Lab Values That Matter For Athletes (and why doctors shouldn't do nutrition) Ep 148

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All right, welcome back to the Find Your Edge podcast.
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I am your host, Coach Chris Newport.
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And today's topic is a fun, nerdy one, special lab values of interest, in particular for athletes and endurance athletes, of course, because you know you're our people.
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And I want to back up a little bit because when I first started practicing and I would have folks come in for nutrition consults, I would be giving them a list, like writing them out a little, like here are the things that I want you to go to your doctor and ask them, pretty please, to order because dietitians are in a little bit of a special bucket.
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We cannot order labs.
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We have found a little bit of a loophole to that.
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So now we're able to get them without necessarily having to go through your doctor because sometimes, in defense of doctors, sometimes they can't order something specific because they don't have an appropriate diagnosis code.
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And they can't just be like, well, yes, wouldn't it be sure, wouldn't it be nice to know some of these things, but we can't get it through your insurance company.
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They're probably not going to pay for it.
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And why are we doing this anyway without a more specific diagnosis code?
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Right.
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So there's that whole thing.
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And then now we're getting into this age of direct-to-consumer labs where you go through a particular company.
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I won't necessarily name any of them, but there's several of them on the market where you're just like, okay, you know, let's get all these biometrics, but you don't necessarily know, nor should you know what they mean.
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And then if there's anything that's out of the ordinary, people generally freak out and they're like, this one number is off.
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And then what does this mean?
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Oh my gosh.
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And then they're not able to, because why should they?
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They're not a healthcare provider.
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They're not able to zoom out and take into account a more holistic view rather than just picking and parting one number that might be out of normal limits.
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When in my mind, I'm trying to work in more functional limits because you guys are high performers.
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Generally, most of you are healthy.
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There are other things that are obviously going on.
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Some we we work with a lot of celiac disease.
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We work with a lot of Hashimoto's and graves and hypothyroidism and high cholesterol, whether it be genetic or not, or whatever.
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Every once in a while we've got some hypertension, uh, we've got fertility, we've got perimenopause, menopause, like all of those things depend on where you are in your life stage.
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What are your goals for your sport?
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And then what are the things that we want to hone in on that are also related to your genetics?
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So we've got all these different pieces.
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So I think of labs as what are the metrics that we should be tracking on a regular basis?
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And then what are maybe some of the metrics that are more specific to you and what you're trying to achieve.
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So, all of that to say is that these special labs are special.
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You're special.
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So having said that, Emily Q is here.
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She is my dietary intern, and she uh did some really great homework because, of course, she's been hearing it from me and been hearing it in our longevity lab program that we have of all the different labs that we have access to that we can get for people and start to look at trends and then have someone with you have a healthcare provider who is with you interpreting these and then helping you either get follow-up care or adjust accordingly from a diet, lifestyle, or supplement perspective.
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So, anyway, Emily, thanks for coming.
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Of course, I'm happy to be here.
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I think I've had too much coffee.
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So, for those of you guys who are listening right now, we're doing a couple of back-to-back episodes.
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And I I was on a bit of a rant in the last episode.
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So here we are.
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Welcome all the rants.
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I I I love the high-energy stuff.
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Okay, cool.
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All right, so let's get into it.
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What are the these are like some standard labs that you would see just and these are like, you guys, these are like dirt cheap.
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And when I say dirt cheap, I mean like really dirt cheap.
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Anyway, talk us through these, Emily.
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I will, I promise I wouldn't grab.
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No, say something if you got something to say.
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But first of all, just wanted to go through the like kind of more standard lab panels.
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You probably, if you go to your PCP like every year or something like that, they'll probably run these just to make they're just like really basic labs for screening for really common conditions like you know, cardiovascular disease, diabetes, anemia.
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So they just want to make sure everything's good on all those ends.
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They're probably gonna have um a complete blood count or a CBC.
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This is measuring um your red blood cells, white blood cells, hemoglobin, hematocrit, and platelets.
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This is like a screening for anemia mainly.
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You also you're also gonna have some sort of metabolic panel, either a basic, a BMP, or a comprehensive, a CMP.
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That will probably get you your fasting glucose, serum calcium, electrolytes, like sodium and potassium and all that stuff, BUN and creatinine, which are measures of kidney function.
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You're and then the CMP will add on liver enzymes, bilirubin for just overall liver function, and then also total protein and albumin.
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Yes.
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Love that.
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So cool.
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And then what else, generally speaking, are you gonna do at like a physical?
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You get CBC, you get a CMP or a BMP, and then what else?
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You'll probably see the lipid panel.
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This will tell you your uh total triglycerides in your blood, your total cholesterol, as well as the subcategories of cholesterol.
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You've probably heard of the LDL, which is the quote unquote bad cholesterol, and then the HDL, which is the, I guess they call it the good cholesterol.
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So you'll see all those.
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Something that's getting more common now is hemoglobin A1C.
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That's going to measure your overall uh blood glucose for the last like two to three-ish months.
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It's a good indicator of prediabetes or diabetes if it's in certain ranges.
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And then sometimes an iron panel, if they're if you like ask for one, if they're concerned about anemia.
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For athletes, I feel like the iron panel is important, but they don't always do it.
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Yeah.
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Because usually it's you're not gonna get triggered with an iron panel unless you complain about some sort of excess fatigue.
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Sorry, you guys, you're athletes.
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At some point you're gonna get tired.
