Blood panel: I am the T(estosterone)-1000

Heavy cream is apparently Testosterone Replacement Therapy, lol

Author at local store acquiring his testosterone-boosting supply of heavy cream.

tl;dr:

• I’ve eaten 88% of calories from fat, mostly heavy cream, for the last 6 months

• Lost 48lbs so far

• My testosterone was measured as 1057ng/dL, which is TOO HIGH

• Maybe heavy cream is a steroid? Lol

In which the author gets a blood panel

I’m a big fan of Direct Primary Care. I think it’s somewhat US-specific. The short version: our healthcare system is commercially and bureaucratically so overloaded and ruined that most people get to see their doctor for maybe 5 minutes. Then they walk out with 20 prescriptions.

DPC is an attempt to return to “having a physician” who actually remembers your name and knows your history and can give you long-term care and guidance. I’ve used DPC before and was very happy with it.

DPC providers are funded by a monthly membership of about $150. If you have the means I highly recommend this, as your DPC provider can give you access to all kinds of blood tests, CAC scan, CGMs, anything that helps you take care of yourself.

The DPC providers I’ve worked with were all super nice, professional, open to my crazy diet ideas, and really took time to listen to and understand my concerns and experiences. All of them spent at least an entire hour with me talking in person when I first joined their practice and there’s often weekly to monthly follow-up for any issues. You can reach your DPC provider at any time using text, email, or phone.

I used this tool to find a DPC provider near me: Direct Primary Care mapper

Anyway

So I signed up with a new DPC provider recently after being unable to procure a Coronary Artery Calcium scan on my own. My new provider immediately got me the CAC scan (came back 0 - perfect score). She also suggested I get a whole bunch of blood tests since I was on a crazy heavy cream diet. I agreed.

Six vials later I got my results. The first thing that jumped out at me was this:

Yes, my testosterone is literally TOO HIGH.

I immediately called all my friends about the news. Then I called people I went to school with, listened patiently to their life stories, and informed them as well.

Telling a man his testosterone is too high is like telling him his pickup truck is too big to fit in your garage.

All week I felt a spring in my step and I would walk around grinning from ear to ear, sympathizing with the lesser mortals around me. But I digress.

This is the first time I ever had my testosterone tested and I don’t know if it’s always been high. But probably not. I was never a real athlete and obese most of my life. Somehow doesn’t sound super T to me.

Did I mention I’m sedentary AF and haven’t lifted weights or worked out regularly in years? Sitting up straight is the biggest workout I get.

So it’s probably the cream. It’s full of saturated fat and cholesterol and gives you high LDL which is a testosterone-precursor.

But my guess is as good as anybody else’s and maybe it’s a fluke? I don’t know.

My free testosterone was a pretty normal 14 (reference range: 8.7-25.1pg/mL).

When I bring this up a lot of people ask about something called SHBG. That wasn’t on the test so I have no clue. I’ll get it tested next time.

Slightly bad timing for a trash-keto re-feed

One bad decision on my part was maybe the timing. I visited my DPC on the first day after ex150deli. So after the visit I bought a bunch of keto junk food like keto protein bars, some dark chocolate, supermarket chicken salad with PUFA-mayo, and other somewhat garbage franken-foods. That night I even ate fried chicken! Then I got the blood drawn 1-2 days later. So that could’ve had some impact on the shorter-term blood markers. But over the previous 6 months I’d spent about 5 on ex150 eating mostly heavy cream. So I think it’s largely representative, especially when it comes to the longer-term blood markers.

Lipids

Pretty much as expected for a high-saturated-fat diet. Personally I don’t worry about Total and LDL cholesterol as long as the HDL/Triglycerides ratio is decent.

Total Cholesterol: 281 (high, ref 100-199mg/dL)
Triglycerides: 116 (ref 0-149mg/dL)
HDL: 54 (ref: >39mg/dL)
VLDL Cholesterol cal: 21 (ref 5-40mg/dL)
LDL Cholesterol Calc: 206 (ref 0-99mg/dL)
ApoB: 146 (high, ref <90mg/dL)

I’ve been doing keto for 7 years and paleo before that so I’ve always had very high total and LDL cholesterol. I don’t think it’s bad per se, it just indicates that you recently ate saturated fat. Some people will disagree.

The HDL is pretty good but not amazing. I think it’s just barely the highest I’ve ever tested (by 1 point).

Triglycerides are higher than normal for me and higher than I’d like to see. Not sure if the trash-keto re-feed had anything to do with it? It’s technically not yet in the “official bad” range but then I disregard the official range for LDL, so..

Speaking of disregard: I also don’t much care for ApoB, which is apparently the new hotness. I’m not quite sure where to put it yet, with some claiming it’s The Definitive Heart Disease Predictor and others saying It’s Trash Just Like LDL. Guess we’ll see.

