How to get out from under the lamppost

A framework to use biometrics to improve your health

Greg Beary, GJBServices LLC

An Updated copy of this posting can be found at: 

https://to-your-health-and-wealth.blogspot.com/

Greg is NOT: a medical doctor, a researcher, any type of health professional, or someone you should be taking medical advice from. See your doctor for medical advice.

 

Measure your health by your sympathy with morning and Spring. If there is no response in you to the awakening of nature, if the prospect of an early morning walk does not banish sleep, if the warble of the first bluebird does not thrill you, know that the morning and spring of your life are past. Thus you may feel your pulse.

Henry David Thoreau

 

We don’t know how to measure what we care about so we care about what we measure

Chris Dancy from Don’t Unplug

 

The lamppost

 

It occurred to me when I started using Levels, a software tool combined with a CGM (continuous glucose monitor), that while I was producing biometrics, I wasn’t getting the depth of insight that I had expected. Sure, I was recording my blood glucose level and trying to tie it to my diet and exercise via logs. What I found was that, in general, the glucose level I expected to see, I did see. I enjoyed the insight I did receive; it just wasn’t as rich as I thought it would be.

 

The experience wasn’t as revealing as I had hoped. It reminded me of my old days in software development. Some organizations would collect lots of metrics. Often, the metrics were what was easiest or most obvious to collect. Not necessarily the metrics that provided great, or even any, insight.  I’m not faulting Levels. After all, it does provide an important data point in the large complex human system.  A system that historically hasn’t been measured very well.

 

I was also collecting biostatistics that didn’t seem to fit into Levels. Things like my readiness level, heart rate variability, or sleep score from my Oura ring. I’m sure that sleep has an impact on blood glucose, but I didn’t see a clean way to associate it.

 

My biostatistics seemed to be a grab-bag of numbers without any unifying or organizing principle.   That reminded me of an old paper I’d read many years ago, On building software process models under the lamppost by William Curtis, et.al. The paper alludes to the old joke about the drunk fellow looking for his keys under the lamppost, rather than down the street where he’d dropped them, “since the light is so much better over here”. Bill Curtis made the point that much of how we constructed software in those days was about management visibility, it wasn’t about actually helping people to build software. I realized that many of the tools that I was using were doing the same thing. They were collecting biostatistics to provide visibility into isolated areas, or biostatistics that were easily collected. They weren’t providing insight into my processes and my health direction.

 

This led me to believe that processes should be associated with biostatistics. After all, are the processes producing the results you want or expect? Are you executing the processes correctly? Are you even conscious of the processes that you are executing?  If you have no metrics to guide the processes, are you essentially driving blind? Likewise, if you have no process with which to impact the biostatistics, are you really going anywhere? Is positive change occurring? The old adage came to mind, “you can’t manage what you can’t measure”. You can’t manage the health and longevity processes, that you are using consciously or unconsciously, unless you can measure their associated biostatistics.

 

I was wondering if the issue I was seeing with biostatistics was that much of this is in its infancy. Much as we stumbled around the lamppost with software process and metrics, were we stumbling around the lamppost with biostatistics? Could the same approach that I found useful for software process and metrics be applied to biostatistics? 

 

The best approach I’ve found to the collection and usage of software metrics was developed by Victor Basili and his team at the University of Maryland. The goal, question, metric, (GQM) approach led to the collection of meaningful metrics, that were put into context by answering important questions, to reach business goals.  

The framework

 

In a nutshell, the GQM approach asks you to start by elucidating the key goals that you wish to reach. The number of goals should be in the range of 3 to 7. More goals, and you’re probably too granular Too few, and you probably aren’t being specific enough. You then work from these goals to decide what questions (3-7) would you need to answer to understand if you’re getting closer to your goal, or further from your goal. It then becomes important to look at what information, i.e., biostatistics, would you need to answer each of the questions. That collection of biostatistics then becomes the information that you should be focused on collecting to be able to answer the questions to see if you’re moving toward your goals.

