Although you may not like to go to the doctor, it is important to see your doctor at least once a year for a physical exam or a set of blood tests.
And, if you have diabetes, then, you may need to see several types of doctors during the year, e.g. primary care physician, endocrinologist, cardiologist, neurologist, nepthrologist, podiatrist,etc. Refer to the Annual Doctor Appointments web page for details.
Normally, your doctor will perform an annual physical examination, which usually includes a close examination of all the parts of your body, from head to toe.
The tests performed by your doctor/physician assistant usually include the following:
Check medical history. Your doctor will usually ask you about your medical history to see if there any major diseases that run in your family. Your doctor may ask you about lifestyle behaviors like smoking, excessive alcohol use, sexual health, diet, and exercise. Your doctor may also check on your vaccination status and update your personal and family medical history.
Note: This is your chance to mention any complaints or concerns about your health to your doctor.
Check general appearance. Your doctor gathers a large amount of information about you and your health just by watching and talking to you. How is your memory and mental quickness? Does your skin appear healthy? Can you easily stand and walk?
Measure your height and weight. Your doctor or physician assistant may also measure your waist because waist size has proven to be a better indicator of a weight problem and insulin resistance.
Check your blood pressure. Your doctor or physician assistant will use an instrument called a sphygmomanometer to measure your blood pressure.
First, a cuff is placed around your arm and inflated with a pump until the circulation is cut off. A small valve slowly deflates the cuff, and a stethoscope, placed over your arm, is used to listen for the sound of blood pulsing through the arteries. That first sound (whooshing noise) of rushing blood refers to the systolic blood pressure; once the sound fades, the second number indicates the diastolic pressure, the blood pressure of your heart at rest.
Check your heart rate. Your doctor feels your pulse in order to check your heart's rate, rhythm and regularity. Each pulse matches up with a heartbeat that pumps blood into the arteries. The force of the pulse also helps evaluate the amount (strength) of blood flow to different areas of your body.
You can tell how fast your heart is beating (heart rate) by feeling your pulse. Your heart rate is the amount of times your heart beats in one minute.
Check your respiration rate. From 12 to 16 breaths per minute is normal for a healthy adult. Breathing more than 20 times per minute can suggest heart or lung problems.
Check your body temperature. 98.6 degrees Fahrenheit is the average, but healthy people can have resting temperatures slightly higher or lower.
Check your eyes, including movement, pupil response to light, and the back of the eye (retina). Make sure to tell your doctor of any changes that have occurred, even if you are also seeing an eye care specialist.
Check your mouth and neck. Your doctor will examine your gums, teeth, mouth, and throat.
Check your thyroid gland. Your doctor will check this gland for any swelling by feeling it while you swallow. Thyroid problems sometimes develop in people who have diabetes.
Listen to your heart and lung sounds (through a stethoscope) and checking your blood flow (pulse) in your arms, legs, and feet. Your doctor also may listen to the blood flow in your neck (carotid) arteries for evidence of plaque buildup from atherosclerosis.
Sometimes an electrocardiogram or stress electrocardiogram may be performed.
Check abdominal area. Your doctor can use a range of examination techniques including tapping your abdomen to detect liver size and presence of abdominal fluid, listening for bowel sounds with a stethoscope, and palpating for tenderness.
Hernia exam. The famous "turn your head and cough" checks for a weakness in the abdominal wall between the intestines and scrotum.
Check for a skin condition called acanthosis nigricans (skin tags).
Examine your nervous system by checking your reflexes and your ability to feel touch in your arms, legs, and feet.
If you are experiencing any persistent problems, such as dizziness on standing, pain, burning sensation, numbness in your legs or arms, constipation, diarrhea, difficulty urinating, or difficulty with erection or sexual satisfaction, you should mention them to your doctor.
Examine your feet for sores, injuries, and decreased sensation. Your doctor will gently touch your feet and hands with a vibrating metal tuning fork and small pieces of fine nylon fiber (microfilament testing) to look for any loss of feeling that could indicate neuropathy.
