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    The Four Lab Results You Absolutely Must Know

    While there are many comprehensive lab tests that I routinely recommend to clients, there are four highly informative test results that everyone should know and monitor for themselves. These four markers can provide important preventative and diagnostic information to you as well as your doctor.


    The results on these four lab tests can provide immediate insights into your,

    • Overall inflammation status – “What chronic issues is your body struggling with?”
    • Blood sugar control – “Are you pre-diabetic, insulin-resistant, or at risk for these?”
    • Immune system resilience – “Are you aging before your time?”
    • Hormonal status – “What happened to your energy, memory, and libido?”
    • Stress response – “How are you handling your everyday stress?”
    • And whether you are supporting your body’s bone, brain, and heart health!

    This information sounds pretty important, right?

    These blood tests can usually be found for minimal cost (typically costing under $125 in total) and can be easily ordered (even without a doctor’s prescription).

    I recommend every adult over the age of 40 takes these tests at least annually; more frequently if embarking on health-focused lifestyle interventions (diet, exercise, etc.) or taking hormones, supplements or medications (or if having underlying health conditions), as changes in these biomarkers should be monitored.

    I always say, “Test, Don’t Guess,” and that is especially true relating to these four lab results. None of us should be guessing about how we measure-up relating to these markers. 

    So what are these four critical test markers

    • Vitamin D level (25-hydroxy vitamin D test)
    • hsC-reactive protein (also referred to as cardio-CRP and highly sensitive CRP)
    • Hemoglobin A1C
    • DHEA-sulfate

    Do you know your current numbers?

    Test #1: Know your vitamin D level!

    An estimated 40% of Americans may be deficient in vitamin D. (1) And that statistic isn’t measuring for optimal levels…at optimal levels, I think the percentage of those who are deficient would soar into the 80+ percentile! 

    It is such an important nutrient; we have vitamin D receptors throughout our bodies, and healthy levels are essential for a number of reasons, including:

    • It plays a key role in our overall immune system health.
    • It is an important indicator of bone weakness or strength. Vitamin D helps our body absorb the calcium needed to support bone health.
    • It supports our mood, memory, and brain health! It can help with depression and seasonal affective disorder, as well. (2) 
    • And it does so much more.

    Growing scientific evidence is implicating vitamin D deficiency with many chronic conditions, including cardiovascular disease, hypertension, type 1 diabetes, rheumatoid arthritis and several common cancers (including breast cancer). (3)  Low levels of vitamin D have been associated with autoimmune disorders such as Hashimoto’s, as well. (4) 

    So why are so many of us deficient in vitamin D? Well, we are too careful with sunscreen when we do go out, and we don’t go out-of-doors enough, resulting in insufficient UVB exposure (and frankly, less exercise and connection with nature!). We also wear sunglasses when we do go out-of-doors. People having darker skin pigmentation are particularly at risk for vitamin D deficiency as their skin doesn’t absorb as much vitamin D. Some of us are obese (found to be associated with deficiencies) or have gastrointestinal issues such as fat malabsorption (seen a lot in people having hypothyroid disease), or are deficient in magnesium and/or testing as acidic versus alkaline. (5) 

    The 25-hydroxy vitamin D blood test is the best test to give you the level of vitamin D in your body so you can assess whether your levels are too low or even too high.

    What’s an optimal level for vitamin D? 

    When tested, a regular reading on the 25-hydroxy vitamin D3 test is 30-80 ng/mL. Remember,  we always want to look at optimal levels, however. The optimal level that I reach for is 50-100 ng/mL. 

    Should you test as deficient, you can work with your doctor to determine what interventions might be appropriate for you. Most functional practitioners will recommend supplementation if your vitamin D level tests below 50 ng/mL. The typical recommended dose will be for vitamin D3 (most effective at increasing serum levels of vitamin D) in the range of 5,000 to 10,000 IUs per day for approximately 3 to 4 months (The timeframe is typically longer, and the dose may be higher in the winter months).

    You can usually then switch to a lower maintenance dose of 2,000 IUs per day (or whatever your doctor recommends for your particular situation). Many of the women in my programs find they need to supplement at about 5,000 IUs a day ongoing, and then retest to measure their levels. 

    I recommend my formulation combining 10,000 IUs of D3 along with K2, Pura D3K2. You must combine vitamin K with vitamin D to help with absorption and minimize the risk of calcium toxicity to the arteries (Vitamin K activates a protein called MGP, which helps ensure calcium deposits to the bone, where we want it, instead).