 

The extension I’ve added to GQM is associating the processes you’re using to achieve your goals. It’s the execution of the processes that then produces the biostatistics and results in progress toward your goals. The second extension is the inclusion of the vehicles or tools being used to collect and manage the needed biostatistics.

Processes and tools:

In no particular order, here are some of the processes and tools that I’ve been using to try to improve my health and longevity. They, like my biostatistics, were a grab-bag of things I was doing without any unifying or organizing principle.

• Abstain from drinking alcohol
• Maintain a ketogenic diet that overlaps with a Mediterranean diet
•  Eat foods high in polyphenols and foods identified as healthful by Dr William Li
• Maintain a supplement regime to support overall health and longevity
• Exercise to both lose weight and gain more muscle
• Use Ulta Lab Tests to order self-directed blood tests to measure key metabolic factors
•  Use ElusiveIron as a consultant to help make sense out of my blood tests
• Use SelfDecode to feed my 23andme results and my lab test results into their analytic engine to see what insights they can provide
• Regularly perform Egoscue exercises for my back and overall health
•  Utilize Levels a tool that is coupled with a CGM to provide insight into my metabolic health
• Utilize Oura to measure and track my sleep, my activity level, and my readiness
• Utilize Cronometer to track my food and supplement intake
• Utilize Keto-Mojo to measure and track my glucose and ketone levels
• Utilize Qardio to measure and track my blood pressure
• Try to use GoogleFit  to aggregate information from some of these sources and to try to provide a more unified view

Tying it all together

 

As you see, I had a collection of processes that I was trying to use to improve my health, while also collecting some biostatistics along the way. What I wasn’t doing was using a framework like GQM to provide a unifying or organizing principle to the mess.

In Appendix A, I’ve tried to answer the question “why?”. I’m trying to answer, “Why have I chosen the processes, foods, and supplements that I have”. The “why” isn’t just important to explain to other people, but the process of answering the question helps to explain it to myself. Putting together a framework like this for yourself helps to clarify your thinking about your own health. The experience, learnings, and thinking things through, in creating your GQM framework are what is important, not necessarily the framework itself.

The following is my attempt to use GQM to make sense of and unify my goals, processes, questions, measurements, and tools.

Goal – I don’t want to go blind or have a heart attack

 

I’m in the first stage of AMD (age-related macular degeneration) - drusen in both of my eyes. My mother and her mother both lost their vision to AMD a decade or so before they died. Based on familial history, I also have a high likelihood of developing glaucoma. My CACs (coronary artery calcium scores) put me at above average risk for a heart attack. All of which, I’d like to avoid. The reason that these are lumped together is that they share very similar roots – diet and insulin resistance. At a blood vessel level, atherosclerosis and AMD look a lot alike. 

Processes:

•  Follow a Paleo Mediterranean Keto eating plan that aligns with Dr. Chris Knobbe’s recommendations in “Ancestral Dietary Strategy to Prevent and Treat Macular Degeneration”. 
•   Emphasize polyphenol-rich foods
• Manage my insulin levels to maintain a healthy metabolism
• Fast periodically to go into autophagy
• Avoid alcohol
• Use supplements to try to reverse or at least stabilize both the AMD and arteriosclerosis

 

