How to get out from under the lamppost
A framework to use biometrics to improve your health
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.