What Labs do I order?
What Labs do I order?
Check out the video on What Labs do I order?.
Hello everybody it is election night and it is Tuesday November 8th welcome to the show I do have an awesome show for you tonight uh on a really hot topic that several of you have written into the channel about saying please tell me what to do here what labs do you order so I ordered my own labs and I'm sharing them with you tonight for what I wanted.
To know in my system so stick around for that we have some traditions here on the show that we are going to get to and we always bury a few really good deals that uh if you are a regular and looking for some of the most important uh ways to to keep your pocketbook lasting longer we have some ways to help you with that and hope that you find them as valuable as.
We do uh let's see here I have I can see all of your chats and I see that the sound is coming through that's always a good place to start let me check my numbers I have had a few um I'm in a pretty good fast I've had this cold since last week I think last week I was about one in four words on the show and definitely yeah.
Um have looked at a couple of days where I had nothing wow so um it wasn't this good yesterday um I was still feeling pretty sleep deprived my husband went out of town for our son's uh College uh dad's day so for all of you old married folks like me when your husband's out of town I just don't sleep as well so between the cough.
And this and the sleeping my my sugars definitely rocked my world a little bit we're gonna talk about not the meter that you can see I I've been using Mojo but tonight I left my mojo meter at the house and so I'm using these and it works out well for tonight's Labs on why I choose one over the other and which ones.
Um uh where that where that separates so before we uh get too far along Let's uh see if I can uh let's see here I am going to look over here pull this over here I have a couple of announcements here I am a little worried actually that one of my things isn't showing up here let me.
Do this here we go all right yeah a little forgiveness there I I forgot to do this before I started so a couple of things uh just to show you that on the channel um we do have a few things we've been working on the DR Boss favorites actually that page isn't published yet.
Uh as far as the updates I think they're the same um but in the store we do have a new product that we're going to talk a little bit about tonight but before we do that I have to I have to take care of some real live business which is I messed up and you guys should be profiting.
There are two mess-ups uh one of them is the um keto combo this is actually one of my favorite it is my favorite it's my one of the best products out there it's got both BHB and MCT in it and I don't get to sell it after the first of the year so I really do need to get rid of these.
Um uh bags before the end of the year because I definitely wish it wasn't true but it is that um I um yeah whatever is left at the end of the year after destroy so if you buy four or more all sales are final but you do get 25 off these don't expire until 2024 so you've got a couple years to use.
Them my sister who's very methodical about everything I say she has stocked up she says I have eight bags that's not gonna last me two years like well I'm sorry girl that's uh so anyway um there is one other thing that I wanted to tell you that I am super excited to be invited to low carb USA so.
If you go to low carb USA you'll see that under events there is an event in January and yours truly has been added to this list I'm really excited about that I actually was on the phone this past week with a couple of them let's see uh I talked with or I I talked to Dr cyvis he's a a local Floridian with me and let's see Dr Westman was the other.
Person I got to chat with just saying I'm so excited to get to see him in person and um you know kind of come full circle so if anybody needs CME this is how I get my CME so I will have my butt in the seat just uh taking in the education but also being one of the speakers so keep um keep that in mind if you need that.
But even if you're just uh interested in what the doctors are learning and what you could take home to your doctor this is a great place to do that um I am gonna drink a little before my voice goes out because we have a really great show tonight um I'm looking over at the comments and just saying thanks for checking in I.
Have a couple of um important things tonight I'm gonna do some teaching about Labs it's something I have had so many of you writing about we've tried to do little videos about it but I I I I I just can't get it that's that that tight of a script I really do need uh to um to to just take time to educate you.
So I am excited to show this to you but I do need to get started or we will never get done um I also wanted to say if you have questions put them in the chat we'll try to get to the questions the ones that are relating to Labs um or some of the other stuff that I talk about I'm gonna try to come full.
Circle on um and I think I think that's far that's it for my announcements I am drinking ketones the reason I do this is not because I need to drink ketones I want to move my vote thing up so you can see that I voted.
Um there yes um no I don't need to drink ketones I'm making plenty of them but uh I have had lots of products for my patients out there that spent a lot of money didn't raise their ketones at all you should be able to measure the ketones go up when you drink.
Them and there are reasons to do that we cover that in several of the other classes we're not going to talk about that tonight we are going to talk about yeah I went to my um I went to uh a local lab here and I paid cash to check the labs that I wanted to check now part of this is because I'm working on my computer system for my clinic and I.
Needed to confirm uh that all of this is working but I've also been very curious about uh checking some of my labs because I haven't done that in a while and when I got my my butt handed to me on a platter this summer when I checked my point of care A1C it made me think I probably should check my labs I probably should look so.
Um we're going to get started on this um and we're going to start with not just showing you what the normal ranges are and what the costs were but I'm trying to start with the highest priority uh when I get to the bottom there's a little bit of um it's not that they're not important it's that if I was looking to spend your.
Money um again I paid cash and I know a lot of people do pay cash when they want to just go get their own Labs taken without a physician's prescription so I try to do this in the order of um what did the labs um what did what did they um.
Order of importance all right so let's start now for those of you that have watched the show long enough you might have guessed that um I was I would put A1C at the top of the list so yes A1C I thought it was very interesting because these point of care tests have come out on the market and.
