Tired of Feeling Like Crap? Request These Medical Tests From Your Doctor
By: Dave Asprey
- It’s frustrating to deal with problems like inflammation, fatigue, and mood disorders. These medical tests can help you get to the root of the problem.
- You can request these tests from your doctor, or you can take them at home.
- When you’re ready to go over your results, work with a functional medical doctor. They’ll recommend treatment options that treat the disease — not the symptoms.
- To feel balanced, energized, and focused, you need to understand your inflammation, hormone levels, gut health, thyroid hormones, and heavy metal toxicity.
When I was 26, I had less testosterone than my mom. Why? I was obese. I had mitochondrial dysfunction because my body was loaded with inflammation. I have a gene that predisposes my body to convert everything into estrogen.
All of that meant that I had extra weight and man boobs, and I felt crappy … all the time.
So, I visited an anti-aging doctor and got a full hormone test. That’s how I found out my testosterone levels were out of whack. I started bioidentical testosterone replacement therapy, and it turned a switch back on in my brain. You can read more about my experience taking testosterone for a decade here.
By taking control of my hormones, I hacked my mitochondria. I had more energy. I felt a renewed zest for life. More importantly, I felt like myself again.
Why you should test yourself (before you wreck yourself)
I wouldn’t have realized my testosterone levels were low if I hadn’t gotten a test and gone over the results with my doctor. That’s why I believe everyone should order five specific tests to understand what’s happening in their body. This is true whether you’re a hardcore biohacker or just trying to figure out why you’re tired all the time.
It’s frustrating to deal with problems like inflammation, brain fog, fatigue, mood disorders, and gut issues. I’ve been there. It’s not fun. You deserve to feel great, and these tests can help you can get answers that point to the root of your problem.
Maybe it’s a thyroid issue. Maybe it’s your gut biome. More likely, it’s a combination of variables.
You can order some of these tests on your own to do at home (more on that later), or you can ask your doctor to see if the tests are covered by your insurance. When you’re ready to go over your results, I recommend working with a doctor trained in functional medicine. That means they focus on identifying and addressing the root cause of disease — not just treating your symptoms.
5 tests to get at your next doctor’s visit
1. Measure your inflammation
As documented in my book Head Strong, inflammation is always driven by mitochondrial dysfunction. Your mitochondria power your cells. They determine how your brain operates, how your body performs, and how you react to your environment. The better your mitochondria work, the better you feel.
Inflammation and mitochondria are like coffee and orange juice: they don’t mix. Inflammation lowers mental and physical performance, and it’s linked to chronic disease. If you don’t want to have Alzheimer’s or diabetes, you should monitor inflammation to understand your triggers and support your mitochondria. Period.
Here are two cheap and widely available tests to measure inflammation:
C-reactive protein (CRP): CRP is a marker of systemic inflammation. It’s also known as hs-CRP, which stands for high-sensitivity C-reactive protein. If you have elevated CRP, you’ll have a baseline for inflammation levels in your body. You can use that data to to biohack your way to lower levels of CRP. (A low-carb, high-fat diet like the Bulletproof Diet is a great place to start.)
Homocysteine: Homocysteine is an amino acid in your blood. High levels of homocysteine have been linked to inflammation, dementia, heart disease, stroke, and osteoporosis. It can also cause mitochondrial dysfunction — no thank you. If you have a homocysteine problem, you probably have either a vitamin B12/folate deficiency or, more likely, you have a genetic inability to process the common forms of B vitamins due to a MTHFR gene mutation. According to some estimates, up to 40% of people have this mutation.
You should also consider getting a DNA test to measure your genetic disposition for inflammation. 23andme, DNAFit, and Ancestry.com are all good ones. You can get your data from any of these sites and run it through a variety of online engines, like MTHFR.net or Genetic Genie, to find out if you have any mutations.
Here’s why you should go the extra mile and check your DNA: If your homocysteine levels are high, a DNA analysis might reveal that you have a MTHFR mutation and your body can’t process folic acid. Folic acid and B vitamins are supposed to help your body get rid of homocysteine.
If you can’t process folic acid, you should take folic acid in its methylated form instead, which is easier for your body to absorb. That, plus vitamin B12, will help you lower your homocysteine levels. Done and done.
With hard data in front of you, you can more effectively figure out what’s causing your inflammation — not spin your wheels for years trying to find the root cause.
2. Hormone panel
Everyone should get a hormone panel that includes testosterone, estrogen, estradiol, and progesterone. These hormones have such important jobs in the body that any fluctuations can dramatically impact your mood, heart health, bone density, energy levels, and more.
People can have substantially different baseline hormone levels. If you feel like you’re kicking ass and taking names right now (go you!), a hormone panel will give you a good idea of what your optimal levels should be.
That’s important data to lock down in case you start to suffer from an abnormal thyroid, sexual dysfunction, and fertility challenges down the line. If that happens, get another hormone panel. Odds are, something is imbalanced, and you’ll have the data you need to biohack your way to a better you.