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Like it's like it's just part of the equation, but oftentimes that's not gonna be triggered unless your hemoglobin or hermatocrit are low.
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And that's not an automatic thing that means your ferritin is low or your iron panel is off.
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So I always encourage folks to try to get that one tested.
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Um, and we have seen a couple of people who have done our genetic testing do have the hemochromatosis gene and did not know it.
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So if they had had their iron panel run, they probably would have been triggered to be like, huh, something is awry.
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Yeah.
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So, okay.
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So that's just kind of like the standard deal.
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Generally speaking, you do usually have to ask for an A1C, you do usually have to ask for an iron panel, and then I all I like to add in ferritin to go along with the iron panel.
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Um for sure.
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Yeah.
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So, but CBCs and CMPs are like does get run all the time.
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And they're again, like I said, dirt cheap.
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Okay.
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Ooh, this is a good one.
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So yay! We've got some relational workers of heart health.
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So tell us apolipoprotein B.
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Yeah.
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So now we're gonna try to get into some of the ones that are like less known or understood, or just kind of if a lot of your your normal labs are fine, but you still have concerns, these are some that you can measure to just check on things.
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So apolipoprotein B, or apoplee for short, this is a protein that's found on the surface of LDL and VLDL cholesterol, which as we uh said earlier is kind of like the quote unquote bad cholesterol that we we want to reduce.
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Yes.
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And more specifically, because everybody thinks of all LDLs being bad, they're not all bad.
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They're not all bad.
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Right.
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But the VLDLs are bad.
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Some LDLs are like, I like to describe them as like big dopey cotton balls that just like, you know, float around in your blood and they're just kind of, you know, whatever.
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They're not necessarily hurting anything.
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But the VLDLs are like really very low density blood proteins.
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So they're very, they're like BB guns.
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And those are the ones that go through your system and pick off those plaques that are no bueno.
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So go ahead.
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So you might be wondering, like, okay, why is this different than like the standard lipid panel and what they measure there?
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So the standard lipid panel, when they measure your LDL, they're measuring like the weight, or I guess you could say the concentration of LDL in the blood in total.
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While the APOB test is really going to measure how many particles you have, how many LEL particles you have, which can be it can be different because you could have an like an average or normal concentration of LDL in the blood, but somebody who has a lot more of like the cotton ball-y type LDL.
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Big dopey was saying, yes, the big dopey ones, it's gonna be a very different cardiovascular risk than somebody who has a lot of smaller, denser particles.
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And like they're gonna, and the APOB test will show the difference between those.
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They could the because each molecule only has one APOB.
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So the APOB will give you an accurate count of how many particles you have, as opposed to just how much space it takes up in your blood.
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Yeah.
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Cool.
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And then yeah, I like how you really emphasized here the higher sensitivity and the specificity.
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APOB proving to have higher sensitivity and specificity than LDL cholesterol alone, right?
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Because so many people are like, oh, your LDL is high.
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Let's put you on a stat.
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And it's like, no, no, no, let's get more information.
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So better marker of predicting cardiovascular risk, right?
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Exactly.
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Yeah.
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It's usually more recommended to get an APOB test if you have either high triglycerides, if you have metabolic syndrome, type 2 diabetes, or a family history of cardiovascular disease.
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Because you could be showing higher LDL because of like a genetic thing, but maybe like you're not actually like super at risk for cardiovascular events based on your APOB test.
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You never know.
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And of course, you know, we're all nerds here, and uh, we test this because we can in our longevity lab, because we just want a bigger picture uh because that's why people come to us, right?
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They oftentimes your standard healthcare provider is like, they don't get the fact that I'm doing Iron Man or I'm riding my bike for multiple hours a day, or you know, even if you're not, even if you're doing sprint triathlons, they're like, wait, what?
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You know, well, let's just put you on a stat and you're like, but I you know, and then they're like, be sure to exercise.
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And you're like, oh my God, do you know what I like?
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Do you know how much I exercise?
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Like, this is it's like, no, I've got that covered.
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Yeah, I've got that heart covered.
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Can you not send me this like really lame note in the portal that's like, be sure to exercise and eat your vegetables?
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You're like, you got, I mean, come on, you guys.
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So uh, and that sounded really rude to all physicians out there.
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I'm so so I'm not it's our medical system is created more for is more of a sick model.
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It's more for treating disease.
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So why can't we know what this number is on a more regular basis?
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So in our longevity lab, we test this annually because we can.
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Like, why not have the markers to be proactive about our health rather than, oh, now I see your LDL is high.
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Let's go ahead and do all the other numbers when I could have been done doing something about this two years ago, three years ago, 10 years ago, before I even had to know any of this stuff.
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Like preventative rather than reactive.
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Yes, 100%.
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Yes.
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Okay, what else do we want to know about?
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Let's get into this guy.
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Okay, another really good one is magnesium, which I feel like has been getting more hype recently.
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It's so important.
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Magnesium is required by every organ in the body.
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It's in over 300 biochemical reactions.
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That's bananas, if you think about it.
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Isn't it?
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Yeah.
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Yeah.
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Keep going.
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I love this in the body.
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It's so awesome.
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It's involved in so many different processes, like the just to name a few protein synthesis, muscle and nerve function, blood glucose control, energy production, all such important like big things.
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And we know that magnesium deficiency is super common.
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And a lot of people suffer maybe some symptoms that they don't know that it's because of their magnesium.
