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What Blood Tests Should I get for Health Optimization?

by Rocco Castellano

As a biohacker, I advise many of my clients to get basic blood tests for vitamins, hormones, nutrients, and metabolic factors for all my Health Optimization programs. I take my blood panels four times a year. 

After all, if you don’t know what’s happening inside your body, how do you know you’re not one of those people who look healthy but are sick inside? And if you have problems like brain fog, constipation, bloating, low libido, lousy sleep, or slow recovery from a workout, you are probably in the group of people who should get these blood tests. 

Even if you work out hard and eat well, some pretty scary things are happening inside your body. 

Low testosterone and high cortisol cause overtraining symptoms, low libido, lack of motivation, and loss of competitive drive. 

Low luteinizing hormones, high estrogens, and low progesterone make it hard to think, make you want to eat, and make it seem like you can’t lose fat even though you train hard and often. 

High levels of thyroid-stimulating hormones and low levels of thyroid hormones can cause a constant feeling of being cold, a slow metabolism, problems with digestion, gas, and bloating. 

Low levels of magnesium and electrolytes can make it hard to fall asleep at night, wake up several times during the night, or make you tired during the day. 

High inflammation markers can cause sore joints, injuries that won’t go away, missing workouts because you’re sick or always having a runny nose, and sometimes “ghost symptoms” like headaches, heart palpitations, or tingling and numbness in the muscles. 

At Home Blood Tests 

It can be hard to figure out how to get the right blood tests. There are quick and easy testing services like Lifeforce, which lets you buy a test online, print a requisition form, and bring it to a lab near your home for a quick blood draw. But many people have doctors who can do these tests (which are usually covered by insurance), but I’m still asked what the parameters to test if you want to get the best value for your money and find out exactly what’s going on inside your body. 

 

1. Ratio of HDL to Triglycerides 

On a cholesterol panel, you can test many things, like LDL, total cholesterol, HDL, VLDL, etc., but the ratio of HDL to triglycerides is one of the most important things to pay attention to. Triglycerides tend to be sky-high, and HDL tends to be low in people whose diets are high in vegetable oils and processed foods and low in fiber-a typical “gym junkie” diet. You should have more HDL than triglycerides, and a ratio of 1:1 or better between the two is best. 

 

2. HS-CRP 

C-reactive protein is a sign of inflammation in the whole body. HS-CRP can go up for many reasons, including not getting enough rest or overtraining, eating lots of inflammatory foods like sugar, commercial meat, or dairy, and being stressed. Individuals who want to have the best anti-inflammatory levels keep their HS-CRP below 0.5. 

 

3. Free Testosterone 

Testosterone is a hormone that helps both men and women lose fat, gain muscle, increase their libido, take care of their hearts, and slow the aging process. But even if the total testosterone is high, free testosterone is often low. Most of the time, this is because all of the testosterone is linked to sex hormone-binding globulin (SHBG). Most of the time, this is caused by too much stress or not getting enough calories. A free testosterone measurement is an excellent way to determine if this is happening. 

 

4. TSH 

A small gland in your brain called the pituitary gland makes thyroid-stimulating hormones. Thyroid-stimulating hormones tell your thyroid gland in your neck to make thyroid hormones (triiodothyronine (T3) and thyroxine (T4))-essential for how your body uses energy. 

Three things usually cause high TSH in active people: 

  1. High levels of cortisol make thyroid receptors on cells less sensitive. 
  2. Small intestinal bacterial overgrowth is caused by gut dysbiosis, usually caused by eating too many carbs, being stressed out, or both. 
  3. Too little food or too few carbohydrates. 

A beneficial tested level of TSH is between 0.5 and 2.0. 

 

5. IGF-1 

You probably know that growth hormone (GH) is a powerful hormone that slows down aging and builds muscle. IGF-1, or insulin-like growth factor-1,  a protein affected by GH. It is easier to measure GH activity by measuring IGF-1 than by directly measuring GH, which is a more complicated and less accurate lab test. These hormones are essential for cell and muscle growth and support anabolic pathways that help repair and recovery. If IGF-1 is suppressed recovery is slow. IGF-1 levels below 115 ng/mL are usually caused by lifestyle stress, exercise stress, calorie restriction, or nutrient depletion. 

 

6. Vitamin D 

25-hydroxy vitamin D is a blood test that shows if you have enough of this powerful precursor to steroids and hormones. Most athletes and people who work out don’t get enough of this anabolic vitamin that dissolves in fat, and low vitamin D is often linked to low testosterone and high cortisol. 

