Barbell Shrugged - Physiology Friday: [Bloodwork] What Your Doctor Isn’t Telling You About Your Bloodwork w/ Anders Varner, Doug Larson, Coach Travis Mash and Dan Garner Barbell Shrugged

Episode Date: December 6, 2024

In this Episode of Barbell Shrugged: Why blood chemistry is trusted world wide What tests should you get when doing blood work What are hidden markers your doctor may not be seeing How often should you get bloodwork Performance, health, and longevity through bloodwork testing Connect with our guests: Anders Varner on Instagram Doug Larson on Instagram Coach Travis Mash on Instagram Dan Garner on Instagram  

Shrug family, this week on Barbell Shrug Physiology Friday is back and we're going to be taking a deep dive into all the things that your doctor is not telling you about your blood work. We call these things inside rapid health optimization performance reference ranges. And the reason is because no point in your life have you ever set out to be average or normal. So if you're one of those people, why are you going to go to your doctor and have them tell you about normal reference ranges? That's like the antithesis of all things performance is being this idea of normal. And those reference ranges are probably getting worse because as we get more and more unhealthy as a society,

the more normal becomes more unhealthy. You're trying to be elite. You're trying to know what the four minute mile is and how close you are to that, not the average mile. And's what we're going to be digging in today as always friends make sure you get over to rapid health report that is where you can check out all the lab lifestyle performance analysis testing programs that we are going to be offering you to optimize your health and performance inside rapid health optimization you can find all of that over at rapidhealthreport.com friends let's get into the show welcome to barbell shrugged i'm anders varner doug larson dan garner on the show again today

and travis mash hopefully will be joining us sometime in the middle if he buzzes in he's got things to do today um on today's episode we're going to be talking about blood work the pros and cons of going to your primary care physician, whoever that is, getting your yearly blood work and what may show up on there and why that is a good thing to get done yearly, but also some of the pitfalls you may be running into. And Dan, Doug and I just got all of our blood work read to you. And I can honestly say that you brought up things that no physician has ever, uh, ever told me I've had high cholesterol for the last like 10 years of my life.

And you're the only person that has said, Hey, no need to worry about that. Not a big deal. But, uh, I think people think that, you know, their blood work is like this, like, well, they seen the blood. So this is exactly what's going on, but there's, there's many, many things going on there that people need to be aware of. Yeah, I mean, absolutely. The blood chemistry, first and foremost, it is the most valuable lab someone can get. There's a reason you can get it in Hong Kong, in Canada, in Southern California, Hawaii, in Taiwan. It is worldwide the most standardized. It has the most research behind it. It's the most reliable

and valid lab out there. There's a reason why it's everywhere and why it's so reliable and valid is because there's 1000s and 1000s of research papers on it. This is like, if you ever want to get deep into lab work, I highly suggest starting with blood chemistry, because there's simply so much to learn in this area. And there's so much that you can draw from blood chemistry to kind of piggyback on your point, Anders, that almost nobody is drawing from it with respect to trending high and trending low, not just waiting until you're actually low or high, you know, acting preventatively rather than reactively to certain ranges. What trending high and trending low, not just waiting until you're actually low or high, you know, acting preventatively rather than reactively to certain ranges. What trending high and trending low even mean? Like,

for example, GGT. GGT, not even actually high, but just trending high has been tightly associated with exposure to environmental pollutants. So it's like, it's something where you'll see on it, no one will ever tell you that, by the way, it's just trending high. And yet, if you look into the literature for five fricking minutes, you'll see that GGT is tightly connected to environmental pollutants. Uric acid, an excellent water soluble antioxidant marker, whereas bilirubin is an excellent fat soluble antioxidant marker. Uric acid and bilirubin, water soluble and fat soluble antioxidant status, you're getting like a real large, big picture view of one's inflammation status in their body. And yet no one's going to tell you that either. There's with respect to

trending high, trending low, the ratios, what certain things can mean for others. Like for example, bilirubin's a waste product of red blood cell destruction, but its counterpart, Billy Verdin is the fat soluble antioxidant. So even though some people think you're just looking at one thing, which is a product of red blood cell destruction, they don't know the actual metabolic processes that lead to that and why that may also result in many other things. So blood chemistry, it's one of my most passionate and favorite topics to discuss. So I'm real happy to dig into the weeds into this. You're talking about trends, like when you get

blood chemistry for somebody, you get a snapshot of your physiology in a specific moment, but you don't get to see, you're not looking at like an ongoing graph of your physiology in a specific moment, but you don't get to see, you're not looking at like an ongoing graph of your physiology, which would be that much more beneficial than just seeing a snapshot. Anytime I've ever been to a doctor and gotten, gotten my labs done, got my blood work done. They almost never asked me, do you have any past blood work I can look at? They just, they just look at the blood work they took, but never, they never asked me what, like, and I have it. I have all my stuff for many years. And I even tell them sometimes, like, I have a folder with all my old past blood work.

And they're like, oh, yeah, I don't know. Just they, like, don't care. They, like, don't even want to see it. Like, I'm too busy to look at all your past blood work. Like, I'll just look at the stuff that I normally look at. Don't inconvenience me with past numbers. Yeah, yeah. Like, that seems wild to me.

