This summer I was a guest on the Man In The Arena podcast, with host Craig Spear. Craig is a former CFL football player and is dedicated to helping men over 40 optimize their health and lose weight. For this episode we discussed the importance of getting bloodwork done as a baseline, before things go off the rails, and the importance of getting it done regularly. We also discussed bloodwork and supplementation specifically for men. For the podcast you can subscribe on itunes or listen here: https://www.thespearmethod.com/blog
Bloodwork gives us an objective snapshot of what is going in the body. It tells us the HEALTH of a variety of organs. Blood markers of course can show us nutritional deficiencies like vitamin D and iron, but blood markers can also flag a number of conditions and diseases like cancer, and diabetes, and celiac.
In an adult new patient consultation (which is 60 minutes), I always ask when is the last time bloodwork was done. I ask for a recent copy of bloodwork to see what has been checked off and what may be missing that is relevant to the patient’s health concerns and goals. And if the patient hasn’t had bloodwork for a while I will requisition a comprehensive healthy assessment panel so I get a great overall picture of what is going on. Sometimes the patient has a very specific health concern so I may choose very specific markers to get a better picture of what is going on. Here in Ontario, as a Naturopathic Doctor I can requisition many of the same blood markers as an MD, but OHIP does not pay for the bloodwork when I requisition it.
Sometimes there is a need to get bloodwork done earlier than 20 years of age. Many people in their 20s have never gotten bloodwork done before and this is an important time to get a baseline. Somewhere between 20 and 25 years of age would be great: get an idea of what your body is like, before the typical stressors in life really start, like consistent work schedules, kids, etc. As we get older we should have a check-ins with bloodwork more frequently. And if a concern pops up then we check-in accordingly. In the podcast Craig and I dialed in on men over 40. The bloodwork that would be important for men to do would be a CBC (complete blood count). Its a good flag for many things, including the health of your red blood cells and your immune system, your white blood cells. Then checking a lipid profile is key: cholesterol, good (HDL) and bad (LDL) and triglycerides.
And let’s talk about sugar. I see bloodwork so often that just includes fasting blood glucose. That just gives us a snapshot of what is going on. Fasting blood glucose can be normal for quite some time in insulin resistance and prediabetes. I have been practising for over 20 years now and in the last 10 years I have seen more and more prediabetes in young, seemingly healthy people. Doing fasting insulin, and HbA1c, alongside the fasting glucose gives us a better picture of the metabolic landscape. If we can manage someone at the insulin resistant level with diet and exercise before they become prediabetic or diabetic, that's a huge win!
For men I also like to include testosterone, and a PSA ratio for prostate health and some inflammation testing is always a good idea especially in a baseline comprehensive panel. So I may do ESR, or hs-CRP.
My training as a Naturopathic Doctor is all about prevention and being proactive so I place high value in doing regular bloodwork before things happen. I also think it keeps people on track. It is an objective measure of their health. And I think if someone sees their HBA1C (measure of glucose over the course of 3 months) creeping up, it is motivation to get their blood sugar and their diet and exercise in check before becoming prediabetic or diabetic. Insulin resistance and blood sugar management problems are the beginning of the difficult cycle of gaining weight around the mid-section and craving sugar and inflammation. If we can manage blood sugar and inflammation early, then we can really change the course of aging.
Most patients I see have bloodwork results from the family medical doctor. Most of the time patients need or want 30 minutes for someone to explain to them what each marker means and what their level means to their overall health. I think that is where the value lies in prevention and knowledge and of course seeing a Naturopathic Doctor.
If everything looks good in that comprehensive panel, we talk about being proactive and preventative. We may discuss nutritional and exercise and lifestyle strategies to prevent going down that diabetic path if there is a high genetic predisposition to diabetes. We may talk about what kind of exercise is best for managing cholesterol, or decreasing risk of different cancers. We also may talk about supplementation. Here in Canada most people are vitamin D deficient, as per the bloodwork I see, so typically a vitamin D supplement on a daily basis year round is necessary.
The bottom line is individualized medicine. Everyone needs something different. Get bloodwork done, as comprehensively as possible, get it done regularly depending on your age, and then work with me or a Naturopathic Doctor to build a nutritional and supplementation plan that works for your body and your goals.