Although you can there was an a point of care test um for A1C that I just didn't like it I mean I several times I had patients trying to get this and it didn't turn out to be as reliable as I wanted it to be so I was really careful that I paid that 27 for this test on the exact day that I had that Omega Quant test done.
Now for those of you that have uh have I don't know if I don't know how many of you have done Omega Quant tests but let me see if I have that on my favorites page yet so let me uh well anyway the test that you uh that you order on our website is a point of.
Care and the person we we co-brand that with Omega Quant they're the ones who have done the research and science behind that I um it's forty dollars I there's not a big profit in there but it is more expensive than what I was paying cash for but most importantly that I'm excited to say is it was exactly the.
Same so I've been disappointed in the past by some of the other kits that are on Amazon um that uh they oopsie some of the kits that are on Amazon you'd pay for these kits and you'd have two or three tests but when I compared them head to head to what my lab was checking it did not it did not match that well so.
Um I was testing Omega Quant a little even though they have lots of literature saying how reliable those home A1C tests are our team has been doing them every so months every few months and I was like I wonder how accurate it is if I tell tested on the exact same day so I was very happy to see that it came back exactly the same all right so that's.
Where I'd put your money first that is your average blood sugar and it really does matter it does predict things like cancer and autoimmune disorders and I had a a case in the 21 Day course oh gosh I keep pushing the wrong one and I had a case in that 21 day course that we put on where she said you know I have these autoimmune disorders I wonder if I.
Should go get antibodies checked for my kids to see if they have these problems and I'm like don't do that keep their average blood sugar down uh you know again this lecture that I'm going to give in Boca has made me go back to the literature and really make sure my I can Source the place that I uh that I'm that I'm speaking from and so it's forced me.
To reread some of the places that when you look at the ideal A1C my goal is to keep it between 4.5 and 5 5.0 so at 5.1 it's not it's almost there um but when it came back at 5.6 yeah I was not happy about that that is definitely way too high for me way too high for pre-diabetes I told my husband that's bad for brand.
again I hadn't looked but I was really happy to work with my gals and be accountable to get it down all right so yes number one is a hemoglobin A1c 27 so uric acid is the next one that I would have you check that one cost 17 and although the normal range is from 2.6 to 6.2 I think anything less than five is.
Perfect I'm not perfect as you can see it's 5.4 okay so that brings me back to um why why was this one really important oh I did it again um all right I want to show you that when I look at a couple of the of the the fouracare um uh benefits one of them is that you can.
Actually um use the the strips that test uric acid inside the four care meter now I will um I've said many times on here that I picked the four care meter initially because it had the best strips and it didn't take long for keto Mojo to not only match the strips but do a better.
Job of the strips and do a better job of the price of the strips which matters a whole lot let me grab this so I'm gonna do live here um two checks I have uric acid in both of them at four carat we're gonna see how different they are on a live show oh shoot that one's already been.
Deployed um I have a little clicker here they go all right um um let me just get one of these so I I pricked my finger and I can't find where my little little deployers.
Are all right it's kind of messy I guess all right let me just do it this way okay so let's uh check these uric acid live so again the uric acid strips you can't do in um Mojo keto Mojo but I would contend they are actually working on a strip that is for uric acid I will have to say after all of the.
Hundreds of patients that I've walked through um with uh the um well 6.8 6.2 and right before the show it said 5.1 and 6.2 so um this has been the hardest part with uh the four care meters is that the accuracy of some of these other strips wasn't as good which is what sent me back to the literature looking that when.
You have a uh two really good meters again ten years ago we had nothing close to how well these meters work but over the last couple of years we've seen the meters get Tighter and Tighter on their point of care and how well how accurate they are so even though I use four care here on the show tonight I am pushing to have my my patients all use that.
Meter by keto Mojo because of its accuracy the sad part is is their sugars look better on foricare than they do on MO Mojo but the Mojo was more accurate yeah so um but when it comes to uric acid that 6.1 and 6.8 it is done at the end of a fast you should not check uric acid when you are fasting but um and this was only.
A 12 hour fast that I was in or maybe like a 16 hour fast I was in right now I'm at 48 Hours fasted so you'll see the uric acid rise during the end of a fast so it's probably not too far off from accurate all right the next one that I did was um again okay let's remind you why do I check uric acid uric acid is like.
Looking at the trash in my cells um that when the trash is really high and it is a it's a byproduct it's a waste product um when people have they check uric acid they're usually looking at um gout um and the gout.
Um um measurements we want them to stay less than seven even less than 6.2 if you really want to stay out of the the flare-up range but gout is a process where the the the buildup of wasted proteins of wasted nitrogen actually so they've just been eating too much.
Um uh especially in the setting of high insulin and so when when I look at reversing uric acid it is not easy to do that but it is a very good predictor of how fast are you aging so when I can see that uric acid get below five they're doing great again I like their A1c to be lower than five and I like my uric acid to be lower than five and.
Neither of those are lower than five and me but um yeah I'm not perfect all right so the next one is vitamin D again the first one you could do point of care for about forty dollars those uric acid strips are ten dollars a strip so I just um spent twenty dollars um because I did one you know one in.