Check your blood. Usually (before the exam) a sample of blood will have been drawn to test for glucose levels and hemoglobin A1C. A fasting lipid profile, which measures cholesterol and triglycerides, will have been performed to determine the levels of these fats in your blood. Your urea nitrogen and serum creatinine concentrations in the blood will also be measured to assess your kidney function.
Check your urine. Kidney function is also assessed by testing urine for ketones, glucose, and protein. People with diabetes are more likely to have urinary tract infections because of the high concentrations of glucose in urine and the loss of the sensation of knowing when the bladder is empty or full because of neuropathy.
Vaccinations. People with diabetes are more likely to develop complications from the flu or pneumonia. You may need a pneumonia vaccine once in your lifetime; and, you may need a flu shot each year. However, make sure that you do your research about vaccines so that you understand the risks.
Testicular exam (men). A doctor can check each testicle for lumps, tenderness, or changes in size. Most men with testicular cancer notice a growth before seeing a doctor.
Penis exam. A doctor might notice evidence of sexually transmitted infections such as warts or ulcers on the penis.
Prostate exam. Inserting a finger in the rectum lets a doctor feel the prostate for its size and any suspicious areas.
Breast exam (for women). Feeling for abnormal lumps may detect breast cancer or benign breast conditions. The doctor will also check the lymph nodes in the underarm area and look for visual abnormalities of the breasts and nipples.
Pelvic exam. The pelvic exam allows examination of the vulva, vagina, cervix, uterus and ovaries. Routine checks for sexually transmitted infections are often done. A Pap test and HPV test can screen for cervical cancer and help assess risk.
Other tests. For women, this includes a Pap smear, mammogram, and gynecological and rectal exam. For men, this includes prostate and rectal exams. Both sexes should have their stool samples tested for blood to detect colon cancer.
The MajorBlood Tests
There are several major types of blood tests that your doctor may perform to help determine your current state of health (diagnosis) and your future state of health (prognosis). These tests are very important in your overall health planning.
The critical blood tests usually include:
- Fasting Blood Glucose
- Hemoglobin A1C
- Fasting Insulin
- Postprandial Blood Glucose
- Blood Pressure
- Cholesterol (LDL, HDL, TG, Total)
- Cardiac Risk/Inflammation Factors
Other key tests mayinclude:
- Liver Enzymes
- Thyroid Tests
- Hormone Panel
- Waist Size/BMI
- Excretory Factors
Note: This is not a complete list of all of the many blood tests and other medical tests. Refer to the Doctor Visits, Exams & Blood Tests ebook for a complete and comprehensive list of all the various blood, urine, etc. tests.
Critical Blood Tests
Fasting Blood Glucose measures the amount of glucose (sugar) in the blood after fasting for several hours.
Hemoglobin A1C measures the percentage of glucose in the blood during the past 2 to 3 months.
Glucose, formed by the digestion of carbohydrates and the conversion of glycogen by the liver is the primary source of energy for most cells. It is regulated by insulin, glucagon, thyroid hormone, liver enzymes and adrenal hormones.
Glucose is elevated by diabetes, liver disease, obesity, pancreatitis, steroids, stress, or diet. Low levels may be indicative of liver disease, overproduction of insulin, hypothyroidism, or alcoholism.
Range for Fasting Blood Glucose: 80 to 120 mg/dl; Optimum value: < 100 mg/dl
Range for Hemoglobin A1C: 4.2% to 5.5%; Optimum value: < 5.0%
Fasting Insulin measures the amount of insulin in your blood after fasting for several hours and is an indication of insulin ressitance.
Range: 2 to 5 µIU/mL
Since this measurement is a strong indicator of insulin resistance, it provides an earlier warning of impending prediabetes and full-blown diabetes since insulin resistance is a precursor to developing Type 2 diabetes. In addition, your fasting blood glucose tends to lag your fasting insulin and doesn't exceed the normal range until months after your fasting insulin level.
