4HB: Some Lab Work

If you are going to improve your health, then one thing you need to get is some lab work. So I got a number of blood tests done end of last year.

The Tests

In the Four Hour Body, Ferris suggests you get the Spetracell Vitamin Deficiency test. I went looking for someone near me that did the test and found Dr. Martin Basaldua, who is like 5 minutes drive from my work. He also does the kind of hormone replacement therapy that I’ve been going to Hotze Health and Wellness center for the last three years. I decided to change doctors since he is so much closer.

I went in and talked with Dr. Basaldua and gave him some older lab work Hotze had done. He wanted to get numbers on free testosterone and a PSA. Since I’ve got high cholesterol we also wanted to get that tested. Spectracell has a special cholesterol test that reports the size of the cholesterol lipids and I asked the doctor about it. He said he preferred the Berkley Heart Lab’s test, which breaks down your HDL and LDL levels into sub groups, some more important that others. I decided to do the Berkley.

I asked about testing Dihydrotestosterone as well, since Ferris recommended it and it is believed to the actual form of hormone that causes the benign enlargement of the prostate. The doctor wasn’t that interested in testing it because the OK range was so large as to be almost meaningless, and really you need to see is change, and since we don’t know what mine was, how can we know if there is a problem. I told him I wanted it anyway, because how would we know it changes if we don’t have a baseline.

Today I got back those results.

The Good

Spetracell came back showing I had no vitamin deficiencies. Dr Basaldua was impressed because he said since he’s been doing it only 5 people have come back with no deficiencies the first time. So I guess I’m doing something right.

I still want to do some research, especially into Vitamin D, because not being deficient doesn’t mean you have an optimal amount. Though it looks like the results are in percent of the control group, which might not be helpful.

The Bad

I know my cholesterol is high. Actually very high, with a low HDL. Low HDL is almost worse than a high LDL. About the only known treatment for low HDL is Niacin, and the doctor prescribed that even before the blood work was back.

It came back and even broken down, I’ve got issues. My HDL is just in the OK range according to Berkley and their test is actual level, where most test are calculated levels. Still the doc would like to see it higher. My HDL2b is an “intermediate” risk.

Total and LDL overall are high. Of the sub LDLs, most are OK, but the ApoB is very high. 141 where 120+ is bad and less than 60 is recommended. Homocystein, CRP, Fibriogen and Insulin are all green.

The most interesting finding was that my ApoE Genotype is 3/4. There are 3 kinds of genotypes that effect cholesterol, and for each of them some things work better than others. For instance in my type, exercise has only a moderate effect on raising HDL and lower LDL. Fish oil actually makes things worse, and the really effective treatment is a low fat diet.

I need to do some more research on this genotype stuff and I’ll be interested to see what 23andme says when I get my genetic profile back.

Action

Doesn’t do any good to know your values if you aren’t going to do anything about it. So what action am I going to take?

1. Niacin. I’m taking the Niacin the doctor prescribed every night. At first it wasn’t pleasant, but I’m getting used to it.

2. Exercise. While exercise may not help my LDL/HDL, it is still good for me. I’m training for the Warrior Dash and will be running at least 3 days a week.

3. Diet. It’s time to admit to myself I can’t keep eating anything I want. Even if my weight/body shape are something I’m currently comfortable with. I’m going to have to go on a diet. I’d prefer low-carb, or slow-carb and a day off like Ferris suggest in the book. But I may have to look into a low-fat diet.

4. Keep measuring. Did you know Google has a health tracking site? Google Health. I’m putting all my labs in there. I’ve hooked it to my pharmacy so it automatically get any medicine I’m taking. Tracks my Wifings scale results. I put in BP when I get it taken.

Getting old sucks.

4HB: Improving Sleep

The chapter on improving sleep was the first one I read upon getting the book. It was finals week and I was strung out. I’ve been taking Adderall (Amphetamine Salt) for a couple of months now to help me focus and study. It works but has a couple of side effects – increased heart rate and messing with my sleep.

So I felt like I needed more or better sleep. But what is better sleep?

If I’m going to measure something and try and improve it I need to know what is better. There are two things I think we can start with.

How I feel when I get up.
How tired do I feel during the day.

Both of these things are subjective. Still I could measure them based on my subjective feeling. Just ask myself when I get up to grade my crappiness on a scale of 1 to 10 would do it.

Enter the Four Hour Body.

Tim tried a number of gadgets and settled on recommending the Zeo Sleep Coach. I put it on my Christmas list and got it.

The coolest thing about the coach is it lets you actually track you sleep. When I first started taking Adderall and noticing the sleep problems I started writing down when I went to sleep and when I got up. Also when I took my pills. These numbers were soft because I may have gotten into bed and laid there for an hour unable to go to sleep, but my number was when I got in bed. Also I might have woke up during the night 3 times for 15-30 minutes. Not in my log.

