We all know intuitively that not all 60 year olds, picking a number I am fast approaching, look the same age. Some have a strikingly youthful appearance and others appear a few decades older. There is even software that analyzes facial appearance and provides a biological age that is being tested against other measures like telomere length and artery calcification.
The idea that certain blood and urine tests may be able to predict health and longevity is not new and has been popularized by Russell Jaffe, MD, Ph.D, one of the brightest and most entertaining of researchers in the field. Want to upgrade your next visit to a healthcare provider by bringing a “longevity list” of labs to perform? Some are general enough for all to consider and a few are more appropriate for heart patients.
1) HemoglobinA1c (Hgb A1c). This widely available blood test measures the degree that hemoglobin, the oxygen carrying protein in red blood cells, is sugar coated. When our blood sugar rises excessively from refined sugars, added fats, processed foods, or the failure of the pancreas to make insulin (type 1 and late stage type 2 diabetes), the Hgb A1c rises slowly. This test reflects an average over 2–3 months how our glucose control has been, the higher the number, the worse the control. The ideal goal for predicting long term health is <5%, a tough measure to reach in a world overloaded with excess calories. The test can return to normal over time with changes in diet, exercise, weight, sleep and supplemental and prescription agents.
2) High sensitivity C-reactive protein (hsCRP). Many things can drive our immune system into overtime releasing chemicals into the bloodstream that defend our health but can reflect an imbalance by their presence. The hsCRP is one of those and is particularly useful at identifying inflammation of blood vessels. An elevated hsCRP should lead to an evaluation of diet, food allergies, dental health, skin health such as psoriasis, sleep disorders, inflammatory bowel disorders, nutritional deficiencies like omega 3, and toxic burdens. Changes in lifestyle, particularly diet, weight loss, periodontal treatments, and other measures can return this test to normal and lower risk. The role of lowering the hsCRP in reducing death and other heart events was shown recently in the multinational CANTOS study. The optimal level of hsCRP is <0.5 mg/L.
3) Homocysteine (HC). HC is a chemical produced during cell metabolism throughout the body. The levels of HC in the blood are determined in part by diet and in part by genetics. Diets high in animal products (particularly the amino acid methionine) raise HC. Diets deficient in B vitamins raise HC. Finally, inheriting a variation of a gene called MTHFR 677 from one or both parents can raise HC. The optimal level of HC for predicting health is <6 umol/L. High levels of HC are associated with heart disease, cancer, and Alzheimer’s dementia. Levels can return to normal by avoiding animal foods and adding in B-complex supplements.
4) Vitamin D. Vitamin D may be better classified as a prohormone than a vitamin but its importance in bone, neurological, immune and cardiovascular health is certain. A role in prevention of diabetes, multiple sclerosis, high blood pressure has been studied. What is certain is that deficiency measured as blood levels is common. The optimal level for health is most predictive at 50–80 ng/ml and usually requires supplementation to achieve.
5) Omega-3 levels. While you may be familiar with measuring levels of vitamin B12 and D, odds are you are not aware that your blood levels, or red blood cell levels, of omega 3 fatty acids (EPA and DHA) can be measured in many labs. Studies indicate both the widespread dietary deficiency of omega 3 and the relationship of low levels to increased mortality. An optimal level for health is over 8% and may require regular use of ground flax, chia and hemp seeds or oils, walnuts, greens, and if desired, fatty fish or fish oils. Many brands are now available of algae based omega 3 supplements which is what I recommend in my clinic.
6). D-Dimer (DD). Brand new data has identified a blood test called the DD as a predictive biomarker in patients with blocked heart arteries and prior heart attacks. The DD is a product produced when clots are forming and being broken down. In an analysis of over 7,800 heart patients, the highest level of DD predicted future blood clots as well as all causes of death, heart deaths, and cancer deaths. While it may not be ready for all readers, a blood DD level at the lowest range of normal would be reassuring if you are a heart patient.
7). Beta-natriuretic peptide (BNP). BNP is a hormone released from the heart when stretched abnormally by elevated blood pressure, heart enlargement or heart failure. Its use as a predictive biomarker for survival has been verified and it is a widely available blood test. Less clear is what can be done if it is found to be elevated beyond maintaining good health and blood pressure levels. There is no specific supplement or drug that reverses BNP levels.
8) Gamma-glutamyl transferase (GGT). GGT is a liver enzyme that is easily measured. I became interested in this lab test when my life insurance company repeatedly asked for it to be run. When I asked why the answer was “it matters for lifespan”. Strong words. Indeed, an elevated GGT (sometimes called GGTP) may indicate an overwhelmed anti-oxidant system unable to make enough glutathione to detoxify the body leading to illness. Elevated levels of GGT have been related to the risk of developing heart disease, the risk of dying of heart disease, and the risk of cancer, in additon to hypertension, metabolic syndrome, diabetes, and dementia. When elevated, focusing on overall health and supporting production of healthy levels of glutathione by supplements and lifestyle is warranted.
The list could continue on to knowing your levels of lipoprotein a (lp a), LDL particle number or apoB cholesterol, and other biomarkers but these 8 tests can arm you to have a more meaningful health evaluation. It may take some work to find a practitioner that offers these tests but they are available from the largest national lab chains. By focusing on optimal nutrition, fitness, sleep, and stress management, along with monitoring tests such as these, you should be able to stay young at heart and glow brightly inside and out.