What labs should you get? The ULTIMATE bloodwork podcast! Part 2

PS

Paul Saladino1h 4m · 2019-09-05

Claims Made

132

Claims Supported

76

Support Rate

58%

Support rate

76 of 132 claims supported

76 supported56 partial / not

Claims from this content

118

Well SupportedPlasma or red blood cell magnesium tests are useful for ruling out severe deficiency but should not be used to determine optimal or sufficient magnesium levels.Well SupportedThe Omega-3 Index, measuring omega-3 levels in red blood cells, is a long-term biomarker of omega-3 status, unlike plasma phospholipid levels which reflect recent intake.Not SupportedFish oil supplements often contain high levels of peroxides and oxidative products.Well SupportedSauna use, particularly at higher temperatures (~174°F), can lead to significant excretion of heavy metals like cadmium, lead, and aluminum through sweat.Partially Supported

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A. Volkovreader

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Bookmarking — the dossier-vs-overview split is the right call. Most of the time I want overview; sometimes I want receipts.

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Would love a "what would change this verdict" RSS feed. Sign me up if it exists.

Increased creatinine levels due to creatine or high meat intake are not harmful and may warrant cystatin C testing for kidney function assessment.

Well SupportedIndividuals on an animal-based diet typically have high vitamin E levels.

Partially SupportedThe vitamin D obtained from sun exposure may be a proxy for other beneficial factors associated with being outdoors, rather than a direct benefit of the vitamin D itself.

Well SupportedAn iron comprehensive panel should include serum iron, TIBC, ferritin, and percentage of transferrin saturation.

Well SupportedConsuming a few ounces of liver daily does not raise concerns about copper toxicity due to the presence of zinc.

Well SupportedRed cell distribution width (RDW) is a strong independent predictor of adverse health outcomes.

Well SupportedElevated GGT can indicate environmental toxins or oxidative stress and should be added to a comprehensive metabolic panel.

Well SupportedProlonged ketosis can adjust thyroid hormone levels and impair carbohydrate management upon reintroduction.

Well SupportedAn omega-3 index of 8% or higher is desirable, and approximately 2 grams of supplemental omega-3 per day is needed to increase the index from 4% to 8%.

Not SupportedKetogenic diets can decrease T3 thyroid hormone levels and cause muscle loss.

Well SupportedOn a carnivore diet, blood glucose levels are typically flat throughout the day, making CGM less essential unless for curiosity.

Well SupportedFree T3, free T4, and TSH levels can change, often negatively, with ketogenic or low-carb diets.

Not SupportedExcess zinc intake without sufficient copper can lead to copper deficiency, causing neurological symptoms similar to B12 deficiency.

Well SupportedEstimated Glomerular Filtration Rate (eGFR) is calculated from blood creatinine concentration to estimate kidney function.

Well SupportedRed blood cell distribution width (RDW) above 12.5% may indicate underlying issues such as micronutrient deficiencies, heavy metal toxicity, toxins, or inflammation.

Partially SupportedPaul Saladino's personal vitamin D blood level is around 75 ng/mL, and he does not take supplements other than desiccated organs and vitamin D.

Partially SupportedPiperine inhibits UDP-glucuronosyltransferase, the enzyme responsible for conjugating bilirubin.

Well SupportedElevated creatinine levels can be caused by high muscle mass and high meat intake.

Well SupportedOmega-3 fatty acids can be obtained from food sources such as fatty fish, salmon roe, and fatty meats from grass-fed animals.

Well SupportedThyroid deiodinases are dependent on selenium.

Well SupportedTesting for thyroid receptor antibodies like thyroid stimulating immunoglobulin (TSI) is necessary for Graves' disease.

Not SupportedConsuming excess omega-6 fatty acids, particularly from seed oils, is not recommended.

Partially SupportedA complete blood count (CBC) assesses white blood cells, red blood cells, and red blood cell size (MCV) to indicate infection, anemia, or specific types of anemia.

Partially SupportedA high ferritin level with low inflammatory markers may warrant further investigation for hemochromatosis.

Partially SupportedMaintaining a healthy mitochondrial electron transport chain requires nutrients like CoQ10, which is found in animal meat and organs.

Well SupportedElevated aminotransferases (AST/ALT) can be caused by muscle injury from workouts, not just by having a large muscle build.

Partially SupportedElevated ferritin on a carnivore diet may be linked to inflammation, but generally, high meat intake does not cause iron stores to become excessively high.

Partially SupportedBlood toxic metal testing is generally adequate for initial assessment.

Partially SupportedA low TSH generally indicates hyperthyroidism, while a high TSH indicates the body is trying to stimulate the thyroid.