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It's also kind of uh fickle to measure.
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So a lot of the times, if you want your magnesium measured, they'll uh the lab that will be done is a serum magnesium test uh that'll measure the level of magnesium in your blood, but uh it's not always like super accurate because most of your magnesium is actually in your cells.
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So um you would really rather get a test that measures the magnesium content in your red blood cells, but that can be more expensive sometimes.
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Yes.
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Yeah, that's uh for anybody in our longevity lab, that's what we test.
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Because again, we want a better reflection of what's actually going on.
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And of course, working with athletes, um, I'm sorry, has anybody not cramped before?
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Or had some sort of muscle issue or fatigue or things like that, you know, and we're losing it in sweat.
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We're losing magnesium in sweat, and it's not something that's necessarily well stored.
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We have to get it from food, which I love that you have foods high in magnesium.
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So for those people who are listening and not watching, you gotta name them off, Emily, because yeah, this is so I will for sure.
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You've got uh pumpkin seeds, black beans, quinoa, flax seeds, Brazil nuts, edamame, cheese seeds, you're probably seeing a pattern here.
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It's a lot of nuts and beans and seeds.
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I do want to mention on that list is also dark chocolate.
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So for those out there who like dark chocolate, like not first.
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Yeah.
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But it for a lot of people, it is hard to get a lot of these foods in like super regularly.
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So you know, leafy greens.
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I know they're not specifically on that list, but yeah.
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But yeah, leafy greens for sure.
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Yeah, it can be a harder sell.
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I get it.
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And some people just, you know, listen, if you have preferences, you have preferences.
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Like, no, it's okay.
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I I remember just being like it's so annoyed when I first started practicing, like, eat your leafy greens, you guys.
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And then I'm like, you know what?
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Whatever.
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We all have different palettes, let's work around it.
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Like, it's like if you're being a brat about it, it's one thing.
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But if you just can't have it, it's another thing.
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So anyway, I think you have one more point on magnesium and then yeah.
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Just because magnesium is so crucial in all these important processes, if you chronically have low magnesium, it can just put you at risk for abnormal heart rhythms and increase your long-term risk of type 2 diabetes and osteoporosis, which no one wants.
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So if you notice that like you don't really eat much of these foods, you might want to get your magnesium checked out and just just be sure you're on the right track.
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We've had folks who are are in this situation and they go through full cardiac workups, which is not bad, not a bad thing.
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Listen, I'm I'm so here for it.
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But then they're finding, like, oh, I just needed some magnesium.
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And then I'm I'm good.
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But again, I'll I'm all for the workout for sure.
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Okay, what's our what's our next uh lab marker?
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All right, vitamin B12, also a very important nutrient that's involved in a ton of processes.
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Making your red blood cells, which take your oxygen around your body, making nerves, making DNA and energy, even more than that.
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We know that B12 deficiency is common in older adults and vegetarians and vegans because uh B12 is only found naturally in animal sources of foods.
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Anyone who's not looking at the slide right now, I've got some pictures of like chicken and cheese and meat and eggs and dairy and all that stuff.
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Yep, for sure.
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And this is dependent on, I know that you mentioned here like an underlying GI issue.
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We talked about this in the bone health podcast too, that in order to adequately absorb B12, you need something called intrinsic factor, which is starts at the initial part of digestion in the stomach.
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And if you're on proton pump inhibitors, if you're taking lots of antacids, you could have a B12 deficiency, which of course is really important when you are trying to push your body to the limits and doing all these athletic endeavors.
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So, you know, we want to make sure that we're doing good things here.
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Also, there are genetic links to vitamin B12 and making sure that you know those, first of all, so that you can optimize and track more effectively.
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MMA, did you talk about MMA and not the sport?
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Not yet.
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Yeah, let's let's talk about it.
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So uh kind of like with the whole like magnesium thing, sometimes just measuring like your serum B12 is not going to be the most accurate picture of your B12 status.
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There's a compound called methylmalonic acid or MMA, uh, because that's kind of a mouthful.
00:19:39.069 --> 00:19:47.789
It's um a metab a metabolite that requires B12 to convert back into usable energy for the body.
00:19:48.029 --> 00:20:00.349
And so if you uh it can better measure your B12 status because it accumulates faster than um the deficiency in B12 like shows up.
00:20:00.750 --> 00:20:20.029
So basically, if you measure your MMA through your it's uh either the blood or urine test, and you see that it's elevated, even though your B12 levels are normal, that can be an indicator that there's not as much B12 as you need to convert all that MMA back to energy if you see it accumulating.
00:20:20.670 --> 00:20:22.190
Yeah, interesting, cool.
00:20:22.349 --> 00:20:25.389
And again, no shocker, folks, this is in our longevity lab.
00:20:25.470 --> 00:20:32.909
And again, we're here to help you translate all this to what does that mean to the food that you need to be eating, supplement strategy in the exercise plan.
00:20:33.230 --> 00:20:33.470
Right.
00:20:33.629 --> 00:20:42.269
Especially if you fall into one of the camps of being like an old older adults or vegetarians and vegans, you might want to consider supplementing.
00:20:42.430 --> 00:20:48.990
Yes, and again, nothing wrong with you or if you're if you're a vegetarian or vegan, like it's fine, it's all good.
00:20:49.149 --> 00:20:50.269
We can work around that.
00:20:50.430 --> 00:20:52.829
But you know, know your genetics and know your numbers.