A burst of insulin is released in response to eating food. Once glucose has been safely shuttled into energy producing cells or stored, insulin levels should drop below 5 µIU/mL. Only a tiny amount of residual insulin should be needed to maintain glucose homeostasis.
When fasting insulin is over 5 µIU/mL, this indicates a metabolic problem such as pre-diabetes, which sharply increases risk for degenerative diseases. Some medical texts state that insulin should virtually vanish from the blood once glucose levels reach 83 mg/dL.
In people suffering from metabolic disorders and/or obesity, insulin levels remain stubbornly high. This not only generates damaging reactions throughout the body, but prevents weight loss as glucose is forced into fat cell storage.
Ideally, fasting insulin should be below 5. Whole Health Source says that fasting insulin between 2 and 6 uIU/ml is ideal. Levels above 60 pmol/ml (8.4 uIU/ml) indicates hyperinsulinemia.
Note: Insulin levels can be reported as uIU/ml or pmol/ml. When comparing values, it is important to have the same type of measurement. To convert from pmol/ml to uIU/ml, divide by 7.175. Thus 60 pmol/ml equates to 8.4 uIU/ml.
Postprandial Blood Glucose measures your blood glucose usually 2 hours after a meal.
A 2-hour postprandial blood glucose test measures blood glucose exactly 2 hours after eating a meal, timed from the start of the meal. By this point blood glucose has usually gone back down in healthy people, but it may still be elevated in people with diabetes. Thus, it serves as a test of whether a person is successfully controlling their blood glucose.
The postprandial test can also be used indirectly as an indicator of whether insulin resistance is being reduced after making dietary changes. For example, if the postprandial reading is above 140 mg/dl and it's not coming down over a period of several days, then, this usually indicates that the pancreas is not meeting the demand for extra glucose from the meal and/or the insulin resistance and cellular inflammation are on the rise.
Blood Pressure measures the pressure (force per unit area) exerted by the blood on the walls of the blood vessels.
The first number is the systolic pressure, which measures the force at which the heart contracts. The second number is the diastolic pressure, which measures the pressure when the heart is at rest (between beats).
High blood pressure is an indication that one or more of the body’s systems is not functioning properly, causing the heart muscle to work harder to push the blood throughout the body.
Systolic (first number): < 120 mm Hg
Diastolic (second number): < 80 mm Hg
In addition, measuring the blood pressure in other parts of the body such as the ankle, leg or toe can help to diagnose other problems that may go undetected.
For example, according to recent research from Sweden, measuring toe blood pressure can be an effective screening method to identify diabetics with lower extremity arterial disease. Unlike the routine arm blood pressures where diastolic and systolic pressure are measured, extremity blood pressures measure only systolic pressure.
Blood Cholesterol measures the amount of lipids (fat) in the blood.
Cholesterol is a critical fat that is a structural component of cell membrane and plasma lipoproteins, and is important in the synthesis of steroid hormones, glucocorticoids, and bile acids. Mostly synthesized in the liver, some is absorbed through the diet, especially one high in saturated fats.
High density lipoproteins (HDL), which indicates more (dense) protein and less cholesterol, is desired as opposed to the low density lipoproteins (LDL), which indicates less protein and room for more cholesterol within the molecule.
Elevated cholesterol levels have been seen in atherosclerosis, diabetes, hypothyroidism and pregnancy. Low levels are seen in depression, malnutrition, liver insufficiency, malignancies, anemia and infection.
Triglycerides, stored in adipose tissues as glycerol and fatty acids, are reconverted as triglycerides by the liver. Ninety percent of the dietary intake and ninety-five percent of the fat stored in tissues are triglycerides.
Increased levels may be present in atherosclerosis, diabetes, hypothyroidism, liver disease, pancreatitis, myocardial infarction, metabolic disorders, and toxemia. Decreased levels may be present in chronic obstructive pulmonary disease, brain infarction, hyperthyroidism, malnutrition, and malabsorption.