Partially SupportedBilirubin is a breakdown product of hemoglobin, and elevated levels, particularly conjugated bilirubin, can indicate liver disease or cholestatic processes.

Partially SupportedOmega fatty acid analysis can be ordered online from OmegaQuant.

Not SupportedExogenous testosterone supplementation can elevate hematocrit, increasing the risk of hypercoagulability and blood clots.

Partially SupportedPaul Saladino's thyroid panel showed TSH around 1-1.5, T4 of 5.7, free T4 of 5.2, and T3 of 55-65.

Partially SupportedIndividuals with hemochromatosis consuming a high-iron diet should monitor iron status and undergo phlebotomy.

Partially SupportedThe omega-3 index, a measure of EPA and DHA in red blood cells, does not have a rigidly fixed target value.

Partially SupportedElevated reverse T3 may indicate stress or poor sleep.

Partially SupportedGlutathione is involved in detoxification of metals and may be supplemented short-term for mercury load.

Partially SupportedA robust amount of EPA and DHA is important and can be obtained from fish, grass-fed animal fat, and egg yolks.

Partially SupportedCopper deficiency can manifest with neurological symptoms, including balance and coordination issues.

Partially SupportedPlant-derived trans fats like elaidic acid are harmful, while some animal-derived trans fats like CLA and acetic acid may be beneficial.

Partially SupportedAn elevated BUN in the absence of other pathological causes may not indicate a problem if it's due to a large protein meal consumed the previous night.

Partially SupportedAthletes on plant-based diets may experience injuries that do not recover due to issues with glycine or collagen synthesis.

Partially SupportedShellfish like mussels, clams, and oysters accumulate heavy metals such as cadmium.

Not SupportedChecking only TSH for thyroid function is inadequate; a comprehensive panel should include free T4, free T3, and reverse T3.

Partially SupportedHigh MCV can indicate folate or B12 deficiency, while low MCV can indicate iron deficiency.

Partially SupportedAnemia, indicated by low red blood cell count, hemoglobin, or hematocrit, requires further investigation into its cause.

Partially SupportedAlkaline phosphatase can be fractionated into heat-labile (bone) and heat-stable (liver) components to determine the source of elevation.

Partially SupportedElevated neutrophils in a white blood cell count may indicate a bacterial infection.

Partially SupportedElevated lymphocytes in a white blood cell count generally indicate a viral infection.

Partially SupportedAstaxanthin can affect DHT levels.

Partially SupportedElevated eosinophils can indicate parasites, allergies, or autoimmune disease.

Partially SupportedGI map testing can identify parasites, pathogens like Blastocystis, H. pylori, worms, and amoebas.

Not SupportedThe plant-based industry is contributing more to environmental impact and human ill health than is commonly believed.

Partially SupportedConjugated linoleic acid (CLA) and acetic acid in animal meat may have beneficial signaling properties for weight loss, immune modulation, and hormonal effects.

Partially SupportedTotal protein and albumin levels are generally normal in individuals following a carnivore diet.

Partially SupportedFructosamine measures average blood glucose over 2-3 weeks, while HbA1c measures it over 3 months.

Partially SupportedSome individuals in ketosis may have longer red blood cell lifespan, potentially leading to higher hemoglobin levels and thus higher HbA1c readings.

Partially SupportedRed blood cell count, hemoglobin, and hematocrit measure blood oxygen-carrying capacity.

Partially SupportedElevated alkaline phosphatase (ALP) can indicate biliary disease like gallstones.

Partially SupportedIndividuals on carnivore diets often exhibit high levels of Coenzyme Q10, with observed levels between 2.4 and 3.5 micrograms per ml.

Partially SupportedSwitching from a standard American diet to a ketogenic or carnivore diet can significantly decrease white blood cell count.

Not SupportedHigh hematocrit from EPO or testosterone increases oxygen-carrying capacity but also the risk of blood clots.

Partially SupportedFolic acid improved cognitive function in individuals with low omega-3 intake.

Partially SupportedThe body eliminates excess iron by sloughing off intestinal cells that bind iron.

Partially SupportedTissue sensitivity to thyroid hormones can change, as evidenced by research reviewed in a talk with Jamie Seaman.

Partially SupportedSerum electrolytes like sodium, potassium, and chloride are tightly regulated and do not reflect tissue levels or body stores unless a person is metabolically deranged or very sick.

Partially SupportedMercury levels below 0.7 micrograms per deciliter in blood are considered good.

Partially SupportedAn elevated RDW in an anemic individual suggests a mix of small and large red blood cells.

Partially SupportedArsenic may be present in apple seeds and drinking water.

Partially SupportedMercury can be found in fatty fish such as swordfish, tuna, and king mackerel.

Partially SupportedA higher omega-3 index, particularly from EPA and DHA, may be associated with increased sunburn tolerance.