Question	Metric	Tool
Am I keeping to a Paleo-Mediterranean Keto diet that is low carb, high polyphenol, with no seed oils?	Carb count of less than 40g/day and ideally less than 20g/day	Cronometer
	Record daily the colors of the foods I’m eating	Color chart for foods I’ve eaten
	Omega-3 and Omega-6 blood levels and ratio	Ulta Labs blood tests
Is my insulin resistance staying at a healthy level?	Fasting glucose with fasting insulin for a HOMA score ((glucose * insulin)/405) of less than 1.5	Ulta Labs blood tests
	HbA1C < 5	Ulta Labs blood tests
	Triglyceride / HDL ratio < 1.5	Ulta Labs blood tests
	A glucose insulin challenge (Kraft test) over 2 hours that scores less than 40	Ulta Labs blood tests
	Morning glucose reading below 90	Keto Mojo test strips with the results going to Cronometer
	Fasting Uric Acid below 5.5	Ulta Labs blood tests
What is my alcohol intake?	Total alcoholic drinks per week	Cronometer
Are I staying at the desired level of ketosis?	Daily GKI (glucose ketone index) level < 8	Keto Mojo test strips with the results going to Cronometer
	Use a CGM periodically to measure my individual response to various foods	Levels CGM used biannually for a month each time
Am I keeping to my time-restricted eating and fasting schedule?	Keep to a 18:6 schedule when eating	Cronometer
	Fast on Monday and Friday	Cronometer
	Fast for 3 days the first week of the month	Cronometer
Is my AMD staying stable?	Need to ask if they use a standard measurement. Right now, he just says “looks the same”	Biannual checkups with a retinologist
Is my risk of glaucoma staying stable?	Pressure level in each eye	Biannual checkups
Am I taking my supplements (Appendix A) and are they having the desired effect?	Record when supplements are being taken	Cronometer
	Targets vs actual for measurements of their effectivity	Ulta Labs blood tests and target values outlined in Appendix A
	CACs growth rate as a measure of improving heart health	Coronary Artery Calcium re-scan every five years or so

 

Goal – I want to feel good and look good

 

I do believe that muscle is critical to longevity and health-span. I want to be able to be self-sufficient into my very late years. Health and mobility are critically tied to physical fitness. I like Dr Attia’s idea of the Centenarian Olympics, though I’d settle for just being able to use the bathroom by myself.

Processes:

• Follow a Paleo Mediterranean Keto plan
• Follow a formal exercise plan 
•  Do my Egoscue exercises on a regular basis

Question	Metric	Tool
Is my body fat ratio trending in the right direction?	height to waist circumference ratio	Cronometer
	Body fat percentage	DEXA scan
Is my weight trending in the right direction?	Weight change over time	Cronometer
	BMI over time	Cronometer
Are my training goals, i.e., adherence to the exercise plan, being met?	Days with workouts	Cronometer, Google Fit, Oura
	Time, effort, or weight in measured units of effort (e.g. ½ mile run, pushups in 2 minutes, etc.)	Cronometer
Are my nutritional macros being met?	Days per month in ketosis	Cronometer
	Days per month where macro goals were met	Cronometer
Are my Egoscue goals being met?	Floor exercises 5x per week	Cronometer
	Tower supine leg progression 5x per week	Cronometer

 

Goal – I want to have a long health-span and a short quick death

 

This should be self-explanatory. I want to live as long and as healthy as possible and to then have a quick demise. Old-age isn’t very appealing if it’s to be spent in ill health with the associated misery and degradations that goes along with that.

Processes:

• Achieve goals 1 and 2
• Develop a mindfulness practice
• Practice breathwork throughout the day
• Adhere to a sleep hygiene routine
• Supplement with senolytic and longevity boosting compounds

 

Question	Metric	Tool
Are my sleep targets of being rested and ready being met?	Daily readiness measurement	Oura
	Daily sleep measurement	Oura
Am I adhering to my bedtime and wake times?	Adherence to schedule	Oura
Am I managing my stress?	Frequency of meditation practice	Oura
	Frequency of meditation as a prelude to sleep	Oura
	Adhoc subjective daily stress scale	Cronometer or Oura log?
Am I doing breathwork throughout the day?	Frequency and context of breathwork	Oura
Am I taking my longevity and senolytic supplements and are they having the desired effect?	Supplement log	Cronometer
	Biological age vs chronological age	TruAge, or similar test, repeated every few years

 

 

Appendix A

Processes used:

·      Paleo Mediterranean Keto eating plan – I try to stay in ketosis most of the month. I do intentionally switch up my diet between low-carb and medium-carb. I want to maintain the metabolic flexibility to be able to switch between food types. https://newmediketo.com/ “Ancestral Dietary Strategy to Prevent and Treat Macular Degeneration”

