Holistic Health Bites podcast by Functional Nutritionist Andrea Nicholson speaking about biomarkers of metabolic health

Vital Biomarkers for metabolic health

93% of the population has metabolic dysfunction at some level...here are the biomarkers and metrics you need to know to assess and correct your health issues. 





EPISODE DETAILS:
Today, we're exploring essential health metrics that provide insight into your metabolic health and overall wellness. By understanding these numbers, you can take control of your health proactively and make informed decisions for a healthier life. So, let’s jump right in!



Metric 1: Triglycerides
Triglycerides are a type of fat found in your blood, and they’re a crucial indicator of how well your body processes sugar and fat. Ideally, your fasting triglyceride levels should fall between 50 to 100 mg/dL. Factors that drive up production of triglycerides in a fasted state are too many carbohydrates, especially refined and simple sugars, unhealthy fats from refined and ultra processed foods, and having other conditions like insulin resistance or diabetes.  High levels are concerning because they increase the risk of heart disease. Lowering your intake of refined sugars and incorporating healthy fats, along with regular exercise, can help keep triglycerides within the optimal range.  Look for this test on your standard lipid panel, but make sure your test is done when you have fasted for 12-14 hours.  If you test when you’re not fasting, your results will be mostly based on your recent meal, not what your body is actively producing and transporting for storage.  One other side note, triglycerides often increase during active weight loss, so don’t panic if you see elevations when you’re on a weight loss journey.  This will drop again when your weight stabilizes.  The increase is due to mobilization of the fat being burned for energy.   
Metric 2: HDL Cholesterol (often mistakenly referred to as the "Good" Cholesterol)
Let’s take a brief moment to explain why this is a mistaken concept. 
  1. There is only one cholesterol, not good and bad. 
  2. HDL isn’t cholesterol, but the carrier of cholesterol as well as fat soluble vitamins, triglycerides and other fat-soluble nutrients.  
  3. It’s considered “good” because it takes cholesterol and fat from the tissues and carries it to the liver to be broken down and eliminated or recycled.  Really, this is just the second part of the transportation of lipids.  LDL carries it from the liver to the tissues, HDL carries it from the tissue back to the liver.  Both have benefits.  Having more HDL means you can clear out excess cholesterol and lipids more efficiently which is why higher levels tend to be healthier.  
An optimal level is above 60 mg/dL when collected in a fasted state. Regular physical activity, a nutritious diet rich in healthy fats like fish, olive oil and nuts, and avoiding smoking can all help boost HDL levels. 
Metric 3: Triglyceride-to-HDL Ratio
This ratio is calculated by dividing your triglyceride level by your HDL level, and a lower number is ideal here, with a target of under 2, but even better closer to 1. Why is this ratio so important? A high triglyceride-to-HDL ratio has been associated with a higher risk of heart disease and can indicate insulin resistance. If you know your triglycerides and HDL, keep an eye on this ratio as a marker for your cardiovascular health. Yet again, we want this to be calculated using a fasting blood test. 
Metric 4: Fasting Glucose
Fasting glucose measures your blood sugar levels after an overnight fast and serves as a key metric for metabolic health. The goal is to keep it below 70-90 mg/dL. Elevated fasting glucose may indicate insulin resistance, prediabetes or even type 2 diabetes. This metric is heavily influenced by diet, lifestyle, and existing metabolic conditions. If your levels are high, adopting a low-glycemic diet and increasing physical activity are great first steps. Medications can assist in lowering blood sugar levels, but many cause worsening insulin resistance.  None address the true underlying cause which is diet, stress, lifestyle and toxins. 
Metric 5: Blood Pressure
Blood pressure measures the force of blood pushing against your artery walls. Ideally, it should be below 120/80 mmHg. High blood pressure is a major risk factor for heart disease and stroke. Key influences include diet, physical activity, stress, and genetics. Contrary to popular belief, salt intake most often isn’t the driving factor, though a diet high in sodium alone, such as high intake of ultraprocessed foods, can increase the risk.  Regular exercise and stress management techniques like meditation can all help maintain healthy blood pressure levels.  Adequate hydration, nutrient status, and nitric oxide can also make a positive difference in blood pressure. Medications can also help to manage blood pressure, but don’t address the true underlying cause of the hypertension to begin with which can be dehydration, nutrient deficiencies, stress, or kidney dysfunctions.  
Metric 6: Waist Circumference