I usually recommend to my clients to aim for levels between 80 and 100 ng/mL, and if you test low, you don’t have to go out and take a massive amount of Vitamin D. Instead, eat vitamin D from natural sources like wild-caught fish, whole eggs, and liver. 

 

7. Glucose 

Even if your glucose level is within the normal range when you wake up, that doesn’t mean you’re safe. Too much glucose in your bloodstream can cause your body to make too much insulin, which is bad for your cells, your ability to heal, and your waistline. For example, if your fasting glucose is 95 mg/dL, a doctor may say you are not at risk. Active people should keep their fasting glucose levels below 85 mg/dL. If they aren’t, you may be under too much stress, which makes the liver release carbs it has stored, or you may be overeating sugar. 

 

8. Measuring Adrenal Stress (ASI) 

An ASI looks at four samples of saliva taken at different times of the day-showing how healthy your adrenal glands are. A simple ASI measures two things: 

Cortisol Levels: You will measure your cortisol levels four times daily to see if you have a normal circadian rhythm. Your cortisol levels should usually be highest in the morning and go down as the day progresses. This pattern will give you the energy you need during the day, and the lower cortisol levels at night will help you relax and fall asleep. 

When you overtrain, your cortisol levels are usually low in the morning and tend to stay low for the rest of the day. But as you now know, cortisol levels are often high in the early stages of overreaching because this is how the body reacts to long-term stress. But over time, the adrenal glands will get weaker, which will cause cortisol levels to drop in the morning.

DHEA: Made by your adrenal glands and is essential for your immune system and how you react to stress. If you have a lot of chronic stress, your levels of these hormones will likely be low. 

 

9. Heart Rate Variability (HRV) 

HRV is a meaningful sign of how well your nervous system is working and how well you are recovering. There are some wearables and apps that measure HRV. The one I use is called Whoop 4.0 

HRV works like this; your parasympathetic nervous system (also called “rest-and-digest”) affects your heart rate by making your vagus nerve release a chemical called acetylcholine. This chemical can stop your heart’s electrical activity from firing and make your heart rate less variable. On the other hand, your sympathetic nervous system (“fight-or-flight”) controls your heart rate by releasing epinephrine and norepinephrine-increasing electrical activity in the heart, making your heart rate more variable. When well rested, your parasympathetic nervous system works with your sympathetic nervous system to make your heart rate respond to breathing, temperature, blood pressure, stress, and other things. 

Your HRV values measure on a scale from 0 to 100. The better your score, the higher your HRV. But if you aren’t well rested (you’ve overdone it or haven’t slept enough), the healthy difference between each heartbeat gets smaller. 

Normal variability would show that your sympathetic and parasympathetic nervous systems are in balance and that your nervous system is properly controlling your heartbeat. However, if you have abnormal variabilities, such as consistently low HRV values (below 60) or HRV values that change a lot from day to day, this could be a severe problem (70 one day, 90 another day, 60 the next day, etc.). 

 

10. Oxygen Saturation

Also measured with your Whoop 4.0 wearable is oxygen saturation (SPO2) is a way to measure how much oxygen your blood is carrying as a percentage of how much it can carry. At sea level, the healthy range for oxygen saturation is between 96% and 99%. Oxygen saturation below 95% could mean the person isn’t getting better. Still, it could also mean that they have anemia, especially if they are always weak and tired and have trouble breathing when they exercise. 

Most of the time, I want my clients to have consistently 96% and above values. 

 

Getting Your Blood Panels

Using online testing services, a full panel that includes the first seven tests above, as well as a variety of other tests (such as red blood cells, white blood cells, kidney and liver markers, etc.), will usually cost between $450 and $800. Still, if you send your receipt to your health insurance, they may cover some of the cost. Of course, you can also ask your doctor to do these tests. The ASI, HRV, and SPO2 tests would be extra, but they are also pertinent to keep an eye on. 

Find a functional medicine or naturopathic practitioner in your area, if you want a health professional to help you choose which blood tests are best for your needs and lifestyle. Look for a doctor who has worked with athletes or people who are physically active and are willing to pay attention to factors that affect not only health or the risk of dying but also performance and making the most of life. 

Remember that looking healthy on the outside doesn’t mean you are. If you are a wanna-be biohacker, these blood tests are a good start to figuring out the best way to see what’s happening inside your body. 

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