·      Emphasis polyphenol-rich foods - keep colorful foods abundant in my diet. Supplement with additional antioxidant rich substances (e.g. quercetin). https://dhrupurohit.com/try-this-the-power-of-polyphenols/

·      Eliminate seed oils – stay away from any use of seed oil. This is really hard since it’s buried in many packaged foods and ubiquitous when dining out. Per Ben Bikman, seed oil (Omega-6 fatty acid) is linoleic acid which turns into a molecule that causes fat hypertrophy.
https://www.levelshealth.com/blog/what-causes-insulin-resistance-glucose-levels https://carnivoremd.com/the-omega-6-apocalypse-are-seed-oils-to-blame-for-diabetes-heart-attacks-and-chronic-disease/

·      Fasting – I use both time-restricted eating (20:4) and periodic fasting. This is to both control my weight and to improve my insulin sensitivity. The longer fasts are used to help trigger autophagy. https://www.thefastingmethod.com/

·      Low to no alcohol – avoid any alcohol intake. It’s as damaging as high-fructose corn syrup to your metabolic health. https://health.clevelandclinic.org/6-surprising-ways-alcohol-affects-health-not-just-liver/

·      Take dietary supplements – The rational for my supplements is found in a later section.

·      Exercise Plan – movement equals life. If I want to be able to grow old and have a great life, I need to be in shape to enjoy it. https://peterattiamd.com/does-exercise-affect-lifespan/

·      Egoscue exercises– my back has been having episodes of pain over the years. I find if I do the Egoscue exercises that I was given over ten years ago on a regular basis, I don’t have back pain. http://www.lower-right-backpain.com/rehabilitation-exercises/the-egoscue-method/

·      Mindfulness practice – I use mindfulness as a tool to better control my eating and drinking. https://livingvino.com/mindful-eating-drinking-how-to-improve-our-life-health/

·      Breath work – along with mindfulness I’ve been practicing breath work throughout the day and especially at bedtime. Nose breathing not only relaxes me but is also supposed to improve my nitrous oxide blood level. https://www.breezejmu.org/culture/a-wealth-of-health-breathing-misconceptions-and-tips/article_b72d97b2-c235-11eb-a1bd-43f1c66d96ff.html

·      Senolytic and longevity supplements – the supplements I’m using for longevity are detailed later in this document. In the chart of supplements these are indicated as “aging” related. https://www.nature.com/articles/s41598-021-02544-0?error=cookies_not_supported&code=9d1b4cbd-5d7d-4977-852a-30455acbec89

 

Foods eaten as supplements:

·      Berries – eaten almost every day. I focus on blackberries and blueberries with some strawberries added occasionally. They are usually combined with either full fat (5%) Greek yogurt or chia pudding made with coconut milk.

·      Kiwi – eaten periodically. This low carb fruit is supposed to be good for repairing DNA damage to cells. It’s also high in vitamins and polyphenols. https://drwilliamli.com/wp-content/uploads/2019/01/A-Plant-Based-Approach-to-Eating-To-Beat-Disease.pdf

·      Sardines – eaten roughly 5x per week. Goal is to increase Omega-3 levels in the interest of improving heart health. Generally used product is Season’s Brand. The reason is to improve cardiac health. It seems to be working well based upon my blood tests for Omega-3 EPA/DHA levels. I was concerned about the olive oil they are packed in being adulterated. However, blood tests for Omega-3 and Omega6 showed very low Omega6 levels. Leading me to believe that the oil is really true extra virgin olive oil.     https://pubmed.ncbi.nlm.nih.gov/27090218/

·      Blue Butterfly Pea Flower – drunk daily as a tea (15g of flower per quart of water) with roughly eight ounces taken about an hour before bed. The goal is to increase antioxidants for a general health and longevity benefit. I use dried flowers sourced from Thailand. These flowers have been used to make a tea for Chinese medicine and Ayurvedic medicine for thousands of years. https://pubmed.ncbi.nlm.nih.gov/34996311/