Waist circumference is a straightforward measure of belly fat and is another vital indicator of metabolic health. Increased waist circumference is a significant indicator of higher amounts of visceral fat which is the unhealthy fat surrounding abdominal organs.  This type of fat often accompanies another dangerous type of fat, ectopic fat, which is the kind that infiltrates organs like liver, pancreas, heart, and muscle.  For men, the goal is a waistline under 40 inches, and for women, under 35 inches, though other countries have more stringent recommendations of less than 35 and 31.5 inches for men and women respectively. Excess belly fat is associated with a greater risk of heart disease, stroke, and type 2 diabetes. This metric is easy to track and can serve as a helpful reminder to stay active and choose nutrient-dense foods.
Metric 7: Fasting Insulin
Fasting insulin levels indicate how much insulin your body needs to maintain normal blood sugar levels after an overnight fast. An ideal fasting insulin level is below 8.0 mIU/mL, with great levels between 2 and 5 mIU/mL. Elevated fasting insulin often points to insulin resistance, which is a precursor to type 2 diabetes. By controlling insulin levels through diet and lifestyle, we can support our body’s natural balance and reduce diabetes risk.  There are no medications that can lower insulin levels.  
Metric 8: HOMA-IR Score
The HOMA-IR score estimates your level of insulin resistance by combining fasting glucose and fasting insulin values. Ideally, this score should be below 2.0, with lower being healthier. A high HOMA-IR score signals an increased risk of metabolic syndrome and type 2 diabetes. Monitoring this metric, especially if you’re already at risk for diabetes, is essential for early intervention and prevention.
Metric 9: hs-CRP (High-Sensitivity C-Reactive Protein)
High-sensitivity C-reactive protein, or hs-CRP, is a marker of inflammation in the body. An optimal level is below 1.0 mg/L. Chronic inflammation is linked to various health conditions, including heart disease, diabetes, cognitive decline, autoimmunity, and more. Inflammation can be managed through a quality diet, regular appropriate physical activity, adequate quality sleep, and stress reduction techniques.
Metric 10: Hemoglobin A1c
Hemoglobin A1c estimates your average blood sugar levels over the past two to three months. Conventional medicine determines a normal A1c level is below 5.7%, though functional health professionals aim for under 5.4%. High A1c indicates prolonged elevated blood sugar levels, which can lead to complications like diabetes and heart disease. Monitoring A1c provides a broader view of your blood sugar health, helping you track long-term trends rather than just a single reading. Outside of elevated blood sugars and insulin contributing to elevated hemoglobin A1c are factors such as iron deficiency anemia, inadequate hemoglobin levels, nutrient deficiencies, and other red blood cell imbalances.  
Metric 11: Uric Acid
Uric acid is a waste product found in the blood from the breakdown of fructose and purines. For optimal health, it should be below 5.0 mg/dL for men and 4.0 mg/dL for women. High levels of uric acid can lead to conditions like gout and may also be linked to cardiovascular issues. Reducing fructose, alcohol and purine intake can be helpful in reducing the production of uric acid.  Fructose intake especially has dramatically increased over the past several decades with high fructose corn syrup being used as a popular sweetener in beverages and food products.  
Metric 12: Liver Enzymes (AST, ALT, GGT)
Liver enzymes, including AST, ALT, and GGT, reflect the health of your liver, biliary system and more. While normal levels can vary, elevated enzyme levels suggest liver stress or damage, possibly due to alcohol consumption, viral hepatitis, or fatty liver disease. Maintaining a balanced diet and limiting alcohol intake are key steps to supporting liver health. Optimal ranges for AST and ALT are under 17 U/L, and for GGT 10-24 U/L.
Metric 13: Vitamin D
Vitamin D is essential for bone health and immune function. Ideally, your levels should range between 40 to 60 ng/mL. Vitamin D levels are influenced by sun exposure, diet, and certain medications. Deficiency is common, but spending time outdoors and consuming foods like fatty fish, egg yolks, and animal fats can boost levels. Vitamin D is critical for both physical and mental well-being, so keep an eye on it! I recommend when supplementing with vitamin D, that you make sure it’s a D3 and has K2 along with it.  Magnesium is also vital to obtaining ideal vitamin D status.  Excess vitamin D intake without adequate magnesium stores can actually drive magnesium even lower.  



That wraps up our rundown of essential health metrics! By understanding these values, you can take proactive steps toward better health and longevity. Remember, small, consistent changes in diet, exercise, and lifestyle can have a profound impact on these numbers. If you’d like to get a new set of labs analyzing these values, send me a message. I can assist with getting the labs ordered or share details on how you can order them yourself. 
Thanks for tuning into the Holistic Health Bites podcast! If you found this episode helpful, please share it with friends and family who might benefit. Until next time, be well and vibrant!



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