00:20:53.149 --> 00:20:53.869
There you go.
00:20:54.109 --> 00:20:54.829
Okay, cool.
00:20:54.990 --> 00:21:00.750
Ooh, and on the line of um B12, homocysteine.
00:21:01.149 --> 00:21:02.269
Homocysteine.
00:21:02.509 --> 00:21:02.829
Yes.
00:21:03.069 --> 00:21:06.109
Yes, it's very closely related to B12.
00:21:06.670 --> 00:21:14.430
So um we we know that homocysteine is a natural byproduct of metabolizing methionine.
00:21:14.509 --> 00:21:16.029
You might have heard of methionine before.
00:21:16.109 --> 00:21:22.990
It's an essential amino acid that or EAAs is we all like to, you know, uh abbreviate everything.
00:21:23.470 --> 00:21:24.909
I get I get my EAAs.
00:21:25.069 --> 00:21:26.190
I'm like, okay, good.
00:21:26.349 --> 00:21:27.549
All right, cool.
00:21:28.109 --> 00:21:28.349
Yeah.
00:21:28.670 --> 00:21:29.869
Methionine is a little bit.
00:21:30.829 --> 00:21:35.149
Yeah, you'll just get that in like regular protein and your body will like break it down.
00:21:35.389 --> 00:21:42.430
So when your body processes methionine, homocysteine is just kind of it's a product of that process.
00:21:42.670 --> 00:21:55.950
And we know that B12 plays a huge role in converting homocysteine back into methionine, and B6 kind of helps convert it to a different amino acid called cysteine.
00:21:56.109 --> 00:22:01.710
So a lot of B vitamins are working to convert homocysteine into other things.
00:22:01.869 --> 00:22:13.389
So if you're deficient in any in the specific B vitamins that play a role, B6, folate, or B12, if you're deficient in any of those, that process is a lot less efficient.
00:22:13.549 --> 00:22:18.430
And so you'll see an elevated level of homocysteine in your blood.
00:22:18.670 --> 00:22:19.069
All right.
00:22:19.230 --> 00:22:20.909
So, did we go over all of those things?
00:22:21.069 --> 00:22:22.589
Some cardiovascular outcomes.
00:22:22.750 --> 00:22:25.869
Also, I love this picture that you have if you guys are watching on YouTube.
00:22:26.269 --> 00:22:28.909
It's bringing me back to my biochem days.
00:22:29.230 --> 00:22:30.430
Biochem, yep.
00:22:30.670 --> 00:22:32.909
All the diagrams, all the processes.
00:22:33.230 --> 00:22:34.589
All the processes, yep.
00:22:34.750 --> 00:22:42.670
So I do like, I do want to point out in that process off to the left, because so many of us are getting things that are fortified.
00:22:42.750 --> 00:22:55.549
Anything that's fortified, which again, not necessarily anything wrong with it, but when you see folic acid needs to be converted to five methyl tetrahydrofoliate and goes through that whole process.
00:22:56.269 --> 00:23:10.670
Of supporting B12 and all this entire breakdown, some of us just don't convert very well the synthetic version of folic acid to the methylated version of folate.
00:23:11.549 --> 00:23:13.869
So, anyway, side note on that.
00:23:13.950 --> 00:23:22.190
And same thing with methylated B12 versus the synthetic version, which is often cyanocobalamin.
00:23:22.269 --> 00:23:25.470
So if you are taking a multivitamin, look at the label.
00:23:25.629 --> 00:23:32.430
If you bought it off of the grocery store shelves and it says cyanocobalamin, that is attached to a molecule of cyanide.
00:23:32.509 --> 00:23:33.629
Nobody needs that.
00:23:33.950 --> 00:23:39.789
So get on a better quality vitamin, talk to your local dietitian, reach out to us.
00:23:39.869 --> 00:23:41.789
We're happy to help you with that whole process.
00:23:41.869 --> 00:23:52.349
But you know, I'm on a mission to get people on better quality vitamins and whole foods so that they can do this little diagram all by their lonesome selves.
00:23:54.430 --> 00:23:55.629
Yeah, like do it efficiently.
00:23:55.710 --> 00:23:57.710
Do it if I'm all I'm all for efficiency.
00:23:57.869 --> 00:24:00.589
Anyway, what else do you want to say about homocysteine?
00:24:00.990 --> 00:24:01.309
Yeah.
00:24:01.470 --> 00:24:18.430
So in addition to all those like vitamin deficiencies that elevated homocysteine can catch, we also don't want to see elevated homocysteine because if those levels remain high in your blood, it can contribute to the development of blood clots, artery lining damage.
00:24:18.589 --> 00:24:26.750
And if you like already have developing atherosclerosis, it can make that worse and eventually lead to negative cardiovascular outcomes.
00:24:26.909 --> 00:24:42.349
High homocysteine levels have also in the literature that it's been associated with other chronic diseases and conditions like I don't know, like a lot of neurological ones, like Parkinson's, Alzheimer's, other types of dementia, that kind of thing.
00:24:42.509 --> 00:24:49.149
So if if you have concerns, family histories of any of that, you might want to get your homelysteine checked out.
00:24:49.389 --> 00:24:49.629
Yeah.
00:24:49.789 --> 00:24:50.909
Again, shameless plug.
00:24:51.069 --> 00:24:56.190
Emily did this without I mean, she knows about the longevity label.
00:24:56.829 --> 00:25:02.349
But um, this is why we test this in our longevity lab, is for that exact reason.
