Blood analysis: some important numbers

Blood testing is useful in assessing the state of health of the body, but also as a motivational tool if you are making changes to your lifestyle with the intention of improving your health. Below is what I recommend getting tested (beyond the default standard blood profile), mid morning, after the standard 12-16 hour overnight fast. Italics denote the most important.

If you decide to engage in a health-transformation programme by following the guidelines and advice given throughout this blog, I would encourage you—for your own education and personal satisfaction—to get this blood work done before or just at the start of your programme, and then, at the very least, after 1 month and after 3 months.

Furthermore, if you do adopt these guidelines as your basic lifestyle—which is naturally what I whole-heartedly encourage you to do and gain an increasingly deeper level of health—then you should get another blood analysis done after 6 months, after a year, and then yearly. This is not to see you are ok: you will be for sure, but it is primarily for the sake of seeing the numbers and having the data for your own satisfaction and as a means to convince others of the benefits of carefully choosing what we eat and drink.

Finally, I would be tremendously grateful if you were willing to share the results of these blood tests with me, both for the pleasure of knowing that I have helped you get healthier and for the sake of my interest in this as a scientist.

Insulin resistance/nutritional ketosis

  • Glucose < 85 mg/dl
  • Insulin < 3 mcIU/ml
  • Haemoglobin A1c (HbA1c) < 5.1% (measures glycation of red blood cells and is related to glucose levels over the last 3-5 months)
  • Serum ketones: Beta-hydroxybutarate (B-OHB) > 0.5 for ketosis (0.5-5 mmol; optional)

Inflammation, clotting, blood pressure

  • C-Reactive Protein (hsCRP) < 1 mg/l
  • Serum Ferritin < 55 mcg/l (40-55)
  • Blood pressure measurement
  • Leukocytes (white blood cells) > 3500 but < 6000 cmm
  • Interleukin-6 (IL-6)
  • Homocysteine (HcY) < 9 mcmol/l (5-15)
  • Fibrinogen 200-300 mg/dl

Vitamins and minerals

  • Vitamin D – 25(OH)D > 50 and < 100 ng/ml, 80 is excellent
  • Vitamin B12 (> 600 pg/ml, 600-2000, 1000 is optimal), B6 and folic acid (B9)
  • RBC Magnesium (in red blood cells) 6.5 mg/dl
  • Serum calcium ions (optional)
  • Total serum calcium (optional)

Blood acid and kidney function

  • Uric acid < 5 mg/dl
  • Urea (BUN) < 30 mg/dl
  • Creatinine 0.5-1 mg/dl (also BUN/Creatinine ratio)
  • Glomerular filtration rate (eGFR), as high as possible: 100-120 is excellent
  • Angiotensin should be low (optional; state of hydration/dehydration)
  • Creatinine clearance 24-hour urine test (optional; if suspecting kidney disfunction)

Standard lipid profile (for reference)

  • Triglycerides < 70 mg/dl
  • Total cholesterol (between 200 and 240 mg/dl, roughly balanced LDL and HDL)
  • HDL (roughly around 100)
  • LDL (roughly around 100)
  • LDL particle size distribution (optional)
  • VLDL and Chylomicrons (optional)

Standard urine test, plus

  • Concentration of urinary Ca and Mg (optional)

Hypothalamic-Pituitary-Adrenal (HPA) Axis (optional)

  • Combined Dexamethasone (DEX) / Corticotropin-Releasing Hormone (CRH) test

4 thoughts on “Blood analysis: some important numbers

  1. You mention that serum ketones should be in excess of 0.5. I have seen several posts from people who have been on a ketogenic diet for many months or years (low protein and carbohydrate less than 50gms) who say that they never test positive. The usual explanation given is the body only produces ketones on a “just in time” basis. The counter argument is that these people are not actually in ketosis – which would seem surprising! Can you shed some light on this? I was going to purchase a meter but now wonder if there is any point! Many thanks. Terry

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    • Hi Terry, if they don’t test positive that’s because they are not in ketosis. Every account I have read from people who actually test their levels often shows that if you eat most of your calories from fat your beta hydroxy butyrate will be above 0.5, and often much higher than that, like 2 or even 5. Those people that test negative either eat too much protein or not enough fat. There is just no other way because if blood sugar is low, the liver will produce ketones to feed the brain. Levels of B-OH-B do vary during the day and also depending on what you do and what/when you eat.

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      • Many thanks indeed for your reply. It will be interesting to see what the blood numbers are when I get the meter and how these compare with the glucose levels, I am thinking there is an inverse ratio between the two which widens as the body adapts to the ketogenic diet.
        I can understand your comment about people not being in ketosis if they eat too much meat but unable to work out why this is also the case if they eat too little fat. If it’s not enough to supply energy needs then doesn’t the body simply use body fat with the production of ketone bodies, itself, being unaffected? I assume this is the way people lose weight on a ketogenic diet.

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      • Hi Terry: The numbers for BHB will not so much be inversely proportional to glucose, although they will be of course, as they will be to insulin. It’s only if insulin is low that the body turns to burning fat. But it is a very complicated affair, with lots of caveats and various behaviours that depend on the time scales. Have you read “The crux of intermittent fasting”? If not, you should. The reason why I wrote that we have to eat enough fat is that the body switching to ketosis depends very strongly on the ratio of calories, in addition to being under your personal carb threshold, which varies from one person to another and also depending on your level of activity (exercise). An extreme example is a person who stops eating all simple and starchy carbs, and focuses only on green veggies with a little protein. The result will still be very low fat, and if they are not already keto adapted, they will lose the water stores (because inflammation will go down by taking our the carbs), but they will lose their muscle and even bone tissue because the body can’t really burn the fat. I had a colleague who was very insulin resistant even though she wasn’t fat, and she would in a whole day have only coffee with sugar and a few cookies, and she would not lose a gram of fat! Her body simply turned down the metabolism and went into starvation mode to keep everything in place. It is only when she followed my advice to cut our all sugar and pile on the fat that she started losing the water and fat reserves.

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