Last month we covered C-reactive protein, creatine kinase and ferritin. In this newsletter we'll go over white blood cell count, haemoglobin A1C and 25 hydroxy vitamin D.
An elevated white blood cell count usually indicates an acute (recently acquired) infection. We don't see this type of thing very often as you are usually quite ill and in need of urgent medical attention. What we see quite frequently is a low white cell count. This also indicates infection but it reflects a chronic situation i.e. an infection that you have had for years...sometimes decades. This could be a parasite, a bacteria or a virus. Your body cannot maintain an elevated white cell response indefinitely and over time an adaptation occurs where the white cell count comes down and ends up lower than "normal". The typical causes for a chronically depressed white blood cell count are parasites, h. pylori (a bacterial infection that compromises your ability to digest red meat and other protein foods) and viruses like Epstein Barr. Additional, more specific testing is needed to identify the exact cause.
Haemoglobin A1C (HbA1C) is by far the best way to determine how effectively you are controlling your blood sugar levels. This test measures the degree of damage to red blood cells created by fluctuating blood sugar levels. If you eat too much carbohydrate i.e. things like grains, baked goods, bread, pasta, jams, fruit juices, candies and chocolate then your haemoglobin A1C will reflect this. If your reading is over 6% then you meet one of the diagnostic criteria for type 2 diabetes...this is not good! It is now possible to buy HbA1C meters and test strips from pharmacies without a prescription. Here in the US these meters cost about $35. If you have too much body fat around your belly (another sure sign of poor glycemic control) then you can bet that your HbA1C reading is on the high side. Gradually reduce the carbohydrates in your diet and gradually increase the meat, fish, eggs, poultry and fats. Re-test HbA1C every 4 weeks until you see the reading fall below 5.5 or you see clearly defined abdominal muscles in the mirror!
25 hydroxy vitamin D is the test that currently represents the gold standard for assessment of vitamin D status. Don't confuse it with the 1,25-dihydroxy vitamin D test...that's not the test you want. Make sure you get the right test. Your body makes vitamin D when sunlight gets on your skin. The problem is that most Westerners spend way too much time indoors and even when they do go outside they are so paranoid about the "dangers" of the sun that they cover every square inch of their bodies with either clothing or an impenetrable layer of sunscreen. For these reasons very few of us have optimal levels of vitamin D...yet another reason to "go native" and live outdoors from time to time.
Low levels of vitamin D are associated with an increasingly long list of health problems. In fact, the list is so long that we recommend you read the Wikipedia entry for vitamin D and go to www.vitamindcouncil.org to get a sense of just how many health problems are associated with sub optimal vitamin D levels. Only a few years ago it was thought that if your vitamin D was 30ng/mL or more then you were "healthy" but almost every year this "healthy" target has been revised upwards as better data becomes available. You should aim for an absolute MINIMUM of 50ng/mL and some experts are now looking for at least 60ng/mL. We predict that this number will rise again in the next 2-3 years as more information becomes available.
By far the best way to increase your vitamin D levels is to get outside and get sunlight on your skin on a daily basis. Stop short of creating sunburn of course! Unless you live somewhere that is hot and sunny all year round you will also need to take a supplement. There are two common forms of vitamin D, vitamin D2 or ergocalciferol
and vitamin D3 or cholecalciferol
. Make sure you take the D3 form.