Each I think they're about ten dollars a strip um and then I did two of them before the show so I spent forty dollars because I just checked it four times but uh those strips are pretty interesting to watch how well you can improve them if you buy the the pack of ten um and I think you can find those on our.
On my favorites page let's see if I can actually go to the right page this time um uh if you go to the doctor boss favorites up here you can scroll down and see uh let's see here I thought I thought there was a uric acid oh it might be that when you click on here uh it takes you to the uric acid.
Page or maybe I haven't done that yet anyway that that will be on the favorites page coming up in the next couple of weeks I will have the keto Mojo I will have the ability for you to trade up your meter to a keto Mojo and I will also have uric acid on there linked a little better than this all right so next we have.
Um the vitamin D so when I ordered my vitamin D I was actually shocked to see that it cost 85 dollars on our website we let you get two of them for 100 and again their point of care the reason we did two of them for a hundred dollars is we we often find that when you check your vitamin D I know that it says normals from 30 to 100 but I like them.
To always be oh let's try that again I like them to be greater than 50 and I even say even up to 150 I I'm not concerned um so I'm happy to say my sister hangs out at the 110 range because she takes her vitamin D every morning I don't take my vitamin D every morning and my number is only at 46. so I would.
Love it to be higher than 50. the reason I'm pushing patients to have their vitamin D at least higher than 50 is brain health you have got to have a vitamin D for the of 50 or greater for the best brain repair people who stay stuck in depression they either have an iron problem or a depress vitamin D problem that is those are fixable.
Reasons that their depression won't go away there's other reasons depression won't go away but that vitamin D is absolutely critical to get at least 50 or higher for their brains to function immune systems also require that that vitamin D should be at least 50. it it sends a signal through your white blood cells to transpose proteins that come.
Out of your white blood cells if that vitamin D is low that it cannot signal the the transcription of that DNA inside the white blood cells to make those proteins same thing goes for the the brain cells okay let's move on these are going to be a little faster those were a little um a little more in depth um when I'm looking at people especially.
On the ketogenic diet they're usually coming to see me because they want to lose weight so I start with just the basic thyroid hormones I know there's a whole bunch of ways to test thyroid but when I find when these two are normal um I can chase ghosts meaning I can chase a lot of things but the answer usually isn't in.
Um I mean there can be a few ancillary things that end up in a thyroid reverse T3 but remarkably I find if especially if they're close to one on both of those TSH and free T4 collectively that that gets you north of you know almost 70.68 uh for checking your thyroid if you're going to pay cash the next.
Um layer that I check is iron studies and again people that come to see me on the ketogenic diet they want their metabolism to work well and I focus a lot on brain health so they're coming to me to say how well is my brain working and I will um take a a slight moment to rant about how important it is that when patients come.
To see me and they say Doc I just can't seem to be getting better um I've been on these antidepressants for a long time I'm not feeling well and I checked their iron studies and they are woefully undersupplied for their iron when you build the neurochemistry in your brain I'm talking serotonin norepinephrine.
Um the the um the dopamine the the types of signals that allow one neuron to talk to the next the basic building block for those components in your brain is iron and if you're not if you're if your iron studies are low the the chances that you're going to.
Have uh a way out of the ditch from depression becomes almost zero until you fix the iron it is a critical part of taking care of broken brains is without normal iron studies we we fail I mean um not only is it a depression thing but it also is a Peak Performance if you do math for a living for heaven's sakes your iron needs to be high enough.
Um and the other part that I am really careful about is let's go over here if you go to um you might have noticed I know some of you noticed um let's quick see if I can show this uh that on the website uh under store you can see that there's a new product and it's because I have a lot of you.
That will not take will not eat liver and I'm telling you that source of beef liver is I'm so proud of where that liver comes from that it is uh Worth showing you that that is now for sale I'm going to talk more about that a different day but it really dovetails into when I go to replace someone's iron if there are two.
Places in the universe that you can get iron from one is called Elemental iron Elemental iron comes from the elements so it's in the soil it's in the dirt when you eat vegetables and you say hey it's high in iron well it's only high in iron if the roots of that vegetable were able to reach iron in the soil and then put it in the spinach leaf or whatever.
It is you're eating that's high in iron but even if you do that the most perfect iron absorption uh the gut that is in perfect health you know a teenager lean healthy never been overweight um not anemic they're beautiful perfect gut lining um when we tag the elemental iron uh we know that the perfect gut can only.
Absorb 10 of that iron ninety percent of it goes down the toilet it is difficult to absorb when that iron has only been Elemental iron and has never been hemoglobin iron which is the other kind of iron hemoglobin iron means that it has been in a circulation I don't care if that circulation is a cow or beef liver I don't care if it's a pig or a.
Duck or a moose or a snail it's been in circulation and when the hemoglobin iron when the iron is attached to hemoglobin and we tag it again in these perfectly healthy guts over 75 percent or excuse me over 90 percent of their iron gets absorbed only 10 percent goes out in their stools so when we take healthy people to healthy people we can.