Yeah, it's basically a lot of them are just a snapshot. Some of them that are a little bit more representative of long term status would be say, for example, hemoglobin A1C is a representation of glucose control over a certain period of time. All of your red blood cell markers, the red blood cells have a turnover rate of 120 days. So that means everybody should get their lab work technically once every four months, because that's when your blood work has its expected turnover rate. So besides those two, and maybe a couple others, because they slowly, they take decades to change. Yeah, you should absolutely be looking at pre and post labs over

an extended period of time to create trends like, like you said, not just trending high and trending low within a specific marker, but trends, predictable trends at where you're headed to in the future. Because a lot of pathologies can be predicted 10 years beforehand. If people just put in the work to actually look to see where that physiology is headed in the current snapshot actually look to see where that physiology is headed in the current snapshot that is currently at. Yeah. It seems that like, if you're looking at something like blood glucose, like you can be in the eighties and then, then a couple of years later, you're

in the nineties and a couple of years later, you're in the high nineties and a couple of years later in the low and hundreds. And all of a sudden they're like, Oh, pre-diabetic. We got to start talking about this. And it's like, this is a big one. Dan's about to blow your mind. Cause I was in this. He's about to drop knowledge team. You better start talking about this. This is a big one. Dan's about to blow your mind because I was in this. He's about to drop knowledge, team. You better start listening right now. Let him have it. Give us a smile. Yeah.

What he's about to say, I was the person. I'm trending in the wrong direction. Most people are. And that's kind of a representation of people's daily diet these days and insulin sensitivity and glucose control. But yeah, there's absolutely excellent, excellent research out there that predicts for every one

point you are of glucose above 85 represents a 6% increase in the risk of type two diabetes over the next decade. So somebody moving from 85 to 95 has a 60% increase of the risk of type 2 diabetes over the course of the next decade. And yet you're not considered out of the range until you're above 99. So that is when you're considered. I was like, oh, sorry, you're pre-diabetic. So it's like you've been walking towards this cliff like a zombie for a long period of time. And then nobody tells you until you step

off the cliff and fall over. And that's when you're diagnosed. That's when you're acting reactively rather than preventatively. Yet 10 years ago, when you moved to 86 instead of 85, I could have told you that we're trending in the wrong direction. Not to mention going above 95 has been connected to diabetic retinopathy. So the actual degradation of your eyes, the actual, your breakdown of vision begins to occur after 95. And yet you're considered normal from 95 to 99, even though your risk for type two diabetes is over 60% higher over the course of the next decade. And your eyes are beginning to break down. It's absolutely absurd to me. Everybody listening to this show,

probably that has blood work near them is going to go look at this. So like what, what actually is, say they've gone from 90 to 95. I think I came in right at 90. So I'm like five points over, which is a 30% increase in me becoming pre-diabetic in however many years. What are the contributing factors to that number increasing? And then what can people do to start moving it in a healthier direction? So that's all comes down to glucose control. And there's a lot of different ways in which we can go about this. And I think it's going to be good to kind of set the stage for podcasts that we're going to do in this year, because a lot of people approach blood work as if it's just a recipe book. So if this is high, take this supplement. If this is low, take this

supplement. If this is low, utilize this diet, you know, all of course that, okay. So let's just kind of debunk that for a second, because you asked me, how are we going to correct glucose control? So what's the average person, their go-to? Ah, man, well, I'm going to take Berberine and then I'm going to go on a low carb diet. That's a wrap, man. We good to go. Like that's like everybody's kind of quick go-to solution, almost as if it's obvious, right? Yet you got, if you understand cellular biochemistry, there's a lot of routes that you can take towards poor glucose control that people have no idea of. So a good backdoor example of this is selenium. So just just to make a point, selenium, it's a mineral, a lot of people just know it because they associate it with glutathione. But it has a very, very narrow

therapeutic window. So it's a U shape. If you don't but it has a very, very narrow therapeutic window. So it's a U-shape. If you don't have a lot of it, it creates some issues. If you have a little bit of it, it's quite good. But if you have too much of it, it becomes really bad again. It's a very narrow therapeutic window. And selenium, what happens inside the cell, and this gets pretty complex in the cellular biochemistry, but the details aren't as important as the overall lesson. When you have selenium, selenium activates an enzyme inside the cell called GPX1. GPX1 actually lowers intracellular hydrogen peroxide.

Hydrogen peroxide is a cell signaler for glucose disposal. So just a quick recap. If we have a lot of selenium, selenium activates GPX1 in the cell. GPX1 in the cell lowers intracellular hydrogen peroxide. When hydrogen peroxide is low, that can't be, that is not good for blood glucose control because it is a cell signaler for glucose disposal. So we just went over a situation where somebody may have high fasting blood glucose and poor glucose control, not because of their carbohydrate rich diet, not because of their inflammation status, not because they're not taking enough berberine or fish oil

to try and improve their glucose. No, it's because they had too much selenium. And it's actually pretty easy to have too much selenium if you're eating Brazil nuts and you're on a multivitamin. So it's unfolding. People, like physiology is like an onion. There's layers and layers and layers and layers and layers. So when you ask me, how do I improve blood glucose control? That can go in many different directions that have fricking nothing to do with carbohydrates. Yeah. We're going to do a full show

on kind of reading all of our stuff as well. Cause I'd love to know specifically what you put in mind too. So I'm like, oh, that's the thing. I need to eat that nut more. I need to eat that one. Yeah. Travis Smash, welcome to the show, buddy.