Testosterone, estrogen, estradiol, and progesterone are covered either in basic or advanced panels, and your doctor can usually order them for you. You can also do these tests at home without a doctor if you want — EverlyWell is a good resource — but it’s a good idea to have a functional medicine doctor interpret the results. If anything is off, your doctor can help you find treatment options.
When I found out I had low testosterone, I started taking a mix of topical replacement testosterone cream and small doses of pharmaceuticals like clomid and arimidex. Conversely, if you have estrogen dominance, it’s time to reduce your toxic load and limit your exposure to estrogen in your food, personal care products, and water.
Read more about how to fix estrogen dominance here. To find out how to have the hormones of a 20-year-old, check out my conversation with medical theorist and researcher T.S. Wiley on the Bulletproof Radio podcast (iTunes).
3. Viome gut microbiome test
Full disclosure: I’m an advisor to Viome. That doesn’t change the fact that this company is doing incredible things to help people understand their gut.
Viome supplies an at-home gut test so you can analyze your stools. You get a detailed report of your gut bacteria, including supplement and diet recommendations. Viome will also tell you how much human DNA you’re shedding in your gut, which is both critical to know and kind of gross. It’s usually a sign of GI inflammation, and potentially an early sign of colorectal cancer.
You can use the data in your report to make smarter decisions for your gut. Here’s an example that might ruin your morning power green smoothie.
In The Bulletproof Diet, I tell people to watch out for raw kale because it naturally has oxalates, a toxin that can cause symptoms like muscle weakness, abdominal pain, and lowered thyroid function. Oxalates are also found in spinach, beets, rhubarb, and bran.
Viome determined that roughly 30% of people lack the right microbes to digest oxalates. If you’re one of those people, you should probably avoid kale (or at least raw kale — lightly steaming it reduces oxalate levels). If you do eat oxalates, you’re increasing your risk of kidney stones, arthritis, and vulvodynia. Read more about how oxalates are ruining your kale shake.
You need to know what your kryptonite foods are. Polyphenols are awesome sources of antioxidants, but if you don’t have the right gut microbes that use specific polyphenols, you aren’t going to benefit from them. If you’re eating more protein than you need, you’re not getting swole — you’re increasing inflammation.
Eat smarter. Test your stool.
4. Advanced thyroid panel
Your thyroid controls your energy levels. It’s also your body’s thermostat. If your weight is where you want it, you’re happy with your skin, and your energy levels are high, you probably don’t need a thyroid panel. If any of those variables are off, having an advanced thyroid panel will tell you what’s going on.
Thyroid hormones play a role in the health and survival of your brain cells. Without enough thyroid hormone, your mitochondria can’t function properly. If you feel tired a lot, you should stay on top of your thyroid health (and get your gut levels checked once a year).
Heads up: Basic thyroid panels only measure thyroid stimulating hormone (TSH). That doesn’t give you all the data you need. Your liver converts T4, the main thyroid hormone into T3, which is what powers up your mitochondria. If your liver is on the fritz, it won’t create enough T3.
Why is that a problem? Your tests might show that you have normal TSH levels. However, if your T3 levels are low, your cells aren’t able to properly make energy. In reality, you need an advanced thyroid panel that includes TSH, Free T4, Free T3, Reverse T3, Thyroid Peroxidase Antibodies (TPOAb), and Thyroglobulin Antibodies (TgAb).
5. Toxic metal test
Environmental toxins cause mitochondrial dysfunction, and heavy metals are some of the worst offenders. These are metals like lead and mercury. They’re everywhere in your environment, from your water to your food.
A toxic metal test will tell you how much you have in your system. Mercury is especially toxic. It contributes to inflammation, cell damage, mitochondrial dysfunction, and even reduced IQ.  No thanks.
Your body naturally eliminates minerals and heavy metals through your hair and urine. To figure out how much heavy metal is floating around your body, do a provocation test with a chelation agent.
“That’s basically pulling the metals out of the tissue, so we can gauge your total body burden of heavy metal toxicity,” says Tim Jackson, MD, in our conversation on this episode of the Bulletproof Radio podcast (iTunes). “If we just measured your urine without the provocation agent, most of the time, you’re not going to be expelling metals.”
The other way is to check your hair with a hair mineral analysis, which will reveal heavy metal toxicity and mineral deficiencies. (Plus, you don’t have to pee in a cup.)
Anyone can benefit from the information in these tests if you know how to interpret them. Once I hacked my hormone levels, reduced my systemic inflammation, and removed heavy metals from my body, I got my life back. I felt more energized, focused, and balanced.
So, look at your inflammation, wrangle your hormones, remove the foods that aren’t right for you, get your thyroid up and running, and deal with your toxic load. If you do all that, you’ll have a Bulletproof setup.
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