Say wow there's a huge difference but now take the patients that come in to see me they're sick they've been depressed they have immune systems that don't work their gut lining is not healthy so when you take 10 of the absorbable iron in an elemental iron which is what is in most I mean it's in what all iron tablets that don't come.
From liver which is the most concentrated organ with iron in it when you just take Elemental iron and you say hey I put it in a capsule and I'll take it every day the absorption problem is still there they can still only absorb 10 if their gut is healthy but when they have real guts with.
Inflammation it takes me like three I mean I never reach normal iron levels when I'm asking that gut to do there I end up using IV iron to get their iron normal I skipped their gut put it right in their vein and try to Short Circuit the outcome because I can't wait for the brain I mean the brain can't make the next step until the iron was replaced.
All right so now knowing that several of you have written in saying but what if your your ferritin's high okay so let's take a look at my labs back to the right one here all right so we've done thyroid here come my iron studies okay so my iron level of 88 was normal that cost me 17 my ferritin which this is the part where.
I I say make sure you look at your ferritin the ferritin should always be greater than 50. okay well mine's clearly greater than 50. but it's in the abnormal range it's up to up nearly 500 so is that dangerous you Google it and it says oh my gosh that's that's iron overload uh no that's not iron overload let me teach you a few things okay so.
Iron is what we're looking at that's what we're measuring I'm in the normal range for that the ferritin ferritin is a protein it is a protein that delivers iron to your body think of it as the bus that's carrying iron and I have a bunch of buses carrying iron the next question says is what is your.
Iron binding capacity meaning what are the what's the seats that are filled with iron on your buses and my my iron capacity um says that I if you have a high iron this is an inverse relationship if you have a high iron capacity it means there's a lot of empty seats if you have a low iron capacity you have.
Less empty seats so you're carrying more more iron these two are proportional they're related so because this is so confusing it is the inverse like total iron binding capacity so if there's a high number there's a lot of empty seats on your bus if there's a low total iron binding capacity then there's no empty seats on your bus that's what iron.
Overload looks like so the next thing we look at is what is iron saturation so we never want this to be less than 20. but when we look at dangerous levels it gets that the iron the total iron saturation is how saturated are these seats on the bus so when my iron saturation is 33 it's saying essentially that one-third of my seats on the bus are holding iron.
That is not iron overload okay but why is that ferritin high we're going to get to that so iron is not an easy like I mean by just checking iron I don't learn anything I almost wouldn't check that okay it's part of the equation you need it to do this math so you have to check it but be sure to get the ferritin the ferritin is really important that one.
Does cost thirty two dollars and then this essentially this is math it's really not a lab at all but that cost an extra sixty dollars so for this iron studies you know that's about a hundred dollars I would say that's worth it um I mean to me that's a really important part of the equation for how well I mean I talk about brains but um.
When you look at iron it is also an another key component for how well is there cortisol doing is are they in adrenal adrenal fatigue which I don't like that word but it's everybody understands it um all right so we're gonna get to the next panel which is what are the vitamins that I would check.
Yes yes I check iron that's a vitamin I check vitamin D but that's more like a hormone so the vitamin D was for your whole body that's one of my top two tests or top three tests iron is next on the list um and then these vitamins um I want you to just to notice the vitamin B12 is 31. uh 31 I wouldn't.
I wouldn't spend okay vitamin B12 is really important if especially if you drink excessive alcohol or if you are not uh if you're vegan and you can find B12 getting lower um folic acid always uh is actually a precursor for that uh if you're if your folic acid is low it usually happens before the B12 is low so doing them in.
Combination is really helpful this lab right here methylmalonic acid is actually the best predictor for whether or not B12 is actually low we see a lot of false positives false I mean we see B12 being called normal when it's not really normal and in that case the methylmalonic acid will be abnormal but look at how expensive that is.
Um I I I just love Omega quanta so Omega Quant I don't call the brand this one this one but if you go to their website um you can actually order a methylmalonic acid in the urine for something as little as like 30 or 40 dollars to see if you think you're low on B12 and you don't want to check your blood the urine methylmonic actually is.
Actually more accurate than the the vitamin B12 or the folic acid and you can do that without a prescription for me so if you want that you can go there so let's just look my vitamin B12 was very normal um my folic acid was lovely anything above three is good and I was in the fours and then my methylmalonic acid was.
Perfect 117. so I'm not low on any vitamins there so so far I'm a little low on vitamin D because I'm not as good as taking my vitamin D as my sister is I keep thinking I live in Florida darn it I shouldn't just get it while I go outside but means I can't spend so much time in the office now the next two Labs I checked but they.
Would not make the list for something I would check in patients they I I've always wondered what mine are and mine came back normal but in for both zinc and copper but they're really esoteric they do not teach me much it's really rare uh I check them in people who actually have had gastric bypass but I also wanted to know what was the real.
Cost so they're pretty expensive for a hundred dollars each I would not do that again it doesn't teach me anything they are really they really correlate heavily with iron so when the iron is low if I've replaced the iron and things are still not going well then sometimes I'll check a copper or a zinc but as you can see they're really expensive there's.
Usually skin issues that with people so when their skin looks healthy I said to not to waste their money on that all right the next thing we're looking at is a comprehensive metabolic panel this whole thing was 30 bucks or 27 and a whole bunch of things came back so I did this lab at about 11 30 in the morning.