Travis. Sorry I'm late to the show, buddy. Sorry I'm late. It's important, though. You guys know. Future Olympians, no big deal. Go ahead, Doug. We'll talk about it after the show. I was just saying what's up with Travis.

I didn't have a specific question there. I was going to say, I was listening to Dan. I saw some big time, I guess, you know, personal trainer on Twitter the other day just give this random recommendation of things to take to everybody in the world. And all I could think about, you know, like literally before I met you, Dan, I'd have been like, oh, maybe I should do that. Then I'm like, oh, no, you're going to poison somebody. That's what's terrifying about it, right? When you hear how many directions this thing can go. i'm not taking anything until dan says take that yeah okay so we were talking about blood glucose we kind of got in the weeds there for a second which which is totally awesome but i want to

zoom back out like what can blood work tell us and what does blood work is what is it not able to tell us like what are the pros and cons of blood work? Okay, so it can, it is one of the most well rounded. So like, it gives us insight toward many organ systems of the body gives us insight toward environmental pollutants gives us insight towards hormone status gives us insight toward vitamin and mineral status, it tells us a lot about a lot of things. So it won't tell you exactly some certain pathologies. So for example, if somebody has a neutrophil to lymphocyte ratio, that's greater than three to one that is predictive of a bacterial or parasitic infection, which one exactly we're not sure. So that's why I would want to order a stool analysis after that.

But that predictive measure is already there. So it tells us a lot until we need to dig a little bit more and utilize things such as saliva, urine, stool for that deeper dive. But when it comes to blood, we know what else we need to dive deep into. But we also get a lot of performance inferences from it as well. So for example, albumin is a good one. Albumin, lots of these markers have like a lot of reasons why they could be high or why they could be low. Albumin, the only reason it's high is due to dehydration. So if somebody has trending high or high albumin, I know this athlete isn't hydrated and I'm going to need to look deeper into their fluid intake, but also understand

and respect that hydration isn't just water. Hydration is water plus electrolytes. So I'm going to now need to look at this athlete's sodium and potassium status, as well as his magnesium and calcium to ensure that he's optimally hydrated because hydration is a rate limiting step to performance. Because if your calories and macros are perfect, and you slept great last night, and you're on a phenomenal Travis Mash training program, you are still going to perform poorly if you show up to the meet dehydrated. It's a rate limiting step to performance. So when I see something like that, I'll instantly ask like, wow, you know, I just did a basic basic blood blood count. And I know

that I can improve this athlete's performance with out of doubt, just looking at his hydration status. And there's I mean, I could this could go on for a long time, like low sodium, high potassium is associated with adrenal insufficiencies. C-peptide is something almost nobody's running, but it is a way better marker for blood sugar control than fasting glucose, insulin, or hemoglobin, A1C. Like I said previously, GGT is connected to high levels of environmental pollutants. ALT, most people just see ALT as the liver enzyme, right? Alanine transferase. If it's high, our liver is taking damage from whatever it's currently taking damage from. However, ALT is co-factored by vitamin B6. So if somebody doesn't have enough vitamin B6,

they can't take a lot of ALT. Now, you guys had B6 issues. So if somebody, for example, was taking, let's just say oral anabolic steroids that would drive ALT up. Well, it's a very realistic situation where someone could be on oral drugs, but have low levels of B6. And therefore, their ALT looks normal, even though their liver is being damaged. So it's, it's, it's just comes full circle to where I could look at every single marker on a blood chemistry and take a lot of inferences away that people just don't know are there. And then there are calculations on top of this that provide a major, major, major insight towards different outcomes as well. Like for example, there's something called osmolarity. Osmolarity sounds fancy, but it's not.

It just means there's more of one thing on one side of a cell layer than another side. So the body will want to bring more from the higher concentrated side and then even it out to the other side. So you can look at something called serum osmolarity, and it is the gold standard prediction for hydration. And all that you need to predict serum osmolarity is glucose and urea. That is on any basic blood chemistry. You run it through an evidence-based calculation to predict serum osmolarity. Serum osmolarity predicts intracellular osmolarity. So when I know the osmolarity of your blood, I already know the osmolarity of your cells due to something called

osmotic gradients. And again, the details aren't as important as the overall lesson, is that it's not just these markers that tell us so much about your physiology, but there are evidence-based calculations such as anion gap, serum osmolarity, blood viscosity. When we combine these things, we can get an even greater insight on your physiology as well. So a basic blood panel gives you just for people that have not gotten their blood done recently or really don't even look at it when they get it done. The doctor just tells them what to look at. Like what is the basics of what's actually on there and how do the kind of the main components

connect to each other? Okay, so the basics that you're gonna get, you're gonna get a lipid profile, you're gonna get white blood cells and you're gonna get your red blood cells. Now everything connects to everything in physiology. So they just, your red blood cells, like we'll just connect red blood cells for something cool and fun.