·      Broccoli Rabe– eaten about 14 days per month. The goal is to get more folate and vitamin K into my diet for the health benefits that they bring. The brand I eat is almost always organic Andy Boy. https://www.verywellfit.com/broccoli-rabe-nutrition-facts-and-health-benefits-5186826

·      Broccoli Sprouts– eaten about 5x a week. The goal is to get more sulforaphane to improve my immune health. The source I normally use are a combination of clover and broccoli sprouts. It was Dr William Li who had recommended these. https://drwilliamli.com/the-powerful-immune-properties-of-broccoli-sprouts/

·      Macadamia Nuts– eaten daily. The goal is to use nuts to lower cholesterol and improve cardiovascular health. The brands I normally eat are from Costco or Whole Foods. https://pubmed.ncbi.nlm.nih.gov/18356332/

·      Dark Chocolate – eaten daily with the macadamia nuts. It was recommended by Dr Li to help with heart health and stem cell function. The brand I almost always eat is 92% dark chocolate. Per Dr Li, the benefits are many fold. https://drwilliamli.com/7-pleasantly-surprising-health-benefits-of-dark-chocolate/

·      Ground Flaxseed - eaten daily and generally mixed with yogurt or added to Chia seed pudding. It was recommended as a natural way to lower blood pressure. https://pubmed.ncbi.nlm.nih.gov/24777981/

·      Chia seeds whole - eaten frequently as chia pudding when mixed with coconut milk. An ancient food of the Aztec and Maya peoples, it’s high in fiber, antioxidants, and minerals. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6994964/

·      Olive Oil - eaten daily and often mixed with MCT oil and vinegar prior to taking my morning supplements. It has been recommended not to take some of the supplements on an empty stomach. The brand I use is available at Costco. https://pubmed.ncbi.nlm.nih.gov/29904393/

Supplements and research-based justifications:

l-Lysine

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4147981/

Dietary l-lysine elevated plasma alanine, proline, arginine, and homoarginine but not lysine. Analyses in vitro demonstrated that alanine and proline inhibit apoptosis of cultured vascular smooth muscle cells, and that arginine and homoarginine attenuate mineral precipitations in a supersaturated calcium/phosphate solution. In conclusion, dietary supplementation of l-lysine ameliorated vascular calcification (VC) by modifying key pathways that exacerbate VC.

 

l-Citrulline

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073798/

Diminished bioavailability of nitric oxide (NO), the gaseous signaling molecule involved in the regulation of numerous vital biological functions, contributes to the development and progression of multiple age- and lifestyle-related diseases. While l-arginine is the precursor for the synthesis of NO by endothelial-nitric oxide synthase (eNOS), oral l-arginine supplementation is largely ineffective at increasing NO synthesis and/or bioavailability for a variety of reasons. l-citrulline, found in high concentrations in watermelon, is a neutral alpha-amino acid formed by enzymes in the mitochondria that also serves as a substrate for recycling l-arginine. Unlike l-arginine, l-citrulline is not quantitatively extracted from the gastrointestinal tract (i.e., enterocytes) or liver and its supplementation is therefore more effective at increasing l-arginine levels and NO synthesis. Supplementation with l-citrulline has shown promise as a blood pressure lowering intervention (both resting and stress-induced) in adults with pre-/hypertension, with pre-clinical (animal) evidence for atherogenic-endothelial protection. Preliminary evidence is also available for l-citrulline-induced benefits to muscle and metabolic health (via vascular and non-vascular pathways) in susceptible/older populations.

 

NAC - N-Acetylcysteine – precursor to glutathione

https://pubmed.ncbi.nlm.nih.gov/11380598/

https://pubmed.ncbi.nlm.nih.gov/34439468/

N-acetyl-L-cysteine exerts direct anti-aggregating effects through an increased bioavailability of platelet nitric oxide.