Um and I had coffee I had ordered black coffee but there was um I ordered it off my app and I accidentally had a little splash of cream in there so it wasn't a perfect fast um I didn't tell the lab that but my sugar was fine uh bun creatinine are a way to look at your kidneys.
Um really the best way to to use these is to look at your estimated glomerular real filtration rate so this is really looking at what percentage of my kidneys are functioning and so when you get a 95 on this math it says your kidneys are doing great this bun and cutting ratio is another way to look at your kidneys.
So that's all pretty straightforward um this is my electrolyte panel my potassium did come back slightly outside the range of normal uh I don't think of that as abnormal actually at all these are just again other wet places all these came back normal uh this is also part of that complete metabolic panel uh and this is really.
Kind of the liver section so alkaline phosphate is made by bones and liver and that was normal my AST and a alt are also liver enzyme measurements um for 27 I it's a pretty good list of a whole bunch of things but you really kind of got to study it to know um what if you know do you have a kidney problem do you have a liver problem.
Um I like the astn the alt to always be less than 25. my AST I would love that to be a little lower but it's not bad it's just I like it less than I like it in the 20s so I wish it would have been a little lower all right so now the good one let's let's I did order a lipid panel on myself again one of the other things that you can check on a four care.
Is you can check a total cholesterol I did not bring those strips back here so I'm not going to check those live um I don't find these as useful but I think it's worth uh checking on the ketogenic diet to show you what mine was and then what am I going to do about it all right so first of all a lipid panel cash cost about forty dollars I think.
It's worth it but I would definitely be doing it in conjunction with a couple of other things so let's show you my numbers the total cholesterol came back elevated so it's never supposed to be more than 200 and mine was 276. frankly don't care kind of proud of that triglycerides you always want to be less than 100.
Um again I wasn't exactly fasting when I did this and you really want to be fasting and there was I had a little bit of cream in that coffee um so 88 is pretty good for knowing what I had eaten my healthy cholesterol my good cholesterol was over a hundred and um I for those of you that have watched my.
Cholesterol lecture I have I have another uh particle size that I checked on my labs that I'm not going to cover tonight but I'm going to use this lipid panel and the particle size uh data to do some teaching but I want you to notice how low my vldl was so again vldl is the cholesterol that is emptying out the triglycerides so when it gets down.
To this low it's a sign I I do not have a high residency time in my blood residency time stands for what I mean cholesterol is meant to fuel your body it's meant to it I mean it's a source what we're measuring in this class this this lipid panel is how much cholesterol are you circulating and what are the little carrying units that are.
Delivering it to your body too much cholesterol um the the too much cholesterol in circulation that doesn't get recycled is when it starts to oxidate that's when it starts to become more damaging to the insides of.
Your blood vessels that um when the vldl cholesterol is that low I mean I don't ever really look at this I mean I'm studying it my own but but it's a hint that when my bad cholesterol my LDL cholesterol came back high uh I I don't worry when that vldl is that low and the LDL cholesterol even though they like it to be less than 100.
Uh I'm I'm not worried but it's not because I stopped there when you really look at cholesterol the the the parts that I like patients to take notice of is my triglycerides were 88 my HDL was 107. so if you take 88 divided by 107 that ratio should always be less than 1.5 when you're down into the when your triglycerides are lower than your HDL.
That's a really good sign so I'm not worried about this this ratio also gives me a hint about how long is that cholesterol staying in circulation how high is of a residency I mean that's time in circulation do do you um do you have and I I don't pretend to think that um this is I mean this is pretty.
Complicated stuff so uh that's why I'm going through it but here's the most important part that adds to this equation this is going to bring ferritin back into that our discussion when I oh I don't want to talk about this one yet I'm going to come back to that one I want to talk about this okay so I'm.
Watching in the chat and I want to know if anybody knows what a said rate is I'm going to talk about ferritin for just a second and then I'm going to come back and talk about Cedric so remember earlier my ferritin was elevated it was almost 500 uh almost 500 and you know the the lab says it shouldn't be more than 150. so if you if you know what a.
Said rate is I would love for you to type it in I'm going to type in said so it's a little bit of a delay that I get to see the comments but I want to see if anybody knows what a set rate is what I want to show you um after I explain what said rate is is why I order every stink in time for 20 plus years that you should have a highly.
Sensitive C-reactive protein now people screw this up and they say C-reactive protein yeah there you go very good okay so now they're answering the said rate stuff so the answers that came back in were non-specific for inflammation that's what a said rate is a set rate is actually measured by units of Time.
How fast do these erythrocytes these red blood cells settle over time so if you think of this as your test tube here and and you feel your your test tube is filled with blood there's a whole bunch of of red blood cells in here right and then they they measure how long does it take to set to settle does the sediment take to acquire at the bottom.
And so it sits there and they they measure how how long does it take for these red blood cells to sink to the bottom so if you look at all the other stuff in the way of the of in the blood you have your red blood cells but they're they're suspended in this serum but the other stuff in the serum is a bunch of proteins and when the proteins.