So when you're looking at red blood cells, they have 120 day turnover. So every four months you've got brand new red blood cells in your physiology. So again, you should get your labs done. I mean, I think a minimum of two times per year, but a high level athlete should get it done three, four times per year, just to always keep on top of the red blood cells. But one, uh, somebody can absolutely have problems with fat loss due to red blood cell issues. So your red blood cells, they are what carry oxygen around the body.

And if you know your cellular biochemistry, fat burning is beta oxidation. You need oxygen present at the mitochondria and electron transport chain to actually burn body fat and lose fat very efficiently. Now, red blood cells, they are what contain iron and create hemoglobin. And that's what carries oxygen around the body. So if there is a problem with red blood cell function, then you've got a problem with oxygen delivery and oxygen absorption. If you've got a problem with oxygen delivery and oxygen absorption, you don't just have a problem with fat loss, you have a problem with ATP generation. So there's a very real scenario where somebody's conditioning can be decreased or somebody's fat

loss efforts can be decreased, not because anything is wrong with their macronutrients or training, but because they have a micronutrient insufficiency. And it goes even deeper than that because red blood cells, they go through, in order to create a red blood cell, it all begins in the bone marrow with something called a hematopoietic stem cell. But ultimately, it goes through a process called erythropoiesis. Erythropoiesis is a multi-step process, but right around the middle, something called nuclear maturation happens, where the nucleus of a red blood cell is being created. This is dependent upon B12 and folate. And if you don't have enough B12 and folate, what happens is a red blood cell grows way too big. And I'll be able to see this on your lab with something called an

MCV or a mean copuscular volume, mean average copuscular red blood cell volume size. The larger this MCV is, again, even if it's just trending high, it gives me an insight towards your B12 and folate status. So if you can't even make a red blood cell, it doesn't even matter if your iron is on point because your red blood cells are unhealthy as it is. So if you have a B12 and folate problem, if you have an iron problem, you're going to have an oxygen delivery problem. You're going to have an ATP problem. You're going to have a fat loss problem. And that's just one marker. That's me really just looking at MCV. So looking at red blood cells, your white blood cells give us insight on infectious states that hold back your recovery and impact gut health in many different ways. And your lipid panel,

your cholesterol, LDL, VLDL, excellent inferences towards inflammation, overall cardiovascular disease risk, but let us know the health of your liver as well. So I don't know how long you guys want me to go on these different types of markets, but is there anything in specific you want me to cover? Because this is an enormous, enormous thing that goes in many directions uh yeah i know anders wanted to dig into cholesterol a little bit uh yeah let's go

down that route that's my that's my 10 year long journey where i i hate uh the snapshot piece of it but over 10 years you start to realize like oh i just have high cholesterol but i'm also like pretty healthy and anytime i it comes back and they go cholesterol is high you gotta stop eating red meat i go i don't think that's the answer dude like i might not have the the md behind my name but i kind of talk to people i don't think that's the thing. What should people be aware of? And then you're the first person that told me my ratios are fine, so I shouldn't have to worry about it. You're the only person that's ever told me this. Dr. Justin Marchegiani Let's actually go down that very specific recommendation. I hear that all the time.

Why do people say that? Why do doctors or whoever say don't eat red meat because your cholesterol is high? And why is that not necessarily the whole story? It's not the whole story because it doesn't say what's going on in your physiology. So let's just kind of take a step back and see how we even get cholesterol to begin with. So when you eat, let's just use red meat. When you eat red meat, you're going to eat a lot of fat, right? And that fat is going to be uptaken. The first place fat gets uptaken into your body is in the lymphatic system. It's going

to get uptaked into the lymphatic system. It's going to hang out in the lymphatic system for two to three hours. And then it's finally going to enter circulation after that. Now it's going to enter circulation in the form of a big thing called a chylomicron. And you can consider it for everybody listening right now, you can consider or just imagine a chylomicron as a very large pie chart where the overwhelming majority of it is fat. And then there's a small amount of three other things, protein, cholesterol, and phospholipids. So just imagine a giant circle with, you know, 85, 90% of it being fat, and then a little bit of cholesterol, protein, and phospholipid. This giant chylomicron has now left the lymphatic system and it's entering our circulation. So it goes around

in circulation and now it's going to deposit all of this fat that it's got in it into different areas. So some fat might go into storage and become a triglyceride. Some fat may go over there to create more hormones. Some fat may go in to create new cells because the phospholipid bilayer cells are actually, the layer is actually made of fat. All of these fat drops are going to be taking this chylomicron slower and slower and slower until, lower and lower and lower rather, until it becomes something known as a VLDL. So you also see this on your lab. This is a very low density lipoprotein. So all we've done is we've had a chylomicron that's dropped fat off at different areas of the body until it's become a

VLDL. Now it's a very low density lipoprotein. So we're getting closer to that core cholesterol value and it is going to continue to shrink, shrink, shrink, shrink even further until it just becomes LDL. So we're not VLDL anymore. We are just LDL. So now when we have remaining LDL left over in circulation, LDL is really going to go into two places. Number one, it's going to go over for hormone synthesis because we actually make hormones.

