#21

The practical approach is first to not get very excited about any of this. I appreciate their formula for predicting age … but it’s not outcome based (sadly). If you are 12 years younger on their approach, does this mean you have the same years of life left as a typical 38 yr old? That’s what one would assume, but the data isn’t there to support these outcome measures.

With HsCRP, Monocytes, Ferritin all can go up with a chronic infection, inflammation, autoimmune disease, acute infections also. Sirolimus, statins, Curcumin, Omega 3’s all help - but an evaluation for an underlying condition may be reasonable, as much as the abnormalities are minor. Could there actually be iron overload at a low level? Possibly, but ferritin is also an inflammatory marker.

Free T being low - worth a recheck and if so - consideration of discussion with a physician whether to address this.

MCV not exciting - and still normal - typically things that increase this include alcohol use, B12 or Folate deficiency.

IGF-1 being up - most common issues are too much protein in the diet, too much growth hormone, low cortisol. Rapamycin typically drives this down.

DHEA-S - can address with direct supplementation, but sometimes improves simply with normalizing testosterone. I’d typically check a 4 point salivary cortisol on someone with this (ZRT offers this).

That would be my quick general approach on this - but as usual - don’t implement anything based on this general discussion without consulting your doctor.

7 Likes
#22

@DrFraser Thanks for that response! Maybe I need to cut out my protein supplement to lower IGF-1. It probably won’t affect my HS-CRP or liver enzyme issues, but may affect other biomarkers as well.

It seems that your take on this is that there’s not much to worry about. It seems like the low testosterone is your biggest concern followed by the inflammation.

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#23

Here’s a chart from Rejuvant.com to show the results from one user of a product they sell.
The product is basically CaAKG, which I’ve been taking for about a year. I get mine from Prohealth
for about $38 a month, at 1000 mg per day. My recent blood test results have been equally fantastic!
CRP went from above 2.0 to 0.86 and it had been over 2.0 for the last ten years. Also my LDL and
triglycerides are way down just like those in the chart. Actually not too happy aboout my LDL
being that low. You might want to give CaA
CaAKG result chart
KG a try to lower your CRP.

Just for interest, here’s another chart I found, showing how inflammatory markers typically change
with age (Inflammatory Markers Change with Age, but do not Fall Beyond Reported Normal Ranges - PMC). 180 healthy people not taking
any medications were tested.

Inflammatory markers with age
Inflammatory markers with age749×546 97.4 KB

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#24

Did you take a rest day before your blood draw? The higher than usual CRP could be excercise induced;

How does exercise before blood sampling affect vitamin D and high-sensitivity C-reactive protein (hs-CRP) levels?

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#25

I did not exercise for two weeks before the test as I am on summer holidays in the USA. Good guess though.

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#26

Maybe I missed it, but did you describe your diet? Maybe a good idea to go off all supplements for at least a few days before next blood draw to make sure you’re not partially masking something. And get blood work done fairly frequently until you have this nailed down. I have had some good results using an AI tool to answer health related questions, but I always ask for a supporting links to research papers so I can validate answers.

3 Likes
#27

I was on holiday for the week before my blood draw so I did not eat very well. When I do my Hong Kong blood draw, I will be on my normal healthier diet. I am not sure 1 week of poor eating would cause a problem?

I had high inflammation in my liver readings last year as well, but did not have it the year before that.

#28

OK. Well, maybe just track what you’re consuming the week or two before next blood draw. If I recall correctly elevated ferritin tracks with elevated AST, ALT, and hsCRP which could all converge on your liver. But a knowledgeable physician would be a big help with this. My brother in-law had much higher ferritin than you as he is a long time heavy meat eater. You probably know that a simple blood donation should drop your ferritin a lot and it could (speculation) have an effect on other parameters.

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#29

Thanks for the chart. Will check some of these markers. Especially interested in IL-6. My highest hsCRP over last number of years is 0.4 mg/L. 71 yo male. Will be going off all supplements for at least a week before next test to see how my body handles inflammation unassisted.

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#30

Agree 100%. Give he body a chance to heal itself

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#31

It’s been many years, but I used to have elevated crp (I’d have to look but maybe it’s was 3-4?)

Now it’s .75

I’ve done over a dozen rounds of prolon, but I’m also on colchicine. I can’t say that either of these are related to my drop, but if I were a betting woman… One day I’ll have to dig up my old results to see if I can see a correlation.