Adderall is a treatment for ADHD with a side effect of insomnia. But insomnia is also a symptom of ADHD. People with ADHD will lay in bed with their mind bouncing from one thing to another unable to sleep. The trick is to get your Adderall on the way down when you are ready to sleep, so it slows the thoughts down, but also allows you to sleep.

The Zeo changes all of this. It tracks when you get in bed, how long before you are asleep, how many times you wake up and for how long. It also tracks total sleep time and sleep phases – REM, Deep and Light sleep. It gives you an overall Z score and we will see how well that score helps me. When you put the headband back in the cradle it asks you to rate how well you slept on a scale of 1-5. Those numbers should be interesting.

The other pieces of data I need to collect are when I take my pills. I’m taking a number of different substances including thyroid, testosterone, Lisinopril, and supplements. I plan on measuring them as well.

Zeo gives you a number of “sleep stealers” to log and suggest changing. I will keep those too.

Will I sleep better. Hard to say. Just tracking my sleep for 4 days so far has been cool. I’ve found I sleep way longer than I thought. When I get up in the night – normally to pee – I’m not awake as long as I thought. Two things that haven’t happen are going to school and taking my Adderall in the afternoon.

Data and results to come.

The Four Hour Body And Me

Most years I give a book to my friends that I want to give a general gift to for Christmas. Books aren’t too expensive and yet thoughtful. (I’m big on thoughtful gifts, and I thought I’d written a blog post about it, but seems not. One for the future.) This is generally a book that is or has made an impact on me.

This year the book is The Four Hour Body by Tim Ferris.

This is appropriate because last year I gave a number of people the Four Hour Work Week by Ferris. That book lead to the creation of Photographer and Model and my involvement in entrepreneurship.

This time Tim has turned his thoughts to fitness and health.

He’s tried different things to change everything from how he sleeps to gaining muscle to losing fat to running faster and longer. The subtitle kind of sums it up, “An Uncommon Guide to Rapid Fat-Loss, Incredible Sex and Becoming Superhuman.”

Underlying Theme

The underlying theme is try stuff and measure to see if it works. Measure what matters. These are very important principles.

I wrote a post a long time ago, and just published, asking if I was a Metric’s Asshole and it was based on the principle that you don’t know something will or won’t work unless you try it and have a way to confirm it worked. People often tell me something will or won’t work and when asked how they know, they don’t have any real proof.

Medicine is going through a renaissance right now with something called “Evidence Based Medicine”. We studied it in Paramedic School and it is often mentioned in the literature. Basically this means we should test and measure the things we do in EMS and in medicine and see if they really make a difference. Where they’ve done this they’ve found major things taught as must do are really not needed or even harmful. For instance, the newest guidelines for CPR have lowered the importance of breathing in CPR. It used to be you started breathing for them as soon as possible. Now you should start and continue chest compressions before even trying to breath for them. It significantly improves outcomes for the patient.

To call Ferris’ book evidence based medicine might be a stretch, but he doesn’t recommend anything unless he’s tried it, measured the results, and found a positive outcome.

Measure What Matters

Measure what matters is a quote from Peter Drecker and one I’ve used a number of times. To me there are two meanings. One is measure the right thing, and the other is to measure what is important for the change you want to make.

Ferris’ has a story of a man who decided he wanted to lose 28 lbs in 6 months. So he created a spreadsheet that told him where his weight should be each day. Then he calculated a min and max for each, giving himself a range where he needed to be. Then he’d measure himself every day. And made no other changes. He made a conscious effort to not change diet nor exercise during the experiment. The only time he changed that was the couple of times he got too low, under his min. Then he gorged on doughnuts.

Six months later he was down 28 lbs, doing nothing but measuring.

Another meaning of measure what matters is the measure the correct things. Many people measure weight when they diet. This is a mistake. It can and will work, especially if you are really fat, but just making your mass go down, doesn’t tell you how much fat you’ve lost. You need to measure body fat, or lean mass. The easiest way to do this to measure your circumference. Use a tape measure and measure your belly, hips, chest, arms, thighs.

The second easiest, and the high tech one that I use, is a body fat scale. You step on it and it tells you your weight and percent body fat. These scales are very effected by hydration, but if you do it exactly the same every day, you get good trend data. (Discovered a few days ago, I’d been hitting the wrong preset button – you have to enter your height – for weeks. When it thought I was 6’1″ instead of 5’8″ like my wife, my %BF dropped dramatically.)

A Bunch of Specifics

The only problem with the book is there is so much you can do in it. Do you want to gain muscle? There’s chapters for that. Lose fat (notice not weight)? Chapters for that too. Better sleep? Better sex? Chapters there too. You could make lots of changes.

The back of the book says, “Which 150 pages will you read?” He suggests you pick out one or two things you want to change and just read those parts.

So that’s what I’m going to try and do. And for each thing I try I’ll write a blog post with my experiments and outcomes, hopefully with measurements and data.

Afterward: I’m not making these changes because it is the beginning of the year. I’m making them because the book just came out. So they aren’t new years goals or resolutions.