We utilize vitamin B5, acetyl-CoA, and LDL to enter steroid hormone synthesis. Or this LDL, in the majority of cases, will go up to the liver to create bile. So we create bile out of LDL. Bile is what we use to actually digest fats. And that's how the whole thing comes full circle. But your LDL is used to create bile. And that's actually how fiber lowers cholesterol. Your fiber actually binds onto bile and pulls it out of the body. So then your body's forced to use more cholesterol to make more bile all over again so then that's kind of the whole trip that one can have for ldl and cholesterol in general but if you're paying very close attention you'd pick up i didn't mention hdl once everything your your

chylomicron your ldl your vldl these are all liver mediated or all created in the liver. Whereas HDL is actually made of the periphery. So if you see somebody say with a normal HDL and an offset LDL, you know that you want to start looking at the liver first to address that LDL problem. Or if you see someone with a really low HDL, you're actually going to be looking outside of the liver for that situation to identify what's going on with HDL. And to kind of connect it to our previous conversation on blood sugar control, insulin activates an enzyme called HMG-CoA. HMG-CoA is what actually allows the body to convert cholesterol into bile. It's one of the

reasons if you use a statin, statins actually inhibit HMG-CoA and that's how they lower cholesterol. But HMG-CoA, sorry, rather HMG-CoA creates cholesterol in the liver and HMG-CoA is activated by insulin. So just high levels of insulin by itself will increase your cholesterol. So somebody may not actually have a cholesterol problem per se, as much as they just have a blood sugar problem that's driving up their insulin. And also thyroid hormone, hypothyroidism. Thyroid is what actually allows the body to convert cholesterol into bile. But if you don't

have enough thyroid hormone, then you decrease that ability, that process from happening as well. So if we don't have enough thyroid, we can have a cholesterol overload. If we have too much insulin activating on HMG-CoA, we can have a cholesterol overload. If we're not making enough bile, if something's going on with the gallbladder, then we can have a cholesterol overload. If we're not making enough bile or something's going on with the gallbladder, then we can have a cholesterol overload. If we are just simply having weight, like finally, then if we can rule out all of this shit, then maybe it has something to do with saturated fat intake, inflammation, and dietary cholesterol intake. But we've got a lot of stuff to rule out first that we can act on way before I would just look at a blood chemistry and say, hey, lower your red meat. There's way too much to consider. What was the ratio piece when you looked at mine?

I can't remember exactly what you were looking at saying, yeah, my cholesterol may show up high, but I have a ratio of something that is in the right ranges. So I don't really need to worry about it. Total cholesterol to triglyceride being two to one is an excellent longevity predictor. So if somebody's total cholesterol and triglycerides, even if they're a little elevated, so long as that ratio holds true, I'm not too worried about it. But there are more ratios than that you want total cholesterol to HDL to be less than three, you want triglyceride to HDL to be less than 3.8. There are many different ratios that you can look at and start kind of analyzing and when you understand the biochemistry behind Okay, where is HDL created?

Where is LDL created? What's happening to triglycerides? When you understand how those things are created and you start looking at the ratios, you understand what tissue you need to target afterwards to correct lipids. So yours specifically was total cholesterol to triglycerides, and that's at a two to one. There's excellent literature on that for healthy longevity, regardless of current number, the current measurement rather. Can I ask why? What is it about triglycerides to total cholesterol where a two to one ratio matters or is that just what it is? That's just what it is. That's what has been predicted. And part of the reason why it's what it is, is because there's still a lot more to learn in this area. Because people have been blaming cholesterol for problems that aren't cholesterol's fault for a very, very, very long

time. There are people with very high cholesterol that live a long time. And there's also people with really low cholesterol who do not live a long time. But one of the big ones that is absolutely true is that you do want to have an LDL to HDL ratio greater than two. That's one that is, and people, when you have a very high HDL, this is something a lot of people don't know, high HDL is associated with cancer. And people, they want the good cholesterol. They want the really high, good cholesterol. That's good, right? Wrong. When HDL is over 80, it's very connected to cancer. And you actually want, it's considered a pathology. If your LDL and your HDL are one-to-one, you actually want it to be greater than two-to-one for an optimal lipid profile. I'm pulling up my, my lab results right now because I want to see what all of those numbers are.

While you pull it up, I'll give the audience an analogy that's easy to remember. When it comes to HDL and LDL, it's kind of like that old fairy tale of where the kids left breadcrumbs everywhere they went. That's what LDL is. LDL, when going around the body and doesn't have something to do, like become bile or create more steroid hormones, well, then LDL actually leaves little droplets around the body that can harden arteries and create a problem. However, HDL is like a janitor. So when you have little kids leaving breadcrumbs around. So long as you have enough janitors to clean up the mess, then your ratio is actually quite on point. Because HDL, what it does, why it's considered the good cholesterol, is it grabs onto these little LDL droplets, redistributes it back to the liver, so the liver can metabolize it. So HDL cleans up your circulatory system. LDL is a lot of important roles as well.

