Get a blood test
You don’t know what you’re fixing if you don’t know what is wrong
You’ve hopefully already ordered a scale and started taking measurements. You don’t need a coach yet. Hire one only when you’re ready.
What you do need next is a blood test. Any good diagnostic laboratory will do. Some will even come home to collect a blood sample. The following cannot be said emphatically enough:
You are groping in the dark if you don’t have a blood test report. Get one first thing tomorrow morning. It has to be done in the morning.
If you are 30 or older, you need a blood test at least once a year. If you are trying to fix your health (at any age), you need one at least every six months. Your weight is not the only metric that matters. The blood test is an incredibly rich source of data on what’s happening in your body, and it only takes one prick.
Find a place located close to you and make an appointment (search for “diagnostic centres” on Google Maps).
There’s a lot of medical jargon on this page. We’ll cover each in detail in upcoming posts. Bear with us for now.
The fasting glucose (blood sugar) test is the most important. It requires you to not have eaten anything for the prior 13 hours, so it works best if you take the test first thing in the morning. Early dinner and no midnight snacks please. Nothing other than plain water. Eat your last meal by 7 PM and show up at the clinic at 8 AM.
You don’t want to ruin your weekend missing a night out, so do this today—a weekday. Take the test before work tomorrow. They may not require an appointment, but it can’t hurt to call and book.
Fees vary from a few hundred rupees to several thousand depending on the tests you want. Here are the ones that matter:
- Glucose (fasting): This tells you if your blood sugar is under control and is an essential test. If your sugar level is above normal despite a 13 hour fast, that means your body is unable to handle the carbohydrates (sugar and starch) in your diet.
- Insulin (fasting): A high level of insulin despite the fast is a concern. Essential.
- HbA1C: Watch out for this test, it will be expensive. It is an assessment of your glucose levels over the past 60–90 days and indicates if you are at risk of diabetes (“pre-diabetic”) or already have it.
- Lipid panel: This is the standard cholesterol test. It measures HDL (High Density Lipoprotein), LDL (Low Density Lipoprotein), VLDL (Very Low Density Lipoprotein) and the HDL:LDL ratio. Wikipedia has a good explanation of the various lipids in the human body. There are other sources of information if you want to understand how your body creates lipids. The lipids in your blood might not always be a direct outcome of dietary cholesterol.
- Uric acid: Uric acid is a by-product of your body processing organic compounds called purines, present in a variety of foods. Too little is a symptom of liver or kidney disease. Too much (hyperuricemia) leads to a form of arthritis called gout, which causes pain in the feet and toes, and may also be an indicator of cancer or cancer treatment (uric acid released by accelerated cell death).
- Thyroid panel: This is to check if you have a thyroid imbalance that could lead to weight gain. Your coach may insist on this test.
- Haemogram: Counts white blood cells, red blood cells and platelets. Anaemia (shortage of red blood cells) could be a factor in your weight loss or gain.
- Kidney function: Make sure they’re all right. Poor diets can damage your kidneys.
- Liver function: Likewise. The liver processes fats and carbohydrates in your diet.
- 25(OH)D: The Vitamin D test. You live in tropical India and get enough sunlight? Nope. Too many Indians are Vitamin D deficient. All sorts of strange ailments are linked to this. Get it tested.
- Vitamin B12: Your body can’t make B12 and it’s only found in animal sources (dairy or eggs). Often deficient.
- Urinalysis (optional): This isn’t a blood test. It checks your urine for anything unusual.
If your diagnostic lab does the test in-house, you should receive your results on the same day. If they send it elsewhere, there is a higher chance of handling errors and delays. Pick one that does it in-house.
If you’re working with a coach, they may require additional tests depending on your condition. This list is courtesy coach Aniruddha Shankar, and is ranked in order of importance:
- ApoB and ApoA: Apolipoprotein B will indirectly estimate LDL particle count in the blood, a potent indicator of cardiovascular risk.
- Lipoprotein(a): A lipoprotein subclass which, in high levels, is linked to cardiovascular disease and stroke.
- Homocysteine: An amino acid which, in high levels, is linked to arterial inflammation and cardiovascular disease.
- hs-CRP: C-reactive protein binds to dead and dying cells and bacteria and therefore measures infection and inflammation in the body.
- Fibrinogen: A blood clotting factor with a strong association with heart disease and inflammation.
Interpreting the report
If your report shows anything unusual, consult your coach (if you have one), or a doctor. The lab may recommend a doctor. Much of anything that’s wrong can only be fixed by changing your diet. Unfortunately, too much dietary advice consists of generic statements like “eat healthier” or “eat less”. There are better ways to approach a diet. We’ll cover that in upcoming posts.
(Thanks to Venkat Mangudi for help composing this post.)
Kilter is HasGeek’s humble attempt to provide a space for reasoned debate on how your body actually works, and how you can find your own path to good health via better nutrition, fitness and habits.
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