The Biohacker's Guide to Blood Work
Today we're interviewing Dr Alexis Shields, who specializes in the interpretation of blood work. She's going to explain the importance of getting your blood tested if you're serious about your biohacking.
Can you tell us about why getting regular blood tests is important?
Basic blood work is the backbone of biohacking. It gives us a window into the inner functioning of your body. And many times you will start to see small changes in your blood before you have identified a symptom that tells you there is something wrong. So if you track your basic blood biomarkers from year to year, you will see these shifts and be able to make changes in diet and lifestyle to address them.
The idea with doing bloodwork on a regular basis, when you don’t actually have an illness, is to catch your body when it starts going in that direction. You can do very basic blood work that will tell you about your organs and glands, your vitamin levels, mineral levels, hormones and inflammation levels.
You can see when something is out of the optimal range, so then you can do something about it. You’re not just waiting for a disease to happen – it’s more proactive and preventative to do blood work every year and figure out what your ‘normal’ looks like, so you can catch those things early.
For the biohacker, this information is vital. Optimizing your mental and physical performance really relies on having accurate data about your specific biochemistry, and how your body responds to various changes.
What kind of information can you expect to get from your blood tests?
From very basic blood work you can see…
- The health of your liver, kidneys, and adrenals glands.
- Vitamin & mineral levels, cholesterol, and the pH of your body.
- Your thyroid is like the engine of the body, and testing it properly will tell you about your metabolism and ability to create energy.
- Different inflammation markers which indicate systemic as well as cardiovascular inflammation levels.
- The health of your blood and your ability to carry oxygen around the body, as well as the health of your immune system.
- Reproductive hormones are sometimes tested with basic blood work.
Then there are other things like trace mineral testing and stool testing that can tell you about your digestive function. These things are used in functional medicine and can be very useful. You can get very specific, to the point of being able to see individual nutrients, and down to specific processes.
For example, lots of people are interested in the process of methylation at the moment, and there are a combination of tests that will let you see how well your methylation is working.
However, the mistake I see a lot of biohackers making is getting attracted to the shiny lights.
There are all these very exciting tests you can do, but they do that without doing the basic overview – they skip doing all the basics and do all these individual nutrient tests and so on, when you really have to start with the basics.
The big tests might not be as exciting, but they will tell you a lot about your body, your health and what you might be predisposed to.
From the basics you can see if you would benefit from other more specific tests. For example, if your homocysteine levels (inflammation marker) are elevated, then further testing for methylation problems would be useful. This in-depth analysis can be really useful, but you need to start at the beginning to get that.
Which blood tests do you recommend, and why?
At a minimum, I recommend that people test the following yearly:
- Complete blood count
- Blood sugar (fasting and long-term indicators)
- Liver, kidney, and thyroid function
- Inflammation markers
- Vitamins and minerals (vitamin D)
A complete blood count (CBC) is a very basic level test. If you’re going to get any testing done, they’ll do a CBC because your red blood cells basically carry everything in your body. Everything is going through your bloodstream.
At this level, it’s looking at your ability to transport nutrients and oxygen around the body. A CBC is always run whenever you have any kind of blood test done; it’s really cheap and can indicate how well your body is functioning on a basic level.
It also tells you things like whether you have enough iron, enough B vitamins, whether you’re anemic, how your white blood cells are doing. Your red blood cells and white blood cells - so, your ability to carry oxygen and fight infection - are vital indicators that you should always keep a close eye on.
Beyond that, the comprehensive metabolic panel (CMP), assesses liver and kidney function, as well as your adrenals from a Functional medicine perspective. The CMP also tests your electrolyte levels to give you an indicator of your body’s pH. In the US the CMP is a single test – it covers basic metabolic function and organ function.
Cholesterol should also be tracked yearly.
Most people are aware that it can be too high, but it can also be too low. Low cholesterol is often not caught by conventional medicine, because everyone is so focused on the problems that high cholesterol can cause.
Low cholesterol can also cause a lot of problems, though, because you need it to make hormones, maintain proper levels of neurotransmitters in your brain, and for inflammation repair. You need sufficient cholesterol levels to keep all those critical functions working well, so that one is also important to track.
Once you’ve got your test results, how do you interpret them? What do you need to know about how results are interpreted?
The interpretation of blood work is challenging because the normal reference ranges that appear on your lab reports are not the optimal health ranges. Laboratory reference ranges are determined on a bell curve, based on a sample population from that lab.
The problem is, most people going to a lab for blood testing are sick.
They are not representative of a healthy population, so measuring yourself against that range can cause false interpretation of your data. Therefore, more narrow, optimal reference ranges must be considered when looking at your lab reports.
Optimal health reference ranges are the ranges for each blood biomarker based on scientific research and the observation and experience of thousands of functional medicine doctors world-wide.
Imbalances in the body occur before your blood is outside of the standard lab range.