You want an optimal amount of both, but if you've got kids leaving breadcrumbs around, so long as you have enough janitors to clean up the mess, then you are going to be good and on point. And that's, you want to be at about greater than two to one. Gotcha. The primary reason people tend to be concerned about cholesterol uh especially as you get older is you know clogging your arteries having heart attacks stroke etc you're talking about uh ldl and hcls with the ldls depositing and the hcls cleaning things up um i've heard i've heard analogies there where um you know after there's damage in in your artery you have ldls come and make deposits,

but it's really the damage. That's the problem. Not necessarily the fact that LDL is, is, um, making deposits. Yes, absolutely. Yeah. Yeah. Yeah. Yeah. Cause that's a, that's an inflammation status. So, and that's the thing in the literature. That's, it's funny you say that cause that LDL, that two to one LDL to HDL, that's an inflammation predictor and the inflammation is the damage. So that's, it's perfect timing that you said that. So it's not specifically LDL's fault. It's, it's whatever's causing the inflammation slash damage that, that you need to, again, look further into your physiology to figure out what the root cause is there.

Okay. Okay. So that, that begs a good question. And it's a part of the philosophy at which I operate. Whenever you see anything, you have to ask, okay, why does the body think this is a good idea? Okay. Evolutionary biology has existed for millions of years. Our bodies aren't stupid. We aren't smarter than our bodies. So whenever you see something high or low, it's because the body is already predetermined that it wants to leverage off of a dysfunction or another organ system in the body for its own greater good. Our body does nothing in the act of damaging itself. So if you see high LDL, you would say, why does the body think this is a good idea?

Oh, because there's damage. I'm looking at that right now. Okay, cool. Where did that damage come from? So that's exactly how that comes full circle, because the body thought driving LDL up was a good idea because there was damage, and now it's your freaking job to find out where the damage came from. Mine is 152. And that's 50% higher than the highest level it should be, the LDL. Your LDL is 150. Yeah, but what's your HDL? HDL is 44.

Yeah. So you want to be greater than two. So you being at a greater than two to one, I would still want to lower your LDL, which is what we're going to do. But, um, you're, you're from a ratio perspective, you're, you're not, you're not in a bad spot. Only if your HDL was driven way up. Yeah. Um, if we were to move on right at the top of, uh, the blood work we got done and read by you, a C reactive protein. Um, can we dig into that a little bit? I don't know

a ton about it, but it's always something that shows up. I'm always in healthy ranges, so it's kind of like something I've never really dug into, but what is C-reactive protein and how does that play into just physiological health? So C-reactive protein is a non-specific inflammatory marker. So it really just represents inflammation. So if C-reactive protein came back high, then that would be your job to figure out where that inflammation come from, be it a gut infection, blood sugar control issues, metal control, vitamin mineral status, all of these things, whatever can precursor that type of inflammatory response it's just your job to find out so c-reactive is non-specific so 0.15 we're doing pretty solid that's a low

inflate low inflammatory human being yeah greater than three all around fellas greater than three is when you're at a risk for cardiovascular disease and you're at yeah all right your instagram profile i'm a low inflammatory human being i am a low inflammatory human being that's that's what that's what anders would put on his tinder profile right 0.13 baby high ldl but low inflammation i inflammation. I've got good ratios. I hope you're wrong. Most Tinder profiles want lots of inflammation. Dan, are you coming to Miami?

I hope so. No. I hope so, too. Unfortunately, Canada just went into another lockdown. No. Yeah, dude. went into another lockdown. No! Yeah, dude. You need to leave. Not all of Canada, just Ontario.

But, dude, it's been like freaking North Korea here. I don't know how many lockdowns. This might be our fourth. It sucks when you lose count. I guess I'll say that. But it's been brutal, man. I wanted to do some in-person seminars in the US, basically unpacking this because like, sometimes I feel like it's tough to do podcasts and maybe you guys pick up on it because someone asked me a question and then I've got to answer 14 questions before I can

answer the question they just asked me. But if I did an in-person seminar, I could unpack the whole method from the square one. And then that's kind of what was going to be my plan is to unpack blood chemistry from the ground up. Yes. One thing people are going to also get when they go get their yearly checkup is a urinalysis. And one thing that just popped on mine as abnormal, but likely has a ton of just questions around it is ketones. When that shows up, and how about this, just to start at the top, where does the urinalysis come in to play for you? What are those tests? What are you looking for? So when you're doing a urine analysis, you're typically...

And this is on the blood work. On the blood work? Yeah, it's on the same thing. It's not the extra hormones that we took. So ketones would be pretty representative of mitochondrial status. But what I'm looking at primarily in urine on a blood assessment is if there's proteins in the urine, because if there's proteins in the urine, then there's a kidney dysfunction and kidney dysfunction in strength athletes and in professional athletes, like who I typically always work with kidneys, your kidneys and your liver. I like to describe them as like water and eggs. So water

is like your liver because you can freeze it, but then you can also thaw it and it'll just go back to water. Whereas kidneys, if you have an egg, if you hard boil that egg, it can't just go back to an egg. That's a hard boiled egg at that point. That's what damage is like in the body. The liver is unbelievably regenerative. You can actually, I've worked with some people who have messed up their livers and it goes back fine. I've had you guys brace yourself. I've actually had a power lifter I worked with who, when he came to me, his ALT was over 700. So your ALT should technically not exceed 40. And his ALT, which is measure of liver damage is over 700.

