You may already be familiar with the basic measures of metabolic health: blood sugar, blood pressure, triglycerides, cholesterol, and waist circumference. But these aren’t always enough to give you the whole picture. Case in point: you can still be diabetic with normal fasting glucose levels, and as many as three in four heart attack patients have perfectly ‘normal’ LDL levels.
To get a more accurate measure of your metabolic health, you should consider biomarkers that often fly under the radar. I’ve collected a few that may be of interest to your health journey, including how to interpret them and where to order tests.
The less-common measures of your metabolic health
Just because certain biomarkers fall into the ‘normal’ range doesn’t always mean you’re metabolically healthy. This is especially true if you’re suffering from unexplained symptoms and can’t find the root cause based on typical blood work.
With this in mind, here are some lesser-known biomarkers worth testing for metabolic health.
Homocysteine
Homocysteine (abbreviated HCY in lab results) is an amino acid your body can use to synthesize protein. Its effect on the body is similar to glucose: it’s critical for metabolism, but too much or too little is a clear sign of dysfunction.
For example, high levels of homocysteine may increase your likelihood of blood clotting. This plays a major role in heart disease, stroke, and neurological disorders such as Parkinson’s and dementia.
But homocysteine is also a strong marker of inflammation. Here’s the fly-by overview of how this works:
- Chronic inflammation increases your body’s production of cells
- This requires a large amount of vitamins, which often depletes the body’s stores
- This triggers hyperhomocysteinemia (the proliferation of homocysteine in the blood)
Above-average levels of homocysteine may indicate oxidative stress, which as you can guess, will wreak havoc on your metabolic health. Your ideal range should be around 5.0 to 7.0 mmol/L, although anything outside this range is usually treatable with diet (especially foods that are high in B vitamins like eggs, milk, and red meat).
If you’re already following a metabolically healthy diet, high levels of homocysteine may indicate an underlying vitamin deficiency, medication interference, or a chronic or autoimmune condition. It might be wise to test against another inflammation biomarker like High-Sensitivity C-Reactive Protein (hs-CRP).
Speaking of CRP:
CRP
If you’re currently living with high inflammation, then you likely have high levels of C-reactive protein (CRP). This is a ring-shaped protein released by the liver that binds to damaged tissue, antigens, and pathogens like viruses to heal them.
CRP levels rise and fall according to natural occurrences, like stubbing your toe or getting a cold. However, it can also rise in response to chronic internal damage. This is a very strong sign of tissue damage and one of the best early predictors of heart disease.
Here’s why:
- Waxy substances like LDL cholesterol damage the walls of your arteries, triggering inflammation.
- Your liver produces CRP to bind with damaged tissue. It is unable to slow or stop the progression of disease, as inflammation in the body remains high.
- CRP levels remain constantly high, which may indicate heart disease earlier than other tests.
You can also use CRP tests to check for other inflammation-related illnesses, including chronic diseases like IBS or autoimmune conditions such as rheumatoid arthritis. Either way, a reading under 3.0 mg/dL is considered ideal. If you’re at 3.0 mg/dL or higher, you may want to address the causes of underlying inflammation.
If you’re looking for a ‘quick win’ here, start avoiding foods with added sugar. Studies show that sugar-sweetened beverages significantly increase CRP levels for metabolically compromised people.
Fasting insulin
When you eat heavy carbohydrates, your blood sugar (glucose) rises. Your pancreas then releases insulin to allow your cells to accept more sugar.
But if your cells are insulin resistant, they won’t readily accept more glucose. So your insulin levels climb higher to accommodate, until your pancreas can no longer keep up with demand (hyperinsulinemia). This is the beginning of many metabolic illnesses, including insulin resistance, diabetes, and chronic disease.
Unfortunately, fasted blood sugar tests rarely measure your fasted insulin levels. And trying to use glucose tests or H1C as substitution could cause you to miss clear signs of metabolic dysfunction.
Here’s why:
- Fasting glucose evaluates your blood sugar level at a certain point in time. This is typically measured by finger pricks or continuous glucose monitors. Your numbers can vary widely depending on what you eat and if you’ve fasted, but the general scale is 70 to 99 mg/dL depending on your last meal.
- Fasting insulin measures how much insulin remains in your body long after you’ve eaten (typically eight to 12 hours). Experts suggest that optimal fasting insulin levels hover around <5 uIU/ml. More than that, and you likely have metabolic dysfunction, even if your glucose appears ‘normal’ on the surface.
This is why standard blood sugar tests often fail to provide a holistic picture of your health: because you can still be insulin resistant and have normal blood glucose readings. A fasting insulin test will predict signs of insulin resistance long before you start seeing changes to your glucose or HbA1c.
Sleep and stress management are two major components of insulin management. Low-carb diets may also help.
Either way, it’s a good idea to schedule follow-up tests every six to 12 months to keep an eye on your levels and progress over time.
Advanced lipid study with particle sizes
It’s not just about the amount of cholesterol you have — it’s also about their size and ratio. Even if your most recent LDL/HDL came back within normal ranges, an abnormal presentation of ratios or particle sizes may clue you in that something is amiss.
There are two different kinds of lipid size: small dense, and large fluffy. Small dense LDL is heavily associated with cardiovascular disease, while large fluffy LDL is much less so. These benefits are carried over to HDL: some studies suggest that large fluffy HDL may be more protective than small dense HDL.
There’s usually no easy way of testing this via standard lipid testing. However, an advanced lipid study can help you calculate your particle sizes using your ratio of HDL cholesterol to triglycerides.
High levels of triglycerides and low levels of HDL (4:1) usually indicate metabolic dysfunction. A ratio of 2:1 (ideally 1:1) usually indicates optimal health.
You can use this ratio to get better insights on how to proceed with your metabolic health journey. If your triglyceride-to-HDL ratio is high, you may try eating more saturated fat. Studies show this can increase large fluffy LDL, decrease small LDL particles, and potentially increase protective HDL particles.
Remember: the vast majority of heart attack patients do not present with abnormal LDL cholesterol levels. You shouldn’t be worried about total cholesterol numbers in isolation — you need the full picture of your particle sizes and ratios.
Options for checking your metabolic biomarkers
Many of these biomarkers are uncommon on routine blood tests, especially the average CMC or lipid panel. So depending on your circumstances, you’ll have two options: order from your doctor, or purchase at-home tests.
Physician-ordered lab work can be helpful for investigating specific illnesses. However, you’ll need your doctor to agree to order the test first.
At-home testing may be better if you want to keep tabs yourself. It’s often faster with less waiting, which may be preferable if you’re in a rush for results.
I recommend at-home metabolic testing kits from SiPhox so you can test more than 50 biomarkers from the comfort of your home. If you order from me, you’ll receive training to interpret your results, plus a customized results video to take your next steps in confidence.