00:25:02.509 --> 00:25:05.950
And I didn't know that about Parkinson's Alzheimer's and dementia.
00:25:06.109 --> 00:25:15.869
But when you s when you think through the biochemical process, yeah, why wouldn't that have something to do with not only cardiovascular risk, but also brain health?
00:25:16.190 --> 00:25:18.509
Or neurological, neurological health.
00:25:18.670 --> 00:25:18.829
Yeah.
00:25:19.069 --> 00:25:19.230
Right.
00:25:19.629 --> 00:25:22.190
Yeah, oh fascinating.
00:25:22.349 --> 00:25:22.829
So good.
00:25:23.069 --> 00:25:23.389
Okay.
00:25:23.629 --> 00:25:24.589
More nutrients.
00:25:24.829 --> 00:25:25.389
More nutrients.
00:25:25.710 --> 00:25:26.269
More nutrients.
00:25:26.509 --> 00:25:26.670
Okay.
00:25:26.909 --> 00:25:27.309
Yes.
00:25:27.710 --> 00:25:29.629
I would say definitely check out, yes.
00:25:30.509 --> 00:25:37.789
Check out our last podcast episode on bone health because we we talk a lot about vitamin D there and calcium.
00:25:38.109 --> 00:25:48.990
But just looking at vitamin D right now, we know that it's extremely common to be deficient in vitamin D, about a third of US adults, maybe even a little more.
00:25:49.309 --> 00:26:01.470
Uh most commonly, if you go get a vitamin D test, they're going to measure the 25 hydroxyvitamin D form, which is the primary form that circulates in your blood.
00:26:01.710 --> 00:26:09.389
And they will measure that as opposed to like the active vitamin D in your body because it just has a longer half-life.
00:26:09.549 --> 00:26:12.430
So a little bit of nerding out right there.
00:26:12.670 --> 00:26:12.829
Yeah.
00:26:12.990 --> 00:26:13.309
Love it.
00:26:13.869 --> 00:26:14.109
Yeah.
00:26:14.269 --> 00:26:22.349
There's uh, as we we talked about this a little more in the last episode, but there aren't too many foods that naturally contain vitamin D.
00:26:22.829 --> 00:26:29.950
Um, it includes like fatty fish, beef liver, egg yolks, maybe a little bit in mushrooms.
00:26:30.190 --> 00:26:45.149
But if you struggle to get any of those foods in or don't live in an area where there's a ton of direct sunlight, or just don't go outside much to get that like natural vitamin D, you might want to look towards uh fortified foods and supplementation.
00:26:45.309 --> 00:26:51.710
And a lot of you might have seen a lot of milk and milk alternatives are fortified with vitamin D.
00:26:51.789 --> 00:26:56.029
There's also yogurt and breakfast cereal and orange juice for some reason.
00:26:56.190 --> 00:26:58.349
Those are all fortified with vitamin D as well.
00:26:58.509 --> 00:26:59.149
Yeah, for sure.
00:26:59.389 --> 00:27:02.670
Usually most people, when they come to me, they're like, yeah, I take vitamin D.
00:27:02.750 --> 00:27:04.509
And I'm like, okay, well, what's the brand and how much?
00:27:04.589 --> 00:27:05.710
And then they're like, I don't know.
00:27:05.869 --> 00:27:14.269
Like, you know, this is it's I would relate it to being like, I have a pair of running shoes, and then I'm like, well, what brand are they and what size are they?
00:27:14.349 --> 00:27:15.710
And you're like, I don't know.
00:27:15.950 --> 00:27:19.789
I just bought, you know, like I just I was I just bought it off the shelf.
00:27:19.950 --> 00:27:21.069
Like, does it matter?
00:27:21.309 --> 00:27:22.589
Yes, it matters.
00:27:22.829 --> 00:27:24.589
Yes, it does matter very much so.
00:27:24.750 --> 00:27:26.990
So I think we're, I don't know.
00:27:27.069 --> 00:27:32.829
I just there's so many general recommendations, and I'm just not into general recommendations anymore.
00:27:32.909 --> 00:27:47.069
But you know, if you're at least getting like 400 IU, I think that they just boosted it to maybe 800 IU a day as like the general recommendations, but I just get so much more into precision nutrition than general recommendations.
00:27:47.549 --> 00:27:47.869
Right.
00:27:48.109 --> 00:27:55.710
Because like you mentioned earlier, like some people don't convert no vitamin D from the sun into the active form as well.
00:27:56.349 --> 00:27:59.629
800 800 IU is gonna do them a hot bit of nothing.
00:28:00.109 --> 00:28:07.789
Yeah, I mean, seriously, like their vitamin D is just gonna be in the tank, and then we're gonna be like, I'm scratching our head, like, why didn't 800 IU work?
00:28:07.950 --> 00:28:11.230
And most folks are like, oh, your vitamin D needs a little boost.
00:28:11.389 --> 00:28:13.869
Go take a thousand IU a day or two thousand IU a day.
00:28:13.950 --> 00:28:15.789
And sometimes you need more than that.
00:28:15.950 --> 00:28:22.109
And sometimes you also need like a quick boost, and then we can go to a maintenance dose.
00:28:22.349 --> 00:28:26.589
Uh so again, know your metrics and know your brands, know your amounts.
00:28:26.750 --> 00:28:30.109
But if you don't care to know your brands and amounts, that's what we help with.