However, most doctors are not trained in how to see these early dysfunctional patterns in blood work. And they do not know the diet and lifestyle modifications and natural medicines that effectively bring the tests back into an optimal range.
At a very rough level, you can see that if you’re at the far ends of the range, you’re probably not at the optimal health level, but if you’re roughly in the middle then you’re more likely to be in the optimal health range. That’s very rough though - you want someone who is trained and looking at your results because there’s a lot more to it.
Once you’ve got your interpretation, what should you do with that information? How often should you get blood work done?
It is very important that you work with a Functional Medicine doctor who specializes in recognizing these optimal ranges for blood work. This will help you to accurately interpret your blood test results and how often they should be retested.
If your doctor is looking at it from a functional health perspective, they should be helping you to figure out what the patterns are telling you:
- Are your inflammation markers elevated?
- Are you making too much cholesterol or too little?
- Do you have elevated or depleted levels of particular vitamins and minerals?
They should be able to pinpoint the underlying causes based on your current diet and lifestyle, and then point you towards shifts in your diet and lifestyle to change the results.
This might involve adding particular supplements to your routine, changes in diet or exercise routines. Over time you’ll be able to track the results of these changes.
For the average healthy person I recommend getting basic blood work done yearly to track the progression of their health from year to year. If you are making big changes to your diet and lifestyle or taking supplements, you might even want to do it every six months.
What is the impact of taking supplements and nootropics on your blood profile?
If you are deficient in nutrients such as magnesium and vitamin D, you can directly monitor the impact of taking these nutrients on the levels in your blood. You’ll start noticing the difference too, in how your body and mind feel and function.
Measuring something like the benefits of resistant starch would be more easily seen in some specialized stool testing. But taking it may also have an effect on blood inflammation levels, if the inflammation was coming from an inflammatory digestive disorder or something similar.
Seeing the benefits of nootropics in the blood is a little bit more difficult, because the area is still so new.
There have not been any studies yet, but since nootropics like CILTEP also contain vitamins and minerals, you can see patterns start to emerge in your blood work. There’s not a direct marker that’s changed by nootropics, and a lot of people who are using nootropics are really wanting to optimize their health. They’re already focused on their health, so often there’s not a particular marker that is out of balance when they start, so that can make things a bit harder to track.
However, if you are familiar with your blood biomarkers you may see changes in your blood when you take certain nootropics. But this would be on an individual basis, rather than applying to everyone.
Everyone has their individual experiences, which don’t happen across the board, so the more familiar you are with your own blood work and health status, the easier it is to measure.
To really watch the benefits from taking supplements and nootropics, you would want to rate different areas of your health on a scale from 0-10, and then track that progress. For example, you might keep note of your mental clarity, focus, motivation, memory, concentration, and mood based on your supplementation routines.
Biohacking like this can really improve your body’s ability to perform at a very high level for the long term. You’re much more conscious of what’s going on in your body, often down to the very fine details (especially if you’ve gotten into the quantified self movement). This can prolong both your lifespan and your quality of life.
How much can you expect to pay for your tests, and where is best to have them done?
Costs for blood work varies greatly. Some basic blood work can be ordered by your physician and covered by your health insurance. However, be aware that insurance will only pay for the tests that are required based on your current health situation. So if you are wanting to optimize your health and monitor the progression from year to year, you may need to pay out of pocket for these types of tests.
I partner with a very inexpensive national lab to provide my patients with an affordable blood testing option. The complete health screening packages are often 80% less than paying through your local lab or physicians office.
There are great companies popping up that are attempting to make it easier for you to order your own blood work such as WellnessFX and Direct labs. These companies are looking to make blood work more accessible, and there are also functional medicine doctors who have different contracts with labs to make it affordable by paying wholesale prices.
Prices between those options, and hospitals or doctors offices, still vary wildly at the moment, so it’s really worth doing your research.
Right now, the cost for complete blood screening can be anywhere from $270 to $2000, so the best thing you can do if you’re going to a doctor or lab is to ask them for an itemized list. Have them list everything you want to have tested and how much each one is going to cost, so you don’t get stuck with an enormous bill.
If you can find a functional medicine doctor who gives you really in-depth interpretation of your results, and good recommendations on how to improve, stick with them. Alternately, I think the Wellness FX program is amazing (I am a consulting doctor there). They’re offering a lot of really cool things.
The best thing about their program is how they present the results. You can log into their system and see all your blood biomarkers, see where they are in the reference range, so while they’re still a bit more expensive than just the lab work I would usually get for a client, you get their complete system for tracking your blood work. They’re making it really easy and accessible for a lot of people.
Getting started with tracking your blood work can really revolutionize your health and mental performance. Even small changes based on your results can yield significant improvements, so if you want know which specific tests to ask for, get Dr Alexis’ free Biohackers Guide to Blood Work: