Athlete Blood Test - Q1 2018 Blood Biomarkers For Professional Triathlete Thomas Gerlach

My body / my blood on January 11, 2018

This post discusses my Q1 2018 Athlete Blood Test. I have links to all my previous posts/tests below. You can save 10% on your own Athlete Blood Test with coupon code: bloodtest10.

Athlete Blood Test (ABT) specializes in blood work for endurance athletes. They have worked exclusively with endurance athletes to understand the specific blood biomarkers that affect performance. They then apply that learning to help athletes proactively manage levels before it can negatively affect training.

Their process is simple:
(1) Order a test online (mine was the Gold panel + add-ons)
(2) Go to a LabCorp facility (at your convenience).
(3) Get the results and analysis via email.

With that I present my Q1 2018 blood report: Thomas Gerlach Q1 2018 ABT Report.pdf

Analysis - My take on MY blood work

As endurance athletes, we push our bodies beyond what they are designed to do and it is important to be proactive and identify deficiencies. Too often as athletes, we are reactionary and dig ourselves into holes before we finally capitulate and seek answers. The reality is that it can take weeks, months, or even years to fix those issues. The goal of my blood testing is to stay proactive and identify minor cracks before they become holes. Hopefully, by reading this, you are also taking the first step in being more proactive. With that being said here is my analysis:

By and large, everything looks good. It should be noted that I took this test after a solid afternoon swim. Hydration is supercritical and anyone that knows anything about kidneys will see the BUN is a little high. I will keep an eye on this for sure, but it is a reminder that although I usually don't drink during swims, maybe it isn't a bad idea. 

I want to briefly touch on a chronic health issue. Many people don't know this but I was diagnosed with ETD (Eustachian Tube Dysfunction) this past summer via a Type C Tympanogram. This means I have negative ear pressure in my right ear. It is a modern miracle that I was even able to compete last year but that is a story for another post. However, I mention this because I started a few different OTC allergy meds to reduce symptoms of the ETD. This may play a role in some biomarkers.

- Testosterone - this number is going to be affected by the midday test as T is highest in the morning. Total Testosterone was slightly lower than the last test. Free T is quite low and is the important T number as it represents the bioavailable T that can be used by the body. Unfortunately, Sex Hormone Binding Globulin is there in excess which literally binds to Free T and inactivates it. 

Last test I indicated I reduced both a calcium supplement and Benadryl (at night) which can have a negative effect on this area. Unfortunately, I went back on both of these due to the ETD. 

I also continued three supplements recommended by another triathlete who has chronicled his story with low-T. They are supposed to help with natural testosterone production in the body and include:

• Pregnenolone, a naturally occurring building block needed by the body to create testosterone. It is legal today. Here is the current USADA status.
• Gaia HPA Axis - various natural herbs & plants that are known to help support adrenal health and natural testosterone production, including Ashwagandha Root
• Zinc - I switched from MgSport's Magnesium to their new product ZMG which has a very bioavailable form of zinc included in it. 

I will continue to supplement with three above, along with working to increase my Vitamin D levels and Magnesium levels. Both of these can help reduce the amount of Sex Hormone Binding Globulin (SHBG) which binds all that Free T. If I can reduce SHBG then I should have more Free T circulating.

- B12 back down - I was low in Q1 2017 so I started supplementing with a specific B12 pill. Then I was high on my next report (Q2/Q3 2017) and I went to a standard B pill with a lower total B12. I am lower in B12 again and I will go back to a normal B12 pill in a reduced quantity.

- Iron levels back up but Ferritin high. On the previous test this was low, but with Iron supplementation, reduced workload, and an increased meat intake, I was able to significantly raise it. However, my Ferritin is a little high. This can be dangerous, hence why you have to be careful with Iron supplements and should only take them if you are deficient. This is a great example of how being proactive allows me to readjust my Iron levels to better levels. Although my numbers are still in the optimal range, long-term high levels could lead to liver damage.  

MgSport's new ZMG
Magnesium + Zinc

- White Blood Count back to normal. For the prior test, I was on the tail end of Amoxcillian for 10-days for a middle ear infection. I assume that was the reason for the low WBC and it is nice to see my WBC is back in my normal range as a chronically low number could be an ominous sign.

Magnesium Low!!! - this was my first year training in a southern climate in summer. I have warned people about losing Magnesium stores training in tough conditions and there is no tougher place than Central Florida in the dead of summer. While my Magnesium is still in the normal range, this number fell outside of the optimal range. It takes a long time to build stores so it pays to stay on top of your Magnesium levels before they are a problem.