00:28:30.589 --> 00:28:39.069
We just tell you what to do, tell you what to take, and then it's up to you to and then try to work with you from a perspective of uh executing it.
00:28:39.470 --> 00:28:42.349
You know, because some people are like, I just I don't take pills very well.
00:28:42.430 --> 00:28:43.149
There are drops.
00:28:43.389 --> 00:28:47.069
There are like, listen, we have ways around these things.
00:28:47.470 --> 00:28:47.629
Right.
00:28:47.869 --> 00:28:51.309
We will make it as easy as possible so that you can be compliant.
00:28:51.389 --> 00:28:53.950
Because if you are not compliant, what's the point?
00:28:54.430 --> 00:28:56.109
Anyway, that was the end of my rant.
00:28:56.269 --> 00:28:56.750
Let's do that.
00:28:57.869 --> 00:28:59.389
Now we have calcium.
00:28:59.710 --> 00:29:00.109
Yes.
00:29:00.269 --> 00:29:06.430
Anyways, we we need the vitamin D and the calcium to ensure our bone health, among other things.
00:29:06.670 --> 00:29:14.269
So I think I mentioned earlier that in the C the the BMP or the CMP like basic labs, they usually measure the serum calcium.
00:29:14.430 --> 00:29:14.670
Yes.
00:29:14.990 --> 00:29:26.990
But usually if you're deficient, if you're not eating enough calcium, if that doesn't really show up in your blood level, because your your body really tightly regulates your blood level of calcium.
00:29:27.230 --> 00:29:42.190
And the bad part is that if that ever drops and you're not eating enough calcium, your body's gonna take calcium from your bones, it's gonna break down some bone and release the calcium from there in order to maintain the blood levels.
00:29:42.990 --> 00:29:49.069
So your bone if you're not eating enough calcium, your bones might be slightly degrading and you don't even know.
00:29:49.470 --> 00:29:49.710
Yeah.
00:29:50.589 --> 00:29:51.389
That's the danger.
00:29:52.109 --> 00:30:00.029
So if you want to have a better grasp of what your calcium status actually is, you're gonna want to go get a DEXA scan.
00:30:01.950 --> 00:30:02.349
Yep.
00:30:02.670 --> 00:30:04.190
Emily, I was like holding my tongue.
00:30:04.269 --> 00:30:06.750
I was like, she's gonna say it in my favorite thing.
00:30:07.309 --> 00:30:09.789
And I did a DEXA scan.
00:30:10.190 --> 00:30:11.470
It's it's really, really good.
00:30:11.629 --> 00:30:15.149
It it really tells you um a lot of things, really.
00:30:15.309 --> 00:30:25.549
Your bone mineral density to see if you're eating enough calcium, but then also body composition things, uh, your fat and muscle mass, it will tell you that too.
00:30:25.710 --> 00:30:25.950
Yeah.
00:30:26.190 --> 00:30:27.470
I have seen, I've seen both.
00:30:27.549 --> 00:30:30.269
I've seen the one that uh you can pay out of pocket for.
00:30:30.589 --> 00:30:36.589
Of course, it is a medical expense and you can use an HSA FSA card and you can, you know, submit it on your taxes, et cetera, et cetera.
00:30:36.750 --> 00:30:48.349
But there are also, if there is any concern of that and your doctor orders it, you can still get a DEXA scan, but you don't get the, you know, cool pictures of broken down, you just get your actual like bone density.
00:30:48.509 --> 00:31:04.109
You don't get the pictures of your, here's how much lean body mass you have, here's how much body fat you have, you don't get the literal pictures of your body and seeing what that all looks like, but it still will evaluate your bone health, which is good.
00:31:04.430 --> 00:31:06.109
I find it fascinating.
00:31:06.190 --> 00:31:21.549
This is such an interesting marker because depending on your calciums, that doesn't necessarily dictate whether you should be cons like having an additional supplement again, like zooming out and seeing what are you more regularly getting in terms of food sources in order to get that.
00:31:21.789 --> 00:31:26.190
It does, if you are not eating dairy, um, you have to be a little bit more intentional.
00:31:26.509 --> 00:31:30.909
If you're having non-dairy milks, that makes it a little bit easier.
00:31:31.230 --> 00:31:46.430
But if a glass of milk or plant milk is somewhere around 400 milligrams, I mean you're still needing to do that's several glass, that's several glasses a day outside of you know, smaller sources of you know, and we got some broccoli and maybe greens.
00:31:46.589 --> 00:31:53.470
But anyway, I just find that whole calcium process to be so fascinating.
00:31:53.710 --> 00:32:12.430
And your body's acidity is tied into that, and how much protein you're getting, and um, you know, protein and albumin, which are part of your uh CMP2, those are necessary to see what what does that whole process look like rather than oh my calcium is low, therefore I need to supplement.
00:32:12.589 --> 00:32:15.710
That is that is not the way you want to go about that particular lab.
00:32:15.869 --> 00:32:16.670
There's right.
00:32:16.829 --> 00:32:19.950
There's there's a lot a lot that goes into it.
00:32:20.190 --> 00:32:21.149
Yes, for sure.
00:32:21.389 --> 00:32:29.069
So that's why I always recommend if you are gonna do direct-to-consumer labs, you need to have somebody supporting you interpreting this.
00:32:29.149 --> 00:32:37.309
This is literally why one of our main reasons why we created the longevity lab, which again, shameless plug, theendurance edge.com forward slash longevity.