LDL or Low density lipoprotein is the cholesterol remnants of the lipid transport vehicle VLDL (very-low density lipoproteins).
A high level of LDL is an indication of a clogged liver, an unbalanced metabolic system, or possible arterial wall damage (atherosclerosis). Due to the expense of direct measurement of LDL, the Friedewald formula is used:
LDL = Total Cholesterol - HDL Cholesterol - Triglycerides/5
Note: When triglyceride levels are greater than 400, this method is not accurate.
HDL or High density lipoprotein is the cholesterol carried by the alpha lipoproteins.
A high level of HDL is an indication of a healthy metabolic system if there is no sign of liver disease or intoxication. HDL inhibits cellular uptake of LDL and serves as a carrier that removes cholesterol from the peripheral tissues and transports it back to the liver for catabolism and excretion.
The normal ranges for these cholesterol parameters are:
- Total Cholesterol (TC): < 200 mg/dl
- Low Density Lipoprotein (LDL): < 130 mg/dl
- High Density Lipoprotein (HDL): > 40 mg/dl
- Triglycerides: < 150 mg/dl
- TC/HDL Ratio: < 4:1; LDL/HDL Ratio: < 3:1
Note: Actually the ratios are better indicators of your cholesterol health than the absolute numbers, which can be misleading, especially if you have a high HDL, which is a good indicator.
Body Mass Index (BMI) provides a measure of weight relative to height to use as a guideline to determine whether your weight is at a normal, overweight, or obese level.
- BMI Range: 20 to 25
- BMI greater than 25 indicates an overweight level.
- BMI greater than 30 indicates an obese level.
Waist Size: Actually the size of one’s waist may be a better measure and indicator of one’s health state. In general, if the waist size exceeds 40 inches (for a male), or 35 inches (for a female), this indicates a risk factor for developing diabetes and other weight-related health problems. Keep in mind that these are only guidelines for average-sized people.
Note: Refer to the Obesity web page for more information about obesity and excessive weight gain.
Cardiac Risk/Inflammation Factors include homocysteine, lipoprotein (a), LDL particle number, Small LDL, C-reactive protein (CRP), and fibrin; and, are better indicators of cardiovascular disease and inflammation than your level of cholesterol.
They measure the size of LDL and the amount of inflammation and amino acids in the blood. However, since your doctor may not order these tests until he/she has determined that you may be at risk for cardiovascular disease, you may need to request these tests, especially if you are not making any significant progress with your health.
Homocysteine is a sulfur-containing amino acid created by a normal metabolic breakdown of the amino acid methionine; and is an indicator of inflammation.
Lipoprotein (a) is produced by the liver to repair arterial injuries due to a lack of Vitamin C to produce collagen for tissue repair.
LDL particle number (measured as apoprotein B) is the number of LDL particles in one cubic centimeter, or one milliliter of blood. LDL particle number is among the most powerful tools available to predict the risk of heart attack.
It can be measured directly as LDL particle number by the nuclear magnetic resonance spectroscopy method or indirectly as apoprotein B, which is a more widely available method. Apoprotein B is the major protein particle of LDL, with a single protein per LDL particle.
High LDL particle number can be a source of danger even when LDL levels are lower. This is why people who have low LDL can still suffer a heart attack because their LDL particle number is high.
Small LDL is a measure of the size of the LDL particles. LDL particles vary in size—big, medium, and small. The size difference is crucial.
Small LDL particles are a far more destructive force than their larger counterparts because these smaller particles more effectively penetrate the cellular barrier and enter arterial walls, contributing to atherosclerotic plaque. They also persist longer in the circulation, which allows more opportunity to cling like little magnets to tissues within the arterial walls.
Once in the arterial wall, small LDL particles are more prone to oxidation, which stimulates the release of inflammatory and adhesive proteins. Small, dense LDL promotes endothelial dysfunction and enhanced production of pro-coagulants by endothelial cells. Small, dense LDL thus appears to be more atherogenic—that is, more likely to contribute to the build-up of plaque within arteries—than normal LDL.
