A bit of help with my lab results please

[Jmac]

My doc did a bazillion tests and most came back in the ranges I'd like. Per my snips/genes I have potential issues with utilizing B12, choline, probs with cholesterol, iron so I expected some things to pop but some of these have me puzzled.

Insulin 2.1 (norm 2.6 - 24.9)

CBC - MCV 99 (norm 79-97) --- know that CAN have something to do with B12 malabsorption
B12 - 1562 (232-1245) --- so can I "assume" my body isn't utilizing or is it just I'm taking too much? Since it's water soluble I would "assume" I should just flush out excess?

Iron 148 (norm27 - 139)
Iron Saturation 43 (norm 15-55)
Ferritin was 127 ("norm" range 15-150) so I'm "in the norm"
Folic 18 (s/b >3.0 with 3.1 deficient)

Bilirubin 1.5 (norm 0.0 - 1.2) (gather this could be liver/gallbladder beginning issue?)

Cholesterol
Total 226 (norm 100-199)
LDL 126 (0-99)
Triglycerides 53
VLDL 11

She did every kind of test we could swing from thyroid (all good) to food sensitivity (all good) and more. I can post any others if it dovetails with some I posted / helps explain.

I have a follow up with my doc on the 22nd so am sure we'll go over all these, just like to get a better understanding, figure out if I should be starting to do something to correct anything diet-wise. I'm primarily plant-based (eat wild-caught salmon 2-3 times a week now), lots of fruits, veggies, olive oils, low on carbs, I am completely sugar-free except natural fruits, gluten-free (although the current tests show I'm not sensitive to wheat, eggs, peanuts ), drink plenty of fluids, probably overdo it on supplements , fairly sure I'm doing great on fiber, work out almost every day (walk/run plus weights 3 times a week)...

Thanks

[SusanJ]

I expected some things to pop but some of these have me puzzled.

Given your diet (mostly vegetarian, no eggs, liver, or animal protein), and you're a woman (I don't recall, but are you postmenopausal?), my first instinct is you need extra choline. Choline would certainly help your liver and gall bladder. Are you tracking choline in Cronometer or other food tracker? Others can feel free to chime in.

Also, if you want to see if your B12 is actually being used, do a MMA (Methylmalonic Acid) test. You want results that are on the low end of the range.

Good luck, and let us know how it goes.

[Jmac]

Given your diet (mostly vegetarian, no eggs, liver, or animal protein), and you're a woman (I don't recall, but are you postmenopausal?), my first instinct is you need extra choline. Choline would certainly help your liver and gall bladder. Are you tracking choline in Cronometer or other food tracker? Others can feel free to chime in.

Also, if you want to see if your B12 is actually being used, do a MMA (Methylmalonic Acid) test. You want results that are on the low end of the range.

Good luck, and let us know how it goes.

I signed up for Cronometer as soon as I read your response so will now do a better job of tracking diet (thank you). I take 250mg of Citicoline one day, 300 mg of Alpha GPC the next. I alternate simply because I have no clue as to which is better & what I might need. Also, I get some in my multi. I eat a lot of spinach, broccoli, nuts, avocado, other foods with choline so thought I MIGHT be getting enough. I may just take the citicoline & Alpha every day instead of alternating.

I saw that the test for choline is called a "serum chloride" or just a chloride test. I just looked and here's a line with chloride:
CHLORIDE 102 96-106 mmol/L Final 01

I will ask my doc if she'll do the MMA test, didn't see anything like that in the long list (she took 7 vials of blood, tried to do a lot of tests...).

I am postmenopausal.

[Jmac]

Are you tracking choline in Cronometer or other food tracker?

THAT was an eye-opener! I am going to have to change my supplements, getting way more than I need on quite a few. On some will have to change my diet a bit --- getting more carbs than I thought. I've been hoping to find a way to customize my supplements a bit better. Thank you, thank you!

[slacker]

I saw that the test for choline is called a "serum chloride" or just a chloride test. I just looked and here's a line with chloride:
CHLORIDE 102 96-106 mmol/L Final 01

Chloride is not the same as choline.

Bilirubin 1.5 (norm 0.0 - 1.2) (gather this could be liver/gallbladder beginning issue?)