A molecule that actively participates in counteracting the oxidizing effect of reactive species is reduced glutathione (GSH), a tripeptide that is present in all tissues and that its synthesis and/or regeneration is very important to be able to respond to the increase in oxidizing agents. In this review, we will address the role of glutathione, its synthesis in both the heart and the liver, and its importance in preventing or reducing deleterious ROS effects in cardiovascular diseases.

 

l-Serine -– precursor to glycine

https://www.medrxiv.org/content/10.1101/2020.10.02.20202614v1.full

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566166/

Glutathione (GSH) is a critical endogenous antioxidant found in all eukaryotic cells. Higher GSH concentrations protect against cellular damage, tissue degeneration, and disease progression in various models, so there is considerable interest in developing interventions that augment GSH biosynthesis. Oral GSH supplementation is not the most efficient option due to the enzymatic degradation of ingested GSH within the intestine by γ-glutamyltransferase, but supplementation of its component amino acids—cysteine, glycine, and glutamate—enhances tissue GSH synthesis.

 

Kaneka Ubiquinol

https://www.kaneka-ubiquinol.com/wp-content/uploads/2015/07/bates-a-et-al-nursing-health-sciences2014-qh_review.pdf

Evidence reveals that alterations in myocardial energetics, such as defective energy metabolism and increased oxidative stress, an excess production of reactive oxygen species (ROS) in relation to antioxidant defense is a significant factor in HF (Tsutsui et al., 2011). Studies are emerging to evaluate the effects of a potent antioxidant, ubiquinol – the active reduced form of CoQ10 – on the myocardium. In a small pilot study, Langsjoen and Langsjoen (2008) reported improvement of left ventricular (LV) function among patients with congestive heart failure from the use of supplemental ubiquinol.

 

NMN - Nicotinamide Mononucleotide

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238909/

Numerous studies have demonstrated that boosting NAD+ levels increases insulin sensitivity, reverses mitochondrial dysfunction, and extends lifespan. NAD+ levels can be increased by activating enzymes that stimulate synthesis of NAD+, by inhibiting an enzyme (CD38) that degrades NAD+, and by supplementing with NAD precursors, including nicotinamide riboside(NR) and nicotinamide mononucleotide (NMN). Taken orally, NMN is rapidly absorbed and converted to NAD+.¹⁴ In numerous studies, supplementation with NMN has increased NAD+ biosynthesis, suppressed age-related adipose tissue inflammation, enhanced insulin secretion and

insulin action, improved mitochondrial function, improved neuronal function in the brain, and more.

E-Annatto vitamin E tocotrienols

https://nutraceuticalbusinessreview.com/news/article_page/Clinical_study_confirms_cardiovascular_benefits_of_annatto_tocotrienols/104638

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5775572/

Annatto tocotrienol — mainly composed of delta-tocotrienol — improves cardiovascular risk factors including cholesterol, triglycerides and inflammatory cytokines, according to clinical findings published in the British Journal of Medicine and Medical Research.

Thus, based on the evidence available to date, tocotrienols are a safe and potential candidate in improving cardiovascular health, especially for the elderly, who can be more susceptible to more aggressive pharmaceutical interventions. In addition to this, there are also other health benefits related to reducing oxidative stress and pathological inflammation which plays a role in providing holistic health benefits for the elderly.

 

Resveratrol

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5630366/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3058481/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2546476/

Resveratrol and caloric restriction (CR) are the powerful therapeutic options for anti-aging.

Cardiovascular diseases are the most common cause of death among the elderly in the Western world. Resveratrol (3,5,4´-trihydroxystilbene) is a plant-derived polyphenol that was shown to exert diverse anti-aging activity mimicking some of the molecular and functional effects of caloric restriction. There is reasonable consensus that oxidative stress plays a central role in the development of atherosclerosis and that redox-sensitive molecular pathways (e.g. NF-κB) promote vascular inflammation in aging. While a healthy diet and lifestyle is strongly recommended in prevention of such conditions, the future bodes well for the use of resveratrol and analogues of higher potency than the natural form for treatment of diseases that afflict humans, particularly as they age.