Small LDL can be an inherited predisposition that is activated by unhealthy lifestyles and weight gain. When the genetic factors are strong, it can occur in healthy people who are not overweight. It frequently causes heart disease and is found in more than half of all people who suffer heart attacks. Small LDL particles triple the likelihood of developing coronary plaque and suffering a heart attack.
This one little measure also holds a world of hidden information. Not only does it indicate a higher risk for heart attack, but small LDL suggests that you are more resistant to insulin and more likely to develop metabolic syndrome, or even diabetes, if you become overweight. It also suggests that a very low-fat diet (deriving less than 20% of calories from fat) may paradoxically heighten your heart disease risk.
Small LDL can augment the dangers of other cardiac risk factors, such as high total cholesterol, increased LDL particle number, or high C-reactive protein (a measure of inflammation). Researchers have noted that while elevated small LDL particle count alone can raise heart attack risk by up to 300%, heart attack risk is sixfold higher (600%) when elevated C-reactive protein is also present.
C-Reactive Protein (CRP) is a plasma protein produced by the liver in response to inflammation.
Fibrin is an insoluble protein that is deposited around a wound in the form of a mesh to dry and harden, so that bleeding stops. Platelets, a type of cell found in blood, release the enzyme thrombin when they come into contact with damaged tissue, triggering the formation of the soluble protein, fibrinogen. Fibrinogen is then converted to fibrin as the final stage in blood clotting, which helps to repair damaged arterial walls.
The normal ranges for these cardiac risk/inflammation parameters are:
- Homocysteine: < 17 umol/L
- C-Reactive Protein (CRP): < 10 mg/L
- Lp (a): < 25 mg/dl
- Fibrin: 145-348 mg/dl
These numbers are only guidelines and may be slightly different depending on the test methods used by your doctor’s lab. Therefore, when you review your blood and urine test results with your doctor, you should always ensure that you understand the normal range for each blood or urine test and how far you are outside that range.
Waste Products include blood urea nitrogen (BUN), creatinine, and uric acid.
They indicate the health of the kidneys. Blood Urea Nitrogen (BUN) is the end product of protein metabolism and its concentration is influenced by the rate of excretion. Creatinine is the waste product of muscle metabolism. Its level is a reflection of the bodies muscle mass. Uric acid is the end product of purine metabolism and is normally excreted through the urine. Bun/Creatinine Ratio is a good measurement of kidney and liver function.
Electrolytes/Minerals indicate the health of the kidneys, adrenal glands, parathyroid glands, and the acid/alkaline status of the blood.
- Potassium helps to regulate blood pressure and heart function; along with sodium, helps to maintain osmotic balance; is involved in acid-base balance; and, is needed for proper nerve and muscle action. It has an inverse relationship with sodium -- when potassium is increased, sodium decreases and vice versa.
- Sodium functions in the body to maintain osmotic pressure, acid-base balance and to transmit nerve impulses. It functions with chloride and bicarbonate to maintain a balance of positive and negative ions (electrically charged particles) in our body fluids and tissues.
- Calcium levels are highly sensitive to elements such as magnesium, iron and phosphorus as well as hormonal activity, Vitamin D levels, alkalinity and acidity, and many different drugs.
- Carbon dioxide level is related to the respiratory exchange of carbon dioxide in the lungs and is part of the bodies buffering system.
- Magnesium plays a major role in the metabolism of glucose. It is required for the formation of enzymes that release energy from food; and, is used in the production of cellular energy and to create protein.
- Phosphorous is needed for its buffering action, calcium transport and osmotic pressure.
- Chloride influences osmotic pressure, as it helps to keep the amount of fluid inside and outside of cells in balance.
Proteins measure the amount and type of protein in the blood.
- Albumin is the major constituent of serum protein (usually over 50%). It is manufactured by the liver from the amino acids taken through the diet. It helps in osmotic pressure regulation, nutrient transport and waste removal.
