Dr. Myatt’s Longevity Lab Profile
Americans LOVE medical tests. This isn’t just my professional opinion after twenty–three years in practice, it has been proven. In fact, we spend more on medical testing than any other country in the world
In spite of all the "looking" and testing, the average American lifespan is 78 years, 11 years behind the longest-lived industrial nation and 51st in the world.(33) All our testing isn’t helping us live longer or even better. Much of this testing is a bust.
So, am I recommending that we forgo ALL medical testing? Heck no! A simple chemistry screen and CBC (complete blood count) annually can tell us a lot about one’s general state of health and help us make early "course changes" to avoid problem. I always recommend these simple tests annually. They are inexpensive and easy, "cheap health insurance" in my opinion. I get mine done twice per year.
However, in examining the scientific literature and looking for the most important markers to follow, there are several tests that emerge as being true "longevity markers." These tests have an "optimal range" that is smaller (tighter) than the conventional medical range. Stay within that range, and your risk of "all cause mortality" is dramatically diminished.
SO, on that note, I present the simple collection of tests that I consider an indispensable part of an anti-aging / longevity program.
1.) hgA1C optimal range: 5.0-5.4
Hemoglobin A1C is a measure of the amount of hemoglobin’s exposure to plasma glucose. It is now considered the "Gold Standard" for monitoring blood sugar levels because it reflects what the average blood sugar levels have been for the preceding three months or so.
Conventional reference ranges are typically 4.0-5.6, with 5.6-6.4 considered "pre diabetes." However, one large study found that an hgA1C outside the 5.0-5.4 range was associated with an increased risk of death from all causes. This is called "all cause mortality." (1)
2.) TSH optimal: 0.5-1.4 (check thyroid hormones below 0.5 to evaluate for hyperthyroid)
Thyroid Stimulating Hormone is a measure of the amount of TSH that is being put out by the pituitary gland in order to stimlate thyroid hormone output. In conventional medicine, it is considered the "Gold Standard" screen test for thyroid function.
I have actually seen many patients with abnormal thyroid hormone levels (free T3 and free T4) who had normal TSH levels. I have also seen patients with abnormal TSH levels who had normal thyroid hormone levels. This makes me question TSH’s "Gold Standard" position as the best screen for thyroid hormones. I personally prefer to also test the thyroid hormones directly the first time I evaluate thyroid function. I also look at "reverse T3" which can block thyroid utilization even in the presence of normal thyroid levels. But, I digress.
The standard “normal” range for TSH on lab tests is about 0.5 to 4.6 mIU/L. This range reflects two standard deviations around the US mean, meaning that 95% of the population falls in the “normal” range. Unfortunately, there is no evidence that TSH values in this range are health or normal. In fact, many people with “normal” TSH live with symptoms of hypothyroidism.
Research demonstrating that many people are thyroid-deficient and that improving thyroid status can dramatically improve health has been conducted in Europe:
The HUNT study of 25,000 healthy Norwegians found that those with a TSH level of 1.5 to 2.4 were 41% more likely to die over the next 8 years than those with TSH below 1.5; those with TSH 2.5-3.4 were 69% more likely to die.(2)
3.) hs-CRP (highly sensitive C-reactive protein). Optimal range <1.3.
Inflammation is recognized as an important mechanism of cardiovascular injury. Subtle inflammation as measured by hs-CRP, is highly associated with heart disease risk and with an increased risk of death from all causes. (3-19)
It should be noted that hs-CRP was an “emerging risk factor” back in 1998 when I first reported on it in HealthBeat. Many physicians had not even heard of the test, including cardiologists. I advised my patients to get the test even though it wasn’t yet covered by insurance. Today, ordering an hs-CRP is “standard of care” and a routine part of most conventional cardiac risk profiles. But it should also be a routine anti-aging marker since it is associated with all-cause mortality.
4.) Ferritin optimal range 25-80; slightly < 50 may be ideal.
Ferritin is an iron storage protein and is a measure of body iron stores. High (even "high normal”) iron levels increase free radical production and are highly associated with increased risk of atherosclerosis and peripheral vascular disease. Serum ferritin was one of the strongest risk predictors of overall progression of atherosclerosis. (20-29)
5.) Vitamin D (optimal range: 50-60 nmol/liter)
There is a strong association between vitamin D levels and all-cause mortality. All-cause mortality was 26% higher among those in the lowest vitamin D quartile compared with those in the highest quartile with optimal vitamin D status above 32.1 ng/mL after controlling for baseline demographics. (30-32)
- Carson AP, Fox CS, McGuire DK, Levitan EB, Laclaustra M, Mann DM, Muntner P.Carson AP, Fox CS, McGuire DK, Levitan EB, Laclaustra M, Mann DM, Muntner P. Low hemoglobin A1c and risk of all-cause mortality among US adults without diabetes. Circ Cardiovasc Qual Outcomes. 2010 Nov;3(6):661-7. doi: 10.1161/CIRCOUTCOMES.110.957936. Epub 2010 Oct 5.