 

Berberine

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6032421/

https://www.longevity.technology/berberine-could-be-longevitys-best-kept-secret/

Taken together, these results demonstrated that BBR was able to protect RPE cells against oxidative stress via the activation of AMPK pathway. Our findings also indicate the potential application of BBR in AMD treatment. Berberine has been shown to enhance AMPK activation (one of the few chemicals that does), enhance autophagy and mitigate apoptosis (cell death) induced by high glucose levels. 

 

Supplements, Brand, Motivation, Target Level to achieve:

 

Supplement	When taken	Brand name	Frequency	Why	Goal level
Iron	am	ProFerrin Clear 10.5 mg	2 Once Per week	Peripheral Neuropathy	100 - 120
C vit	am	Nature’s Bounty Vitamin C 500mg	1 daily	Peripheral Neuropathy	None
NMN	am	Alive by Science 125mg	2 daily	Aging	None
Resveratrol	am	Purely Beneficial RESVERATROL 1450mg per 2 capsules	2 daily	Aging	None
Quercetin	am	Amazing Formulas 500mg	1 daily	Aging	None
Berberine	am	Toniiq 500 Mg High purity	1 daily	Aging, AMD	None
K vit	lunch	Koncentrated K	1 daily	Heart	None
l-Lysine	lunch	Superior Labs L-Lysine 500mg	1 daily	Heart	None
CoQ10	lunch	Doctor’s Best Ubiquinol with Kaneka Ubiquinol 100mg	1 daily	Heart	≥ 2.0 ug/mL
Omega-3	lunch	Nordic Naturals Ultimate Omega Fish oil 325 EPA, 225 DHA	2 daily	Heart	EPA + DHA > 4%
l-Citrulline	lunch	Nutricost L-Citrulline 1500mg	2 daily	Heart	None
D vit	lunch	NatureWise Vitamin D 5000IU	1 daily	Overall	70 – 80 ng/mL
Multi vit	lunch	Centrum Silver for Men	1 daily	Overall	None
NAC	lunch	Thorne N-Acetylcysteine 500mg	1 daily	Heart, Aging	None
l-Serine	lunch	Double Wood 500mg	2 daily	Heart, Aging	None
B vit	lunch	SuperiorSource Balance B complex micro lingual (.5 values below)	3 per week (M,W,F)	Peripheral Neuropathy	Normal ranges
Lutien	lunch	Doctor’s Best Lutein from OptiLut Lutien 20 mg, Trans-Zeaxanthin 4mg per 2 capsules	2 daily	AMD	None
Mg	pm	Rhythm triple-calm Quad-Magnesium 75mg, glycinate chelate, orotate, malate, taurinate and Magtein nightly	2-3 days a week	Peripheral Neuropathy Leg cramps	Mg RBC => 6
E vit	pm	Delta Gold E-Annatto vitamin E tocotrienols 125mg	2-3 days a week	Peripheral Neuropathy Heart	7 - 15 mg/L

 

Blood tests:

 

I use Ulta Labs to order my own tests. I do this complete set once a year and follow-up tests based on what I’m trying to improve. I paid $748 for the below panel of lab tests. Ulta Labs doesn’t take any insurance. It’s all paid for out-of-pocket when you order the tests. The lab that Ulta uses (Quest Labs) draws the samples and runs all the tests using the order(s) that Ulta Labs creates.