- Globulin is important for its immunologic responses, especially its gamma portion.
Liver Enzymes measure specific liver enzyme levels to assess how well the liver and the body’s systems are functioning and whether there has been any tissue damage; indicating injury to the cells of the muscles, liver, or heart.
Enzyme tests include Aspartate aminotransferase (AST), Alanine amino-transferase (ALT), Alkaline phosphatase (ALP), Gamma-Glutamyl Transpeptidase (GGT), Lactic acid dehydrogenase (LDH), and Bilirubin.
Note: Your should ensure your liver enzymes are checked if you are taking a statin drug because of the damage that these drugs can do to your liver.
Thyroid Tests measure the levels of the thyroid hormones in the blood, Thyroxine (T4) and Triiodothyronine (T3).
Note: If you are diagnosed with an underactive thyroid (hypothyroidism), you may have an iodine deficiency -- especially if you live in mountainous regions of the world where food is grown in soil poor in iodine or remote inland areas where no marine foods are eaten. Iodine food sources include: seafood, sea salt, kelp, wakame, kombu, nori, other sea vegetables, iodized salt.
FYI: Iodine is a mineral that is essential for proper thyroid function. Iodine, when combined with the amino acid tyrosine, produces vital thyroid hormones that control our metabolism, insulin sensitivity, enzyme and protein synthesis, and are essential in the development of the skeletal and central nervous systems of developing fetuses.
Note: The combination of a low-salt diet, no sea food, and drinking tap water (with chlorine) can inhibit iodine absorption, and may cause a possible iodine deficiency, which, in turn, may decrease insulin-receptor sensitivity.
Complete Blood Count (CBC) measures the quantity of different cells in the blood.
Other blood count tests include White Blood Count (WBC), Red Blood Count (RBC), Platelet Count (PLT), Mean Corpuscular Volume (MCV), and Hemoglobin (Hgb or Hb).
Bone Density measures the density of the bones to identify potential bone loss -- osteopenia (the early stage of bone loss) or osteoporosis.
Blood pH measures the alkalinity/acidity of the blood, and may indicate acidosis if the pH level is less than 7.365.
Urine Tests can be performed to provide additional insight, especially concerning the health of the kidneys.
Microalbumin measures the amount of protein that is not removed by the kidneys and has leaked into the urine. When kidneys function properly, they filter out waste products from the blood, but when the kidneys become damaged, the waste products remain in the blood and protein leaks into the urine.
At first, when the damage is just beginning, only very small amounts of albumin escape into the urine, a condition known as microalbuminuria. In later stages of kidney disease, large amounts of protein leak into the urine (> 30g/dl), causing a condition called macroalbuminuria, also known as proteinuria.
Ketones measure the level of ketones, which are the by-product of the fat burning process that occurs in the absence of insulin. Other urine tests include pH (acidity for your urine), specific gravity (SG), glucose, protein, bilirubin, nitrate, leukocyte esterase, and sediment
Excretory Factors are usually overlooked, but they can tell your doctor a lot about what you’ve been eating and how your body has been processing what you eat on a daily basis. Infrequent bowel movements (constipation) or indigestion is usually the first sign of problems in the gastrointestinal tract.
Bowel movement frequency, texture, shape: 3-4 times per day (1 per meal), soft, peanut butter-like texture, slightly S-shaped
Urination frequency, color: 4-6 times per day, yellow-straw in color
Note: This is not a comprehensive list of tests. Depending on your health, there are many other blood tests and medical diagnostic tests that your doctor may perform to better understand your health state.
Other tests include hormone tests, vitamins/minerals tests, liver detoxification tests, amino acids tests, fatty acid analysis, intestinal permeability test, stool test, immune system tests, oxidative stress analysis, and hair analysis tests.
Although health insurance coverage may be a concern, do not hesitate to ask your doctor if there is an additional test that he/she could perform that would better define your health state.