And then he got his ALT all the way back to normal. The liver is unbelievably regenerative. And that's why people can take hard medications and regenerate themselves as well. Not even just performance enhancing, but just in the hospital situation. So liver will handle it. But the kidneys, if you do damage to the kidneys, man, it's you got to just manage it after that because you can't rely on it to regenerate like the kidney so when i'm looking at a urine analysis on a typical blood chemistry if it's been added on then i'm looking for proteins in the urine to see what's going on with the kidneys yeah yeah uh i kind of want to kind of things would specifically damage your

kidneys uh so if you want to so certain performance enhancing drugs will absolutely create issues on the kidneys. Dehydration is one of the greatest stressors on the kidneys. High blood pressure is one of the greatest stressors on the kidneys. But then there's also acid load, dietary acid load. And, you know, let me preface this by like, I'm not one of these alkaline diet hippie dudes. I'm not a part of that in any way, shape or form. This is biochemistry. So there's two things that create an acid load. And there's three things that are alkaline promoting.

The two is one macronutrient and one micronutrient, protein and phosphorus. These create an acid load on the kidneys. Whereas there's three micronutrients, calcium, magnesium, and potassium that are alkaline forming. So when you understand this one macronutrient and these four micronutrients, acid, protein, phosphorus, alkaline, calcium, magnesium, potassium, you want to balance those to create an optimal acid-base ratio within the body. And this is something you can actually look up in the literature and measure yourself using an app called Cronometer. It's called your PRAO score.

PRAO is P-R-A-O, potential renal acid load. Potential, because it comes from your diet. Renal, kidneys, acid, damage, load, degree of damage. So you're looking at your PRAL score, and the PRAL score is essentially a measurement, how well are you offsetting protein and phosphorus intake in your diet with calcium, potassium, and magnesium. That is an excellent, excellent thing

that will have a major impact on your kidney health. It's one of the big things I do with, say, bodybuilders and powerlifters because lots of times they're very protein heavy and very calcium, potassium, and magnesium poor. So just offsetting that alone improves the health of their kidneys dramatically. And then when you correct their blood pressure, you correct their hydration status, they have a way healthier kidney, and they win the game of longevity. Could you generalize that to if you're going to eat a lot of protein, just like make sure you drink a lot of water and eat a lot of vegetables? Or is that like way too simple? Or somebody's not getting any tests done yeah so i mean always everything i say is i'm working with a one

percenter right so like in a lot of cases drink more water and eat more vegetables will work that that's something that definitely will i mean you could be a little bit more precise and say say spinach and swiss chard are excellent sources of alkaline forming micronutrients, whereas other vegetables aren't really. But drinking more water, if you get half an ounce of water per pound of body weight per day, so if you're 200 pounds, and you have 100 ounces of water per day, that's a great starting point. And then just simply include and you can look this up, you can look up Prowl Food List online and it'll show you based on micronutrient content, which foods are more

alkaline and which foods are more acid loading. And again, I'm not telling people to not eat acid loading foods. All I'm saying is offset it a little bit more with the ones that contain the micronutrients for optimal kidney health. I love him being on our show. I've got an ongoing note of Dan Garner notes. This is so great because he's so opposite of everything that I study and what I need to know, the physiology. The last one I want to dig into, especially as I kind of like just roll through the blood work stuff that we got done, and just hitting some of the like high topics, and I know we're going to spend a ton of time talking about each individual one. But many people are going to have questions about vitamin D, which shows up at the bottom of the blood work panel. What, obviously, it gives you the normal ranges,

but on one of the prior shows we did, we talked about how you can live in sunny San Diego and be outside, you know, five hours a day, and it's 75 degrees every single day and still be vitamin D deficient. Where does vitamin D, if it's not just direct access to sunlight on bare skin, what do we do? Exactly. Let me just answer the question with a question. Does it make sense to you that people in California have similar vitamin D to the people I do in Canada? No, not at all. I assume your whole country is vitamin D deficient. You can see how white I am. How is anybody in Alaska alive? Let's be honest.

I actually read a paper on inuits this morning only i would right yeah i love that there's two papers on inuits this morning that said selenium improves their lifespan because it binds up the mercury that's contained in the whale blubber that they eat so what wild wild sidebar fun fact yeah if you want to help out your Inuit brothers, get them a selenium supplement. Amazon Prime, roll into their house. Yeah. They're igloo. Yeah.

We probably just made like 10 generalizations that don't actually exist. To back up to vitamin D, because you say generalizations, why don't we? So people will look at a vitamin D and say they're low and they're already on like 5,000 IU. And they're like, well, better bring that up to 10,000 and still doesn't move. Like, well, better bring that up to 15,000. The logic has left the room. Logic never showed up to the party in that situation because you're driving up a dose that's a thousand plus percent greater than what you need. And yet your marker isn't moving. So it is not that simple, my friend. So when you're looking at vitamin D, there are many different things that can offset it. So in San Diego, for example, would you agree in San Diego that there's a lot of traffic?