Vitamin D Low - Within the normal range but not optimal for an endurance athlete. I spent an inordinate amount of time this off-season working on home-improvement projects and staying indoors. This could explain the Vitamin D level being a little low despite living in sunny Florida.

Folate Low - Within the normal range but not optimal for an endurance athlete. Again home-improvement projects may have played a role as I would assess my quality of diet as being sub-par given the lack of availability of a kitchen for proper food prep. This should get fixed naturally with more vegetables in the diet.

Action Plan / Changes:

• Athlete Blood Testing - Continue quarterly tests.
• Iron - Switch to every other day iron supplementation.
• B12 - Switch back to straight B12 pill and consider every other day usage.
• Vitamin D - Add a 2000IU capsule to midday supplements for a total of 6000IU a day. Consume with fat.
• Magnesium - Ensure I am taking two capsules every night.
• Folate - Should be an easy fix without the need for supplementation. I simply need to eat more vegetables.

That is it for Q1 2018. I look forward to seeing progress on my biomarkers and revisiting the BUN in my next test.

Athlete Blood Test Report History:

- January 2018 - Blog Post - Test Results

- June 2017 - Blog Post - Test Results 

- January 2017 - Blog Post - Test Results 

Links:
- Athlete Blood Test - use code bloodtest10 to save 10%.
- Why MgSport Magnesium by Thomas Gerlach

Supplement Links:
- MgSport Magnesium on Amazon - use code  TGMS2017 to save 20%
- MgSport ZMG on Amazon - use code  TGMS2017 to save 20%
- Heme Iron on Amazon
- B12 on Amazon
- Life Extension Pregnenolone on Amazon
- Gaia HPA Axis

Athlete Blood Test Coupon Code - Save 10%

I am working with Athlete Blood Test again in 2018 to increase awareness of wellness blood testing. This isn't blood testing for sickness and because it is wellness testing it usually falls outside of insurance reimbursement. However it is the perfect solution for those that are: time-crunched, may have high-deductible insurance, or just have a desire to be more proactive and less reactive in an otherwise complex health care system.

With ABT you get the tests you want and the process is simple. Just order your test at AthleteBloodTest.com - save 10% with Athlete Blood Test coupon code: bloodtest10.

Dr. Rock and ABT will submit your blood draw request after you order. You head to a Labcorp at your convenience - either walk-in or schedule an appointment - and get your full ABT report sent to your email in just a few days. You can also add on a phone consult if you would like for an additional cost.

I wrote two blog posts in 2017 that included my test results.  Each post also explains a little more about the process. Those posts can be read here:

Q1 2017 Thomas Gerlach Blood Test
Q3 2017 Thomas Gerlach Blood Test

Professional Endurance Athlete Blood Work Biomarkers - Q2 2017

ABT Report

This post is about my results of my Q2 blood work by Athlete Blood Test. My Q1 post detailed the simple process of working with Athlete Blood Test (ABT) and can be found here. If you are interested in getting your own Athlete Blood Test you can do so and save 10% in the process with Athlete Blood Test coupon code: bloodtest10.

Athlete Blood Test (ABT) specializes in blood work for endurance athletes. They have worked exclusively with endurance athletes over many years to understand the specific blood biomarkers that affect performance. They then apply that learning to help athletes proactively manage levels before they negatively affect training.

Their simple process of ordering a test online, going to a LabCorp facility (at your convenience), and getting the results and exclusive analysis emailed back is both quick, compared to your General, but also more insightful. The reality is that your General does not specialize in highly trained endurance athletes nor their blood values.

With that I present my Q2 blood values: Thomas Gerlach Q2 ABT Report.pdf

Analysis - My take on the blood work

- By and large everything looks pretty good.

- Testosterone - there was a slight bump in testosterone which may be because:

• Took mid-season break before the test (1 week of yard work instead)
• Took the test a bit earlier in the day (about an hour earlier). 
• Lifted weights - I did far more weights in the first half of the year than I have ever done in the past. Lifting weight is one of the many things you can do to naturally increase testosterone. 
• Stopped antihistamine Bendryl - I was using this for allergies and took it before bed. Bendryl has been shown to affect testosterone production negatively. I recently went back on Bendryl, after this blood test, to help with allergies issues I am suffering from.
• Eliminated a calcium supplement I was taking for a broken foot last year. Over calcium fortification has been shown to reduce Zinc bioavailability. More on zinc below. 