Are in excess there's too many proteins in your blood blood that's a sign of inflammation so yes a sed rate uh is meant to predict how much stuff is in the way in this in this tube of blood so I mean you'll see them all settle down here at the bottom and someone is measuring the time it's a really cheap test because it's it doesn't take a lot.
It's not very complicated but when we see said rates in the single digits we say oh there is not a lot of proteins in the way there's not a lot of inflammation in that same respects when I am looking at a C-reactive protein there is a common mistake that people do not order the highly sensitive c-reactor protein.
They order just eight C-reactive protein you'll know if you get the price of your AC reactor protein is a few dollars a highly sensitive C-reactive protein is 32 dollars so let me explain the difference so if you look at all these proteins okay in in a sed rate in this test tube you know we're saying well how long does.
It take for these um these red blood cells to settle to the bottom of the test tube and we know that there's thousands of different types of proteins that are getting in the way when you look at C-reactive protein there's a whole bunch of of proteins that are reactive that second word in there is the word.
Reactive and what does it mean to be a reactive protein it means that your body made it as a reaction to something so that's that's what inflammation is inflammation responds I mean inflammation is our response and is it appropriate does it Peak and then settle back down or does it stay this blaring noise in your body.
And there's a whole bunch of different types of C reactive proteins but there's one that's called highly specific because it's it's specifically made on the endothelial lining inside your blood vessels so if this is your blood vessel and you looked down the tube in here the skin lining on the inside of that tube is where this highly sensitive.
C-reactive protein is made and that is what is the inflammation on the insides of your red blood cells and if that protein is high that predicts a heart attack when I take a look at that in the setting of a high LDL cholesterol that makes me say you have got to decrease the inflammation in your body you really have to wring that out.
The other thing that I use to separate um is using okay so let me just show you so you actually my C reaction protein was lovely it was less than one so you want it between zero and three or at least always less than three uh I like it less than 1.0 for sure the lower the better when I look at my ferritin of 500.
Ferritin is also another protein it is a reactive protein and it can raise and cause the ferritin level to be very high for for a host of reasons that don't necessarily correlate to a whole body inflammation my whole body inflammation is very low I have a sed rate less than five it was actually less than five um meaning it was so little we couldn't.
That it was taking too long to say we it was taking way too long to uh to um you know I mean you actually know I'm saying it the other way it was quickly it was so quickly that it it settled out that we don't think there's any extra proteins in your system my highly sensitive c-reactor protein the specific one is made on the endothelial lining of.
My arteries is also very good these tests I can believe they're hard to screw up ferritin easy to screw up ferritin is complicated uh when I see my ferritin's high do I think oh my gosh I have iron overload no go back and look at those iron studies again that my the percentage of seats that are filled with iron in my body is only a third that's.
Not too much it's plenty to keep my brain working right it's plenty to keep me nourished I'm not worried about being um malnourished in the in respects to um to uh see reactable to having too high of a ferritin okay so I know the last slide that I flashed past was LP little.
A and if you go back and look at it I'll make you guys remind that because I'm not gonna go back and do that I'll do that on the next one because I see that we are a long ways into this story and I am going to do another uh another slide deck on what what was my particle size for my cholesterol and I will describe.
LP little a but um here's the cliff notes I would put LP little a as high as I put vitamin D I think that is a hugely valuable uh asset to be looking at to say are you healthy all right so I told you I give you a very um a a discount yes I I want you to buy those uh the bags that I have to throw.
Away at the end of the year if you're looking for great Christmas gifts please consider giving them a bag of Keto combo but uh there is there are some um we had a helpful problem with supply chain during covid uh some of them we couldn't get posted on the websites and then some of them we couldn't move and.
Then anyway there are several of the Dutch chocolates that are going to expire and so we are selling them at 50 off so if you you go to the Dutch chocolate on our website bossmd.com find the Dutch Chocolate BHB and type in this promo code nov50 November 50. we'll take 50 off until the supplies are gone I think there's only a few dozen of them.
That are at this expiration date that's coming in the next couple of months but I don't like that I don't like them to get close to the expiration date and I will I would have them in my family I'm not afraid to use them I just no I can't sell them once they're past the expiration date and God knows I need all the help I can get selling products um.
I'm a great doctor the salesman side of this stuff is not as easy for me so um all right so that does bring me to a couple of things that I um I will give updates for um and I mean that in when the folks stick around to say what are the best labs to have done I know that daylight savings time is.
Really has wrecked my last week but checking the numbers and really keeping track of what your body's system is I mean I am definitely guilty of that before the point of care stuff I don't know if you know how hard it is for a doctor to go and get labs done for themselves to get another doctor to do it I suppose.
It's no harder than anybody else but I was I was I was not doing it so I got my labs checked hopefully just to not only check my system in preparation for patient care but also uh to show you what which ones I would care about um we do have some pretty interesting things coming up in the next month of.
November so stick around for that we announced them here on Tuesdays um if you have not signed up for our email list on what bosmd.com please do that because we have a couple of really cool Christmas specials that I mean packages that are worth over almost that are worth about eight hundred dollars that we're trying to put them on sale.
For somewhere between 270 and 300 the shipping costs actually have been a nightmare the last two months like insane increase in shipping costs so I'd love to give it for you to around 270 but the shipping cost might push me up closer to 300 but it's a hell of a good deal so I will announce that on the email first.
