard of before but a therapeutic phlebotomy. So can you talk about the issues with iron a bit?
Mike: Yeah, sure. So taking a look at your blood results, the ferritin is a little bit elevated. Now I definitely wouldn’t say it’s high and here’s the station we have to make really quickly when we’re interpreting our results is what we’ve done is generate an optimized zone for you as an individual based on everything we know about you again. So when you’re looking at it, there’s a red zone and that’s kind of what we classify as “at risk” and that’s different. That is explaining if your blood result is outside of a clinically-acceptable range. If you go to a doctor, they’re going to have an issue with an “at risk” result. For us then, the yellow which is still outside your “optimized” zone so it appears as high for you is clinically okay. So from a chronic disease or acute illness perspective, you’re medically good to go. Now from a completely optimized you, making you the healthiest version of yourself that you can be, that is a little bit elevated. But there is that differentiation between elevated and actually high.
Logan: Let me just interject this because I’ll be actually like sharing some of these charts and different things on our website, either along with this podcast so you can check that out in the show notes or as a sort of separate article but of the markers tested I had 29 optimized, 9 need work so this is in that yellow zone and 3 were at risk in that red zone. Go on.
Mike: Yeah, great. So for you with that slightly elevated ferritin, when we talked about this a little before coming on it just sounds like you’re getting a lot red meat. Red meat is very high in iron. So what ferritin is, it’s this storage protein for iron because you’re right, it is dangerous and poisonous to have iron kind of free by itself in your bloodstream outside an okay zone. Let’s clarify there. So it’s acceptable within a certain limit. So what your body does is as it has enough iron in the blood, it stores it with this protein called ferritin. The more iron that you take in, the more your body is going to try to store it as ferritin. So that’s really kind of what it looks like from that perspective.
And if you take at your blood iron, again it’s a little bit elevated and then your transferrin saturation is also a little bit high. So there is a protein called transferrin which available in the bloodstream and that’s your body’s attempt to keep iron kind of bound to something and how it transports it through the bloodstream so it’s not available by itself as kind of a free radical, which would be kind of poisonous to your system in the bloodstream. So it transports it from the storage and in your organs as ferritin and then transfers that to the protein transferrin and moves it through your bloodstream to whatever target tissue it needs to be going to.
So again, your levels are elevated but they’re not too high. Simple recommendations, simple effects would be to eat one or two less servings of red meat a week than you’re eating now and even replacing it with another meat source like chicken, you’re going to see a trend in the positive direction there in terms of decreasing your ferritin storage and decreasing your blood iron levels down to your optimized zone. Really what we’re looking for from an Inside Tracker perspective there is taking a look at your oxygenation and performance markers. We’re really trying to tinker how well your body is able to deliver oxygen to different parts of your tissues. What does iron have to do with that? Well, iron is very important in the formation of hemoglobin and hemoglobin is a protein that’s found in your red blood cells. At the center of that is an iron molecule and that’s where oxygen binds. So everybody knows that red blood cells are important for oxygenation and this is why. So without proper iron stores, eventually you won’t be able to produce hemoglobin in significant amounts and we’ll see your performance decrease and that’s what we’re trying to optimize by getting your iron levels in that optimized zone.
Logan: Okay. So if I did work on this, should it help to improve my endurance a little bit better?
Mike: Yeah, it should. We’ve seen high iron levels that can correlate to kind of a chronic fatigued feeling, decreasing the time it takes to get to exhaustion which is definitely not something that we want from a performance perspective. So yeah, I would definitely think that decreasing your iron source a little bit would help. The quick way to do that, yes, would be go to give blood or what was the word that you used for the second option? I like that.
Logan: Therapeutic phlebotomy. If they can’t use your blood for whatever reason, they can just draw the blood and then basically toss it. I’ve never heard that term either. I thought it was interesting.
Mike: Yeah, because the only you’re going to get rid of the iron in your body, your body is very good at recycling iron so the way it normally gets excreted would be through some sort of bleeding action.
Logan: This is one of the reasons that women are theorized to live a little bit longer than men. It’s because they do monthly bleed and so they are actually discharging some of that iron whereas men tend not to bleed unless you get into a sword fight pretty often.
Mike: Yeah. No, that’s definitely true and then you get into different sports have a larger and a smaller effect on that, a lot of the endurance athletes obviously for the same reason you just mentioned for women. For men, as you’re running for example over a longer period of time, you get a little bit of more gastrointestinal bleeding just from the shear rubbing and bouncing and running, it has on your affected organs. You’ll see a little bit lower levels of iron in those endurance athletes. So again, you really have to take into account what you are doing as individual to see, do you need to take iron into account in terms of should you be getting a little bit more or should you be mindful of hey, I’m eating red meat every day, I’m probably getting a good amount of iron. I might be able to cut back the amount of red meat I’m eating from the hind perspective. If you were to do that, what you might also see is a decrease in your blood fasting glucose levels. High consumption of red meat has been correlated to high levels of blood fasting glucose, as well as your LDL cholesterol might be lower a little bit just due to the amount of saturated fat that’s in red meats and saturated fat raises blood LDL cholesterol levels.