I also started taking three new supplements recommended by another triathlete who has chronicled his story with low-T. They are supposed to help with natural testosterone production in the body and include:

• Pregnenolone, a natural occurring building block needed by the body to create testosterone. It is legal today, but I wonder if in the future that may change. Here is the current USADA status.
• Gaia HPA Axis - various natural herbs & plants that are known to help support adrenal health and natural testosterone production. 
• Zinc - I switched from MgSport's Magnesium to their new product ZMG which has a very bioavailable form of zinc included in combination with the magnesium which I had been taking. The combo avoids taking a mag and zinc pill separately. Appropriate zinc availability is key in natural testosterone production, but too much zinc can be dangerous.

As for effects, I did notice considerably more night wood if I woke up to pee. It is a small bump in T but a noticeable bump in that area. It will be interesting to see how the number fluctuates as volume comes back up and time for weights and strength goes down.

- B12 levels up - I was a low last quarter so I started supplementing with a generic B12 pill. Based on the report I can reduce the IDU that I am taking. I like to reduce supplements if I can.

- Iron levels are low. Although well within the normal range for a human, my iron levels are low for an athlete to perform at their best.

Kim's Cabbage Patch - Clermont FL

Although I did NOT make a conscious effort to reduce intake of meat, my meat intake in the past quarter has been drastically reduced. The reason is because I moved recently to a new place and I have this great little fruit market (Kim's Cabbage Patch) across the street. More trips to Kim's and less to the store for meat may have caused this decrease.

I need to increase my consumption of meat and/or supplement with iron this quarter. I have opted to go with a heme (iron type found in animals) version of iron. Non-heme iron is the type of iron found in vegetables and most store bought iron. For meat eaters with normal blood levels of iron, heme iron has been shown to be better absorbed by the body. However iron supplementation in general is a really complicated subject so I will leave it at that.

- WBC a little low. Prior to this test I was on Amoxcillian for 10-days for a middle ear infection prescribed by guess-who, urgent care. Ironically I didn't have a ear infection at all as I would later find out, but it took a ENT specialist to figure that out. My low WBC is almost identical to a 2009 WBC value when I was also on antibotics.

Regardless, it will be good to check this next quarter because if it stays low that could be a problem. This is another benefit of these tests in having a track record of your blood labs so when something does pop up you can look back at the biomarker and see how it has changed. It is easy for doctors to draw correlation about symptoms to an objective finding like blood values, but if the blood value has stayed consistent then the correlation is probably not correct.

MgSport's new ZMG
Magnesium + Zinc

- Magnesium - this number I was most curious about because I know training in the summer can wreck havoc on magnesium levels, but training in an 110 degree heat index in Florida is just another level. And while magnesium can take a while to draw down, it also takes a long time to build up, so it is important to stay on top of it as magnesium plays a role in over 300 different vital body functions. The number is right where I want it to be. MgSport would be proud.

That is it for Q2. I'll work towards improving iron levels, reducing the amount of B12, and be sure to check that WBC number next quarter.

Links to items talked about in this post

- Athlete Blood Test - use code bloodtest10 to save 10%.

- Q1 Write Up w/Blood Results

- Q2 Blood Results

- MgSportMagnesium Blog - Why MgSportMag

- MgSport Magnesium on Amazon - use code  TGMS2017 to save 20%

- MgSport ZMG on Amazon - use code  TGMS2017 to save 20%

- Heme Iron on Amazon

- B12 on Amazon

- Kim's Cabbage Patch - Clermont FL

Athlete Blood Testing - Blood Work Test Results for Ironman Pro Triathlete

Complete blood tests results at bottom of post

Athlete blood testing - frankly it is one of those topics that no one talks about. While I have seen a few professionals talk Testosterone, I don't recall anyone discussing it openly in a general sense. As a result, I thought I would share my own blood test numbers, the process I took to get them, and the benefits I get from testing. Complete test results, Testosterone and all are at the very bottom!!!

Why I got my blood tested

Completing an Ironman Triathlon is tough and the months of high-level training can easily wreak havoc on the body. Getting a blood test before ramping up training is an essential part of the process as it establishes a baseline for my blood values. It also helps me understand if I am truly ready to embark on my training program and it gives me the confidence to do so.