And and on this show but if you're looking for a really cool gift I'm I'm excited to share that with you guys um let's see I am going to go to the questions now um yeah so Cheryl actually just wrote in and said Quest and LabCorp do walk-in laps yeah that's what I did but you you can only get certain labs done at Quest.
And LabCorp as a walk-in you need a doctor's prescription to get most of the ones done that we just talked about here today I mean I think about 80 actually I don't know the percentage I know it's more than I was I thought I'd be a little more forgiving than that and it wasn't okay so let's go to your questions.
Tonight because this is the one place I do uh be sure to answer your questions uh there is that button here we go here we go all right so Krista wrote in first saying hi Dr baz speaking of labs what does low creatinine mean mine was .46 my GFR is 120 liver function is good okay so GFR of 120 means that you have a hundred and twenty percent of your.
Kidney function again it's a mathematical equation when a creatinine is low it means you're cleaning your blood really well your kidneys are doing a really good job of removing that debris from your blood system the GFR is a calculation saying well how good is the kidney doing mine was 95 it's 95 perfect yours is more than perfect it's.
Mathematically beyond what we were guessing so um it's good I'm on your protocol and feel great but wondering what the local candy means so congratulations on the Improvement um your kidneys and and liver think it's great so keep up the good work all right what lab do I check for insulin.
Resistance okay Brian that's a good question I have gone full circle on this uh I have done the um the Houma IRS I have battled with the labs and spent literally twenty five hundred dollars for one um insulin craft insulin test uh for those of you that uh don't I've I've lectured on this a couple times the.
Craft insulin test is like doing a um a blood glucose uh or glucose tolerance test like they do in pregnancy to say have the woman come in fasting check her blood sugar give her a bunch of sugar and then check her blood sugars every 30 minutes for I think it's three hours there's one that's two hours there's one that's three hours craft.
This is a pathologist said let's do that and check insulins at the same time how much insulin is it taking to keep that blood sugar controlled and so when they have these normal blood sugars but that the blood sugar was like delayed it wasn't the spiky blood sugar was a little weird uh it was usually happening with such a heavy blanket of insulin.
Everywhere that you were missing the people with the pathology because they weren't checking the insulin well if you try to get that done in a lab today unless you own the lab not only do they charge the patient over two thousand dollars to get that test done they mess it up most the time so then you can do a home IR you there's.
Several other places you can do this you can do a fasting insulin but I contend the fasting insulin should be done like in a hospital where you're sleeping sleeping sleeping sleeping they wake up check to check the insulin when when you start to rise and and you know get in your car get your clothes on God forbid you shower and even though you're.
Fasting you drive to the lab you know somebody nearly rear-ends you you know there's stress it raises your insulin so you really don't get an honest check of what their insulin is when you're sending them to the lab to do it and then insulin is not very common so then they say insulin and then they have a little stress about is it really insulin.
They're checking and they do all this drama yeah so I have just found that is not I don't get I don't get authentic assessments of what I'm looking for the tests I went through tonight okay minus the copper and zinc are ones that I'm like no I can rely on them there is enough standardization in the tests and.
There is enough reliability in the way the test is done and the way the blood is preserved that I can be confident in the results I cannot be confident in insulin responses because of how volatile it is and this is where I've really come back to say looking at average blood sugar which is hemoglobin A1c it misses people.
It's not perfect but then also looking at what is your morning fasting glucose your morning fasting ketones that's why I check these numbers I don't do this because it's fun I do this because what is my insulin 48 hours into a fast when I can get a doctor boss ratio less than um you know whatever it was today the.
Lower the doctor Bob's ratio the lower the insulin impact because even when we would find insulins that were high we needed to know well how well is that insulin controlling their blood sugar which is what a craft test would tell you but it's so stinking expensive and then I would want to do a craft test every other week until they're better I.
Want to know over time how well are they progressing well all of that is far too expensive keeping track of fasting blood sugar fasting ketones again test on toilet t-o-t sit your butt on the toilet and and don't get up until you check your fasting glucose fasting ketones that teaches me a ton there is less noise in the data I can rely on it even.
When you're using the the meter that's not as accurate the stability of their sugar is really important I have had a few people where I I said you have got to send your four meter in where every single one of their blood sugars was the same for three weeks I'm like that's mathematically impossible you need a new meter if you flat line on.
Your forearm upgrade to one of the mojos I do really like Mojo's meter it is and it is very impressive um they have done they've done some nice upgrades and some they need praise in the room award for how good their meter really is it takes a lot for me to say that because I have been such a fan of 4 care and I do like how four cares um has.
Just really delivered on quality but times change and Mojo's meter is really amazing it's really better than that it was when I first looked all right so um so if you are let's do a couple more questions and then I'll check my blood sugar again before I leave and then.
We'll call to go see what the election results are let's go back to the questions here we go all right so there's Brian's uh okay you should Brian you should tune in for the follow-up question the follow-up lab test that I'm going to do because between that LP little a and my NMR particle size I will be doing uh.