3 Likes
#32

I would probably focus on the testosterone as the most easily modifiable factor here. Certainly some sort of inflammatory state could lower your testosterone, but I wouldn’t be at all surprised if normalizing your testosterone normalized some of your other markers simply because these things tend to be bi-directional.

Also, your AST is fine, not sure where they’re pulling these ranges but lower is generally better for AST/ALT unless there’s some underlying disease causing it to be low.

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#33

Yes, lower is better for AST/ALT, but the ratio between the two matters too.

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#34

Could you share more details on that? I wasn’t aware the ratio mattered.

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#35

It’s known as De Ritis ratio.

Some color:

2 Likes
#36

Thanks for that! My De British ratio is 0.74, so that seems to be normal. However I am not sure if there is an optimal value. It appears to be on the low end of the median value - 0.74-1.19 of which 75% of people fall into.

Although it seems lower is better.

Prognosis: The De Ritis ratio can serve as a prognostic tool, with higher ratios often associated with poorer outcomes in certain conditions like COVID-19, adult trauma, and renal cell carcinoma.

#37

First question which I didn’t see anywhere: how old are you? From other comments, I’m guessing 50?

CRP of 1.67 isn’t really that high IMO. I’m not expert in this, but I seem to observe that some people have very different baselines. 1.67 vs 1.59 almost certainly does not represent any sort of change.

Total testosterone is great IMO. The lab is using some weird cutoff where 700-1000 is normal. In reality, that’s like the upper 20th percentile. (doi:10.1371/journal.pone.0109346). 579 is a perfectly normal number.

The free testosterone is definitely more mysterious. What time of day was the blood test? (Again, SHBG is totally fine, and not actually low).

MCV of 93 is totally normal. Saying 84-91 is “optimal” is not supported by evidence that I know of.

I also wouldn’t worry about IGF-1. This number alone doesn’t mean much. And after all, IGF-1 plays very useful roles, and I would never stop taking protein supplements because of a serum IGF-1 blood test.

Monocytes and lymphocytes are totally fine. And anyway, these are % numbers. What matters more is the actual concentration of cells.

ALT and AST are both high. But GGT is low. So to my eyes, that means your liver is probably fine, and these are being released from somewhere else - probably muscle.

I agree with others that you might have had some infection which you didn’t consciously register. That could explain almost everything, including the raised fibrinogen.

Also, I gather you’re from HK, but on holiday in the USA… did you think of the massive disruption to your circadian rhythm? Testosterone, IGF-1 etc all normally follow a circadian rhythm, and you’ve just switched time zones by 10-12 hours.

3 Likes
#38

Normal for an unhealthy population IMO. Most health metrics are skewed horribly towards the bad side because the population averages are taken from an unhealthy population. 800-1200ng/dL at least. I personally think that TRT anywhere between 150mg to 300mg/wk is totally fine long term with the proper ancillaries. I don’t think the OP is on TRT now, but should consider it.

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#39

I don’t think there’s any real evidence to say this, is there?

Yes, normal reference ranges are essentially a snapshot of 2 standard deviations around the mean of the population. And we do see a slight creep in some reference ranges, like ALT which has gone up over the decades because almost everybody has fatty liver now.

But if you take testosterone, I’m not aware of any good evidence that testosterone levels today are dramatically lower than they used to be. Things have shifted a little due to obesity-induced hypogonadism, but 800-1200ng/dl is really much, much, much higher than average. I’m also not aware of any evidence that a man is better off in the 800-1200 range as opposed to >400, as long as he has no symptoms. Taking myself as an example, my natural level is always around 350-450. I’ve never been obese, have always been active, energy is no problem, I’ve deadlifted more than 200kg in the past, successfully fathered children, no libido issues etc. The number on paper has never been an issue.

So if OP isn’t having symptoms of hypogonadism, jumping on TRT doesn’t make any sense IMO.

2 Likes
#40

All of you raise some excellent points which has given me some areas to investigate! I’ll be getting my next blood work done at a hospital in Hong Kong in February so I’ll compare the results to these. Hopefully that will provide some possible answers.

Also, when I get back from vacation, I’ll compare these results to my old ong Kong blood work to see if there are any clues. The problem is that with testosterone and CRP, the testing for these items is not performed in my HK blood work.

And, yes, I am 50 years old this year.