 

Elusive Iron - Cover All the Bases 

• ANA Screen, IFA with Reflex to Titer and Pattern, IFA [ 249 ]
• C-Reactive Protein (CRP) [ 4420 ]
• Cardio IQ Vitamin D, 25-Hydroxy, LC/MS/MS [ 91735 ]
• Cardio IQ™ Hemoglobin A1c [ 91732 ]
• Cardio IQ™ Homocysteine [ 91733 ]
• Cardio IQ™ Insulin [ 91731 ]
• Cardio IQ™ Lipid Panel [ 91716 ]
• Cardio IQ™ Omega-3 and -6 Fatty Acids, Plasma [ 91734 ]
• CBC (includes Differential and Platelets) [ 6399 ]
• Coenzyme Q10 [ 19826 ]
• Comprehensive Metabolic Panel (CMP) [ 10231 ]
• Copper [ 363 ]
• Ferritin [ 457 ]
• Fibrinogen Activity, Clauss [ 461 ]
• Gamma Glutamyl Transferase (GGT) [ 482 ]
• Glucose [ 483 ]
• Iron and Total Iron Binding Capacity (TIBC) [ 7573 ]
• Magnesium, RBC [ 623 ]
• Rheumatoid Factor [ 4418 ]
• Selenium [ 5507 ]
• T3 Reverse (RT3), LC/MS/MS [ 90963 ]
• T3, Free [ 34429 ]
• Thyroglobulin Antibodies (TgAb) [ 267 ]
• TSH [ 899 ]
• Uric Acid [ 905 ]
• Urinalysis (UA), Complete [ 5463 ]
• Vitamin A [ 921 ]
• Vitamin B1, Blood, LC/MS/MS [ 5042 ]
• Vitamin B2, Plasma [ 36399 ]
• Vitamin B6, Plasma [ 926 ]
• Zinc [ 945 ]

 

 

Target lab values for items of special interest:

 

Test	Target Value or range	Notes
BUN	8 – 24 mg/dL	Low is bad (poor diet) High is bad (over 30) due to high protein diet
Creatinine	0.5 – 1.3 mg/dL	Low is good, shows good kidney function
Fasting Glucose	75-95 mg/dL	Low is good but <75 could be an issue
Fasting Insulin	2 - 6 uIU/mL	Low is good but not too low, <5 is a good target
HOMA-IR	0.5 – 1.5	((Insulin * Glucose) /  405) +1.9 is early insulin resistance, +2.9 is insulin resistant
HgbA1C	4.5 – 5.5%	Low is good
Triglyceride TG	40 – 100 mg/dL	Low is good
HDL	+60 mmol/L	Over 100 may be an issue
TG:HDL ratio	0.5 – 1.9	2.0 – 3.0 some insulin resistance, +3.0 insulin resistant, goal is less than 1.5
hs-CRP	<1 mg/L	+2.4 unless you’re sick isn’t good
Uric Acid	<5.5 mg/dL	Lower is better
Homocystine	<10 umol/L	Lower is better, high indicate low folate and is a marker for heart disease and Alzheimer’s
Vitamin D	40-70 ng/mL	Too low or too high is not good
Omega-3	> 3.2%	< 2.2 high risk for CVD, 2.2 – 3.2 moderate risk for CVD, > 3.2 low risk for CVD
EPA	+1.5%	High is good
DHA	+2.5%	High is good
Omega-3 / Omega-6 ratio	> 3.2	< 2.2 high risk for CVD, 2.2 – 3.2 moderate risk for CVD, > 3.2 low risk for CVD
Ferritin	50-300 ng/mL	High ferritin is bad
Iron, Total	90 – 120 mcg/dL	Too low or too high is not good
AST, ALT	0-40 U/L	Lower is better
TSH	0.4 – 4.0 uIU/mL	Lower is bad and higher is bad
Free T4	0.9 – 1.7 ng/dL	Lower is bad and higher is bad
Free T3	2.3 – 4.2 pg/mL	Lower is bad and higher is bad
GGT	3-30 U/L	Lower is better, it’s a good marker for fatty liver disease

 

 

 

About the author:

Over the past few years, I’ve become much more focused on improving my health. Along the way, I learned a lot about what works well for me and picked up advice from many corners.  I developed a hobby of sorts in absorbing health-focused podcasts, books focused on health, and YouTube videos of all sorts focused on healthy living and longevity. I sought out tools and techniques that would be helpful in my journey toward a healthier and longer life.