    Lifestyle interventions include getting your skin exposed to the sun in a healthy manner! It only takes about 15 to 20 minutes a day of morning sun (without sunscreen). It is also recommended that you don’t bathe or shower for about half an hour after sunbathing to allow for your skin to produce vitamin D. Dark skin individuals typically need four times the exposure times. 

    You can listen to a wonderful (and wild!) podcast that I did several years ago with Dr. Jack Kruse on the importance of getting outdoors and letting the sunlight hit our skinand retinas in the morning. Light hitting our retinas in the morning is one way our circadian rhythm gets reset each day, which is essential to so many things, including our hormone production and getting a good night’s sleep.

    Vitamin D supplementation is usually required as few foods contain high levels of vitamin D.Small amounts are found in egg yolks and beef liver. The best sources are fatty fish such as salmon, mackerel or tuna, or fish liver (cod liver) oils. Unfortunately, one of the best sources for vitamin D is fortified foods, which are highly processed and can result in the body becoming acidic and definitely not Keto-Green! Dairy can be a good source but many people have food sensitivities to dairy products. Vitamin K can be found in green leafy vegetables, hard cheeses, and organ meats.

    Test #2: Know your highly sensitive CRP number!

    CRP stands for C-reactive protein, also referred to as hsC-reactive protein, hs-CRP, highly sensitive CRP or cardio-CRP testing. I want to be clear there is the straight CRP test vs hs-CRP test and there is a key difference in sensitivity.  I recommend the hs-CRP test.

    CRP measures the amount of “hidden” inflammation in your body. Note that I’m emphasizing the term hidden as oftentimes inflammation may not be expressing itself but may still be silently developing and worsening off our radar…eventually showing up as a full-blown, advancing disease. This is the worst kind of inflammation, typical of many chronic diseases such as diabetes, heart disease, autoimmune diseases, and even dementia.

    CRP is produced mainly by the liver and basically tells the immune system when there is inflammation and points out the bad cells that the immune system needs to deal with. If you have a bacterial infection or something acute or short-term, CRP will elevate and flags the immune system to become activated; it can then eliminate the bacteria or issue. So that’s good. But if you have an underlying, progressive problem, like diabetes or heart disease, your increasing CRP level may be signaling that there is some hidden inflammation that hasn’t been addressed and is getting worse.

    In research elevated hs-CRP levels have been found to predict increased cardiovascular mortality risk in both men and women and an increased risk of cancer mortality in men. (6) 

    High CRP levels have also been linked to weak bones. (7) Even inflammation elsewhere in the body, such as in the gums (gingivitis), has been found to nearly double people’s CRP levels compared to those with healthy gums. So my good friend, Dr. Steven Masley, actually looks at gum inflammation as a marker for increased cardiovascular risk.

    What’s an optimal number for your CRP?

    Normal CRP levels are below 3.0 mg/dL.But remember, we want to see optimal levels, which are those below 1.0 mg/dL.

    Should you test higher you will want to do all that you can to reduce your overall inflammation, including identifying any underlying issues you may be having. One important way to reduce inflammation is to become more alkaline and eat a less inflammatory diet (dump the high-sugar, processed foods diet and inflammatory fats and gain the benefits from eating Keto-Green!).

    Other inflammatory culprits include food sensitivities (gluten and dairy are common), mold and environmental allergens (my CRP went off the chart when my home was over-ridden with mold after being flooded by one of Georgia’s recent hurricanes), toxicity from your food and your environment, stress, an unhealthy gut, and much more. You can learn about inflammatory bad guys and how to outsmart them by reading and following the principles in my book, The Hormone Fix.

    Test #3: Know your A1C number!

    Hemoglobin A1C (HbA1c) is your “heads up early warning” marker for blood sugar issues and for developing insulin resistance, pre-diabetes and diabetes! Many people know A1C has  “something to do with diabetes” as there are so many commercials on TV about any number of prescription meds for lowering your A1C number. But did you happen to catch all of those potential side effects? Much better to know your number and be preventative with your blood sugar control.

    A high A1C marker can also increase your risk for Alzheimer’s disease and cancer. Oh, and because having a high A1C can result in insulin resistance you’ll also have a higher risk factor for urinary incontinence along with your blood sugar issues!  

    We don’t want any of these things, especially the damage to our delicate blood vessel linings, retinal tissue and microvasculature of our extremities (such as our feet!) that occurs with diabetes.

    Hemoglobin A1C measures the percentage of red blood cells that are saturated with glucose. The higher the A1C the higher the estimated average blood glucose. Your HbA1c number is generally considered to correlate to your average blood glucose over 2 to 3 months. People who have diabetes need this test regularly to check their progression or improvement of disease. 

    In my women’s restorative health programs many participants take this test themselves to see how the changes they are making to their nutrition and lifestyle choices are working at reducing their A1C. Time and time again I’ve had women happily report to me that their A1C number of 5.7 or above (considered pre-diabetic or diabetic) has dropped to healthier numbers like 5.3 or 5.4. You can read about one beautiful participant’s improvements on her A1C number (and other lab tests as well as reducing her terrible hot flashes and other symptoms) at this earlier blog. 

    What’s an optimal number for your A1C?

    If your hemoglobin A1C comes back at 6.5 or higher that qualifies for a diagnosis of diabetes. 

    But just because your results are lower than that doesn’t mean you are at optimal or healthy levels. We view 5.7 to 6.4 as pre-diabetes. And even under 5.7 you are increasing your risk for health issues. Research has shown that every 0.1 percentage point above 5.3 percent significantly increases your risk for Alzheimer’s disease, brain shrinkage and cancer.

    Ideally we want to see something in the normal range at a minimum, between 4 and 5.3 percent. Optimal is a result under 5.3 percent. This typically correlates to a glucose measure between 82 and 97, by the way. 

    If you want to listen to an excellent podcast that discusses A1C and blood glucose levels, you might enjoy this interview I did with my good friend Dr. Ritamarie Loscalzo. Dr. Ritamarie is my “go to” doc on all things blood sugar. (note that his podcast talks about a class that is no longer available, but I wanted to share the podcast anyway as it contains great info).

    One of the best things you can do to address an unhealthy A1C marker is simple dietary change, both in terms of “what” you eat as well as “when” you eat. My Keto-Green diet provides an answer to both of these, providing alkaline foods and the mechanisms (such as intermittent fasting) to get you into ketosis (burning fat while gaining many additional health benefits such as improving insulin sensitivity!).

    One of my clients, Angie age 50y, after following my Keto-Green plan for 1 month dropped her HbA1c from 6.0 to 5.4!  She also feels great plus lost 12 of those hard to lose pounds she’s been trying to get off for years! We continue to see great results like this from many women!

    Test #4: What’s your DHEA-sulfate level?

    The DHEA-sulfate (DHEA-s) test measures the amount of DHEA-sulfate in your blood. Dehydroepiandrosterone (DHEA) is a hormone made by your adrenal glands and to a lesser extent the testes or ovaries. DHEA is converted into DHEA-s in your adrenal glands and liver.

    DHEA-s is a biomarker of aging as well as a way to assess the functioning of the adrenal glands and your stress response. DHEA is an important hormone in our bodies (in both women and men) that starts to naturally decline in our 30’s, but is also impacted by stress and other factors. It is a precursor hormone to estrogen and testosterone and also plays a role in making insulin growth factor (supportive of muscle growth and insulin sensitivity). By age 70 we synthesize only about 10 percent to 20 percent of our youthful levels of DHEA.  

    Low levels of DHEA-sulfate are associated with insulin resistance, immune disease, atherosclerosis (clogged arteries), poor memory, dementia, vaginal atrophy (vaginal dryness and thinning/shrinking of the vaginal tissues), and reduced libido (sex drive). 

    Optimal levels are associated with protection against cardiovascular disease and cancer, decreased risk of osteoporosis, healthier bones, a healthier immune system, better memory and cognition, and better sexual function, too. DHEA has been heavily researched relating to a positive impact on libido! You can read much more about DHEA in this earlier research article on my site.

    DHEA also increases the production of collagen making skin appear smoother and younger. No wonder it helps with vaginal dryness as well.

    What’s an optimal number for your DHEA-sulfate?

    Results for your DHEA-s level need to be looked at based on your age, sex and general health condition. Typical normal ranges for women are:

    Ages 30 to 39: 45 to 270 μg/dL or 1.22 to 7.29 μmol/L

    Ages 40 to 49: 32 to 240 μg/dL or 0.86 to 6.48 μmol/L

    Ages 50 to 59: 26 to 200 μg/dL or 0.70 to 5.40 μmol/L

    Ages 60 to 69: 13 to 130 μg/dL or 0.35 to 3.51 μmol/L

    Ages 69 and older: 17 to 90 μg/dL or 0.46 to 2.43 μmol/L

    For most women over 40, however,  I like to see results within the optimal range of 100-250 ug/dL

    If a woman tests outside the optimal range she should work with her doctor to determine the best solution for her, which can be unique depending on her specific health status and symptoms. As an example, if a woman is experiencing vaginal dryness or issues with libido, I’d likely suggest they try my Julva®anti-aging cream for the vulva, which contains DHEA along with many other beautiful ingredients including Alpine Rose stem cells. DHEA can also be prescribed for insertion directly into the vagina for these types of symptoms. Oral DHEA can also be obtained over-the-counter.

    Before supplementing with oral DHEA I do suggest you have your DHEA-s levels tested, as too high a level isn’t good either. Then, if your DHEA-s level is low (under 120 ug/dL), I recommend beginning your treatment with 5 milligrams of DHEA per day and working up - slowly - to what feels like an optimal level for you (usually not above 15 milligrams, and you should be retested along the way). Your physician should be able to help you adjust your dosage.

    Stress impacts our adrenals and DHEA levels, so anything you can do to help manage your stress will likely help support healthier levels.

    My key test panel gives you all four of these important numbers

    Remember we want to “Test, Don’t Guess”, especially when it comes to these four important numbers.

    If your doctor doesn’t want to run the tests, I’ve made it easy for you to get them yourself in a single panel. And, if your doctor doesn’t feel you need this info you might want to consider finding a new, functionally-inclined doctor who encourages the tests. 

    My Key Marker Panel includes all 4 tests discussed in this article (7 Biomarkers). Note that there are restrictions in NJ, NY and outside of the USA relating to having these types of blood labs drawn. Please follow the noted instructions when ordering and prior to having your lab drawn.

    How to learn more about improving your numbers!

    Remember, these numbers tell you important information about your health trajectory. 

    Are you at risk for becoming diabetic or having blood pressure issues, heart disease, etc.? I’ve had women in my programs who have lost a lot of weight and have reduced symptoms including hot  flashes, insomnia, arthritis and brain fog…but most have been more grateful to see that their underlying health has improved. Seeing inflammatory markers significantly reduced, or seeing one’s risk for diabetes decreased dramatically…and knowing you are doing all that  you can to be around and healthy for your spouse or significant other, kids and family…that is why I want you to pay attention to these numbers.

    You can learn more about additional lab panels that I recommend for various conditions and symptoms, as well as many additional ways to be preventative with your health by reading and embracing the principles in my book, The Hormone Fix

    You won’t always know when you have an issue brewing under the surface. With these four simple markers you can get a head-up to many serious issues including cardiovascular concerns, diabetes (or pre-diabetes), adrenal dysfunction and other common conditions we women face as we gracefully age!

    Gluten-Free Gravy

    Instructions:

    1. Remove any leftover juice from turkey pan and carefully pour it into a saute pan.
    2. Turn burner on low heat.
    3. Combine 1 tablespoon of potato starch to drippings, whisking constantly. Continue until you reach your desired consistency.
    4. Add additional broth or potato starch to get to desired consistency. Enjoy!
    P.S. Want another easy way to test at home?

    I've found over the years is that the key to real results is keeping track of your progress. Use these Urinalysis Test Strips to start tracking your body's pH so you know for sure if you are on track to less bloating, healthy fat loss, and balanced hormones. Get your own here!

    References:

    1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6075634/ 
    2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908269/
    3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6075634/
    4. https://www.ncbi.nlm.nih.gov/pubmed/29528579
    5. https://jaoa.org/article.aspx?articleid=2625276&resultClick=1
    6. https://www.ncbi.nlm.nih.gov/pubmed/28327451  
    7. https://onlinelibrary.wiley.com/doi/full/10.1002/art.34474
    8. https://www.ncbi.nlm.nih.gov/pubmed/26529410  

     

    25-hydroxy vitamin D test - optimal level is 50-100 ng/mL

    hs-CRP – optimal level is below 1.0 mg/dL

    A1C - optimal level is less than 5.3 percent

    DHEA-s - optimal range is 100–250 ug/dL (in women over 40)

    Dr. Anna Cabeca

    Dr. Anna Cabeca

    Dr. Anna is a Triple Board Certified OB/GYN, Anti-Aging Medicine expert, and author of the best selling book, The Hormone Fix.

    Dr. Anna helps women heal the 9 most dreadful symptoms of menopause with natural, safe solutions. Follow her for content on hormonal imbalances, vaginal dryness, menopause (and more) that are medically backed, and created to empower women — not just treat them.