00:32:37.710 --> 00:32:56.190
We go into genetics, we go into specific biomarkers, and then you get the support with interpretation trends so that you can understand your health and your needs, and then work alongside your additional healthcare team for making sure that you're staying on point.
00:32:56.269 --> 00:33:04.269
Cause again, so many different healthcare providers don't understand the demands and necessities of an athlete.
00:33:04.430 --> 00:33:10.349
And they're just like, Well, you're getting your exercise and you're healthy, so have a nice day.
00:33:10.670 --> 00:33:16.349
You're like, but something just seems off, and you know, uh, so you have to advocate for yourself a little bit more.
00:33:16.589 --> 00:33:35.389
Anyway, being able to have this process alongside your sport and your coach and being able to interpret all this so that you can make agile changes in your protocols that you are already implementing and making sure that they are fully directed at you.
00:33:35.549 --> 00:33:38.589
So uh we don't have a slide about longevity, but it doesn't matter.
00:33:38.750 --> 00:33:42.909
So um, you know, endurance edge.com forward slash longevity to learn more about that.
00:33:42.990 --> 00:33:45.629
Any Emily, anything else you want to say about labs?
00:33:46.589 --> 00:33:48.909
Um, I guess I have a little personal story.
00:33:49.309 --> 00:33:50.109
Oh, yes, please.
00:33:50.509 --> 00:33:52.029
Yeah, about the the calcium.
00:33:52.269 --> 00:33:54.990
So I was really, I was really lucky when I was growing up.
00:33:55.069 --> 00:33:57.149
I was maybe like 13 or 14.
00:33:57.230 --> 00:34:00.430
I was just getting like my annual physical for like my school sports or whatever.
00:34:00.589 --> 00:34:02.829
I was a I was a track and cross country girl.
00:34:03.069 --> 00:34:08.590
So my pediatrician was going over, she looked at my labs and they were she was like, okay, they're all normal.
00:34:08.750 --> 00:34:12.269
But then I like that she she asked me questions about like my diet too.
00:34:12.430 --> 00:34:12.829
Oh yeah.
00:34:13.470 --> 00:34:15.869
Just to like get a good picture of what was going on.
00:34:16.030 --> 00:34:21.389
And she kind she asked me, like, do you like, do you, do you eat usually eat any dairy?
00:34:21.470 --> 00:34:33.630
And I was like, no, because as a self-proclaimed picky eater, ever since I was a little kid, I've never liked milk, I've never liked cheese, I've never really liked yogurt very much.
00:34:33.789 --> 00:34:41.550
And she was like, but that and and even though my blood calcium was fine, she looked at me and was just like, you need to be eating more calcium.
00:34:41.950 --> 00:34:46.990
Or or like and and she would she like prescribed me a supplement like right there on the spot.
00:34:47.150 --> 00:34:53.150
Like I don't DEXA wasn't like a huge thing back then, but also she knew I was growing.
00:34:53.309 --> 00:34:54.990
I was I was 13 or 14.
00:34:55.150 --> 00:35:02.190
I was still like in puberty and trying to build like my I was growing like taller, my bones.
00:35:02.750 --> 00:35:05.469
She I think she knew that that just wasn't great for my bone health.
00:35:05.630 --> 00:35:10.670
So she she told me to get a cow to get on a calcium supplement, and I did for a while there.
00:35:11.070 --> 00:35:16.909
So just just love it when we were talking about it last week, and you're like, huh, I probably should be thinking about that again.
00:35:17.070 --> 00:35:21.469
Yeah, I should probably get maybe get maybe I should get back on it because now I do eat more dairy.
00:35:23.869 --> 00:35:25.230
It's so cheap.
00:35:25.309 --> 00:35:25.869
I love it.
00:35:26.029 --> 00:35:26.750
Uh wow.
00:35:26.909 --> 00:35:29.070
This is a like bonus internship, you know?
00:35:29.230 --> 00:35:30.590
Yeah, it's bonus internship, right?
00:35:30.829 --> 00:35:30.909
Yeah.
00:35:31.469 --> 00:35:35.789
You get workouts, you get you get something like that.
00:35:35.949 --> 00:35:36.590
Yeah, totally.
00:35:36.750 --> 00:35:36.909
No.
00:35:37.150 --> 00:35:55.070
I I wish if I had my way, I wish more pediatricians, more orthopedists, more physical therapists, more folks were referring to dietitians when there is any sort of potential abnormality in that respect.
00:35:55.230 --> 00:35:58.429
Like, you know, you're an athlete and you're growing.
00:35:58.509 --> 00:36:00.429
Like, go see a sports dietitian.
00:36:00.750 --> 00:36:00.989
Yeah.
00:36:01.309 --> 00:36:03.469
That's what I should have done, honestly, after that visit.
00:36:03.869 --> 00:36:06.509
Like, you have anemia, go see a sports dietitian.
00:36:06.750 --> 00:36:13.070
Like, physicians see, generally speaking, this has been been my experience, they see 28 patients a day.
00:36:13.309 --> 00:36:17.869
I see on a large load, I see seven at the most.
00:36:18.110 --> 00:36:27.630
And that's like a day when I I want to like cross my eyes and fall apart because we spend an hour, 30 minutes to an hour with folks, and they don't.
00:36:27.710 --> 00:36:29.070
They don't have the luxury of that.