Many athletes look to blood tests ONLY when they are feeling off in the middle of the season. The problem with this approach is that I would have NO baseline to compare values to. I might have abnormal levels which could explain the issues, or those levels could have been abnormal all along. Establishing a baseline can help me and my doctors make better and more informed decisions down the road.

The process of getting my blood tested

Getting blood tests proactively under the "wellness" category is no easy task in the US Healthcare system. Typically people only get blood tests when they are sick, and as a result so called "wellness" testing is not frequently covered by insurance. In addition, unless your doctor is familiar with endurance athletes, chances are he/she might not even prescribe the testing or understand why you need to be tested.

I decided to go with a Dr. Garret Rock at Athlete Blood Testing for my blood test. InsideTracker and BluePrint are two other services I considered but Dr  Rock has been intimately involved in research on using blood biomarkers in athletes for 8 years. He has personally worked with thousands of professional athletes including pro triathletes, runners, and cyclists. Dr. Rock's expertise allows him to truly understand the significance of blood biomarkers in a way that no general physician or other service can.

In his words, Dr. Rock says: "Don't try to interpret yourself. I have seen tens of thousands of tests on athletes now and analyzed a giant database that we've been populating over the last 4 years, as well as read thousands of studies...and I am still learning something new occasionally. To get the most out of your tests, rely on those that have a comprehensive understanding of how to tie all of the information together. It's much more complex than simply looking at a number and comparing to normal/abnormal range. Ideal ranges and normal ranges vary based on your age, gender, and frequency/duration/intensity of training/racing. These should be factored in to your interpretation."

In addition to Dr. Rock's expertise, Athlete Blood Test was super simple when it came to the process. Instead of a process that can take weeks, ie. getting an appointment into my primary, being sent for labs, and then getting another appointment with my primary to discuss the labs, Athlete Blood Testing took only days and I was over 2,000 miles from Athlete Blood Test the entire time. The whole process included:

1) Selecting the test panel. I opted for the Gold Panel as I wanted the most comprehensive panel to establish my baseline. I added it my cart and completed the checkout process answering a few questions along the way. I received a confirmation email that included instructions on the closet LabCorp location to get my blood drawn from.

Two vials of blood drawn

2) Get Blood Drawn - My LabCorp location doesn't need an appointment, but because I had already eaten that day and I was told to fast, I opted to use the online scheduler and scheduled an appointment for the next day, a Thursday FWIW. There is no additional payment at LabCorp, my payment to AthleteBloodTest covered all the testing. I was in an out of LabCorp within 10 minutes.

3) Get Results - I had my report emailed to me on the following Monday. I also had a chance to talk to Dr. Rock on Tuesday over the phone, although phone follow-up is an additional charge.

My Blood Test Results

Here is my report. Dr. Rock explained to me that I was the 1 in 100 with ideal labs and that the typical lab results and reporting are much more complicated than mine. His work with professional triathletes has shown that an extremely high number of them have deficiencies in: Iron, Vitamin D, and/or Magnesium. However, I did not have any deficiencies. I will say that I have been supplementing all three over the years, and I know MgSport is proud of me for keeping my Magnesium levels up. I know Matt Miller at Base Salt is proud of my electrolyte numbers.

While my Testosterone was on the low side of normal, Dr. Rock was also confident that my numbers were unlikely to fluctuate significantly given a similar training profile as previous years. He also assured me while they were on the low side of normal, they were quite normal among my professional peers. My LDLs are a little high, but frankly much lower then when I wasn't a triathlete altogether.

Overall getting my blood tested was a very positive experience. Not only did it clear the path for my training, but it was also hugely refreshing mentally knowing where my numbers were.

If you are interested in getting your own Athlete Blood Test you can do so and save 10% in the process with Athlete Blood Test Coupon Code: bloodtest10. 10% off brings the plans to Gold ($314), Silver ($224), and Bronze ($143).

Links to related blood test items

- Athlete Blood Test - use code bloodtest10 to save 10%.

- Q1 2017 Thomas Gerlach Blood Test PDF Report

- Q2 2017 Thomas Gerlach Blood Test Blog Post

- MgSportMagnesium Blog - Why MgSportMag

- MgSport Magnesium on Amazon - use code  TGMS2017 to save 20%

- MgSport ZMG on Amazon - use code  TGMS2017 to save 20%

- Heme Iron on Amazon

- B12 on Amazon