Oh, yeah. Yeah, it is. Environmental pollutants drive down vitamin D. That's established. So environmental pollutants drive down vitamin D levels, even in the presence of vitamin D intake. That's number one. Number two, magnesium is what's required for vitamin D synthesis. So one may have quite a bit of vitamin D, but if you don't have magnesium to optimally synthesize 25 hydroxy, which is inactive, which is what labs are freaking measuring. If you don't have enough magnesium to synthesize 25 hydroxy vitamin D into 125 hydroxy vitamin D, then you don't have a vitamin D problem. You have a magnesium problem. And we've seen in research that magnesium supplementation alone increases blood vitamin D even without vitamin D supplementation. And the reason why is because it's allowing the synthesis to take place.

Another component as well is glutathione supplementation has been demonstrated to bring up vitamin D as well. So there is an inflammation component because vitamin D is what's known as an acute phase reactant. Acute phase reactant means that it will acutely react in response to inflammation. So if somebody is highly inflamed, they're going to have lower vitamin D because it's an acute phase reactant. So you just said, you know, we just talked about C-reactive protein. If somebody has slightly elevated C-reactive protein and then lower vitamin D, don't take vitamin D, dude. You're in the presence of inflammation.

That's what's driving your vitamin D down, period, okay? We've also seen that it matters per person. So actually hypothyroid people have certain gut microbiota that are more efficient at converting 25 to 125 vitamin D. So hypothyroid patient will actually come back with a very low 25 hydroxy vitamin D. But that's because they're so efficient at converting it into 125, which is the active amount in one's physiology. So if you don't know that you think, oh my god, this person's hypothyroid and they have low vitamin D. I'm going to have to give them a supplement. No, they're better converters of it than you. So you actually need to understand and respect that and be more careful about their

vitamin D intake rather than just add gas to the fire of their already existing conversion machine. Metals, trace minerals specifically impact vitamin D as well. So for example, boron has been demonstrated to increase vitamin D status, whereas lead suppresses vitamin D status. And that's because a lot of people don't know vitamin D actually enhances heavy metal absorption. So it's seen as a safety mechanism of the body that it lowers its own vitamin D status in the presence of heavy metal toxicity. So we've seen lead reduce vitamin D status. That's the body saying, I want to reduce what creates further heavy metal absorption so that I don't absorb more of this lead. Yet when you have someone, they'll say, hey, hey i got low vitamin d a lot of coaches will

just say hey dude take 10 000 iu of vitamin d and they've got no idea what their lead status is they're poisoning them yes that patient's not going to get better that and this is established stuff you guys this is absolutely already existing in the literature so So, you know, you tell me if I'm the average personal trainer out there, how many of them have ruled out environmental pollutants, boron, hypothyroidism, lead status, magnesium status, glutathione status, and inflammation? Do you think people are ruling that stuff out before they take 10,000 IU, which is an absolutely absurd dose of a vitamin. And then they take into consideration, no one's even thinking about why someone in California would be low. Well, it's low because of one of these reasons. It's not low because the sun,

we know that, because the sun's there and you're outside. It's low because of one of these reasons that you're tossing aside because you don't do your labs. Wow. I'm scared to do anything now. Can I get a bubble? Dan Garner, where can the people find you? At Dan Garner Nutrition on Instagram. If you want 10 more answers for every one question you have. Exactly. If you want to take the deep dive. Travis Mash. Mashlead. Exactly. If you want to take the deep dive.

Travis Mash. Mashlead.com. Dan, is there a book like someone like me who's, you know, aspiring to be

to pursue my PhD? Is there a book you would suggest or somewhere that you would suggest I could go to get better at,

you know, I guess blood chemistry or I guess the body chemistry. Not off the top of my head, man. I'm one of these guys. Like I don't, I don't like follow anybody or read any books. I read research. Yeah, I do.

So I could send you a bunch of really cool papers. Absolutely. Like everything, everything we discussed this week and also the hedonism versus eudaimonic living i could send you all that stuff you'll see it's all just papers that i read these days yeah i don't send that one that sounds cool so yeah hey hey but before we go do you want the inuit paper that was an important one. Everybody needs the annual paper. Please post that. Maybe I will. I found a study, the role of cholesterol metabolism in cancer.

So I found that while you were talking about, you know, the good cholesterol being a marker for cancer. The 2018 is fairly recent. Yeah. Anyway, yeah, this is a lot. I'm so glad you're on our show. Matchlead.com, at Matchlead Performance, if you want less than Dan Garner.

But pretty good at other things. You'll also get really strong. You'll get strong. You'll probably get low magnesium or something, though. That's really important here, you know? Yeah. Doug Larson. All right, follow my Instagram, instagram doug larson i don't post anymore it seems but you can follow me anyway i'm andrews varner at andrews varner we are barbell shrugged at barbell underscore shrugged make sure you get over to

diesel dad mentorship.com where all the busy dads getting strong-witted athletic and get over to your local walmart uh i never thought i'd really say this, but we were chosen as the one product to have a sale at Walmart. They call those rollback prices. You guys know about these things? Well, they only take one product from each category in performance nutrition. Well, it's store-wide, but we only care about the place where you go to get supplements, get jacked. And they chose us for the new year. So January, February, and March, we've got rollback pricing. You can save like 25%. Get over to your local Walmart.

Look for my face on the box. Friends, we'll see you guys next week.