You'll learn a lot from that one okay anyway what are the key labs for heart health yeah um again hopefully you see that at highly sensitive C-reactive protein um I really like to see their a1cs in between 4.5 and 5.0 um and then your uric acid should be less than five you know in the fours.
Okay I'm not there yet I know that I'm saying this without mine being perfect but um those are a much better predictor of are you making inflammation um so where did I get these labs done at um you know in my clinic I have um aspirations of of seeing people from all over the country so one of the.
Hardest parts about getting the clinic back going is to been integrating into uh the two Labs that are found across the country and that is LabCorp and Quest let me tell you oh my goodness I hope I don't give up praise God for Michelle who's helping me uh I said the way we get to the first patient is going to be a winging a prayer on her because.
It is really a lot um but that one was done by LabCorp and I sent my husband a quest Quest has not done their job yet um I mean I've got a problem with Quest yet well we'll figure it out calm down we'll get it there but it's annoying okay let's go back to these a couple more questions.
Um so Naomi says uh what's the test for uric acid yeah the test for uric acid is definitely looking at the trash in my cells I want to know how clean are my cells living it's one way that I measure how rapidly is the patient aging um and when it's above 12 I don't care how skinny you are I don't care that.
Your A1C is normal it has to be you have to get that uric acid out of there and really autophagy is and routine fasting is a really important part of how to accomplish that there's a gal who comes to my support group a very fun person I've met in Tampa her name is Ginny and she was when I was teaching people how to start a support group she was one of.
The volunteers that showed up and I welcomed me to Florida but we tested everybody's uric acid and hers was 12. and she was so proud she had lost all this weight with keto she was teaching her family and I was like no check it again again it was like 11.7 or something really high and so I said you know I know that you've done a lot of.
Things that are great but and she's in her 70s so I said you really need to be doing a 72 hour fast once a week your keto adapted you're doing great you've had all the success but if you want to reverse that the Aging of yourselves if you want your brain to have the best brain health you've got to get that uric acid down oh by God why she did it.
Um and she did you know at least eight weeks of 72 hour fast it might have been longer a longer succession of that and the next time we checked her uric acid it was in the sixes so she was able to do that over like a six month period you do not change uric acid quickly it is a difficult thing to change to change but um and she looks at she said I didn't.
Think I had another 20 pounds to lose or whatever she lost more of um but her uric acid was really my clue that there's more going on under the hood than she was aware of so that is a great question I get that question a lot all right Aloha 22 you had some great questions last week too okay does an intake of iron supplement cause.
Constipation okay oh that's a great thing I did not bring that point up either uh so constipation happens because that Elemental iron is being pooped out so that last section of your of your colon when you put iron in it it just kind of paralyzes I mean it really makes it hard to move the stools along ask any.
Pregnant woman who starts taking a multivitamin with iron in it that's Elemental iron their stools turn dark and that's the iron that you're putting out the toilet because ninety percent of it in the healthiest of people cannot be absorbed when you take iron from liver of course I'd love you to eat liver but I've been told by many of you that.
You're not doing that so I sourced awesome liver grass-fed beef liver this took me forever I should have had this supplement out two years ago but I couldn't get it done I am so thankful that it's available now if you have um I mean the iron saturation should never be less than 20 it should be in the 30s and 40s.
Um that process of keeping enough iron around for your brain to make the molecules that improve depression that keep your brain working well that is critical it is critical especially for all those young girls whose iron goes down once they start menstruating don't do that that's hard on their brain development if you want them to be.
Engineers or doctors or scientists they need that part of their brain that uses iron also does Math and Science and Engineering so don't get me started on that it'll take you a long time and I go oh my goodness at seven o'clock I need to have a wrestler to go pick up let me do one more.
Um oh let's see here I'll do the last two questions really quick so Gail says is cod liver oil uh bought in tins a good source of iron yes yes I usually can't get people to eat it so you win uh last one is the fasting that you often recommend advisable if you are.
Um iron deficiency anemic so honestly I would I would not be doing an uh a fast I mean your body is telling you if your iron deficiency and anemic I would be getting on those iron pills I mean I would recommend up to six of those pills a day and the reason for that is you have to replace the iron before any of these other hormones can work correctly.
When people write in and say ah keto just doesn't feel very good to me I mean my brain instantly says what aren't you making what aren't you doing well and as much as I don't like to be in the middle of uh everybody's you know Saga I like you to be able to test on your own and learn these things on your own I don't come here on YouTube out all the you.
Know share all my lab data because it's not helpful I want you to see this is the same plan I have to have for me and if my iron was low I'd be giving myself IV iron or B eating liver twice a week until that iron was normal because you cannot fix this you cannot absorb you cannot heal you cannot think you can you can't believe how quickly that brain.
Ages when you spend time iron deficient not not okay ladies don't do that don't and I wouldn't have you fasting I mean I would have you doing a sardine fast or maybe join Gale and do a cod liver fast three days only Cod Liver get that iron up it is that important all right I got a kiddo who is at the wrestling room right now saying.
Mom where are you so I do want to know that the end screen which is the little bitty box at the end of this video that we put on the end I have several of the tests that I went through today that are point of care that are home tests and because I was a little scattery when I was teaching them watch this video at the end to see which ones you can do at.
Home all right guys thanks again we'll see you next
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