If you and your doctor do not fully understand your health state, it may be difficult to devise an effective “get well” plan. As a result, two to three years later, you may find that you’re either not feeling better or you’re taking more medication. Both of these are signs that indicate that the original diagnosis may have been incorrect.
Refer to Chapter 11 of Death to Diabetes or the Doctor Visits and Critical Blood Tests ebook for a comprehensive list and explanation of all the various blood tests, urine tests, hjormonme tests and other medical tests.
Other Important Blood Tests for Most Other Diseases
Dehydroepiandrosterone (DHEA), a hormone produced by the adrenal glands, is a precursor to the sex hormones estrogen and testosterone. Blood levels of DHEA peak in one’s twenties and then decline dramatically with age, decreasing to 20-30% of peak youthful levels between the ages of 70 and 80. DHEA is frequently referred to as an “anti-aging” hormone.
Recently, researchers in Turkey found that DHEA levels were significantly lower in men with symptoms associated with aging, including erectile dysfunction. Healthy levels of DHEA may support immune function, bone density, mood, libido, and healthy body composition.
Elevated levels of DHEA may indicate congenital adrenal hyperplasia, a group of disorders that result from the impaired ability of the adrenal glands to produce glucocorticoids.
Supplementation with DHEA increases immunological function, improves bone mineral density, increases sexual libido in women, reduces abdominal fat, protects the brain following nerve injury, and helps prevent diabetes, cancer, and heart disease.
Prostate-specific antigen (PSA) is a protein manufactured by the prostate gland in men. Elevated levels may suggest an enlarged prostate, prostate inflammation, or prostate cancer. PSA levels may also be used to monitor the efficacy of therapeutic regimens for prostate conditions.
Elevated levels of PSA may not necessarily signal prostate cancer, and prostate cancer may not always be accompanied by expression of PSA. Levels can be elevated in the presence of a urinary tract infection or an inflamed prostate. A PSA level over 2.5 ng/mL, or a PSA doubling time (the time required for PSA value to double) of less than 12 years, may be a cause for concern.
Testosterone (Free). Testosterone is produced in the testes in men, in the ovaries in women, and in the adrenal glands of both men and women. Men and women alike can be dramatically affected by the decline in testosterone levels that occurs with aging.
In men, testosterone levels normally decline with age, dropping to approximately 65% of young adult levels by age 75. This drop in testosterone is partially responsible for the significant physiological changes seen in aging men.
In fact, low levels of testosterone are associated with numerous adverse health conditions, including diminished libido, metabolic syndrome, erectile dysfunction, loss of muscle tone, increased abdominal fat, low bone density, depression, Alzheimer’s disease, type II diabetes, and atherosclerosis.
Women: Following menopause, levels of testosterone in women decrease, along with a concomitant decline in libido, mood, and general well-being. Although women produce only small quantities of testosterone, evidence indicates that this important hormone helps women maintain sexual function, as well as muscle strength and mass.
Men (Standard/Optimal): 6.6-26.5 pg/mL, 15-26.5 pg/mL
Women (Standard/Optimal): 0-2.2 pg/mL, 1.4-2.2 pg/mL
Estradiol. Diminished levels of estradiol in women correlate with low levels of bone mineral density, which is a strong risk factor for osteoporosis. Optimizing estradiol levels in early menopausal women has been associated with relief from hot flashes, irritability, and insomnia.
In older men, low levels of estradiol have been linked with an increased risk of vertebral fractures; conversely, estradiol levels are found to be positively associated with bone mineral density, suggesting an association between low serum levels and the development of osteoporosis. A recent study from France found a correlation between low estradiol and skeletal frailty.
Men (Standard/Optimal): <54 pg/mL, 10-30 pg/mL
Women (Standard/Optimal): 0-528 pg/mL, 352-528 pg/mL
Blood or urine tests can determine the levels of various hormones in the body. This includes reproductive hormones, thyroid hormones, adrenal hormones, pituitary hormones, and many others.
