Blood Tests and the Naturopath

A 58-year-old male Naturopathic Doctor (myself) presented at my clinic complaining of unexplained low energy, feeling uncharacteristically emotional with a decreased of motivation to do any physical or mental beyond that required for his job. Power naps during the day did return some energy but at the end of the day he has little left to do anything other than watch television. The diagnosis could be anything from depression, to low thyroid, so blood work was requested (14 vials to be exact) In addition, a blood spot test was completed – a relatively new way to measure to measure hormones like testosterone.

The preliminary results of the blood tests have returned. Iron metabolism (Ferritin, Hemoglobin, Serum Iron and Iron Saturation) were normal. Thyroid parameters were normal – although the Free T4 was at the lower end of the range. No thyroid antibodies and the ANA was negative (which reduces the possibility of autoimmunity). In other words, low thyroid and anemia were ruled out. The Fasting Blood Glucose was normal as was the HBA1c. His waist-to-hip ratio, however, is 1.0 (and should be less than 0.9) and a previous blood insulin reading was at the top of the range, so he may have some Insulin Resistance.

The most revealing parameters have to do with cholesterol, heart and hormones. Total Cholesterol was 5.32 (which Man with conceptual spiritual body artis slightly above the upper range of normal). His total cholesterol had been around 5.4 for 20 years. Cholesterol usually is released by the liver when the body has a need to make more testosterone or when there is a low thyroid state (Both conditions are on the rise in aging males). When the cholesterol is high there is also a suspicion that plaque may be forming on the arteries. Of the blood parameters tested, the HDL was low (1.03 versus the optimal 1.5 or more) and the Apolipoprotein B was 1.13 (any value above 0.8 is associated with an increased risk of heart disease). The Total testosterone, although in the normal range was in the lower third and the Free Testosterone was so low that it was almost out of range. Testosterone in males is heart protective and anti-plaque as estrogen is in women.

From the first round of blood work, the working diagnosis is Low Testosterone – especially low Free Testosterone (some of the symptoms include fatigue, tiredness, depression and lack of motivation).
The first line of defense is to attempt to increase the testosterone naturally. In this case, moderate exercise – both interval training and strength training was prescribed which will increase the testosterone and the HDL and reduce the insulin resistance. To protect the heart by decreasing the Apo B and increasing the HDL, Niacin, Pantethine (B5), Resveratrol and Green Tea were also prescribed.

The answer to the question from the last blog is Homocysteine. Homocysteine is an indirect measure of methylation. “More than any other single test, homocysteine correctly identifies the risk of such conditions as heart attack, stroke, and dementia years before the onset of any symptoms.” (Dr. Hyman, M.D.)

In the next blog, we will track the progress of the patient, discuss the results of the blood spot analysis (if available) and investigate certain herbs that are reputed to raise testosterone naturally.

Until then…

Dr. Gatis

How Does A Naturopath Think?

I have enjoyed relatively good health over my life – with a few minor/major blips along the way.  As an aging male Naturopathic Doctor, I am acutely aware of the fact that – although I have taken care of my body and mind reasonably well over the years – my level of health has not yet achieved optimization.  In short, like the rest of you, life gets in the way.  I have decided, therefore, to use this blog as an instructional tool (how a naturopath thinks) over the next few months by using my own situation as a reference point rather than case studies.  In other words, I will assess myself as if I was one of my clients – including any naturopathypossible blood work and/or functional tests that are available – and, based on the findings, will put myself on a treatment regimen and monitor the results.

I am currently reading a book (one of many) by Dr. Mark Hyman, M.D. called “Ultraprevention”.   He is a brilliant man and far more Naturopathic Doctor than Medical Doctor, in my opinion.  I say this because he has come to the conclusion that the human body is complicated and health is a process.  There is no “magic bullet to shoot down all your health issues”.  There are “forces” that lead us down the path to illness.  When we are aware of these forces and make them personal i.e., understand that one size does not fit all when it comes to our own health, we can truly be more in control of our own well being rather than at the whim of “illness”.  These (naturopathic) factors as summarized by Dr. Hyman are:  1) Malnutrition/Mal-digestion (sludge),  2) Impaired metabolism (burnout),  3)  Inflammation (heat),  (4) Impaired detoxification (waste);  Oxidative stress (rust).  Over the next few months, we will explore these topics in more depth.

Until then, there is one crucial test (according to Dr. Hyman) that will provide you with personally with the inside track on the possibility of preventing diseases like heart attack stroke, dementia, and some forms of cancer.  This test is:

  1. Cholesterol
  2. Blood sugar
  3. Vitamin E
  4. Homocysteine

See the answer in the next blog.

Dr. Gatis

HOT & Aging Go Together

Hardly anyone would say that I need to “optimize my hormones” for good health and longevity.  In fact, many of the signs of aging can be directly related to declining amounts of major hormones.  Testosterone, DHEA, Progesterone, Estrogen, Growth Hormone all decline with age, for example.  Why are many people almost obsessed with the idea of anti-aging?  We all are going to die, right?  Well let me tell you a simple fact.  When I reach the age of sixty and beyond, when asked “How are you?”, I want to be able to look them in the eye, give them the thumbs-up sign and say “Golden” (and mean it).

That is why I am a proponent of “H.O.T.” or Hormone Optimization Therapy.  To this end, for myself and my Naturopathic patients, I have taken the training and become a Fellow and Board-Certified in Anti-Aging, Regenerative and Functional Medicine from the American Academy of Anti-Aging Medicine – and I have decided to “blog” about relevant

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issues that we all should know about when it comes to healthy aging.

H.O.T. is not just bio-identical hormone replacement therapy– as important as this can be.  Excessive hormonal levels – like insulin and cortisol – also adversely affect health.  Hormone Optimization Therapy takes into account that hormone levels and organ systems are all interactive.  Reducing stress and restoring adrenal function is absolutely necessary for individuals with low thyroid activity, for example.  Optimizing both adrenal and thyroid function is necessary to have balanced female and male hormones. A Naturopathic Doctor by virtue of his or her training is a specialist in supporting and optimizing the body’s functions.

It was a surprise to me that a high percentage of men have symptoms of and suffer from hypothyroidism and low testosterone as they get older.  The “grumpy old man” syndrome is actually the result of low T!  Maybe it is just the male in me, but there is a distinct difference between being sensitive to your female partner’s needs and being an emotionally “sensitive” male as a man ages.  One of my patient’s just today mentioned that as her father has gotten older, he cries much more often – and “that isn’t my dad”.  In my opinion, his Testosterone to Estrogen ratio has changed and he has become more hormonally like a female.   Please understand that I am not saying that there is anything wrong with a man or a woman crying.  In a man, however, inappropriate or increasing crying (or anger) may indicate a testosterone deficiency.  Optimal testosterone levels are absolutely essential to a man’s health – his mind, heart and “bone” in particular.  More on this in the next blog.

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Until next time,

Dr. Gatis