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- Goicoechea M, de Vinuesa SG, Gómez-Campderá F, Aragoncillo I, Verdalles U, Mosse A, Luño J. Serum fibrinogen levels are an independent predictor of mortality in patients with chronic kidney disease (CKD) stages 3 and 4. Kidney Int Suppl. 2008 Dec;(111):S67-70.
- Gotto AM Jr. Role of C-reactive protein in coronary risk reduction: focus on primary prevention.Am J Cardiol. 2007 Mar 1;99(5):718-25. Epub 2007 Jan 10
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- Ridker PM, Stampfer MJ, Rifai N. Novel risk factors for systemic atherosclerosis: a comparison of C-reactive protein, fibrinogen, homocysteine, lipoprotein(a), and standard cholesterol screening as predictors of peripheral arterial disease. JAMA. 2001 May 16;285(19):2481-5.
- Libby P. Inflammation and cardiovascular disease mechanisms. Am J Clin Nutr. 2006 Feb;83(2):456S-460S.
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- Munk PS, Larsen AI. Inflammation and C-reactive protein in cardiovascular disease. Tidsskr Nor Laegeforen. 2009 Jun 11;129(12):1221-4.
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- Ridker PM, Rifai N, Cook NR, Bradwin G, Buring JE. Non-HDL cholesterol, apolipoproteins A-I and B100, standard lipid measures, lipid ratios, and CRP as risk factors for cardiovascular disease in women. JAMA. 2005 July 20;294(3):326-33.
- Shlipak MG, Ix JH, Bibbins-Domingo K, Lin F, Whooley MA. Biomarkers to predict recurrent cardiovascular disease: the Heart and Soul Study. Am J Med. 2008 Jan;121(1):50-7.
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- de Godoy MF, Takakura IT, Machado RD, Grassi LV, Nogueira PR. Serum ferritin and obstructive coronary artery disease: angiographic correlation. Arq Bras Cardiol. 2007 Apr;88(4):430-3.
- Depalma RG, Hayes VW, Chow BK, Shamayeva G, May PE, Zacharski LR. Ferritin levels, inflammatory biomarkers, and mortality in peripheral arterial disease: a substudy of the Iron (Fe) and Atherosclerosis Study (FeAST) Trial. J Vasc Surg. 2010 Jun;51(6):1498-503. Epub 2010 Mar 20
- Kiechl S, Willeit J, Egger G, Poewe W, Oberhollenzer F.Body iron stores and the risk of carotid atherosclerosis: prospective results from the Bruneck study.Circulation. 1997 Nov 18;96(10):3300-7.
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- Mainous AG 3rd, Diaz VA. Relation of serum ferritin level to cardiovascular fitness among young men. Am J Cardiol. 2009 Jan 1;103(1):115-8. Epub 2008 Oct 17.
- Menke A, Fernández-Real JM, Muntner P, Guallar E. The association of biomarkers of iron status with peripheral arterial disease in US adults. BMC Cardiovasc Disord. 2009 Aug 3;9:34.
- Valenti L, Swinkels DW, Burdick L, Dongiovanni P, Tjalsma H, Motta BM, Bertelli C, Fatta E, Bignamini D, Rametta R, Fargion S, Fracanzani AL. Serum ferritin levels are associated with vascular damage in patients with nonalcoholic fatty liver disease. Nutr Metab Cardiovasc Dis. 2011 Aug;21(8):568-75. Epub 2010 Apr 13.
- Zacharski LR, Shamayeva G, Chow BK. Effect of controlled reduction of body iron stores on clinical outcomes in peripheral arterial disease. Am Heart J. 2011 Nov;162(5):949-957.
- Melamed ML, et al. 25-Hydroxyvitamin D Levels and the Risk of Mortality in the General Population. Arch Intern Med 2008; 168: 1629-1637.
- Saliba W, Barnett O, Rennert HS, Rennert G. The risk of all-cause mortality is inversely related to serum 25(OH)D levels. J Clin Endocrinol Metab. 2012 Aug;97(8):2792-8. doi: 10.1210/jc.2012-1747. Epub 2012 May 30.
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- CIA World Factbook: https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html
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