For a list of the major 30+ tests go to this link:
Male Comprehensive Hormone Panel
This panel contains the following tests:
-- Estradiol (E2)
-- Testosterone (Free and Total)
-- Sex Hormone Binding Globulin (SHBG)
-- Free T3
-- Free T4
General Health Markers:
-- Chemistry Panel (Complete metabolic panel with lipids)
-- Complete Blood Count (CBC)
-- PSA (screening test for prostate cancer)
Female Comprehensive Hormone Panel
This panel contains the following tests:
-- Estradiol (E2)
-- Estrogens, Total
-- Testosterone (Free and Total)
-- Sex Hormone Binding Globulin (SHBG)
-- Free T3
-- Free T4
General Health Markers:
-- Chemistry Panel (Complete metabolic panel with lipids)
-- Complete Blood Count (CBC)
Comprehensive Vitamin Panel Blood Test
The Comprehensive Vitamin Panel includes testing the blood for 13 vitamins and is used to detect deficiencies across the vitamin spectrum.
Comprehensive Mineral Panel Blood Test
The Comprehensive Mineral Panel includes testing the blood for five minerals and is used to detect deficiencies or overexposure (toxicity) across the mineral spectrum.
Heavy Metal Testing
Heavy metals testing is used to screen for or to diagnose heavy metal poisoning in those who may have been acutely or chronically exposed to one or more heavy metals and to monitor excessive metal concentrations in those who work with various heavy metals.
Such occupations include construction work, mining, radiator repair shops, and firing ranges. Testing is also conducted to monitor the effectiveness of chelation therapy, a treatment to rid the body of high amounts of a heavy metal.
Heavy metal panels are set up in groups of tests that mirror potential metal exposures. A laboratory may offer several different groupings that are specific for either blood or urine. A healthcare practitioner will order the metals panel that corresponds to the person's occupation, hobby, suspected exposure, and/or clinical symptoms. Some of the metals that are more commonly tested include:
If a healthcare practitioner suspects that someone has been exposed to a specific metal, such as lead, the practitioner may order that specific test instead of, or in addition to, a panel. Lead is usually ordered by itself when screening for exposure, especially in children because of how susceptible they are to its effects. Some metals can also be measured in fluid, hair, fingernails, and body tissues. Usually these are ordered individually.
The ABCs of Diabetes Testing
Tip: One of the best ways to remember what you need to control and get tested on a regular basis to ensure you stay as healthy as possible, is to remember the acronym "ABC", where A stands for A1C, B stands for blood pressure, and C stands for cholesterol.
"A" stands for "A1C" – Hemoglobin A1C is a blood test that shows what your average blood sugar level has been during the last few months.
"B" stands for "blood pressure" – If you have diabetes, controlling your blood pressure is just as important as controlling your blood sugar. High blood pressure puts you at risk for heart attack, stroke, and kidney disease.
"C" stands for "cholesterol" – Cholesterol is a waxy substance found in the blood. High cholesterol is another factor or indicator that increases your risk of heart attacks, strokes, and other serious problems.
Your ABCs are important because compared with people who do not have diabetes, people who have diabetes are 2 to 3 times more likely to have a heart attack or a stroke. People with diabetes also have heart attacks at a younger age.
In addition, people with diabetes are much more likely to get kidney disease. By keeping your ABCs under control (with diet and exercise), you can significantly lower your risk of these problems.
Next Steps to Wellness
If you haven't had a physical in more than a year, you should schedule an appointment with your doctor.
Before you go to your doctor's appointment, read our Doctor Appointments web page to learn how to prepare for your appointment and learn what questions to ask.
If you haven't done so yet, we recommend that you get the author's Death to Diabetes book (or expanded ebook). The book will help you to understand how to get the most out of your doctor's appointment.
In addition, you will learn a lot about diabetes and nutrition so that you'll have a better idea whether your doctor can help you.
Disclaimer: This site does not provide medical advice, diagnosis or treatment.
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