ApoB is LDL-C’s hot younger sister. Just yell Mandelian Randomization a lot when people question if it’s a better predictor of CVD than LDL.

Other stuff that was whack

There were a bunch of other things out of reference range. I’m not very familiar with blood panels besides the usual high-fat/vegan online battles of lipids and glucose so I’ll just mention them here.

RBC (Red Blood Cell count): 6.18 (high, ref 4.14-5.80)
Slightly high.
Reason probably: whatever gave me T-1000? I’ve heard someone say that eating lots of saturated fat can increase the lifespan of red blood cells. Not sure if true.

BUN (Blood Urea Nitrogen) : 5 (low, ref 6-20mg/dL)
Slightly low.
Reason probably: very low-protein diet over 6 months.

A/G Ratio: 2.4 (high, ref 1.2-2.2)
Slightly high.
Reason probably: could be slightly dehydrated, “unbalanced diet” is a reason lol. Yea my diet is very unbalanced. It’s somewhat cream-heavy.

Iron Binding Capacity: 221 (low, ref 250-450ug/dL)
Slightly low. All other iron values in ref range.
Reason: Maybe dehydration? Seems there are lots of things that could cause this.

TSH (thyroid-stimulating hormone): 0.405 (low, ref 0.45-4.5)
Other thyroid values (T3, T4) in range.
Reason probably: indicates high thyroid? Not sure.

Vitamin D: 19.3 (low, ref 30-100ng/dL)
Reason probably: I am a huge nerd who never goes outside to get sunlight.
My DPC recommended I go outside in the sun like a real human being and I’m taking a Vitamin D supplement for now.
Interestingly I looked up a blood panel from years ago and my Vitamin D was 17 then. Even worse! I guess my doctor at the time (not a DPC) either didn’t mention it or I just forgot. So it’s probably not related to ex150, just me being a night owl.

Homocyst(e)ine: 29.5 (high, ref 0-14.5umol/L)
Reason probably: Could either be low B vitamins from eating very low protein over 6 months or because I’d been mainlining energy drinks. I was drinking an average of 2 energy drinks per day the couple of weeks before the blood test. Energy drinks typically contain insane amounts of Vitamins B6 and B12 (think 4,000% the RDA) and apparently that can trip up how these are used in the body or bring them out of balance.
I stopped the energy drinks (switched to bougie sparkling water) and am taking a Vitamin B complex supplement for now. So 2 supplements total (this and Vitamin D). I wasn’t taking any before this unless you count the cream.

Fine fine fine!

These are values that weren’t out of reference range but might still be interesting in the context of a diet experiment.

Glucose: 98 (ref 70-99mg/dL)
This is pretty high for me given that it was fasted. I currently wear a CGM and, the few days before the test, my glucose was usually in the low 80s even during the day unless I had just eaten.
I suspect that this is from my junk-keto food that I ate the days before the blood draw. It seems that something in my usual “junk keto refeed” routine gives me increased blood glucose for several days to weeks. Not sure what.

Insulin: 6.8 (ref 1.6-24.9)
Not crazy good, but pretty good for somebody who’s still obese, I think. I wonder if whatever messed up my glucose also made this worse. Will see next time I get tested.

Leptin: 14.5 (ref for my BMI: 4.9-44.9)
Apparently this is a pretty good sign because leptin in obese people can cause issues when they lose weight. If leptin somehow doesn’t adjust as well, it can cause rebounds I think. It’s somewhat of a thermostat-type hormone that’s involved in regulating body fat. The reference ranges for these are extremely wide but I suppose I’m in the lower half of the range, so yay.

C-Reactive Protein, Cardiac: 0.7 (ref 0-3mg/L)
An inflammation marker. Apparently <1mg/L means very low risk of heart attack. Yay! Don’t tell them about my ApoB and LDL.

HbA1c: 5.2 (ref 4.8-5.6%)
Long-term marker of glucose. Pretty much what you’d expect from a super low carb diet. It’s actually not thaaat low given the diet. Maybe the refeed a few days prior made it rise? I’ve also heard the theory that eating lots of fat, which allegedly causes the red blood cells to live longer, artificially raises this marker. 5.2 is still good so whatever. If I wanted to impress people with numbers I’d use my testosterone. Did I mention it’s over 1,000?

AST: 20 (ref 0-40)
ALT: 33 (ref 0-44)
I don’t really know what these do but I know a lot of people who had slightly elevated levels on keto and everybody lost their freaking minds about it. One, it turned out, was eating too many vegetables and those were full of pesticides. No more vegetables. Doctor’s orders! Not making this up.

I’ve never had AST/ALT out of range but some people on keto seem to have slightly high values. So might be of interest.

Going Forward: All The Tests

Probably going to get some more tests done in the future. In fact, I just did one on micronutrients & fatty acids. Results should come in shortly.

I’ll also try to just get this same panel again to compare values over time.