High Hba1c, etc. - but I do everything I'm supposed to (I think...)!
Hello Dr. Peter - I am a 42 year old female endurance athlete. I've been interested in preventative medicine since hearing about it through Dr. Andrew Weil in my early college years. Since then, I've been an avid runner, dabbled in triathalon and eaten very well. Unfortunately, my blood work does not represent the work I've put in. Nor do I "feel" that great. My weight is good (although BMI hovers 18-19), my HDL is high (sometimes as high as 140, usually 120-140) and my fasting glucose is within the "good" range. However, I just started tracking my Hba1c over the last 6 months or so. Since then, I've seen 5.3, 5.1, and most recently 5.4 which my blood test provider marked as border line high. I've also noticed my fasting glucose seems to be rising (past couple of years in the mid-upper 80s. Used to be more in the 60s to low 80s) and my trigylcerides fluctuate (used to always be under 100, now they go from 70 to 150 to 100, etc). I also have (and have always had) high LDL, but my ratio for LDL to HDL and Tri to HDL is good because of my HDL and my liver enzymes are chronically slightly elevated. I realize some of the this could be genetic, but my real question is, could over exercising induce a stress response that outweighs its benefits in regards to these numbers? I'm going to start wearing a CGM to see if what I am eating is the real cause. Although, like I said earlier, I eat very healthy (no processed foods, not too many carbs, meat of all sorts, healthy fats, etc.). But, I do drink a glass of wine every night and I do eat carbs (old fashioned rolled oats for breakfast, sourdough bread, sweet potatoes, farro, brown rice and millet occasionally) so maybe that is the culprit? Anyway...so sorry for the long winded question. But the gist of it is, can something other than diet have a real impact on your sugar/other blood tests results? Or, is it not enough alone to truly affect them? Thank you so much for your time. I really appreciate the type of medicine you do and I truly wish I could work with you or someone like you as I've struggled mentally for physically for years and mainstream medicine continues to fail me. I want to be a part of the "Centurian Olympics" as you call them, but I don't think that's even in sight at the rate I'm aging... Thanks again :)
Zone 2--Testing Specifics
Hi, I know there's been multiple episodes and AMAs covering Zone 2, which I'm fully integrating now and purchased a lactate meter, but my questions on zone 2, (now that I am actually testing lactate) have more to do with the logistics of testing. (1) The prescription for Zone 2 training is 3 hours a week (45 min 4x/week, or 1 hr 3x/week). Is warm-up estimated in this time? So, basically, if you warm up for 15-20 minutes to reach lactate of 1.7-2.0, do you go for another 45-60 minutes from that point on? (2) If 20 min into zone 2 training, lactate levels show > 2mmol, how long does it take for lactate to decline before retesting in the same workout? (3) if you do higher intensity training (zone 3-5) before or after zone 2 on the same day, does this negate the metabolic benefits of zone 2? (4) I don't have a powermeter to use watts as a measure of zone 2, but as I test my lactate, I am able to compare to my HR on my Apple Watch and use that as a general goal range to maintain for zone 2...once I am able to observe my general HR and perceived exertion to maintain lactate at 1.7-2.0 mmol/L, how often should I retest? (just trying to minimize cost of testing)
Find a Doctor
Hello I live in Colorado and I'm looking for a new primary care physician. Do you have some advice about how to find someone who thinks similarly to you? I'd like a doctor who will dig deeper and understands the topics you raise (cholesterol testing for example). I'd like to know the top questions to ask or items to look for. Thank you