This result looks like a total bilirubin, which is made up of both direct and indirect bili. If your mildly elevated total bilirubin is driven by mostly indirect bili, you may have a benign genetic condition called Gilbert's, which does not cause liver damage.

[Jmac]

Bilirubin 1.5 (norm 0.0 - 1.2) (gather this could be liver/gallbladder beginning issue?)

This result looks like a total bilirubin, which is made up of both direct and indirect bili. If your mildly elevated total bilirubin is driven by mostly indirect bili, you may have a benign genetic condition called Gilbert's, which does not cause liver damage.

Thank you --- very well could be. I fasted for roughly 24 hours (test was 1 p.m. but didn't happen until after 2...and I hadn't eaten since around 2 the day before), didn't sleep well and I worked out with weights that morning...so that could have easily highlighted Gilbert's if that's what it might be... Maybe I should cover my skin with curcumin when I go see my doc, see if I can scare her

This has been, and will be, an interesting journey. I have learned so much and sometimes it gets to a point where my brain bucket is full and things are spilling out

The biggest plus for me right now is finding out about Cronometer ---- talk about an education!

[JudyH]

Bilirubin 1.5 (norm 0.0 - 1.2) (gather this could be liver/gallbladder beginning issue?)

Likely nothing to worry about. I was diagnosed with Gilberts almost 30 years ago. Through those three decades, my liver numbers vary from completely normal to mild elevations in both bilirubin and liver enzymes. Always different, always a surprise which numbers will be elevated. My last bloodwork my bilirubin was 2.2 while my liver enzymes were within range. Bloodwork before that, 6 months ago my liver enzymes were elevated and my bilirubin normal. Oddly enough, my brother has a liver transplant due to an autoimmune disease which destroyed his liver so it is something we keep tabs on pretty well with me.

1.5 is a mild elevation and is not something I would worry about.

[SusanJ]

I am postmenopausal.

Postmenopausal women need more choline. Estrogen can push PEMT to produce more when we were younger and not getting enough in our diets (makes sense, choline is critical for a developing baby), but we lose that advantage at menopause.

[Julie G]

Kudos on getting a good work up. What about HDL, A1c, fasting glucose and insulin?

THAT was an eye-opener! I am going to have to change my supplements, getting way more than I need on quite a few. On some will have to change my diet a bit --- getting more carbs than I thought. I've been hoping to find a way to customize my supplements a bit better. Thank you, thank you!

Be very careful about changing your supplements based upon Cronometer results. Cronometer has many inherent problems with it's algorithm. For instance, it doesn't distinguish between complete and incomplete sources of protein. Likewise it doesn't distinguish between plant and animal sources of omega-3s when we know very little of the former is actually converted to bioavailable DHA. Also, your dietary intake of various nutrients rarely translates to your body's levels due to genetics, metabolism, stress, etc. If you have concerns about a specific deficiency, ask your practitioner to test your blood levels.

[Jan18]

My doc did a bazillion tests and most came back in the ranges I'd like. Per my snips/genes I have potential issues with utilizing B12, choline, probs with cholesterol, iron so I expected some things to pop but some of these have me puzzled.

Insulin 2.1 (norm 2.6 - 24.9)

Iron 148 (norm27 - 139)
Iron Saturation 43 (norm 15-55)
Ferritin was 127 ("norm" range 15-150) so I'm "in the norm"
Folic 18 (s/b >3.0 with 3.1 deficient)

Cholesterol
Total 226 (norm 100-199)
LDL 126 (0-99)
Triglycerides 53
VLDL 11

In searching for ferritin discussions, I noticed your post. I, too, am in Georgia. I'm wondering if we might compare doctors and talk by phone? Perhaps communicate through private email via this site?

I'm curious, as I see your results are reported to you in "norms" -- Mine are reported to me as "optimal," "mildly low/high," "low," or "high." And my doctor put me on iron supplements to increase my stores with results of iron 47, Ferritin 20, Transferrin 343 (all "optimal") and TIBC of 504 (high.) She wrote "anemia" by my MCV of 79.7 (when equal to or below 80.6 was "low") and my MCH was 27 (when equal to or below 28.5 is "low.")



Care to talk?

Barbara