Risk Assessment in the Genomic Era: Are We Missing the Low-Hanging Fruit?

Dec. 29, 2017

Doctor Bryan Walsh is back with us today, discussing the diagnostic benefits of a simple blood chemistry.  He says the results of common and inexpensive lab panels can be mined for meaningful health information, potentially saving patients a lot of time and money on testing – that is, if you know what these blood markers actually mean (and your average doctor probably doesn’t). Fortunately for us, Bryan knows and loves to teach.

In this podcast, he shares a bit about his own journey - what led him to study these basic blood markers, and what now inspires him to teach others.  If you like this episode, visit Bryan’s Metabolic Fitness Pro website, where he continues to develop new educational material for health practitioners and other avid learners.

Here’s the outline of this interview with Bryan Walsh:

[00:00:58] Bryan's WellnessFX videos.

[00:02:07] Textbook: Fischbach's A Manual of Laboratory and Diagnostic Tests 10th Edition.

[00:04:27] Albumin.

[00:05:58] Study: Allen, Larry A., and Christopher B. Granger. "Risk assessment in the genomic era: Are we missing the low-hanging fruit?." American heart journal 157.5 (2009): 799.

[00:06:36] Podcast: How to Understand Glucose Regulation with Dr. Bryan Walsh.

[00:06:49] Organic Acids Test. Podcast: How to Measure Your Metabolism with Organic Acids with Dr. William Shaw, PhD.

[00:07:33] Blood has to be the first place you go.

[00:08:13] Reference ranges.

[00:08:40] A lab determines a bell-shaped curve for the population of a given region; the reference range might then be +/- 2 standard deviations.

[00:10:21] Vitamin D.

[00:13:41] Functional reference ranges.

[00:14:30] Harry Eidenier, PhD, widely considered to be the Grandfather of Functional Blood Chemistry analysis.

[00:18:26] Total cholesterol.

[00:19:18] Bilirubin: A metabolic breakdown byproduct of red blood cell destruction.

[00:21:22] Study: Ong, Kwok-Leung, et al. "The relationship between total bilirubin levels and total mortality in older adults: the United States National Health and Nutrition Examination Survey (NHANES) 1999-2004." PloS one 9.4 (2014): e94479.

[00:24:19] Insulin and c-peptide.

[00:25:07] GGT Studies: Long, Y., et al. "Gamma-glutamyltransferase predicts increased risk of mortality: A systematic review and meta-analysis of prospective observational studies." Free radical research 48.6 (2014): 716-728. and Koenig, Gerald, and Stephanie Seneff. "Gamma-glutamyltransferase: a predictive biomarker of cellular antioxidant inadequacy and disease risk." Disease markers 2015 (2015).

[00:25:52] Podcast: How to Measure Hormones, with Mark Newman, 8-OHdG.

[00:27:57] GlycoMark, adiponectin.

[00:28:39] HDL cholesterol 2.65mmol/L (in US, 102 mg/dL).

[00:29:35] Study: Rosenson, Robert S., et al. "Dysfunctional HDL and atherosclerotic cardiovascular disease." Nature reviews cardiology 13.1 (2016): 48-60.

[00:30:43] HDL - Above 75-80 could indicate dysfunction in the body (e.g., cancer, autoimmunity, liver dysfunction).

[00:32:14] Study: Iannello, S., et al. "Low fasting serum triglyceride level as a precocious marker of autoimmune disorders." MedGenMed: Medscape general medicine 5.3 (2003): 20-20.

[00:34:20] Undereating as a possible cause of low triglycerides.

[00:35:17] Complete Blood Count (CBC) and haemoglobin.

[00:36:19] Red blood cells (RBCs), white blood cells (WBCs) and platelets.

[00:36:52] Mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC).

[00:37:40] CBC indicates ability to carry oxygen around the body.

[00:38:18] B12, folate, iron, copper and zinc deficiencies.

[00:38:55] Red cell distribution and mortality studies:  Patel, Kushang V., et al. "Red cell distribution width and mortality in older adults: a meta-analysis." Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences 65.3 (2009): 258-265. and Lippi, Giuseppe, et al. "Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients." Archives of pathology & laboratory medicine 133.4 (2009): 628-632.

[00:41:37] Causes of low RBC count: Production, destruction and loss.

[00:43:22] First, look at the MCV.

[00:45:19] Normal RDW: low RBC probably due to destruction or loss.

[00:45:38] Occult blood stool test to determine if there is a GI bleed (loss).

[00:45:49] Reticulocytes: an underrated blood marker.

[00:46:33] Erythropoietin (EPO).

[00:49:30] HbA1C.

[00:51:42] Estimation of RBC lifespan from the reticulocyte count: RBC survival (days) = 100/[Reticulocytes (percent) / RLS (days)], where RLS = 1.0, 1.5, 2.0 and 2.5 days at hematocrits of 45, 35, 25, and 15 percent, respectively.

[00:53:17] Bryan and Tommy in a box.

[00:54:16] Fatty Liver Index. Study: Bedogni, Giorgio, et al. "The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population." BMC gastroenterology6.1 (2006): 33.

[00:55:58] Website: Metabolic Fitness Pro.

[00:57:46] Relying on protocols without knowing the physiology.

[00:58:18] Website: Drwalsh.com.

[00:58:32] Glucose course: Everything you ever wanted to know about glucose regulation. Detox course: Everything you wanted to know about detoxification.


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