Logan: So one other thing, and I’m running low on time so I’m going into this pretty quickly, you recently added CBC or complete blood count to your panels. Can you talk a little about this and why it’s important?
Mike: Yeah, definitely. So the CBC, and we kind of get into this with the iron, but the CBC is definitely one of the most commonly ordered blood panels by your doctor. They’ll likely send you to get your CBC done when they think that you might be anemic, maybe you’re extremely tired all the time, you’re a female and so they might send you there to get that done. They might also send you to get one if they suspect you have some sort of an infection or clotting problem. But what it does is it measures a good amount of biomarkers that can reveal a lot about your health and performance. It shows how efficiently oxygen is carried throughout your body. It shows how healthy your oxygen-carrying blood cells are, your red blood cells. It can expose some inflammation issues if you have any. It can explain why you might have low iron levels, like we just teased out a little bit, and it can also tell you if you have a little bit higher risk for poor cardiovascular health.
So things they are actually measuring if I were to run through them off the top of my head, you’re looking at things like hemoglobin, hematocrit, red blood cell count, what those red blood cells actually look like, how big and how small they are, which have different effects on how healthy they are, how much hemoglobin is actually in each cell, what does your white blood cell count look like in total, and then what does each certain type of white blood cell look like. Knowing those different levels, you can start to tease out whether you have low white blood cells because of more of a training thing. Maybe you increased your training load, which is going to show you the decrease in some of your white blood cell counts. Maybe you have a viral infection versus a bacterial infection or visa-versa. You can kind of tease out all of these things with this additional CBC that we have now added to our ultimate plan.
Logan: Nice. And speaking about the white blood cells, it makes sense if it’s too low then you have bad immunity and it’s too high then there’s too much infection, or inflammation, or different things that your body is fighting. My white blood cell count came in a little bit low. Basically, the optimal zone borders the too-low zone and I’m just barely into that too low zone. So what are the things that may be causing that and what would be useful? So you just mentioned that over-training is one thing that could lead to that so perhaps my volume of work had been a little bit high. What else there?
Mike: Yeah, in short kind of the neutrophils which is the only white blood cell for you to have as being a little bit low, first of all they make up the majority of white blood cells of that total. Roughly about 70% to 75% of our total white blood cell count are neutrophils and their primary job are responders to bacterial infections. But they can be triggered high from emotional and physical stress in addition to bacterial infections. But on the other side, lower neutrophil numbers can often be seen in viral infections or again as an adaptation to harder training volumes and training loads. So you mentioned that you were recently in the Amazon and had a cough and that could definitely have been a viral infection. Same as if you had recently been pumping your training over the past let’s say month or two, a pretty long time point there, that can also be affecting it as well. Definitely a possibility.
Logan: Right. Well, so many more questions we can go into but I know you’ve got another appointment and so do I in a short bit. So I’d like to say anyone that’s interested in this, if you head to InsideTracker.com and what’s more we have a coupon for you so you can save I believe it’s 10% off any test. Is that right?
Mike: Yup. it’s 20% off any test and if they have any questions, they can feel free to reach out to me directly as well. I can help answer their questions or get them set up with the test that’s definitely best for them given their goals. If this goes on your website, you can definitely put my email out there and again, they can shoot me any questions they have.
Logan: Okay, absolutely. So to get that 10% off once again, go to InsideTracker.com and use that coupon code: LOSTEMPIRE20 and I believe that’s all. It’s one word with no space in there. And if you head to show notes, we’ll actually have the link that kind of automatically puts that coupon in there just to make it a little bit easier for you. We’ll have Mike’s contact information. As he said, any other questions you have on this. I think it’s a really cool service. I know a lot of people are interested in getting healthier, right? Who isn’t interested in that? Everyone should be interested. So this is just one option that can certainly help you along those ways. I’m having fun digging into this fort and I hope you enjoyed and got something out of this call, kind of hearing me getting a consultation about my results a little bit here. I hope you found that interesting. If you have any questions, feel free to ask. I just want to say thank you Mike. This was great.
Mike: Yeah, thank you for having me. I really enjoyed it. I always love talking about this sort of stuff and there’s always so much to talk about and so little time.
Logan: Absolutely. Well, thanks everyone for listening. Once again, post any questions you have but hopefully you’ll find this useful. You’ll be able to find more information. And as I said, I will be posting some more of my results on the website so you can take a look. All right. Thanks everyone.
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Hello. What is the cost of one of the blood test? Thank you very much.
Depends on which one you get. Click this link to see pricing (and remember you get 10% off too). https://www.insidetracker.com/qr/onboarding/LOSTEMPIRE/