Partially SupportedTesting for toxic metals like arsenic, cadmium, lead, and mercury at least once is valuable.

Partially SupportedMagnesium is difficult to obtain from plant foods, and supplementation may be beneficial despite potential side effects like loose stools.

Partially SupportedAlcohol consumption can elevate AST relative to ALT.

Partially SupportedLow red blood cell magnesium may be related to low vitamin D status, suggesting increased magnesium supplementation might be necessary.

Partially SupportedLow eosinophils are desirable to avoid missing a potential gastrointestinal parasite.

Partially SupportedGamma-glutamyl transferase (GGT) is involved in the formation of glutathione, an endogenous antioxidant that neutralizes free radicals.

Partially SupportedNeutrophils are part of the innate immune system and respond to bacterial infections, while lymphocytes generally respond to viral infections.

Partially SupportedAncestral or ketogenic diets are unlikely to cause significant derangements in kidney function, liver function, or thyroid function and may lead to feeling better.

Partially SupportedElevated GGT can be caused by gallbladder or liver processes and can be investigated using AST, ALT, and alkaline phosphatase.

Partially SupportedIf fasting glucose is high on a ketogenic or carnivore diet, consider fat-to-protein ratios and monitor glucose throughout the day.

Partially SupportedContinuous glucose monitoring can help identify foods that trigger illogical glucose responses.

Partially SupportedPostprandial glucose excursions may damage the glycocalyx, making stable blood sugar important.

Partially SupportedFasting glucose levels in the 80s are considered ideal, with levels above 90 prompting consideration of high protein intake or other factors.

Partially SupportedHemoglobin A1c (HbA1c) should ideally be below 5.5%.

Partially SupportedElevated leptin levels may indicate leptin resistance, which is associated with inflammation.

Not SupportedProvoked urine heavy metal testing is not recommended without expert guidance due to a lack of reference ranges.

Partially SupportedSardines and animal meats are good sources of selenium.

Partially SupportedAnemia of chronic disease can present with a normal MCV.

Partially SupportedThe best way to measure vitamin D is via 25-hydroxyvitamin D.

Partially SupportedHigh levels of lead in drinking water indicate a need to investigate the source.

Partially SupportedA breath test can be used to diagnose small intestinal bacterial overgrowth (SIBO).

Partially SupportedThe presence of both small and large red blood cells suggests an abnormality in the blood.

Partially SupportedOrganic acid testing can provide insights into vitamin and mineral metabolism.

Partially SupportedThe platelet count is a measure of clotting ability and should typically be normal.

Partially SupportedA slightly low white blood cell count with a normal differential may indicate a calm immune system.

Partially SupportedNathan's vitamin D level is 27 ng/mL, which is below the reference range.

Partially SupportedFasting glucose can be an early indicator of diabetes and may rise under stress or with a high-protein diet.

Partially SupportedCystatin C is a blood marker that can be used to assess kidney function, especially in individuals with high muscle mass or high protein intake.

Partially SupportedElevated AST and ALT may be seen in individuals consuming very high amounts of protein.

Partially SupportedThe AST to ALT ratio can differentiate causes of liver enzyme elevation, with alcohol tending to raise AST relative to ALT.

Partially SupportedFructosamine measures average blood glucose over a two to three week period, reflecting a shorter time horizon than A1c.

Partially SupportedConsuming a high-meat diet does not typically cause iron stores to become excessively high due to homeostatic regulation mechanisms.

Partially SupportedVitamin D should be included on a list of essential micronutrients for everyone.

Partially SupportedWhole genome sequencing generally lacks significant clinical relevance for most individuals unless they have undiagnosed rare conditions.

Partially SupportedConsuming excessive protein may overwhelm the liver's urea cycle capacity, potentially leading to elevated ALT levels.

Partially SupportedWilson's disease is a genetic condition characterized by copper toxicity and accumulation, not caused by high dietary copper intake from sources like liver.

Partially SupportedCertain blood markers, including thyroid hormones and cholesterol, may change in a ketogenic state without necessarily indicating a negative health outcome.

Partially SupportedT4 is a precursor to T3, and stress or fasting can convert T4 to inactive reverse T3, slowing metabolism.

Partially SupportedLead levels below 2 micrograms per deciliter are desirable.

Partially Supported23andMe can identify specific genetic variants like APOE4 or hemochromatosis carrier status.

Partially SupportedElevated alkaline phosphatase due to bone pathology is degraded by heat, while liver-derived alkaline phosphatase is not.

Partially SupportedElevated alkaline phosphatase (ALP) warrants medical evaluation as it can indicate issues with bile flow or liver function.

Partially SupportedA white blood cell count that is outside the normal range indicates that homeostasis is disrupted.