00:36:29.150 --> 00:36:37.230
But that's okay, because then we can get into the nitty-gritty details of this is the supplement you should be on.
00:36:37.469 --> 00:36:40.909
This is these are the foods that you need to be eating.
00:36:41.070 --> 00:36:53.949
And if you don't eat those foods for, you know, because you are gluten-free or because you're lactose intolerant, or because you don't tolerate this protein or have this sensitivity or this allergy or whatever, that's the all the stuff that we do as dietitians.
00:36:54.029 --> 00:36:56.029
So, shameless plug for dietitians.
00:36:56.190 --> 00:37:09.550
I think we're the heroes of the healthcare industry that can spend deeper time working into these details of your health and wellness such that you can generally go to the doctor less.
00:37:09.949 --> 00:37:10.190
Right.
00:37:11.230 --> 00:37:14.989
I mean, that's kind of the and I'm all for physicals.
00:37:15.389 --> 00:37:18.909
I'm all for that and like regular checkups and all that kind of stuff.
00:37:18.989 --> 00:37:21.150
But doctors should not be doing nutrition, period.
00:37:21.469 --> 00:37:22.029
End of story.
00:37:22.110 --> 00:37:22.269
Yeah.
00:37:22.429 --> 00:37:27.309
Like so many people are oh, doctors need to know know more about nutrition.
00:37:27.469 --> 00:37:28.509
Absolutely not.
00:37:28.750 --> 00:37:46.509
I think that that is a horrible idea because we have spent the time going through that process to work as a collaborative team rather than continuing to send them to more education when they need to be practicing medicine and we can practice dietetics and we can do it better together.
00:37:46.829 --> 00:37:47.150
Yes.
00:37:47.389 --> 00:37:52.909
Anyway, I need a like I don't think you don't see people telling doctors to go study physical therapy.
00:37:53.230 --> 00:37:54.750
Like that's because that's not their job.
00:37:54.989 --> 00:37:57.150
No, it's like it's not their job at all.
00:37:57.389 --> 00:37:59.150
And nutrition is not their job.
00:37:59.309 --> 00:38:00.029
It's just not.
00:38:00.269 --> 00:38:06.509
And yeah, it just it pains me a little bit when so many people are like, oh, this this doctor wrote this nutrition book.
00:38:06.590 --> 00:38:09.710
I'm like, where are the dietitians writing the nutrition books?
00:38:10.029 --> 00:38:22.509
So many doctors also will like prescribe you a supplement or something, and then you just don't get any type of follow-up or like continuity of care until like your next yearly physical.
00:38:22.670 --> 00:38:22.829
Yes.
00:38:23.070 --> 00:38:28.110
It's just with the dietitian, you get so much more regular, like, how's that been going?
00:38:28.269 --> 00:38:28.509
Yes.
00:38:28.670 --> 00:38:40.509
Is there any like it is more accountability, more ongoing care, more opportunities to see what motivation is, you know, just working through the ups and downs of what happens, like, okay, so you're an athlete and you're injured.
00:38:40.590 --> 00:38:42.429
Does that mean your nutrition needs to change?
00:38:42.590 --> 00:38:43.230
Yes.
00:38:43.550 --> 00:38:44.190
It does.
00:38:44.429 --> 00:38:44.829
Absolutely.
00:38:44.989 --> 00:38:48.269
Does that need to be mean that we need to stay on top of your labs?
00:38:48.429 --> 00:38:49.389
Yes, absolutely.
00:38:49.550 --> 00:39:01.230
And staying on top of your labs as it relates to this podcast is the same great thing to monitor overreaching and monitor overtraining because overreaching happens before overtraining.
00:39:01.469 --> 00:39:03.550
Those are things that you can see from the inside out.
00:39:03.630 --> 00:39:07.070
Those are things that we can see from your dietary patterns.
00:39:07.230 --> 00:39:14.029
I mean, all of this is so important and cheaper.
00:39:14.190 --> 00:39:17.869
Like it's cheaper than going to the it's cheaper than going to the doctor.
00:39:18.110 --> 00:39:18.750
It is.
00:39:19.070 --> 00:39:21.789
Anyway, that is all that is all of my rant.
00:39:21.869 --> 00:39:23.150
And this is great, Emily.
00:39:23.309 --> 00:39:24.909
Nice work on putting this together.
00:39:25.550 --> 00:39:25.949
Thanks.
00:39:26.029 --> 00:39:30.029
It was a lot of fun and really jogged jogged my jogged my brain there.
00:39:30.269 --> 00:39:30.670
That's right.
00:39:30.750 --> 00:39:32.509
I know you're gonna be so ready for this test.
00:39:32.590 --> 00:39:33.309
I'm excited for you.
00:39:33.550 --> 00:39:33.869
Thank you.
00:39:34.190 --> 00:39:38.989
All right, well, y'all, thanks for listening to our rants and thanks for listening to the Find Your Edge podcast.
00:39:39.070 --> 00:39:47.630
And if there are things that you want us to get deeper into, or whether it be a soapbox or some particular topic, uh let us know.
00:39:47.789 --> 00:39:55.070
Reach out, send us a DM on Instagram at the EnduranceEdge, or uh send us a contact us form on our webpage, theenduranceedge.com.
00:39:55.230 --> 00:39:59.070
Learn more about our longevity program, theenduranceedge.com forward slash longevity.
00:39:59.469 --> 00:40:02.029
And thanks for listening, and we will catch you next time.